Anthrax: No Terrorism in Florida Anthrax Case, Thompson Says

A 63-year-old man from Lantana, Florida, is critically ill with inhalation anthrax, the deadliest form of the disease that has been developed for use as a biological weapon.  U.S. officials said the man most likely contracted the disease through natural means, not from a terrorist attack (Rick Weiss, Washington Post, Oct. 5).

Health and Human Services Secretary Tommy Thompson said yesterday the case is isolated and there is currently no evidence that a terrorist attack caused the man’s illness.   He reminded the public that anthrax does not spread from person to person.  He said the public should continue about daily life in a normal way and go to a doctor if they have a severe respiratory problem.  He said his department has enough antibiotics, which he said could treat anthrax, for 2 million people for 60 days (see GSN, this issue). 

Thompson said the speed with which health institutions alerted the authorities to the case showed that “our health reporting system worked in a very timely fashion” (see GSN, Oct. 1).  After the patient was diagnosed with anthrax, health officials notified the state health department, which notified the Centers for Disease Control and the FBI.  Both agencies are investigating the man’s whereabouts over the last few weeks to determine the source of the disease. 

Thompson said anthrax cases occur sporadically in the United States, but added, “they’re very rare.”  He said the most recent reported cases were one in Texas within the last year and another in Florida in 1974 (White House briefing, Oct. 4).  Only 18 cases of inhaled anthrax have occurred in the United States in the last century.  A 1999 Journal of the American Medical Association issue said that the disease is so rare, “that even a single case [is] cause for alarm today” (Washington Post, Oct. 5).

The Washington Times reported that Florida doctors said the man’s case is likely to be fatal (August Gribbin, Washington Times, Oct. 5).

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U.S. Response: U.S. Plans Response to Biological Attacks

The United States has plans to distribute medicine for some diseases in case of a bioterrorist attack, but several obstacles to a successful response remain, according to current and former U.S. officials.

In the event of a biological attack, the government will immediately ship 50-ton packages of medical supplies able to treat 10,000 to 35,000 people to local hospitals on the first day of response.  These supplies are stored at eight sites around the country.  After the initial shipment, authorities will ship more supplies from other stockpiles and sources and begin emergency production. 

The United States currently has antibiotics to treat 2 million anthrax cases and has plans to stockpile enough for 10 million people, according to government officials (see GSN, this issue).  There are also caches of antibiotics, such as streptomycin and gentamicin, to treat other diseases, such as the plague. 

Experts are trying to find ways to overcome remaining obstacles.  One of the largest problems is quickly identifying an outbreak, as some diseases incubate for days to weeks.  The Sept. 11 attacks, however, have raised awareness.  Centers for Disease Control (CDC) Director Jeffery Koplan said a Florida state lab worker recently trained by the CDC tested the blood of a man in Florida who became ill with anthrax this week and sounded the alarm (see GSN, this issue).  Koplan said that might not have happened before the Sept. 11 attacks.

Another obstacle is deciding who distributes drugs to whom and how to mobilize workers in the case of a crisis.  New York has set up 300 potential distribution points, and if all 300 locations were needed, 40,000 workers would have to staff them, bioterrorism specialist Jerry Hauer said (Lauran Neergaard, Associated Press/Miami Herald, Oct. 5).

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Anthrax: Progress Made on Possible Cure

Harvard Medical School scientists have discovered what makes anthrax so deadly, according to research published in Current Biology yesterday, according to the Financial Times.  This discovery could lead to a cure for a disease that health experts fear could be used in biological warfare.

Researchers have tried to explain why white blood cells, the main line of defense in the human immune system, are unable to destroy anthrax bacteria.  According to the Harvard research, when white blood cells eat the bacteria, the anthrax toxin is able to find hiding places within the cells.  The white blood cells attempt to send chemicals to the toxin’s hiding places, but are unable to manufacture the right transportation proteins.  With this new research, scientists could develop new treatments that focus on improving the targeting mechanism used to kill the bacteria, according to the Financial Times.

There are now treatments for anthrax using antibiotics, but they are only effective if the disease is identified before symptoms appear.  Many health officials confuse the symptoms of anthrax with those of influenza.  An anthrax vaccine exists, but in short supply and unavailable to the public. Stocks could be released in the event of a biological warfare attack, but by then it could be too late to be effective, according to the Financial Times.

Using anthrax as a biological weapon is attractive because of the relative ease to acquire samples and its high fatality rate, according to experts.  People should not panic, however, because people must inhale anthrax to become infected, and producing anthrax in airborne particles is incredibly difficult, health officials say (Victoria Griffith, Financial Times, Oct. 2).     

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U.S. Response: Biotech Companies May Be Good Investment

With fears looming over a possible bioterroism attack, biotechnology firms that specialize in infectious diseases may be a good investment, according to a report recently released by the financial services group Friedman, Billings, and Ramsey.  The report lists nine public and 15 private firms, such as the British company Acambis, which has been contracted by the Centers for Disease Control to develop, supply, and maintain 40 million doses of smallpox for 20 years.  Acambis has seen its share price increase by 30 percent in the last month. 

“The global infectious diseases market is worth more than $37 billion and although it looks like growth is sluggish at 2 percent a year, this masks the double digit growth of niche sectors such as vaccines and anti-virals,” said Mike Ward, co-author of the report. 

Pharmaceutical stocks are an “extraordinary” opportunity right now because they are trading at average prices relative to their historical price-to-earnings ratio, according to Sam Isaly, managing partner of OrbiMed Advisors and manager of the Eaton Vance Worldwide Health Services Fund.  Any involvement the companies have with the fight against bioterrorism, however, should not be a consideration for investors, Isaly said.  “If a large portion of the population were going to be treated either pre-exposure or post-exposure [to smallpox, for example], it’s true it would be a large one shot lump of money and the quantity would be several hundred million dollars.  But this is a $400 billion worldwide industry.  I don’t think it would have much commercial impact,” said Isaly (Allison Beard, Financial Times, Oct. 3).

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Pakistan Response:  Islamabad Faces Biological Threat From Terrorists

The United States warned Islamabad last weekend that terrorists could use biological weapons in Pakistan in retaliation for cooperation with the U.S.-led war on terrorism.

Two biological defense laboratories, one in Karachi and the other in Islamabad, were capable of preparing vaccines for biological weapons, but additional funding would be needed for the labs to produce large amounts of material in a short period of time, according to Pakistani sources.  Pakistani officials have asked the United States for $1 million in assistance, the sources said, that could also make available two mobile, self-contained microbiology laboratories (Baqir Sajjad Syed, Dawn, Oct. 1).

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International Response: WHO Outlines System

The World Health Organization has set up a global infectious disease monitoring and detection system that is in place and ready to use, according to David Heymann, director of the WHO’s infectious disease division, in an interview last week. 

“In practice, it can detect the potential consequences of bioterrorist acts.  Of course, every nation should be prepared for all catastrophes,” said Heymann.  The system also monitors outbreaks of diseases such as anthrax, botulism and hemorrhage causing fevers, diseases that could also be used as part of a biological warfare attack, according to experts.  The WHO will also soon publish an updated guide establishing the basis for a public health response to biological or chemical attack, according to Heymann, which will be provided to all WHO member states.

The WHO has about 500, 000 doses of smallpox vaccine in stock in the case of an outbreak, according to Heymann who supported U.S. efforts to mass produce a smallpox vaccine.  “We do not have the financial resources to make commitments with vaccine producers to get this type of production started,” said Heymann (Le Monde, Sept. 28 in FBIS-WEU, Sept. 28).  

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International Response: Roundup of BW Threat

Countries are preparing for biological terrorism in light of the Sept. 11 attacks on the United States and a warning from the World Health Organization of biological terrorism threats (see GSN, Sept. 28).

Philippines

President Gloria Macapagal-Arroyo announced last week that she would seek U.S. and U.N. assistance against biological and chemical attacks and will personally coordinate preparation and prevention efforts. 

Filipino Health Secretary Manuel Dayrit urged stronger border controls and said he would order Health Department field offices to increase disease surveillance.  Dayrit said that the Philippines are unprepared to respond to any biological attack other than anthrax and would require WHO assistance.

Filipino National Security Adviser Roilo Golez said a biochemical attack was not a “serious concern” (Manila Philippine Daily Inquirer, Sept. 28 in FBIS-EAS, Oct. 1).

Ireland

An Irish interdepartmental committee is scheduled to meet today to consider measures to prevent, detect and respond to biochemical attacks.  The committee is expected to determine the feasibility of such terrorist attacks and recommend emergency plan changes to local authorities.

“We have already advised local authorities to ensure plans are up to date and effective in protecting water supplies in particular.  This committee will see what further advice needs to be given in light of the WHO’s warning,” said a Department of Environment and Local Government spokesman.

Other government committees, including the National Security Committee, have met several times since the Sept. 11 attacks to evaluate the chances of a biochemical attack and formulate new responses (Joe Humphreys, Irish Times, Oct. 2).

Poland

Polish epidemiologists have created a list of symptoms that could result from biological weapons to help hospitals, ambulance stations and general practitioners detect an attack.  Poland’s first microbiological laboratory will open in a few weeks, but “unfortunately, we are not prepared to handle big-scale operations,” said Michael Bartoszcze, head of the Military Institute of Hygiene and Epidemiology (Warsaw Rzeczpospolita, Sept. 28 in FBIS-EEU, Oct. 1). 

Albania

The Albanian Health Ministry held a meeting last week to examine what measures authorities should take to respond to a biochemical threat.  Health Minister Gjergi Koja has proposed creating a group of experts and department representatives to prepare for potential threats (Tirana ATA, Sept. 28 in FBIS-EEU, Oct. 1).

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U.S. Response: Focus Should Shift to Public Health System, Experts Say

Bioterrorism discussions should focus on strengthening the public health system and preparedness rather than on antibiotics or vaccines, according to some health experts (see GSN, Sept. 28).  “For bioterrorism, the No. 1 inadequacy, if you rank them, is the inadequacy of our public health infrastructure.  This is a product of about 15 years of neglect,” said U.S. Senator Bill Frist (R-Tenn).

Many problems face the U.S. public health system, according to the New York Times.  Doctors are poorly trained to recognize symptoms of possible biological warfare agents, such as anthrax, which can resemble the flu.  Many hospitals lack necessary equipment, in some cases even tools like fax machines, to receive or report information in an emergency.  Government agencies cannot agree on what diseases are the biggest threats -- with the Centers for Disease Control listing smallpox as a major risk and the FBI not even placing smallpox on its list.  Two important health positions, commissioner of food and drugs and director of the National Institute of Health, remain unfilled.

While a number of federal agencies have established bioterrorism response teams and there has been steady improvement in laboratories on testing and identifying biological agents, it is a patchwork set against the larger arena of cities, states, and counties all with their own reporting requirements and plans (Sheryl Gay Stolberg, New York Times, Sept. 30).

U.S. Health and Human Services Secretary Tommy Thompson has said that the United States is prepared in the event of a biological attack. “We’ve got to make sure that people understand that they’re safe.  And that we’re prepared to take care of any contingency, any consequence that develops from any kind of bioterrorism attack,” Thompson said.  There are eight staging areas around the country that are each stocked with 50 tons of medical supplies including vaccines, antibiotics, gas masks and ventilators, that can be moved to the site of a biological attack within hours, according to Thompson.  There are also 7,000 trained medical personnel ready to respond, Thompson said (Associated Press/Salon, Sept. 30, 2001).

Some public health officials agree that the United States is better prepared than it was three or four years ago, but worry that improvements still need to be made in identifying when a biological attack is under way.  “We are not going to have a bomb fly out of the sky and land on somebody so that we can say, ‘Look, there’s a bomb, and we are all dying of anthrax,’” said Asha M. George, who studies bioterrorism for the Nuclear Threat Initiative.  “It is most likely going to be a covert release, and people will get sick and go to their hospitals, and the public health system will have to pick up on this,” George said (Stolberg, New York Times).

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