Oct. 12, 2001 -- A tiny little spore with the jarring name of anthrax is dominating the airwaves because of the damage it has done -- and can still do. The obvious question is: what can you do to protect yourself from anthrax and other forms of bioterrorism? Should you stockpile antibiotics and protective gear? Or is that too drastic?
Luciana Borio, MD, of the Johns Hopkins Center for Civilian Biodefense, gives her advice on what you should and should not do.
Q: The antibiotic Cipro (ciprofloxacin) has been noted as a defense against anthrax. Some have also said it would be useless. What is your opinion on it, and is it something we should consider getting our hands on?
Borio responds: We know that ciprofloxacin, which is also known by its brand name Cipro, is an effective antibiotic in that it prevents the progression of inhaled anthrax for people who have been exposed to the type of bacteria.
Because the majority of people would die of anthrax without treatment, the government or the CDC in particular, has built a national pharmaceutical stockpile that contains large quantities of medical equipment as well as antibiotics such as ciprofloxacin. In the event of an attack, it is anticipated they would distribute the antibiotic to those who have been exposed. They have the ability to move their materials within 12 hours to any place in the U.S.
Therefore, we do not recommend private citizens stockpile their own antibiotics.
Q: Some people are suggesting stockpiling tetracycline and doxycycline. What would they do to protect me from a biological threat?
Borio responds: Again, if given within a timely fashion, these antibiotics are useful in preventing the development of the disease for which an individual may have been exposed. However, exposed means during an attack.
Anthrax is not contagious -- that means it does not pass from one person to another. So there is no reason for people to take antibiotics out of fear of contracting the disease. It is not recommended to take these antibiotics continually -- that could be dangerous and could lead to development of resistance, and they are expensive. So the only role for them is to be administered if somebody is known to have been exposed to anthrax during a biological release.
So the decision is complex, and the determination of when a release happens is best accomplished by public-health officials, at which time people would be given the antibiotics.
Q: These antibiotics that have been mentioned -- ciprofloxacin, tetracycline and doxycycline -- are they safe for children, pregnant women, and the elderly?
Borio responds: Under normal situations, these antibiotics are avoided in children and pregnant women. However, if that individual has been exposed to anthrax, the benefit may outweigh the risks of taking the antibiotic. These are consensus recommendations, but they have not been studied in children and pregnant women.
Q: Is the purchase of electrolytes, latex gloves, paper surgical masks, and paper gowns a wise choice? How do they protect us?
Borio responds: They would not protect people because, again, most of these agents are not contagious from person to person, and in the case of smallpox they would likely not suffice. There is very little reason to purchase these materials.
Borio responds: The early symptoms of anthrax are very much like the flu; however, in the absence of a case, I don't think people with flu-like symptoms need to be concerned. Healthcare personnel are on alert so that if somebody presents with a rapidly progressive illness that is consistent with anthrax, they would make the diagnosis as quickly as possible.
Q: Can people do things to build up their immune systems now so that in the event of bioterrorism they'd have a better chance?
Borio responds: Not that I am aware of. We know that people who are chronically ill are at higher risk of acquiring infections, but I am not aware of any specific therapy that would boost one's immune system.
Q: It sounds like you can't really prepare or protect yourself.
Borio responds: I think it is wise to compare this to a terrorist attack -- there is very little we can do, and as Americans we hate that. We are the doers, you know.
It really is in the hands of our government and public health system to protect the population in the event of such a horrible event. There has been considerable anxiety, which is understandable from the events of Sept. 11, 2001, but I believe the threat itself has not increased; the perception of the threat has changed. As a citizen, I would prepare my house and family just as I would for any other natural disaster, such as have water, flashlights, and commonsense things in place.