[iwar] [fc:Anthrax.Scare.Prompts.Run.on.Dubious.Drug]

From: Fred Cohen (fc@all.net)
Date: 2001-09-27 15:59:23


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Subject: [iwar] [fc:Anthrax.Scare.Prompts.Run.on.Dubious.Drug]
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Anthrax Scare Prompts Run on Dubious Drug 
New York Times, 9/27/2001
<a href="http://www.nytimes.com/2001/09/27/national/27DRUG.html">http://www.nytimes.com/2001/09/27/national/27DRUG.html> 

Many New Yorkers - and to a lesser extent, people across the country -
are stocking up on Cipro, an antibiotic that they believe can be used to
treat anthrax. 

Most scientists say that taking Cipro after the appearance of symptoms
of exposure to anthrax, a potentially deadly form of bacteria, is
useless. 

But Sebastian Manciameli, a pharmacist at Zitomer Pharmacy on
Manhattan's Upper East Side, said: "We can't keep it in stock.  It
started the day after the World Trade Center, with a few prescriptions,
and now there's more and more."

Mr.  Manciameli added, "I usually keep 100 tablets in stock, but this
time I ordered 3,000 and sold out.  One person bought 1,000 tablets." At
the Village Pharmacy in the Boston suburb Brookline, Mass., Donald
Silkes said that enough people had been asking about antibiotics to
prompt him to place an extra order. 

"They say, `I've spoken with my doctors and we decided this would be the
best in the case of anthrax,' " Mr.  Silkes said. 

Many experts, however, say Cipro would probably be useless in treating
anthrax.  "We believe, based on animal studies, that once you're showing
signs it's probably too late," said David R.  Franz, a former official
in the Army's germ defense establishment who is now vice president for
chemical and biological defense at the Southern Research Institute at
the University of Alabama. 

Mr.  Franz and others said that the United States had no detectors to
routinely sample the air for anthrax, and that at any rate such an
attack was considered unlikely.  Experts in the field also pointed out
that even if an attack with anthrax was tried, it would have only a
slight chance of succeeding. 

Many doctors see the push for antibiotics as an expression of the same
panic that has led Americans to stock up on gas masks, handguns and
bottled water.  "We have 12,000 patients, and we've probably had 11,000
requests, but our policy is that we won't do it," said Dr.  Michael
Traister, a Manhattan pediatrician.  "This is about fear, and it doesn't
make a lot of medical sense.  There are all kinds of possible agents of
bioterrorism, and there's no reason to single out anthrax."

Last summer, Cipro, made by Bayer, became the first drug to win Food and
Drug Administration approval for use in the event of a biological
attack.  At the time, the agency said that based on animal studies, the
drug was "reasonably likely" to help humans fight off the disease, but
only if taken soon after exposure to anthrax, which would be hard to
detect.  The agency said that 500 milligrams of Cipro, or ciprofloxacin,
could be given twice a day to individuals who inhaled anthrax. 

Many doctors and public-health officials say there is no cause to stock
up on Cipro.  They point out that neither Cipro nor any other antibiotic
works on botulism, smallpox or other possible weapons of bioterrorism. 
"Theoretically, Cipro should work in an anthrax attack, but it's never
been tested, so no one really knows the optimal dose or therapy, or
even, for sure, that it works at all," said Dr.  Vincent Quagliarello,
clinical director of infectious diseases at the Yale University School
of Medicine.  "There is a risk that if anthrax were sprayed, thousands
of people could inhale the spores and get sick.  You have to inhale the
spores to get sick; if you're sick, you don't give it to me.  And as an
agent of mass destruction, frankly, I'm much more scared about
smallpox."

The federal government says there is no need for individuals to hoard
Cipro.  "We have a national stockpile, which includes Cipro, and we have
delivery plans to bring it into any area in 12 hours," said Scott
Lilybridge of the Department of Health and Human Services.  "We believe
there's a 24- to 36-hour window to initiate therapy."


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