This page discusses biologic threats to our health. At the bottom of this page is a link to our information about natural methods you can use to improve your immunity.
Anthrax - a cause for alarm?
Section titled “Anthrax - a cause for alarm?”As I write this, there is a good deal of media attention to anthrax, to the point of repeating the same news several times in an hour. The local health department reports some calls from people who are alarmed, but our patients and most people in Port Townsend seem to be responding with alert interest, but no alarm.
You may read the unvarnished details on the CDC weekly report.
There is something about we human beings, that we react with horror to the unexpected, such as an airplane crash, or these anthrax deaths. And yet, just considering the odds, you are more likely to come to harm from an automobile accident on highway 20 than you are to be harmed by anthrax.
For an unpolished view of the difficulties of making these "attacks" work, here is an article written by a retired American military man with knowledge in the field.
Antibiotics for Anthrax
All anthrax infections experienced so far (November 23, 2001) in the US have proven susceptible to ciprofloxacin and doxycycline. Penicillin and amoxicillin tested effective for post-exposure prophylaxis. We do not suggest stockpiling antibiotics against anthrax and personally have not done so. Drugs go out of date and the chances of actually using such drugs is too small to stock them.
Life and Death
Section titled “Life and Death”Before we go into details about anthrax, let me repeat what may be already obvious to you. Life carries risk. We can never reduce that risk to zero.
To close every building because of white powder in an envelope or box would bring our nation to a halt. Food, fuel, and clothing would become scarce. As Jay Leno mentioned on his show "A scientific experiment was done today to determine the effect anthrax spores could have on chicken. But enough about Congress."
Elimination of all risk
Government has issued regulations for years to improve the quality of health care. We are now at the point that some of those regulations impair our ability to provide care. For example, conscientious and competent physicians and nurses in emergency departments are required to spend an hour doing paperwork for every hour they take care of patients. Care is excellent, but who can afford it?
(For an example from industry, I enjoyed the article "The Lessons of ValuJet 592" in the March 1998 Atlantic Monthly. The subtitle is "As a reconstruction of this terrible crash suggests, in complex systems some accidents may be 'normal' -- and trying to prevent them all could even make operations more dangerous.")
Biologic Attack
Section titled “Biologic Attack”Biologic aggression is not new. The Pilgrims in Massachusetts noted that the natives were dying and took this as heavenly encouragement for their colonization of this New World. The natives of course were dying from smallpox, measles, and other illnesses brought by the Pilgrims. This was a biologic disaster that occurred accidentally.
or Terrorism?
Section titled “or Terrorism?”There is a great deal of discussion on the international level about what is and isn't terrorism.
It is also becoming clear that we face other dangers besides criminal or military biologic attack.
- overuse of antibiotics by physicians and by the livestock industry is leading to the evolution of new strains of bacteria that are no longer susceptible to antibiotics.
- drug resistant tuberculosis, now epidemic in India and other countries, might become a major health problem in the US in five to ten years. This is a much greater threat than anthrax.
So we will begin this discussion with military/criminal threats and later extend it to cover all biologic threats.
Anthrax
Section titled “Anthrax”Anthrax is the disease of the month, so we'll start by discussing anthrax. This is an illness common to sheep and goats. Even when exposed to anthrax, many people did not become ill. This is because some strains of natural anthrax are just not infective. Even with highly infectious strains, conditions have to be just right for a person to contract it. The most dangerous situation, as we all now know, is to be exposed to a cloud of the anthrax spores.
An Insider's View
Thursday October 18, Tom Locke, MD of the Jefferson County Health Department gave us an insider's view of biologic threats. Of interest is that the public health agencies have been working on these issues for several years. A few of the issues that concern them are
- Biologic agents used in warfare or by criminals
- Emerging epidemics such as drug-resistant tuberculosis
- Surveillance and prevention of contagious disease
- Surveillance and prevention of environmental illness
They have been hampered by poor funding and a lack of public interest.
Will we run out of cipro?
We needn't worry about running out of antibiotics to treat anthrax. Historically penicillin has been quite effective, though resistant strains of anthrax have developed over time. Natural anthrax is about 100% sensitive to doxycycline, a common and inexpensive antibiotic. Amoxicillin is another effective antibiotic when the strain of anthrax has been shown to be sensitive to it. Because the Russians were working on drug-resistant strains of anthrax before ciprofloxacin was developed, military authorities decided to use ciprofloxacin to treat military anthrax.
Anthrax vaccine
The anthrax vaccine is given to selected military personnel in six doses over 18 months. Arguments over its safety continue, but at the moment it appears that a nationwide anthrax vaccination program might result in much more illness than we are currently seeing from malicious mail. Dr Smith-Poling pointed out that studies in monkeys have shown that one dose of vaccine prevents 90% of cases of anthrax, two doses prevent 100% of cases.
Dr. Locke said that even though every local physician has brushed up his or her knowledge of anthrax, none of us are likely to see it. This is an awfully big country. There are things to worry about, but anthrax probably isn't one of them. That said, the public health services have been preparing for these threats for years and are stepping up their efforts.
Don't forget the basics
Section titled “Don't forget the basics”Finally, as one of the RN's at the meeting wisely pointed out, don't forget the basics. The average person will probably benefit most from hand-washing, careful hygiene, and good nutrition.
Other Biologic Threats
Section titled “Other Biologic Threats”Smallpox
A number of us physicians and nurses have been vaccinated for smallpox to be ready in case of need.
Conclusion
Section titled “Conclusion”Details are important. Some people make their living by misleading you. Well-meaning people can pass on false information. Wikipedia is generally accurate.
Be careful.
Email comments and questions to FAQ@rienstraclinic.com.