Is U.S. still vulnerable to anthrax attack?

• Position: Public Health

A reasonable defense against an airborne anthrax attack requires more aggressive action by the Federal government than the current protocol outlines. Washington is relying too heavily on biosensors to pinpoint a potential outbreak and not doing enough to get large quantities of drugs and medical personnel to affected areas within hours, argues Lawrence Wein of the Graduate School of Business, Stanford (Calif.) University

Wein, professor of operations, information, and technology, and his fellow researchers considered the possibility that drug intervention against anthrax could start earlier if the attack was detected by biosensors--devices that sniff out anthrax spores Although the Federal government is spending millions of dollars to develop them, their use alone is insufficient and could create a false sense of security Huge numbers of costly sensors would have to be spread throughout the nation in order to be in proximity of where the spores are released and to detect them, an unrealistic goal Also needed, according to clinicians, are the aggressive distribution of prophylactic antibiotics, such as Cipro, and the ability to ready a large capacity of emergency medical personnel for rapid deployment in affected areas. "There is still no substitute for getting people antibiotics and medical care as last as possible," Wein asserts.

In the same vein, the researchers make a plea for speedy mass vaccinations as soon as a case of smallpox appears in a population rather than the more time-consuming practice advanced by the government of identifying individuals the victim had been in contact with, locating, and then vaccinating them.

"Our country has made great strides in the past year at preparing for a potential smallpox attack." Wein reasons Although smallpox is a contagious disease, it is also a slower moving disease and as my colleagues and I showed in a study published [in 2002], postattack mass vaccination would nip even a large smallpox [outbreak] in the bud. Unfortunately, controlling the consequences of an anthrax attack may be a bigger challenge."

Airborne anthrax, while not contagious, is a swift and vigorous pathogen. Treatment for those exposed must begin within hours of the first cases being diagnosed, rather than days, as with smallpox. Without antibiotic intervention, 90% of people exposed to the inhalation form of anthrax will die. Because anthrax is durable, lethal, and available, it is a likely weapon in a bioterrorist attack...