Military

DATE=10/25/01

TYPE=CORRESPONDENT REPORT

TITLE=TREATING ANTHRAX (L-ONLY)

NUMBER=2-282270

BYLINE=DAVID McALARY

DATELINE=WASHINGTON

VOICED AT:

INTRO: U-S government health officials have issued guidelines for treating anthrax. V-O-A's David McAlary reports that the recommendations are based on animal studies because there is little evidence to suggest ideal doses for people.

TEXT: It is not hard to understand why human anthrax treatment has attracted little research. It usually infects animals. Worldwide, only two-thousand human cases are reported each year, according to a 1999 study by U-S doctors and scientists who formed the Working Group on Civilian Biodefense.

Until this month, only 18 cases had been reported in the United States since 1900, the last occurring 23 years ago. The patients were mostly people processing wool, goat hair and animal hides.

As a result, the Centers for Disease Control and Prevention in Atlanta the C-D-C says only limited clinical experience is available for treating human anthrax cases. In fact, it says there have been no controlled human medical trials on treating the deadliest form of anthrax, the inhaled version.

But what the C-D-C calls the first bioterrorist anthrax attack in the United States has prompted it to issue guidelines for treating the infected, based on animal studies.

The C-D-C recommendations confirm the public health practice since the first new U-S anthrax cases became known in early October: People exposed to a contaminated item or environment should be treated immediately, even in the absence of laboratory test results.

The most widely publicized drug is Cipro, made by Germany's Bayer Corporation. But the C-D-C guidelines indicate that another compound, doxycycline, is just as good. The health agency advises doctors to use either one of them intravenously for 60 days for inhaled anthrax.

But because this form is so often fatal, the C-D-C says doctors should not use one drug alone. Instead, they should fortify the regimen with two to three of eight other drugs. These include the anti-tuberculosis compound rifampin and those widely used against staph and respiratory infections.

Penicillin and its cousin, ampicillin, are also usually important weapons against inhaled anthrax. But the C-D-C says preliminary genetic data from strains appearing in Florida, New York and Washington indicate that they may be resistant to these drugs, so it warns against using them alone to treat the disease.

For the milder cutaneous or skin form of anthrax, the C-D-C says only Cipro and doxycycline are needed unless there is swelling or lesions on the head and neck, or it has spread. In these cases, it recommends the multi-drug approach.

Treatment for skin anthrax usually lasts seven to 10 days. But the health officials advise the 60-day treatment because it says the risk for simultaneous aerosol exposure is high in this bioterrorist attack.

The C-D-C hints that these guidelines are not its final word on anthrax therapy. It says the public health ramifications of the anthrax attack continue to evolve. (SIGNED)

NEB/DEM/MAR