FMMS PRIMER ON BIOTERRORISM

The Centers for Disease Control and Prevention (CDC), the California Department of Health Services, the Fresno-Madera County Office of Public Health, the Fresno-Madera County Medical Society, the Infectious Disease Society of America, and the Infectious Diseases Association of California have all stated that you SHOULD NOT PRESCRIBE ANTIBIOTICS OR VACCINES to prevent potential Bioterrorism related infections.

No single antibiotic will protect against all potential agents. Many agents could be used in a Bioterrorist event, including bacteria, viruses, chemical or biological toxins. The necessary measures to prevent or minimize morbidity and mortality are specific for each agent.

The duration of protection conferred by antibiotics is short, and the duration needed for ongoing protection is undefined (essentially limitless in the absence of a discrete event). If and when there is a Bioterrorism event, clinical and public health evaluation will determine who would benefit from antibiotic administration. Indiscriminate antibiotic use needlessly diminishes existing supplies, increases drug resistance and may lead to adverse events.

Availability of antibiotics and vaccines will be most critical at the actual sites where Bioterrorism has occurred. CDC has a plan in place to distribute antibiotics and/or vaccines to the specific locations where they are needed through the National Pharmaceutical Stockpile (NPS) Program. CDC has made a commitment to deploy supplies relevant to a given Bioterrorism event within 12 hours via a series of regional NPS warehouses. Medications and supplies were available in lower Manhattan 7 hours after the attack on the World Trade Center.

Individual medical providers do not have access to either anthrax or smallpox vaccine at this time.

It is possible that agents used for a Bioterrorism event will have been engineered to be resistant to the established therapies and perhaps even to vaccines.