Bioterror: What You Need To Know
Bioterror: What You Need To Know
BIOTERROR: WHAT YOU NEED TO KNOW Description: Moderated by former ABC Medical Correspondent George Strait, Panelists include Dr. Dan Hanfling, director of Emergency Medical Services at INOVA Fairfax Hospital; Amy E. Smithson, a chemical and biological weapons expert and a senior associate at the Henry L. Stimson Center; Dr. Julie E. Fischer, a bioterrorism expert and a professional staff member on the Senate Committee on Veterans Affairs; and Dr. Ivan Walks, director of the District of Columbia Health Department. Airdate (local broadcast only): October 26, 2001
Bioterror: What You Need To Know
DO NOT USE: Show Title
Bioterror: What You Need To Know
Medical Correspondent George Strait introducing the program. The program will feature Washington-area residents and public health experts in a straightforward exchange about the myths and realities of bioterrorism and how to safeguard oneself in these difficult times. Panelists will address questions such as what the chances are of becoming ill from biological weapons, what steps can be taken to ensure personal safety and how serious the current threat is for average Washingtonians. MCU pan of studio audience.
Bioterror: What You Need To Know
Introduction of the panelists: Dr. Dan Hanfling, director of Emergency Medical Services at INOVA Fairfax Hospital. Amy E. Smithson, a chemical and biological weapons expert and a senior associate at the Henry L. Stimson Center. Dr. Julie E. Fischer, a bioterrorism expert and a professional staff member on the Senate Committee on Veterans Affairs. Dr. Ivan Walks, director of the District of Columbia Health Department.
Bioterror: What You Need To Know
George Strait asks Dr. Ivan Walks about the current status of the Anthrax outbreak in the District of Columbia. Dr. Ivan Walks We have good news about Anthrax in D.C. A couple of days ago we knew about two people who unfortunately died from Anthrax but we know that inhalation Anthrax is not a death sentence. People can receive good care and live through inhalation Anthrax.
Bioterror: What You Need To Know
George Strait asks the audience for questions. Man asks about the symptoms of Anthrax. Dr. Julie E. Fischer responds The first type is inhalational, that is Anthrax that is breathed in. And those are the flu-like symptoms that people have mentioned. Flu-like symptoms usually are considered to be fever, coughing, difficulty breathing or chest pain. Even with Anthrax, some nausea with this, and those appear within the first 24-48 hours of illness, when Anthrax is still very treatable with antibiotics.
Bioterror: What You Need To Know
DO NOT USE: Photos
Bioterror: What You Need To Know
Dr. Julie E. Fischer explains the symptoms of Cutaneous Anthrax. That produces a rash, it s very distinctive and it would never be mistaken for poison ivy or an allergic reaction. It s like a blister, like a spider bite, but turns into in just a day or two something like an ulcer which is gross but very distinctive. And that gets a very dark shiny center like coal. And that s where we get the name Anthrax, from the Greek word for coal.
Bioterror: What You Need To Know
George Strait asks the audience for questions. Woman asks how long it will take to see the symptoms of Anthrax. Dr. Dan Hanfling responds The best guess is anywhere between two to three days. Most people we expect to come with symptoms in a week. We know from scientific studies it can go as long as 60 days. The patients who we saw were each sick for about three days before they came to the hospital.
Bioterror: What You Need To Know
George Strait asks Dr. Ivan Walks if it, Anthrax, is contagious. Dr. Ivan Walks responds It is not contagious person to person. George Strait asks Dr. Ivan Walks why Cipro. Dr. Ivan Walks responds I think a lot of it is help. Cipro is the flavor of the month and it s an effective broad spectrum antibiotic that kills a lot of bugs, one of those bugs is Anthrax. But the Anthrax that we ve seen so far can be killed by other antibiotics. George Strait asks about side effects. Dr. Ivan Walks responds Well there s side effects to every medication. I think that that s why it s important to make sure that the person that s giving you the Cipro, and I don t mean the internet, should know your medical history so they can make sure that you shouldn t be on something else.
Bioterror: What You Need To Know
Dr. Julie E. Fischer comment on the use of Cipro There are very clear dangers of every use and as you said the main one is that using these very powerful broad spectrum antibiotics can make them less useful tools when we need them. When an antibiotic is used poorly or is not taken as prescribed or it is overused there is a change it can make bacteria in the body resistant. And that resistance can either happen in an organism that causes disease and a bacteria that causes disease or can spread it around later to another bacteria that causes disease. So when we actually need these tools in the future they won t be effective anymore and we find ourselves without anything to treat an infection.
Bioterror: What You Need To Know
Man in audience asks question about symptoms and how soon is treatment needed after being exposed to Anthrax. Dr. Ivan Walks responds: Anthrax exposure can result in illness anywhere for two days up to several weeks, maybe even as long as a couple of months. But because when you become sick with inhalation Anthrax, it s such a ghastly illness, without getting into really complex medical terminology it really breaks you down from the inside, it s a gassy thing to have and doctors who are able treat it successfully are truly heroes who are breaking the ground. Two weeks ago inhalation Anthrax was a death sentence now it s not. If you are in an exposure category, if you are at risk. take those medications. And if you have side effects from the one they gave you the first time call and say. this one is hard for me to take, maybe you go from Cipro to Doxycycline but get treatment early because once you become ill with inhalation Anthrax it is a tough, tough disease to battle.
Bioterror: What You Need To Know
Man in audience states that he is currently taking Doxycycline, George Strait asks panel about Doxycycline vs Cipro, what should he be taking? Dr. Ivan Walks responds: He should only be taking exactly what his doctor presscribes. And that s important, Cipro is not the drug for everyone, and none who has not prescribed Cipro or any other antibiotic, there s a reason why they re called prescription drugs.
Bioterror: What You Need To Know
George Strait asks panel about the length of antibiotic treatment. Dr. Julie E. Fischer responds Well first it has to do with the assessment the professionals on site have made of the risk. And I think when we ve hear for example that the capitol that there were 5000 people on 3 day Cipro. When the exposure first happened in Senator Daschle office no one knew how extensive that exposure had been. And so the prudent thing to do while determining how many people were exposed, that s the epidemiology how far it had spread, was to treat everyone who was in the area as if they were at risk, and begin treatment in what seemed the most prudent manner. George Strait asks how one knows how long they should be on it. Dr. Julie E. Fischer responds Well the 3 days is really a precaution. It was given because no one knew if those people were truly exposed or not. What the risk really was, what the perimeter would look like. The 60 days is to cover that possible incubation period. We know from old, historical studies, from some animal studies, that those spores, those Anthrax spores that are kind of like bacterial seeds, can kind of hide for awhile, might not germinate, might not sprout at once. So that 60 day course is for the people who may have some risk of exposure. To cover that whole period, to give then the best protection possible. It s not just a random arbitrary you get 3 days, you get 6 days, and we like you get 60, it s really an assessment that s been made by the health professionals there of the amount of risk.
Bioterror: What You Need To Know
Man in audience asks if there is a home kit for testing Anthrax. Dr. Ivan Walks responds: If you are well, it you don t have flu-like symptoms, there is no test that will guarantee you that you have not been exposed to Anthrax and you are fine go home. There isn t one. George Strait asks how long after being tested does it take to confirm that you have Anthrax. Dr. Dan Hanfling responds: The official answer to 24-48 hours as you allow the cultures to grown in the laboratory. The unofficial answer, as soon as our first case was put upstairs and per feral blood was smeared and put under a microscope, this is unspun blood, there was no question that he Anthrax.
Bioterror: What You Need To Know
George Strait asks Dr. Ivan Walks about a confirmed case of Anthrax were the man was unaware that he was in the immediate risk zone. Dr. Ivan Walks responds: That s a tough one, this gentleman was not told the day that Daschle letter was found that he had a risk of Anthrax. However, a couple of days ago there was a clear announcement made that anyone downstream and this guy worked in a government mailroom, got mail directly from the Brentwood office. That announcement was made, but somehow we in the public health department didn t get the message to that man and I think that s something we should be concerned about. Shows like this are critical.
Bioterror: What You Need To Know
Man in audience asks about the possibility of a small pox attack. Dr. Julie E. Fischer responds We do not know for sure, but we do know that the former Soviet Union again had a very active biological weapons program and it seems that they did make small pox. Wither they destroyed it or not is another issue. George Strait asks What about in this country? Dr. Julie E. Fischer responds In this country there is an official store of small pox that has been saved at the CDC, the last store of small pox here. We decided not to destroy it, a couple of years ago on the grounds that there might be more to learn from it. But we don t know of any large stocks of small pox. And unlike Anthrax, small pox only lives in people. There are no animal hosts out there that could be harboring it.
Bioterror: What You Need To Know
Woman in Audience asks about the symptoms of small pox. Dr. Julie E. Fischer responds The first symptoms of small pox unfortunately, the same nonspecific flu-like symptoms. The good thing about small pox if there is a good thing is that it s a very distinctive disease. It starts with a very high fever general icky malaise, that feeling of not felling well. And then there s a very distinctive rash in the mouth and then that skin rash that none of here have seen in real life.
Bioterror: What You Need To Know
DO NOT USE: Photo
Bioterror: What You Need To Know
Dr. Julie E. Fischer talks about small pox rash I is a sign that a person is contagious. People don t spread small pox until they have that rash in the mouth and on their skin. George Strait asks about the difference in treat of small pox vs Anthrax. Dr. Ivan Walks responds There s a huge difference. There s a profound difference. Anthrax is a bacteria and we have antibiotics that you can take so if you re exposed, you take those and essentially you re fine. Small pox is a virus, we don t have antibiotics that you can take to kill small pox we have to vaccinate people in order to prevent small pox. That is a profound difference. Dr. Dan Hanfling responds And I think even more importantly Anthrax is not transmissible, it s not contagious person to person, small pox is and that s why and although the risk might be small and as Dr. Smithson says you know, we don t know exactly where those stocks of small pox may be. The reason we re concerned about it and the reason why I m sure you re concerned about it is because it is contagious and so it could leak tremendous disease across our world.
Bioterror: What You Need To Know
George Strait asks about small pox vaccination. Dr. Ivan Walks responds I think thinking about it yes, planning for it yes. Dr. Dan Hanfling responds I agree although when you talk about small pox vaccine at least this vaccine that we currently hold in storage now it don t come without risk and that has to be remembered as well.
Bioterror: What You Need To Know
Woman in audience asks how health officials will be able to tell the difference between the common flu vs Anthrax and small pox. Dr. Dan Hanfling responds We have heard a lot of information about nasal swabs that we now know are not longer necessary. They re an epidemiologic tool, they re a science tool but they re not a diagnostic tool. On the other hand with influenza we can use influenza swabs that are also nasal swabs that we can run in the labs to see on fact if those flu-like symptoms are flu.
Bioterror: What You Need To Know
Man in audience asks if we are prepared for something more deadly than small pox or anthrax. Amy E. Smithson resounds Having surveyed 33 cities across this country there s one thing that I can tell you, there is an infrastructure there. Has it been neglected for decades in terms of the public health system, yes and there are new resources going into that long overdue. But there are hospitals and physicians and nurses who are in all the cities and towns across this country. And even if they haven t got the best capabilities and most up to date training, they re gonna do the absolute best that they can with what they got to help you."
Bioterror: What You Need To Know
George Strait asks if there re enough small pox vaccine to go around. Dr. Julie E. Fischer responds There are about 15 million doses of that vaccine left. And you don t have to be great at math to figure out that s not everyone in the US. We re keeping that vaccine to use it there is an outbreak so that it can be used to prevent a true epidemic. There are test happening right now to see if you can extend that vaccine by diluting it and still have it be effective by maybe such as 10x, which would give us instantly 150 million doses. CDC has contracted with a company to produce a lot more doses by the end of next year as a precaution. And they re looking at a possibility of an even faster way of producing a whole lot of doses, maybe enough for everyone in the US. But again I have to reiterate, what Dr. Hanfling said, this is not a vaccine that s without risk. When we had small pox in the world it was an acceptable risk that this live vaccine caused some complications and rarely some deaths. When we re just looking at a threat and we re just looking at fears that may be real but may be just that a threat, it is not an acceptable risk especially for children here in the United States.
Bioterror: What You Need To Know
Man in audience asks how is small pox contagious. Dr. Julie E. Fischer responds It transmits in drops from the secretions, that s a lovely world, of an infected person who coughs, is sick and has these secretions and someone else breaths them in or gets them on their fingers and puts them in their nose or in their eyes. It s very much the same way the flu is transmitted. Man in audience asks if the lesions are contagious. Dr. Dan Hanfling responds The lessons are not contagious but what Dr. Fischer says then is something that we should all remember which is cover our mouths when we cough and wash our hands when we re done.
Bioterror: What You Need To Know
Man in audience small pox vaccination for infants in the current public health system. Dr. Ivan Walks responds Under existing public health programs no he would not be vaccinated for small pox. And I think we always need to weight the public health risk and benefit. If the small pox vaccine were available but there was no risk of small pox you would still not vaccinate. That s why we stopped in 1972.
Bioterror: What You Need To Know
George Strait asks if all mail should be irradiated for disease. Dr. Julie E. Fischer responds We didn t realize that there was a threat. This was not someone deliberate gross negligence. No one pictured that a sealed envelope, even with Anthrax inside, would be so dangerous and it s partly a side effect of our very efficient method of moving mail around with compressed air. But now that we know that there s a threat we can take steps and one of those steps may be irradiating the mail. The technology exists, people are looking at it. They re looking at how quickly it can be done and how efficient it works. But yes, now that we know there s a threat that is definitely an option and clearly it would be targeted to places like the DC area first, where there is more of a target.
Bioterror: What You Need To Know
George Strait asks if the public has the right attitude, they are concerned but will go on with their lives. Dr. Dan Hanfling responds In the say way that I think that we should be flying and we should be going about our lives as we did before all of this began. I think that s a very reasoned approach .
Bioterror: What You Need To Know
George Strait asks woman in audience how she feels. She states that it s not going to stop her life and asks about the what s being done to find the source of the Anthrax. Amy E. Smithson responds This is a very complex investigation both from the standpoint of epidemiology and criminology. And the toughest thing to do now is to let these people do their work. I m not giving you much comfort here. It s probably going to take quite some time to actually trace this stuff back. But there are literally hundreds and thousands of people working on just that.
Bioterror: What You Need To Know
Woman in audience asks how to talk to children without scaring them. Dr. Julie E. Fischer responds The risk for them is ext rely small. These are vicious atacks that are being aimed at public officials and media figures. And to understand a little bit about the biology of this. Understand that anthrax spores are not smart things that float through the air and climb tall buildings and hide and wait for unsuspecting people. This is a disease that can be understood that we re learning more about all the time. And that it doesn t lay and wait, it s not that sneaky. It s really something that we can understand and the more we understand the less we fear.
Bioterror: What You Need To Know
Woman in audience asks how our country will protect us against bioterrorists attacks. Dr. Julie E. Fischer responds I think the first thing to remember with anthrax for example it has to be prepared, the kind we are seeming in the letter for example sent to senator Daschle did not come off a dead cow. It was prepared by someone and grown by an expert who knows what they re doing. But we can t worry about sealing our boarders to anthrax because it exists naturally.
Bioterror: What You Need To Know
George Strait asks it our water supplies are being protected. Panelists assure the public that security measures have been taken and water filtration will keep the public safe.
Bioterror: What You Need To Know
George Strait asks panelists what the public should do if they open mail and coming in contact with anthrax. Dr. Julie E. Fischer responds by saying to remain calm, it is time critical but you do have time. Secure the area, inform others around you and know who to call.
Bioterror: What You Need To Know
Woman in audience asks how long anthrax is active. Dr. Julie E. Fischer responds by saying that they are like spores and can stay dormant for a long time. It s when they are released into the air or in a wound they can be dangerous. Dr. Ivan Walks adds that when identified it can be cleaned up. Amy E. Smithson reassures the audience that the professionals are on full alert.
Bioterror: What You Need To Know
George Strait thanks his panelists and wraps up the program.
Bioterror: What You Need To Know
DO NOT USE: Credits