14 September, 2004

Anthrax Vaccine After Exposure to Aerosolized Anthrax Spores

 

 

On September 9, 2004, the US Centers for Disease Control and Prevention (CDC) provided updated information on anthrax that emphasizes a role for three (3) shots of the anthrax vaccine in the event persons are exposed to “potentially aerosolized Bacillus anthracis spores.". In this potential situation of aerosol release of anthrax the CDC will recommend "60 days of selected antibiotics in conjunction with a 3-dose regimen (0, 2, 4 weeks) of anthrax vaccine (BioThrax, formerly known as AVA) as an emergency public health intervention...Biothrax is not licensed for post-exposure prophylaxis for prevention of inhalation anthrax, or for use in a 3-dose regimen. Therefore, this program would be considered under an Investigational New Drug (IND) application.” 

 

The CDC guidelines go on to make explicit that two antibiotics are FDA-approved for post-exposure prophylaxis (PEP) against anthrax, and these two drugs are doxycycline and ciprofloxacin. Initial therapy with either “Cipro” or "Doxy” is recommended for adults and children when no information is available about the antimicrobial susceptibility of the implicated strain of Bacillus anthracis, while awaiting sensitivity testing.

 

These recommendations, focusing on aerosolized anthrax, deserve careful attention by medical and public health personnel. In particular, use of the anthrax vaccine in an IND setting should be communicated and discussed prior to any further anthrax attacks.

 

Daniel R. Lucey, MD, MPH

Director, Center for Biologic Counterterrorism and Emerging Diseases

Washington Hospital Center