This is an excellent article on Anthrax that everyone should print off and keep in a safe place.
Deborah

Anthrax: More Deadly Than Reported

    Col. Byron Weeks, M.D., Ret.
    Monday, Oct. 15, 2001

Dr. Weeks has had a distinguished medical and military career with the U.S. Air Force Medical Corps. Dr. Weeks began military service as the youngest flight surgeon in the U.S. Air Force during the Korean War. After 15 years of military service, during which he served in senior posts, including Hospital Commander at Bitburg Air Force Base, Germany, Dr. Weeks retired and entered private practice. During the past two decades, he has focused his studies on the threat of biological and chemical agents as weapons of war. Dr. Weeks has lectured and written numerous articles on infectious diseases and biological warfare.
 

Anthrax poses a significant threat to Americans and should not be dismissed as an ineffective bio-weapon, as many media are portraying it. Bacillus anthracis, the causative agent of anthrax, is a Gram-positive, spore-forming rod.
 

The spores are the usual infective form. Anthrax is primarily a zoonotic (communicable from animals to humans) disease of herbivores, with cattle, sheep, goats and horses being the usual domesticated animal hosts, but other animals may be infected.

Humans generally contract the disease when handling contaminated hair, wool, hides, flesh, blood and excreta of infected animals and from manufactured products such as bone meal.

Infection is introduced through scratches, abrasions and wounds, or by inhaling spores, eating insufficiently cooked infected meat, or being bitten by flies.

The primary concern for intentional infection by this organism is through inhalation after aerosol dissemination of spores. All human populations are susceptible.

The spores are very stable and may remain viable for many years in soil and water. They resist sunlight for varying periods.

History and Significance

Anthrax spores were weaponized by the United States in the 1950s and 1960s, before the old U.S. offensive program was terminated.

Other countries have weaponized this agent or are suspected of doing so. Anthrax bacteria are easy to cultivate and spore production is readily induced.

Moreover, the spores are highly resistant to sunlight, heat and disinfectants – properties which could be advantageous when choosing a bacterial weapon.

Weaponized spores are heartier than ones that Western medical experts have seen before; therefore, the risk from these spores is greater than many may believe.

Iraq admitted to a United Nations inspection team in August of 1991 that it had performed research on the offensive use of B. anthracis prior to the Persian Gulf War, and in 1995 Iraq admitted to weaponizing anthrax.

Dr. Ken Alibek, a recent defector from the former Soviet Union's biological weapons program, revealed that the Soviets had produced anthrax in ton quantities for use as a weapon.

This agent could be produced in either a wet or dried form. Coverage of a large ground area could theoretically be facilitated by multiple spray bomblets containing desiccated spores disseminated from a missile warhead at a predetermined height above the ground.

Clinical Features

Anthrax presents as three somewhat distinct clinical syndromes in humans: cutaneous, inhalational and gastrointestinal.

The cutaneous form (also referred to as a malignant pustule) occurs most frequently on the hands and forearms of persons working with infected livestock.

It begins as a papule (bump) followed by formation of a fluid-filled vesicle (blister). The vesicle typically dries and forms a coal-black scab (eschar); hence, the term anthrax (from the Greek for coal). This local infection can occasionally disseminate into a fatal systemic infection.

Gastrointestinal anthrax is rare in humans, and is contracted by the ingestion of insufficiently cooked meat from infected animals.

Endemic inhalational anthrax, known as woolsorter's disease, is also a rare infection, contracted by inhalation of the spores. It occurs mainly among workers in industrial settings who handle infected hides, wool and furs.

Inhalational anthrax usually has an incubation period of 1-6 days, although in an outbreak in Sverdlovsk in the Soviet Union, one patient had a six-week interval between exposure and onset. [See note at end for more on outbreak.]

Because the number of spores needed to kill an animal from inhalational anthrax is much smaller than for a human, animals will be the first to shows symptoms of the disease and die. Thus, the unusual incidence of deaths of dogs, cats and other pets may serve as an early warning of an anthrax outbreak.

In humans, the mortality of untreated cutaneous anthrax ranges up to 25 percent; in inhalational and intestinal cases, the case fatality rate is 90 percent to 100 percent.

Diagnosis

After an incubation period of 1-6 days, presumably dependent upon the strain and number of organisms inhaled, the onset of inhalational anthrax is gradual and nonspecific.

Fever, malaise and fatigue may be present, sometimes in association with a nonproductive cough and mild chest discomfort.  These initial symptoms are often followed by a short period of improvement (from hours to 2-3 days), followed by the abrupt development of severe respiratory distress with sweating, shortness of breath, stridor (sound of respiration when airways are obstructed) and cyanosis (bluish color of skin due to insufficient oxygen in blood).

Septicemia (blood poisoning), shock and death usually follow within 24-36 hours after the onset of respiratory distress.

Physical findings are typically non-specific, especially in the early phase of the disease.

The chest X-ray often reveals a widened mediastinum (chest cavity) with or without pleural effusions late in the disease in about 55 percent of the cases, but typically is without lung infiltrates.

Pneumonia generally does not occur; therefore, organisms are not typically seen in the sputum. Bacillus anthracis will be detectable by Gram stain of the blood and by blood culture with routine media, but often not until late in the course of the illness.

Approximately 50 percent of cases are accompanied by hemorrhagic meningitis, and therefore organisms may also be identified in cerebrospinal fluid.
 

Only vegetative encapsulated bacilli are present during infection; spores are not found within the body unless it is opened to ambient air.

Bacilli and toxin appear in the blood late on day 2 or early on day 3 post-exposure. Toxin production parallels the appearance of bacilli in the blood and tests are available to rapidly detect the toxin. Concurrently with the appearance of anthrax, the WBC (white blood cell) count becomes elevated and remains so until death.

Medical Management

Almost all inhalational anthrax cases in which treatment was begun after patients were significantly symptomatic have been fatal, regardless of treatment.

Penicillin has been regarded as the treatment of choice, with 2 million units given intravenously every 2 hours. Tetracyclines and erythromycin have been recommended in penicillin-allergic patients.

The vast majority of naturally occurring anthrax strains are sensitive to penicillin in vitro (in the laboratory). However, Russia has developed new strains that are resistant to penicillin, tetracyclines, erythromycin and probably other antibiotics, through laboratory manipulation of organisms.

All naturally occurring strains tested to date have been sensitive to erythromycin, chloramphenicol, gentamicin, and ciprofloxacin (cipro).

In the absence of antibiotic sensitivity data, empiric intravenous antibiotic treatment should be instituted with cipro at a dose of 400-800 mg IV twice daily at the earliest signs of disease.

U.S. military policy (FM 8-284) currently recommends ciprofloxacin (400 mg IV every 12 hours) or doxycycline (200 mg IV load, followed by 100 mg IV every 12 hours) as initial therapy, with penicillin (4 million units IV every 4 hours) as an alternative once sensitivity data is available.

Published recommendations from a public health consensus panel recommends ciprofloxacin as initial therapy.

Recommended treatment duration of the active case is 60 days, and should be changed to oral therapy as clinical condition improves.

Supportive therapy for shock, fluid volume deficit and inadequacy of airway may all be needed.

Standard precautions are recommended for patient care.

There is no evidence of direct person-to-person spread of disease from inhalational anthrax.

After an invasive procedure or autopsy, the instruments and area used should be thoroughly disinfected with a sporicidal (spore-killing) agent such as formaldehyde. Sodium or calcium hypochlorite can be used, but with the caution that the activity of hypochlorites is greatly reduced in the presence of organic material.

Prophylaxis (Prevention)

Vaccine: A licensed vaccine (Anthrax Vaccine Adsorbed) made solely by BioPort Corp. is derived from sterile culture fluid supernatant taken from an attenuated strain.

Therefore, the vaccine does not contain live or dead organisms. However, because of numerous severe immunologic reactions to this vaccine, I cannot recommend it.

Antibiotics: Both military doctrine and a public health consensus panel recommend prophylaxis with ciprofloxacin (500 mg orally twice a day) as the first-line medication in a situation with anthrax as the presumptive agent.
 

Ciprofloxacin recently became the first medication approved by the FDA for prophylaxis after exposure to a biological weapon (anthrax).

Bioweaponized anthrax is very likely to be resistant to alternatives such as doxycycline (100 mg orally twice a day) or amoxicillin (500mg orally every 8 hours).

Should an attack be confirmed as anthrax, antibiotics should be continued for at least 4 weeks in all those exposed.

Optimally, patients should have medical care available upon discontinuation of antibiotics, from a fixed medical care facility with intensive care capabilities and infectious disease consultants.

References:

"Biohazard" by Ken Alibek, M.D., Ph.D.

USAMRIID: Manual of Biological Warfare

NOTE:

In April 1979, an anthrax outbreak in the Soviet city of Sverdlovsk, roughly 850 miles east of Moscow, killed 66 of 94 infected
people. The first victim died after 4 days; the last one died 6 weeks later.

The Soviet government claimed the deaths were caused by intestinal anthrax from tainted meat. It was not until 1992 that President Boris Yeltsin admitted the outbreak was the result of military activity at a suspected Soviet biological weapons facility located in the city.
 

NewsMax.com

Bio Threat: Worse Than You're Told

    Christopher Ruddy
    Monday, Oct. 15, 2001

Let us agree on one matter: The attacks of Sept. 11 were not significant ones.

Anyone who believes these attacks were significant is foolish, delusional or both.

The death of 5,000 Americans is no small matter. But the casualty list of Sept. 11 is small compared to what could have happened, and what may happen.

I am baffled that in the wake of Sept. 11 the major media, and some government officials, continue to downplay the significance of ongoing events.

The media have given great coverage to such non-issues as racial profiling, Jerry Falwell's comments, how misunderstood Islam is, and other matters that don't deal head-on with the present crisis. The American people are very reasonable, as long as they have the facts. But that’s not what they are getting from CNN and the rest of the media pack. Here are some stories the heartland of America would like to see on CNN:

    The need for a stronger military that can deal with two regional wars at the same time (something we cannot do today)

    How rogue nations that back terrorists are building ballistic missiles, and why America needs missile defense to defend against future threats

    What went wrong at the CIA and the FBI, and the reforms necessary at these agencies to make sure Sept. 11 does not take place again

    The real and significant threat posed by weapons of mass destruction -- nuclear, chemical and biological ones

    The steps necessary to protect us from such threats, and the need for Americans to create their own civil defense system.

Such "rational" stories are not on the media’s radar screen.

Instead, as America faces the new biological threat of anthrax, the media are flooding the airwaves with experts and government officials saying "no need to worry folks, anthrax is hard to make, hard to deploy, can’t hurt you, no need to worry, yadda, yadda ..."

Recently, I spoke with Dr. Byron Weeks. Dr. Weeks is a retired Air Force colonel. He has the distinction of having been the youngest flight surgeon in the Air Force during the Korean War.

After years of military service, and after serving in several senior medical posts in the Air Force, including hospital commander at the U.S. Air Force Base, Bitburg, Germany, Dr. Weeks retired to private practice.

Since the late 1970s, Dr. Weeks has been specializing in biological warfare. He has lectured and written on the subject. He has also given many warnings about its dangers.

In my conversations, I found much of what he said startling. He says exactly the opposite of what we hear from the "don’t worry" p.c. crowd. For starters, Dr. Weeks believes America is woefully unprepared for an anthrax attack -- one that he says could kill millions.

Dr. Weeks has consulted with the former head of Russia’s bio-weapons program, Dr. Ken Alibek. He knows what capabilities the Russians developed over a decade ago -- and what Russian friends like the Iraqis likely have access to.

According to Weeks, the Russians developed a "weaponized" form of anthrax that is hearty, doesn’t break down easily in sunlight or heat, and can be easily dispersed.

But anthrax, Weeks said, is the not the greatest threat. He also talks about the danger of bubonic plague, easily manufactured and deployed. Also dangerous, he says, is smallpox.

As far the so-called government "stocks" of smallpox vaccine and antibiotics, Dr. Weeks dismisses these as insignificant. He told me what he believes will happen when a significant outbreak occurs, perhaps with 100,000 cases or more.

The reported antibiotic supply for 2 million cases will likely arrive too late to be effective -- amidst panic and other problems.

Dr. Weeks suggests that as the gravity of the attack sinks in among political and military leaders, they will decide NOT to dispense the stocks.

Why?

Because they know that once the small amount of antibiotics is used up there will be none for the U.S. military and for them, the political elites. The decision will be made not to deplete the stocks. The epidemic will rage, and many will die.
 

Two weeks ago, Secretary of Health and Human Services Tommy Thompson claimed that there was no need to worry about a biological attack because the antibiotic stockpile is set aside for 2 million cases. He said this was more than sufficient.

Fast-forward to this past week: Thompson announced he is seeking to increase the antibiotic stockpile to 10 million cases. If 2 million was enough just two weeks ago, why the sudden need for a supply for 10 million?

Weeks knows the truth: Even 10 million may not be enough for a country of 280 million souls.

Weeks advises directly -- and counter to what the talking heads are saying on TV: Make sure you have a supply of Cipro, the best antibiotic for countering anthrax, for you and your family. Don’t depend on the government.

One reason not to count on the government is how inconsistent the official line has been.

Consider what officials were saying about the threat of biological weapons before Sept. 11.

Last week, I came across a paper prepared for the U.S. Air Force’s Air War College by Lt. Col. Lansing E. Dickinson, entitled "Military Role in Countering Terrorist Use of Weapons of Mass Destruction."

In his brilliant and often prescient 68-page report published in 1999, Col. Dickinson lays out the facts about the threat of
biological and other weapons of mass destruction.

Here is an excerpt from his Introduction:

The terrorist threat is real. Some say it is only a question of time before terrorists use weapons of mass destruction against our military forces. Secretary Cohen in the Report of the Quadrennial Defense Review concluded "the threat or use of chemical and biological (CB) weapons is a likely condition of future warfare, including in the early stages of war to disrupt U.S. operations and logistics. ... This requires that the U.S. military continue to improve its capabilities to locate and destroy such Chemical/Biological weapons, preferably before they can be used, and defend against and manage the consequences of CB weapons if they are used."

Another excerpt:

Most experts agree terrorist groups are more likely to use chemical or biological weapons versus a nuclear weapon. This is due to the ease of acquisition, inexpense, and easier methods of delivery. Bruce Hoffman, Director of the Centre for the Study of Terrorism and Political Violence, says, "previously, terrorism was not just a matter of having the will and motivation to act, but of having the capability to do so -- the requisite training, access to weaponry, and operational knowledge. ... Today, however, the means and methods of terrorism can be easily obtained at bookstores, from mail-order publishers, on CD-ROM, or even over the Internet. Relying on such commercially published or readily accessible ... manuals and operational guides ... the `amateur' terrorist can be just as deadly and destructive as his more professional counterpart."

In an Advanced Concept Research Report, B.J. Berkowitz summarizes:

The chief advantages of Chemical/Biological weapons are the unrestricted availability of the necessary information, the relatively small resources needed, and the ability to test the product. There are no meaningful controls on the availability of chemicals, and what little control exists over pathogenic cultures can be overcome in a variety of
ways. Perhaps most important is the fact that the chemical and biological materials can be produced under the cover of an apparently legitimate commercial venture such as a small research company, fine chemical manufacturer, or bio-medical laboratory.

As for what the U.S. government really thinks about anthrax, Lt. Col. Dickson writes:

Brigadier General John Doesburg, the former Director of the Joint Program Office for Biological Defense, says,
"Anyone who makes home-brewed beer can make anthrax. Anthrax is a deadly toxin that, depending on the quantities used, can disable and kill thousands of people within hours or days. ... Another agent that could be in the enemy's arsenal is staphylococcus enterotoxin B (SEB) -- an incapacitant that, if it goes into the lungs, causes a fever of 106 degrees within an hour to three hours. The force will go into immediate malaise, but the agent will not kill them. If they ingest it, they will have severe diarrhea and vomiting."

The most effective means of delivering toxic agents is through aerosol clouds. Kupperman and Smith state that "aerosol dispersal technology is easy to obtain from open literature and commercial sources, and equipment to aerosolize biological agents is available as virtually off-the-shelf systems produced for legitimate industrial, medical, and agricultural applications. With access to a standard machine shop, it would not be difficult to fabricate aerosol
generators and integrate components to produce reliable systems for dispersing microorganisms or toxins.

Others suggest dispersing agents with cropdusters or through building air ventilation systems. The OTA [Office of Technology Assessment] study sums up the biological threat by stating, "Standard biological agents for covert sabotage or attacks against broad-area targets would be relatively easy to produce and disseminate using commercially available equipment, such as agricultural sprayers."

I have reprinted these lengthy excerpts so that you may compare them to what the media talking heads are telling us today:
Biological weapons are difficult to make, difficult to deploy, and difficult to die from.

You can believe the media if you like. I would tend to believe Dr. Weeks and Lt. Col. Dickinson. They don’t care if CNN invites them onto a show, they are just revealing the truth as they see it.
  

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