Aaaaaaaaaaaaack!!!!!!

[Guest guest]

Notice the mention of EBOLA here!!

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http://dailynews./h/ap/20011007/hl/attacks_vaccines_1.html

Sunday October 7 2:40 PM ET

Scientists Seek Germ Warfare Vaccines

By DANIEL Q. HANEY, AP Medical Editor

Bioterrorists? Germ attacks? If the threat is real, why not roll up

our sleeves and get vaccinated?

Vaccine experts say the question has come up often since Sept. 11,

and though certainly a reasonable one, many doubt population-wide

shots will be a practical defense anytime soon against the deliberate

release of deadly microbes.

The possible health hazards of mass vaccination could easily outweigh

the benefits, they say, especially considering that no one really

knows the likelihood of such a catastrophe.

But beyond that are significant problems: No vaccines are available

for civilian use except smallpox shots, which are in extremely short

supply until at least next year; and the government's sole supplier

of anthrax vaccine has failed to meet federal drug standards and

isn't currently producing the vaccine.

But even if immunizing the entire U.S. population against terrorist

bugs is unlikely, creating new and better vaccines is widely viewed

as a key part of defense against bioterrorism.

For some potential terrorist weapons, such as smallpox and Ebola

(news - web sites) virus, there are no treatments at all. Anthrax and

other bacteria can be treated with antibiotics, but in the case of

anthrax, at least, treatment must begin rapidly. On Friday, a Florida

man died of anthrax three days after being hospitalized, despite

treatment with antibiotics. So vaccines that prevent infection

entirely could be far more effective in the face of a large outbreak.

Even before the attacks on New York and Washington, developing

vaccines against the A-list of bioterrorist weapons was high on the

research agenda at the National Institutes of Health (news - web

sites) and the Defense Department.

In the works are vaccines against virtually every potential

bioterrorist germ. Some might be given ahead of time to soldiers,

hospital workers and police, but most would probably be held for

distribution after an attack to stop further spread.

Scientists are seeking vaccines that could be produced rapidly and,

once given, build up protection much more quickly than the standard

shots now available.

Researchers who consult with government agencies speak of a new

urgency there. ``We suddenly realize, my God, we've got to deal with

this,'' says Dr. Myron Levine, director of the University of

land's Center for Vaccine Development.

Health and Human Services (news - web sites) Secretary Tommy

said last week the government hopes to have 40 million fresh doses of

smallpox vaccine by next summer, well ahead of the original deadline

of 2004. Acambis, a British firm, will speed up its 20-year, $343

million program to replenish the U.S. supply. About 15 million doses

of the old vaccine remain from the 1970s.

Smallpox was eradicated in 1977, and routine vaccinations ceased in

1980. However, the Russians produced tons of smallpox for their

bioweapons program in the 1980s, and some experts fear some of it may

have escaped, perhaps to other countries that make biological

weapons.

About half of Americans alive today were vaccinated against smallpox,

but the protection wears off. Dr. D.A. , director of the

s Hopkins Center for Civilian Biodefense Studies, estimates that

only 10 percent to 20 percent of them still have immunity against

smallpox.

Acambis' new vaccine will be grown in cell cultures and will be much

purer than the original version, derived from the pus of infected

cows. The Centers for Disease Control and Prevention (news - web

sites) plans to store it at guarded warehouses around the country, to

be shipped off quickly after an attack to keep the highly contagious

and untreatable virus from spreading.

The plan: Quarantine areas where smallpox is seen, then vaccinate

everyone who lives around them. Nine million doses of vaccine would

be needed to contain an outbreak that begins with just 100 infected

people.

The logistics are daunting, especially if people are infected in

several cities. In 1947, it took a week to vaccinate 6 million people

in New York City in response to an outbreak of eight cases.

So why not inoculate everyone as soon as a vaccine is available?

``It has to be re-examined. I am certainly beginning to think that

may be a reasonable approach,'' says Dr. Atlas of the

University of Louisville, president-elect of the American Society for

Microbiology.

However, many specialists are dubious, including , who

headed the global smallpox eradication campaign. Two years ago, he

led a committee of government and academic specialists who rejected

the idea, and that conclusion still stands.

``The answer is definitely no,'' says .

The main reason is the vaccine's safety. When smallpox was a true

health hazard, those risks were small in comparison. But the equation

changes when the threat cannot be measured. Experts contend that even

a few hundred deaths or serious complications that are vaccine-

related would be considered unacceptable.

About 3 in every 1 million people vaccinated would get encephalitis

that may lead to death or permanent neurological damage, experts

estimate. Another 250 would get a smallpox-like rash caused by

vaccinia, the usually harmless virus used for the vaccine. The rash

could be fatal if not treated.

People with weakened immune systems - cancer and transplant patients,

those taking high-dose steroids and people with AIDS (news - web

sites) - could be especially susceptible. Even if left unvaccinated,

they might catch vaccinia from those who are vaccinated.

Recently, British researchers announced they had deciphered the

genetic blueprint of plague bacteria. The discovery could offer new

hints for vaccine design. The current vaccine protects against the

bubonic form of plague but not the inhaled variety, which is feared

as a terrorist weapon.

Plague and other bacterial hazards, such as anthrax, can be treated

with antibiotics. But medicines often must start soon after exposure,

even before symptoms start, to be effective. Since there probably

would be no warning of a germ attack and early symptoms could be

mistaken for the flu, treatment might start too late for many.

Nevertheless, some people have stocked up on prescription

antibiotics, such as Cipro and doxycycline.

The current anthrax vaccine is reserved for the military, and experts

seem unanimous that it is too cumbersome for civilian use. It

requires six shots over 18 months, then yearly boosters. <>>

Several labs are doing government-financed research to find a better

anthrax vaccine, which would eliminate the need for speedy

antibiotics. One of them, Vaxin in Birmingham, Ala., is working on a

genetically engineered version that could be given with a skin patch.

While it might be aimed initially at soldiers or health workers,

``vaccinating the entire population is not all that farfetched,''

says Kent Van Kampen, the company's president. But that vaccine is

not expected to be available for three to five years.

If it or another new anthrax vaccine works out, the thinking about

large-scale vaccination could change.

``If we had a great vaccine in enough quantity with no side effects

and we felt the threat was large and imminent, that would be a

reasonable question for public health discussion,'' said s

Hopkins' Dr. Luciana Borio. ``We do not have that.''