Anthrax defenses need to be strengthened: Experts

By Dr. Ananya Mandal, MDSep 28 2011

It has been a decade since the anthrax attacks brought home the reality of bioterrorism and the nation now has a stockpile of some basic tools to fight back against a few of the threats that worry defense experts the most.

These defenses are not just gathering dust awaiting the next attack. In August, a Minneapolis hospital dipped into the stockpile to treat a critically ill patient — a tourist who, somewhere on his Midwest vacation, had the extraordinary bad luck to breathe anthrax spores that naturally linger in the dirt in parts of the country. The man, who survived, received a kind of medication not available in October 2001 when anthrax spores sent through the mail killed five people and sickened 17.

Concern is that the nation's arsenal hasn't grown fast enough. A decade later, there are no treatments for a number of bugs on the concern list. Even a long-promised next-generation anthrax vaccine, that would be easier to produce, hasn't arrived yet. Nor is there information on how to treat children.

“Where are the countermeasures?” advisers to the Department of Health and Human Services asked in a critical report last year. There are a few treatments for the toxins produced by anthrax and botulism, and a smallpox treatment is due soon. But federal health officials are working to jumpstart production of more countermeasures and they say that more than 80 candidates are in advanced development..

That's a major shift that should entice more big drug companies to the field, says Dr. Robin Robinson, who heads the federal Biomedical Advanced Research and Development Authority, or BARDA. It funds late-stage research of promising countermeasures. BARDA just agreed to help pay for drug giant GlaxoSmithKline's testing of a novel antibiotic that might fight bioterrorism germs like plague — as well as certain hospital-spread bacteria that cause such problems as pneumonia in the already seriously ill.

So-called broad-spectrum antibiotics that can kill more than one kind of bacteria aren't unusual — this one just targets some hard-to-treat types in a new way. Scientists are beginning to create the first broad-spectrum antivirals, medicines that would treat more than one kind of virus. Rather than having an anti-flu drug and a separate anti-AIDS drug, the goal is to have a single injection that could treat those viruses plus the gruesome Ebola virus and a few more for good measure.

Dr. Michael Kurilla, biodefense research chief at the National Institute of Allergy and Infectious Diseases says its too early to hope. “We feel very excited and confident that what we're working on … can change the whole paradigm of how we approach infectious diseases,” Kurilla says. The U.S. has invested $67 billion in biosecurity since 2001, according to research by the Center for Biosecurity at the University of Pittsburgh Medical Center.

Center for Biosecurity chief Thomas Inglesby said he is concerned that federal spending reductions for public health programs will reduce the pace of work on vaccines and other treatments for biological threats.

A program for supporting development of vaccines and other countermeasures requires congressional approval to continue past 2013. Legislation that would reauthorize Project Bioshield and other key biodefense initiatives is winding its way through both chambers of Congress.