Questions raised as localities stockpile anthrax antidotes

Drugs for first-responders seen as bioterror necessity

June 06, 2005|By Greg Barrett | Greg Barrett,SUN STAFF

Fire Lt. Randall Owens keeps one in the locker at his Rockville station and another in the master bathroom of his Frederick County home. His are two of the 7,000 "bio-packs" of anthrax antidotes given to 3,500 Montgomery County firefighters and police officers.

First-responders are given two supplies of doxycycline or ciprofloxacin -- antibiotics used to treat anthrax infections --in clear pouches the size of fanny packs, to keep with them at home and work.

In a push to control their own fate, Montgomery County, Baltimore City and other jurisdictions around the country are spending federal homeland security grant money to create stockpiles of antidotes that duplicate drugs readily available through the six-year-old Strategic National Stockpile program, which has cost more than $2 billion to assemble.

The jurisdictions want to ensure that they have drugs on hand to treat emergency personnel -- and in some cases, their families -- on a moment's notice so that fire, police or health department employees can respond to a bioterrorism event.

"It makes a difference knowing that you can take the medicine immediately and not put your family at risk through exposure," said Owens, 48, a grandfather and 28-year firefighting veteran.

`Kind of nuts'

But William Stanhope of the Institute for Bio-Security at the Saint Louis University School of Public Health, is highly critical of the practice.

"The idea is kind of nuts," he said. "It presumes it is going to be an anthrax attack, and it presumes that we will know in an instant. ... A bioterrorist attack will not be white powder floating out of the sky. It will not be obvious. It will be covert."

In Baltimore City and Montgomery County alone, the cost for the drugs has totaled about $100,000 since the terrorist and anthrax attacks of 2001.

Von Roebuck, a spokesman for the Centers for Disease Control and Prevention in Atlanta, said that Montgomery County was among the first --perhaps the first -- jurisdiction to stockpile the antidotes into bio-packs. Roebuck said other governments around the country are bolstering the supplies of bioterrorism antidotes in hospitals, police stations and firehouses. For reasons of security, he declined to name the cities and counties.

Nor would he comment on the advisability of duplicating drugs in the national stockpile, which costs $397 million a year to maintain. The CDC keeps storehouses of antidotes in more than a dozen secret locations throughout the nation, including the Washington suburban area. Between 2002 and 2005, the stockpile increased its capacity of anthrax antidotes from 12 million to 60 million.

Baltimore Health Commissioner Dr. Peter L. Beilenson said the city has no plans "to just start throwing cipro out" to people and rushing into a bioterrorist event without analyzing the situation carefully.

"I'm a doctor. My first concern is to do no harm," he said. "We're just trying to be proactive and do the right thing with this [homeland security] money in a very smart, targeted way."

Although each pill costs about 6 cents -- and a fully stocked bio-pack is less than $7 -- the drugs expire and must be replaced every three years. Ciprofloxacin was the drug of choice during the anthrax attacks of 2001, but some people who take it suffer allergic reactions. Doxycycline is a widely used alternative.

In Montgomery County, which was the scene of some of the 2001 anthrax attacks, the cost has resulted in a recurring expense of $35,000 every three years.

The county used money from a 2002 Byrne grant -- a federal law-enforcement fund -- to buy its first supply of antidotes. County workers then assembled the bio-packs and handed them out. That batch of drugs will expire in November.

This year, the county is using money from a homeland security grant. Montgomery County homeland security director Gordon Aoyagi said he expects to pay for the drugs in the future with federal grants.

"As long as there remains a threat I would think the [federal] money would be available," he said.

Montgomery County officials bought their first drug supply in the fall of 2002, several months after the idea was hatched at a terrorism preparedness seminar in St. Michaels. During a brainstorming session, someone mentioned the "go packs" of supplies given to U.S. soldiers, and the bio-pack initiative grew from that, said Montgomery County bioterrorism coordinator Kathy Wood.

Since then, Wood and others have given bio-pack presentations at the CDC and fielded phone calls from public safety officials in Seattle, Boston and elsewhere, Wood said.

She said Montgomery County decided it was important for emergency personnel to have antidotes at their fingertips during a bioterrorist event instead of having to rush to a hospital or the health department to receive the medicine.

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