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Low GraphicsWednesday, 10 October, 2001, 14:00 GMT 15:00 UK Anthrax: How do you stop it?

Can gas masks protect from anthrax The threat of biological attack has prompted panic-buying of gas masks and antibiotics. BBC News Online examines whether anything can be done to protect people from the threat of diseases such as anthrax. Anthrax spores are silent, odourless, and invisible. No-one is likely to be aware they have been exposed, and symptoms of infection will not emerge for days after exposure, at the earliest. All of which adds up to a worrying prospect for public health specialists - and a large number of understandably worried citizens. But are there any practical steps that people can take to protect themselv es? Gas masks Gas masks may have been flying off the shelves in recent weeks, but their value against biological attack is questionable at best. In laboratories, researchers tend to hook themselves up to fully sealed body suits to prevent organisms getting through. The success of a gas mask relies heavily on a perfect seal between mask and face, which is very difficult to achieve. Any gaps and the organism could get through. And, of course, because there is no warning of such attacks, or even any indication that one is in progress, the mask would have to be worn 24 hour s a day. Antibiotics The antibiotic of choice against the anthrax bacterium is ciprofloxacin, or Cipro, which is thought likely to prove effective against many strains of anthrax. In patients with diagnosed inhalational anthrax, very high doses are given . If successful, the treatment is continued for 60 days to make sure all spores have germinated and been destroyed. A similar regime is likely to be given to patients who have been exposed to anthrax but who have not fallen ill. Bayer, the maker of Cipro, says that general demand for the antibiotic has definitely increased, and it is planning to boost its production by a quarter from November 1. However, the use of preventive antibiotics in the general population is not necessarily an easy solution. Again, as no-one knows when they are exposed to anthrax, the antibiotic would have be taken - at relatively high doses - for the entire duration of what is perceived to be the "terrorist threat". Doctors would be uneasy about any long-term regimen at such high dosage. The use of Cipro in children younger than 16 to 18 is not recommended especially not in the long-term - because of possible side-effects. These include joint damage. Vaccination The most medically-acceptable way to tackle anthrax is through vaccination . However, this has in the past been restricted in availability to military personnel and those working in industries which involve possible contact

with animals which are harbouring anthrax, such as tannery workers. Those producing vaccines for this purpose would be unlikely to be able to respond to a huge surge in demand caused by a fear of biological attack among the general population. BioPort, the sole US manufacturer, has not produced any vaccine at all since winning a government contract in 1998. Its failure to meet targets means that a US military project to vaccinate 2.4m troops has been cut back. The company said in September that it was ready to "launch into full production" if required. The effectiveness of the vaccine is undoubted. In tests on monkeys, inoculation was completely effective against airborne anthrax eight and 38 weeks later, and 88% effective 100 weeks after inocul ation. The UK makes its own vaccine at the Centre for Applied Microbiology and Re search at Porton Down. However, this has not been made widely available to the public. It is unlikely that many people would be able to persuade their GP to prescribe them a jab - and if they did, any supplies not already aimed at the arms of servicemen and women would be exhausted swiftly. Raising production to meet the demands of a mass vaccination campaign would require large amounts of money.

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