CDC to study combination treatment for anthrax

From Elizabeth Cohen and Miriam Falco
CNN Medical Unit.

ATLANTA, Georgia (CNN) -- The Centers for Disease Control and Prevention said Wednesday it wants to study combining anthrax vaccine with antibiotics to treat people who have already been exposed to anthrax bacteria.

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CDC spokesman Tom Skinner told CNN the CDC has asked permission from the U.S. Food and Drug Administration to study the possibility, as well as the use of the vaccine alone for people who cannot tolerate the antibiotics used to combat the disease.

Some medical experts recommend both the vaccine and antibiotics as a treatment for anthrax exposure. The vaccine, they say, would battle bacteria released by spores that remain dormant after the patient ends an antibiotic treatment.

The American Public Health Association, the Journal of the American Medical Association and the British Public Health Laboratory Service all issued reports making the recommendation. And Dr. Phillip Hanna, coauthor of an article on anthrax in the New England Journal of Medicine and assistant professor of microbiology and immunology at the University of Michigan, said he would want the vaccine if he had been exposed.

"I think it's a safe vaccine," he said. "I think the benefits are potentially very good, and I would want all the possible medical treatments available pointed in my direction."

When anthrax spores are inhaled, they nestle into tissues in the body. For a period of time -- for days or even months -- the spores may rest in the tissues and do nothing. But when conditions are right, anthrax bacteria sprout out of the spore. Those bacteria release toxins that can destroy vital organs and eventually kill.

Antibiotics help, if taken early enough, by killing the bacteria and preventing the release of the toxins. But once someone stops taking antibiotics, there is still a possibility that some dormant spores could sprout bacteria.

An anthrax vaccine, which prompts the body to produce antibodies that neutralize any toxins, is then a kind of insurance policy.

"What we are really attempting to do here is make sure you have antibody defense after you stop the antibiotics," said Michael Osterholm, a member of the Civilian Working Group on Biodefense and director of the University of Minnesota's Center for Infectious Disease Research and Policy. "Should one of those dormant spores come around, we can then take care of it."

But Surgeon General David Satcher said officials didn't see a need for both the vaccine and the antibiotic.

"We don't believe it's indicated," he said, "... so that's why we're not doing it."