Frequently Asked Questions About Anthrax
Bioterrorism Concerns After September 11
Since the terrorist attacks of September 11, public concern regarding a potential biological attack has increased. One of the primary concerns of the American Homeowners Association is to make sure our members are fully informed regarding potential hazards in their home or workplace. With the kind permission of the The Johns Hopkins Center for Civilian Biodefense Studies we have published the following questions and answers regarding bioterrorism. The Johns Hopkins Center for Civilian Biodefense Studies received a steady stream of phone calls from the general public seeking more information about bioterrorism and ways to protect themselves. In response, the Center prepared the following "Frequently Asked Questions" (FAQ) fact sheet. Individuals may also want to contact their local health department and physician for additional information.
Should I buy a gas mask?
Should I have my own supply of antibiotics?
Is it safe for me to drink water from the tap?
What is smallpox?
If smallpox is a potential threat to the U.S., why shouldn't we all get vaccinated?
If I was vaccinated against smallpox before 1980, am I still protected?
What is anthrax?
Is anthrax contagious?
What is the National Pharmaceutical Stockpile (NPS)?
What can I do to protect myself and my family?
What if my fear about bioterrorism is having a serious impact on my family and work life?
Should I buy a gas mask?
No. A mask would only protect you if you were wearing it at the exact moment a bioterrorist attack occurred. Unfortunately, a release of a biological agent is most likely to be done "covertly," that is, without anyone knowing it. That means you would not know ahead of time to put on your mask. To wear a mask continuously or "just in case" a bioterrorist attack occurs, is impractical, if not impossible.
To work effectively, masks must be specially fitted to the wearer, and wearers must be trained in their use. This is usually done for the military and for workers in industries and laboratories who face routine exposure to chemicals and germs on the job. Gas masks purchased at an Army surplus store or off the internet carry no guarantees that they will work. In fact, one national chain of surplus stores provides the following statement: "(X) has been selling gas masks as a novelty item since 1948. We have never been able to warrant their effectiveness and we cannot do so at this time...We do not know what each type of gas mask we sell might or might not be effective against...We do not know the age of each gas mask..."
In brief, no guarantees whatsoever are provided. More serious is the fact that the masks can be dangerous. There are reports of accidental suffocation when people have worn masks incorrectly, as happened to some Israeli civilians during the Persian Gulf War.
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Should I have my own supply of antibiotics?
There are a number of different germs a bioterrorist might use to carry out an attack. Many antibiotics are effective for a variety of diseases, but there is no antibiotic that is effective against all diseases. Thus, no single pill can protect against all types of biological weapon attacks. Keeping a supply of antibiotics on hand poses other problems because the antibiotics have a limited "shelf life" before they lose their strength.
There is currently no justification for taking antibiotics. Also, it should be known that antibiotics can cause side effects. They should only be taken with medical supervision.
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Is it safe for me to drink water from the tap?
It would be extremely difficult for a bioterrorist to contaminate our drinking water supplies to cause widespread illness. There are two reasons. First of all, huge amounts of water are pumped daily from our reservoirs, most of which is used for industrial and other purposes; very little is actually consumed. Thus, anything deliberately put into the water supply would be greatly diluted. Secondly, water treatment facilities routinely filter the water supply and add chlorine in order to kill harmful germs.
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What is smallpox?
Smallpox is a disease caused by the Variola virus. Historically, 1 out of 3 people who contracted the disease died. The disease can spread from person to person. Transmission usually occurs only after the patient develops a fever and rash. Although there is no treatment for the disease, a vaccine against smallpox provides excellent protection and serves to stop the spread of the disease. While many vaccines must be given weeks or months before a person is exposed to infection, smallpox vaccine is different. It protects a person even when given 2 to 3 days after exposure to the disease and may prevent a fatal outcome even when given as late as 4 to 5 days after exposure.
Smallpox was stamped out globally by 1980 and vaccination stopped everywhere in the world. However, the Centers for Disease Control and Prevention (CDC) maintain an emergency supply of smallpox vaccine. Currently there are 12-15 million doses in storage, and a program to produce more vaccine began a year ago. For more information on smallpox, click here.
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If smallpox is a potential threat to the U.S., why shouldn't we all get vaccinated?
The vaccine may cause serious side effects. In 1972, the U.S. decided to stop routinely vaccinating its citizens because many people were experiencing side effects, while they had almost no risk of getting smallpox. By 1972, the disease was present only in a few countries of Asia and Africa. Today, health authorities would only recommend vaccination if there was clear evidence that the disease had resurfaced and those in the U.S. were at risk of acquiring infection.
Many people over age 30 have a vaccination scar. Vaccination consists of introducing the virus into the top layers of the skin. Over the following few days, a blister forms at the site of vaccination (usually the upper arm). The arm is sore, and there is fever. Very rarely, some people get a vaccine-related infection of the brain (about 1 case per 300,000 vaccinations); one fourth of these cases are fatal. Other potential negative effects of the vaccine are a severe skin reaction, spread of the vaccine virus (known as Vaccinia) to other parts of the body, and spread of the Vaccinia virus to other people.
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If I was vaccinated against smallpox before 1980, am I still protected?
Probably not. Vaccination has been shown to wear off in most people after 10 years but may last longer if the person has been successfully vaccinated on multiple occasions. If health authorities determine that you have been exposed to smallpox or are at risk of infection, they would recommend that you be re-vaccinated immediately.
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What is anthrax?
Anthrax is a disease caused by bacteria called Bacillus anthracis. The form of the disease that health authorities are concerned that a bioterrorist attack might produce is inhalational anthrax. Inhalational anthrax occurs when a person breathes in anthrax spores. As early as a day or two after exposure or as late as seven weeks afterward, the spores begin to grow rapidly and the victim develops fever, has difficulty breathing and feels miserable. Death typically occurs within a few days after these symptoms if the person doesn't receive medical treatment. It is believed that antibiotics can stop the disease if they are taken at the time the anthrax spores begin to grow or very soon thereafter.
In the event of a bioterrorist attack, health authorities would conduct a rapid investigation, determine the place and time of the release, and identify individuals who need antibiotics. The federal government has stockpiled antibiotics for large-scale distribution in the event of a bioterrorist attack. For more information on anthrax, click here.
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Is anthrax contagious?
No. Anthrax is not contagious. It does not spread from person to person. Healthy people who come into contact with persons sick with anthrax cannot acquire the disease.
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What is the National Pharmaceutical Stockpile (NPS)?
The NPS is a large reserve of antibiotics, chemical antidotes and other medical supplies set aside for emergencies. The CDC reports that it has the capacity to move these stockpiled materials to affected areas in the U.S. within 12 hours of notification. There are a number of different stockpiles, strategically located around the country. In addition to the medical supplies already set aside, the federal government has made agreements with drug manufacturers to make large amounts of additional emergency medicine. For more information on the NPS, go to http://www.cdc.gov/nceh/nps/default.htm.
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What can I do to protect myself and my family?
Unfortunately, there is presently little that individuals can do in advance to protect themselves from a bioterrorist attack. However, there is much that government agencies, health care institutions and public health departments can and should be doing to improve the capacity to protect the public following a bioterrorist attack. Medical institutions and public health agencies, in particular, have not received adequate attention and resources to cope with disasters like bioterrorism. For more information, click here.
You can express your concern regarding adequate protections against the potential threat of bioterrorism to your local leaders. In each area, local health departments have an important responsibility for helping protect your community against outbreaks of infectious disease, whether they occur in nature or because of a malicious terrorist act. They can assist you with additional bioterrorism-related concerns that are pertinent to your own community.
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What if my fear about bioterrorism is having a serious impact on my family and work life?
Given the attacks upon civilians that took place on September 11, it is reasonable for citizens to feel anxious about their personal safety. Should your fear get to the point that it stops you from doing the things you would normally do in a day, it might be helpful to talk with someone. Your health care provider can make a referral if you do not already have someone in mind. In the wake of the attack on New York City, we have learned how helpful it has been to many New Yorkers to speak with a counselor or to go to a mental health center.
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