Skip to navigation | Skip to content

A threat worse than anthrax?


Anthrax bacteria (Bacillus anthracis) in a blood smear from a rhesus monkey that died of inhalational anthrax. (Pic: Journal of the American Medical Association / Zajtchuk and Bellamy)

Australians feeling jittery about the potential for anthrax-based terrorism are being warned off reaching for the antibiotics, as scientists fear excessive use could add to the problem of antibiotic resistance.

A spokesperson for the Chief Medical Officer reports that "a fearful public" have been calling state and federal health departments concerned about protecting themselves from anthrax and smallpox.

The Australian Government's policy, however, is not to supply antibiotics or vaccines until there is a clear need.

"People are saying I want a vaccine or I want antibiotics. But also a lot of people ring wanting to know what sort of gas mask to buy and that sort of thing," the spokesperson told ABC Science Online.

While there have been a number of anthrax hoaxes in Australia, no anthrax spores have yet been detected in these incidents.

"There is a certain amount of concern and paranoia out there in the community and we're just continuing to try and allay fears by very clearly indicating that Australia is well prepared," the spokesperson said.

"The drugs will be there for anyone who needs them, should something happen, but certainly there isn't a capacity for giving out antibiotics or vaccines in advance of an incident. As I say to people who ask about wearing gas masks: 'When are you going to wear them? All the time?'"

An editorial in this week's British Medical Journal by C. Anthony Hart and Nicholas J. Beeching argues that a far greater health risk than anthrax could result if care is not taken.

Large amounts of the antibiotic ciprofloxacin (known in Australia as Ciproxin), the first choice of antibiotic against anthrax, have been purchased from the manufacturer, Bayer, by the United States and other governments.

In the US, many potentially exposed individuals have started preventative treatment and Bayer has pledged to triple national production to 200 million tablets over the next three months.

"Unofficial use of ciprofloxacin will be common in the light of the worldwide panic," write Hart and Beeching.

"The important thing is to ensure that prophylactic treatment is only given to those who really need it, and to discourage its mass use by an understandably alarmed public."

Not only could inappropriate use lead to resistant bacteria, it could induce side effects in users, say Hart and Beeching.

"Although generally safe, ciprofloxacin is associated with rupture of tendons and neuropsychiatric disorders, especially in elderly people. In most countries it is not licensed for use in pregnancy or children," they write.

The Australian Office of the Chief Medical Officer has told doctors not to prescribe or supply Ciproxin to people who want to take it preventatively or have some on hand just in case.

But what would happen if Australia did have a genuine case of anthrax terrorism?

"When the time comes, we will certainly instigate all the proper medical procedures to protect the people who are most at risk and [they] would be given antibiotics, but to what extent and to whom would be a decision made at the time," the Chief Medical Officer's spokesperson told ABC Science Online.

If this situation did arise, it would be a tough call to ensure "appropriate" use of antibiotics in the face of the public's concern for safety and the government's need to be seen to be doing something.

But as Hart and Beeching argue: "To induce antimicrobial resistance on a mass scale would be an even greater triumph for the terrorists."