Second Opinion: Another Way to Treat Anthrax

Oct. 16 -- An old and discarded treatment for anthrax infection could be manufactured in a matter of weeks and help save many lives.

The vaccine-like antidote is "anthrax antitoxin." It's cheap to make and can be used as an experimental treatment in addition to the use of antibiotics. The antitoxin treatment can quickly act against the infection.

As this column has pointed out, there are serious scientific questions about whether the anthrax vaccine can effectively prevent an infection in humans via the inhalation of spores. (See archive, right.) And antibiotics used after an exposure to anthrax work before symptoms appear. They are not likely to affect a toxin produced by the anthrax bacterium already working in the body and producing symptoms.

Given mounting concerns about a possible wider-scale attack with anthrax, it only makes sense to pull together whatever treatments might prove to be valuable. The science on anthrax antitoxin suggests it can be. Anthrax antitoxin stopped being used as effective antibiotics became available.

China Uses it Already

A 1999 review article on anthrax in the New England Journal of Medicine concludes that anthrax antitoxin has potential but that "unfortunately, antitoxin preparations are not currently available in the United States," Dr. Meryl Nass, associated with Parkview Hospital in Brunswick, Maine, who has testified on numerous occasions before congressional committees looking into anthrax prevention and treatment, also wrote in 1999 in the Infectious Disease Clinics of North America, that "multiple case reports as well as experimental studies have documented some benefit of this approach."

Nass told me that China uses an anthrax antitoxin, along with antibiotics, as standard treatment, and that the United States could either buy it from the Chinese or drug companies could easily start their own production.

What an Antitoxin Is

Antitoxins are typically made by injecting a toxin in increasing amounts into an animal. Horses have often been used for this purpose. The animal then produces antibodies to the toxin. These antibodies are then extracted from the animal's blood and purified. The goal in injecting the antibodies into an infected human is to have the antibodies (the antitoxin) neutralize the toxin that is damaging the individual's body. The antibody effect is temporary, but there is evidence that it works.