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CNN Live At Daybreak

As Anthrax Cases Continue to Appear, Doctors Focus on Treatment and Vaccines for Bioterrorist Threats

Aired October 22, 2001 - 08:02   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: A Washington postal worker is the latest victim. There are now 41 anthrax cases in the United States. Those include 9 infections and 32 exposures to the disease.

Now let's get the latest now from our correspondents in the field, Rea Blakey is in Washington, and she has the latest from there -- good morning again, Rea.

REA BLAKEY, CNN CORRESPONDENT: Good morning, Paula.

That D.C. postal employee is in serious but stable condition at Inova Fairfax Hospital, one of the suburban hospitals to Washington, D.C. The Brentwood station is now closed, as is the BWI station. That's at Baltimore-Washington International. Both of those mail facilities closed until further notice indefinitely.

What will be happening today in Washington: some 2,200 to 2,300 postal employees from both facilities will complete their testing to determine how far the exposure has gone, and how severe any other cases may be.

The D.C. public health commissioner, Dr. Ivan Walks, indicate that there are some five people, who are also being monitored. One of them, we are told, is a postal worker, who may have presented with flu-like symptoms, which is basically the only indication that public health officials would, in fact, have.

And by the way, there is heightened surveillance, not only in Washington, but obviously across the country, but this apparently allowed the detection of these possible cases to come to light sooner rather than later -- as you might imagine, this being the most severe form of anthrax. There is a great concern about not only containing, even though this is not a contagious disease, but limiting the area of exposure so that cleanup can also get under way as soon as possible if, in fact, there is no criminal investigation that follows, but obviously, this all unfolding at just this very moment.

And just a quick reminder that, in fact, this is new, for not only the United States, but the world to see so many inhalation cases. This is something that they're taking step by step, but obviously, these people are, in fact, under prophylactic medications, and the gentleman, who was hospitalized, is obviously being cared for as well as possible at this time. And now we go to Jason Carroll at the New York post office -- Jason.

JASON CARROLL, CNN CORRESPONDENT: Well, Rea, environmental tests were done at several news organizations -- several media outlets, including right here at the "New York Post." So far, those tests have come back negative.

Also, Governor George Pataki's office will reopen today. It was closed last week after investigators found traces of anthrax there. They did an environmental sweep of his office; 140 samples were taken so far. All of those tests have come back negative.

To date, we have four confirmed cases of anthrax here in New York City -- cutaneous anthrax, the skin form of the disease. We have an employee from NBC, a seven-month-old baby boy -- the son of an ABC news producer -- an assistant at CBS and also an assistant here at the "New York Post."

The only place where we know the source of anthrax that is at NBC, where they received a tainted letter from New Jersey.

For more on what's happening there, I'm going to turn it over to my colleague, Michael Okwu, who is standing by live for us with the very latest -- Michael.

MICHAEL OKWU, CNN CORRESPONDENT: Jason, good morning.

Preliminary tests here indicate that 13 areas were contaminated with cutaneous -- I'm sorry -- with -- contaminated with anthrax spores. Now, health officials, over the weekend, started to contact several workers from each section of the facility here, which is a mail processing center here in Trenton, New Jersey, to have them have nasal tests.

Now, more than 200 of those employees, at this point, have had those tests, and we expect to get those results soon in the coming days. They have also started taking Cipro as a precaution.

Now, meanwhile, the FBI has discovered that an anthrax-laced letter -- an anthrax-contaminated letter addressed to the "New York Post" also passed through this facility. Now, letters that were sent to Senate Majority Leader Tom Daschle, as well as to Tom Brokaw at NBC, also passed through this facility.

Now, as many of our viewers know, two New Jersey postal workers have tested positive for anthrax or cutaneous anthrax or the skin version of anthrax here. We believe, according to health officials, they say, that a third postal worker in all likelihood will test positive as well.

Meanwhile, investigators continue gathering clues along a mail route used by one of the handlers here who touched and came into contact with one of the letters, trying to pinpoint exactly what the source of that anthrax was -- Paula.

ZAHN: Michael, thanks so much.

We continue to talk about anthrax now a man who knows an awful lot about it. Anthrax is not the only bioterrorist threat. Some experts are also worried about a deadly disease that the world thought it had wiped out: smallpox.

But is the U.S. ready for such a threat? Dr. Anthony Fauci is director of the National Institute for Allergy and Infectious Diseases. He joins us now from Washington -- welcome.

DR. ANTHONY FAUCI, NATIONAL INSTITUTE OF INFECTIOUS DISEASES: Good morning.

ZAHN: So, Dr. Fauci, there are people out there who believe we should be putting far more emphasis on an anthrax vaccine right now than a smallpox vaccine.

What do you think?

FAUCI: Well, I think we need to address both problems. Certainly, smallpox, given the fact that it is transmissible from one person to another, is the kind of disease that is very amenable to vaccination with regard to its control. So the efforts that have been highly accelerated with regard to smallpox to be able to have a store of vaccines available --will we need to use it or even make a decision, which would engender some debate, about whether we would even want to preemptively vaccinate people. But that's something that's rapidly moving along.

With regard to anthrax, clearly the important approach towards anthrax is identification, caution, alertness, a high state of vigilance and treatment where appropriate. Although there have been these unfortunate cases, which we're very concerned about -- about individuals who have been infected have gotten very ill.

In fact, the broad impact, thus far, on the public health of anthrax has been relatively minor with a very high impact on the terror. If we had a vaccine available that was a safe vaccine that we know was effective against pulmonary anthrax -- and we're not sure about that with the current one, we know it's effective against cutaneous anthrax -- certainly you would want to consider just whom you would want to vaccinate.

I don't think you would want to vaccinate the entire population. In fact, most public health people agree very strongly that given the situation, even if we had an anthrax vaccine right now, given the containment of the cases, you wouldn't want to do that.

Treatment appears to be working well. However, this is a work- in-progress. Things are evolving, which is the reason why you have to continue to reevaluate your approach, as was mentioned a little while ago by Dr. Walks from D.C. Public Health System.

ZAHN: Yes, absolutely. But part of your challenge, and I think the media's challenge, is to keep this all in perspective, and...

FAUCI: Right, exactly.

ZAHN: ... Ezekiel Manuel writes in the "Wall Street Journal" today in an op-ed, he's quoted: "The risk of dying of anthrax needs to be put into perspective. One death among 280 million Americans is a minuscule risk. It is less than the dying from driving just one mile."

FAUCI: Right, he's correct. That's a very important point. And what we need to do is that we can tell America you shouldn't be concerned. There should be a concern, but you have to channel that concern, but you have to channel that concern into something productive, like a higher state of awareness, alertness and care about being observant as to what might be a potential risk. But when you cross the line and that concern -- justifiable concern becomes panic, than you've actually accomplished what the bioterrorists want to accomplish.

So you have to continue to walk that delicate balance. Public health officials must be ready for the worst, but the individuals in the general public cannot have the worst-case scenario always constantly on their mind. They have to look at the facts of what's happened, and go about their life carefully, but nonetheless not panicking.

ZAHN: And when you say getting ready for the worst that is part of the motivation behind this whole acceleration of this smallpox vaccination...

FAUCI: Absolutely.

ZAHN: ... issue. Right now, the government on hand -- has on hand some 15 million doses, and there is a debate about whether you get a five-fold increase by actually diluting that vaccine. Are you in favor of that to say you have 75 million dosages on hand?

FAUCI: It's not a debate. It's pure science. We're doing the clinical trial that we will have the answer to within a period of a couple of months, where you take the undiluted amount, and you compare it to individuals in a clinical trial, who are going to get a one-to- five dilution and a one-to-ten dilution.

If the one-to-five works, which is likely it will, because we already have preliminary data that it might, then all of a sudden, you have 75 million doses. If the one-to-ten dilution works, you have 150 million doses.

So it isn't a debate. It isn't a guess. It's a clinical trial that's going to give us the answer. So in a couple of months, we'll know whether we've gone from 15 million stores to 75 to 150 million stores. And simultaneous with that, notwithstanding that is the clinical trial, as well as the production -- the extraordinarily scaled-up production to have a goal of having 300 million units ready to go -- 300 million doses of vaccine ready to go within 6 to 12 months.

At that point, we'll have it in hand, and then we can have the debate about whether or not you want to preemptively vaccinate people, or you want to do what is the general public health approach is that when a case occurs to vaccinate around it to try and contain it if it's an isolated case. If it's a more diffuse involvement, then you'll have to consider the risk-benefit ratio of whether or not you want to vaccinate everyone.

So it's really a scientifically-driven process.

ZAHN: Oh, sure. I need a closing thought, then, on the prospect of wide-scale vaccinations. You know, we all know, that 1 in 4,000 people, who will get this vaccination, or could get this vaccination, could possibly have brain damage as a result of the vaccination and could end up dying.

Just clarify all of that for us this morning as we continue to launch into this debate.

FAUCI: Well, all vaccines are not without risk, but the smallpox vaccine clearly, historically, has had a rare, but nonetheless, serious complication. So when public health officials sit down to try and make that decision, there has to be an open, healthy debate about what the risks of what we're facing from a bioterrorism incident or diffuse involvement would be versus. vaccinating people and finding out nothing has happened. And yet, you've done some damage to people.

That's the thing that needs to be debated, and an informed decision needs to be made in that regard.

ZAHN: Thank you for your insights this morning, Dr. Fauci.

FAUCI: You're welcome.

ZAHN: We know how busy you are -- glad to spend a couple of minutes with you this morning.

We'd love for you to log onto CNN.com for more on the threat of bioterrorism -- lots of good information on that Web page. Just click on "Anthrax Attacks: Get the Complete Story." Or you can learn the 10 things you should know about anthrax and more on the antibiotic, Cipro. That's CNN.com, AOL keyword CNN.

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