Raccoon Roundworm Encephalitis—Chicago, Illinois, and Los Angeles, California, 2000

Abstract

MANY PERSONS WHO WERE EXPOSED TO inhalational anthrax in the recent bioterrorism-related anthrax attacks have or are concluding their 60-day course of antimicrobial prophylaxis. Some persons, especially those who were exposed to high levels of anthrax spores, might want to take additional precautions. The U.S. Department of Health and Human Services (DHHS) is providing two additional options beyond the 60-day anti-microbial prophylaxis course: an extended 40-day course of antimicrobial prophylaxis and investigational postexposure treatment with anthrax vaccine. The three preventive options for persons with risks for inhalational anthrax are (1) 60 days of antimicrobial prophylaxis, accompanied by monitoring for illness; (2) 40 additional days of antimicrobial prophylaxis (intended to provide protection against the theoretical possibility that anthrax spores might cause illness up to 100 days after exposure) accompanied by monitoring for illness or adverse reactions; and (3) 40 additional days of anti-microbial prophylaxis plus 3 doses of anthrax vaccine administered over a 4-week period. Although not a use approved by the Food and Drug Administration, the vaccine might provide additional protection by inducing an immune response to Bacillus anthracis. As an investigational new drug, the vaccine should be administered with informed consent, and vaccinated persons may participate in a follow-up evaluation measuring the effect of the vaccine when administered after exposure.