Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |19 April 2005

What Is the Most Cost-Effective Way To Protect People in the Event of an Anthrax Terror Attack?

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • The summary below is from the full report titled “Cost-Effectiveness of Defending against Bioterrorism: A Comparison of Vaccination and Antibiotic Prophylaxis against Anthrax.” It is in the 19 April 2005 issue of Annals of Internal Medicine (volume 142, pages 601-610). The authors are R.A. Fowler, G.D. Sanders, D.M. Bravata, B. Nouri, J.M. Gastwirth, D. Peterson, A.G. Broker, A.M. Garber, and D.K. Owens.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
×
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
  • FULL ARTICLE
    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
    • Who was studied?
    • How was the study done?
    • What did the researchers find?
    • What are the limitations of the study?
    • What are the implications of the study?
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link

What is the problem and what is known about it so far?

Anthrax is an infectious disease caused by bacteria that can survive for years as spores. It is usually found in animals, such as cattle, sheep, and goats. Although human cases are uncommon in the United States, people can get anthrax by inhaling spores from infected animals or animal products. Anthrax leads to breathing problems, serious illness, and often death. In 2001, anthrax spores were deliberately spread through the U.S. mail. The release of a large amount of anthrax spores into the air could harm many people, so terrorists could use anthrax in an attack. It is uncertain what would be the best way to protect people in such an attack. Antibiotics can help reduce serious anthrax illness, but they must be given early because the disease worsens rapidly. A vaccine for anthrax is available, but public health officials are reluctant to vaccinate the general population because of the vaccine's side effects and costs.

Why did the researchers do this particular study?

To determine the best way to protect people in the event of an anthrax terror attack, balancing issues of effectiveness, safety, and cost.

Who was studied?

The researchers did not study actual patients. Instead, they developed a computer simulation of an anthrax terrorist attack.

How was the study done?

The researchers used information from published studies and experts to estimate the number of people who might be exposed to anthrax if terrorists released anthrax into the air in a large U.S. city. They also estimated the number of people who would become sick or die from such an attack. Finally, they estimated the potential costs and benefits of several different strategies to protect people in the area of the attack. Officials could vaccinate people before an attack, with or without administering antibiotics after the attack. Officials could wait for an attack to occur and then vaccinate people after the attack, give people antibiotics, or both. Or officials could not vaccinate and not give antibiotics.

What did the researchers find?

Waiting for an attack and then giving people in the affected area both vaccination and antibiotics was the strategy that best balanced benefits, side effects, and costs.

What are the limitations of the study?

The researchers had a limited amount of anthrax research on which to base their computer model, so the conclusions about the best strategy might change as we learn more about anthrax. They also used decisions that officials would make for large groups of people, not decisions that individuals would make about their own treatment. The findings apply to large-scale urban attacks in which anthrax is released into the air; they do not apply to other forms of attack, such as that which occurred in the U.S. postal system in 2001.

What are the implications of the study?

The likelihood of a wide-scale attack is probably small; however, if an attack did occur, the best strategy would be to give persons potentially affected both antibiotics and a vaccine.

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

What Is the Most Cost-Effective Way To Protect People in the Event of an Anthrax Terror Attack?. Ann Intern Med. 2005;142:I–40. doi: https://doi.org/10.7326/0003-4819-142-8-200504190-00002

Download citation file:

  • Ris (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2019

×
Permissions

Published: Ann Intern Med. 2005;142(8):I-40.

DOI: 10.7326/0003-4819-142-8-200504190-00002

©
2005 American College of Physicians
0 Citations

See Also

Cost-Effectiveness of Defending against Bioterrorism: A Comparison of Vaccination and Antibiotic Prophylaxis against Anthrax
View MoreView Less

Related Articles

Effect of Money-Back Guarantees on the Cost-Effectiveness of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors
Annals of Internal Medicine; 168 (12): 896-898
Cost-Effectiveness of Individualized Management of Diabetes Among U.S. Adults
Annals of Internal Medicine; 168 (3): I-22
Review: Newer second-line drugs for diabetes are not more cost-effective than sulfonylureas
Annals of Internal Medicine; 168 (2): JC8
Triple Therapy Versus Biologic Therapy for Active Rheumatoid Arthritis: A Cost-Effectiveness Analysis
Annals of Internal Medicine; 167 (1): 8-16
View MoreView Less

Journal Club

Review: Newer second-line drugs for diabetes are not more cost-effective than sulfonylureas
Annals of Internal Medicine; 168 (2): JC8
In treatment-resistant depression, adding cognitive–behavioral therapy to usual care was cost-effective at 1 y
Annals of Internal Medicine; 160 (12): JC13
Compared with warfarin, high-dose dabigatran might be cost-effective for preventing stroke in older patients with nonvalvular AF
Annals of Internal Medicine; 154 (12): JC6-12
Screening for abdominal aortic aneurysm (AAA) in men 65 to 74 years of age was cost-effective for AAA mortality at 10 years
Annals of Internal Medicine; 151 (10): JC5-15
View MoreView Less

Related Topics

Bioterrorism Infectious Agents
Healthcare Delivery and Policy
Infectious Disease

Bioterrorism Infectious Agents, Healthcare Delivery and Policy, Infectious Disease.

CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Latest RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards and Cover

  • Personae (Cover Photo)
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×