In medicine, clinical developments are always occurring, and the treatment of a disease can radically change from year-to-year. Bioterrorism-related diseases are no different. In the 13 years since the anthrax attacks, many important developments have occurred in the treatment of these diseases, and my colleagues and I sought to encapsulate them in an article aimed at clinicians.
That article, to our delight, was published by the most prestigious medical journal in the world, The New England Journal of Medicine. Our article discusses the new knowledge that has accumulated in the treatment of anthrax, botulism, plague, tularemia, and smallpox over the last 13 years. For some pathogens, the treatment is essentially the same, but for others new treatments, prognostic information and vaccines are available. For example, a monoclonal antibody is available for the treatment of anthrax, a hepatavalent anti-toxin is available for the treatment of botulism, and experimental antivirals have been developed for use in the treatment of smallpox.
Busy clinicians are understandably unable to follow every development with these diseases, as they are rare and not part of their day-to-day practice. However, in the event of another bioattack (or a natural occurrence), these clinicians will be the front-line of defense, and the degree of their astuteness will be directly related to the degree of our vulnerability. As the world unfortunately learned during the Ebola outbreak, arming our front line clinicians with the most up-to-date information about potentially serious infectious diseases protects us all.