> Information about anthrax and breastfeeding
>
> The following information about breastfeeding, anthrax, and use of the
> anthrax vaccine by lactating women comes from Carol Huotari, Manager of
the
> LLLI Center for Breastfeeding Information (CBI). Carol obtained most of
this
> info via phone calls to the USA Centers for Disease Control (CDC) and the
> anthrax vaccine manufacturer.
>
> Joel Rogers of the Emergency Response System of the CDC (phone
404-639-2283)
> reiterated that, as all doctors on TV and in the written media here in the
> USA have recently stated, anthrax is not transmitted from person to
> person--and that includes via breastfeeding. He said that the anthrax
> vaccine should not be administered to pregnant women. When given to
> breastfeeding mothers, there is no harm to the baby. The CDC website (see
> below) states: "No data suggest increased risk for side effects or
> temporally related adverse events associated with receipt of anthrax
vaccine
> by breast-feeding women or breast-fed children. Administration of nonlive
> vaccines (e.g., anthrax vaccine) during breast-feeding is not medically
> contraindicated." Carol also heard from Cindy Franko of Bioport, the
> Michigan manufacturer of the anthrax vaccine. Cindy said the same thing
as
> Joel, that the vaccine does not contain live bacteria and would pose no
> threat to a breastfeeding baby.
>
> For further information about anthrax and the anthrax vaccine, please see
> the article "Use of Anthrax Vaccine in the US" (Recommendations of the
> Advisory Committee on Immunization Practices) by CDC staff members DA
> Ashford, B Perkins, and LD Rotz from the Dec 15, 2000 issue of "Morbidity
> and Mortality Weekly Report" posted on the CDC website
> www.cdc.gov/mmwr/preview/mmwrhtml/rr4915a1.htm
> <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4915a1.htm> If you have
trouble
> accessing the article at this URL, just go to www.cdc.gov/mmwr and do a
> search for anthrax vaccine in the Dec 15, 2000 issue of MMWR.
>
> Information about the anthrax vaccine can also be found in "Medications
and
> Mothers' Milk" (Hale, 2000, p.52). "The vaccine should only be
administered
> to healthy men and women from 18 to 65 years of age since investigations
to
> date have been conducted exclusively in that population. Because it is not
> known whether the anthrax vaccine can cause fetal harm, pregnant women
> should not be vaccinated. There are no data or indications relative to its
> use in breastfeeding mothers. While it consists primarily of protein
> fragments of anthrax bacteria, it is very unlikely any would transfer into
> milk, nor even be bioavailable in the infant."
>
>
> Ciprofloxacin, or "Cipro," is the antibiotic for treating anthrax
infection
> and for prophylactic use after exposure. It is classified as "usually
> compatible with breastfeeding" in the newest AAP Policy Statement, "The
> transfer of drugs and other chemicals into human milk"[Pediatrics 108:3, p
> 799]. Thomas Hale places Cipro into lactation risk category L4, citing a
> possible risk of serious joint and GI system side effects. Category L4
> calls for a risk-benefit analysis before the decision is made to use the
> drug in a breastfeeding mother. [Medications and Mothers' Milk, 2000
> edition, pp 16, 147-8]
>
>
____________________________________________________________________________
> ___________________________________
> The following press release from the American Academy of Pediatrics
> addresses concerns AAP member physicians in the USA have expressed about
> preparing for possible attacks with biologic agents.>
> *************************
>
> AAP press release
> Oct 2001
> www.aap.org/advocacy/releases/smlpoxanthrax.htm
>
>
> AAP Responds to Questions about Smallpox and Anthrax
>
> In the wake of the terrorist acts on September 11, questions about
> smallpox
> and anthrax vaccines have come from members who are concerned about
> preparing
> for possible attacks with biologic agents.
>
> The last known case of smallpox occurred in Somalia in 1977, and in 1980
> the
> World Health Organization certified that smallpox has been eradicated
> from
> the planet. The only known remaining samples of smallpox virus are held
> in
> secure facilities in the Centers for Disease Control and Prevention (CDC)
> in
> Atlanta, and the Institute for Viral Preparations in Koltsovo, Russia.
>
> Smallpox vaccine is no longer licensed and is not available commercially
> in
> the United States, because there is no current need for its use. The U.S.
>
> Public Health Service does maintain an emergency stockpile of smallpox
> vaccine. At the present time, smallpox vaccine is released only under an
> Investigational New Drug (IND) permit from the Food and Drug
> Administration
> (FDA) for vaccination of certain laboratory workers who may be at
> occupational risk of infection with smallpox-like viruses. The IND does
> not
> permit release of the vaccine for any other persons or reasons.
>
> Anthrax vaccine is not recommended for people younger than 18 years of
> age
> and currently is administered only to people in the military service.
> Dispensing antibiotics or prescriptions for doxycycline or ciprofloxacin
> in
> anticipation of a possible anthrax outbreak is not recommended. If an
> outbreak occurs, antibiotics will be dispensed through a coordinated
> effort
> by the CDC and other appropriate healthcare organizations.
>
> The Academy is aware that plans are being made by the Department of
> Health
> and Human Services, the CDC and other parts of the Federal Government to
> respond to bioterrorism. These plans do not include widespread use of
> smallpox or anthrax vaccines. The benefit and risk of re-introduction of
> smallpox vaccine will continue to be examined both by the PHS Advisory
> Committee on Immunization Practices (ACIP) and by the AAP Committees on
> Infectious Diseases (COID) and Environmental Health as the situation
> dictates.
>
> Our COID remains in close contact with the CDC and other federal agencies
> and
> will continue to monitor these vaccine issues and keep AAP members
> apprised.
>
> You may wish to consult the following for more detailed information:
> The AAP Subject Review, "Chemical-Biological Terrorism and Its Impact on
> Children," published in Pediatrics, March 2000; 105:662-670 and available
> at:
> http://www.aap.org/policy/re9959.html
>
> The AAP 2000 Red Book, pp. 84-87, 168-170.
>
> The US Public Health ServiceAdvisory Committee on Immunization Practice
> recommendations on smallpox vaccination at:
> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htm or
> http://www.cdc.gov/mmwr/PDF/RR/RR5010.pdf (PDF Format)
>
> The U.S. Public Health Service Advisory Committee on Immunization
> Practice
> recommendations on anthrax vaccination at:
> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4915a1.htm or
> http://www.cdc.gov/mmwr/PDF/RR/RR4915.pdf (PDF Format)
>
> CDC Web sites on bioterrorism and preparedness efforts at:
> http://www.bt.cdc.gov/ and http://www.bt.cdc.gov/Agent/Agentlist.asp
>
>
>
>
>
>
>
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