Health officials warn against inappropriate antibiotics use

By Emily Richmond (contact)

Friday, Oct. 26, 2001 | 9:38 a.m.

Health fears in recent weeks have focused on letters and envelopes containing mysterious white powder, but some Nevada officials are bracing for what could be bioterrorism's second wave -- the fear that antibiotics misuse by the "worried well" will lead to drug-resistant strains of bacteria.

"We were facing the problems of inappropriate use of antibiotics long before Sept. 11," said Randall Todd, state epidemiologist with the Nevada Health Division. "The current scares over bioagents are certainly increasing the potential for widespread misuse."

Drug-resistant strains of bacteria are becoming increasingly common in the United States and around the world, according to the Centers for Disease Control and Prevention in Atlanta. Too many people are taking antibiotics when it isn't necessary, thus allowing stronger strains of bacteria to flourish.

Antibiotics work on bacterial illnesses, such as strep throat. Antibiotics don't work on viruses, such as a cold or the flu. Antibiotics also don't work on fear, Todd said.

"Given the events of the past few weeks, people are right to be concerned," Todd said. "But taking antibiotics unnecessarily may have serious, longterm consequences for all of us."

Across the country, fears of being exposed to anthrax have spurred demand for Cipro, a powerful antibiotic used to treat the disease. But the drug has no preventive capabilities and can cause serious side effects when taken needlessly.

In some cases, doctors are writing prescriptions for the drug to pacify patients. In others, the drug is being obtained illegally through overseas mail order companies and online pharmacies, state and federal authorities say.

Gov. Kenny Guinn will be in Las Vegas Monday to attend a meeting of the Nevadans for Antibiotic Awareness task force, created in August by more than 30 private companies and public agencies. The rush for Cipro over the past few weeks has only highlighted the need for the public awareness campaign, said task force spokeswoman Jenny DesVaux Oakes.

Private doctors are struggling to reassure their patients, said Dr. Lawrence Matheis, executive director of the Nevada State Medical Association. Some patients are demanding Cipro even though the drug has no preventive capabilities, Matheis said. There is no shortage of Cipro, and stockpiling it isn't necessary, he said.

"Doctors are in a difficult position," Matheis said. "On one hand, they want to reassure their patients and ease their fears, but at the same time we know that overuse of antibiotics will render them ineffective when we really need them."

Matheis suggested that people get a flu shot. The shot won't prevent anthrax, but it could lessen fears when flu season hits, he said. Early symptoms of anthrax include coughing, fatigue, fever and a sore throat. All of which could be mistaken as symptoms of the flu.

By getting the shot, people may be able to escape worry as to whether they are experiencing flu symptoms or something more sinister.

"You can understand why people worry, when the symptoms flash on the television every day and they think to themselves, 'Hey, I feel like that,' " Matheis said. "But we don't want hysteria to escalate so that it overwhelms emergency rooms."

Todd echoed Matheis' flu shot suggestion.

"It's one active thing that people can do for themselves, since there's so much of this they'll have to trust the government agencies to do for them," Todd said.

Health and Human Services Secretary Tommy Thompson said Thursday his agency planned to start a public health campaign aimed at getting more people vaccinated against the flu to reduce the chances of confusing the symptoms with anthrax.

But the CDC, which operates as a division of Thompson's department, sent a contrary memo Thursday to state health departments. The CDC said it doesn't recommend flu shots as a way to reduce confusion with anthrax symptoms, noting that the vaccine doesn't always prevent the flu or the other numerous viruses that also produce symptoms similar to early-stage anthrax.

Because of manufacturing problems, some shipments of flu shots have been delayed this year. Still, a repeat of last winter's vaccine shortage isn't expected, according to the CDC. A run on flu shots caused by anthrax-related fears could disrupt the public health programs and prevent some members of high-risk groups from getting the shots first, the CDC said.

The Clark County Health District offers flu shots to members of the at-risk population, including seniors and people with chronic illnesses. Commercial pharmacy chains have also begun to implement flu shot programs and some private doctors will also receive shipments of the vaccine next month. Health experts recommend people without serious illnesses wait until November or December to seek flu shots since the Nevada flu season tends to hit later in the winter season.