April 21, 2004

Vermonters Help Fight Anthrax

Vermont, Channel 3 News

An already shaky nation after 9/11 faced another challenge: anthrax. Several letters laced with the deadly bacteria killed five and caused countless anthrax scares around the country, including here in Vermont. And a letter addressed to Sen. Patrick Leahy, D-Vermont, also contained anthrax. The culprit behind the biological attacks is still at large.

The events prompted the federal government to focus on the anthrax vaccine. Currently only members of the military are immunized. The vaccine has side effects and takes several doses to reach full protection.

"The old vaccine was made years ago, developed in the 1950's and it's made from a very impure combination of ingredients that come from a bacterial culture," says Dr. Beth Kirkpatrick of the University of Vermont.

Now UVM is one of twelve sites where researchers will test a newer, potentially better vaccine.

"The purpose of this vaccine is to see if we can get similar good response with a safer more effective and shorter dosing vaccine," says Kirkpatrick.

Potential study participants, like Linda DelHagen, would get the vaccine. Researchers will follow her body's response for one year. UVM hopes others will step up to test the new vaccine.

"I'm a volunteer, and I guess this is something I can do to help. I'm willing to do it. I can't always give blood, so this is something else I can do," says DelHagen.

Kirkpatrick says there's no actual anthrax in this vaccine: "No, not at all. There's no way this vaccine can cause anthrax, it's made of a bit protein called the protective antigen made of ingredients that's part of anthrax bacteria but doesn't contain the bacteria."

UVM is looking for up to fifty Vermonters who will be paid for participating. You must be healthy without any chronic illnesses, between the ages of 18 and 55 and never have had the anthrax vaccine before.

April 14, 2004

Smallpox Vaccine Test Stopped Due to Side Effects

Health Central

Recruitment of volunteers to test a new smallpox vaccine has been halted early after participants developed significant heart inflammation, the Washington Post reported.

While biodefense contractor Acambis PLC said it would continue to study those who had already been given the experimental vaccine, it said it would no longer administer the inoculation to new recruits, the newspaper said.

The trials had been conducted to test the Acambis product, ACAM2000, versus Dryvax, a smallpox vaccine that has long-since been approved. The company said three participants among the 1,132 volunteers who had been given either vaccine experienced heart inflammation -- at least one coming from the group testing the newer shot, the Post reported.

A spokesman for the U.S. Centers for Disease Control and Prevention told the newspaper he didn't know what effect the announcement might have on the government's plans to use more than 200 million doses of ACAM2000 it has stockpiled in the event of a bioterrorist attack -- enough for every American.

The newer product is a modernized version of Dryvax, and experts had predicted the two vaccines might share some harmful side effects, the newspaper reported. A leading government health official called the initial stockpile a "stopgap" until a safer alternative became available.

April 13, 2004

Acambis smallpox vaccine blow - Smallpox Vaccine too Reactive

Jim Armitage
Evening Standard

ACAMBIS, the Cambridge-based drugs company that supplies the US government with smallpox vaccines to protect the population against biological attack, today suspended trials on the medicine after finding serious side-effects among some volunteers.

With the US on high terrorist alert, it fast-tracked orders for 209 million doses of the drug from Acambis before it had been fully tested.

Now, intense monitoring has discovered that some of those used in the test suffered a major heart condition. The drug has not been given to anybody outside the trials.

Acambis, headed by chief executive Gordon Cameron, is one of many drugs companies attempting to make a safer version of the only licensed existing vaccine, Dryvax, which has been used for generations. Despite its efficacy, Dryvax's manufacture, from calves' bellies, is seen as dated.

The company's Acam2000 is a chemically produced version of the vaccine given by injection.

Acambis was one of the companies that lost out in the bidding for the contract to provide vaccines for Britain. That deal was controversially won by PowderJect, whose founder Paul Drayson was a major Labour Party donor.

Smallpox was eradicated in 1971 after a worldwide Dryvax vaccination and quarantine programme organised by the World Health Organisation.

But the threat of biological weapons use by rogue states and terror organisations has led most first-world governments to stock up on unlicensed vaccines to give to the public in the event of an attack.

The military and front-line medical workers vaccinated since 9/11, considered most likely to come into contact with the disease, have been given Dryvax from old stock.

Shares in the group fell 41 1/2p to 322 1/2p on the news.

• THE threat from terrorists has led governments around the world to rush out orders for stockpiles of smallpox vaccines, none of which has been fully licensed.

As part of its contract with the US, Acambis was asked to get the drug through the normal trials required for other drugs and prove that it was as effective as Dryvax, its predecessor.

The problems now appearing in the Phase III trials were anticipated because heart conditions had been noticed in previous Dryvax vaccination programmes.

It is unclear whether the findings reported today are down to the intensive monitoring now being conducted into Acam2000 or the product itself.

The smallpox vaccine drawn from calves' bellies was invented in the 1890s when a scientist, Edward Jenner, spotted that milkmaids were less prone to the disease than the rest of the population.

April 3, 2004

Broken US troops face bigger enemy at home

A stretched Pentagon is sending unfit soldiers back to Iraq long before they are ready to serve again

Suzanne Goldenberg in Washington
The Guardian

All Jason Gunn ever wanted was to be a soldier. He put on the uniform three days after high school graduation, and served six years with distinction. But in the last real conversation he had with his mother he swore he would never go back to Iraq.
The army specialist came within inches of death last November 15, when the Humvee he was driving hit a roadside bomb, killing his sergeant. The entire left side of Gunn's body was splattered with shrapnel, his elbow was shattered and, as he lay in the US military hospital bed in Germany, he was tortured by nightmares.

Late on March 23, Gunn told his mother, Pat, that his commanders were putting pressure on him to return to Iraq, but there was no way he was getting on that plane. A few hours later, he was airborne. This week, Gunn's distraught mother, who is herself a navy veteran, received a first official response to her demands to know why a soldier, who was being treated by military doctors for combat stress, was sent back to the war.

The note, which acknowledged Gunn suffered post-traumatic stress, said: "After discussion of his case it was determined ... this may be in his best interest mentally to overcome his fear by facing it. Therefore, he has been cleared for redeployment."

Gunn is not the only broken soldier being sent to battle. The Guardian has uncovered more than a dozen instances in which ill or injured soldiers were sent to war by a US military whose resources have been stretched near to breaking point by the simultaneous fronts in Afghanistan and Iraq. In its investigation, the Guardian learned of soldiers who were deployed with almost wilful disregard to their medical histories, and with the most cursory physical examinations. Soldiers went to war with chronic illnesses such as coronary disease, mental illness, arthritis, diabetes and the nervous condition, Tourette's syndrome, or after undergoing recent surgery.

One sergeant major was shipped out two months after neck surgery, despite orders from his military doctor for six months' rest. "The nurse told me to put my hands above my head and said you are good to go," he told the Guardian. A female supply sergeant said she was sent to Kuwait under medical advice not to walk more than half a mile at a time, or carry more than 50lb. Both had to be medically evacuated within weeks; the sergeant major required surgery on his return.

In some cases, the wounded were recycled with alarming speed. A mechanic, who suffered brain damage last June when his vehicle was hit by a suicide bus, was sent back to Iraq in October despite reported blurred vision and memory loss. He returned with his unit last month, and medical evaluations showed he had continued bleeding from the original head injury.

In Gunn's case, the determination to return him to battle is puzzling. His unit, the 1-37 Armoured Division, is due to return from Iraq in May. "They are sending an injured soldier back there for seven weeks. I can't for the life of me imagine why," says Ms Gunn. "They say they want him to go back and face his fears, but I just keep thinking what this whole thing will do to a person. What are they going to send home to us? Someone who is going to be on disability for the rest of their lives?"

All of the injured or ill soldiers knew of other unfit troops who were sent to Iraq last year, or have recently been redeployed. Some, who like Gunn suffered combat stress after sustaining serious injury, came under enormous pressure from their commanders to return to Iraq. Equally disturbing, a number of returning soldiers declared unfit for service told the Guardian the military had tried to force through their discharge to take them off the benefit rolls.

Such soldiers are almost never seen or heard from in a war now entering its second year, but their numbers are growing. The Pentagon's senior health official told Congress this week that the military had carried out 18,000 evacuations from Iraq of wounded or ill soldiers.

Disability claims

Meanwhile, 15,000 soldiers who fought in Iraq and Afghanistan have filed for disability claims. Some 12,000 have sought medical treatment from facilities run by the department of veterans affairs. About 4,600 have sought psychological counselling. That demand threatens to overwhelm a veterans' healthcare system that has received no new funding since the Iraq war began.

The drain on combat-ready soldiers - and the costs of carrying those damaged by this war - are becoming logistical nightmares for military planners. The Pentagon has already been forced to extraordinary measures. Last year, it locked up the service contracts of National Guard members and army reservists, preventing them from leaving the military when their time is up.

Gunn's commanders seem adamant on keeping him. On Wednesday, Ms Gunn was forwarded a statement from her son. "It is my wish to be redeployed with my unit to finish my tour of duty with my unit here in Iraq," the statement said. "I feel that I am able to complete my mission here as well as any other duties assigned to me while on current deployment." It also said he had discontinued his prescription. Ms Gunn is convinced the statement was coerced.

Veterans' advocates say Gunn's saga reflects a pattern in the Pentagon's dealings with casualties of the war: send them back to battle fast or get them off the military's books before their ailments drive costs up. "This is a particularly stressful time for the military because they have been committed far far beyond their capability, and that is the reason there is such pressure," says Stan Goff, a veterans' activist and writer. "The numbers are becoming more and more important. They have got to keep more bodies in theatre."

Battle readiness barely registers. Veronica Torres, a supply sergeant with 27 years service, was sent to Kuwait four months after toe surgery, and with previous injuries that restricted her movement. "Could I run? No. Could I jump in and out of trucks? No. Could I march a mile or two? No," she says.

She was there less than a week before reporting to sick bay. After being medically evacuated last July, she was diagnosed with diabetes and fibromyalgia.

Others who were evacuated for injury or illness say their real war started on their return - with the military bureaucracy.

Gerry Mosley, 49, a first sergeant in a transportation unit, was injured jumping off a truck that came under fire. By the time he was medically retired on March 17, he was taking 56 pills a day for shoulder, back and spinal conditions, post-traumatic stress disorder, and Parkinson's which was not diagnosed when he was shipped out.

Mosley also developed an abiding anger against an institution he served for 31 years, accusing the army of trying to shirk responsibility for his condition now he was surplus to requirements.

"I went to Iraq and fought the enemy, not knowing I was going to come back to the United States and fight a bigger enemy," he says.

April 1, 2004

Medical evacuations in Iraq war hit 18,000

United Press International

WASHINGTON, March 31 (UPI) -- In the first year of war in Iraq, the military has made 18,004 medical evacuations during Operation Iraqi Freedom, the Pentagon's top health official told Congress Tuesday.

The new data, through March 13, is nearly two-thirds higher than the 11,200 evacuations through Feb. 5 cited just last month to Congress by the same official, William Winkenwerder Jr., assistant secretary of defense for health affairs.

In both cases, Winkenwerder described the evacuations as "total evacuations out of theater," and he said both times that the majority of evacuations represented routine medical treatment and not life-threatening injuries.

"As of March 13, 2004, data from the Transportation Command shows 18,004 total evacuations out of theater," Winkenwerder said Tuesday.

"As of February 5, 2004, data from the Transportation Command shows 11,200 total evacuations out of theater," he told a separate House panel Feb. 25.

A spokesman for Winkenwerder, James Turner, said the latest figure represents multiple evacuations for single patients -- including moving some soldiers back into theater. He said the 18,004 evacuations was for 11,700 patients.

Turner did not return e-mails or phone calls Tuesday and Wednesday asking for elaboration.

Winkenwerder appeared Tuesday before a House Government Reform panel with four Army Reserve and National Guard soldiers. Those soldiers offered a litany of complaints about poor health care for reserve and guard troops -- problems they said have been widespread during the war on terror, particularly on return to the United States.

Soldiers described being deployed to war with serious medical conditions and then getting poor and erratic health care upon return -- including months-long waits for doctors, surgeries or treatments. United Press International first reported that problem last October.

Two soldiers said better access to mental health services might have prevented two suicide attempts at two separate bases, and asserted that soldiers are sometimes prescribed powerful drugs by military health professionals in place of medical care. The soldiers also described widespread concern about being put out of the military without fair compensation for wounds and illnesses they received during service.

"Is it a question of incompetent medical care or a question of a well-organized government system that achieves just what it is supposed to achieve?" Retired Army Reserve First Sgt. Gerry Mosley, who served in Iraq, asked the panel.

"Use people, strip them of all human dignity, disrespect them, wear them down, and be pleased when soldiers no longer have the physical and mental capacities to continue to fight to have the same rights and respect as those American citizens for whom we have fought to preserve those entitlements."

Mosley said that after returning from Iraq last summer, he has had to drive 195 miles each way at his own expense to see a specialist. He said the Army put him out of service without compensating him for a neck injury or vertigo apparently triggered from mortar explosions. He can no longer work his civilian job. Since being put out of the Army, he has been diagnosed with Parkinson's Disease.

The wives of two soldiers also testified. Laura Ramsey, wife of Florida Army National Guard Spc. John A. Ramsey, said through tears that she did not want her husband to serve in the guard anymore, after fighting for nine months to get surgery on his shoulders that were injured in Iraq. "Not after the nine months of hell that we have been through," Ramsey said.

Pentagon health officials described a series of steps they are taking to better screen soldiers for health problems before and after deploying for combat. They also have taken steps to ease the strain at major bases -- including a new policy to send some soldiers back home for treatment near their families after 25 days if they are unfit for duty after showing up for service.

While they wait, the Pentagon has set new standards to help ensure that living conditions are appropriate for sick, injured or ill troops.

Pentagon health officials mostly have emphasized swift and professional care for the acutely wounded by combat in Iraq.

"During Operation Iraqi Freedom, we used far-forward surgical and medical teams and technologies to care for casualties within minutes of injury," Winkenwerder told Congress last month. "Based on the current analysis, 98 percent of those wounded who, in fact, reached medical treatment survived their injuries."

But Pentagon data and interviews with soldiers at six bases in the United States and Europe show combat wounds represent a minority of casualties during wartime. The Pentagon "Operation Iraqi Freedom U.S. Casualty Update" on Tuesday listed a total of 2,998 soldiers wounded in action, in comparison to the 18,004 medical evacuations described by Winkenwerder.

The Pentagon defines a casualty as "any person who is lost to the organization by having been declared dead, duty status-whereabouts unknown, missing, ill, or injured."

More mundane wartime injures seem more prevalent: back and neck injuries, torn knees and elbows, heart and lung problems and mental problems like post-traumatic stress disorder that may not be diagnosed for months after returning from combat.

Soldiers say acute care for the wounded at Landstuhl Regional Medical Center in Germany and at Walter Reed Army Medical Center in Washington, D.C., is excellent. But ill and injured troops -- particularly National Guard and Army Reserve soldiers -- sprinkled across the United States describe widespread concern for medical care and benefits described by the panel Tuesday. Some are in "medical hold" at U.S. bases while they wait for treatment.

"I have spoken probably with hundreds of soldiers since I was placed in med hold," Spc. Timothi M. McMichael told the panel Tuesday. He is on medical hold at Fort Knox, Ky. "I can only say that the uniform consensus is one of frustration, disappointment and anger. I have had soldiers with 15, 20, even 25 years in the military tell me they are disgusted," McMichael said. "The Army cannot afford to lose the number of senior non-commissioned officers it is losing every day."

In addition to the new policies, Winkenwerder said the Pentagon is racing to do better for these troops, as well as those wounded in combat. "I believe we are doing better. I really do," he told Congress Tuesday. "We understand. We appreciate that there are some issues that need to be addressed. We are aggressively addressing them."