Letter Re: Potential Bioterrorism Agent Found in Colorado

Hugh,

In the 19 July 2014 entry by Dr. Koelker, she brought up the potential for use of weaponized plague. Many years ago when I was in the Air Force, my tattered old shot record says I was inoculated against “Plague”. Is there currently any vaccine available that works to prevent pneumonic and/or bubonic plague? And how long is/was my ancient (1968) inoculation effective? Thank you for the excellent heads-up, Doc. BUFF Driver

Cynthia Koelker, MD Responds: In my recent article on pneumonic plague I stated that no vaccine is available, but to answer this reader’s question, let me address that further.

Per the CDC, there is no plague vaccine currently available in the United States (last updated November 2013). Although their web site does not state this explicitly, I believe they mean that there is no commercial plague vaccine available. New plague vaccines are apparently under development but not expected to be available in the near future.

Buff Driver is correct in that old vaccines did exist. I have come across records of others inoculated against plague in the 1960s. Recommendations for plague vaccine have varied through the years. Per a 1982 CDC Report, vaccination has been studied since the late 19th century, but vaccine effectiveness has been largely unknown. Per that same report vaccinated persons who are exposed to plague should be given the same prophylactic antibiotics as non-vaccinated personnel. So anyone who did receive a plague vaccine years ago is NOT considered immune and should be treated the same as someone who was never vaccinated.

Per a 2001 report on Vaccination against bubonic and pneumonic plague, the previously available killed whole cell plague vaccine was considered to offer poor protection against pneumonic disease. A live attenuated vaccine was also studied and has been considered more effective but “retains some virulence,” meaning it occasionally causes the disease it is intended to prevent. A safer sub-unit vaccine (based on the F1 and V-antigens) has been effective in animal models but has not been thoroughly tested in humans. Previous recommendations included dosages for both adult and pediatric vaccination.

I do not know for a fact that absolutely no vaccine is available. In recent years vaccination was recommended for all lab and field personnel who work with the causative agent, Yersinia pestis or hosts thereof. If I myself were doing research on live cultures of this disease or infected fleas, I certainly would hope to receive even a partially-effective vaccine; it would be crazy not to.

If a full-blown epidemic besieged America, I expect some vaccine would be liberated from researchers but doubtfully enough to treat a significant portion of the population.

Should a new vaccine be released, I will update the above information. For now, your best bet is to follow the guidelines I suggest in my recent article. – Cynthia Koelker, MD is SurvivalBlog’s Medical Editor. Bioterrorism is one of the many topics covered in her Survival Medicine Workshops, which you will find at www.armageddonmedicine.net.

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