(00:00:00) From Minnesota Public Radio. I'm Steven John authorities finished Anthrax testing at the mail Recovery Center in st. Paul last night the facility processes unclaimed letters and Parcels with no return address including mail from the East Coast where postal workers have contracted Anthrax. John kalinin is a US Postal Inspector working in st. Paul. He says it's a precautionary but necessary step to ensure that contaminated male has not been sent to the mail Recovery Center or possibly some equipment or something like that. The only way we can ensure that the mail Recovery Center has not been contaminated is by bringing in the testing gallon dad says results of the test will not be known for several days. The st. Cloud Regional Airport. No longer has an armed police officer standing guard a police officer has been stationed at the airport off and on since the September 11th terrorist attacks FAA security officials. Notified the airport this week that it no longer needs police and it's terminal during passenger flights, Minnesota. (00:01:00) Just laid (00:01:00) of leaders plan to ask baseball commissioner Bud selig to delay any discussion of contraction of the league team owners could vote as early as next week on whether to eliminate the Minnesota Twins franchise Senate Majority Leader Roger Mo and house Speaker Steve, swing mm plan to send a letter to selig asking him to postpone any contraction discussion enrollment is up for the third consecutive year at the 34 Minnesota state colleges and universities this fall more than one hundred sixty one thousand students are enrolled in credit classes compared with 150 mm in the fall of 2000 at Minsk you schools mostly cloudy still for a while in the Northeast a chance of some showers and becoming partly cloudy there. Otherwise, mostly sunny and Breezy Statewide some drizzle right now in or it's 39 degrees there. It's 57 in Albert Lea 55 in the Twin Cities. That's news from MPR. Thank you. Stephen six minutes past 12:00 o'clock. And good afternoon. Welcome back to midday and Minnesota Public Radio. I'm Gary eichten. Glad you could join us. Well on the one hand it is a story of vital importance one about which you want to know every possible detail on the other hand. It's a story that is virtually impossible to keep up with almost numbing in its scope and complexity it of course is the anthrax story more than four weeks after the first case was diagnosed the Centers for Disease Control now says it has confirmed 16 cases of Anthrax in America 10 of the more serious inhalation type for those people have died. But even those numbers don't begin to summarize the scope of the problem dozens of buildings have been tested for Anthrax many of them have required decontamination thousands of people have been prescribed antibiotics to head off the danger of Anthrax traces of Anthrax have now been found in the midwest in Kansas City in Indiana last A postal facility in st. Paul was tested as a precautionary measure traces of Anthrax have been reported at several locations overseas. It is all very confusing. But Michael Oster home has joined us today to try to sort out what we know don't know and should know about this threat, Michael osterholm is an internationally recognized expert on bioterrorism. He's a former Minnesota state epidemiologist, and he is currently the director of the University of Minnesota's Center for infectious disease research and policy. He's also author of The Prussian book released last year titled living Terrors what America needs to know to survive the coming bioterrorist catastrophe Michael Oster home is our guest this hour, and if you have a question related to the anthrax threat, we invite you to give us a call this afternoon Twin City area number is 6512276 thousand 6512276 thousand outside the Twin Cities 1-800 to for 22828. Five one two two seven six thousand or one eight hundred two four two two eight two eight Michael Oster home. Thanks for joining us this morning or this afternoon. (00:03:59) Thanks Gary. (00:04:00) Appreciate it. Are you surprised at how this has threatened spread from one part of the country to the other seem to start out as a fairly isolated incident or some suspicious lenders and to a few news organizations Senate majority leader, but now it's moved Way Beyond that (00:04:18) well, you know, I think Gary that is you and I have discussed this issue on a number of occasions on this very program. I think that I would even take a step back and say that we're really just at the beginning of this situation. We're still not really far into it and what I mean by that is that the letter situation will continue to play itself out. It's possible that there could be more letters. It will be sent that could go to other parts of the country. It is in fact true that the envelopes containing this powder may have cross contaminate other envelopes, which would then Rotate its the presence of this particular bacteria and other locations and we need to talk about what the significance of that is, but I continued to really emphasize the fact that for Americans that don't sit in the back now and say well this is just a letter issue. I think one of the Grave concerns we have is that this was the first shoe to drop and that as Americans we have to understand the implications for additional shoes at could and very likely will drop in association with with Anthrax by (00:05:19) itself. Just so as to what's happened so far. Are you confident that all of the anthrax that's been reported has been spread by mail or do you think that already there are some some indications that perhaps other methods of distribution have been (00:05:34) used? Well, I'm actually quite confident at other methods of distribution have not yet been used even though we have two cases that are not necessarily clearly linked to mail their remember the young child ABC Studios. We still don't have a defined letter that ever entered into that facility. that child developed cutaneous Anthrax, which meant that they came in contact with the bacteria somewhere on the outside of their body the most recent case which has occurred in New York City is one that is a very difficult case frankly to evaluate because it was an individual who lived alone was a person who was too sick by the time investigators realized that she had Anthrax to be able to interview her the fact that innovational Anthrax can have an incubation period of up to well up to 60 days could mean that her exposure was, you know, three days before her on said was you know, ten days before onset or maybe it was 30 days before her on set so that now to try to place her in a given location would make that difficult what is important to understand that was the absence of other cases so far that do not have an unexplained source so that if you're going to have this to released in any effective means you're going to see other cases so the investigation in this case New York City continues, its a very Comprehensive investigation and we may never know where her Source was in terms of the investigation itself. But if one could have the ultimate knowledge, we I'm sure it would tie in to whatever is currently happening. (00:07:06) But as far as we know right now the male is still the primary and apparently the only source of distribution best. We (00:07:12) know at this point. That's all we have right now is the mail as the distribution (00:07:18) system which leads us then to that basic question that we talked about a couple of weeks ago given what's happened since we last talked folks here in Minnesota the fellow and friendly. Is there any reason for him to worry that the male that's coming over his transom is contaminated with Anthrax (00:07:39) at this point the potential for male to have come in contaminate any one individual home in this country as a result of what was released in September and October and again I point that out to you because As we do have to be honest with our citizens and say, you know, whoever is perpetrating. This event could have mailed letters yesterday now could be in the system somewhere that are going to pose a whole nother round of problems, but given the previous event the citizen and friendly hasn't really nothing to worry about in that regard. There has been a lot of misinformation out there and unfortunately a lot of almost knee-jerk reactions to this issue and I say knee-jerk I don't want to minimize the cases that have occurred the 16 cases the for Death Star all obviously tragic but here are some facts. First of all, we were might say somewhat surprised it maybe even more than that very surprised that letters that were sent in to the post office would in fact result in a relational Anthrax among postal workers. Not just cutaneous. Why do I say that well because we know that when these spores these pieces of bacteria that are of such small size When they're actually released it's almost like a puff imagine instead of a bunch of bacteria floating in the air imagine a perfume or a you know, an odorous material when that's in a room or in a building that literally happens and it's out of there with in some cases minutes depending on the ventilation system up to within an hour to two hours. All of this are testing is going on right now in postal offices is bogus. It doesn't mean anything because what happened happened during that very quick time period to get in a relational Anthrax. That's because those very very small pieces are exhaust out of the building quickly where you have the larger particle sizes the imagine the ones floating in the air is equivalent to say and now Imagine The Boulders that were also part of this mix the kind of fell to the floor fell on the surfaces to get those aerosolized again in break them up into small enough pieces to inhale into your lungs is virtually impossible to do without an extraordinary source of energy on the case of the postal situation. What happened we believe is we had no idea that those We're still sorting machines were such good Munitions me and they were like guns when they when they smack that letter as it was going through there. Obviously, they could get Puffs out. In addition. There was potentially the risk where they used air guns where they went back in there and literally were cleaning out the machines with these high-pressure dares guns, which could are slice some of that but beyond that there's a postal worker will should never be at risk of inhalational Anthrax could they get cutaneous potentially very unlikely that it would be in a second or third level of letter out there but it's not impossible fortunately cutaneous is a disease. It's virtually a hundred percent treatable as we've demonstrated already in this outbreak. So I think that that for the vast majority of postal workers weather in Minnesota, and I think it's unfortunate that we had a group in testing the Minnesota postal facility last night to an air samples because it's clear to me that those people don't know what they're doing and second of all it it's the postal workers here in Minnesota. They do not have Risk at this point of inhalational Anthrax in a very very remote risk of cutaneous Anthrax in the citizens have virtually none of either (00:10:59) so that test that was conducted at the postal facility last night and saying Paul was (00:11:04) bogus. You can use my words bogus and one of the reasons I'm so hard on that right now is because we have an epidemic of testing out there going on by groups who have been hired who know very little about Anthrax in the citizens have to know that because if we're going to have a credible response in this country. It's got to be based on the best science we have and if worked in doing are testing in a facility like that and let's say some envelope or some other thing ends up somewhere else every citizen out there would have the right to say wait a minute was good enough for the postal service to be tested like that. Why don't we being tested and that just furthers the myth of what really makes a difference in what doesn't make a difference so some of us are taking a stand and saying, you know, just because everything's being done right now that appears to be good. It not isn't necessarily good or (00:11:45) helpful. If I'm one of the post of people who work at that postal facility, should I just Are the test results then and assume that the place is dangerous or should I assume it's safe for (00:11:56) I would at this point absolutely assume it's safe number one because I've already made the case and this is based on the data from the 50s in the 60s were extensive work was done in the similar manner. It's based on the expertise of any number of people who have recently brought to bear on this the old bio-weapon ears. It's been based on additional scientific work that you will not have sufficient quantity of spores or the energy to aerosolize this material by just having a positive Anthrax spores somewhere in your environment. That just won't happen you've got to have is it's like a bullet you can put a bullet on a desktop all your all day long and it won't cause any damage toilets in a gun and that's what you have here. Now on top of that even if you did come in contact with that bullet with your hand and you had an open cut the amount of material that would occur as a result of a cross-contaminated letter is still very very Remote it's very small given all the letters that went through the New York New Jersey area whether it's two or three and then all the potential cross-contaminated letters were still talking about total 16 cases in this country that occurred. That's the despite the fact that literally millions of pieces of mail went through that very facility at the same time. So that then once you get one step further could that then cross-contaminate something else and then result in somebody getting it you can start to, you know, do the math and realize it's really really very low risk. So I would say here that the postal workers in Minnesota and such an extremely low risk. I can't measure it (00:13:29) one more question for you Michael osterholm. Then I want to get this we have a full Bank a callers here as you might expect in general tough to generalize but in general do you get the sense that the people we hear on the radio see on TV the health officials do they know what's going on or are they just making it up as they As they move through this crisis and in other words can people actually trust what they're hearing. (00:13:58) Well, I guess that would be like me asking you Gary. Can you trust already owe interviewers on the radio? And I guess the answer is you would I'm sure tell me is some of them absolutely some of them may be some of them absolutely not I think that part of the problem we have today is we have 24/7 TV, which means they have to cover every minute and so we have a lot of Talking Heads out there right now who are being pulled in just because there's a absence of seven minutes of coverage in a given hour and they've got to go find somebody to fill it. (00:14:29) Well, let's let's are narrow the field to the back to the to the official officials the okay. I think the Surgeon General types and you know (00:14:37) those people yeah, I think at that point you're getting very good information. I think that there there is a learning curve that for all of us relative to The Postal letter issue and could that occurred that not but I think that you are getting a much better picture today than you did even three or four weeks ago. I think Washington understands the Means of having accurate information for the public I think now you've seen people like Tony falchi the head of the Infectious Disease area at the NIH you've seen David satcher the Surgeon General you've seen Jeff Copeland from the CDC who are now some of the few that are out there talking and I think you've witnessed a might say a convergence of message much more clear message. And so I'd say I think it took us a little while but I think the government really is getting its act together in that (00:15:27) regard Michael Oster home is with us bioterrorism expertise. The director of the University of Minnesota's Center for infectious disease research and policy and he has joined us today to try to sort through what we have learned haven't learned what we should know about the anthrax threat Lord knows there's been plenty of reporting on this subject lots of information, but trying to sort the wheat from the chaff is not always easy. Let me give you the phone number here, but don't call because all our lines are busy in a few minutes. We'll clear some of the lines you'll like to get your question on. X5 12276 thousand 6512276 thousand outside the Twin Cities 1-800 to for 22828 John go ahead place. (00:16:08) Thank you very much. I'm wondering about the if there's any been any thought I imagine there has been to the idea that this threat may not have come from, you know may not have come from for example, anybody working with his Hama Bin Laden and and maybe part of something else some other group or groups of people who want to take advantage of the current climate in this country. I wonder if you could address, you know that type of information and I also appreciate your comments regarding uh separating the wheat from the chaff, and there's a lot of Talking Heads out there and a lot of fear out there, and I think part of the problem is the the media. So anyway, please respond to that. Thanks, sir. Well, thank you and Think is anyone who's been following this issue and least the comments that I've made. I've been very careful to say I we don't know who is perpetrating this event at this point and I think that anyone that says that they do know is is basing it on information that I think the highest levels of government don't have right now. I will tell you however regardless of who is doing it. This is a very very powerful material that they've developed this material based on public discussion public testimony and Congress and based on the fact that 29 individuals and Senator daschle is office and to individuals in Congress or in Senator find Gold's office actually were exposed to this just by merely opening a letter meaning that it within that first hour after they were in the room or rooms nearby when this letter was opened had the anthrax spores in their nose that tells you it's a very very high quality. Ariel that would only come from someone who has extensive experience. So if it is someone in this country, they clearly have to have a lot of know-how a lot of experience in doing this whether if it came from a rogue Nation other source, obviously, that's also clear and evident that the the the issue may not be awesome Bin Laden, even though he may have acquired it elsewhere, but it could have been a third party totally just ins coincidental with the 11th or link to the 11th only because they saw an opportunity but not because it was cause and effect. I would add one piece to this that makes me very very concerned and continues I think to set the agenda for what we ought to be looking at nationally. If I were to present to you a single chocolate chip cookie, he would say to me and I asked you what that meant. You'd probably lookin like I was crazy well to me as a as an epidemiologist I'd say whoever makes a single cookie you basically make a batch of cookies. Because that's what the ingredients call for and we clearly have enough evidence that whoever has made. This material is likely made much more of it in the process of making it because of the high quality of how they've made it to begin with and that would tell us that this wasn't a one shot deal that somebody is merely probing the system warming up you might say for what they're going to do and that is a very very Troublesome fact. And so I think that we have to realize that the letters very likely represent just the first probe into the system as to what will do how to do it how will respond and that's what we have to really be concerned about at this point regardless of who the perpetrator (00:19:35) is assuming there is some kind of follow-up additional attack as it were is there any way to know that without other than just waiting for people to get sick? Well, I think (00:19:46) part of it is Gary that we're trying really hard right now to prevent that from happening as you know, I've packed I just arrived back from Washington DC where I've been spending most of my time right now advising. Fred Thompson on this issue and I think you're going to be hearing from the federal government very shortly a warning that will be coming out and I'm willing to say it here in Minnesota right now and stand very strongly behind it that everyone who is in the management or supervision of any large building in this country any building of historic or otherwise importance should be aware of this fact that we've got to be protecting our ventilation air intakes. Most of the buildings today are based on heating ventilation systems that have a very limited small intake area that then brings air into the building and it's forced out from there through out the ventilation system. And one of the great concerns we have is that whoever is doing this could very easily put 4 or 5 tablespoons of this material which each tablespoons containing literally hundreds of millions of infectious doses of this material and literally that that go into a ventilation system suck it up into a 25-story building. In and no one would be the wiser for it. You'd never feel it. You'd never smell it you'd never sense it in any way shape or form only to realize that a couple of days later when the first cases started developing a relational Anthrax that you now have potentially tens of thousands of people exposed. So, you know, that would be the horrible horrible scenario to understand that that's how we first recognize it. So there are some of us as past week. I made a public statement yesterday in Washington with Senator Frist about the need for Americans to look carefully at protecting the air intakes of large buildings. That would be in my mind the box cutter equivalence right now of further disseminating this to very large numbers of people and if those are the kinds of things we need to be looking at to prevent right now and if we don't prevent them at the very least we've got to be prepared to respond to them (00:21:46) and I want to go back very briefly to the to the question that our caller had or follow up on that is it can see in terms of who might be responsible for this kind of thing as you I mean nobody really knows but is it conceivable that Unabomber type character could be doing this or would you have to have a network of people working on a project like this? (00:22:09) Well again, let me just say within the context of what I can talk about publicly that this is a very very high quality material that is evident of some real professional training. It is based on a fair amount of research and how to actually make and and actually grade this material how to mill this material in a sense of what is has been done. This is not likely to be you know, some Unabomber microbiologist type person in a garage at all. The means to disseminate it to date have really been very ineffective overall for what the quality of the product is. I as you've as I said in the last time I was on the show a couple weeks ago someone has a Very powerful bullet here. They've to date used a very ineffective gun to deliver it. It wouldn't take much to make that a more effective gun. The technological hurdle was the bullet not the gun having said that someone or individuals groups who ever have done. This has a lot of experience and that begins to I think take out a lot of the just Unabomber type people from being the (00:23:21) culprit Pat your question. (00:23:24) Is there a vaccine for Anthrax and if there isn't or is why don't we see these people that have made it coming down with this? Well, first of all Pat that is an outstanding question in the sense of kind of trying to figure out who done it. Let me just say there is a vaccine and I'll come back to that but one of the issues that we've all been looking at is whether indications of individuals who were sick in July August September in various parts of the country that at the time we're not recognized as having been anthrax. That that in fact could have indexed somebody working with it that just didn't quite know how to handle it or the fact that somebody was working with it and a little bit got out and got into the air in an adjoining buildings and in joining neighborhoods that this could happen. Remember when an event like that happened in the former Soviet Union back in 1979 were less than a gram a tablespoon of weapons-grade Anthrax got out of a production facility in the former Soviet Union late one night in Griff just drifted in the wind. It literally went out the ventilation system. It was intentionally released and animals as far down Windows 70 kilometers people a number of people all died from result that exposure of less than a tablespoon. If you had a perpetrator here in this country who wasn't quite that experienced. It's very possible in the neighborhood. You had a couple of cases is something that just got out and got into the wind that hasn't been the case. We have no evidence to date in this country of cases of unexplained illnesses that in retrospect. Out that was Anthrax wasn't it that has to tell you that these people are really good. Whoever's handling. This material is really very good this past week. The FBI has released additional information, which says that the envelopes were very professionally handled not only is there not any fingerprint but there's not an evening evidence of human DNA at all of any kind on these envelopes that would lead us to understand my to be doing this. So so again that just as further evidence to me that this is being done and masterminded by both a developer of the anthrax itself and a perpetrator who may not be one of the same one could have bought it from the other one or it could be the same both the grower the material the refinery of the material in the deliver the materials one of the same. They're very good as far as the vaccine question you asked to actually again, this is something that we've talked about a number of times on this show because it goes back to the controversy of vaccinating the military. We do have an anthrax vaccine. Crude one I will tell you based on the fact that we can make better ones. But a crude one that has worked very effectively there a good data to show that it's very protective against inhalational Anthrax. Unfortunately, 26 dose regimen that we now realize probably after two doses is highly protective but it's one that's been controversial controversial because some military individuals have indicated. They think they've had severe reactions to it sort of there have been some localized reactions soreness and so forth. I tend to be one of those that dispute the evidence that there's really been severe reactions clearly people have gotten sick after having gotten the vaccine but people get sick every day in this country and it's not cause and effect and when you've actually in hundreds of thousands of people if somebody develops cancer develops a muscle skeletal disease in the next week or two two weeks is that means cause and effect. I don't think that's the case. The biggest problem we have is we don't have any of the vaccine in large quantities because the production plan for this bio-port in Michigan has basically had major production problems for the last Years, so we only have a very limited amount of it. One of the things I'm very happy to report to you yesterday. Secretary - secretary Thompson announced that he was appointing. Dr. Bill Russell former head of you Samra. The US Army infectious disease Research Institute in Fort Detrick world-famous vaccine researcher and developer and he together with others are coming in at HHS and we'll be heading up the vaccine initiative. There's a major piece on smallpox right now. You're going to hear a great deal about anthrax vaccine in the next couple of weeks and they really are developing Manhattan type projects in this area and not only to get a better vaccine but one that can be used much more effectively in terms of the number of doses and so it's coming and but unfortunately like many of us who have been talking about this for years. I wish I had been here already (00:27:48) Michael Oster home is with us. He is the director of the University of Minnesota's Center for infectious disease research and policy one of the well, he's an internationally recognized expert On bioterrorism author of a book titled living Terrors when America needs to know to survive the coming bioterrorist catastrophe. He has joined us this hour to try to sort through the barrage of information. We've been receiving about the outbreak of Anthrax in parts of the country what we know about this attack what we don't know but we should know again, let me give you the phone number. It's 6512276 thousand or one eight hundred two, four two two eight two eight. Why don't you wait a few minutes as we get through some more callers. Some of our lines will clear six five. One two, two seven six thousand or one eight hundred two, four two two eight two eight gets more of your questions right after news headlines here Stephen John's David. Thank you Gary Police and firefighters faced off this morning during a protest at Ground Zero in New York police were trying to keep angry firefighters back from a sealed-off area. The firefighters are upset about plans to scale back. The number of workers searching for bodies at the site. The reduction is being done for safety reasons, but the firefighters are worried. Some of the remains of their missing comrades will never be found. Another indication. There will be no bombing pause over Afghanistan for the Muslim. Holy month of Ramadan President. Bush says the enemy won't rest during Ramadan. And neither will we Ramadan starts in mid November many West Coast folks say they're not changing their commutes because of the new terrorism warning the FBI says there may be attacks aimed at west coast bridges in the next few days u.s. Steel firms and Steel Workers said today, they would propose tariffs ranging from 30 to 50 percent on the bulk of u.s. Steel Imports to give domestic producers time to restructure. The recommendations will be forwarded to the US International Trade Commission, which last month rule that domestic producers had been harmed by Imports. The ITC will begin hearings next week in the remedy phase of its investigation a report by the University of Minnesota is calling for a Statewide commission to find solutions to the worker shortage in Minnesota's long-term care. 3 the report says the worker shortage is hurting care for the state's elderly and that better pay a loan cannot fix the problem State Health commissioner. Jan Malcolm is encouraging minnesotans to get flu shots this year Malcolm told a senate committee. That getting a flu shot is a good idea this year since it could help reduce the incidence of diseases that may be confused with Anthrax. Mostly cloudy skies this morning and afternoon now in the Northeast with a chance of showers, then becoming partly cloudy mostly sunny and Breezy elsewhere highs in the mid 40s Northeast to low 60s South West sunny and Moorhead 48 degrees now, it's cloudy and Duluth with 44 sing cloud has a sunny sky and 53:59 and Marshall 55 in the Twin Cities, and that's the latest from the MPR news room. Thank you. Stephen 25 minutes before one o'clock. This is midday on Minnesota Public Radio in our guest this hour Michael Oster home director, the University of Minnesota's Center for infectious disease research and policy Joy has a question online from Buffalo Joy. Go ahead place. (00:30:56) Thanks for taking my call. Of your home. It was encouraging to hear your initial comments about the potential for infection at least currently being low because the vehicle is is not that well developed. However, I am a family practitioner who practices in the land of the worried well (00:31:10) and (00:31:12) differentiating between Anthrax and flu and a large patient population of mine does travel across the country. And so even though we are we perceive ourselves as being low risk at this point. Maybe you can go on to talk about the difference between the two and how we could best look into that. Well, first of all, let me just say thank you for the call. And this has been one of I think the issues that America really doesn't see in the face of the anthrax threat is it's been Physicians just like this caller and others who have been the front lines. We see fire and police often involved with this and they do have some role Hazmat has some role but it's really been the Frontline Physicians emergency rooms, very astute Physicians, by the way. In some cases, I'm convinced or absolutely responsible for some of the people who didn't die because of the early recognition of this but it does pose a really difficult Challenge and you know this living in fear, which every sign or symptom could be Anthrax versus not is is a challenge. I think a point that was just made in the news broadcast just now commissioner Malcolm was testifying yesterday on the flu vaccine and and I just want to clarify this issue because I know the health department actually is very clear on this issue and they've done a great job in the flu issue. We're not recommending that everyone go out and get a flu shot which is unfortunately kind of the message that some people are perceiving was given and wasn't what was given today. We only have 85 million doses of flu vaccine for this season. That's a problem only in the sense that would be ideal if we had 300 million then we could tell everybody to get a flu shot influenza kills 10,000 up to 20,000 people per year given a bad year in this country. And we don't want to lose sight of that the people who are most at risk of a fatal outcome or the elderly people are immunocompromised to have any underlying health conditions. And we want to make darn sure we have enough vaccine for those people. So if you're 25 years old and healthy today, you should not be going out and getting a flu shot because you are going to take it away from someone else who very well needs it and in the ideal world where everybody had a dose that would be fine. So first of all, that's an important message right there to clarify that issue second of all is the fact that I think the one thing we're going to be doing here is trying to provide the kind of educational experiences for Physicians and so forth to help differentiate when my takase be Anthrax when it won't be and it's not going to be a bright line that says yes or no. Ideally. We need better Diagnostics many of us have been saying that wouldn't it be great if we had a rapid test that individual physician could use on a blood sample for example in no right in the office does this patient have the beginning of Anthrax infection or is this patient actually got some other thing? Those have all been lagging? I think the R&D the research and development component is going to be there now because people finally get it they realized the need for these kinds of tests. But in the meantime docks and citizens are going to be stuck. I would only reassure people that again, I don't believe it's also been Laden he has most minnesotans address in his Rolodex. I don't believe that they've got to worry about the fact they're going to get a letter from him that's going to transmit Anthrax. Do they have to worry that in fact a letter cross-contaminated coming out of Washington DC again that risk is so infinitesimally low. So part of it is in this is a balance that I have had a very difficult time personally dealing with is how do we keep our level of awareness Our concern in perspective to what is the real risk for any one individual? I worry about that big building getting hit I absolutely do and I don't want to see us have to one day go back and ask why 20,000 people died needlessly because we could have protected an air intake system. But an everyday basis your chance of developing Anthrax as a result of a letter right now in this country. Tree is much lower than getting struck by lightning and trying to blend those two together to come up with a very affirmative and a very thoughtful public policy is not an easy thing to do. And unfortunately the docks is a state in this country are on the front lines trying to deal with that interface every day. And there's no magic (00:35:14) answer. It is difficult for people to sort out what to what to what message to take away because it did seem like yesterday commissioner Malcolm was saying everybody should get the flu shot. So then at least they could eliminate that from there at the the spectrum of things to worry (00:35:30) about well in in in the ideal world would be great to get a flu shot for everyone again, and I know the commissioner Malcolm was commenting in the context of making sure the people who are at risk of having a potential high-risk illness with blue should get vaccinated. She's well aware of the fact is is the department our department has done an incredible job here in Minnesota in both furnace for bioterrorism. Dr. Richard Alan the group there have I think just been a national example In how to work with the medical community attempting to put together information and so forth and clearly we have one of the best vaccine-preventable disease groups in the country here and they know that it's just ideally if we had you know, basically four point seven million doses of vaccine a lot of the Minnesota for flu. We could make that recommendation. We don't and so we've got to still make sure that we get at or high risk people and knowing that it's going to be delayed again this year unlike are just like last year. We had the same problem. We're even worried about making sure that we get enough vaccine to people so if there's any civilian out there who believes that they need and want vaccine there under 40 years of age. They're healthy. Please don't go get it because in fact you are taking it away potentially from someone who really needs it and I think that that's a very important message one last question on (00:36:44) the the flu business. There is a story going around that says well with Anthrax you don't get a runny nose. So if you have a runny nose, then you don't have Anthrax is that true? (00:36:54) Actually there's some truth to that but part of the experiment. We have only a limited experience quite honestly with inhalational Anthrax and there's a group of us right now that are involved with a very extensive review of these cases. I'm part of an expert group is currently reviewing the 16 cases that have come in to date. We'll have our findings by early next week. And one of the things we're attempting to do is say Okay based on the experience we have today with these most recent cases. What can we say? Clinically that will give us the best information on a very small in very small number of cases that we can get that information out. So I think even that piece of advice is a little bit premature to say, but that's the kind of information we need the unfortunate thing is the way we're going to get a lot more experience with this and be able to tell people what they can use a signs and symptoms. We have two more cases and what we don't want so we're kind of in a conundrum here Lisa your question. Good afternoon, and thank you for taking my call. I can't wait to get back to the vaccine issue again. Sure. Now the anthrax vaccine manufacturers been cited for problems, very strong manufacturers of Hedrick. For contaminants in the process when I'm concerned about is the actual security of the vaccine Supply because of the potential for tampering either during the manufacturing process or the distribution process with whatever sort of harmful biological agents. Someone might choose to tamper with. Well, thank you for that. Again. That's an excellent call. I mean it may sound like Tom Clancy sci-fi here that you're talking about. But in fact that's a very important consideration. What a way to enhance the terror is actually go at the very tools that you might use to attack the terror and do them in and so that in this regard great deal of emphasis has been placed on the safety and integrity of the product through production and delivery. Now, I can tell you that the problems that the corporation that has been making this bio-port has had have been more in good manufacturing practices that aren't related to the safety of the vaccine per se it's making sure it's stabilized quantity stabilized potency. APS using that's what were the issues have been is not been around safety considerations per se but as we find that, you know, I used to say out there that you know, you were worth your weight in gold. And of course that was a standard everybody could understand today. I say you're worth your weight in smallpox vaccine and takes on a whole new value. And so that that's a very important consideration and you're absolutely right. And one of the things that was done early on was a great deal of additional security placed around not only the vaccine manufacturing facilities the product but also the distribution line (00:39:31) seems like Secretary of Health and Human Services secretary Thompson, if I recall right indicated or indicated here a little while ago that soon they would have enough smallpox vaccine for everybody. Is that (00:39:45) true? Well, actually I think you know we talked last time I was very involved with those discussions out in Washington and I was one of those that urged the secretary to push for 300 million doses of smallpox vaccine. I honestly believed Beyond Shadow of a doubt that if we could say to every American there was a dose out there with your name on it that should smallpox ever happen that it would at least allay some of the panic and fear that might occur if rather than Americans thinking there's only a hundred million doses. Am I going to get mine? And you know, there has been a lot of media attention paid to the gaps or the you know, the mistakes that have been made and I think secretary Thompson is also on a learning curve as an elected official and trying to deal with complicated science information. I can tell you having worked with him. He is a genuinely very concerned individual who I believe beyond a shadow of a doubt wants to do the right thing and is attempting to do the right thing. I you know, I did not had not worked with him before this situation didn't know him. I have no political ties or political Persuasions that way but I recognize an American who cares deeply and is responding first and foremost as a patriot not a politician and I'm actually very Happy to tell you that because I'm not as I wouldn't have told you that if I didn't believe it having said that I think that what secretary Thompson did in ordering the federal government response was remarkable, you know, three and a half week period his office was able to put together an entire procurement document detailed descriptions arranged for the financing and put into place. What is no less a Manhattan project for smallpox vaccine. You know, Gary you've heard me on this show say before that. We were hoping to have 40 million doses by the to your 2004 to 2005 and that was not going to do it. I am convinced we will have 300 million doses of smallpox vaccine within 12 months. It is remarkable and all of the vaccine manufacturing industry has responded as Patriots. I mean, obviously you can say they're going to make some money on this thing, but it's been incredible the kinds of efforts have been placed in this thing. And so that's one of the successes that's one of the American can-do kinds of things. As a country if we decide we're going to do something is remarkable. We can do it just took people a while to understand that. This is a real war both on a foreign Shore in our own Shore and that they have to do this. So I you know, I pray to God there isn't something that happens with smallpox in the next year. We will be able to respond but can we respond sufficiently? I don't know but I'm absolutely convinced that within the years time we will and I might add that those doses all won't be delivered 12 months from now production will actually start within the next few months in large quantities, and we actually believe that will will be at 300 million and 12 months. (00:42:33) Jim your question. (00:42:34) Yeah. Hi. Thanks for taking my call. I'm I'm actually most concerned about who is going to protect the money supply and whether or not that's being screened. We know that these terrorists are obviously suicidal. What's the prevent them from taking cash laying it out in their apartment spreading the anthrax spores on the cash going out that day and spending it. I work in retail. I know that money is Positive nightly and I'm just curious if we think that these letters and tracks and letters is killing people if that got into the money supply. It could lead to hundreds of thousands of people being affected and I'll take my hands off the air. Yeah again, another important kind of question in terms of how do you anticipate ahead of these terrorists? And that's one of the things that our group in Washington have been doing is trying to figure out you know, what might be the next shoe to drop and therefore where should we be one step ahead of them again. I just come back to the money supply issue because it has been discussed. It's been evaluated is as I pointed out earlier, even if they had spores on these dollar bills to $10 bills two hundred dollar bills without the kind of energy the the very effective power applied to those dollar bills. You're not going to get sufficient quantity of Anthrax spores to cause an Elation Anthrax, which you could start causing his cutaneous Anthrax now, I'm not going to sit here and publicly try. You know understand a terrorist because first of all, I wouldn't want to give away a card that we might hold but second of all be crazy because God knows what they're thinking but I will tell you that just on the outset if I were a terrorist and I wanted to make sure people knew what was doing this. I wouldn't put it in the money because with money exchanging hands as it does in the way it does even if I got cutaneous Anthrax, it might very well never be found that that's how it happened or why it happened. So it wouldn't accomplish shutting down the money side. It would still create panic and fear about four or five unexplained cases of Anthrax in the community, but nobody figure out was money because there'd be such a disjointed relationship there. And so I don't have a fear at this point that they will be able to shut down the money system. What they could do, of course is and we've already known this in the mail servicers there is people pay their bills by males. So does that begin to affect the economy and we have to look at that very (00:44:54) carefully. Here's a dumb question. If you get the skin type Anthrax are you do you have some immunity then down the road from inhalation Anthrax? (00:45:04) Well, first of all, it's not a dumb question. That's a great question the amps answers. Absolutely. Yes, that is very good thing you actually developed immunity long-term particularly since most people will not be caught better lie and you will start to develop some immunity and you know in that regard, let me just make a comment and I know Gary you will shudder at my suggestion at this but you know, I think minnesotans and I know you're in pledge week and I heard somebody you were talking about this earlier, but don't (00:45:30) fortunately we're done (00:45:31) with what you're done with that. Okay. Well, excuse me. I've been out of the state so I can't keep up with it. But you know, your program has been I think the single best form in this country for disseminating information on this area and I think minnesotans are very fortunate because there is a lot of bad information out there right now and I you know, I just have to give credit where credit's due and I think Kim PR deserves a great deal of credit. I mean I can just tell you the for my ability to be on this form several times in the last few weeks has been And by far the most complete and you know the best opportunity to kind of share the general sense information, so I have to give you great credit and I think that's what we're going to need more of his shows like this that people can actually get more information more comprehensive information more thoughtful information and not just, you know to Second Banner headlines that just scared the hell out of people without any context or without any understanding of what those headlines (00:46:20) mean. Thank you, sir, Carol your (00:46:22) question. I had heard recently on one of the major news programs that they had found two ingredients in this strain of Anthrax that were key ingredients in Iraq's development of Anthrax. Is there any truth in that? I can't comment on that as much as data still classified information. Let me just tell you that this material is a material that is not just Anthrax spores, but there's additional additives to it, which has made it even more effective in staying in the Are potentially made it more effective at actually being introduced into the lymph nodes of the chest and only very few programs that we know of have that level of expertise. So I can't say at all that this isn't a rocky product again. I just come back to the fact that this is a very very high level material. This is exactly the kind of material that Gary and I had talked about many times on this show that I feared more than ever would fall into the hands of someone willing to use it and ladies and gentlemen, the Genies out of the bottle. It is out there. It's a very very high quality material. (00:47:33) Let me ask you this understanding there are things you can't talk about there is a I think among the general public a perception that nobody knows anything about this. I have no idea who's done this they don't know anything about it. Can we safely assume as members of the general public that somebody knows more about this than has been disclosed publicly. Clay, and and that there are people working behind the scenes on making some progress frankly in determining what's going on here. (00:48:05) Well first and foremost, this is obviously a criminal investigation. It's a public health investigation at the same time, you know, I can't and won't comment on the criminal investigation aspects to it from a public health investigation standpoint. Obviously, it's a very complicated and difficult one. I can assure you that the very best minds and resources in this country are going into trying to find the perpetrator of this now not just to bring them to justice for what they've done but to make damn sure that they don't do it again and I think that's really a very very important message that I am convinced that the very best Minds energy are going into this and this government is taking this very seriously. And you know, I'm confident that down the road somewhere somehow we'll find him. I my concern continues to be that a that we won't find him in time before they do something. Listen be even if we do find them. We now live in a world where terrorism is an accepted means of you might say adjudicated ones decisions in life. And number two is the fact that this is going to be going grouper individual that has weapons. There are going to be more people out there that have this expertise we know of at least 17 Rogue Nations. We know of Splinter groups groups that have have hired the the wherewithal of the former Soviet Union bio-weapon ears and so forth. And so one of the things I think that the president has made very clear is that this is a war against Bin Laden, but that is a world we have to understand we've hit a new order terrorism is now something that is within the reach of a number of different organizations and groups that might very well use these these (00:49:41) weapons wretch your question. (00:49:44) Oh, yes. Thank you. You had mentioned earlier the the possibility of an attack on like a large building are the filtration systems in those buildings. Completely ineffective partially effective or or what? I guess yeah for the most part Rich, they're terribly ineffective. And the reason for that is because we never thought about trying to filter out a 1 Micron particle size, which is in fact infinitesimally small particle just on the normal material that comes in from the outside whether it's you know, just dirt and leaves and and the very large piece of material down to the finer pieces of dust. You've seen how your furnace filter gets clogged or the intake and somewhere in your own personal furnace in your house. Now imagine for a building that is using an extensive amount of air coming in any kind of filter that would get down to that one micron size would plug up almost immediately. What we need to do is work on new methods there. We have things in hospitals and many industrial applications called clean rooms where we actually do try to filter down and week successfully filter down to To the Micron size particle, but the problem is you have a lot of steps before that are gets to that point where it's already been pre-filtered. There will be a lot of research in this area. There are some activities already going on electrostatic charge filters that actually use zap dust and particles out and allows larger particles be taken out that way so that by the time the air hits the very very small tight filters. It's no longer clogging them up, but that's not going to help us in the short term right now. There are many buildings out there whose air intake systems are right on the first floor level because it's convenience for maintenance anybody could walk by dump something in one of those air intakes. I'm not telling the bad guys what to do. They will, you know, they already know that and we as Americans have to understand that the good guys have to get ready to do something about that. And that's why we're urging people who have such buildings that they take every make every effort to make sure that those air intakes are (00:51:54) protected just about out of time Kresser real quick question before We wrap up (00:51:58) high. I understand that Cipro and doxycycline can be used to treat Anthrax, but I'm wondering about other types of antibiotics. My doctor has me on prophylactic antibiotic therapy 365 days, and I'm just wondering if I'm covered there's a number of different antibiotics that will work doxycycline is one that we've gone to now as opposed to Cipro. It's a very effective antibiotic both in terms of preventing infection. If you've been exposed and treating you afterwards penicillin has some effect here we're looking at that more carefully as or maybe some penicillin resistance here, but the key factor is that we have the bugs they've all been the same so far your doctor will know which treatments to use and and that's a very good piece these again have been antibiotic sensitive across the board and it made it a lot easier for us to respond that may not always be the case in the future. (00:52:46) Finally. The east coast is really been been smacked by this particular outbreak of Anthrax have health and they seem to be they say they're learning as they go along here. Kind of getting their systems up to speed Health officials elsewhere around the country tracking along with that and getting their systems up in advance or (00:53:05) I kind of waited. Yeah. I think we're all struggling. I mean frankly again. One of the things I did yesterday. I was spoken in that group in Capitol Hill and I took Congress to task and our own Congressional Delegation knows that very well because you know within days the September 11th event, we build out the airline industry last week Northwest Airlines reported a quarterly profit Continental reported quarterly profit because of the bailouts not a single penny not a single penny has come to state or local Health Department's out there from Washington DC September 11th, and they have done the Lion's Share of the work and trying to respond to these issues and prepare us for the potential future issue. And I think that has on from Washington DC sent a very bad message to how DC and our Capital values public health and the Medical Care community and that's got to be rectified Senator Frist and Kennedy are trying to do that. Give them great credit for their bipartisan effort to do that. And if they don't do it soon, there's going to be a lot of Public Health agencies out there. That won't be in the position of responding should something much larger happen and Americans if you can do anything today don't go out and buy gas masks don't go and take antibiotics contact your congressmen and senators and tell them to get with it. They've got to understand that the locals and states is where the action is going to be if they're not supported and don't have the resources don't be surprised when you don't have an adequate response or even a minimal response when one of these things happened (00:54:28) my cholesterol and thanks for joining us. Thanks for the information. Thank you for talking with it Michael osterholm who is former Minnesota state epidemiologist. He is currently the director of the University of Minnesota's Center for infectious disease research and policy. Well that does it for our midday program today. I'm Gary eichten. Thanks so much for joining us. Hope you learn something today. Sarah Mayer is the producer of our midday program care a fig and shoe is our assistant producer. We had helped this week for Mike. Upendra Clifford Bentley Cara hetland Scott laborers and Genaro Vasquez. We have those debates two o'clock the Saint Paul candidates seven o'clock the Minneapolis candidates Sunday night. Hope you can join us. Otherwise tune in Monday for Midday on the next all things considered a look at Governor. Ventura has self proclaimed war against the media plus the rest of the day's top stories on the next All Things Considered weekdays at 3:00 on Minnesota Public Radio, KN o WF M 91.1 We have a sunny Sky 55 degrees at Kinder wfm 91.1 Minneapolis. And st. Paul sunny and Breezy through the afternoon with a high near 60 clear skies are forecast for tonight with an overnight low in the mid 30s. Sunny tomorrow high in the low 60s partly cloudy upper 50s on Sunday. Talk of the Nation Science Friday will be coming along here. Just as soon as we can get our technical issues worked out. Apparently we're having some satellite difficulty between are receiving station here in st. Paul and National Public Radio in Washington DC. Hopefully that will be resolved and then we'll have Science Friday while we have a moment. We mentioned the debates the mayoral debates again, we do invite you to join us on Sunday in person. If you can two o'clock at the Fitzgerald theater, the st. Paul candidates will be on hand and at seven o'clock at the Minneapolis public library in Downtown Minneapolis, the Minneapolis mayoral candidates will be debating the issues will hope you can join us in person will have the debates on the radio and on the web but to see you Sunday two o'clock and 7 o'clock. Let's catch up on news.