TRANSMITTAL OF POLICY MEMORANDA

File: 120396_sep96_decls86_0005.txt
Page: 0005
Total Pages: 6

Subject: TRANSMITTAL OF POLICY MEMORANDA                                 

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003203

Folder Title: TRANSMITAL OF POLICY MEMORANDA                                                                  

Document Number:          1

Folder SEQ  #:        179






                             DEPARTMENT OF THE ARMY
                            OFFICE OF THE SURGEON GENERAL
                                   5109 LEESBURG PIKE
                                FALLS CHURCH, VA 22041-3258

               FTEPLY TO
               ATTENTION OF
          SGPS-PSP



          MEMORANDUM FOR COL ROBERT P. BELIHAR, COMMAND SURGEON, U!      Om,
                           MACDILL AIR FORCE BASE, FL 33608-7001

          SUBJECT: Policy for the Use of Botulinum Antitoxins


          1. Purpose: To present policy for use of botulinum ant:        S.

          2. Discussion:

              a. Botulism results from the irreversible binding oi       ns
          produced by any of seven serotypes of Clostridium botulii
          neurons blocking neurotransmission. I a biowarfare attz
          botulinum toxin would be delivered by aerosols with rapi(      rp-
          tion and distribution throughout the body. Onset of symi       is
          dose-related, but could occur as quickly as 2-3 hours afi
          exposure.

              b. Several botulinum antitoxin preparations are pot(       ly
          available. Equine antitoxins are available from several        es
          worldwide. A commercial trivalent product is distribute        he
          Centers for Disease Control for treatment of food-borne I      SM.
          Its efficacy is unproven outside animal studies. Use rec
          pretesting for sensitivity to horse serum, and disadvanti
          include limited serotype coverage, rapid clearance, and i      f
          serum sickness. A human pentavalent antitoxin produced t
          plasmapheresis of toxoid vaccinees is available in very I      d
          quantities. It is an investigational product. Neither i
          nor pharmacokinetic studies have been performed. There i
          prospect for additional human antitoxin to be produced ar      e
          available in the foreseeable future. A "despeciated' eqL
 by cleaving the F
          fragments from horse IgG. This technology has been used f
          preparing human anti-lymphocyte serums. There is no expe       e
          in humans with this antitoxin. Dose has yet to be deters
          but should be approximately 10 ml.

          3. Recommendation: Insufficient quantities and/or abser
          information precludes recommending antitoxin for general
          exposure use. Once bottled and tested, the despeciated a
          toxin will offer an option for post-exposure prophylaxis.




                                          FREDERICK J. ERDTMANN
                                          Colonel, MC
                                          Chief, Preventive and mil
                                            Medical Consultants Div

Document 6 f:/Week-36/BX003203/TRANSMITAL OF POLICY MEMORANDA/transmittal of policy memoranda:11259610133626
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = TRANSMITAL OF POLICY MEMORANDA
Folder Seq # = 179
Subject = TRANSMITTAL OF POLICY MEMORANDA
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 25-NOV-1996