TRANSMITTAL OF POLICY MEMORANDA

File: 120396_sep96_decls87_0004.txt
Page: 0004
Total Pages: 6

Subject: TRANSMITTAL OF POLICY MEMORANDA                                 

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003203

Folder Title: TRANSMITTAL OF POLICY MEMORANDA                                                                 

Document Number:          1

Folder SEQ  #:         39






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


               REPLY TO
               ATTENTION Of
          SGPS-PSP



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

          SUBJECT: Policy for Use of Botulinum Vaccine


          1. Purpose: To present policy for use of botulinum vaccine.

          2. Discussion:

              a. Botulism is caused by the action of toxins produced by
          Clostridiurn botulinum on neurons, preventing release of
          acetylcholine and blocking neurotransmission. A biowarfare
          attack by aerosolized botulinum toxin would be expected to cause
          symptoms similar to those observed with food-borne botulism.

             b. A pentavalent toxoid of C. botulinum types A, B, C, D,
          and E has been shown to be effective in inducing serum antitoxin
          levels in humans. Data suggests that limited and transient
          antitoxin levels are induced after 3 injections. There is little
          data available to assess immunogenicity after 1 or 2 doses,
          although lower levels of antitoxin than those currently
          recommended for laboratory workers may offer protection in a
          field setting.

              C. Contraindications include sensitivity to alum,
          formaldehyde, and thimerosol, or hypersensitivity to a previous
          dose. After the first dose, 2-4% of vaccinees report erythema,
          or induration which peaks at 24-48 hours. Frequency of local
          reactions increases to 7-10% after the second and third doses.
          Mild systemic reactions are reported in up to 3%. Severe local or
          incapacitating reactions are rare. The vaccine must be
          refrigerated but not frozen.

n available stocks, three (3) doses of
          0.5 ml by deep subcutaneous injection at 0, 2, and 12 weeks are
          currently recommended for preexposure prophylaxis for only highly
          selected individuals or groups. A dose at 52 weeks should be
          considered if additional vaccine becomes available.





                                          FREDERICK J. ERDTMANN
                                          Colonel, MC
                                          Chief, Preventive and Military
                                            medical Consultants Division

Document 6 f:/Week-36/BX003203/TRANSMITTAL OF POLICY MEMORANDA/transmittal of policy memoranda:11259610133727
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = TRANSMITTAL OF POLICY MEMORANDA
Folder Seq # = 39
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