TRANSMITTAL OF POLICY MEMORANDA

File: 120396_sep96_decls87_0005.txt
Page: 0005
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 22041-3256


                FTEPLY TO
                ATTEMTION OF
           SGPS-PSP



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

           SUBJECT: Policy for the Use of Botulinum Antitoxins


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

           2. Discussion:

               a. Botulism results from the irreversible binding of toxins
           produced by any of seven serotypes of Clostridium botulinum to
           neurons blocking neurotransmission. I      biowarfare attack,
           botulinum toxin would be delivered by aerosols with rapid adsorp-
           tion and distribution throughout the body. Onset of symptoms is
           dose-related, but could occur as quickly as 2-3 hours after
           exposure.

               b. Several botulinum antitoxin preparations are potentially
           available. Equine antitoxins are available from several sources
           worldwide. A commercial trivalent product is distributed by the
           Centers for Disease Control for treatment of food-borne botulism.
           Its efficacy is unproven outside animal studies. Use requires
           pretesting for sensitivity to horse serum, and disadvantages
           include limited serotype coverage, rapid clearance, and risk of
           serum sickness. A human pentavalent antitoxin produced by
           plasmapheresis of toxoid vaccinees is available in  'very limited
           quantities. It is an investigational product. Neither safety
           nor pharmacokinetic studies have been performed. There is no
           prospect for additional human antitoxin to be produced and made
e
           heptavalent antitoxin has been prepared by cleaving the FC
           fragments from horse IgG. This technology has been used for
           preparing human anti-lymphocyte serums. There is no experience
           in humans with this antitoxin. Dose has yet to be determined,
           but should be approximately 10 ml.

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




                                            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