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Reprinted from:
Palm Beach Post

Anthrax drug Cipro blamed for lingering ailments

Cipro was approved in 2000 for treatment of anthrax poisoning, but it had to be done without testing on humans because there were no anthrax victims to test it on.

By John Lantigua, Palm Beach Post Staff Writer
Sunday, October 20, 2002


For some American Media employees, veterans of last year's agonizing anthrax scare, it isn't over yet.

A very small number of people say they continue to suffer physical problems that are both persistent and perplexing. They attribute those discomforts to the drug they were given to fight possible anthrax poisoning -- Cipro -- a product of the Bayer Corp.

In fact, some have decided that the medicine has posed more of a threat to them than the malady -- a claim challenged by some doctors involved in the crisis and by the company. But the federal Centers for Disease Control and Prevention in Atlanta is concerned enough that it is in the middle of a two-year study of people who took anthrax antibiotics.

"I think the stuff is horrible and wish I hadn't taken anything," says a 45-year-old mother of two who still works at AMI and asked that her name not be used. "Ten days into taking it, I got pains in my right foot, and then it started in my left Achilles tendon. I stopped taking it after 20 days, but in all the months since I haven't taken a step that I didn't feel it."

Computer technician G.T. was working at AMI as a contract employee last October when anthrax was discovered in the Boca Raton building, and he took Cipro as recommended by county health authorities.

"I've had respiratory problems ever since," he says, adding that his doctors have him taking Allegra, an over-the-countermedicine for allergies that he never needed before.

Jill Perel, wife of David Perel, editor of AMI's The National Enquirer, suffered severe illness after taking Cipro, including vomiting, major muscular pain and pounding headaches, and had to be hospitalized. She stopped taking it after seven days.

"I figured it would be easier to die of anthrax," she said recently, although she has now recovered fully.

"But there are employees who have suffered more than I have," Perel says. "I know there are people, especially those who are very physically active, who've had problems. It seems the more physically active a person is, the more problems they've had and some of them run marathons."

None of those interviewed hesitated to take the Cipro when it was offered, and they all signed releases freeing county health authorities of responsibility.


'We were all flipped out'

The releases were requested because, with fears of bioterrorism growing among federal officials, Cipro was approved in 2000 for treatment of anthrax poisoning, but it had to be done without testing on humans because there were no anthrax victims to test it on.

"I don't really know what I signed. We were all flipped out," says the mother of two. "I would have signed to take poison, that's how afraid we were."

Stonecypher agrees. He was asked to provide a verbal release, which was taped.

"I would have said anything to know what was happening to me," he says.

According to the CDC, 1,132 people who either worked for AMI, were related to employees, had been in the building in the previous 60 days or worked at post offices that processed AMI mail took antibiotics. Most -- 86 percent -- were put on Cipro, two 500 mg doses per day, and the recommended duration was 60 days. The others -- including children and pregnant women -- were given either amoxicillin or doxycycline, also antibiotics, and were also placed on 60-day regimens. Cipro is not approved for children or pregnant women because clinical testing showed cartilage and tendon damage in immature rats.

A study by the CDC released this month revealed that of 5,343 people studied who took the anthrax antibiotics last year -- not only in Florida but in New York, New Jersey and Washington, D.C. -- 57 percent reported adverse side effects while they were taking the drugs. Almost all were minor, with the most common being nausea, vomiting, headaches and dizziness, but some also suffered tendinitis, fainting spells and seizures. Sixteen percent of those people, including Jill Perel, were sick enough to require medical attention.




Largest-selling antibiotic

The Bayer Corp. says Cipro is the largest-selling antibiotic in the world and has been prescribed over 280 million times since it was introduced in 1987.

It is most often used for one to two weeks to treat such ailments as acute sinusitis, infections of the lower respiratory and urinary tracts and cystitis in women, but it is strong medicine and also has been used for longer periods to treat bone infections and cystic fibrosis.

After anthrax was discovered at AMI, Bayer went on a 24-hour production schedule and produced at least 200 million tabs of Cipro to head off a possible anthrax epidemic, which has yet to happen.

The FDA lists the possible side effects of Cipro as dizziness, tremors, hallucinations, depression, increased risk of seizures, hypersensitivity, colitis and increased sensitivity to the sun. Another side effect is tendinitis, including possible tendon rupture, and it is that infirmity that seems to have lingered more than any other in some unlucky individuals.

"But I believe that warning about tendinitis is right on the bottle," says Bayer spokesman F. Bennett. "And people taking it are also advised that they should contact their doctors if they are having an adverse reaction."

Bob Michals, a reporter for The Star, suffered a foot injury while taking Cipro.

"I was out for a little jog, and I had a tendon snap like a rubber band. I still have a bump under my skin from the scar tissue," he says. But his foot pain has disappeared since then.

The mother of two says she and her workmates suffered various side effects.

"I suffered immediate and severe drowsiness which lasted for months," she said. "And we would have what we called 'Cipro moments.' You would forget completely what you were saying in the middle of a sentence... and problems with anger, suddenly blowing up."

She says those other problems have passed, but the tendinitis hasn't.

"I can't take my kids anywhere that involves standing or walking," she says. "No state fair this year. No Halloween night in Orlando. I couldn't do the Fourth of July because of the walk to the fireworks."

Stonecypher says his respiratory problems have also persisted.




Epidemiologist unsure

But epidemiologist Dr. Larry Bush of Atlantis is doubtful. Bush, who treated Bob Stevens, the AMI photo editor who died of anthrax, insists Cipro side effects are common but only as long as a person is taking the medicine. He said Cipro can be taken in heavy doses and for weeks at a time, as it was by AMI employees, and that it disappears from the body some 48 hours after the last pill is taken.

Bush thinks many lingering symptoms are the result of stress.

"We are dealing with very subjective symptoms," he says. "I think that the people involved could have some lingering psychological effects from what happened at AMI. But the symptoms are not related to the disease or to the drug, but to events and to fear."

The CDC, in its most recent report, agrees that stress may have contributed to the side effects reported, but the report also maintains that the high number of people who suffered adverse short-term effects suggests the need for further study.

The mother of two doesn't believe her symptoms have been brought on by stress.

"Stress isn't affecting my MRIs," she insists. "My MRIs show swelling in my tendons."

She cites a study by three Kansas City, Kan., physicians published in 2000 that indicates that out of every 100,000 Cipro takers, some 15 to 20 have serious tendon problems, and some of those develop months after the dosage is ended. She appears to be one of those few unlucky individuals.

But Jill Perel says whether the lasting side effects are real in the case of some people or psychosomatic in other cases, one thing is for sure.

"Emotionally, we'll all never be the same."

john_lantigua@pbpost.com

Reprinted from:
Palm Beach Post

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