COMMENTARY

CDC's Emergency Drugs for US Clinicians and Hospitals

Julian Jolly, PharmD, RPh

Disclosures

June 05, 2017

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Hello. I am Dr Julian Jolly, a pharmacist with the Centers for Disease Control and Prevention's (CDC's) Drug Service in the Division of Scientific Resources. I'm here today to talk about the emergency drugs offered by CDC to treat rare diseases, and how clinicians in the United States can get access to them for their patients.

Figure 1. Los Angeles CDC quarantine public health officer Kenta Ishii takes a call for help with an emergency drug shipment. (Photo by Julie Konidakis, CDC)

Imagine that a patient arrives at your local emergency department with a partially paralyzed face, droopy eyelids, and slurred speech. After a diagnostic assessment, you suspect botulism and call the state health department to notify officials about the patient. You and the health department then call CDC's Emergency Operations Center for a consultation. A CDC botulism duty officer assesses the case with you, and agrees with the suspected diagnosis (Figure 1).

The duty officer quickly contacts the nearest CDC quarantine station with heptavalent botulism antitoxin stocked by CDC's Drug Service and authorizes shipment to the hospital (Figure 2).

Figure 2. Erin Rothney, officer in charge of CDC's Chicago quarantine station, prepares a package of botulism antitoxin for shipment. (Photo by Derek Sakris, CDC)

CDC's Drug Service and quarantine stations collaborate to distribute certain emergency drugs for critically sick patients, 24/7. The quarantine station springs into action and gets the antitoxin out on the next available flight. Within hours, your patient receives the antitoxin and is saved from further paralysis—or death.

The CDC Drug Service is a unique pharmacy that clinicians and hospitals can use in an emergency when they need certain lifesaving drugs that no one else has. Drugs provided through this CDC service either aren't commercially available or are in limited supply in the United States. They are usually available from CDC under investigational new drug protocols.

 
The CDC Drug Service is a unique pharmacy that clinicians and hospitals can use in an emergency when they need certain lifesaving drugs that no one else has.
 

From CDC headquarters in Atlanta, CDC's Drug Service distributes, through common courier services, a small formulary of drugs, biologics, and vaccines for treating or preventing rare diseases. CDC provides these products free of charge as a public health service to hospitals in emergencies when requested by treating clinicians or public health officials.

Strategically located at US airports across the country, CDC quarantine stations support CDC's Drug Service by sending out emergency doses of antitoxin for botulism and diphtheria, as well as artesunate for severe malaria—thus reducing the shipping time to hospitals in need. This factor can make a major difference in saving lives (Figure 3).

Figure 3. US locations of CDC quarantine stations. Courtesy of CDC.

Also, drugs for treating rare parasitic diseases, such as Chagas disease, leishmaniasis, filariasis, and African sleeping sickness, are available to US clinicians for patients who meet certain requirements. A clinical consultation with a CDC expert will determine the need for products from CDC's Drug Services.

Available drugs are listed below and on the formulary website.

Before releasing the drugs, CDC and state health departments ensure that appropriate procedures for clinical consultation are followed. A clinician makes the initial request by contacting the local or state health department, who then contacts the CDC Emergency Operations Center or CDC experts (contact information below). CDC then requires consultation between its experts and treating clinicians (Figure 4).

Figure 4. Atlanta CDC quarantine public health officer Paul Livingston takes a call and prepares an emergency drug shipment of diphtheria antitoxin for release to a treating clinician. (Photo by Olubunmi Akinkugbe, CDC)

You won't find these drugs at your local pharmacy; CDC is the only source in the country—and that affords a built-in surveillance system for diseases treated with these drugs across the United States.

Together, we can save lives. Please see the CDC website for complete guidance on the products carried by the CDC Drug Service. If you have a patient in need of one of these products, please contact CDC 24/7 through the Emergency Operations Center at (770) 488-7100. The CDC Drug Service can also be reached directly during business hours at (404) 639-3670.

Web Resources

CDC Drug Service Formulary

Submitting Specimens to CDC

Suggested Reading

Roohi S, Grinnel M, Sandoval M, et al. Evaluation of emergency drug releases from the Centers for Disease Control and Prevention quarantine stations. J Emerg Manag. 2015;13:19-23.

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