Investigation of bioterrorism-related anthrax, United States, 2001: epidemiologic findings

Emerg Infect Dis. 2002 Oct;8(10):1019-28. doi: 10.3201/eid0810.020353.

Abstract

In October 2001, the first inhalational anthrax case in the United States since 1976 was identified in a media company worker in Florida. A national investigation was initiated to identify additional cases and determine possible exposures to Bacillus anthracis. Surveillance was enhanced through health-care facilities, laboratories, and other means to identify cases, which were defined as clinically compatible illness with laboratory-confirmed B. anthracis infection. From October 4 to November 20, 2001, 22 cases of anthrax (11 inhalational, 11 cutaneous) were identified; 5 of the inhalational cases were fatal. Twenty (91%) case-patients were either mail handlers or were exposed to worksites where contaminated mail was processed or received. B. anthracis isolates from four powder-containing envelopes, 17 specimens from patients, and 106 environmental samples were indistinguishable by molecular subtyping. Illness and death occurred not only at targeted worksites, but also along the path of mail and in other settings. Continued vigilance for cases is needed among health-care providers and members of the public health and law enforcement communities.

MeSH terms

  • Adult
  • Aged
  • Anthrax / drug therapy
  • Anthrax / epidemiology*
  • Anthrax / mortality
  • Anthrax / prevention & control
  • Antibiotic Prophylaxis
  • Bacillus anthracis / isolation & purification*
  • Bioterrorism / statistics & numerical data*
  • Centers for Disease Control and Prevention, U.S.
  • Disease Outbreaks
  • Environmental Exposure
  • Environmental Monitoring
  • Epidemiological Monitoring
  • Female
  • Humans
  • Infant
  • Inhalation Exposure
  • Male
  • Middle Aged
  • Occupational Exposure
  • Postal Service
  • Powders
  • Public Health
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / mortality
  • Respiratory Tract Infections / prevention & control
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / epidemiology
  • Skin Diseases, Bacterial / microbiology
  • Skin Diseases, Bacterial / prevention & control
  • Spores, Bacterial / isolation & purification
  • United States / epidemiology

Substances

  • Powders