title: Inhalational anthrax outbreak among postal workers, Washington, D.C., 2001.
abstract: In October 2001, four cases of inhalational anthrax occurred in workers in a Washington, D.C., mail facility that processed envelopes containing Bacillus anthracis spores. We reviewed the envelopes' paths and obtained exposure histories and nasal swab cultures from postal workers. Environmental sampling was performed. A sample of employees was assessed for antibody concentrations to B. anthracis protective antigen. Case-patients worked on nonoverlapping shifts throughout the facility, suggesting multiple aerosolization events. Environmental sampling showed diffuse contamination of the facility. Potential workplace exposures were similar for the case-patients and the sample of workers. All nasal swab cultures and serum antibody tests were negative. Available tools could not identify subgroups of employees at higher risk for exposure or disease. Prophylaxis was necessary for all employees. To protect postal workers against bioterrorism, measures to reduce the risk of occupational exposure are necessary.
authors.affiliation: Centers for Desease Control and Prevention , Atlanta, Georgia 30333, USA.
authors.forename: Puneet K
authors.initials: PK
authors.lastname: Dewan
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Kayla
authors.initials: K
authors.lastname: Laserson
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Tierney
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Quinn
authors.forename: James A
authors.initials: JA
authors.lastname: Hayslett
authors.forename: Laura N
authors.initials: LN
authors.lastname: Broyles
authors.forename: Andi
authors.initials: A
authors.lastname: Shane
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Winthrop
authors.forename: Ivan
authors.initials: I
authors.lastname: Walks
authors.forename: Larry
authors.initials: L
authors.lastname: Siegel
authors.forename: Thomas
authors.initials: T
authors.lastname: Hales
authors.forename: Vera A
authors.initials: VA
authors.lastname: Semenova
authors.forename: Sandra
authors.initials: S
authors.lastname: Romero-Steiner
authors.forename: Cheryl
authors.initials: C
authors.lastname: Elie
authors.forename: Rima
authors.initials: R
authors.lastname: Khabbaz
authors.forename: Ali S
authors.initials: AS
authors.lastname: Khan
authors.forename: Rana A
authors.initials: RA
authors.lastname: Hajjeh
authors.forename: Anne
authors.initials: A
authors.lastname: Schuchat
mesh_terms: D000328:Adult; D000368:Aged; D000881:Anthrax / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D019072:Antibiotic Prophylaxis; D001408:Bacillus anthracis / Q000302:isolation & purification; D023482:Bioterrorism; D004196:Disease Outbreaks; D004219:District of Columbia / Q000453:epidemiology; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006306:Health Surveys; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology; D016273:Occupational Exposure; D011177:Postal Service; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D012307:Risk Factors; D012698:Serologic Tests; D012874:Skin Diseases, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D013997:Time Factors