title: Anthrax postexposure prophylaxis in postal workers, Connecticut, 2001.
abstract: After inhalational anthrax was diagnosed in a Connecticut woman on November 20, 2001, postexposure prophylaxis was recommended for postal workers at the regional mail facility serving the patient's area. Although environmental testing at the facility yielded negative results, subsequent testing confirmed the presence of Bacillus anthracis. We distributed questionnaires to 100 randomly selected postal workers within 20 days of initial prophylaxis. Ninety-four workers obtained antibiotics, 68 of whom started postexposure prophylaxis, and of these, 21 discontinued. Postal workers who never started or stopped taking prophylaxis cited as reasons disbelief regarding anthrax exposure, problems with adverse events, and initial reports of negative cultures. Postal workers with adverse events reported predominant symptoms of gastrointestinal distress and headache. The influence of these concerns on adherence suggests that communication about risks of acquiring anthrax, education about adverse events, and careful management of adverse events are essential elements in increasing adherence.
authors.affiliation: Centers for Desease Control and Prevention , Atlanta, Georgia 30333, USA. znv8@cdc.gov
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Williams
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Noviello
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Griffith
authors.forename: Heather
authors.initials: H
authors.lastname: Wurtzel
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hamborsky
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Perz
authors.forename: Ian T
authors.initials: IT
authors.lastname: Williams
authors.forename: James L
authors.initials: JL
authors.lastname: Hadler
authors.forename: David L
authors.initials: DL
authors.lastname: Swerdlow
authors.forename: Renee
authors.initials: R
authors.lastname: Ridzon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000881:Anthrax / Q000188:drug therapy* / Q000517:prevention & control*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001408:Bacillus anthracis / Q000302:isolation & purification; D023482:Bioterrorism; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003237:Connecticut; D004318:Doxycycline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010349:Patient Compliance; D011177:Postal Service; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D004318:Doxycycline