First case of bioterrorism-related inhalational anthrax in the United States, Palm Beach County, Florida, 2001.
On October 4, 2001, we confirmed the first bioterrorism-related anthrax case identified in the United States in a resident of Palm Beach County, Florida. Epidemiologic investigation indicated that exposure occurred at the workplace through intentionally contaminated mail. One additional case of inhalational anthrax was identified from the index patient's workplace. Among 1,076 nasal cultures performed to assess exposure, Bacillus anthracis was isolated from a co-worker later confirmed as being infected, as well as from an asymptomatic mail-handler in the same workplace. Environmental cultures for B. anthracis showed contamination at the workplace and six county postal facilities. Environmental and nasal swab cultures were useful epidemiologic tools that helped direct the investigation towards the infection source and transmission vehicle. We identified 1,114 persons at risk and offered antimicrobial prophylaxis.
Traeger
Marc S
MS
Centers for Disease Control and Prevention, Atlanta, GA, USA. Marc.Traeger@mail.ihs.gov
Wiersma
Steven T
ST
Rosenstein
Nancy E
NE
Malecki
Jean M
JM
Shepard
Colin W
CW
Raghunathan
Pratima L
PL
Pillai
Segaran P
SP
Popovic
Tanja
T
Quinn
Conrad P
CP
Meyer
Richard F
RF
Zaki
Sharif R
SR
Kumar
Savita
S
Bruce
Sherrie M
SM
Sejvar
James J
JJ
Dull
Peter M
PM
Tierney
Bruce C
BC
Jones
Joshua D
JD
Perkins
Bradley A
BA
D000881:Anthrax / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*; D019072:Antibiotic Prophylaxis; D001408:Bacillus anthracis / Q000302:isolation & purification; D023482:Bioterrorism / Q000706:statistics & numerical data; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D017809:Fatal Outcome; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology; D011159:Population Surveillance; D012307:Risk Factors; D017132:Workplace