title: Opening a bacillus anthracis-containing envelope, Capitol Hill, Washington, D.C.: the public health response.
abstract: On October 15, 2001, a U.S. Senate staff member opened an envelope containing Bacillus anthracis spores. Chemoprophylaxis was promptly initiated and nasal swabs obtained for all persons in the immediate area. An epidemiologic investigation was conducted to define exposure areas and identify persons who should receive prolonged chemoprophylaxis, based on their exposure risk. Persons immediately exposed to B. anthracis spores were interviewed; records were reviewed to identify additional persons in this area. Persons with positive nasal swabs had repeat swabs and serial serologic evaluation to measure antibodies to B. anthracis protective antigen (anti-PA). A total of 625 persons were identified as requiring prolonged chemoprophylaxis; 28 had positive nasal swabs. Repeat nasal swabs were negative at 7 days; none had developed anti-PA antibodies by 42 days after exposure. Early nasal swab testing is a useful epidemiologic tool to assess risk of exposure to aerosolized B. anthracis. Early, wide chemoprophylaxis may have averted an outbreak of anthrax in this population.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. vhsu@cdc.gov
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Hsu
authors.forename: Susan L
authors.initials: SL
authors.lastname: Lukacs
authors.forename: Thomas
authors.initials: T
authors.lastname: Handzel
authors.forename: James
authors.initials: J
authors.lastname: Hayslett
authors.forename: Scott
authors.initials: S
authors.lastname: Harper
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: Conrad P
authors.initials: CP
authors.lastname: Quinn
authors.forename: Rima
authors.initials: R
authors.lastname: Khabbaz
authors.forename: Ali S
authors.initials: AS
authors.lastname: Khan
authors.forename: Gregory
authors.initials: G
authors.lastname: Martin
authors.forename: John
authors.initials: J
authors.lastname: Eisold
authors.forename: Anne
authors.initials: A
authors.lastname: Schuchat
authors.forename: Rana A
authors.initials: RA
authors.lastname: Hajjeh
mesh_terms: D000881:Anthrax / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D019072:Antibiotic Prophylaxis; D001408:Bacillus anthracis / Q000302:isolation & purification*; D023482:Bioterrorism; D002487:Centers for Disease Control and Prevention, U.S. / Q000458:organization & administration; D004219:District of Columbia; D004781:Environmental Exposure; D004866:Equipment Contamination; D006801:Humans; D019570:Inhalation Exposure; D009297:Nasal Mucosa / Q000382:microbiology; D009305:Nasopharynx / Q000382:microbiology; D011634:Public Health / Q000379:methods*; D012307:Risk Factors; D014481:United States; D017132:Workplace