title: Adherence to antimicrobial inhalational anthrax prophylaxis among postal workers, Washington, D.C., 2001.
abstract: In October 2001, two envelopes containing Bacillus anthracis spores were processed at the Washington, D.C., Processing and Distribution Center of the U.S. Postal Service; inhalational anthrax developed in four workers at this facility. More than 2,000 workers were advised to complete 60 days of postexposure prophylaxis to prevent inhalational anthrax. Interventions to promote adherence were carried out to support workers, and qualitative information was collected to evaluate our interventions. A quantitative survey was administered to a convenience sample of workers to assess factors influencing adherence. No anthrax infections developed in any workers involved in the interventions or interviews. Of 245 workers, 98 (40%) reported full adherence to prophylaxis, and 45 (18%) had completely discontinued it. Anxiety and experiencing adverse effects to prophylaxis, as well as being <45 years old were risk factors for discontinuing prophylaxis. Interventions, especially frequent visits by public health staff, proved effective in supporting adherence.
authors.affiliation: Centers for Desease Control and Prevention , Atlanta, Georgia 30333, USA. mnj5@cdc.gov
authors.forename: Mariaelena D
authors.initials: MD
authors.lastname: Jefferds
authors.forename: Kayla
authors.initials: K
authors.lastname: Laserson
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Sharon
authors.initials: S
authors.lastname: Roy
authors.forename: James
authors.initials: J
authors.lastname: Hayslett
authors.forename: Laurence
authors.initials: L
authors.lastname: Grummer-Strawn
authors.forename: Laura
authors.initials: L
authors.lastname: Kettel-Khan
authors.forename: Anne
authors.initials: A
authors.lastname: Schuchat
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; D019072:Antibiotic Prophylaxis; D001408:Bacillus anthracis; D023482:Bioterrorism; D004219:District of Columbia; D005260:Female; D006306:Health Surveys; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010349:Patient Compliance; D011177:Postal Service
chemical_list: D000900:Anti-Bacterial Agents