title: Isolated case of bioterrorism-related inhalational anthrax, New York City, 2001.
abstract: On October 31, 2001, in New York City, a 61-year-old female hospital employee who had acquired inhalational anthrax died after a 6-day illness. To determine sources of exposure and identify additional persons at risk, the New York City Department of Health, Centers for Disease Control and Prevention, and law enforcement authorities conducted an extensive investigation, which included interviewing contacts, examining personal effects, summarizing patient's use of mass transit, conducting active case finding and surveillance near her residence and at her workplace, and collecting samples from co-workers and the environment. We cultured all specimens for Bacillus anthracis. We found no additional cases of cutaneous or inhalational anthrax. The route of exposure remains unknown. All environmental samples were negative for B. anthracis. This first case of inhalational anthrax during the 2001 outbreak with no apparent direct link to contaminated mail emphasizes the need for close coordination between public health and law enforcement agencies during bioterrorism-related investigations.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. tkh3@cdc.gov
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Holtz
authors.forename: Joel
authors.initials: J
authors.lastname: Ackelsberg
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Kool
authors.forename: Richard
authors.initials: R
authors.lastname: Rosselli
authors.forename: Anthony
authors.initials: A
authors.lastname: Marfin
authors.forename: Thomas
authors.initials: T
authors.lastname: Matte
authors.forename: Sara T
authors.initials: ST
authors.lastname: Beatrice
authors.forename: Michael B
authors.initials: MB
authors.lastname: Heller
authors.forename: Dan
authors.initials: D
authors.lastname: Hewett
authors.forename: Linda C
authors.initials: LC
authors.lastname: Moskin
authors.forename: Michel L
authors.initials: ML
authors.lastname: Bunning
authors.forename: Marcelle
authors.initials: M
authors.lastname: Layton
mesh_terms: D000881:Anthrax / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D001408:Bacillus anthracis / Q000235:genetics / Q000302:isolation & purification; D023482:Bioterrorism; D002939:Ciprofloxacin / Q000494:pharmacology; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D019570:Inhalation Exposure; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011177:Postal Service; D013171:Spores, Bacterial / Q000302:isolation & purification; D014930:Women
chemical_list: D004269:DNA, Bacterial; D002939:Ciprofloxacin