title: Airborne infection with Bacillus anthracis--from mills to mail.
abstract: The lack of identified exposures in 2 of the 11 cases of bioterrorism-related inhalation anthrax in 2001 raised uncertainty about the infectious dose and transmission of Bacillus anthracis. We used the Wells-Riley mathematical model of airborne infection to estimate 1) the exposure concentrations in postal facilities where cases of inhalation anthrax occurred and 2) the risk for infection in various hypothetical scenarios of exposure to B. anthracis aerosolized from contaminated mail in residential settings. These models suggest that a small number of cases of inhalation anthrax can be expected when large numbers of persons are exposed to low concentrations of B. anthracis. The risk for inhalation anthrax is determined not only by bacillary virulence factors but also by infectious aerosol production and removal rates and by host factors.
authors.affiliation: Department of Medicine, New Jersey Medical School-UMDNJ, Newark, 07107-3000, USA. fennelkp@umdnj.edu
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Fennelly
authors.forename: Amy L
authors.initials: AL
authors.lastname: Davidow
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Miller
authors.forename: Nancy
authors.initials: N
authors.lastname: Connell
authors.forename: Jerrold J
authors.initials: JJ
authors.lastname: Ellner
mesh_terms: D000391:Air Microbiology; D000881:Anthrax / Q000382:microbiology / Q000635:transmission*; D001408:Bacillus anthracis / Q000472:pathogenicity*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008954:Models, Biological; D016273:Occupational Exposure; D013171:Spores, Bacterial; D014691:Ventilation