title: HEPA/vaccine plan for indoor anthrax remediation.
abstract: We developed a mathematical model to compare 2 indoor remediation strategies in the aftermath of an outdoor release of 1.5 kg of anthrax spores in lower Manhattan. The 2 strategies are the fumigation approach used after the 2001 postal anthrax attack and a HEPA/vaccine plan, which relies on HEPA vacuuming, HEPA air cleaners, and vaccination of reoccupants. The HEPA/vaccine approach leads to few anthrax cases among reoccupants if applied to all but the most heavily contaminated buildings, and recovery is much faster than under the decades-long fumigation plan. Only modest environmental sampling is needed. A surge capacity of 10,000 to 20,000 Hazmat workers is required to perform remediation within 6 to 12 months and to avoid permanent mass relocation. Because of the possibility of a campaign of terrorist attacks, serious consideration should be given to allowing or encouraging voluntary self-service cleaning of lightly contaminated rooms by age-appropriate, vaccinated, partially protected (through masks or hoods) reoccupants or owners.
authors.affiliation: Stanford University, Stanford, California, USA.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Wein
authors.forename: Yifan
authors.initials: Y
authors.lastname: Liu
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Leighton
mesh_terms: D016902:Air Pollution, Indoor / Q000517:prevention & control*; D000881:Anthrax / Q000517:prevention & control*; D022122:Anthrax Vaccines / Q000008:administration & dosage*; D001408:Bacillus anthracis / Q000276:immunology; D023482:Bioterrorism; D004189:Disaster Planning / Q000379:methods*; D006801:Humans; D008851:Micropore Filters; D008954:Models, Biological; D009519:New York City; D013171:Spores, Bacterial; D014611:Vaccination; D014691:Ventilation
chemical_list: D022122:Anthrax Vaccines