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update: investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, october 2001.since october 3, 2001, cdc and state and local public health authorities have been investigating cases of bioterrorism-related anthrax. this report updates previous findings, provides new information on case investigations in two additional areas, presents the susceptibility patterns of bacillus anthracis isolates, and provides interim recommendations for managing potential threats and exposures and for treating anthrax.200111699843
update: investigation of bioterrorism-related anthrax, 2001.this report updates the investigation of bioterrorism-related anthrax and the provision of antimicrobial prophylaxis to exposed persons and highlights cdc assistance to other countries investigating cases of bioterrorism-related anthrax. since november 7, 2001, cdc and state and local public health agencies have identified no new cases of bioterrorism-related anthrax. as of november 14, a total of 22 cases of anthrax has met the cdc case definition; 10 were confirmed inhalational anthrax, and 12 ...200111724158
from the centers for disease control and prevention. update: investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, october 2001. 200111757528
antimicrobial postexposure prophylaxis for anthrax: adverse events and adherence.we collected data during postexposure antimicrobial prophylaxis campaigns and from a prophylaxis program evaluation 60 days after start of antimicrobial prophylaxis involving persons from six u.s. sites where bacillus anthracis exposures occurred. adverse events associated with antimicrobial prophylaxis to prevent anthrax were commonly reported, but hospitalizations and serious adverse events as defined by food and drug administration criteria were rare. overall adherence during 60 days of antim ...200212396927
adherence to antimicrobial inhalational anthrax prophylaxis among postal workers, washington, d.c., 2001.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 ...200212396929
inhalational anthrax outbreak among postal workers, washington, d.c., 2001.in october 2001, four cases of inhalational anthrax occurred in workers in a washington, d.c., mail facility that processed envelopes containing bacillus anthracis spores. we reviewed the envelopes' paths and obtained exposure histories and nasal swab cultures from postal workers. environmental sampling was performed. a sample of employees was assessed for antibody concentrations to b. anthracis protective antigen. case-patients worked on nonoverlapping shifts throughout the facility, suggesting ...200212396917
secondary aerosolization of viable bacillus anthracis spores in a contaminated us senate office.bioterrorist attacks involving letters and mail-handling systems in washington, dc, resulted in bacillus anthracis (anthrax) spore contamination in the hart senate office building and other facilities in the us capitol's vicinity.200212472327
epidemiologic investigations of bioterrorism-related anthrax, new jersey, 2001.at least four bacillus anthracis-containing envelopes destined for new york city and washington, d.c. were processed at the trenton processing and distribution center (pdc) on september 18 and october 9, 2001. when cutaneous anthrax was confirmed in a trenton postal worker, the pdc was closed. four cutaneous and two inhalational anthrax cases were identified. five patients were hospitalized; none died. four were pdc employees; the others handled or received mail processed there. onset dates occu ...200212396914
a field investigation of bacillus anthracis contamination of u.s. department of agriculture and other washington, d.c., buildings during the anthrax attack of october 2001.in response to a bioterrorism attack in the washington, d.c., area in october 2001, a mobile laboratory (ml) was set up in the city to conduct rapid molecular tests on environmental samples for the presence of bacillus anthracis spores and to route samples for further culture analysis. the ml contained class i laminar-flow hoods, a portable autoclave, two portable real-time pcr devices (ruggedized advanced pathogen identification device [rapid]), and miscellaneous supplies and equipment to proce ...200312514046
opening a bacillus anthracis-containing envelope, capitol hill, washington, d.c.: the public health response.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 i ...200212396912
the impact of anthrax attacks on the american public.incidents involving anthrax (bacillus anthracis) through the mail in 4 metropolitan areas have raised concerns about the public's response nationally and locally.200212145561
perceptions of state public health officers and state veterinarians regarding risks of bioterrorism in the united states.to assess perceptions of state public health officers and state veterinarians in the united states regarding the risks of bioterrorism and determine the degree of support provided for activities related to bioterrorism.200212092950
2001 anthrax crisis in washington, d.c.: pharmacists' role in screening patients and selecting prophylaxis.pharmacists' development and use of a worksheet facilitating their rapid selection of patient-appropriate prophylactic antimicrobials in an anthrax clinic is described. a clinic housed at d.c. general hospital, in washington, d.c., treated most of the people--many of them postal workers--who may have been exposed to anthrax in that city during the 2001 anthrax crisis. a form was needed to assist pharmacists in the rapid selection of prophylactic antimicrobials and in patient education and counse ...200212073861
bacillus anthracis contamination and inhalational anthrax in a mail processing and distribution center.four inhalational anthrax cases occurred in a large mail processing and distribution center in washington, dc, after envelopes containing bacillus anthracis spores were processed. this report describes the results of sampling for b. anthracis spores during investigations conducted in october and december 2001.200415078521
2001 anthrax crisis in washington, d.c.: clinic for persons exposed to contaminated mail.an anthrax prophylaxis clinic is described. in october 2001, four workers from the u.s. postal service's brentwood facility in washington, d.c., were hospitalized with inhalational anthrax; many others may have been exposed to anthrax spores. u.s. public health service (usphs) teams were deployed to establish an anthrax prophylaxis clinic that would provide education and medication to workers and people who visited the mail facility. the temporary clinic was set up at d.c. general hospital and w ...200212073860
bioterrorism watch. they don't call it bioterror for nothing: fear is the foe when anthrax spores are found within hospital walls. 200212068508
bioterrorism watch. they don't call it bioterror for nothing: fear is the foe when anthrax spores are found within hospital walls. 200212046239
anthrax attack at the united states capitol. front line thoughts.one great fear was realized on october 15, 2001 when united states citizens witnessed firsthand the unprecedented release of anthrax into a community. although the office of the attending physician to congress had been preparing for such an unthinkable act, lessons were learned as the events unfolded. the following is a summary of the findings: preparation, planning, and frequent review of bioterrorism response procedures are essential. effective communication remains the key to successful team ...200211979645
from the centers for disease control and prevention. evaluation of bacillus anthracis contamination inside the brentwood mail processing and distribution center--district of columbia, october 2001. 200211824387
update: adverse events associated with anthrax prophylaxis among postal employees--new jersey, new york city, and the district of columbia metropolitan area, 2001.antimicrobial prophylaxis to prevent inhalational anthrax has been recommended for persons potentially exposed to bacillus anthracis as a result of the recent bioterrorist attacks. during october 26-november 6, 2001, an epidemiologic evaluation to detect adverse events associated with antimicrobial prophylaxis was conducted among 8,424 postal employees who had been offered antimicrobial prophylaxis for 60 days in new jersey (nj), new york city (nyc), and one postal facility in the district of co ...200111808926
on the front lines. anthrax scare, jittery public put focus on the healthcare industry. 200111808414
from the centers for disease control and prevention. update: adverse events associated with anthrax prophylaxis among postal employees--new jersey, new york city, and the district of columbia metropolitan area, 2001. 200111787481
from the centers for disease control and prevention. investigation of bioterrorism-related anthrax and interim guidelines for clinical evaluation of persons with possible anthrax. 200111759667
update: investigation of bioterrorism-related anthrax and adverse events from antimicrobial prophylaxis.cdc and state and local public health authorities continue to investigate cases of bioterrorism-related anthrax. as of november 7, a total of 22 cases of anthrax have been identified according to the cdc surveillance case definition; 10 were confirmed inhalational anthrax cases and 12 cases (seven confirmed and five suspected) were cutaneous anthrax (table 1). the majority of cases have occurred in persons working at postal facilities in new jersey (nj) and the district of columbia (dc) in which ...200111724150
death due to bioterrorism-related inhalational anthrax: report of 2 patients.on october 9, 2001, a letter containing anthrax spores was mailed from new jersey to washington, dc. the letter was processed at a major postal facility in washington, dc, and opened in the senate's hart office building on october 15. between october 19 and october 26, there were 5 cases of inhalational anthrax among postal workers who were employed at that major facility or who handled bulk mail originating from that facility. the cases of 2 postal workers who died of inhalational anthrax are r ...200111722269
clinical presentation of inhalational anthrax following bioterrorism exposure: report of 2 surviving patients.the use of anthrax as a weapon of biological terrorism has moved from theory to reality in recent weeks. following processing of a letter containing anthrax spores that had been mailed to a us senator, 5 cases of inhalational anthrax have occurred among postal workers employed at a major postal facility in washington, dc. this report details the clinical presentation, diagnostic workup, and initial therapy of 2 of these patients. the clinical course is in some ways different from what has been d ...200111722268
update: investigation of bioterrorism-related anthrax and interim guidelines for clinical evaluation of persons with possible anthrax.since october 3, 2001, cdc and state and local public health authorities have been investigating cases of bioterrorism-related anthrax. this report updates findings as of october 31, and includes interim guidelines for the clinical evaluation of persons with possible anthrax. a total of 21 cases (16 confirmed and five suspected) of bioterrorism-related anthrax have been reported among persons who worked in the district of columbia, florida, new jersey, and new york city (figure 1). until the sou ...200111708591
anthrax, united states of america (update). 200111697083
surface sampling methods for bacillus anthracis spore contamination.during an investigation conducted december 17-20, 2001, we collected environmental samples from a u.s. postal facility in washington, d.c., known to be extensively contaminated with bacillus anthracis spores. because methods for collecting and analyzing b. anthracis spores have not yet been validated, our objective was to compare the relative effectiveness of sampling methods used for collecting spores from contaminated surfaces. comparison of wipe, wet and dry swab, and hepa vacuum sock samples ...200212396930
the reality of the modern bioterrorism response. 200212504495
large-scale screening of nasal swabs for bacillus anthracis: descriptive summary and discussion of the national institutes of health's experience.in october 2001, a letter containing a large number of anthrax spores was sent through the brentwood post office in washington, d.c., to a united states senate office on capitol hill, resulting in contamination in both places. several thousand people who worked at these sites were screened for spore exposure by collecting nasal swab samples. we describe here a screening protocol which we, as a level a laboratory, used on very short notice to process a large number of specimens (3,936 swabs) in o ...200212149367
bleach, gas, or foam? 200111727474
reporting of zoonotic diseases.departments of public health and agriculture in all 50 states of the united states and the district of columbia were queried in 1977 to determine which of some selected zoonoses are reportable, the method of reporting and the diagnostic stage at which reporting is required. fifty-three of the 62 diseases on the public health questionnaire were listed as reportable, with hepatitis a required by 49 of the 51 jurisdictions. telephone reporting was required in nearly 19% of the disease-jurisdiction ...19807395853
follow-up of deaths among u.s. postal service workers potentially exposed to bacillus anthracis--district of columbia, 2001-2002.in october 2001, two letters contaminated with bacillus anthracis spores were processed by mechanical and manual methods at the u.s. postal service (usps) brentwood mail processing and distribution center in the district of columbia. four postal workers at the brentwood facility became ill with what was diagnosed eventually as inhalational anthrax; two died. the facility was closed on october 21, and postexposure prophylaxis was recommended for approximately 2,500 workers and business visitors. ...200314523371
anthrax: lessons learned from the u.s. capitol experience. 200314527185
anthrax case timeline. 200314692564
the sniper and the public's mental health. 200415079941
exposure to bioterrorism and mental health response among staff on capitol hill.the october 2001 anthrax attacks heralded a new era of bioterrorism threat in the u.s. at the time, little systematic data on mental health effects were available to guide authorities' response. for this study, which was conducted 7 months after the anthrax attacks, structured diagnostic interviews were conducted with 137 capitol hill staff workers, including 56 who had been directly exposed to areas independently determined to have been contaminated. postdisaster psychopathology was associated ...200920028246
leading during times of trouble: a roundtable discussion of recent terror events. 200315040184
anthrax scare 2005, washington, dc: operational issues in chemoprophylaxis. 200516308077
increased african-american involvement in vaccine studies. 200919095169
building academic-practice partnerships: the center for public health preparedness at the columbia university mailman school of public health, before and after 9/11.the center for public health preparedness at the columbia university mailman school of public health is part of a national network of academic centers established by the centers for disease control and prevention to strengthen links between public health practice and academe, especially for public health workforce development. since its inception in fall 2000, the center has been working in partnership with the new york city department of health & mental hygiene (dohmh) on planning and competenc ...200315503608
in their own words: lessons learned from those exposed to anthrax.we evaluated perceptions of workers at the us postal service brentwood processing and distribution center and us senate employees regarding public health responses to the anthrax mailings of october 2001. we generated recommendations for improving responses to bioterrorism on the basis of the perceptions we recorded.200515727982
public response to an anthrax attack: reactions to mass prophylaxis in a scenario involving inhalation anthrax from an unidentified source.an attack with bacillus anthracis ("anthrax") is a known threat to the united states. when weaponized, it can cause inhalation anthrax, the deadliest form of the disease. due to the rapid course of inhalation anthrax, delays in initiation of antibiotics may decrease survival chances. because a rapid response would require cooperation from the public, there is a need to understand the public's response to possible mass dispensing programs. to examine the public's response to a mass prophylaxis pr ...201121819225
concerns of capitol hill staff workers after bioterrorism: focus group discussions of authorities' response.systematic studies of mental health effects of bioterrorism on exposed populations have not been carried out. exploratory focus groups were conducted with an exposed population to provide qualitative data and inform empirical research. five focus groups of 28 political worker volunteers were conducted 3 months after the october 15, 2001, anthrax attack on capitol hill. more than 2000 transcribed focus group passages were categorized using qualitative software. the category with the most items wa ...200516082296
the us capitol bioterrorism anthrax exposures: clinical epidemiological and immunological characteristics.bioterrorism-related anthrax exposures occurred at the us capitol in 2001. exposed individuals received antibiotics and anthrax vaccine adsorbed immunization.200717191162
recent case developments in health law. rempfer v. sharfstein. 201020449938
bioterrorism-related inhalational anthrax: the first 10 cases reported in the united states.from october 4 to november 2, 2001, the first 10 confirmed cases of inhalational anthrax caused by intentional release of bacillus anthracis were identified in the united states. epidemiologic investigation indicated that the outbreak, in the district of columbia, florida, new jersey, and new york, resulted from intentional delivery of b. anthracis spores through mailed letters or packages. we describe the clinical presentation and course of these cases of bioterrorism-related inhalational anthr ...200111747719
a bitter pill to swallow: nonadherence with prophylactic antibiotics during the anthrax attacks and the role of private physicians.to generate recommendations for improving adherence to public health advice during public health crises, we conducted semi-structured interviews with employees at the brentwood road postal facility and on capitol hill to identify key themes associated with decisions to adhere to recommended antibiotic prophylaxis during the 2001 anthrax attacks. factors used in deciding to adhere to recommended prophylactic antibiotics and concerns about the official response were similar in brentwood and capito ...200415588055
no evidence of a mild form of inhalational bacillus anthracis infection during a bioterrorism-related inhalational anthrax outbreak in washington, d.c., in 2001.the mail-related dispersal of bacillus anthracis spores in the washington, d.c., area during october 2001 resulted in 5 confirmed cases of inhalational anthrax. we identified an additional 144 ill persons who were potentially exposed to aerosolized spores and whose symptoms were compatible with early inhalational anthrax but whose clinical course and nonserologic laboratory evaluation revealed no evidence for b. anthracis infection. we hypothesized that early antibiotic use could have decreased ...200516142664
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