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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 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
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
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
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
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
new jersey hospital runs anthrax screening operation for cdc. 200111794944
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
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
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
surveillance for anthrax cases associated with contaminated letters, new jersey, delaware, and pennsylvania, 2001.in october 2001, two inhalational anthrax and four cutaneous anthrax cases, resulting from the processing of bacillus anthracis-containing envelopes at a new jersey mail facility, were identified. subsequently, we initiated stimulated passive hospital-based and enhanced passive surveillance for anthrax-compatible syndromes. from october 24 to december 17, 2001, hospitals reported 240,160 visits and 7,109 intensive-care unit admissions in the surveillance area (population 6.7 million persons). fo ...200212396918
anthrax case timeline. 200314692564
anthrax in new jersey: a health education experience in bioterrorism response and preparedness.the anthrax attack in 2001 created new challenges to health educators working on the response effort in new jersey. never before had there been a need for educating a group of people who had been exposed to a biological weapon. coming on the heels of the catastrophic world trade center collapse on september 11, 2001, the new jersey department of health and senior services was entrenched in the response to, and management of, the anthrax attack that placed a heavy emphasis on educating the postal ...200516210685
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
an epidemiologist's view of bioterrorism. eddy a. bresnitz, md, ms, discusses state initiatives and preparedness. interview by leah z. ziskin. 200312703333
case study: ed acts quickly after anthrax.after last year's anthrax attacks, eds at capital health system in trenton, nj, had to address decontamination of large numbers of patients. patients who didn't require decontamination were sent to the hospital's employee health facility so they could bypass the ed. clinicians, nursing staff, educators, and paramedics were trained in the decontamination process. direct communication with first responders was established with a portable scanner.200211995230
mechanistic modeling of emergency events: assessing the impact of hypothetical releases of anthrax.a modular system for source-to-dose-to-effect modeling analysis has been developed based on the modeling environment for total risk studies (mentor),((1)) and applied to study the impacts of hypothetical atmospheric releases of anthrax spores. the system, mentor-2e (mentor for emergency events), provides mechanistically consistent analysis of inhalation exposures for various release scenarios, while allowing consideration of specific susceptible subpopulations (such as the elderly) at the resolu ...200818643828
facilitation of risk communication during the anthrax attacks of 2001: the organizational backstory.the anthrax attacks of 2001 created risk communication problems that cannot be fully understood without appreciating the dynamics among organizations. case studies of communication in new jersey, consisting of interviews with a range of participants, found that existing organizational and professional networks facilitated trust among decisionmakers. this interpersonal trust improved communication among agencies and thereby risk communication with the public. for example, "white powder scares" we ...200717666692
training needs of pediatricians facing the environmental health and bioterrorism consequences of september 11th.the september 11, 2001, terrorist attacks have been called "the worst environmental disaster in the history of new york city." as a result of the extensive nature of the destruction, our objective as pediatricians was to determine the experience and training needs of tri-state child health professionals in responding to the environmental health and bioterrorism-related demands placed on their practices.200617285216
postal workers' perspectives on communication during the anthrax attack.in 2001, the nation experienced its first bioterrorism attack, in the form of anthrax sent through the u.s. postal service, and public health professionals were challenged to communicate with a critical audience, u.s. postal workers. postal workers, the first cohort to receive public health messages during a bioterrorist crisis, offer a crucial viewpoint that can be used in the development of best practices in crisis and emergency risk communication. this article reports results of qualitative i ...200516181043
emergency department visits for concern regarding anthrax--new jersey, 2001.in october of 2001, after letters processed in trenton, new jersey, resulted in multiple cases of anthrax, emergency departments (eds) in new jersey experienced an increase in visits from patients concerned about possible exposure to agents of biologic terrorism. information about the effect of an actual biologic terrorism attack on the emergency department population might be useful in the design of biosurveillance systems, particularly with regard to their performance during the mitigation pha ...200516177709
cutaneous anthrax: conservative or surgical treatment?this article summarizes the diagnostic features and treatment recommendations for cutaneous anthrax, exemplified by a case report of nontypical cutaneous anthrax. the treatment of choice is medical, with ciprofloxacin or doxycycline the preferred antibiotics. however, surgical biopsy may be used if the clinical setting and microbiologic examination of swabs are not diagnostically conclusive. histopathologic findings explain the clinical observation that most cutaneous anthrax lesions heal withou ...200515840983
heading-off anthrax at hamilton, new jersey: events of october 2001. 200515790066
history of a public health emergency. 200515790057
daily emergency department surveillance system --- bergen county, new jersey.the purpose of the daily emergency department surveillance system (dedss) is to provide consistent, timely, and robust data that can be used to guide public health activities in bergen county, new jersey. dedss collects data on all emergency department visits in four hospitals in bergen county and analyzes them for aberrant patterns of disease or single instances of certain diseases or syndromes. the system monitors for clusters of patients with syndromes consistent with the prodrome of a terror ...200415714627
new jersey state public health laboratory's bioterrorism response activities. 200415497736
communicable-disease surveillance in new jersey.the dhss and federal agencies have expanded their surveillance efforts to improve existing methods of reporting notifiable communicable diseases and to include additional data sources that might provide a more comprehensive view of disease activity in new jersey. currently, the dhss is evaluating these efforts and recognizes several issues that need to be addressed, including: assessment of the timeliness, completeness, and accuracy of surveillance data; validation of surveillance data through c ...200415497734
responding to a bioterrorist attack: environmental investigation of anthrax in new jersey.a bioterrorism attack using the united states postal system to deliver a hazardous biological agent to specific targets created multiple environmental and occupational exposure risks along the path of the anthrax-containing letters. on october 18, 2001, a suspected case of cutaneous anthrax was confirmed in a postal worker from the trenton processing and distribution center where at least four suspect letters were postmarked. over the next three weeks, a team of investigators collected samples a ...200312959889
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
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
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