The 130th Annual Meeting of APHA

Abstract #45833

Andrew L. Dannenberg, MD, MPH¹, Michael E. Bales, MPH², Philip S. Brachman, MD³, Arnold F. Kaufmann, DVM¹, and David A. Ashford, DVM, MPH, DSc⁴. (1) National Center for Environmental Health, DEEHS, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-30, Atlanta, GA 30341, 770-488-7103, acd7@cdc.gov, (2) Epidemiology Program Office, DAPHT, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop D-18, Atlanta, GA 30333, (3) Department of International Health, Emory University Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, GA 30322, (4) National Center for Infectious Diseases, DBMD, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop C-09, Atlanta, GA 30333

Background: With 50 years of experience investigating anthrax outbreaks, CDC played a major role in the public health response to the intentional release of Bacillus anthracis in 2001. Methods: To review this experience, we used unpublished reports, published manuscripts, and communication with involved investigators to identify 49 anthrax-related epidemiologic field investigations conducted by CDC from 1950 to August 2001. Results: In 41 of the 49 field investigations of suspected anthrax, B. anthracis was the causative organism of human or animal disease. Among the other investigations, 2 focused on building decontamination, 1 was a response to bioterrorism threats, and 5 involved other causes. Of the 41 investigations, 24 were in agricultural settings, 11 in textile mills, and 6 in other settings. Among domestic clinical infections, the reports included 9 inhalational and 39 cutaneous cases of human anthrax. Knowledge gained in these investigations has been critical in responding to the recent release of B. anthracis, especially by addressing the management of anthrax threats, prevention of occupational anthrax, use of vaccines and antibiotic prophylaxis, treatment of clinical disease, spread of B. anthracis spores in aerosols and from objects, clinical diagnostic and laboratory confirmation methods, environmental sampling techniques, and methods for decontaminating buildings. Conclusion: These field investigations yielded new knowledge that contributed directly to the nation's ability to respond to anthrax outbreaks. The intentional release of B. anthracis has posed new and unique challenges. Our ability to prevent and control this threat continues to improve through ongoing investigations of bioterrorism-related and naturally occurring anthrax.

Learning Objectives:

• Describe how past experience in anthrax field investigations has helped CDC respond to bioterrorism attacks involving anthrax.
• Identify the most common settings in which anthrax has occurred in the US in the past 50 years.
• Discuss areas in which further research is needed on response to anthrax as a bioterrorism weapon.

Keywords: Bioterrorism, Epidemiology

Related Web page: www.cdc.gov

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.