The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

5074.0: Wednesday, November 19, 2003 - 9:10 AM

Abstract #73203

Pilot Surveillance for Gram Positive Rod Septicemia or Meningitis, Connecticut 2003

Nancy L. Barrett, MS, MPH1, Patricia Mshar, MPH1, Therese Rabatsky-Ehr, MS, MPH1, Kasia Frenette1, Lisa LoBianco, MPH1, Katherine Marshall, MPH1, Diana Mlynarski, MPH1, Ava Nepaul, MA1, and James Hadler, MD, MPH2. (1) Epidemiology and Emerging Infections Program, Connecticut Department of Public Health, 410 Capitol Ave MS#11Epi, Hartford, CT 06134-0308, 860-509-7994, Nancy.L.Barrett@po.state.ct.us, (2) Infectious Disease Division, Connecticut Department of Public Health, 410 Capitol Avenue, MS#11FDS, Hartford, CT 006134-0308

Background. Timing of a response to an anthrax spore attack would be critical to preventing additional cases among those exposed. Identification of Bacillis anthracis may take 2 or more days after a finding of gram-positive rods (GPR) in blood, potentially delaying the recognition, investigation and response to an outbreak. Other causes of GPR sepsis among spore-forming organisms, in particular, Clostridia, also may have public health importance. Clusters have occurred among injecting drug users and persons receiving contaminated ligament grafts.

Objectives. To pilot surveillance for GPR sepsis and meningitis to enable earlier recognition and response to possible anthrax attacks; to determine the epidemiology and public health importance of other causes of GPR sepsis.

Methods. In January 2003, GPR septicemia or meningitis identified within 72 hours of inoculation was made physician and laboratory reportable by telephone immediately to the Department of Public Health. Standardized laboratory and clinical information is collected. The patient is interviewed for risk factors and relevant recent travel.

Results. In the first 2.5 months, 8 persons with GPR sepsis were reported. The range of time from specimen collection to growth was 12-45 hours. Of the 4 (50%) persons with clinical illness, two had Clostridium perfringens, one Listeria monocytogenes and one Lactobacillus. Of the 3 non-clinically significant cases, two had Bacillus spp. (not anthrax), one Clostridium spp., and one Priopionibacterium. Data collection is ongoing.

Conclusions. The feasibility and benefits of this pilot surveillance effort will be evaluated. Initial information indicates the system will be sustainable.

Learning Objectives:

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.

Counterterrorism and Biomedical Surveillance II: Active Bacterial Core Surveillance (ABCs) System

The 131st Annual Meeting (November 15-19, 2003) of APHA