Public Health Message Regarding Anthrax Case

The Palm Beach County Department of Health, Florida State Department of Health and the CDC are continuing to conduct a public health investigation related to the anthrax exposure at the AMI Building in Palm Beach.

To date, the investigation has confirmed: 1) a single case of anthrax illness in a patient who died, 2) an individual exposed to anthrax with laboratory confirmation of exposure who continues to be hospitalized and, 3) another individual with laboratory confirmation of exposure who is not hospitalized. This latest exposure confirmation was based on a nasal swab from among evaluated workers and visitors to the AMI Building.

Evaluation and screening continues for people who worked or visited the AMI Building since August 1. To date nearly 1,000 people have been given health guidance and protective antibiotics. In addition, nasal swabs were taken from individuals who received the antibiotics to help evaluate the epidemiology of the exposure. A negative swab result does NOT rule out a possible exposure. For that reason, people MUST complete the full 60-day course, regardless of the results of the nasal swab.

Anthrax is a clinical illness caused by Bacillus anthracis (also called B. anthracis); three main types of anthrax are cutaneous (acquired through direct skin contact with source); gastrointestinal (acquired by ingestion); and inhalation (acquired through the airways from environmental sources). Anthrax is NOT contagious, meaning it CANNOT be transmitted from one person to another.

CDC, state and local health officials continue to work closely with medical professionals in Florida and nationwide to monitor hospitals and out-patient clinics for any possible additional cases of anthrax. So far, the cases of anthrax reported in Florida appear to be isolated, but an aggressive investigation is ongoing.

During this heightened surveillance, cases of illness that may reasonably resemble symptoms of anthrax will be thoroughly reviewed until anthrax can be ruled out.

The public health and medical community continue to be on a heightened level of disease monitoring. This is the disease monitoring system in action and that system is working.

Background:

For anyone exposed to anthrax, antibiotics are the appropriate preventive treatment. CDC has an emergency supply of antibiotics readily available for distribution. During this investigation, CDC tapped the National Pharmaceutical Stockpile, which guarantees enough antibiotics were in place to treat several thousand people in Palm Beach County, if needed. A total of 100 cases of antibiotics were air shipped to Palm Beach County and were in place before the clinic doors opened to the nearly 1,000 AMI building workers and visitors who were evaluated and prescribed protective antibiotics.

Every step in this public health investigation has been directed at answering: 1) who might also be ill and may need immediate treatment and, 2) what can be done now to protect anyone else from becoming ill. CDC's disease detectives have 50 years of on-the-job experience in getting answers to tough questions like these.

On October 4, based on a request from the state public health official, CDC had a team of investigators in the air and on their way to Florida, even before CDC's lab confirmed the diagnosis of the first case of anthrax illness.

Although the disease investigation continues at full tilt, CDC is far enough into this investigation to reassure the public that this appears to be a local and isolated exposure focused in one building. Nevertheless, CDC is not packing up and going home. The investigation continues as long as any public health questions remain.

CDC will release all information that is important for public safety. CDC's first priority is to protect the public's health.

Anthrax strain

The priority tests done at CDC were to 1) confirm the organism was Bacillus anthracis and 2) determine what antibiotics would protect people from developing anthrax illness, if exposed. The tests confirmed anthrax and determined that the strain of anthrax was sensitive to a wide range of antibiotics, including penicillin, giving public health officials important treatment information.

Testing to characterize the strain of the Bacillus anthracis found in the Florida case is ongoing. All three confirmed samples analyzed are the same strain. The strain characterization is an interesting part of a disease investigation, but not immediately required for the prevention and/or control of the those who may have been exposed in the AMI building. When available, information will be released, in collaboration with the FBI, and the U.S. Attorney's office.