Update: Anthrax Investigations, Florida and New York

Florida

The Palm Beach Count Control and Prevention have confirmed that the 73-year-old male employee of American Media Inc., hospitalized since the beginning of October, has been diagnosed as a probable case of anthrax disease. The diagnosis cannot be confirmed according to the strictest diagnostic criteria (requires isolation of the bacteria from a clinical specimen such as blood, lung samples, or spinal fluid). However, the overall picture of clinical symptoms combined with positive results on laboratory tests suggest to y Health Department, Florida Department of Health, and the Centers for Disease health officials that this individual has anthrax disease.

Also, a minuscule amount of anthrax spores has been found in a small, non-public mail processing area of the Boca Raton Main post office. There is no indication that these spores pose a health risk to workers or visitors. As an extraordinary precaution, health officials are asking employees to leave this small portion of the building. The affected area will be cleaned tonight — after the post office closes. The post office will be open again for business in the morning.

In Florida, there are 2 cases of anthrax and 1 exposure.

For more information on this investigation, contact the Palm Beach County Health Department, (561) 712–6488/6400.

New York

Preliminary tests indicate cutaneous (skin) anthrax disease in an infant. The child’s mother, an ABC employee, took the child with her to the ABC building on West 66th Street in Manhattan on September 28. While it is not certain that the child came into contact with anthrax bacteria at the ABC building, it is currently the focus of the investigation. The child was started on a course of antibiotics and is doing well. The New York City Health Department is not aware of any other individuals with symptoms of cutaneous anthrax who work in, or visited, the ABC building. The infant’s doctor notified the Health Department on October 12 that the symptoms might be suggestive of a cutaneous anthrax infection. On October 13, a skin biopsy was CDC for testing and the Health Department received the results on October 15.

In New York, there are 2 cases of anthrax and 3 exposures.

For more information on this investigation, contact the New City Health Department, (212) 295-5335 or online at: www.ci.nyc.ny.us/html/doh/home.html

Washington

CDC and health officials in the District of Columbia are conducting an public health investigation related to possible anthrax exposure on Capitol Hill. CDC has sent a team of investigators to assist with the investigation.

Nationally

There are numerous reports of potential anthrax cases throughout the United States. The initial assessment of these incidents is made at the state level. CDC is providing technical assistance to the states on "How to handle anthrax and other biological agent threats."

Facts about anthrax

Cutaneous anthrax accounts for 95 percent of the cases. It is acquired through a cut or scab in the skin. The first sign is an itchy bump that looks like an insect bite. Within one to two days, the bump turns into a 1-3 centimeter blister, eventually covered by a black scab (hence the name anthrax, which is Greek for coal). Nearby lymph glands may also swell. The disease produces headaches, muscle aches, fever, nausea, and vomiting. If left untreated, cutaneous anthrax is fatal in 20 percent of the cases.

Inhalation anthrax is the most serious and rare form of human anthrax. It occurs when a person breathes anthrax spores that are in the air. Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. If left untreated, inhalation anthrax is usually fatal.

Gastrointestinal anthrax stems from eating contaminated meat. It is characterized by an acute inflammation of the intestinal tract. Initial symptoms include nausea, vomiting, loss of appetite, and fever, followed by abdominal pain, vomiting of blood, and severe diarrhea. If left untreated, gastrointestinal anthrax is fatal in 25 to 60 percent of cases.

Antibiotics are an effective treatment if the disease is diagnosed early on; but anthrax can be fatal if left untreated. The effective antibiotics are penicillin, doxycycline, ciproflaxin, and fluoroquinolones. The anthrax vaccine is only available to the military and is not recommended for the general public.

Anthrax is NOT contagious. Because the bacteria do not produce spores while they are growing in an infected person, anthrax cannot be transmitted from person to person. Therefore, there is no need to treat or vaccinate contacts of persons ill with anthrax, such as relatives, friends, or coworkers, unless they were also exposed to the same source of infection.

Surveillance

During this heightened surveillance, cases of illness that in any way resemble symptoms of anthrax will be thoroughly reviewed until anthrax can be ruled out. To protect the privacy of patients, CDC will not discuss specifics of suspect cases. If a case of anthrax is confirmed, CDC will immediately work with state and local health officials to report this case to the public and to describe any actions that should be taken by the medical community or the public.

As we have cautioned, the public needs to understand that we have put the public health and medical community on a heightened level of disease monitoring. So there may be more reports of suspect cases. We are going to respond more aggressively to these cases than in the past. This is the disease monitoring system in action. The system is working.

If anyone has been exposed, antibiotics are the appropriate preventive treatment. CDC has an emergency supply of antibiotics readily available for distribution. If the investigation of the cause of this illness indicated that people need antibiotics, state and local health departments will notify the public and physicians and will assure those who need drugs will receive them.

For the latest update on CDC activities and on-going anthrax investigations visit www.bt.cdc.gov/ or www.cdc.gov/media/