Recognition and Management of Anthrax — An Update

Abstract

The events that began this September, which have been described repeatedly in the media, have heightened awareness of and concern about anthrax. The initial reports documented 12 cases of clinical anthrax. These included two cases of inhalational anthrax (one of them fatal) among employees of a tabloid publishing company in Boca Raton, Florida, and four other cases of inhalational anthrax (two of them fatal) among postal workers in Washington, D.C., and Trenton, New Jersey. The six other confirmed cases of anthrax were of the cutaneous form, including two cases of cutaneous anthrax in New York City in persons who had been in the offices of major broadcasting networks and one case in a postal worker in Trenton. Serologic testing performed by health officials in Boca Raton revealed that five other employees of the tabloid publishing company had antibodies to the anthrax bacillus, although confirmation is needed in the form of rising titers in follow-up samples. There has been widespread concern about the reports that envelopes containing anthrax spores were sent to offices in Washington, D.C., and elsewhere. Newspaper reports indicate that 28 persons in the offices of the U.S. Senate had evidence of anthrax exposure on nasal swabs. (Updated figures on confirmed and suspected cases of anthrax are available on the Centers for Disease Control and Prevention [CDC] Web site, at http://www.bt.cdc.gov.)