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Volume 8, Number 10—October 2002
THEME ISSUE
Bioterrorism-related Anthrax
Anthrax Perspectives

Epidemiologic Responses to Anthrax Outbreaks: A Review of Field Investigations, 1950–2001

Michael E. Bales*, Andrew L. Dannenberg*Comments to Author , Philip S. Brachman†, Arnold F. Kaufmann*, Peter C. Klatsky*‡, and David A. Ashford*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Emory University Rollins School of Public Health, Atlanta, Georgia, USA; ‡Mt. Sinai School of Medicine, New York, New York;

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Table 1

CDC field investigations of suspected anthrax in humans and animals and reported cases of anthrax in humans, United States, 1950–2001a

Years Field investigations
 No. of cases of anthrax in humans reported nationallyc
No. of investigationsb No. of human cases
Cutaneous Inhalational Total
1950–54 2 1 0 1 223
1955–59 11 16 6 22 131
1960–64 4 5 1 6 54
1965–69 7 5 1 6 21
1970–74 8 4 0 4 13
1975–79 6 5 1 6 10
1980–84 0 0 0 0 2
1985–89 1 1 0 1 3
1990–94 1 0 0 0 1
1995–99 2 0 0 0 0
2000–01d 2 2 0 2 Not available
Total 44 39 9 48 458

aCDC, Centers for Disease Control and Prevention.
bExcludes three investigations of suspected anthrax conducted outside the United States (1967, 1986, 1998) and two investigations focused on decontamination of Bacillus anthracis–contaminated textile mills (1967, 1972).
cSources: CDC. MMWR Summary of Notifiable Diseases, United States, 1994 (10); and MMWR Summary of Notifiable Diseases, United States, 1999 (11).
dBefore October 2001 bioterrorism-related anthrax cases.

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References
  1. Centers for Disease Control and Prevention. Interim guidelines for investigation of and response to Bacillus anthracis exposures. MMWR Morb Mortal Wkly Rep. 2001;50:987–90.PubMedGoogle Scholar
  2. Brachman  PS, Gold  H, Plotkin  SA, Fekety  FR, Werrin  M, Ingraham  NR. Field evaluation of a human anthrax vaccine. Am J Public Health. 1962;52:632–45. DOIGoogle Scholar
  3. Kaufmann  AF, Fox  MD, Kolb  RC. Anthrax in Louisiana, 1971: an evaluation of the Sterne strain anthrax vaccine. J Am Vet Med Assoc. 1973;163:442–5.PubMedGoogle Scholar
  4. Brachman  PS, Fekety  FR. Industrial anthrax. Ann N Y Acad Sci. 1958;70:574–84. DOIPubMedGoogle Scholar
  5. Centers for Disease Control and Prevention. Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2000;49(RR-15):1–20.PubMedGoogle Scholar
  6. Tanner  WB, Potter  ME, Teclaw  RF, Kaufmann  AF, Bilderback  WR, Dorris  KD, Public health aspects of anthrax vaccination of dairy cattle. J Am Vet Med Assoc. 1978;173:1465–6.
  7. Consumer Product Safety Commission. CPSC warns consumers of possible contamination of goatskin products. News release no.74-026, May 1974. Accessed July 8, 2002. Available from: URL: http://www.cpsc.gov/cpscpub/prerel/prhtml74/74026.html
  8. Thacker  SB, Dannenberg  AL, Hamilton  DH. Epidemic Intelligence Service of the Centers for Disease Control and Prevention: 50 years of training and service in applied epidemiology. Am J Epidemiol. 2001;154:985–92. DOIPubMedGoogle Scholar
  9. Centers for Disease Control and Prevention. Public health emergency preparedness & response: anthrax. Accessed July 8, 2002. Available from: URL: http://www.bt.cdc.gov/Agent/Anthrax/Anthrax.asp
  10. Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1994. MMWR Morb Mortal Wkly Rep. 1994;43:74, 76, 78.
  11. Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1999. MMWR Morb Mortal Wkly Rep. 1999;48:84, 86, 88–9.
  12. Suffin  SC, Carnes  WH, Kaufmann  AF. Inhalation anthrax in a home craftsman. Hum Pathol. 1978;9:594–7. DOIPubMedGoogle Scholar
  13. Jernigan  JA, Stephens  DS, Ashford  DA, Omenaca  C, Topiel  MS, Galbraith  M, Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. Emerg Infect Dis. 2001;7:1–22.PubMedGoogle Scholar
  14. Centers for Disease Control and Prevention. Human anthrax associated with an epizootic among livestock—North Dakota, 2000. MMWR Morb Mortal Wkly Rep. 2001;50:677–80.PubMedGoogle Scholar
  15. National Institute for Occupational Safety and Health. Krake AM, Connon CL, Gomez TM. Health hazard evaluation report HETA 93-1121-2530, the State of North Dakota Department of Health and Consolidated Laboratories, Bismarck, North Dakota. Cincinnati (OH): The Institute; 1995. National Technical Information Service order number: PB96-197611.
  16. Harrison  LH, Ezzell  JW, Abshire  TG, Kidd  S, Kaufmann  AF. Evaluation of serologic tests for diagnosis of anthrax after an outbreak of cutaneous anthrax in Paraguay. J Infect Dis. 1989;160:706–10.PubMedGoogle Scholar
  17. Center for Disease Control. Animal anthrax—Texas. MMWR Morb Mortal Wkly Rep. 1976;25:293.
  18. Fox  MD, Boyce  JM, Kaufmann  AF, Young  JB, Whitford  HW. An epizootiologic study of anthrax in Falls County, Texas. J Am Vet Med Assoc. 1977;170:327–33.PubMedGoogle Scholar
  19. Young  JB. Epizootic of anthrax in Falls County, Texas. J Am Vet Med Assoc. 1975;167:842–3.PubMedGoogle Scholar
  20. Fox  MD, Kaufmann  AF, Zendel  SA, Kolb  RC, Songy  CG Jr, Cangelosi  DA, Anthrax in Louisiana, 1971: epizootiologic study. J Am Vet Med Assoc. 1973;163:446–51.PubMedGoogle Scholar
  21. Center for Disease Control. Human anthrax—Louisiana. MMWR Morb Mortal Wkly Rep. 1971;20:412.
  22. Center for Disease Control. Cattle anthrax—Wyoming. MMWR Morb Mortal Wkly Rep. 1970;19:389–90.
  23. Communicable Disease Center. Animal anthrax and presumptive human anthrax—California. MMWR Morb Mortal Wkly Rep. 1968;17:279.
  24. Communicable Disease Center. Animal anthrax—North Dakota. MMWR Morb Mortal Wkly Rep. 1965;14:270.
  25. National Office of Vital Statistics. Anthrax in animals. MMWR Morb Mortal Wkly Rep. 1957;6:2.
  26. National Office of Vital Statistics. Anthrax. Wkly Morbidity Rep. 1952;1:1.
  27. Centers for Disease Control. Human cutaneous anthrax—North Carolina, 1987. MMWR Morb Mortal Wkly Rep. 1988;37:413–4.PubMedGoogle Scholar
  28. Young  LS, Feeley  JC, Brachman  PS. Vaporized formaldehyde treatment of a textile mill contaminated with Bacillus anthracis. Arch Environ Health. 1970;20:400–3.PubMedGoogle Scholar
  29. Communicable Disease Center. Inhalation anthrax—Delaware County, Pennsylvania. MMWR Morb Mortal Wkly Rep. 1961;10:2.
  30. National Office of Vital Statistics. Provisional information on selected notifiable diseases in the United States and on deaths in selected cities for week ended March 5, 1960. MMWR Morb Mortal Wkly Rep. 1960;9:1.
  31. Brachman  PS, Pagano  JS, Albrink  WS. Two cases of fatal inhalation anthrax, one associated with sarcoidosis. N Engl J Med. 1961;265:203–8.
  32. National Office of Vital Statistics. Anthrax. MMWR Morb Mortal Wkly Rep. 1957;6:2.
  33. Norman  PS, Ray  JG, Brachman  PS, Plotkin  SA, Pagano  JS. Serologic testing for anthrax antibodies in workers in a goat hair processing mill. Am J Hyg. 1960;72:32–7.PubMedGoogle Scholar
  34. Brachman  PS, Plotkin  SA, Bumford  FH, Atchison  MM. An epidemic of inhalation anthrax: The first in the twentieth century. II. Epidemiology. Am J Hyg. 1960;72:6–23.PubMedGoogle Scholar
  35. Dahlgren  CM, Buchanan  LM, Decker  HM, Freed  SW, Phillips  CR, Brachman  PS. Bacillus anthracis aerosols in goat hair processing mills. Am J Hyg. 1960;72:24–31.PubMedGoogle Scholar
  36. Plotkin  SA, Brachman  PS, Utell  M, Bumford  FH, Atchison  MM. An epidemic of inhalation anthrax, the first in the twentieth century. I. Clinical features. Am J Med. 1960;29:992–1001. DOIPubMedGoogle Scholar
  37. National Office of Vital Statistics. Anthrax. MMWR Morb Mortal Wkly Rep. 1956;5:1.
  38. Centers for Disease Control and Prevention. Bioterrorism alleging use of anthrax and interim guidelines for management—United States, 1998. MMWR Morb Mortal Wkly Rep. 1999;48:69–74.PubMedGoogle Scholar
  39. Consumer Product Safety Commission. CPSC warns about possible anthrax contamination in imported yarn. News release # 76-011, February 1976. Accessed July 8, 2002. Available from: URL: http://www.cpsc.gov/cpscpub/prerel/prhtml76/76011.html
  40. Center for Disease Control. Anthrax—California. MMWR Morb Mortal Wkly Rep. 1976;25:33–4.
  41. Occupational Safety and Health Review Commission and Administrative Law Judge Decisions. Docket number 76-596. Case citation 10 BNA OSHC 1203, 1981.
  42. Communicable Disease Center. Cutaneous anthrax—New Jersey. MMWR Morb Mortal Wkly Rep. 1965;14:308.
  43. Communicable Disease Center. Case of anthrax—New Jersey. MMWR Morb Mortal Wkly Rep. 1969;18:212.
  44. Center for Disease Control. Animal anthrax associated with pack saddle pads—Washington. MMWR Morb Mortal Wkly Rep. 1974;23:339–40.
  45. Consumer Product Safety Commission. Consumers warned about possible saddle pad anthrax contamination. News release # 74-073, Nov 1974. Accessed July 8, 2002. Available from: URL: http://www.cpsc.gov/cpscpub/prerel/prhtml74/74073.html
  46. Center for Disease Control. Anthrax contamination of Haitian goatskin products. MMWR Morb Mortal Wkly Rep. 1977;26:31.
  47. Center for Disease Control. Anthrax contamination of Haitian goatskin products. MMWR Morb Mortal Wkly Rep. 1981;30:338.
  48. Center for Disease Control. Cutaneous anthrax acquired from imported Haitian drums—Florida. MMWR Morb Mortal Wkly Rep 1974;23:142,147.
  49. Center for Disease Control. Follow-up on cutaneous anthrax acquired from imported Haitian drums—Florida. MMWR Morb Mortal Wkly Rep. 1974;23:149–50.
  50. Center for Disease Control. Follow-up on cutaneous anthrax acquired from imported Haitian drums—Florida. MMWR Morb Mortal Wkly Rep. 1974;23:224.
  51. Communicable Disease Center. Anthrax—Ohio. MMWR Morb Mortal Wkly Rep. 1964;13:118.
  52. Roueche  B. Annals of medicine: A man named Hoffman (original article published in 1965). The New Yorker. Posted Oct. 22, 2001 on the archive. Accessed July 8, 2002. Available from: URL: http://www.newyorker.com/FROM_THE_ARCHIVE/ARCHIVES/?011029fr_archive02
  53. Communicable Disease Center. Cutaneous anthrax—South Carolina. MMWR Morb Mortal Wkly Rep. 1965;14:270.
  54. Centers for Disease Control and Prevention. Human ingestion of Bacillus anthracis-contaminated meat—Minnesota, August 2000. MMWR Morb Mortal Wkly Rep. 2000;49:813–6.
  55. Brachman  PS, Kaufmann  AF, Dalldorf  FG. Industrial inhalation anthrax. Bacteriol Rev. 1966;30:646–57.PubMedGoogle Scholar
  56. Centers for Disease Control and Prevention. Update: investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001. MMWR Morb Mortal Wkly Rep. 2001;50:889–93.PubMedGoogle Scholar
  57. Dixon  TC, Meselson  M, Guillemin  J, Hanna  PC. Medical progress: anthrax. N Engl J Med. 1999;341:815–26. DOIPubMedGoogle Scholar
  58. Swartz  MN. Recognition and management of anthrax—an update. N Engl J Med. 2001;345:1621–6. DOIPubMedGoogle Scholar
  59. Center for Disease Control. Human orf mimicking cutaneous anthrax—California. MMWR Morb Mortal Wkly Rep. 1973;22:108.
  60. Carr  EA, Rew  RR. Recovery of Bacillus anthracis from the nose and throat of apparently healthy workers. J Infect Dis. 1957;100:169–71.PubMedGoogle Scholar
  61. Quinn  CP, Semenova  VA, Elie  CM, Romero-Steiner  S, Greene  C, Li  H, A specific, sensitive, and quantitative enzyme-linked immunosorbent assay for human immunoglobulin G antibodies to anthrax toxin protective antigen. Emerg Infect Dis. 2002;8.
  62. Centers for Disease Control and Prevention. Additional options for preventive treatment for persons exposed to inhalation anthrax. MMWR Morb Mortal Wkly Rep 2001;50:1142,1151.
  63. Centers for Disease Control and Prevention. Update: interim recommendations for antimicrobial prophylaxis for children and breastfeeding mothers and treatment of children with anthrax. MMWR Morb Mortal Wkly Rep. 2001;50:1014–6.PubMedGoogle Scholar
  64. Brachman  PS. Inhalation anthrax. Ann N Y Acad Sci. 1980;353:83–93. DOIPubMedGoogle Scholar
  65. Centers for Disease Control and Prevention. Evaluation of Bacillus anthracis contamination inside the Brentwood Mail Processing and Distribution Center—District of Columbia, October 2001. MMWR Morb Mortal Wkly Rep. 2001;50:1129–33.
  66. Turell  MJ, Knudson  GB. Mechanical transmission of Bacillus anthracis by stable flies (Stomoxys calcitrans) and mosquitoes (Aedes aegypti and Aedes taeniorhynchus). Infect Immun. 1987;55:1859–61.PubMedGoogle Scholar
  67. Centers for Disease Control and Prevention. Use of onsite technologies for rapidly assessing environmental Bacillus anthracis contamination on surfaces in buildings. MMWR Morb Mortal Wkly Rep. 2001;50:1087.PubMedGoogle Scholar

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Page created: July 19, 2010
Page updated: July 19, 2010
Page reviewed: July 19, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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