Toll of anthrax cases reaches 15

BMJ 2001; 323 doi: (Published 03 November 2001) Cite this as: BMJ 2001;323:1022
  1. Deborah Josefson
  1. San Francisco

    Concern about the anthrax outbreak is mounting in the United States after several new cases of both the cutaneous and inhaled forms of the disease were confirmed and many governmental offices and postal sorting facilities were found to harbour anthrax spores.

    The incidents have exposed cracks in the epidemiological investigation, surveillance, and tracking systems of the United States. They have also forced government offices into temporary quarters and angered postal workers, who feel that the government was slower to address their fears and provide them with prophylactic antibiotics than they were to deal with higher level government employees.

    As the BMJ went to press on Tuesday the US Centers for Disease Control and Prevention (CDC) had confirmed 15 cases of anthrax. Four more highly suspicious cases are under investigation. The tally so far consists of seven cases of inhaled anthrax (including three deaths) and eight of cutaneous anthrax.

    The new cases are particularly alarming because they may indicate more widespread dissemination of anthrax spores and include the first confirmed occurrence of disease in people unconnected with the media, political office, or the US post office.

    A 51 year old New Jersey woman has tested positive for cutaneous anthrax. Although she lives in the vicinity of the mail processing centre that is thought to have handled the letters sent to NBC news and Senator Daschle's offices, she does not work in the centre.

    The postal workers union in New York is urging its members not to return to work until facilities are properly decontaminated. In the interim, thousands of postal workers are taking prophylactic antibiotics such as doxycycline and ciprofloxacin.

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    A member of Maryland's spill response team enters the US Post Office Express Mail Office in Baltimore to check for anthrax