Thursday, January 10, 2002, 19:35 EST (7:35 PM EST)
CDCHAN-00068-2002-01-10-UPD-N
Investigation of Suspicious Illnesses
The Centers for Disease Control and Prevention's medical epidemiologists have investigated the illness in a postal inspector reported in the current issue of the Journal of the American Osteopathic Association (JAOA). (1) After a thorough review of clinical, laboratory, diagnostic imaging, and serology results related to the case, CDC determined that the illness did not meet the anthrax case definition.
CDC's definition of a confirmed case of anthrax is described as 1) a clinically compatible case of cutaneous, inhalational, or gastrointestinal illness that is laboratory confirmed by isolation of B. anthracis from an affected tissue or site or 2) other laboratory evidence of B. anthracis infection based on at least two supportive laboratory tests. A suspected case of anthrax is defined as 1) a clinically compatible case of illness without isolation of B. anthracis and no alternative diagnosis, but with laboratory evidence of B. anthracis by one supportive laboratory test or 2) a clinically compatible case of anthrax epidemiologically linked to a confirmed environmental exposure, but without corroborative laboratory evidence of B. anthracis infection. (2)
On November 18, 2001, CDC held a meeting of clinicians and health department personnel from areas where anthrax cases were identified, infectious disease experts, representatives of professional societies, and experts from federal agencies to discuss the prophylaxis, diagnosis, and treatment of anthrax. (3) The clinical case definitions were reviewed and agreed upon by the experts at this meeting. CDC has no plans to update or to modify the anthrax case definitions at this time.
CDC understands that physicians throughout the country have a heightened awareness of suspicious illnesses. CDC is very interested in following up on reports of such illnesses as part of our ongoing surveillance and to better understand anthrax and its effects in exposed persons.
1) Symptoms Associated with Anthrax Exposure: Suspected "Aborted" Anthrax. JAOA; January, 2002, 102(1):41-43.
2) Update: Investigation of Anthrax Associated with Intentional Exposure and Interim Public Health Guidelines. October 2001 MMWR; October 19, 2001, 50(41): 889-893.
3) Meeting Summary: Clinical Issues in the Prophylaxis, Diagnosis, and Treatment of Anthrax. Journal of Emerging Infectious Diseases; February, 2002, 8 (2).
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