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Inhalational anthrax outbreak among postal workers, Washington, D.C., 2001
Puneet K Dewan1, Alicia M Fry, Kayla Laserson
1Centers for Desease Control and Prevention , Atlanta, Georgia 30333, USA.
Emerging Infectious Diseases
|October 25, 2002
Summary
Four Washington D.C. postal workers contracted inhalational anthrax from Bacillus anthracis spores in envelopes. Environmental sampling revealed widespread contamination, necessitating prophylaxis for all employees due to undeterminable risk factors.
Area of Science:
- Public Health
- Occupational Safety
- Infectious Disease Epidemiology
Background:
- In October 2001, a Washington D.C. mail facility experienced an inhalational anthrax outbreak.
- The outbreak involved Bacillus anthracis spores contaminating envelopes processed by postal workers.
Observation:
- Four workers developed inhalational anthrax across non-overlapping shifts, indicating multiple aerosolization events.
- Environmental sampling confirmed diffuse Bacillus anthracis spore contamination throughout the facility.
- Exposure histories and nasal swab cultures did not differentiate case-patients from the general worker sample.
Findings:
- Serum antibody tests for B. anthracis protective antigen were negative in all assessed employees.
- Current diagnostic tools could not identify specific subgroups at higher risk for anthrax exposure or disease.
- The study highlighted the challenges in pinpointing high-risk individuals during a bioterrorism event in a shared workspace.
Implications:
- Universal prophylaxis was deemed necessary for all postal workers due to widespread contamination and inability to identify high-risk groups.
- The findings underscore the critical need for enhanced biosecurity measures in mail processing facilities to mitigate bioterrorism risks.
- Developing improved methods for exposure assessment and risk stratification is crucial for protecting workers in similar occupational settings.