Accuracy of screening for inhalational anthrax after a bioterrorist attack

Area of Science:

• Public Health
• Infectious Diseases
• Biosecurity

Background:

• Anthrax bioterrorism remains a public health concern following the 2001 U.S. attacks.
• Mass screening for inhalational anthrax is crucial for effective management and resource allocation post-attack.

Purpose of the Study:

• To establish evidence for outpatient anthrax screening protocols.
• To differentiate clinical presentations of inhalational anthrax from common viral respiratory infections.

Main Methods:

• Systematic review and data extraction from case reports of inhalational anthrax.
• Analysis of epidemiologic studies on influenza and other viral respiratory infections.
• Quantification of clinical feature differences and likelihood ratios.

Main Results:

• Fever and cough are not reliable indicators for distinguishing anthrax from viral infections.
• Symptoms like dyspnea, nausea/vomiting, and abnormal lung auscultation suggest anthrax.
• Rhinorrhea and sore throat are more indicative of viral respiratory infections.

Conclusions:

• Inhalational anthrax exhibits unique clinical features compared to common viral illnesses.
• Screening protocols utilizing these distinct features can facilitate rapid identification of potential anthrax cases.
• This approach supports timely intervention during large-scale anthrax events.