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Screening for inhalational anthrax due to bioterrorism: evaluating proposed screening protocols.

John M Howell1, Thom A Mayer, Dan Hanfling

  • 1Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, VA 22042-3300, USA. john.howell@inova.com

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 4, 2004
PubMed
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The Mayer criteria effectively screened for inhalational anthrax (IA) during the 2001 bioterrorism outbreak, identifying all cases. This method also proved more cost-effective than the Hupert criteria for IA screening.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Bioterrorism-related inhalational anthrax (IA) poses a significant public health threat.
  • Effective screening protocols are crucial for rapid identification and management of IA cases.
  • The 2001 anthrax attacks highlighted the need for validated diagnostic tools.

Purpose of the Study:

  • To retrospectively compare the effectiveness and cost-efficiency of two proposed screening methods for inhalational anthrax.
  • To evaluate the performance of the Mayer and Hupert criteria in identifying IA during a real-world bioterrorism event.

Main Methods:

  • Retrospective analysis of emergency department charts from patients presenting with potential IA symptoms.
  • Application of the Mayer and Hupert screening criteria to patient data.

Related Experiment Videos

  • Comparison of the number of patients screened and associated costs for each criteria set.

    • Main Results:

    • The Mayer criteria would have screened 4 patients (0.4%) with estimated charges of $1900.
    • Screening based on symptoms alone (without fever/tachycardia) would have included 29 patients (2.6%) with charges of $13,325.
    • The Hupert criteria would have screened 273 patients (24%) with estimated charges of $126,025.

    Conclusions:

    • The Mayer criteria successfully identified all IA patients in the 2001 outbreak.
    • The Mayer criteria demonstrated superior cost-effectiveness compared to the Hupert criteria for IA screening.
    • These findings support the utility of the Mayer criteria for efficient IA detection in bioterrorism scenarios.