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Volume 8, Number 10—October 2002
THEME ISSUE
Bioterrorism-related Anthrax

Bioterrorism-related Anthrax

Epidemiologic Investigations of Bioterrorism-Related Anthrax, New Jersey, 2001

Carolyn M. Greene*Comments to Author , Jennita Reefhuis*, Christina Tan*, Anthony E. Fiore*, Susan Goldstein*, Michael J. Beach*, Stephen C. Redd*, David Valiante, Gregory Burr*, James W. Buehler*, Robert W. Pinner*, Eddy Bresnitz, Beth P. Bell*, and the CDC New Jersey Anthrax Investigation Team
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA;

Main Article

Table 2

Initial clinical findings in four patients with bioterrorism-related cutaneous anthrax, New Jersey, September-October 2001a

Clinical finding
No. of cases with clinical finding
Physical findings
Edema surrounding skin lesion 4/4
Black eschar 2/4
Lesion associated with pustules or vesicles 2/4
Tender 2/4
Pruritic 1/4
Laboratory results
Blood culture positive for Bacillus anthracis 1/4b
Blood or tissue positive for B. anthracis by PCR 2/4
IHC staining positive for B. anthracis 3/4c
Convalescent-phase serumd: anti-PA IgG antibodies present (“reactive serology”) 4/4
Initial diagnosis
Cellulitis 3/4
Insect bite 1/4

aIHC, immunohistochemical staining; PCR, polymerase chain reaction; anti-PA IgG, anti-protective antigen immunoglobulin G.
bOnly 1/4 patients with cutaneous anthrax had blood cultures drawn before the initiation of antibiotic therapy. This was the one patient with a blood culture positive for B. anthracis.
cThe 4th patient did not have tissue available for IHC staining.
dConvalescent-phase serum is serum drawn at least 14 days after symptoms begin.

Main Article

1 The CDC New Jersey Anthrax Investigation Team consists of Paul P. Abamonte, Chidinma Alozie-Arole, Gregory Armstrong, Sherrie Bruce, Shadi Chamany, Diane Crawford, Donita R. Croft, Colleen Crowe, Stephanie I. Davis, George DiFerdinando, Catherine Dentinger, Deborah A. Deppe, Mary Dillon, Mary Dott, Leigh A. Farrington, Michael Fraser, Dara S. Friedman, Jessica Gardom, Carol Genese, Dawn Gnesda, Rita Helfand, Beth C. Imhoff, Greg J. Jones, Renee Joskow, Pavani Kalluri, Sean G. Kaufman, Melody Kawamoto, Malinda Kennedy, Jonathon D. King, Susan McClure, Michelle McConnell, Peter D. McElroy, Kenneth R. Mead, Suzanne Miro, R. Leroy Mickelsen, Jeff Nemhauser, Mita Patel, Cindi Pecoraro, Marion Pierce, Lisa Roth-Edwards, Hardeep Sandhu, Donald Schill, Michael Sells, Nicole Tucker, Reuben Varghese, Daniel J. Yereb, and Juan Zubieta.

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