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

Bioterrorism-related Anthrax

Laboratory Response to Anthrax Bioterrorism, New York City, 2001

Michael B. Heller*, Michel L. Bunning†Comments to Author , Martin E.B. France‡, Debra M. Niemeyer§, Leonard Peruski¶, Tim Naimi†, Phillip M. Talboy†, Patrick H. Murray#, Harald W. Pietz†, John Kornblum*, William Oleszko*, Sara T. Beatrice*, and Joint Microbiological Rapid Response Team1New York City Anthrax Investigation Working Group2
Author affiliations: *New York City Department of Health, New York, New York, USA; †Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ‡Warfighting Concepts and Architecture Integration Division (J-8), The Joint Staff, Washington, D.C., USA; §Joint Program Office for Biological Defense, Falls Church, Virginia, USA; ¶Naval Medical Research Center, Silver Spring, Maryland, USA; #Seymour Johnson Air Force Base, Goldsboro, North Carolina, USA;

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Figure 1

Depiction of the algorithm used to determine the priority of items received for testing at the New York City Bioterrorism Response Laboratory. One of the salient features of the surge was the broad array of items that the laboratory received for testing. Many items contained innocuous powdery substances that are now known to be unrelated to the attack, yet prudent practices required that they be ruled out. The laboratory needed to identify which items were the most urgent and place them first and used this algorithm and other triage methods to prioritize the samples. Samples with 8 out of 11 points or greater were deemed STAT for “highest priority for laboratory testing” and received preferential treatment. Most samples fell into a middle category and were processed in order based on time received.

Figure 1. Depiction of the algorithm used to determine the priority of items received for testing at the New York City Bioterrorism Response Laboratory. One of the salient features of the surge was the broad array of items that the laboratory received for testing. Many items contained innocuous powdery substances that are now known to be unrelated to the attack, yet prudent practices required that they be ruled out. The laboratory needed to identify which items were the most urgent and place them first and used this algorithm and other triage methods to prioritize the samples. Samples with 8 out of 11 points or greater were deemed STAT for “highest priority for laboratory testing” and received preferential treatment. Most samples fell into a middle category and were processed in order based on time received.

Main Article

1 The Joint Microbiological Rapid Response Team consisted of the Biological Defense Research Directorate, Naval Medical Research Center, Bethesda, Maryland: F. Baluyot, M. Boyd, and T. Hudson; 4th Medical Support Squadron, Seymour Johnson Air Force Base, North Carolina, USA: L. M. Bayquen and L. Galloway; and 7th Medical Support Squadron, Dyess Air Force Base, Texas: L. De Los Santos and C. Sekula.

2 The New York City Anthrax Investigation Working Group consisted of Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention (CDC), Fort Collins: May Chu, David Dennis, Kathleen Julian, Anthony A. Marfin, and Lyle Petersen; CDC, Atlanta: Mary Brandt, Richard Kanwal, Kristy Kubota, Els Mathieu, Steve Ostroff, John Painter, Dejana Selenic, Allison Stock, Linda Weigel, and William Wong; New York City Department of Health: Neal Cohen, Laura Mascuch, Denis Nash, Sarah Perl, and Don Weiss; New York City Public Health Laboratories: Alice Agasan, Jay Amurao, Josephine Atamian, Debra Cook, Erica DeBernardo, Adeleh Ebrahimzadeh, Philomena Fleckenstein, Anne Marie Incalicchio, John Kornblum, Ed Lee, William Oleszko, Lynn Paynter, Alexander Ramon, Chiminyan Sathyakumar, Harold Smalls, George Williams, Marie T. Wong, and Ben Y. Zhao.

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