Emerging Infectious Disease ISSN: 1080-6059

Syndromic Surveillance and Bioterrorism-related Epidemics

James W. Buehler*

, Ruth L. Berkelman*, David M. Hartley†, and Clarence J. Peters‡

Author affiliations: *Emory University Rollins School of Public Health, Atlanta, Georgia, USA; †University of Maryland School of Medicine, Baltimore, Maryland, USA; ‡University of Texas Medical Branch, Galveston, Texas, USA

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Figure 2

Timeline to presumptive anthrax diagnosis, 11 patients with inhalational anthrax, 2001, United States. Abbreviations: Dx, diagnosis; OutPt, outpatient visit followed by discharge home; ER, emergency room visit followed by discharge home. *Diagnosis delayed—initial blood cultures were negative in three patients who received antibiotic therapy before culture specimens were collected, requiring use of special diagnostic tests. For patients 1–10, case numbers correspond to those in report by Jerniga

Figure 2. Timeline to presumptive anthrax diagnosis, 11 patients with inhalational anthrax, 2001, United States. Abbreviations: Dx, diagnosis; OutPt, outpatient visit followed by discharge home; ER, emergency room visit followed by discharge home. *Diagnosis delayed—initial blood cultures were negative in three patients who received antibiotic therapy before culture specimens were collected, requiring use of special diagnostic tests. For patients 1–10, case numbers correspond to those in report by Jernigan et al. (13); patient 11 reported by Barakat et al. (14). A, timeline begins with presumed date of anthrax exposure, available for six patients. B, timeline begins with day of illness onset for five patients without recognized date of exposure.

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¹For interval calculations, if reported event dates were discrepant in different case reports, dates reported by Jernigan et al. (13) were used.

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