Volume 8, Number 10—October 2002
THEME ISSUE
Bioterrorism-related Anthrax
Bioterrorism-related Anthrax
Epidemiologic Investigations of Bioterrorism-Related Anthrax, New Jersey, 2001
Table 3
Clinical finding | Case 1 | Case 2 |
---|---|---|
Past medical history | Transient ischemic attack | None |
Smoking status | Nonsmoker | Nonsmoker |
Initial symptoms | Fever, chills, vomiting, diarrhea | Fever, chills, vomiting, dry cough, headache |
Signs at ER visit | Fever: temp=38.4°C; Tachycardia: HR=120/min; Hypoxia: arterial paO2=58 (RA) | Fever: temp=38.4°C; Tachycardia: HR=120/min; Hypoxia: SaO2=92% (RA) |
Chest x-ray | Infiltrate, pleural effusion | Infiltrate, pleural effusion |
Hospital course | Re-accumulating hemorrhagic pleural effusions | Re-accumulating hemorrhagic pleural effusions |
Laboratory results | ||
Blood culture | Negative (before start of antibiotics) | Negative (after 2 days of antibiotics) |
Blood positive for Bacillus anthracis by PCR | Yes (before start of antibiotics) | No (after 2 days of antibiotics) |
IHC staining of pleural fluid Cytology | Positive for B. anthracis cell wall Positive for B. anthracis capsule | Positive for B. anthracis cell wall Positive for B. anthracis capsule |
Convalescent-phase serumb | Anti-PA IgG antibodies present | Anti-PA IgG antibodies present |
aER, emergency room; HIC, immunohistochemical; PCR, polymerase chain reaction; Anti-PA IgG, anti-protective antigen immunoglobulin G.
bConvalescent-phase serum is serum drawn at least 14 days after symptoms begin.
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.