Table 2

Planning against Biological Terrorism: Lessons from Outbreak Investigations

David A. Ashford*

, Robyn M. Kaiser*, Michael E. Bales*, Kathleen Shutt*, Amee Patrawalla*, Andre McShan*, Jordan W. Tappero*, Bradley A. Perkins*, and Andrew L. Dannenberg*

Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Trip reports, involving unknown infectious agents or potential agents of bioterrorism (ultimately not considered bioterrorism), the Centers for Disease Control and Prevention, January 1988–December 1999

Report no.	Y	Location	Disease/agent	Conclusion
90-56	1990	Texas, USA	Unknown	Rash and fever in children, no discernable cause
93-02	1992	Wyoming, USA	Coxiella burnetii	Q fever in two bentonite miners
94-02	1993	Georgia, USA	Clostridium botulinum	Botulism outbreak linked to contaminated food
94-32	1994	Five states, USA	Unknown	Cluster of cases, no discernable cause
94-42	1994	Texas, USA	C. botulinum	Botulism outbreak linked to contaminated food
94-86	1994	Connecticut, USA	Sabia virus	Accidental infection with Sabia virus in laboratory worker
94-88	1994	Bolivia	Machupo virus	Bolivian hemorrhagic fever outbreak
95-16	1994	Utah, USA	Unknown	Contaminated solution used in grafting procedure; source undefined
95-40	1995	Palau	Dengue type 4 virus	Dengue type 4 virus outbreak
95-55	1995	Kikwit, Zaire	Ebola virus	Ebola hemorrhagic fever outbreak
95-61	1995	South Dakota, USA	Francisella tularensis	Tick-borne tularemia
98-23	1998	Kenya; Somalia	Rift Valley fever virus	Rift Valley fever outbreak
98-28	1998	Argentina	C. botulinum toxin	Botulism outbreak linked to contaminated food
98-35	1998	Uganda	Rift Valley fever virus	Rift Valley fever virus outbreak
98-55	1998	Texas, USA	Bacillus anthracis	Exposure to live spore vaccine for anthrax
98-83	1998	Kazakhstan	B. anthracis	Reemergence of anthrax, Kazakhstan
11 investigations involving plague	Multiple	10 investigations in USA (Oklahoma, Arizona, New Mexico, Texas, California); one in India.	Yersinia pestis	Mostly in areas of endemic plague in animals
18 investigations involving cholera	Multiple	4 investigations in USA (Mississippi, Maryland, Hawaii, California), 14 elsewhere	Vibrio choleresis	Cholera in two nursing home patients, outbreak involving imported food, outbreak involving consumption of raw fish, and outbreak involving contaminated food on international flight
12 investigations involving unknown agent on cruise ships	Multiple	Cruise ships	Unknown	Gastroenteritis outbreaks in which infectious agent was not identified by laboratory testing
26 additional investigations involving unknown agent	Multiple	24 in USA, 2 elsewhere	Unknown	Gastroenteritis outbreaks, acute illness after surgical procedures, and other outbreaks in which no infectious agent was identified by laboratory testing

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Page updated: December 08, 2010

Page reviewed: December 08, 2010

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

Volume 9, Number 5—May 2003

Perspective

Planning against Biological Terrorism: Lessons from Outbreak Investigations

Table 2