Volume 9, Number 5—May 2003
Perspective
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*
, Robyn M. Kaiser*, Michael E. Bales*, Kathleen Shutt*, Amee Patrawalla*, Andre McShan*, Jordan W. Tappero*, Bradley A. Perkins*, and Andrew L. Dannenberg*
Table 3
Epidemic Intelligence Service investigations in which bioterrorism or intentional contamination was considered a cause
| Report No. | Outbreak | Conclusion |
|---|---|---|
| 84-093 |
Salmonellosis, Oregon, 1984 |
A total of 751 persons became ill with salmonella gastroenteritis. Religious group deliberately contaminated salad bars. Salmonella enterica Typhimurium strain found in laboratory at commune was indistinguishable from outbreak strain (5). |
| 97-008 |
Shigella dysenteriae type 2, Texas, 1996 |
Diarrheal illness in hospital laboratory workers who ate pastries, anonymously placed in break room. Identical strains of S. dysenteriae type 2 were isolated from stool cultures of case patients, from recovered muffin, and from laboratory stock culture, part of which was missing. |
| 98-006 |
S. sonnei, New Hampshire, 1997 |
Seven laboratory workers at local hospital became ill with gastroenteritis. Most cases caused by strain of S. sonnei that was highly related to a stock culture strain maintained by the hospital laboratory. Possibility that first two cases were caused by intentional contamination could not be excluded. |
| 99-025 |
Anthrax hoaxes, 1998 |
Centers for Disease Control and Prevention received reports of alleged anthrax exposure; letters were sent to health clinics in Indiana, Kentucky, and Tennessee and to private business in Tennessee; three telephone threats of anthrax contamination of ventilation systems were made to public and private buildings; all threats were hoaxes. |
| 99-059 |
Unexplained critical illness, New Hampshire, 1999 |
A 38-year-old woman was admitted to a hospital with fever, myalgia, and weakness; severe illness and death occurred 32 days after hospital admission; serum specimens indicated Brucella species. Patient’s history of multiple febrile illnesses suggested unspecified autoimmune process. |
| 99-94-1 | Encephalitis cluster, New York City, 1999 | Several residents were hospitalized with illness of unknown etiology characterized by fever, encephalitis, axonal neuropathy, and flaccid paralysis (unpublished data: Epi-1 report); increase in deaths of New York City birds, especially crows; human and bird tissue samples were positive for West Nile-like virus. |
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