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      Laboratory Response to Anthrax Bioterrorism, New York City, 2001

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          Abstract

          In October 2001, the greater New York City Metropolitan Area was the scene of a bioterrorism attack. The scale of the public response to this attack was not foreseen and threatened to overwhelm the Bioterrorism Response Laboratory’s (BTRL) ability to process and test environmental samples. In a joint effort with the Centers for Disease Control and Prevention and the cooperation of the Department of Defense, a massive effort was launched to maintain and sustain the laboratory response and return test results in a timely fashion. This effort was largely successful. The development and expansion of the facility are described, as are the special needs of a BTRL. The establishment of a Laboratory Bioterrorism Command Center and protocols for sample intake, processing, reporting, security, testing, staffing, and quality assurance and quality control are also described.

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          Most cited references6

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          Clinical recognition and management of patients exposed to biological warfare agents.

          Concern regarding the use of biological agents--bacteria, viruses, or toxins--as tools of warfare or terrorism has led to measures to deter their use or, failing that, to deal with the consequences. Unlike chemical agents, which typically lead to violent disease syndromes within minutes at the site of exposure, diseases resulting from biological agents have incubation periods of days. Therefore, rather than a paramedic, it will likely be a physician who is first faced with evidence of the results of a biological attack. We provide here a primer on 10 classic biological warfare agents to increase the likelihood of their being considered in a differential diagnosis. Although the resultant diseases are rarely seen in many countries today, accepted diagnostic and epidemiologic principles apply; if the cause is identified quickly, appropriate therapy can be initiated and the impact of a terrorist attack greatly reduced.
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            Anthrax as a biological weapon: medical and public health management. Working Group on Civilian Biodefense.

            To develop consensus-based recommendations for measures to be taken by medical and public health professionals following the use of anthrax as a biological weapon against a civilian population. The working group included 21 representatives from staff of major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. MEDLINE databases were searched from January 1966 to April 1998, using the Medical Subject Headings anthrax, Bacillus anthracis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of references identified by this search led to identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. Members of the working group provided formal written comments which were incorporated into the second draft of the statement. The working group reviewed the second draft on June 12, 1998. No significant disagreements existed and comments were incorporated into a third draft. The fourth and final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Specific consensus recommendations are made regarding the diagnosis of anthrax, indications for vaccination, therapy for those exposed, postexposure prophylaxis, decontamination of the environment, and additional research needs.
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              Update: Investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001.

              (2001)
              Since October 3, 2001, CDC and state and local public health authorities have been investigating cases of bioterrorism-related anthrax. This report updates previous findings, provides new information on case investigations in two additional areas, presents the susceptibility patterns of Bacillus anthracis isolates, and provides interim recommendations for managing potential threats and exposures and for treating anthrax.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                October 2002
                : 8
                : 10
                : 1096-1102
                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
                Author notes
                Address for correspondence: Michel L. Bunning, Centers for Disease Control and Prevention, P.O. Box 2087, Fort Collins, CO 80521, USA; fax: 970-221-6476; e-mail: zyd7@ 123456cdc.gov
                Article
                02-0376
                10.3201/eid0810.020376
                2730291
                12396923
                d8cc9225-df52-4e42-ba91-e2e0ccbeab02
                History
                Categories
                Dispatch

                Infectious disease & Microbiology
                bioterrorism,bacillus anthracis,anthrax
                Infectious disease & Microbiology
                bioterrorism, bacillus anthracis, anthrax

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