Journal Article

Screening for Inhalational Anthrax Due to Bioterrorism: Evaluating Proposed Screening Protocols

John M. Howell, Thom A. Mayer, Dan Hanfling, Allan Morrison, Glenn Druckenbrod, Cecele Murphy, Robert Cates and Denis Pauze

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 12, pages 1842-1847
Published in print December 2004 | ISSN: 1058-4838
Published online December 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/426080
Screening for Inhalational Anthrax Due to Bioterrorism: Evaluating Proposed Screening Protocols

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Eleven known cases of bioterrorism-related inhalational anthrax (IA) were treated in the United States during 2001. We retrospectively compared 2 methods that have been proposed to screen for IA [1, 2]. The 2 screening protocols for IA were applied to the emergency department charts of patients who presented with possible signs or symptoms of IA at Inova Fairfax Hospital (Falls Church, Virginia) from 20 October 2001 through 3 November 2001. The Mayer criteria [1] would have screened 4 patients (0.4%; 95% CI, 0.1%–0.9%) and generated charges of $1900. If 29 patients (2.6%; 95% CI, 1.7%–3.7%) with ⩾5 symptoms (but without fever and tachycardia) were screened, charges were $13,325. The Hupert criteria [2] would have screened 273 patients (24%; 95% CI, 22%–27%) and generated charges of $126,025. In this outbreak of bioterrorism-related IA, applying the Mayer criteria would have identified both patients with IA and would have generated fewer charges than applying the Hupert criteria.

Journal Article.  2652 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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