Anthrax As a Biological Weapon, 2002 Updated Recommendations for Management
CONSENSUS STATEMENT Anthrax as a Biological Weapon, 2002 Updated Recommendations for Management Thomas V. Inglesby, MD Objective To review and update consensus-based recommendations for medical Tara O’Toole, MD, MPH and public health professionals following a Bacillus anthracis attack against a civilian population. Donald A. Henderson, MD, MPH Participants The working group included 23 experts from academic medical cen- John G. Bartlett, MD ters, research organizations, and governmental, military, public health, and emer- Michael S. Ascher, MD gency management institutions and agencies. Edward Eitzen, MD, MPH Evidence MEDLINE databases were searched from January 1966 to January 2002, using the Medical Subject Headings anthrax, Bacillus anthracis, biological weapon, Arthur M. Friedlander, MD biological terrorism, biological warfare, and biowarfare. Reference review identified Julie Gerberding, MD, MPH work published before 1966. Participants identified unpublished sources. Jerome Hauer, MPH Consensus Process The first draft synthesized the gathered information. Written comments were incorporated into subsequent drafts. The final statement incorpo- James Hughes, MD rated all relevant evidence from the search along with consensus recommendations. Joseph McDade, PhD Conclusions Specific recommendations include diagnosis of anthrax infection, in- Michael T. Osterholm, PhD, MPH dications for vaccination, therapy, postexposure prophylaxis, decontamination of the environment, and suggested research. This revised consensus statement presents new Gerald Parker, PhD, DVM information based on the analysis of the anthrax attacks of 2001, including develop- Trish M. Perl, MD, MSc ments in the investigation of the anthrax attacks of 2001; important symptoms, signs, and laboratory studies; new diagnostic clues that may help future recognition of this Philip K. Russell, MD disease; current anthrax vaccine information; updated antibiotic therapeutic consid- Kevin Tonat, DrPH, MPH erations; and judgments about environmental surveillance and decontamination.
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