Public health and environmental response to the first case of naturally acquired inhalational anthrax in the United States in 30 years: infection of a new york city resident who worked with dried animal hides.

In Pennsylvania on February 16, 2006, a New York City resident collapsed with rigors and was hospitalized. On February 21, the Centers for Disease Control and Prevention and the New York City Department of Health and Mental Hygiene were notified that Bacillus anthracis had been identified in the patient's blood. Although the patient's history of working with dried animal hides to make African drums indicated the likelihood of a natural exposure to aerosolized anthrax spores, bioterrorism had to be ruled out first. Ultimately, this case proved to be the first case of naturally occurring inhalational anthrax in 30 years. This article describes the epidemiologic and environmental investigation to identify other cases and persons at risk and to determine the source of exposure and scope of contamination. Because stricter regulation of the importation of animal hides from areas where anthrax is enzootic is difficult, public healthcare officials should consider the possibility of future naturally occurring anthrax cases caused by contaminated hides. Federal protocols are needed to assist in the local response, which should be tempered by our growing understanding of the epidemiology of naturally acquired anthrax. These protocols should include recommended methods for reliable and efficient environmental sample collection and laboratory testing, and environmental risk assessments and remediation.

A personal exposure study employing scripted activities and paths in conjunction with atmospheric releases of perfluorocarbon tracers in Manhattan, New York.

A personal exposure study was conducted in New York City as part of the Urban Dispersion Program (UDP). It examined the contact of individuals with four harmless perflourocarbon tracers (PFT) released in Midtown Manhattan with approval by city agencies at separate locations, during two types of experiments, completed during each release period. Two continuous 1 h release periods separated by a 1.5 h ventilation time were completed on 3 October 2005. Stationary site and personal exposure measurements were taken during each period, and the first half hour after the release ended. Two types of scripted exposure activities are reported: Outdoor Source Scale, and Outdoor Neighborhood Scale; requiring 1- and 10-min duration samples, respectively. The results showed that exposures were influenced by the surface winds, the urban terrain, and the movements of people and vehicles typical in urban centers. The source scale exposure data indicated that local conditions significantly affected the distribution of each tracer, and consequently the exposures. The highest PFT exposures resulted from interaction of the scripted activities with local surface conditions. The range measured for 1- min exposures were large with measured values exceeding 5000 ppqv (parts per quadrillion by volume). The neighborhood scale measurements quantified exposures at distances up to seven blocks away from the release points. Generally, but not always, the PFT levels returned quickly to zero indicating that after cessation of the emissions the concentrations decrease rapidly, and reduce the intensity of local exposures. The near source and neighborhood personal exposure route results provided information to establish a baseline for determining how a release could affect both the general public and emergency responders, and evaluate the adequacy of re-entry or exit strategies from a local area. Finally, the data also show that local characteristics can produce "hot spots".