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Positive screening signal for Bacillus anthracis at the Anacostia Naval Postal Sorting Facility in the Washington metropolitan area
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    HAN ; 162
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    Friday, November 07, 2003, 12:40 EST (12:40 AM EST) CDCHAN-00162-03-11-07-ADV-N A routine air-sampling sensor in the Anacostia-Naval Postal Sorting Facility recorded a positive screening signal for Bacillus anthracis, the agent of anthrax. These results are considered preliminary and additional testing is underway to clarify these results and determine whether the initial test was accurate. This mail handling facility is located on the grounds of the Anacostia Naval Station in the Washington D.C. Metropolitan area. Clinicians are urged to review the signs and symptoms of anthrax and consider the diagnosis with their patients. Inhalational anthrax starts with a nonspecific prodrome (i.e., fever, dyspnea, cough, and chest discomfort) follows inhalation of infectious spores. Approximately 2--4 days after initial symptoms, sometimes after a brief period of improvement, respiratory failure and hemodynamic collapse ensue. Inhalational anthrax also might include thoracic edema and a widened mediastinum on chest radiograph. Gram-positive bacilli can grow on blood culture, usually 2--3 days after onset of illness. Cutaneous anthrax follows deposition of the organism onto the skin, occurring particularly on exposed areas of the hands, arms, or face. An area of local edema becomes a pruritic macule or papule, which enlarges and ulcerates after 1--2 days. Small, 1--3 mm vesicles may surround the ulcer. A painless, depressed, black eschar usually with surrounding local edema subsequently develops. The syndrome also may include lymphangitis and painful lymphadenopathy. Clinicians are encouraged to review the additional information on Anthrax at: http://www.bt.cdc.gov/agent/anthrax/index.asp Any suspected cases of anthrax should be immediately reported to the appropriate local or state health department.
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