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Delaware Health Alert Network #53

November 7, 2003 10:40 am

Health Advisory

The Delaware Division of Public Health (DPH) has received the following CDC Health Advisory. DPH will monitor this situation closely. Further information will be provided through the Delaware Health Alert Network as it becomes available. Questions about this advisory and reports of suspected anthrax should be directed to DPH at 1-888- 295-5156. This number is available during normal business hours. It is also answered during non-business hours for emergencies.

CDC Health Advisory


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:

Any suspected cases of anthrax should be immediately reported to the appropriate local or state health department.

Categories of Health Alert messages:

  • Health Alert: Conveys the highest level of importance; warrants immediate action or attention.
  • Health Advisory: Provides important information for a specific incident or situation; may not require immediate action.
  • Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.
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