Anthrax as a biological weapon - Medical and public health management

Objective To develop consensus-based recommendations for measures to be tak en by medical and public health professionals following the use of anthrax as a biological weapon against a civilian population. Participants The working group included 21 representatives from staff of ma jor academic medical centers and research, government, military, public hea lth, and emergency management institutions and agencies. Evidence MEDLINE databases were searched from January 1966 to April 1998, u sing the Medical Subject Headings anthrax, Bacillus anthracis, biological w eapon, biological terrorism, biological warfare, and biowarfare. Review of references identified by this search led to identification of relevant refe rences published prior to 1966, In addition, participants identified other unpublished references and sources. Consensus Process The first draft of the consensus statement was a synthesi s of information obtained in the formal evidence-gathering process. Members of the working group provided formal written comments which were incorpora ted into the second draft of the statement. The working group reviewed the second draft on June 12, 1998. No significant disagreements existed and com ments were incorporated into a third draft. The fourth and final statement incorporates all relevant evidence obtained by the literature search in con junction with final consensus recommendations supported by all working grou p members. Conclusions Specific consensus recommendations are made regarding the diagn osis of anthrax, indications for vaccination, therapy for those exposed, po stexposure prophylaxis, decontamination of the environment, and additional research needs.