Wadsworth Center’sBioterrorismExperience

EnvironmentalAnthrax Threats

In New York

History of Human Anthrax in New York State

109 cases, 5 deaths, from 1943 to 1960

107 cutaneous anthrax

1 Bacteremia

1 Meningitis

Most cases involved employees of carpet mills or leather industries

Prior to 2001, last reported case in 1961

Emerging and Reemerging Infectious Agents

Found in New York State Since 1990

AnthraxBabesiaBrucellaCalicivirusCoccidioidesCryptosporidiumCyclosporaE. coli O157:H7EhrlichiaGiardiaGroup A Strep-Necrotizing

FascitisHantavirus

ListeriaMalariaQ-feverRaccoon rabiesRocky Mountain

Spotted FeverSilver Haired Bat

Rabies VariantVancomycin-Intermediate

Resistant Staphylococcus Aureus

West Nile Virus

Wadsworth CenterAnthrax Incident Log: 1999-2000

Letter/Brown PowderNew YorkNew York City11/28/200017

Letter/PowderNew YorkNew York City11/24/200016

Letter/PowderNew YorkOrange County11/02/200015

LetterVermontBennington1/06/200014

LetterVermontWilliston1/05/200013

LetterNew York CityNew York City1/04/200012

LetterNew York CityBronx1/03/200011

EnvelopeUlsterSaugerties12/07/199910

Letter/BladesOnondagaPompey8/19/19999

LetterNassauHempstead6/15/19998

LetterNassauCanister6/15/19997

CanisterNew York CityBrooklyn5/19/19996

Letter/PowderOnondagaSyracuse5/17/19995

Letter/PowderOnondagaSyracuse5/17/19994

Letter in garbage bag?ColumbiaHudson2/22/19993

LetterVermontSt. Johnsbury1/19/19992

LetterVermontBurlington2/19/19991

THREATCOUNTY/STATETOWN/CITYDATENo.

Photo courtesy: The Albany Times Union

NYC Anthrax Case Summary

SOURCELOCATIONONSETSITEAGE

??MEETH10/25Inhal61 F

Letter 9/18NY Post10/23Cutan38 M

Letter 9/18NY Post10/19Cutan34 M

+env swabCBS News10/01Cutan27 F

+env swabABC News9/29Cutan<1 M

Letter 9/18NBC News9/28Cutan23 F

Letter 9/18NBC News9/25Cutan38 F

Letter 9/18NY Post9/22Cutan32 F

Anthrax Testing Since October 2001

Environmental samples tested: >900

Number positive: 24

Some specimenssubmitted fortesting werevalid concerns…

But many others were the resultof hoaxes or hysteria

Laboratory Response Network

LEVEL A: Rule out critical biological agents Refer positives to higher level laboratory

LEVEL B: BSL-3 facility with rapid, presumptive identification; Refer positives to higher level laboratory

LEVEL C: BSL-3 facility with molecular testing capability; Serve as surge capacity; Refer positives to higher level laboratory

LEVEL D: BSL-4 laboratory capability; High-level characterization; Evaluate unknown agents; Secure storage of organisms

Potential Laboratory Response Network Participants

Clinical Laboratory Reference System (935 )

Clinical Microbiology 293

Virology 76

Environmental Laboratory Approval Program ( 734 )

Environmental Microbiology 282

BT Testing Capabilities

METHODBT AGENT

(EM), (PCR)Smallpox (Variola)

Culture, FA, Antigen capture, (PCR)Francisella tularensis

Culture, Phage-lysis, FA, Antigen capture, (PCR) Yersinia pestis

Culture, (PCR)Brucella spp.

Animal toxicity/neutralization, (PCR)Clostridium botulinum

toxin

Culture, Phage-lysis, FA, Antigen capture, PCRBacillus anthracis

BT Laboratory Preparedness Requirements

Dedicated modern Biosafety Level 3 laboratory for bioterrorism testing, with surge capacity

Specially trained team of scientists to coordinate bioterrorism testing

Validated protocols in place for testing criticalCategory A biological agents assigned toBiosafety Level 3

Concluding Thoughts

Response capabilities and capacities must be developed before they are needed

Current definitions of laboratory functions are becoming outmoded

“Clinical” laboratories are testing environmental samples

“Environmental” laboratories are undertaking biomonitoring

Future incidents could involve multiple/mixed agents

(In the early 1960’s) “American germ-warfare scientists had developed a special cocktail of two germs and one biological toxin designed to work sequentially so that victims would come down with uncommonly long periods of sickness and debilitation…The toxin of the cocktail was staphylococcal enterotoxin B…The virus in the mix caused Venezuelan equine encephalitis…The final element was the bug that caused Q fever.”

From Germs Biological Weapons and America’s Secret WarBy Judith Miller, Stephen Engelberg, William Broad