Active, Prospective Surveillance for Anthrax—Florida

Broward, Martin, Miami-Dade Counties

The purpose of this surveillance system is to identify suspected cases of inhalational anthrax through hospital surveillance in the target counties.

The infection control practitioner (ICP) at each hospital will serve as the key contact person for that hospital.

The in-hospital focus for anthrax surveillance will be the Intensive care unit (ICU).

1. Any time the hospital staff suspects a patient of being infected with anthrax, the hospital ICP will be notified. In turn, the ICP will notify the county health department. "suspected of being infected" includes:

• Shortness of breath and fever AND/OR

• Laboratory findings of gram-positive bacilli in a person without another known etiology, such as Streptococcus pneumoniae.

• Widening of the mediastinum is included if radiographic evidence is available

2. At least once each day, a designated county health department representative will be in contact with the infection control practitioner (ICP) of each hospital in the county to determine if any patients have been admitted to any hospital ICU who meet the above criteria.

The county health department will maintain a log of those persons identified in 1.and 2. and will also document days no such cases are found.

If the patient has appropriate symptoms but no cultures have been drawn, the county health department representative should record the patient’s name and request that blood cultures be done.

If a patient has the above symptoms AND positive laboratory findings, the county health department representative should:

• Request that the isolate be sent to the Miami Branch Lab for testing.

• Use the screening questionnaire to abstract information from the patient’s medical record.

• Contact Dolly Katz, regional epidemiologist (cell phone 305-778-5421, beeper 1-877-636-7176) and arrange to fax her the screening questionnaire. She will contact appropriate persons to assist with consultation and appropriate follow-up.

For all patients identified through the surveillance system, the county health department will monitor follow-up to ensure that laboratory tests are recorded.

This enhanced surveillance will continue through October 31.