Reporting & Investigation of Anthrax

Table of Contents

A. Purpose of Surveillance and Reporting

  • To identify potential sources of transmission in the United States (e.g., imported wool, livestock, or soil), and to stop transmission from such sources.
  • To identify sources of transmission and geographical areas of risk outside the United States and to stop transmission from such sources.
  • To identify human and animal cases as early as possible to prevent transmission to other persons or animals, either through direct contact (unlikely) or through spores that form in carcasses of dead animals.
  • To identify cases and clusters of human illness that may be associated with a bioterrorist event.

B. Laboratory and Healthcare Provider Reporting Requirements

 Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and healthcare provider immediately report any suspicion of anthrax called to your attention by a healthcare provider or any positive laboratory result pertaining to anthrax. (A case with widened mediastinum and/or hemorrhagic mediastinitis with or without presumptive or confirmatory laboratory results is a suspect case.)

The reporting number for Iowa HHS Center for Acute Disease Epidemiology (CADE) is (800) 362-2736, if  calling after business hours, call the Iowa State Patrol Office at (515) 323-4360 and they will page a member of the on-call CADE staff.

Laboratory Testing Services Available

The University of Iowa State Hygienic Laboratory (SHL) provides services for testing clinical specimens for B. anthracis and for confirmation of isolates from sentinel laboratories. Sentinel laboratories can send specimens (blood, tissue biopsies, discharge fluid, vesicle fluid, etc.) to SHL.  Isolates submitted from other laboratories will be confirmed and/or identified. Additionally, SHL requests that all laboratories submit all isolates cultured for further identification to aid in the public health surveillance necessary for this illness as rapidly as possible.  SHL needs to be contacted before samples are submitted. For more information on submitting samples, contact SHL at (319) 335-4500, or visit: www.shl.uiowa.edu/

C. Local Public Health Agency Follow-up Responsibilities

Case Investigation

  1. The most important thing a LPHA can do upon learning of a suspect or confirmed case of anthrax, or potential exposure to anthrax, if bioterrorism is suspected, is to immediately call Iowa HHS any time at (800) 362-2736.
  2. Case investigation of anthrax in Iowa residents will be directed by Iowa HHS. If a bioterrorism event is suspected, Iowa HHS and other response authorities will work closely with LPHAs and provide instructions/information on how to proceed.
  3. Following immediate notification of Iowa HHS, the LPHA may be asked to assist in investigating cases that live within their communities, including gathering the following:
    1. The case’s name, age, address, phone number, status (hospitalized, at home, deceased), and parent/guardian information, if applicable.
    2. The name and phone number of the hospital where the case is or was hospitalized.
    3. The name and phone number of the case’s attending physician.
    4. The name and phone number of the infection prevention staff at the hospital.
    5. If the patient was seen by a healthcare provider before hospitalization, or seen at more than one hospital, be sure to document these names and phone numbers as well.
  4. Institution of disease control measures is an integral part of case investigation. It is the LPHA responsibility to understand, and, if necessary, institute the control guidelines listed below in Section 3), Controlling Further Spread.