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http://www.promedmail.org/pls/promed/f?p=2400:1001:1169119722097890812::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,30577 TULAREMIA, AIR SENSOR DETECTION - USA (DISTRICT OF COLUMBIA) ************************************************************ A ProMED-mail post ProMED-mail is a program of the International Society for Infectious Diseases Sponsored in part by Elsevier, publisher of Tuberculosis [1] Date: Sat 1 Oct 2005 [posting delayed in order to include followup in [2] below] From: ProMED-mail Source: Reuters [edited] USA finds fever bacteria during war protest weekend --------------------------------------------------- Small amounts of a bacterium that causes "rabbit fever" were found on Washington's National Mall last weekend [24-25 Sep 2005], as thousands of protesters marched against the Iraq War, USA health authorities said on Sat 1 Oct 2005. The CDC said several government environmental air monitors in the Mall area detected low levels of _Francisella tularensis_ bacteria that cause tularemia, commonly known as rabbit fever, on 24-25 Sep 2005. Public health agencies had no reports of any related human or animal illnesses caused by the bacteria. The CDC said it issued an alert on Friday night, 30 Sep 2005, as a precaution so medical personnel were aware of the situation and could report any suspected cases. Tularemia does not transmit from person to person and can be effectively treated with readily available medicines, the CDC said. Symptoms usually appear 3 to 5 days after exposure, but in rare cases can take up to 2 weeks. Symptoms of the disease include sudden fever, chills, headaches, conjunctivitis, diarrhea, muscle aches, joint pain, dry cough and progressive weakness. District of Columbia health officials told local radio station WTOP on Sat 1 Oct 2005 that the detected bacteria was not harmful and probably occurred naturally. The CDC waited a week to notify city officials of the detected bacteria because it took that long to test the samples at labs and confirm its presence, the radio station reported. According to the CDC's website, people can get tularemia by being bitten by a infected tick, deerfly or other insect, handling infected animal carcasses, eating or drinking contaminated food or water or breathing in the organisms. The CDC also said the bacterium can be used as a weapon if made into an aerosol that could be inhaled. -- ProMED-mail [Although not many human cases are reported in the USA each year and the disease is primarily endemic in the middle USA, as well as Martha's Vineyard, an island off the coast of Massachusetts, almost every state has reported cases -- see refs. below. Since the bacterium is ubiquitous, unlike plague, the BioWatch system may detect its nucleic acid if, for instance, material containing the organism is aerosolized by landscaping or yard work. A description of the BioWatch system can be obtained from the Federation of American Scientists website at: - Mod.LL] ****** [2] Date: 5 Oct 2005 From: ProMED-mail Source: Washington Post, Wed 5 Oct 2005; Page B01 [edited] Test Results Cited in Delay of Mall Alert; CDC Explains Why Local Officials Weren't Told for Days About Bacterium Detection ----------------------------------------------- Area health officials were not notified for 5 days that sensors on the [Washington DC] Mall had detected a potentially dangerous bacterium there last month [September 2005], because subsequent tests were not conclusively positive, a federal official said yesterday [4 Oct 2005]. The Department of Homeland Security delayed in alerting the federal Centers for Disease Control and Prevention [CDC] for the same reason, said Richard Besser, who directs the CDC's coordinating office for terrorism preparedness and emergency response. More than half a dozen sensors showed the presence of tularemia bacteria the morning, after thousands of people gathered on the Mall for a book festival and antiwar rally, yet the CDC was not contacted for at least 72 hours. Testing never identified all the definitive markers for which scientists were looking, and officials were wary of issuing a false alarm, Besser said. He called the entire incident "highly unusual," but he acknowledged that it would prompt the 2 agencies to review their protocol and the timeliness of their response "to make sure the system doesn't have any flaws in it. It really will cause us to look at the system and say, 'Should things have been different?'" Besser said in a phone interview. In letters Representative Thomas M. Davis III (Virginia Republican) sent on Monday [3 Sep 2005] to Homeland Security Secretary Michael Chertoff and CDC Director Julie Gerberding, he called the notification time frame "alarming" and asked for an accounting of the procedures triggered when the government's "BioWatch network" senses a biological agent. His questions focused on what each agency knew and when it knew it, as well as which local and state officials were called and when. "Why weren't these officials notified immediately following the detection?" Davis wrote. [Probably because it was initially thought to be a false alarm, and the agency did not want to cause unnecessary panic. - Mod.JW] D.C. Health Director Gregg A. Pane, who learned of the situation in a conference call on Friday [30 Sep 2005] morning, said he would have liked to have been involved sooner. Hours after being alerted by the CDC, he and his counterparts across the Washington region put out an announcement for the public. "I wish they'd bring us in earlier," he said yesterday [4 Oct 2005]. "There's got to be a level of trust and communication" among the entities and layers of government, he said. As of yesterday [4 Oct 2005], local and federal health officials said they had confirmed no cases of tularemia from the Mall gathering and, through medical surveillance, had not found any spikes in possible symptoms. Although the germ that causes tularemia is highly infectious, the disease itself is not passed from person to person and can be easily treated with antibiotics. Left untreated, it can be fatal. Besser said that if the initial evaluation had revealed true positives, the laboratory would have immediately contacted Homeland Security, which would have immediately brought CDC and local health agencies into the discussion. Instead, as late as Thursday [29 Sep 2005], CDC officials expected final testing to disprove the presence of the bacteria. "So we didn't really think there was a need to alert [area] public health officials," he said. In his letter, Davis requested specifics about the bacteria levels ultimately detected and the government's plan to inform the public of risk. "How do you monitor the thousands of people who visited the affected areas?" he asked. A Homeland Security spokeswoman did not return calls to comment on the issues Davis raised. [Byline: Susan Levine and Sari Horwitz] -- ProMED-mail [ProMED thanks all the readers who sent in versions of this report. Analysts were correct to suspect a false positive, since the background of tularemia in the DC area is very low -- no human cases reported since 2000 -- and the rarer an organism in the area, the higher the probability of a false positive. A similar incident occurred in Houston (TX), USA in October 2003, when 2 air sensors detected fragments of tularemia bacteria. There were no human cases of tularemia reported after the incident, and some experts in the bioterror field said they believe the incident was actually spurred by a strain of the bacterium that does not affect humans (Source: Petula Dvorak, Washington Post 2 Oct 2005) -- see ref. below. However, it appears from the above report that confirmatory tests were positive, although the levels detected were rather low to be considered a threat. It is important to know eventually whether the bacterium was type A or B or a vaccine strain. - Mod.JW] [see also: Tularemia - USA (WA) (02) 20050907.2658 Tularemia - USA (WA) 20050906.2641 Tularemia - USA (MA) 20050819.2438 Tularemia, oropharyngeal - USA (MA) 20050711.1971 Tularemia, rabbit contact - USA (AZ) 20050609.1604 Tularemia, human, hamster bite, 2004 - USA (CO) 20050107.0042 2004 ---- Tularemia, pneumonic - USA (NYC)(04) 20041115.3081 Plague, tularemia, rodents, human - USA (CO) 20041110.3035 Tularemia, landscaper - USA (MA) 20040713.1882 2003 ---- Tularemia, air sensor detection - USA (TX) 20031023.2657 Tularemia, human - USA (Wyoming) 20030902.2204 Tularemia, tick - USA (San Diego): alert 20030814.2027 Tularemia - USA (Nebraska) (02): comments 20030626.1572 2002 ---- Tularemia, prairie dogs - USA (Texas): OIE report 20021101.5688 Tularemia, prairie dogs - USA (Texas): Alert 20020807.4980 Tularemia, rabbits - USA (Texas) (02) 20020806.4958 Tularemia - USA (Martha's Vineyard, MA) (02) 20020613.4490 2001 ---- Tularemia, wildlife - USA (Colorado): alert 20010924.2326 Tularemia - USA (Utah, Wyoming): alert 20010729.1484 Tularemia - USA (Massachusetts) (06) 20010717.1378 Tularemia - USA (Massachusetts) 20010609.1129 2000 ---- Tularemia - USA (Martha's Vineyard, Massachusetts) 20000901.1465 Tularemia, zoo animals - USA (Arizona) 20000619.0993 1998 ---- Tularemia - USA (New York City) (03) 19980804.1490 Tularemia - USA (New York City) (02) 19980725.1417 Tularemia - USA (New York City): RFI 19980724.1405] .........................ll/jw/msp/jw *##########################################################* ************************************************************ ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. 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