Abstract
We developed a mathematical model to compare 2 indoor remediation strategies in the aftermath of an outdoor release of 1.5 kg of anthrax spores in lower Manhattan. The 2 strategies are the fumigation approach used after the 2001 postal anthrax attack and a HEPA/vaccine plan, which relies on HEPA vacuuming, HEPA air cleaners, and vaccination of reoccupants. The HEPA/vaccine approach leads to few anthrax cases among reoccupants if applied to all but the most heavily contaminated buildings, and recovery is much faster than under the decades-long fumigation plan. Only modest environmental sampling is needed. A surge capacity of 10,000 to 20,000 Hazmat workers is required to perform remediation within 6 to 12 months and to avoid permanent mass relocation. Because of the possibility of a campaign of terrorist attacks, serious consideration should be given to allowing or encouraging voluntary self-service cleaning of lightly contaminated rooms by age-appropriate, vaccinated, partially protected (through masks or hoods) reoccupants or owners.
Highlights
Anthrax is a zoonotic disease caused by the spore-forming bacterium Bacillus anthracis (1,2 )
Before the mechanisms of humoral and cellular immunity were understood, researchers demonstrated that inoculation of animals with attenuated strains of B. anthracis led to protection (41,42 )
In the United States, during 1957–1960, the vaccine was improved through a) the selection of a B. anthracis strain that produced a higher fraction of protective antigen (PA) under microaerophilic conditions, b) the production of a protein-free media, and c) the use of aluminum hydroxide rather than alum as the adjuvant (50,51 )
Summary
U.S DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Atlanta, GA 30333 The MMWR series of publications is published by the Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), U.S Department of Health and Human Services, Atlanta, GA 30333.
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