| Situation Update No. 3 Ref.no.: BH-20091227-24331-USA
Situation Update No. 3
On 2009-12-30 at 10:18:59 [UTC]
Event: Biological Hazard
Location: USA State of New Hampshire Concord Number of Infected: 1 person(s)
Situation: Health officials are waiting for test results on about 30 African drums used at a local ministry center after they were unable to find a link between two of the instruments that tested positive for a form of anthrax and the Strafford County woman suffering from the disease. Dr. Jose Montero, the state's public health director, stressed Monday the case is very complex considering the lack of precedence. The woman is the nation's first case of gastrointestinal anthrax, according to Dr. Elizabeth Talbot, an infectious disease professor at Dartmouth Medical School who is assisting Montero. Over the weekend, a N.H. National Guard civil support team, along with personnel from the state Department of Environmental Services, the federal Environmental Protection Agency and local authorities collected samples from a little more than 30 drums at the Waysmeet Center, which houses United Campus Ministry for the University of New Hampshire. The center holds monthly drum circles, and authorities have focused on the events because two recent U.S. anthrax cases involved drums covered with animal hides. So far two samples tested positive, but "those drums have not yet been able to be determined to be the source of the anthrax," Montero said in a conference call with reporters. The results of the other samples, which are being tested at state labs, are expected to be available Thursday, after the maximum five-day testing period has passed. "We still may have more drums that test positive," Montero said.
Meanwhile, the state has sent the two positive samples to the Centers for Disease Control and Prevention in Atlanta for DNA "fingerprinting" to see if there is a link between the drums and the woman, Montero said. "We are trying to match the strain the patient had with the strain isolated in the drums," he said, adding results should be available early next week. "If they match we may want to think that's the source even if we cannot fully explain what happened." He added it's possible officials won't be able to explain the "mechanism of transmission." The drum used by the woman - who remains in critical condition as she's treated for the potentially fatal disease - was also tested, but so far nothing has been detected, Montero said. Adding to the complexity of the case is the fact the woman's drum is made of synthetic animal hide, while regular animal hides have been a source of naturally occurring anthrax before. Those cases have involved cutaneous and inhalation anthrax - not gastrointestinal anthrax, "which means somehow our patient had to ingest the anthrax," Montero said. "It's not about breathing the anthrax. It's about eating the anthrax," he added. "This is not contagious from one person to another." Other possible sources include soil, certain food and animal products, such as fur or mink, Montero said. "We are interviewing the family and the patient's friends, trying to identify eating habits, anything that ... can be linked as a risk factor" for ingesting anthrax. Montero said officials have not interviewed the patient. There have been about a dozen naturally occurring anthrax in the U.S. since 1957 - including nine cases that year in the Granite State of either cutaneous or inhalation anthrax in Manchester textile mill workers, according to the Department of Health and Human Services.
More recently, two members of a Connecticut family were treated in 2007 for cutaneous anthrax traced to animal hides used to make African drums. In 2006, a New York dancer and drum maker recovered from the first case of naturally occurring inhalation anthrax in the United States since 1976. About 2,000 cases of cutaneous naturally occurring anthrax are reported annually worldwide. Health officials urge anyone who brought their own drum to one of the community drum circles held at the center between October and early December - when the woman reportedly participated in a drum circle. The state is interested in testing the drum, not the drummer, Montero said. So far the state has heard from four or six drummers "and we're working with them ... on a mechanism to get those drums tested," he said. "We are not certain of any clear risk to other people," he added. Pastor Larry Brickner-Wood, chaplain and executive director of United Campus Ministry, said in an e-mail to Foster's that the drum circles have been held on the first Friday of every month, with about 30 people participating each time. He estimated the sessions probably drew an estimated 120 people between the three-month period, but that includes repeat visitors. The ministry is not part of UNH but it houses students and runs a variety of programs and services involving the university community. Montero said the state is taking several precautions to ensure the disease has not spread in local communities. DHHS closed the center until further notice as additional tests take place and "increased surveillance" in emergency rooms, ramped up communication with health care providers and has notified neighboring states. Officials, citing confidentiality, have declined to identify the woman or provide her age or hometown. |
