Bioterrorism-Related Bacillus anthracis Public Health Research Priorities

During the 2001 anthrax bioterror-ism investigation, several areas were identified in which additional research may improve public health response. The disciplines and specific expertise required to approach many of these areas are varied and reside in multiple entities in the federal government and elsewhere. To identify, prioritize, and coordinate short-term Bacillus anthra-cis bioterrorism research for public health response, the Centers for Disease Control and Prevention (CDC) convened a meeting in Atlanta on December 10–11, 2001, to obtain input on research priorities and improve coordination with federal partners and other stakeholders. One hundred thirty-two representatives from the Service, state health departments, universities , and other organizations participated in the meeting. The meeting format consisted of two plenary sessions. In the first plenary session experts provided summaries of key topic areas. Background talks were given on evaluation of B. anthracis–containing powders or substances ; epidemiologic investigation; environmental assessment; surveillance ; diagnosis; treatment; postexpo-sure prophylaxis; and remediation. After the first plenary session, participants were divided into eight pre-assigned working groups, covering the following topics: 1) evaluation of B. anthracis–containing powders or substances ; 2) epidemiologic investigation ; 3) environmental assessment; 4) surveillance; 5) diagnosis; 6) treatment ; 7) postexposure prophylaxis; and 8) remediation. During the second plenary session, each group presented interim results to the larger group of participants. In two working group sessions, the topic-specific groups identified their three top research priorities and prepared a brief written report describing proposed activities. For evaluation of B. anthracis– containing powders or substances, the top three priorities were 1) rapid analysis of anthrax-containing powder: particle size distribution and matrix characteristics; 2) measurement of particle reaerosolization of different anthrax powder preparations, and 3) development of an in vitro model for the study of cutaneous anthrax by human cell culture. For epidemiologic investigation, priorities were 1) analysis of individual host risk factors for anthrax infection; 2) exposure reconstruction and risk characterization; and 3) review of unexamined or previously unpublished (potentially classified) animal data related to dose response. For environmental assessment, the top priorities were 1) validation and standardization of sampling and sample analysis techniques; 2) evaluation of risk of disease in contaminated environments ; and 3) determination of risk of reaerosolization. For surveillance, priorities were 1) expanded veterinary surveillance and integration with human health information; 2) use of alternative sources of data in the surveillance for bioterrorism-related events; and 3) design and validation of surveillance systems to …