Call-tracking data and the public health response to bioterrorism-related anthrax

Abstract

After public notification of confirmed cases of bioterrorism-related anthrax, the Centers for Disease Control and Prevention's Emergency Operations Center responded to 11,063 bioterrorism-related telephone calls from October 8 to November 11, 2001. Most calls were inquiries from the public about anthrax vaccines (58.4%), requests for general information on bioterrorism prevention (14.8%), and use of personal protective equipment (12.0%); 882 telephone calls (8.0%) were referred to the state liaison team for follow-up investigation. Of these, 226 (25.6%) included reports of either illness clinically confirmed to be compatible with anthrax or direct exposure to an environment known to be contaminated with Bacillus anthracis. The remaining 656 (74.4%) included no confirmed illness but reported exposures to "suspicious" packages or substances or the receipt of mail through a contaminated facility. Emergency response staff must handle high call volumes following suspected or actual bioterrorist attacks. Standardized health communication protocols that address contact with unknown substances, handling of suspicious mail, and clinical evaluation of suspected cases would allow more efficient follow-up investigations of clinically compatible cases in high-risk groups.

Figure 1

Emergency Operations Center (EOC) telephone call triage system, Washington, D.C., area, October 2001 through February 2002

Figure 2

Telephone calls documented by staff of the Emergency Operations Center telephone bank, October 8 to November 11, 2001 (N = 11,063 call forms)

Figure 3

Distribution of telephone calls referred to the State Liaison Team, by state of occurrence, October 8 to November 11, 2001 (N = 882 calls)