Re: New Hampshire Woman Critical Because of Gastrointestinal Anthrax
A whole mess of info here. Apparently the victim was not drumming and the drum circle. The electrical outlet looks like an important clue. I had assumed it was airborne spread from a beaten drum, but the moderator here might be right - mechanical transfer by hand while plugging in an appliance might be a more likely source.
Also not clear is the type of drums involved. There is mention that some of the drums are synthetic, that is not made fro animals at all. It is not clear that any of the drums were recently imported from West Africa.
I'm not sure there are no other cases - perhaps someone else was misdiagnosed. Anthrax is not exactly common in that area.
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80695
Archive Number 20091230.4390
Published Date 30-DEC-2009
Subject PRO/AH/EDR> Anthrax, human - USA (03): (NH)
ANTHRAX, HUMAN - USA (03): (NEW HAMPSHIRE)
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[1]
Date: 29 Dec 2009
Source: New Hampshire DHHS Division of Public Health Services [edited]
<http://www.dhhs.nh.gov/DHHS/PIO/LIBRARY/Press+Release/cdcs_anthraxfindings.htm>
(DHHS) Division of Public Health Services (DPHS)
has confirmed a 3rd sample has tested positive
for anthrax. This 3rd sample is an environmental
sample collected from the United Campus Ministry
building in Durham over the weekend. The building
has been closed until further notice under an
order from DHHS Commissioner Nicholas Toumpas.
Earlier test results confirmed that 2 separate
drums stored at the Ministry building are
contaminated with anthrax. The Public Health Labs
have submitted samples from the drums and the
patient to the Centers for Disease Control and
Prevention (CDC) to determine if they are the
same.
"This new information indicates there is a low
level of contamination in the drum room at the
Ministry building," said Dr. Elizabeth Talbot,
Medical Advisor to DPHS. "This has prompted us to
offer antibiotics and the anthrax vaccine to
anyone who was at the drumming circle on 4 Dec
2009. We are contacting these individuals and
discussing possible treatment options with them.
Even though the risk of being infected remains
low for these individuals, we're taking these
precautionary measures." At this point, public
health officials believe the patient may have
become infected at a drumming circle that took
place in the Ministry building in Durham on 4 Dec
2009.
Because of the possible link to the African
drums, DHHS is asking anyone who brought their
own drum to the drumming circle held at the
United Campus Ministry on 4 Dec 2009 to call DPHS
at 271-4496 to discuss the possibility of having
their drum tested.
DPHS, along with the Department of Environmental
Services and the US Environmental Protection
Agency, are working closely with Durham public
safety officials and officials at the University
of New Hampshire on a location where residents
can drop off their drums in the coming days and
weeks for testing.
The patient from Strafford County was confirmed
with gastrointestinal anthrax, which is very
unusual. Of the 3 types of anthrax infections:
inhalation, cutaneous, and gastrointestinal, it
is the most rare. Anthrax is not an illness that
you can catch from someone else.
Contact Information:
Public Information Office: 603-271-4051
For more information about anthrax, visit
<http://www.emergency.cdc.gov/agent/anthrax/> or
<http://www.dhhs.nh.gov>. Anyone with questions
about anthrax can call DHHS? Division of Public
Health Services at 271-4496 or the Centers for
Disease Control at 1-800-CDC-INFO.
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[2]
Date: 30 Dec 2009
Source: 9&10 News [edited]
<http://www.9and10news.com/category/story/?id=194661>
About 80 people are being offered antibiotics and
vaccines after a New Hampshire woman was
diagnosed with a rare gastrointestinal anthrax. A
state health expert says the woman may have
swallowed spores during a drum circle. About 60
people who attended the circle and students who
live and work at the University of New Hampshire
United Campus Ministry center are being offered
the medication.
See: <http://www.msnbc.msn.com/id/34624110/ns/health-more_health_news/>.
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[3]
Date: 30 Dec 2009
Source: Seacostonline.com [edited]
<http://www.seacoastonline.com/articles/20091230-NEWS-912300362>
A New Hampshire woman diagnosed with a rare
gastrointestinal anthrax case may have swallowed
spores propelled into the air by vigorous
drumming, a state health expert said. Officials
haven't confirmed how the woman contracted the
disease but are focusing on a drum circle
gathering she attended on 4 Dec 2009 at the
United Campus Ministry center in Durham shortly
before becoming ill. Public health officials who
learned of her diagnosis last week immediately
began investigating, and earlier this week shut
down the ministry center after anthrax spores
were found on 2 drums.
Some health officials believe it's the nation's
1st case of gastrointestinal anthrax, but the
Centers for Disease Control and Prevention is
unsure. [I doubt that it is the 1st G/E case,
though it might be the 1st in the past few
decades. - Mod.MHJ]
Dr. Elizabeth Talbot, an adviser to the state's
public health division, said one theory is that
the woman ingested airborne spores from a drum's
animal-hide covering. "This was a wild type of
anthrax that is found ubiquitously in our
environment. It can become stirred up or agitated
to a place where it briefly suspends in the air,
and this patient likely contacted it on her
fingers and introduced it into her mouth or
inhaled a ... spore into her mouth, and then
swallowed it," she said.
Two recent U.S. anthrax cases involved African
drums covered with animal hides, but those
involved spores that were inhaled or entered
through the skin.
On Tuesday [29 Dec 2009], officials said spores
also were found on an electrical outlet at the
United Campus Ministry center and that
antibiotics and vaccines would be offered to
about 80 people, including about 60 who attended
the drum circle as well as University of New
Hampshire students who lived in the building and
those who worked there. Samples have been sent to
the CDC to determine whether the patient's
anthrax strain matches that found on the drums or
electrical outlet.
The ministry center is not part of the
university, but it houses students and runs a
variety of campus-based programs. Pastor Larry
Brickner-Wood, the center's director, said the
monthly drum circles involve people playing hand
drums and other percussion instruments to build
community spirit and promote well-being. "Our
thoughts and prayers remain with this young woman
and her family," he said.
[Byline: Holly Ramer]
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[
Some points need to be raised: One: The strain
genotypes have yet to be revealed. Two: _Bacillus
anthracis_ is not enzootic in New Hampshire or
anywhere else in New England. It isn't there
except on or in imported objects, such as West
African hides used for drum making. Therefore, it
is neither ubiquitous nor readily stirred up,
except maybe momentarily from a beaten
contaminated drum head. That an electrical outlet
was contaminated would suggest that spores had
gotten onto the hand (singular) of one of the
musicians [drummer?] when he or she was plugging
in an electrical device. Three: One needs a very
significant number of spores to induce an
infection in humans, especially in young adults.
One spore won't do it. - Mod.MHJ]
******
[4]
Date: 29 Dec 2009
Source: New York Times [edited]
<http://www.nytimes.com/2009/12/30/us/30anthrax.html>
A New Hampshire woman who is critically ill with
gastrointestinal anthrax most likely swallowed
spores while participating in a community
drumming circle, state health officials said
Tuesday [29 Dec 2009]. The United Campus Ministry
in Durham, N.H. is closed after a case of
gastrointestinal anthrax.
Investigators found traces of anthrax on 2
African drums and an electrical outlet in the
room where the event took place.
The ministry advertised the 4 Dec 2009 event on
its website as a drum circle and pasta supper.
Julie Corey, a drumming teacher who led the
session, said
the victim had danced that night
instead of drumming. "She was the 1st to get up
and dance," Ms. Corey recalled, adding that she
thought the woman was a graduate student at
another college. "She's a vital young woman, from
what I've seen of her, a strong-spirited person."
Kris Neilsen, a spokeswoman for the State
Department of Health and Human Services, said
that after consulting with the F.B.I., the state
had concluded the anthrax strain was
naturally
occurring [see comments above - Mod.MHJ] and
unrelated to terrorism [agreed - Mod.MHJ].
Leonard A. Cole, an expert on biological weapons
at Rutgers University, said additional cases from
the drum circle were unlikely because people
would usually have to ingest thousands of spores
to be infected. "
Maybe this woman was unusually
susceptible," he said. "There's a fair chance a
lot of the others did have some contact with
spores but did not become infected" [not unlikely
-Mod.MHJ].
Ms. Corey, for one, said she was reluctant to
take the antibiotics. "I'm not in a panic state
about it," she said. "I've been exposed to drum
hides for 15 years, so what is really the
likelihood that it's a concern for me?" She also
worried aloud that the incident would scare
people out of participating in drum circles. "We
don't need to take something that is so positive
and healing and uplifting and all of the sudden
get it linked to a horrific disease," she said.
"I guess what I'll have to do from now on is say:
'Don't worry, I'm bringing my synthetic drums.'"
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[Rather like the recent UK and NY drumming
experiences, the more you look, the more you find
on your swabs. If this young person was not
drumming that evening but trotting and dancing
around, it is hard to imagine how she acquired
enough spores. Maybe she leant over the
contaminated drums during a hot bit of drumming.
But if that was it, why is the drummer not sick?
It increasingly looks like some host factors were
key to this infection. - Mod.MHJ]
[see also:
Anthrax, human - USA (02): (NH) 20091229.4374
Anthrax, human - USA: (NH) 20091227.4360]
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