Jim Martin, Commissioner           Kathleen E. Toomey, M.D., M.P.H., Division Director

                                       Georgia Department of Human Resources • Division of Public Health                                                                          Two Peachtree Street NW • Suite 15-470 • Atlanta, Georgia 30303-3186 • Tel: (404) 657-2700                    • Fax: (404) 657-2715GDPH Guidelines for Anthrax (B. anthracis ) Diagnostic Testing  (revised 10/24/01)

Asymptomatic Persons WITHOUT Known Exposure to Anthrax

("Worried well"—includes low risk threats)

• • Provide reassurance about the low risk for infection without known exposure and education about anthrax as an agent in bioterrorism;
  • Recommend referral to private health care provider for further concerns and/or diagnostics as deemed appropriate. Currently, no screening tests are available for the detection of anthrax infection in the absence of symptoms. Nasal swabs may be useful as an epidemiologic tool when a confirmed case is identified but are not routinely used for diagnosis or screening. CDC currently does NOT recommend the use of nasal swab specimens as part of evaluating anthrax threats/implied threats or evaluating concerned citizens who think they may have been exposed to anthrax.

• • Asymptomatic Persons WITH Known Exposure to Anthrax or to Credible Anthrax Threats

• • Conduct individual risk assessment in coordination with public health officials and refer to private health care provider if post-exposure prophylaxis is necessary. Currently, no screening tests are available for the detection of anthrax infection in the absence of symptoms.
  • In this situation, decontamination of patients and their clothing is NOT routinely recommended.
  • Patients should be educated regarding clinical symptoms of anthrax infection and advised to seek medical attention immediately if they develop fever or flu-like illness.

Post-exposure Prophylaxis (PEP) Recommendations (per CDC Health Alert, 10/14/01)

	Initial therapy	Duration
Adults (including pregnant woman 1,2 and immmunocompromised)	Ciprofloxacin 500 mg po BID Or Doxycycline 100 mg po BID	60 days
Children 1,3	Ciprofloxacin 15-20 mg/kg po Q12 hrs 4 Or Doxycycline 5: >8 yrs and >45 kg: 100 mg po BID >8 yrs and d 45 kg: 2.2 mg/kg po BID d 8 yrs: same as >8 yrs and d 45 kg