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An outbreak of serogroup W-135 meningococcal disease occurred during the 2000 Hajj in Saudi Arabia. Disease was reported worldwide in Hajj pilgrims and their close contacts; however, most cases were identified in Saudi Arabia. Trends in Saudi meningococcal disease were evaluated and the epidemiology of Saudi cases from this outbreak described. Saudi national meningococcal disease incidence data for 1990 to 2000 were reviewed; cases from January 24 to June 5, 2000, were retrospectively reviewed. The 2000 Hajj outbreak consisted of distinct serogroup A and serogroup W-135 outbreaks. Of 253 identified cases in Saudi Arabia, 161 (64%) had serogroup identification; serogroups W-135 and A caused 93 (37%) and 60 (24%) cases with attack rates of 9 and 6 cases per 100,000 population, respectively. The 2000 Hajj outbreak was the first large serogroup W-135 meningococcal disease outbreak identified worldwide. Enhanced surveillance for serogroup W-135, especially in Africa, is essential to control this emerging epidemic disease. [ABSTRACT FROM AUTHOR]

Presents a study that investigated an outbreak of leptospirosis in Eco-Challenge multisport race athletes to determine illness etiology and implement public health measures. Number of case-patients who were hospitalized; Number of patients positive for leptospiral antibodies; Benefits from taking doxycycline before or during the race.

We examined outbreak investigations conducted around the world from 1988 to 1999 by the Centers for Disease Control and Prevention's Epidemic Intelligence Service. In 44 (4.0%) of 1,099 investigations, identified causative agents had bioterrorism potential. In six investigations, intentional use of infectious agents was considered. Healthcare providers reported 270 (24.6%) outbreaks and infection control practitioners reported 129 (11.7%); together they reported 399 (36.3%) of the outbreaks. Health departments reported 335 (30.5%) outbreaks. For six outbreaks in which bioterrorism or intentional contamination was possible, reporting was delayed for up to 26 days. We confirmed that the most critical component for bioterrorism outbreak detection and reporting is the frontline healthcare profession and the local health departments. Bioterrorism preparedness should emphasize education and support of this frontline as well as methods to shorten the time between outbreak and reporting. [ABSTRACT FROM AUTHOR]

Discusses the role of public health services in the time of anthrax bioterrorism in the U.S. Key components of the public health response to the 2001 bioterrorism-related anthrax outbreak; Collaboration among public health services in an effort to fight anthrax bioterrorism; Challenges posed by the anthrax bioterrorism outbreak to public health services.

Presents a letter to the editor regarding the evaluation and validation of a real-time polymerase chain reaction (PCR) assay for rapid identification of Bacillus anthracis. Results of the real-time PCR assay; Reasons for the high level of sensitivity and specificity of the PCR assay; Significance of the assay to the 2001 bioterrorism-associated anthrax outbreak.

On October 4, 2001, we confirmed the first bioterrorism-related anthrax case identified in the United States in a resident of Palm Beach County, Florida. Epidemiologic investigation indicated that exposure occurred at the workplace through intentionally contaminated mail. One additional case of inhalational anthrax was identified from the index patient's workplace. Among 1,076 nasal cultures performed to assess exposure, Bacillus anthracis was isolated from a co-worker later confirmed as being infected, as well as from an asymptomatic mail-handler in the same workplace. Environmental cultures for B. anthracis showed contamination at the workplace and six county postal facilities. Environmental and nasal swab cultures were useful epidemiologic tools that helped direct the investigation towards the infection source and transmission vehicle. We identified 1,114 persons at risk and offered antimicrobial prophylaxis. [ABSTRACT FROM AUTHOR]

Looks at the control and prevention of serogroup C meningococcal disease (SCMD). Information on outbreaks of SCMD in the United States; What causes SCMD; Information on the control of outbreaks; Definition of an organized-based outbreak of SCMD.

Presents recommendations regarding the control and prevention of meningococcal disease. What is caused by Neisseria meningitidis; Who is at risk of developing meningococcal infection; Information on the meningococcal polysaccharide vaccine; Efficiency of the vaccine; Prospects of new vaccines.

Reports on the Haemophilus influenzae (Hi) invasive disease among the United States population in 1994-1995. Reference to the analysis of the national Hi surveillance data from 1994 and 1995; Availability of serotype data; Description of Hi isolates.

Focuses on the need to enhance the ability of explaining the uncertainty associated with clinical infectious diseases, with the use of improvements in diagnostic technology. Publishing of the recommendations for the evaluation and management of community-acquired pneumonia, developed by the Infectious Disease Society of America; What pathologists should recognize; Information on pneumonia.

Presents a letter to the editor in response to the letter entitled "Industry-Related Outbreak of Human Anthrax," by A. Macher, which appeared in the previous issue of the journal.

Presents the highlights of a meeting convened by the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia on December 10-11, 2001 in response to the anthrax bioterrorism. Priorities of bioterrorism-related public health Bacillus anthracis research; Plenary sessions of the meeting format; Topics covered during the plenary sessions.