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Clinical Observation
March 22, 2004

Differentiating Inhalational Anthrax From Other Influenzalike Illnesses in the Setting of a National or Regional Anthrax Outbreak

Author Affiliations

From the Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical Center/Ann Arbor VA Medical Center, Ann Arbor (Dr Cinti); Department of Internal Medicine, St John's Hospital, Detroit, Mich (Dr Saravolatz); Division of Infectious Diseases and Quality Support Services, Henry Ford Health System, Detroit (Dr Nafzinger); Division of Infectious Diseases, Oakwood Hospital, Oakwood, Mich (Dr Sunstrum); and Division of Infectious Diseases, Botsford Health Care Continuum, Farmington Hills, Mich (Dr Blackburn). The authors have no relevant financial interest in this article.

Arch Intern Med. 2004;164(6):674-676. doi:10.1001/archinte.164.6.674

The workup of a febrile patient who presents with an influenzalike illness in the setting of a national or regional anthrax outbreak presents a unique challenge to the physicians who initially evaluate this patient, and the diagnostic challenge can be even more profound during the influenza season. Based on information gathered from the recent inhalational anthrax cases, we have developed an algorithm to be used by physicians in the emergency department to evaluate patients with influenzalike illnesses during a national or regional anthrax outbreak. The algorithm necessitates stays no longer than 24 hours in the emergency department or hospital.