The beard stays, you go; gastrointestinal anthrax after an animal-hide drumming event — New Hampshire and Massachusetts, 2009

We often host drum circles out on the large lawn where we beat on large animal hides and get into touch with our inner obscure jazz that NPR helps us find. Or Phish live albums.

Or not.

On December 24, 2009, a woman aged 24 years from New Hampshire was confirmed to have gastrointestinal anthrax on the basis of clinical findings and a Bacillus anthracis blood culture isolate. Her symptoms began on December 5.

One day before symptom onset, she had participated in a drumming event at a community organization’s building where animal-hide drums of multiple ages and origins were played. This report describes the case and subsequent investigation, which identified 84 persons potentially exposed to anthrax, including those persons at the drumming event and those who lived or worked at the event site. Review of New Hampshire disease surveillance data and clinical microbiology records for periods before and after the event identified no additional anthrax cases. Initial qualitative environmental testing of the event site yielded three positive samples (two from drum heads and one composite sample of three electrical outlets in the main drumming room). Wider, targeted, semi-quantitative environmental testing of the site and additional drums yielded six positive samples (two from one drum and four from environmental locations in the building).

These results suggested that aerosolization of spores from drumheads had occurred. All isolates obtained from environmental and drum samples matched the patient’s isolate by multiple-locus variable-number tandem repeat analysis using eight loci (MLVA-8). Public health agencies and persons with exposure to animal-hide drums should be aware of the potential, although remote, risk for anthrax exposure associated with these drums.

A total of 72 persons attended the December 4 event, and a total of 59 drums were present, including 17 drums that participants brought from home. Volunteers set up drums and prepared a vegetarian meal; participants ate dinner in the main drumming room (Figure) before beginning the drumming circle, which lasted 2 hours.