Drumming up anthrax

Mention anthrax and about the last thing that comes to mind is whether there’s a drum in the room. Yet tom-toms — or at least the stretched animal hides on their heads — can sometimes spew toxic anthrax spores into the air. Indeed, the Centers for Disease Control and Prevention recently highlighted the case of a previously healthy 24-year-old woman who nearly died, last December, after attending a “drumming circle” in New Hampshire.

The disease, classified as gastrointestinal anthrax, started as flu-like symptoms that quickly morphed into vomiting, abdominal tenderness and hunger pains. X-rays turned up swollen segments of her small bowel and a massive buildup of fluids in the space between the interior lining of her abdomen and the exterior surface of nearby organs. The woman was eventually hospitalized and had a portion of her diseased bowel removed.

Initially, no one knew what was wrong with her. But 11 days after the drumming event, blood tests came back indicting anthrax.

The public health community immediately launched a full scale investigation into where she might have encountered the toxic bacteria. That hunt led to a community group’s building that regularly hosted drumming circles. The anthrax victim and 71 others that showed up for the Dec. 4 event had been offered an opportunity to beat on any of 59 drums, including 17 that various attendees and brought from home.

Most drums came from the rec center’s basement. Samples swiped from the heads of two of these drums came back positive for anthrax — as did a swipe from three electrical outlets in the room where the drumming event took place. Anthrax spores from the building matched those that had poisoned the young woman.

Not surprisingly, the building was shut down earlier this year as a massive decontamination effort got underway. And before you ask: Yes, the tainted drums “were properly disposed of,” according to a report in the July 23 edition of CDC’s Morbidity and Mortality Weekly Report.

Despite the large number of attendees and drummers, only the one woman developed anthrax. And two months after her surgery, she left the hospital and was expected to make a full recovery.

What’s notable about this case, the CDC report says, is that the bacteria poisoned only the woman’s gut. Epidemiologists would have expected that pounding on a drum head would have spewed any anthrax spores into the air, where they would have led to lung disease. Presumably, some spores kicked up by drumming landed in her chow. Or on her hands before she picked up the bread she had eaten at the event.

This is not the only instance where drums have been linked to anthrax. Two years ago, a man died from making drums from an anthrax-tainted hide. A year before that, a Connecticut drum maker developed cutaneous (skin) anthrax while working with untreated goat hides from West Africa. And health officials linked a 2006 case of inhalation anthrax to a New York man’s assembly of traditional African drums using goat hides he’d picked up on a trip to Cðte d’Ivoire. In preparing the skins for use as a drum head, he had soaked the hides in water for an hour, then scraped off the hair with a razor. The man had not worn a mask or glove while he worked.

Anthrax is a naturally occurring bacterium found in soil, so most poisonings affect livestock. Apparently, hide contamination can linger long after an animal dies. For instance, one of the New Hampshire drums found to be tainted earlier this year had been purchased at an “antique shop” at least a dozen years ago. Luckily, investigators learned, it had been played “only rarely.”

CDC has become so concerned about musical instruments as a possible source of anthrax that it has posted a special Q&A for drum makers, percussionists and drum enthusiasts on its website. The new case report also recommends that physicians and public health agencies consider drums as a possible source for any anthrax cases they encounter.