Identifying Meningitis During an Anthrax Mass Casualty Incident Systematic Review of Systemic Anthrax Since 1880

Based on a systematic review of 132 cases of anthrax meningitis, the authors developed a four item, evidence-based screening tool to assess severe headache, altered mental status, meningeal signs, and other neurological signs. The authors suggest that patients who screen positive on two or more of the responses could be categorized as presumptive anthrax meningitis. Use of the tool could improve patient outcomes and resource allocation during an anthrax mass casualty incident.