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Frequently Asked Questions
What is anthrax?
Why has anthrax become a current issue?
How common is anthrax and who can get it?
How is anthrax transmitted?
What are the symptoms of anthrax?
Where is anthrax usually found?
Can anthrax be spread from person-to-person?
Is there a way to prevent infection?
What is the anthrax vaccine?
Who should get vaccinated against anthrax?
What is the protocol for anthrax vaccination?
Are there adverse reactions to the anthrax vaccine?
How is anthrax diagnosed?
Is there a treatment for anthrax?
Where can I get more information about a recent Department of Defense decision to require men and women in the Armed Services to be vaccinated against anthrax?
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What is anthrax?
Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in wild and domestic lower vertebrates (cattle, sheep, goats, camels, antelopes, and other herbivores), but it can also occur in humans when they are exposed to infected animals or tissue from infected animals.
Why has anthrax become a current issue?
Because anthrax is considered to be a potential agent for use in biological warfare, the Department of Defense (DoD) has begun mandatory vaccination of all active duty military personnel who might be involved in conflict.
How common is anthrax and who can get it?
Anthrax is most common in agricultural regions where it occurs in animals. These include South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products. Workers who are exposed to dead animals and animal products from other countries where anthrax is more common may become infected with B. anthracis (industrial anthrax). Anthrax in wild livestock has occurred in the United States.
How is anthrax transmitted?
Anthrax infection can occur in three forms: cutaneous (skin), inhalation, and gastrointestinal. B. anthracis spores can live in the soil for many years, and humans can become infected with anthrax by handling products from infected animals or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. It is rare to find infected animals in the United States.
What are the symptoms of anthrax?
Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.
Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals. Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black necrotic (dying) area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy.
Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal.
Intestinal: The intestinal disease form of anthrax may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases.
Where is anthrax usually found?
Anthrax can be found globally. It is more common in developing countries or countries without veterinary public health programs. Certain regions of the world (South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East) report more anthrax in animals than others.
Can anthrax be spread from person-to-person?
Direct person-to-person spread of anthrax is extremely unlikely to occur. Communicability is not a concern in managing or visiting with patients with inhalational anthrax.
Is there a way to prevent infection?
In countries where anthrax is common and vaccination levels of animal herds are low, humans should avoid contact with livestock and animal products and avoid eating meat that has not been properly slaughtered and cooked. Also, an anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against anthrax.
What is the anthrax vaccine?
The anthrax vaccine is manufactured and distributed by BioPort, Corporation, Lansing, Michigan. The vaccine is a cell-free filtrate vaccine, which means it contains no dead or live bacteria in the preparation. The final product contains no more than 2.4 mg of aluminum hydroxide as adjuvant. Anthrax vaccines intended for animals should not be used in humans.
Who should get vaccinated against anthrax?
The Advisory Committee on Immunization Practices has recommend anthrax vaccination for the following groups:
Persons who work directly with the organism in the laboratory
Persons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax spores.
Persons who handle potentially infected animal products in high-incidence areas. (Incidence is low in the United States, but veterinarians who travel to work in other countries where incidence is higher should consider being vaccinated.)
Military personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare weapon).
The anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office can be reached at 1-877-GETVACC (1-877-438-8222). http://www.anthrax.osd.mil
Pregnant women should be vaccinated only if absolutely necessary.
What is the protocol for anthrax vaccination?
The immunization consists of three subcutaneous injections given 2 weeks apart followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are recommended thereafter.
Are there adverse reactions to the anthrax vaccine?
Mild local reactions occur in 30% of recipients and consist of slight tenderness and redness at the injection site. Severe local reactions are infrequent and consist of extensive swelling of the forearm in addition to the local reaction. Systemic reactions occur in fewer than 0.2% of recipients.
How is anthrax diagnosed?
Anthrax is diagnosed by isolating B. anthracis from the blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood of persons with suspected cases.
Is there a treatment for anthrax?
Doctors can prescribe effective antibiotics. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.
Where can I get more information about the recent Department of Defense decision to require men and women in
the Armed Services to be vaccinated against anthrax?
The Department of Defense recommends that servicemen and women contact their chain of command on questions about the vaccine and its distribution. The anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office can be reached at 1-877-GETVACC (1-877-438-8222). http://www.anthrax.osd.mil
Anthrax is the preferred biological warfare agent
It is highly lethal.
• 100 million lethal doses per gram of anthrax material (100,000 times deadlier than the deadliest chemical warfare agent).
• Silent, invisible killer.
• Inhalational anthrax is virtually always fatal.
There are low barriers to production.
• Low cost of producing the anthrax material.
• Not high-technology. Knowledge is widely available.
• Easy to produce in large quantities.
It is easy to weaponize.
• It is extremely stable. It can be stored almost indefinitely as a dry powder.
• It can be loaded, in a freeze-dried condition, in munitions or disseminated as an aerosol with crude sprayers.
Currently, we have a limited detection capability.
What is Anthrax?
Fact Sheet
also called splenic fever, malignant pustule , or woolsorters' disease acute, specific, infectious, febrile disease of animals, including humans, caused by Bacillus anthracis, an organism that under certain conditions forms highly resistant spores capable of persisting and retaining their virulence in contaminated soil or other material for many years. A disease chiefly of herbivores (grass eaters), the infection may be acquired by persons handling the wool, hair, hides, bones, or carcasses of affected animals.
Anthrax is a naturally occurring disease of plant eating animals (goats, sheep, cattle, wine, etc.) caused by the bacterium Bacillus anthracis.
It is an illness which has been recognized since antiquity. Anthrax was common in essentially all areas where livestock are raised. Intensive livestock immunization programs have greatly reduced the occurrence of the disease among both animals and humans in much of the world, an most outbreaks occur in areas where immunization programs have not been implemented or have become compromised (primarily Africa and Asia; however, outbreaks occurred during the mid- I 990's in Haiti and the former Soviet Union).
Anthrax spores can remain viable for several decades under suitable environmental conditions; thus, absence of cases does not equate to absence of risk.
Humans can contract anthrax in three ways:
• Through cuts or breaks in the skin resulting from contact with an infected animal (cutaneous anthrax), resulting in local and possibly systemic (bloodstream) infection.
• From breathing anthrax spores (termed "woolsorters" disease) resulting in an infection of the lungs (inhalational anthrax).
• From eating infected meat, resulting in gastrointestinal infection (gastrointestinal anthrax). Gastrointestinal anthrax is generally not considered a threat to U.S. forces.
What are the symptoms?
Symptoms of anthrax begin after a 1 to 6 day incubation period following exposure.
For contact or cutaneous anthrax, itching will occur at the site of exposure followed by the formation of a lesion. Untreated contact anthrax has a fatality rate of 5-20 percent, but with effective antibiotic treatment, few deaths occur.
Initial symptoms for inhalational anthrax are generally non-specific: low grade fever, a dry hacking cough, and weakness. The person may briefly improve after 2 to 4 days; however within 24 hours after this brief improvement, respiratory distress occurs with shock and death following shortly thereafter.
Almost all cases of inhalational anthrax, in which treatment was begun after patients have exhibited symptoms, have resulted in death, regardless of post-exposure treatment.
What is the medical countermeasure?
Prior to exposure, prevention through vaccination, using the FDA-licensed vaccine. Link to nbc-med.org with information about the Anthrax Vaccine »
Otherwise, antibiotics such as penicillin, ciprofloxacin, and doxycycline are the drugs of choice for treatment of anthrax.
Treatment with antibiotics must begin prior to the onset of symptoms and must include vaccination prior to discontinuing their use.
The use of antibiotics keep the patient alive until their body can build an immunity to anthrax via vaccination. After symptoms appear however, inhalational anthrax is almost always fatal, regardless of treatment.