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Anthrax: What You Should Know

Q & A concerning the bacteria anthrax and how to protect yourself from exposure

Q: What is anthrax?
A: Anthrax is created by the etiologic agent Bacillus anthracis. This bacterium is large, gram-positive, non-motile, spore forming, and rod-shaped. There are three virulence factors of anthrax: edema toxin, lethal toxin, and capsular antigen.

Q: How can anthrax infect humans?
A: There are three forms of human infections caused by anthrax: cutaneous, inhalation, and gastrointestinal. 

Q: What are the symptoms of exposure/infection?
A: People exposed to cutaneous (dermal) anthrax often develop a small papule where their skin touched the bacteria. This form of anthrax is by far the most common with more than 95% of all cases being dermatitis related. People can become infected via cutaneous anthrax from touching contaminated meat, wool, hides, or the leather of infected animals. Within 1-12 days, the papule will develop in a vesicle and a necrotic ulcer will become visible. The person will also most likely be suffering from fever, malaise, headache, and regional lymphadenopathy. While more than 20% of these untreated infections result in death, patients who are promptly treated with antibiotics rarely die from the infection. 

Those exposed to inhalational anthrax are facing a more difficult battle to survive. This is the most lethal form of infection of the bacteria. The incubation period has been debated. Some scientists think a person who inhales several thousand spores will show signs within one week, while others argue the exposure may not show for up to 60 days. Initial symptoms include sore throat, mild fever, muscle aches, and malaise; however, these symptoms can quickly progress to severe respiratory distress and meningitis.

Gastrointestinal anthrax infects people when they eat meat that has been contaminated with the bacteria. This form of the disease causes severe abdominal problems and includes the following symptoms: fever, signs of septicemia, abdominal pain, nausea, vomiting of blood, and severe diarrhea. More than 25% of all cases are fatal infections. 

Q: How is anthrax exposure different from an anthrax infection?
A: Exposure solely means the person was in an environment where the bacteria were also present. People can be exposed without becoming ill. A person who has fallen ill from anthrax generally will begin to show signs within a week after exposure. 

Q: What treatment options are available?
A: The Food and Drug Administration (FDA) has approved several antibiotics to treat anthrax infection. These include: ciprofloxacin (Cipro, manufactured by Bayer), doxycycline, and amoxicillin. Also, ciprofloxacin and doxycylcine have been approved for post exposure prophylaxis. 

Q: Is there a vaccine available to prevent anthrax infection?
A: While there is a vaccine in existence, it is not available to the general American public. It has been created for military personnel serving in areas of the world that are thought to be highly susceptible to a bioterrorism attack. There are pharmaceutical companies currently working on manufacturing a vaccine for the public, but this service is not available today. 

Q: Can I place my mail in the microwave or iron it as a method of decontamination?
A: UV light, ironing, and the microwave could kill some anthrax spores. Yet, these methods are not recommended as a method of preventing infection. If a package or letter arrives and seems suspicious, or contains any powder, the recipient should immediately call law enforcement. 

For more information about anthrax, log onto: www.anthrax.osd.mil,www.cdc.gov, http://jama.ama-assn.org/issues/v281n18/ffull/jst80027.html

Q & A information from www.cdc.gov.