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Anthrax

 

bulletAnthrax [AN-thracks] is a bacterial disease that mainly affects animals. In rare cases, it can spread to people and cause life-threatening illness.
bulletAnthrax is most common in areas where people raise livestock and where public health programs are lax. Animals get anthrax by grazing on soils contaminated with anthrax spores. Anthrax in people is usually the result of a work-related exposure to infected animals or contaminated animal products.
bulletTo prevent anthrax, avoid contact with livestock and animal products when in countries where anthrax is common. A vaccination is available for people at high risk for work-related exposures.  

What is anthrax?

Anthrax is mainly a disease of animals. In rare cases, it can spread to people and cause life-threatening illness. 

What is the infectious agent that causes anthrax?

Anthrax is caused by Bacillus anthracis, a bacterium that lives naturally in certain types of soil. The bacterium produces spores. Spores are hardy forms of the bacterium that can survive in soil or on contaminated objects for years. 

Where is anthrax found?

Anthrax is found worldwide but is most common in areas where people raise livestock and where public health programs are lax. Materials contaminated with anthrax spores can reach any country in the world. 

How do people get anthrax?

Animals get anthrax by grazing on soils contaminated with anthrax spores. People get anthrax by touching infected animals or animal products, such as wool, hides, leather, or hair products (especially goat hair). The bacteria get into the body through a break in the skin. In rare cases, people can get anthrax by breathing in anthrax spores from contaminated soil or animal products or by eating undercooked meat from infected animals. 

What are the signs and symptoms of anthrax?

In the body, anthrax spores produce a powerful toxin (poison) that causes the signs and symptoms of illness. The signs and symptoms vary depending on how a person was infected.

Infection by skin contact: Most cases occur by skin contact. Skin infection begins as a raised itchy bump that looks like an insect bite. Within 1-2 days, it develops into a boil-like sore and then a painless ulcer with a characteristic dark (dying) area in the center. The infection can also cause swelling of the lymph glands near the site. About 20% of untreated cases will result in death. With proper treatment, deaths from this type of anthrax are rare.

Infection by inhalation: People who get anthrax by breathing in spores have symptoms that are like a common cold. After several days, the symptoms can progress to severe breathing problems and shock. This type of anthrax usually results in death in 1-2 days after the start of severe symptoms.

Infection by ingestion: Intestinal infections from eating contaminated meat are rare. The infection causes severe inflammation of the intestinal tract. The first signs are nausea, loss of appetite, vomiting, and fever, followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases. 

How soon after exposure do symptoms appear?

Symptoms usually appear within 7 days. 

How is anthrax diagnosed?

Anthrax is usually diagnosed by isolating the bacterium from the blood, skin lesions, or respiratory discharges. 

Who is at risk for anthrax?

When anthrax affects humans, it is usually due to a work-related exposure to infected animals or their products. Workers who are exposed to dead animals and animal products from countries where anthrax is common can become infected.

There is little risk to most U.S. travelers to other countries. The greatest risk comes from handling rugs and handicrafts made from goat skin or goat hair. Spores can live indefinitely in wool, blankets, and other animal products. 

What is the treatment for anthrax?

People with anthrax should be treated promptly with antibiotics. To be effective, treatment should be started early. If left untreated, the disease can be fatal. 

How common is anthrax?

Anthrax is most common in animals in agricultural regions of the world. Anthrax is rare in humans. An estimated 20,000 to 100,000 cases occur yearly worldwide, mostly in developing countries. Anthrax is very rare in the United States and in other countries where animals are inspected before and after slaughter. Anthrax is also rare in U.S. travelers, although certain handicrafts might be contaminated and should be avoided. 

Is anthrax a new or emerging infectious disease?

Because of the wide use of animal anthrax vaccines, anthrax is only a minor health problem around the world. However, lapses in local control programs can have serious consequences. Almost 10,000 cases were reported in an outbreak in Zimbabwe in the late 1970s. Hundreds of cases occur each year in several African countries. 

How can anthrax be prevented?

When traveling to countries where anthrax is common and vaccination levels of animal herds are low, avoid contact with livestock and animal products. Avoid eating meat that has not been properly slaughtered and cooked. Do not buy items made of goat hair or goat skin.

An anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against anthrax infection from skin contact. The vaccine is currently approved only for healthy men and women ages 18-65 years. Pregnant women should not be vaccinated.

 Vaccination is recommended for:

bulletPersons whose work can expose them to imported animal hides, furs, bonemeal, wool, animal hair (especially goat hair), and bristles
bulletPersons whose work in diagnosing or investigating anthrax cases might bring them into contact with anthrax spores

Note: Because anthrax is considered to be a potential agent for use in biological warfare, the Department of Defense is implementing systematic anthrax vaccination of all U.S. military personnel beginning in Summer 1998. Military personnel should contact their chain of command with questions about the vaccine and its distribution. 

Where can I find more information about anthrax?

Agencies

CDC, NCID, Division of Bacterial and Mycotic Diseases, Meningitis and Special Pathogens Branch

Websites

http://www.cdc.gov/ncidod/dbmd/anthrax.htm

 

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health-care provider. If you have any questions about the disease described above, consult a health-care provider.

Centers for Disease Control and Prevention
 CDC Home Search Health Topics A-Z
DBMD Disease Information


Anthrax

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Frequently Asked Questions

bullet What is anthrax?
bullet Why has anthrax become a current issue?
bullet How common is anthrax and who can get it?
bullet How is anthrax transmitted?
bullet What are the symptoms of anthrax?
bullet Where is anthrax usually found?
bullet Can anthrax be spread from person-to-person?
bullet Is there a way to prevent infection?
bullet What is the anthrax vaccine?
bullet Who should get vaccinated against anthrax?
bullet What is the protocol for anthrax vaccination?
bullet Are there adverse reactions to the anthrax vaccine?
bullet How is anthrax diagnosed?
bullet Is there a treatment for anthrax?
bullet 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?

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.

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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.

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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.

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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.

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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.

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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.

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Who should get vaccinated against anthrax?

The Advisory Committee on Immunization Practices has recommend anthrax vaccination for the following groups:

bulletPersons who work directly with the organism in the laboratory
bulletPersons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax spores.
bulletPersons 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.)
bulletMilitary personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare weapon).

Pregnant women should be vaccinated only if absolutely necessary.

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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.

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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.

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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 703-681-3292. http://www.aomc.org/ComDiseases/Anthrax.html

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Anthrax (malignant edema, woolsorters' disease)

What is anthrax?

Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in warm-blooded animals, but can also infect man. Anthrax spores can be produced in a dry form (for biological warfare ) which may be stored and ground into particles. When inhaled by humans, these particles cause respiratory failure and death within a week.

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) announced that it will begin systematic vaccination of all U.S. military personnel.

Who gets anthrax?

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 (industrial anthrax) from other countries where anthrax is more common may become infected with B. anthracis. Anthrax in animals rarely occurs in the United States. Most reports of animal infection are received from Texas, Louisiana, Mississippi, Oklahoma and South Dakota.

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 animal 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 seven days.

Cutaneous: Most 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 usually results in death in 1-2 days after onset of the acute symptoms.

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.

How soon after infection do symptoms appear?

The incubation period is usually within seven days.

When and for how long is a person able to spread anthrax?

There are no reports of the disease spreading from human to human. Direct person-to-person spread of anthrax most likely does not occur.

Does past infection with anthrax make a person immune?

A second attack with this disease is unlikely.

What is the treatment for anthrax?

Doctors can prescribe effective antibiotics. Usually penicillin is preferred, but erythromycin, tetracycline, or chloramphenicol can also be used. To be effective, treatment should be initiated early.

What can be the effect of not being treated for anthrax?

The disease could be fatal in untreated cases.

Where is anthrax usually found?

Although anthrax can be found globally, it is more often a risk in countries with less standardized and effective public health programs. Areas currently listed as high risk are South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East.

What can be done to prevent the spread of anthrax?

Anthrax vaccine is available for people in high-risk occupations. To prevent anthrax, carefully handle dead animals suspected of having anthrax; provide good ventilation when processing hides, fur, hair or wool; and vaccinate animals.

In countries where anthrax is common and vaccination levels of animal herds is low, humans should avoid contact with livestock and animal products, and avoid eating meat that has not been properly slaughtered and cooked. For high risk occupations, such as those exposed to potentially contaminated animal hair, wool or hides, vaccination is recommended. An anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against cutaneous anthrax.

What is the anthrax vaccine?

The anthrax vaccine is a cell-free filtrate vaccine, which means it uses dead bacteria as opposed to live bacteria. Anthrax vaccine is indicated for individuals who come in contact in the workplace with imported animal hides, furs, bonemeat, wool, animal hair (especially goat hair), and bristles; and for individuals engaged in diagnostic or investigational activities which may bring them into contact with anthrax spores.

BioPort Corporation is the sole manufacturer of the anthrax vaccine. BioPort, whose headquarters is located in Lansing, Michigan, is owned by multiple shareholders. The two main companies that make up BioPort are Intervac, headed by William Crowe and Faud El-Hibri, and Michigan Biologic Products Inc.

The vaccine is US Food and Drug Administration (FDA)-licensed and has been routinely given in the US since 1970.

What is the protocol for anthrax vaccination?

The immunization consists of three subcutaneous injections given two weeks apart followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are required to maintain immunity.

Are there adverse reactions to the anthrax vaccine?

Like all vaccines, anthrax vaccine may cause soreness, redness, itching,
swelling, and lumps at the injection site. About 30% of men and 60% of
women report these local reactions, but they usually last only a short while.
Lumps can persist a few weeks, but eventually disappear. Injection-site
problems occur about twice as often among women. For both genders,
between 1% and 5% report reactions at the injection site of 1 to 5 inches in
diameter. Larger reactions at the injection site occur in about one in a
hundred vaccine recipients.

Beyond the injection site, from 5% up to 35% will notice muscle aches, joint
aches, headaches, rash, chills, fever, nausea, loss of appetite, malaise, or
related symptoms. Again, these symptoms usually go away after a few days.

Serious events, such as those requiring hospitalization, are rare. They happen
about once per 50,000 doses. Severe allergic reactions can occur after any
vaccination, less than once per 100,000 doses.

A moderate local reaction can occur if the vaccine is given to anyone with a past history of anthrax infection.

Acute symptoms have varied. Depending on the vaccine lot used.

The most common side effects reported are: mild discomfort (localized swelling and redness at the site of injection), joint aches, and in a few cases, nausea, loss of appetite, and headaches.

Are there any long term side effects?

There have been no long term side effects from the vaccine.

Should everyone get vaccinated against anthrax?

Anthrax vaccine is indicated for individuals who come in contact in the workplace with imported animal hides, furs, bonemeat, wool, animal hair (especially goat hair), and bristles; and for individuals engaged in diagnostic or investigational activities which may bring them into contact with anthrax spores. The vaccine should only be administered to healthy men and women from 18 to 65 years of age since investigations to date have been conducted exclusively in that population. Because it is not known whether the anthrax vaccine can cause fetal harm, pregnant women should not be vaccinated.

Who should not get vaccinated against anthrax?

People who should not get the anthrax vaccine are those with a true hypersensitivity reaction (serious allergic reaction) to a previous dose of the anthrax vaccine, people infected with HIV, people who have other kinds of immune suppression, pregnant women, and people under 18 and over 65 years of age. Other temporary reasons for deferring anthrax vaccination include an acute respiratory disease or active infection, and a temporary course of immune-suppressing drugs such as steroids (e.g., prednisone).

People with preexisting autoimmune illnesses such as rheumatoid arthritis, lupus, multiple sclerosis are probably more likely to suffer a serious adverse reaction, as are those with neurologic disease, such as those who had polio in childhood.

With the new DOD vaccination program, is anthrax vaccine available to the civilian population?

Small quantities are made available as needed to civilians who are exposed to anthrax hazards in their work environment such as veterinarians, lab workers and others. Anthrax vaccine is produced exclusively by the Michigan Biologic Products Institute under contract to the Defense Department. Virtually all vaccine produced is earmarked for military use in recognition of the documented threat to military personnel.

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 suspected cases.

Is there a treatment for anthrax?

Doctors can prescribe effective antibiotics. Usually, penicillin is preferred, but erythromycin, tetracycline, or chloramphenicol can also be used. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.

Where can I get more information about the Department of Defense decision to require men and women in the Armed Services to be vaccinated against anthrax?

 

 

 

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