Anthrax Diseases

Anthrax disease is an effective biological weapon because it is relatively easy and inexpensive to produce. Anthrax bacteria form protective coatings, called spores, and contact with a small number of spores causes disease. Infection can occur in three ways: inhalation, intestinal absorption, and cutaneous (on the skin) contact. Humans can contract natural cases of anthrax, although such cases are rare in the US. They have been more common among people who have direct contact with animals or animal products such as leather, fur, and raw meat. In a bioterrorism attack anthrax would not be limited to people in contact with animals and animal products. Instead, terrorists would more likely target densely populated areas, people holding positions and occupations of power, or people in the military. While natural anthrax still exists in farming and grazing communities, weaponized anthrax targeting densely populated areas is a different threat. People living in such areas are at risk because release of a small quantity of anthrax in aerosol form could reach and infect a large number of people. Causative agent: spore-forming bacterium Bacillus anthracis. Time required for symptoms to appear: several hours to one week. Since sickness usually begins after several days, it is often difficult to pinpoint the source of infection. Signs and symptoms: early symptoms of the most dangerous form of anthrax, acquired through inhaling the bacteria, resemble those of a common cold, followed by include loss of appetite and vomiting. The symptoms of anthrax disease differ among the three types: Inhalation anthrax is caused by inhaling or breathing in anthrax spores, and is the likeliest route to be used by terrorists. Initial symptoms are similar to that of a common cold. The infected person will experience generalized weakness followed by a dry cough, sore throat, and runny nose, followed by loss of appetite and vomiting. Sickness caused by inhaling anthrax spores differs from the flu or common cold in that the individual will develop severe breathing problems and respiratory shock. Intestinal anthrax is caused by eating anthrax spores or the uncooked meat of an infected animal. Early symptoms of intestinal anthrax include loss of appetite and vomiting. As the disease progresses, the individual will experience severe abdominal pain, vomiting of blood, and severe diarrhea. Cutaneous anthrax is an infection of the skin which is caused by anthrax spores entering through a cut or skin abrasion. This is the most common form of natural anthrax disease. Early symptoms of cutaneous anthrax are itchy red bumps on the skin, which develop into an open sore after one to two days. The sore grows into a painless ulcer with a black center. The area around the sore may swell. Fatality rate: without treatment, inhalation anthrax is usually fatal. Intestinal anthrax is fatal in 25 to 60 percent of the cases. Cutaneous anthrax is usually not fatal when appropriately treated by a doctor. Attack rate: contact with spores usually results in sickness. Recovery: treated early enough, victims will show improvement following treatment and full recovery after a course of treatment that may last up to 60 days. Prevention: methods to prevent natural anthrax include wearing protective gear when examining animals and animal products, washing one’s face and hands after contact with animal products, and cooking meat thoroughly. Preventing anthrax infections from weaponized forms is a bit more challenging. Since anthrax can take the form of an aerosol or a powder, it is important to use common sense when dealing with such items. Avoid contact with any unusual or suspicious powders or aerosols. In past anthrax attacks, powders containing anthrax have been mailed. Suspicious mail should not be opened. If you think you are at risk to be exposed to anthrax, you may call the U.S. anthrax Vaccine Immunization Program at 1-877-GETVACC or 1-877-438-8222. The vaccine has been recommended for persons frequently handling animal products, military personnel, doctors, veterinarians, and scientists who might be in contact with the bacteria Treatment: treatment of anthrax is most effective in the earliest stages of the disease. All forms of anthrax are treated by a combination of antibiotics. The first antibiotic is usually given at a hospital by injection. Additional antibiotics are then taken at home by mouth in pill form over a period of up to 60 days. It is important to complete the entire dosage of antibiotic pills to prevent the disease from re-infecting the individual. Natural transmission: anthrax disease is transmitted by breathing in anthrax spores, eating anthrax spores, or by spores entering the body through a cut or abrasion on the skin. People rarely contract this disease from other people, and when they do it is through contact with the open sores of cutaneous anthrax. Germ Warfare Modes of Transmission: anthrax disease can be transmitted via a powder or aerosol. A germ warfare attack would be most effective in an unventilated area with a large number of people. The spores remain stable for a long period of time; they release bacteria when they find a suitable environment, such as the human body. Germ warfare characteristics: anthrax is an effective low-cost method of producing a large number of fatalities through inhalation. But it is extremely difficult to work with as a bioterrorism agent. For effective use the bacteria would have to be modified from the form found in animals to make it more virulent and resistant to antibiotics. Then it would have to be milled into a form small enough to be inhaled, but not so small that it would immediately be exhaled again. Finally, the terrorists would probably elect to attack indoors, thereby avoiding the effects of even a slight wind, which would disperse the spores before they have much effect. Confirmation of diagnosis: presence of anthrax bacteria in the body confirms anthrax disease. Response: before opening letters or packages, consider whether there are signs of anthrax, such as powder on the surface. If so, or if an opened item contains a suspicious powder, cover the item or its spilled contents with anything handy, such as a newspaper, leave the room and seal it off, wash your hands with soap and water, and report your suspicions to the local police. Contact a doctor. Remove your clothing and put it in a plastic bag, and then take a shower. Anyone else in the room should take these same steps. If you suspect that anthrax has been sprayed into a room, turn off any ventilation, leave the room, close the door, and report to the police. Seek medical assistance and notify the proper local and state public health authorities.