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 Definition of Anthrax |
| What is Bacillus Anthracis ? |
| How do we get Anthrax ? |
| What are the signs & symptoms ? |
| Specific signs & symptoms |
| How is Anthrax diagnosed ? |
| How is Anthrax Treated ? |
| More More information on Anthrax |
| Frequently asked questions |
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| Definition of Anthrax |
It is an infectious and potentially fatal disease of warm-blooded animals, especially of cattle and sheep, caused by the bacterium Bacillus anthracis. Anthrax can also occasionally effect human population.
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| What is Bacillus Anthracis ? |
The bacteria of Anthrax is a gram-positive, spore-forming, rod-shaped (bacillus) bacterium. It needs oxygen to thrive and has a capsule around it and hence has a protective layer around it. A spore is a cell that is dormant (asleep) but may come to life with the right conditions. Anthrax spores are tasteless, odorless, and invisible. A bacterium is a very small organism made up of one cell. Many bacteria can cause disease.
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| How do we get Anthrax ? |
Anthrax from animals: Humans can become infected with anthrax by handling products from infected animals or by breathing in anthrax spores from infected animal products (like wool, for example). People also can become infected with gastrointestinal anthrax by eating undercooked meat from infected animals.
Anthrax from contaminated mail, equipment or clothing:
In the mail handling processing sites, B. anthracis spores may be aerosolized during the operation and maintenance of high-speed, mail sorting machines potentially exposing workers. In addition, these spores could get into heating, ventilating, or air conditioning systems.
Anthrax as a weapon :
Anthrax also can be used as a weapon. This happened in the United States in 2001. Anthrax was deliberately spread through the postal system by sending letters with powder containing anthrax. This caused 22 cases of anthrax infection. |
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| What are the signs & symptoms ? |
General Signs & Symptoms include :
 Mild fever (temperature greater than 100 degrees F). The fever may be accompanied by chills or night sweats.
Flu-like symptoms.
Cough, usually a non-productive cough, chest discomfort, shortness of breath, fatigue, muscle aches.
Sore throat ( followed by difficulty swallowing, enlarged lymph nodes, headache, nausea, loss of appetite, abdominal distress, vomiting, or diarrhoea ).
A sore, especially on your face, arms or hands, that starts as a raised bump and develops into a painless ulcer with a black area in the center.
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| Specific signs & symptoms |
- Cutaneous : The first symptom is a small sore that develops into a blister. The blister then develops into a skin ulcer with a black area in the center. The sore, blister and ulcer do not hurt.
- Gastrointestinal : The first symptoms are nausea, loss of appetite, bloody diarrhoea, and fever, followed by bad stomach pain.
- Inhalation : The first symptoms of inhalation type of anthrax are cold and flu like symptoms and can include a sore throat, mild fever and muscle aches. Later symptoms include cough, chest discomfort, shortness of breath, tiredness and muscle aches. (Caution: If a person has cold or flu symptoms, do not assume that they are suffering from inhalation anthrax.)
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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.In patients with symptoms compatible with anthrax, providers should confirm the diagnosis by obtaining the appropriate laboratory specimens based on the clinical form of anthrax that is suspected (i.e., cutaneous, inhalational, or gastrointestinal).
Cutaneous - vesicular fluid and blood
Inhalational - blood, cerebrospinal fluid (if meningeal signs are present) or chest X-ray
Gastrointestinal - blood
When is a nasal swab indicated?
Nasal swabs and screening may assist in epidemiologic investigations, but should not be relied upon as a guide for prophylaxis or treatment
Is there an X-ray for detecting Anthrax?
A chest X-ray can be used to help diagnose inhalation anthrax in people who have symptoms. It is not useful as a test for determining anthrax exposure or for people with no symptoms.
Can the presence of Bacillus Anthracis spores be detected by a characteristic appearance, odor, or taste?
Bacillus anthracis spores do not have a characteristic appearance (e.g., color), smell, or taste. Spores themselves are too small to be seen by the naked eye .
What is subtyping?
Subtyping is a laboratory process to identify different subtypes of organisms, which is not possible with standard microbiological testing. Most Bacillus anthracis subtyping is done by examining the organism's molecular structure for certain genetic characteristics that can then be compared with those of other B. anthracis organism's to determine whether they are the same or different. Differences between these two organisms would indicate different strains.
Is subtyping different from polymerase chain reaction (PCR)?
Polymerase chain reaction (PCR) is a laboratory method used to detect and amplify genetic material from organisms. It can be used to diagnose disease by identifying genetic material (DNA) commonly found in all Bacillus anthracis strains or it can be used to subtype the organism by amplifying specific genetic material and comparing it with known strains of B. anthracis to see if it matches or if it is different.
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| How is Anthrax Treated ? |
| Antibiotics are used to treat all three types of anthrax. Early identification and treatment are important.
Treatment after infection. Treatment is usually a 60-day course of antibiotics. If you give anthrax spores the right environment, such as the human body, they can grow into the harmful form of the bacteria that can cause anthrax disease. It takes anthrax spores an average of 7 days to grow into the harmful form of the bacteria, but it can take longer. For this reason, you must continue taking preventive antibiotics for the full 60 days.Success depends on the type of anthrax and how soon treatment begins.
Why can't I take a shot, wear a patch, or take one large dose of the medicine instead of taking it for 60 days?
Spores can stay in the body for some time before they start growing and causing symptoms. When the spores are not growing, antibiotics are not effective. Only after the spores start to grow can the antibiotics work. Therefore, a constant level of antibiotics have to be in the body for 60 days to make sure that when the spores start to grow, the antibiotic is there to kill them.
Can a screening test be done to find out whether an individual has been exposed to anthrax?
There is no screening test for anthrax; there is no test that a doctor can do that says that an individual has been exposed to or carry it.
Can Anthrax be prevented ?
Vaccination is an option to prevent anthrax, but it is not yet available for the general public.
How does the anthrax vaccine work?
Anthrax vaccine works the same way as tetanus toxoid, rabies vaccine, and other vaccines that save millions of lives. Like other vaccines, anthrax vaccine causes the body to make protective antibodies. Antibodies protect by circulating in the blood stream and hunting down anthrax germs.
The vaccine helps the body train to defend itself, by making antibodies ahead of time. To make these antibodies, vaccines have to contain parts of the bacteria (germ). Anthrax vaccine makes the body produce antibodies to the protective antigen, so the bacteria can't produce the anthrax disease. Anthrax vaccine protects against the protein common to all harmful strains of anthrax bacteria.
Is Anthrax vaccine 100% effective?
After an anthrax attack, antibiotics would be given to increase survival even further. Antibiotics plus vaccination would be given to get survival as close to 100% as possible.
What are the side effects of the vaccine ?
Some common signs noted at the injection site after anthrax vaccination:
- Redness
- Swelling
- Pain
- Burning
- Itching
Serious adverse events are rare and occur in about 1 in 100,000 vaccinations .
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| More information on Anthrax |
More facts about the three types of Anthrax are described underneath:
1) Cutaneous ("skin") anthrax The most commonly , naturally occurring type.
Mode of transmission : The bacterium enters the body via a break ( cut or abrasion ) on the skin .
Incubation period : Usually an immediate response up to 1 day. As a result of handling contaminated animal products - such as meat, wool or hides.
Appearance : Begins as a small bump , progresses to a larger blister in
1-2 days,followed by a black scab called an eschar.
Fatality : About 5% to 20% of untreated cases can result in death, but death is rare if given antibiotic therapy.
Treatment options : Obtain specimens for culture BEFORE initiating antimicrobial therapy.
Do NOT use extended-spectrum cephalosporins or trimethoprim/sulfamethoxazole because anthrax may be resistant to these drugs.
Precautions : Standard contact precautions. Avoid direct contact with wound or wound drainage.
2) Gastrointestinal ( " stomach ") anthrax
A very rare disease-no documented cases in the U.S in the 20th century
Mode of transmission : Can occur when eating raw or uncooked contaminated meat.
Incubation period : Usually 1-7 days.
Appearance : Initial signs are nausea ,loss of appetite, vomiting and fever followed by severe abdominal pain, vomiting, and fever-followed by severe abdominal pain, vomiting blood, severe diarrhea.
Fatality : Death results in 25% to 60% of cases.
Treatment options : Obtain specimens appropriate to system affected:
blood (essential)
ascitic fluid
Obtain specimens for culture BEFORE initiating antimicrobial therapy. Early (during initial phase) antimicrobial therapy is critical. Do NOT use extended-spectrum cephalosporins or trimethoprim/sulfamethoxazole because anthrax may be resistant to these drugs.
Precautions : Standard contact precautions.
3) Inhalational anthrax
Mode of transmission : When inhaling as few as 5000-6000 anthrax spores-perhaps in a single deep breath.
Incubation period : Usually <1 week; may be prolonged for weeks (up to 2 months)
Appearance : Initial symptoms may develop in 1-6 days, and resemble the common cold or flu: sore throat, mild fever, muscle aches, and tiredness. Mild symptoms can progress very rapidly after a few days to severe breathing problems and shock-if left untreated.
Fatality : Death rate exceeds 99%. Once severe symptoms develop, 45% to 80% of patients could die.
Treatment options : Obtain specimens appropriate to system affected:
blood (essential)
pleural fluid
cerebral spinal fluid (CSF)
skin lesion
Obtain specimens for culture BEFORE initiating antimicrobial therapy. Initiate antimicrobial therapy immediately upon suspicion.Do NOT use extended-spectrum cephalosporins or trimethoprim/sulfamethoxazole because anthrax may be resistant to these drugs. Supportive care including controlling pleural effusions
Precautions : Standard contact precautions |
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| Frequently Asked Questions |
Which doctor should I consult for Anthrax ?
A general physician or infectious disease specialist is the doctor to consult if Anthrax is suspected or diagnosed.
Consult a General Physician in your City or area
If infected how long does it take for symptoms to develop?
It takes around 1 to 6 days after exposure for anthrax symptoms to develop. However inhalational type of anthrax progresses very rapidly and can cause death within a day or two if not treated aggressively.
For gastrointestinal anthrax, the case-fatality rate is estimated to be 25%-60% and the effect of early antibiotic treatment on that case-fatality rate is not defined.
Early treatment of cutaneous anthrax is usually curative, and early treatment of all forms is important for recovery. Patients with cutaneous anthrax have reported case fatality rates of 20% without antibiotic treatment and less than 1% with it.
Is anthrax contagious?
No. Anthrax is not a contagious disease and the illness cannot be transmitted from person to person.
Does a patient have immunity after recovering from anthrax infection?
There is not enough data at this time to confirm this, however, it is theoretically possible to gain post-infection immunity.
How can I prevent Anthrax after an exposure ?
Treatment is different for a person who is exposed to anthrax, but is not yet sick. Health-care providers will use antibiotics (such as ciprofloxacin, doxycycline, or penicillin) combined with the anthrax vaccine to prevent anthrax infection.
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