What You Need to Know About Anthrax

The following is a list of frequently asked questions about anthrax.

What is anthrax?

Anthrax is a disease caused by the spore-forming bacterium Bacillus anthracis, and is most commonly found in wild and domestic animals (cattle, sheep, goats, camels, antelopes and other herbivores). Humans can be infected with it when they are exposed to infected animals or tissue from infected animals.

How common is anthrax, and where is it found?

Anthrax can be found globally but is most common in farming regions in developing countries in South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean and the Middle East.

How is anthrax transmitted?

People can contract anthrax in three ways: Through the skin (cutaneous), by inhaling it, and by eating or drinking it. B. anthracis spores can live in the soil for 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?

The symptoms vary depending on how the disease was contracted, but all usually occur within seven days.

Cutaneous: Most (about 95 percent) anthrax infections occur when the bacterium enters a cut or scrape on the skin. 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. Nearby lymph glands may swell. About 20 percent of people with untreated cases of cutaneous anthrax will die. Deaths are rare when the disease is treated.

Inhalation: First 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 form is characterized by an acute inflammation of the intestinal tract. Initial 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 percent to 60 percent of cases.

How can you clean up or get rid of anthrax spores?

In a 1999 anthrax scare, people got rid of their clothes and showered in a special shelter using soap and a diluted bleach solution. Their desks were cleaned with a 5 percent hypochlorite solution (i.e., standard household bleach). Spores, however, can survive for years. In 1941, the British released spores on an island near Scotland. The spores persisted until 1986 when the British decontaminated the island with formaldehyde and seawater.

How do you kill the spores?

Spores don't mind being dried out; they can survive for years this way. They can be boiled for 10 minutes with little effect. And they resist most disinfectants. A temperature of 120°C (about 248°F) for at least 15 minutes is usually used to inactivate them.

Can anthrax be spread from person-to-person?

Extremely unlikely. Communicability is not a concern in managing or visiting with patients with inhalational anthrax.

Is there a way to prevent infection?

The anthrax vaccine is about 93 percent effective in protecting against anthrax, but supplies are limited, and right now, all are earmarked for military use. Taking antibiotics as a preventative is not wise; widespread use may mean that the drugs over time may not work against other diseases. Also, taking antibiotics does not give you immunity. If you don't have symptoms or reason to suspect you've been exposed, you may be doing more harm than good by dosing yourself with antibiotics.

How is anthrax 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 antibiotics. To be effective, treatment should be started early. If left untreated, the disease can be fatal.

How old is this disease?

Anthrax was described 3,500 years ago and may have been to blame for two of the plagues of Egypt in 1491 B.C.

How many people die from it in the United States?

Until the death of the Florida newspaper photo editor this month, the last death from the inhaled form of anthrax was in 1976 when a home craftsman died after working with yarn imported from Pakistan. In the past 20 years, less than one case per year of anthrax of any kind has been reported. Between 1984 and 1993, the Centers for Disease Control and Prevention (news - web sites) had only heard of three cases of cutaneous anthrax.

How much do you have to inhale to become sick?

The U.S. Department of Defense (news - web sites) estimates that a lethal dose for some people would be between 8,000 and 10,000 spores.

How does inhaled anthrax progress?

Incubation lasts up to six days. For the next four days, there are aches and pains, tiredness, a cough and fever. Then there may be an improvement. After that, the second stage begins abruptly. It lasts about 24 hours; it includes severe breathing problems, fever, and internal bleeding, among other symptoms, and usually ends in death.

What does anthrax look like?

The spores are too small to be seen with the naked eye. Under a microscope, the bacteria looks like bamboo.

How do I know if I have inhaled anthrax?

It's hard to diagnose early because it has the look and feel of a common cold or viral infection. But if you think you've been exposed, get to a doctor immediately.

This information was gathered from the Centers for Disease Control and Prevention, the American College of Chest Physicians and the National Center for Infectious Diseases Division of Bacterial and Mycotic Diseases.

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