Anthrax Fact Sheet
What is anthrax?
Anthrax is an acute infectious disease that usually occurs in animals such as livestock, but can also affect
humans. Human anthrax comes in three forms, depending on the route of infection: cutaneous (skin) anthrax,
inhalation anthrax, and intestinal anthrax. Symptoms usually occur within 7 days after exposure.
Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the
skin after handling infected livestock or contaminated animal products. 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 are like cold or flu symptoms and can include a sore throat, mild fever, and muscle
aches. After several days, the symptoms may progress to cough, chest discomfort, severe breathing problems
and shock. Inhalation anthrax is often fatal. Eleven of the mail-related cases were inhalation; 5 (45%) of the 11
patients died.
Intestinal: Initial signs of nausea, loss of appetite, vomiting, and fever are followed by abdominal pain, vomiting
of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases.
While most human cases of anthrax result from contact with infected animals or contaminated animal
products, anthrax also can be used as a biologic weapon. In 1979, dozens of residents of Sverdlovsk in the
former Soviet Union are thought to have died of inhalation anthrax after an unintentional release of an aerosol
from a biologic weapons facility. In 2001, 22 cases of anthrax occurred in the United States from letters
containing anthrax spores that were mailed to members of Congress, television networks, and newspaper
companies.
What causes anthrax?
Anthrax is caused by the bacterium Bacillus anthracis. The anthrax bacterium forms a protective shell called a
spore. B. anthracis spores are found naturally in soil, and can survive for many years.
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?
Antibiotics are used to treat all three types of anthrax. Treatment should be initiated early because the disease
is more likely to be fatal if treatment is delayed or not given at all.
How common is anthrax and where is it found?
Anthrax is most common in agricultural regions of South and Central America, Southern and Eastern Europe,
Asia, Africa, the Caribbean, and the Middle East, where it occurs in animals. When anthrax affects humans, it
is usually the result of an occupational exposure to infected animals or their products. Naturally occurring
anthrax is rare in the United States (28 reported cases between 1971 and 2000), but 22 mail-related cases
were identified in 2001.
Infections occur most commonly 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.
How is anthrax transmitted?
Anthrax can infect a person in three ways: by anthrax spores entering through a break in the skin, by inhaling
anthrax spores, or by eating contaminate, undercooked meat. Anthrax is not spread from person to person.
The skin (“cutaneous”) form of anthrax is usually the result of contact with infected livestock, wild animals, or
contaminated animal products such as carcasses, hides, hair, wool, meat, or bone meal. The inhalation form is
from breathing in spores from the same sources. Anthrax can also be spread as a bioterrorist agent.
Who has an increased risk of being exposed to anthrax?
Susceptibility to anthrax is universal. Most naturally occurring anthrax affects people whose work brings them
into contact with livestock or products from livestock. Such occupations include veterinarians, animal handlers,
abattoir workers, and laboratorians. Inhalation anthrax was once called Woolsorter’s Disease because workers
who inhaled spores from contaminated wool before it was cleaned developed the disease. Soldiers and other
potential targets of bioterrorist anthrax attacks might also be considered at increased risk.
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. It is reported to be 93% effective in
protecting against anthrax. It is used by veterinarians, laboratorians, soldiers, and others who may be at
increased risk of exposure, but is not available to the general public at this time.
For a person who has been exposed to anthrax but is not yet sick, antibiotics combined with anthrax vaccine
are used to prevent illness.
Describe its causation in terms of agent, host, and environment. 1) Agent: 2) Host: 3)
Environment:
Agent originally referred to an infectious microorganism or pathogen: a virus,
bacterium, parasite, or other microbe. Over time, the concept of agent has been
broadened to include chemical and physical causes of disease or injury. These
include chemical contaminants (such as the L-tryptophan contaminant responsible for
eosinophilia-myalgia syndrome), as well as physical forces (such as repetitive
mechanical forces associated with carpal tunnel syndrome)
Host refers to the human who can get the disease. A variety of factors intrinsic to the
host, sometimes called risk factors, can influence an individual’s exposure,
susceptibility, or response to a causative agent. Opportunities for exposure are often
influenced by behaviors such as sexual practices, hygiene, and other personal
choices as well as by age and sex. Susceptibility and response to an agent are
influenced by factors such as genetic composition, nutritional and immunologic status,
anatomic structure, presence of disease or medications, and psychological makeup.
Environment refers to extrinsic factors that affect the agent and the opportunity for
exposure. Environmental factors include physical factors such as geology and climate,
biologic factors such as insects that transmit the agent, and socioeconomic factors
such as crowding, sanitation, and the availability of health services.
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