Patient information sheet: Anthrax
While there have been only a few cases of anthrax diagnosed recently in the United States, many people are concerned about contracting this infectious disease. The average American is extremely unlikely to acquire anthrax. Even if you do acquire anthrax, the most common form of the disease is almost 100% treatable. We are providing this educational handout in an attempt to answer some of the common questions people have about anthrax.
What is anthrax?
Anthrax is an infectious disease that is caused by a bacterium known as Bacillus anthracis. Anthrax most commonly occurs in animals such as cattle, sheep, goats, camels, antelopes, and other herbivores. The bacterium also exists as a spore that can remain dormant in the soil for over 40 years.
What do anthrax spores look like?
Since the anthrax spore is a bacterium, you cannot see the spore with the human eye. If anthrax spores are produced in mass quantity and are used as a biological weapon, they are often combined with a dry powder that may appear white or brown. In the recent events involving mailed anthrax spores, the material that has tested positive has a brownish, grainy appearance.
How can I become infected with anthrax?
Anthrax is acquired by three methods: 1) spores can be inhaled into the lungs (inhalational anthrax); it takes at least 8,000 spores for this form of anthrax to occur. 2) spores can contaminate an opening in the skin, a cut, or an abrasion in the skin (cutaneous anthrax); 3) the anthrax bacterium can contaminate meat that is then ingested without being cooked properly (gastrointestinal anthrax).
Is anthrax contagious?
Anthrax is almost never spread from person to person. The inhalational and gastrointestinal forms CANNOT spread from person to person. The cutaneous form of anthrax may have spores in the wound and theoretically those spores can be transmitted to another person with open sores on their arms.
What are the different kinds of anthrax?
Cutaneous anthrax — More than 90% of all anthrax cases are of the cutaneous type. Cutaneous anthrax begins as a tiny bump on the skin which later forms blisters and then becomes an ulcer with a dark black center (called an eschar).
Because of our immune system’s reaction to the infection, the ulcer is surrounded by redness and swelling. In addition, the toxin produced by the anthrax bacterium causes further destruction of tissues. Treatment with antibiotics is successful in almost 100% of cases. Some cases are severe enough to cause the infection to spread to the blood.
Gastrointestinal (GI) anthrax — There are two forms of GI anthrax. One is associated with sores and ulcers in the mouth and throat just like the sores and ulcers seen on the skin. The other form is similar to severe food poisoning with high fever, abdominal pain, and bloody diarrhea. If treated early in the course of infection, GI anthrax can be treated effectively although up to 60% of people have died from this form of anthrax.
Inhalational anthrax — pulmonary anthrax is acquired after inhaling thousands of spores. Since only the smallest of the anthrax spores can reach the part of the lung required to cause infection, this form of anthrax is rare. Lung anthrax begins with flu-like symptoms such as fever, body aches and pains, a feeling of being tired and weak. Symptoms such as runny eyes and nose or a sore throat are NOT common in lung anthrax. Next, the patient would develop severe difficulty breathing, high fever, heavy sweating, and a heavy tight feeling in the chest area. Shock may develop and death can occur 2436 hours later.
How can anthrax be treated?
The anthrax bacterium can be killed by numerous antibiotics including penicillin, amoxicillin, clindamycin, rifampin, vancomycin, and a group of antibiotics known as fluoroquinolones. Cipro is one of the more common antibiotics used to treat patients with anthrax and also used to prevent anthrax if you have been exposed to anthrax spores.
If I receive a package or letter containing a suspicious substance, what should I do?
The most important thing to remember is DO NOT OPEN the letter or package. Emergency response personnel should be contacted at 911 for further advice. If you do open the letter or package and the suspicious substance gets on you, wash your skin with soap and water.
What do I do if I think I was exposed to anthrax?
There are several options:
1. Contact the Poison Control Center at Carolinas Medical Center at 704-355-4000 or 800-848-6946.
2. Contact the Mecklenburg County Health Department at 704-432-0871, 704-336-6438, 704-336-5490, or 704-336-5398
3. Contact your personal physician for advice.
4. Other information is available from the Centers for Disease Control and Prevention at www.cdc.gov or from the county health department at www.meckhealth.org.
How can I tell if I have anthrax or do I have "the flu"?
You may have to be evaluated by a health care professional to be sure. But, people with "the flu" or other respiratory viruses tend to have watery and itchy eyes, a runny nose, and a scratchy sore throat while patients with inhalational anthrax do not.
Can I get vaccinated against anthrax?
No. Although there is a vaccine used for military personnel and certain laboratory workers, health exports do NOT recommend that other persons receive the vaccine. It is associated with side effects that outweigh its general use in others.
Should I take antibiotics to protect myself?
Health experts advise that we should NOT take antibiotics without an active infection being present. If widespread, inappropriate use of antibiotics does occur, the door is open for resistance to emerge. As a result, the antibiotic then would no longer be effective should you need it in the future.
If you are part of an exposure to anthrax, you will be advised by the public health department, and they will provide you with antibiotics at no charge.
Source: Carolinas Medical Center, Charlotte, NC.
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