With the increasing number of anthrax cases appearing in the U.S. as a result of bioterrorism, people are naturally concerned over how to protect themselves and their families.
One of the most important ways to do this is to be well informed about the disease. Here is a
brief overview of anthrax to help you understand the symptoms, how it is contracted and spread,
what role vaccination plays, and how to protect yourself and your family.
WHAT IS ANTHRAX?
It is a bacterium that has been around for millennia. It infects animals, mainly cattle and
sheep. It can also survive in a spore form for decades. People most at risk were those that
worked closely with cattle and sheep such as sheep-shearers and wool sorters. Eating raw meat
was also a risk factor. Mass animal vaccination programs have greatly reduced this disease,
and cases of anthrax are now very rare. The last known case of inhalation anthrax in the U.S.
occurred in 1978.
WHAT ARE THE THREE TYPES OF ANTHRAX INFECTION?
- Cutaneous (skin) anthrax - this occurs when a person's skin comes into contact
with the bacteria. It mainly causes symptoms on the skin only, and responds well to treatment.
This is by far the most common type of anthrax infection.
- Inhalation anthrax - this occurs by inhaling several thousand spores. It occurs
only very rarely because such a large exposure is needed to cause infection.
- Gastrointestinal anthrax - this occurs from ingesting the bacteria or spores
through raw meat. This is also much less common than skin infection.
WHAT ARE THE SYMPTOMS OF ANTHRAX?
- Cutaneous (skin) anthrax - this begins like an insect bite - an itchy bump.
After one or two days it forms a blister. The blister then opens and a black, painless ulcer
- Gastrointestinal anthrax - this begins with nausea and vomiting. It progresses
to abdominal pain, bloody vomiting, and severe bloody diarrhea.
- Inhalation anthrax - this begins as a common cold. As the infection spreads
through the lungs, the cough and fever become increasingly worse, breathing becomes more and
more difficult and shock sets in. This can progress rapidly over a few days or slowly over a
The incubation period (time from exposure to symptoms) is 1 to 7 days.
WHY IS ANTHRAX SO DEADLY?
While the bacteria themselves are quite dangerous, even more deadly is the toxin that they
produce. This toxin attacks a person's immune system, destroying the body's ability to fight
off the infection, which is then allowed to overwhelm the person.
WHAT TYPE OF ANTRAX IS MOST SERIOUS?
Inhalation anthrax is by far the most serious. It is often fatal, unless early treatment is
Gastrointestinal anthrax is fatal 50% of the time if left untreated.
Cutaneous (skin) anthrax is only fatal 20% of the time if left untreated.
If treated promptly, gastrointestinal and cutaneous anthrax are rarely fatal.
IS ANTHRAX CONTAGIOUS?
No. There has never been a reported case of one infected individual passing anthrax on to
another person. This is fortunate because this disease cannot spread through a population.
A person with cutaneous anthrax could theoretically transmit the infection to
another person via the fluid in the blisters; this mode of transmission has not
yet been reported however.
HOW IS ANTHRAX TREATED?
It is treated with antibiotics. Doxycycline, Ciprofloxacin and penicillin are the only
antibiotics that have shown to be effective against anthrax. They are usually given by I.V. to
treat known infections. They may be given by mouth for 4 weeks to treat exposed people before
infection sets in to try to prevent infection. Cipro and doxycycline cannot be given to children
younger than 8 years old because they can harm bone growth.
HOW HAS ANTHRAX BEEN DELIVERED AS A BIOLOGICAL WEAPON IN THE MAIL?
Thousands of spores are mixed into a powder, thus making them easy to inhale.
WHAT ABOUT ANTHRAX VACCINE?
This vaccine is given in six doses spread out over 18 months. It is normally used only for
those at high risk of exposure such as military personnel. Recently, the government began
working on several ways to increase vaccine production so there will be enough in the event of
a large-scale attack. Some experts are considering vaccinating emergency workers and postal
workers in light of recent events. Safety of the vaccine for children has not yet been studied.
HOW YOU CAN BE PREPARED
Vaccination is not yet available to the general public. It probably won't be available for a long
time, except for select high-risk people in military or emergency service.
Antibiotics - some people have begun to stock up on a good supply of antibiotics just
in case they are exposed. They fear that in the event they are exposed, they won't be able to
acquire the necessary antibiotics. This is both unnecessary and irresponsible for several
- If you are one of the very few who get exposed, you can be sure the public health
department is going to get you treated immediately and properly.
- You cannot just randomly start taking one of these antibiotics every day for the next
two years to protect yourself. The toxic side effects of long term Cipro and doxycycline would
kill you long before you would come even close to anthrax.
- People worry that in the event of a massive outbreak, there will not be enough
antibiotics to go around. Well, as stated above, a massive outbreak of anthrax is not
possible because it is not passed from person to person and it takes thousands of spores
just to infect one person. No one could create enough spores to infect a large population.
There will therefore be plenty of antibiotics to go around when needed.
Gas masks and other protective measures are also not effective because you will already be
exposed by the time you even know you were at risk.
I urge people to stay informed by watching and reading credible news sources and follow the
recommendations of the U.S. government and its agencies whose job it is to protect our country.