What Is Anthrax?

Anthrax is a potentially fatal disease caused by the bacterium Bacillus anthracis. It is well known for its
role in the 2001 bioterrorist attacks, in which the lethal bacteria were spread deliberately through the
U.S. mail. Twenty-two people became ill, and five died.
WHAT ARE THE TYPES OF ANTHRAX?
Anthrax is a serious disease caused by the bacterium Bacillus anthracis.
The three major types of anthrax are:
Cutaneous Anthrax, About 95 percent of anthrax infections are cutaneous anthrax.
Transmission occurs when Bacillus anthracis enters a cut or abrasion on the skin, which can happen
when handling contaminated wool, hides, leather, or hair products (especially goat hair) of infected
animals.
A cutaneous anthrax skin infection begins as a raised, itchy bump that resembles an insect bite, but
within one to two days develops into a blister.
This blister then turns into a painless ulcer with a characteristic black necrotic (dying) area in the center.
Lymph glands in the adjacent area may swell, too.
About 20 percent of untreated cases of cutaneous anthrax will result in death.
Deaths from this anthrax type are rare when appropriate treatment is received.
Inhalation Anthrax, Inhalation anthrax is caused by breathing in the anthrax bacteria or spores.
Most of the time, this occurs by breathing in spores from infected animal products.
It can also occur if anthrax was used as a biological weapon.
Initial anthrax symptoms may resemble a common cold.
After several days, the symptoms may worsen, to severe breathing problems and shock.
This type of anthrax is usually fatal,
Gastrointestinal anthrax occurs with the consumption of contaminated meat.
This anthrax type is characterized by an acute inflammation of the intestinal tract.
Symptoms can include:
Nausea, Loss of appetite, Bloody diarrhea, Fever, Severe stomach pain, Vomiting blood.
Gastrointestinal anthrax results in death in 25 to 60 percent of cases.
What Causes Anthrax?
The cause of anthrax is the bacterium known as Bacillus anthracis.
Bacillus anthracis is a bacterium that lives in soil. The anthrax bacterium is different from many other
bacteria because it can form spores, a survival tactic that has allowed it to survive for extended periods
under the harshest of conditions.
A Bacillus anthracis spore is very hardy; it is able to withstand extreme heat, cold, and drought without
nutrients or air.
When environmental conditions are favorable, the spores will germinate into thriving colonies of
bacteria. For example, a grazing animal may ingest spores that begin to grow, spread, and eventually kill
the animal.
The bacteria will form spores in the carcass and then return to the soil to infect other animals in the
future. Bacillus anthracis is an aerobic bacterium, meaning that it needs oxygen to survive and grow.
TYPES OF ANTHRAX AND THEIR CAUSES
As mentioned above, regardless of the type, the cause of anthrax is Bacillus anthracis.
However, how the anthrax bacteria enter the body will determine the type of anthrax.
Cutaneous anthrax infections occur when the anthrax bacteria enter a cut or abrasion on the skin.
This may occur when a person handles contaminated wool, hides, leather, or hair products (especially
goat hair) of infected animals.
Inhalation anthrax is caused by breathing in the anthrax bacteria or spores.
Gastrointestinal anthrax is caused by eating meat contaminated with anthrax bacteria or their spores.
SIGNS AND SYMPTOMS OF ANTHRAX: AN OVERVIEW

Symptoms of anthrax will vary depending on the type of anthrax. For all three types, symptoms can
appear within 7 days of coming in contact with the anthrax bacteria (Bacillus anthracis).
For inhalation anthrax (also known as pulmonary anthrax), symptoms can appear within a week or can
take up to 42 days to appear.
CUTANEOUS ANTHRAX
The first symptom of cutaneous anthrax is a small raised sore that resembles an insect bite, but within
days 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.
Swollen lymph nodes may also occur. About 20 percent of untreated cases of cutaneous anthrax will
result in death. Deaths are rare when appropriate anthrax treatment is administered.
GASTROINTESTINAL ANTHRAX
Symptoms of gastrointestinal anthrax can include: Nausea, Loss of appetite, Bloody diarrhea, Fever, Bad
stomach pain, Vomiting blood. Gastrointestinal anthrax results in death in 25 to 60 percent of cases.
INHALATION ANTHRAX
The first inhalation anthrax symptoms are similar to cold or flu symptoms and can include: A sore throat,
Mild fever, Chills, Night sweats, Muscle aches. Later symptoms include: Cough, Chest discomfort,
Tiredness, Shortness of breath, Muscle aches, Severe breathing problems, Death.
Diagnosing Anthrax With Tests
Certain tests that the doctor may order to help make a diagnosis of anthrax include:

Specimen tests, such as blood tests

Chest x-ray.

Specimen Tests
In order to make a diagnosis, the doctor will take a sample of fluid, and look at it under a microscope for
evidence of the anthrax bacteria (Bacillus anthracis).
The fluid examined will depend on the type of anthrax the doctor suspects:
Cutaneous anthrax -- fluid from the skin blister and blood

Inhalation anthrax (also known as pulmonary anthrax) -- blood and cerebrospinal fluid

Gastrointestinal anthrax -- blood.

Other blood tests will be ordered to confirm that your body is fighting an infection.
Chest X-ray
A chest x-ray can be used to help diagnose inhalation anthrax in people who are experiencing anthrax
symptoms. It is not useful as a test for determining anthrax exposure, or for people with no symptoms.
Treating Anthrax With Antibiotics
Antibiotics used to treat anthrax in both adults and children include:

Ciprofloxacin

Doxycycline

Penicillin.
A doctor may prescribe these medications individually or in combination.
There are different types of the anthrax bacteria, known as strains. Some strains may be naturally
resistant to certain antibiotics and not others. In addition, there may be biologically altered strains that
are engineered to be resistant to various antibiotics. A laboratory analysis can help define which strain of
anthrax is present and which antibiotic would be the most effective for anthrax treatment.
Also, as with all medicines, side effects can occur with these antibiotics. Some of these side effects are
more common in children. Risks of using doxycycline or ciprofloxacin in children must be weighed
carefully against the risks anthrax presents.

Supportive Care
Supportive care for anthrax involves treating symptoms and complications that develop. The specific
supportive treatment will depend on a number of factors, but can include:

Admission to the hospital

Intravenous (IV) fluids

Oxygen

Breathing support from a ventilator

Prevention of secondary infections

Good nursing care.

Providing Anthrax Treatment Before Symptoms Begin
In the event that people are exposed to potentially aerosolized anthrax spores, preventative treatment
for anthrax involves 60 days of oral antibiotics, along with a three-dose regimen (0 weeks, 2 weeks, and
4 weeks) of the anthrax vaccine. This combination may help to prevent the development of inhalation
anthrax.
Sixty days of antibiotics are recommended because it takes anthrax spores an average of seven days to
grow into the harmful form of the bacteria, but it can take longer.