Health/Military Anthrax information
Subject: [Health.mil] Anthrax - Frequently Asked Questions {01}
1. What is anthrax?
Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly
occurs 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.
2. Why has anthrax become a current issue?
Because anthrax is considered to be a potential agent for use in biological warfare, the Department of Defense (DoD) has
begun mandatory vaccination of all active duty military personnel who might be involved in conflict.
3. How common is anthrax and who can get it?
Anthrax is most common in agricultural regions where it occurs in animals. These include South and Central America, Southern
and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. When anthrax affects humans, it is usually due to an
occupational exposure to infected animals or their products. Workers who are exposed to dead animals and animal products
from other
countries where anthrax is more common may become infected with B. anthracis (industrial anthrax). Anthrax in wild livestock
has occurred in the United States.
4. How is anthrax transmitted?
Anthrax infection can occur in three forms: cutaneous (skin), inhalation, and gastrointestinal. B. anthracis spores can live in the
soil for many 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.
5. What are the symptoms of anthrax?
*Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.
- Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as
when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals.
-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 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 disease form of anthrax may follow the consumption of contaminated meat and is characterized by an
acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, fever are followed by abdominal pain,
vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases.
6. Where is anthrax usually found?
Anthrax can be found globally. It is more common in developing countries or countries without veterinary public health
programs. Certain regions of the world (South and Central America, Southern and Eastern Europe, Asia, Africa, the
Caribbean, and the Middle East) report more anthrax in animals than others.
7. Can anthrax be spread from person-to-person?
Direct person-to-person spread of anthrax is extremely unlikely to occur. Communicability is not a concern in managing or
visiting with patients with inhalational anthrax.
8. 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. The vaccine is reported to be 93% effective in protecting against anthrax.
9. What is the anthrax vaccine?
The anthrax vaccine is manufactured and distributed by BioPort, Corporation, Lansing, Michigan. The vaccine is a cell-free
filtrate vaccine, which means it contains no dead or live bacteria in the preparation. The final product contains no more than 2.4
mg of aluminum hydroxide as adjuvant. Anthrax vaccines intended for animals should not be used in humans.
10. Who should get vaccinated against anthrax?
The Advisory Committee on Immunization Practices has recommend anthrax vaccination for the following groups:
- Persons who work directly with the organism in the laboratory
- Persons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax
spores.
- Persons who handle potentially infected animal products in high-incidence
areas. (Incidence is low in the United States, but veterinarians who travel to work in other countries where incidence is higher
should consider being Vaccinated.)
- Military personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare
weapon).
- The anthrax Vaccine Immunization Program: U.S. Army Surgeon Gen's Office can be reached at 1-877-GETVACC
(1-877-438-8222).
http://www.anthrax.osd.mil/
- Pregnant women should be vaccinated only if absolutely necessary.
11. What is the protocol for anthrax vaccination?
The immunization consists of three subcutaneous injections given 2 weeks apart followed by three additional subcutaneous
injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are recommended thereafter.
12. Are there adverse reactions to the anthrax vaccine?
Mild local reactions occur in 30% of recipients and consist of slight tenderness and redness at the injection site. Severe local
reactions are
infrequent and consist of extensive swelling of the forearm in addition to the local reaction. Systemic reactions occur in fewer
than 0.2% of recipients.
13. 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.
14. Is there a treatment for anthrax?
Doctors can prescribe effective antibiotics. To be effective, treatment should be initiated early. If left untreated, the disease can
be fatal.
15. Where can I get more information about the recent Department of Defense decision to require men and women in the
Armed Services to be vaccinated against anthrax?
The Department of Defense recommends that servicemen and women contact their chain of command on questions about the
vaccine and its distribution. The anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office can be
reached at 1-877-GETVACC (1-877-438-8222). http://www.anthrax.osd.mil/
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SOURCE: Center for Disease Control and Prevention (CDC) web site at
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/anthrax_g.htm
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