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Frequently
Asked Questions
(courtesy of the Center
for Disease Control)
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 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
Pregnant
women should be vaccinated only if absolutely necessary.
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.
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.
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?
Doctors can prescribe effective antibiotics. To be effective,
treatment should be initiated early. If left untreated,
the disease can be fatal.
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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