Definition
Anthrax is a rare, life-threatening infection. It leads to swelling, bleeding, and tissue death.
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Causes
Certain bacteria and its spores cause anthrax. They are found in soil and animals. The spores can get into the body in several ways:
- Cutaneous—from breaks in the skin
- Inhalation—by breathing them in
- Gastrointestinal—by eating raw or undercooked meat that has spores
Once in the body, the spores multiply and release toxins.
Risk Factors
The risk of anthrax is higher in those who:
- Live in or travel to places where it is common, such as:
- sub-Saharan Africa
- Asia
- the Caribbean
- Southern and Eastern Europe
- South and Central America
- Work with animals and animal hides
- Work with the bacteria in labs
- Are exposed to criminal or terrorist acts
Symptoms
Symptoms start within a few days after infection.
Cutaneous symptoms may be:
- A raised, round, itchy bump, like an insect bite
- Skin ulcers with a black center—they make a clear or pinkish fluid
- Swelling around the wound
- Swollen, painful lymph nodes
Inhalation symptoms start with:
- Cough
- Tiredness or weakness
- Soreness and swelling in the throat
- Swollen lymph nodes
- Fever and chills
- Headache and muscle aches
Other symptoms begin later such as:
- Severe breathing problems
- Chest pain
- Sweating
- Confusion
- Death
Gastrointestinal symptoms can be:
- In the mouth or throat, with:
- Fever
- Swelling in the neck
- Whitish ulcers
- In the intestines, with:
- Nausea and vomiting
- Fever
- Belly pain
- Bloody diarrhea
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam may be done. The doctor may give tests to rule out other causes.
Tests to diagnose anthrax may be:
- Blood tests
- Tests of fluids, stool, wounds, or tissues
- Imaging tests such as chest x-rays
Treatment
Treatment will start right away. It will involve:
- Antibiotics—to treat the infection
- Antibodies—to target bacteria (inhalation anthrax)
- Cleaning and bandaging skin lesions
- Supportive care—to maintain heart function, blood pressure, and oxygen
Prevention
The risk of anthrax may be reduced by:
- Avoiding contact with infected animals and their products
- Not touching anthrax wounds
- Handling suspicious mail carefully
A vaccine may be given to some people at high risk for anthrax.
RESOURCES:
Centers for Disease Control and Prevention
https://www.cdc.gov
Military Health System
https://health.mil
CANADIAN RESOURCES:
Alberta Health
https://www.alberta.ca
Public Health Agency of Canada
https://www.canada.ca
REFERENCES:
Anthrax. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/anthrax. Accessed February 2, 2021.
Anthrax. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/anthrax Accessed February 2, 2021.
Anthrax. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax. Accessed February 2, 2021.
Bower WA, Schiffer J, et al. Use of anthrax vaccine in the United States: recommendations of the advisory committee on immunization practices, 2019. MMWR Recomm Rep. 2019;68(4):1-14.
Last reviewed September 2020 by David L. Horn, MD, FACP Last Updated: 2/2/2021