Anthrax

Definition

Anthrax is a life-threatening infection.

There are 3 types depending on where it enters the body:

  • Cutaneous—spores enter through a cut or break in the skin (most common)
  • Inhaled—breathing airborne spores into the lungs
  • Gastrointestinal—ingesting spores in raw or undercooked food

Once anthrax is in the body, it multiplies and releases toxins. They cause swelling, bleeding, and tissue death. All forms of anthrax can cause death, but inhaled anthrax is the most fatal.

Anthrax Can Enter the Body Through the Lungs

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Causes    TOP

Certain bacteria and its spores cause anthrax. The spores can survive for decades in the environment. Bacteria and spores are in soil and livestock such as cattle and goats. It’s rare, but people can get anthrax from:

  • Infected livestock and their products
  • Spores in the environment

Risk Factors    TOP

Your chances of anthrax are higher if you:

  • Work with infected livestock
  • Work with the bacteria
  • Are exposed to criminal or terrorist acts

Symptoms    TOP

Symptoms start within a few days after infection. They vary based on how anthrax entered the body.

Inhalation anthrax symptoms come in stages over many days. It may start with feelings of a cold or the flu:

  • Cough
  • Fatigue
  • Weakness
  • Sore throat
  • Swelling in throat
  • Swollen lymph nodes
  • Fever
  • Chills
  • Headache
  • Muscle aches

You may feel better for a short time before a rapid onset of:

  • Severe breathing problems
  • Chest pain
  • Sweating
  • Incoherence
  • Death

Cutaneous symptoms may come in stages:

  • Raised bump, like an insect bite, that is itchy and round
  • Skin ulcers with a black area in the center and producing drainage of clear or pinkish fluid
  • Swelling around the wound
  • Swollen, painful lymph nodes

Gastrointestinal symptoms can be in the mouth, throat, or intestines.

In the mouth or throat:

  • Fever
  • Swelling in the neck
  • Whitish ulcers

In the intestines:

  • Nausea
  • Vomiting
  • Fever
  • Belly pain
  • Bloody diarrhea

Diagnosis    TOP

Your doctor will ask about your symptoms and health history. This will contain questions about how you had contact with anthrax. You may have:

  • A physical exam
  • Testing on fluids, wounds, or mucous membranes
  • Blood tests
  • Chest x-rays

Public health officials will work quickly to find the source of anthrax. Anthrax testing and antibiotics can help to prevent infection in other people.

Treatment    TOP

Care will start right away and will involve:

  • Antibiotics to treat the infection
  • Antibodies to target bacteria (inhalation anthrax)
  • Cleaning and bandaging of skin lesions
  • Supportive care to maintain heart function, blood pressure, and oxygen supply while your body fights the infection

Anthrax has no color, odor, or taste. If you think you came in contact with it, seek medical care right away.

Prevention    TOP

To lower your chances of anthrax:

  • Avoid contact with infected livestock and their products.
  • Avoid touching anthrax wounds.
  • To handle suspicious mail:
    • Don’t open mail from an unknown source.
    • Don’t shake packages.
    • Don’t smell or taste contents.
    • Put the package down and wash your hands with soap and warm water right away.
    • Call local law enforcement.

There is a vaccine, but military personnel use it. It requires several doses and is only partially effective.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov
Military Health System
https://health.mil

CANADIAN RESOURCES:

Public Health Agency of Canada
https://www.canada.ca

References:

Anthrax. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114804/Anthrax. Updated January 24, 2017. Accessed May 15, 2018.
Anthrax. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/anthrax. Updated January 31, 2017. Accessed May 15, 2018.
Anthrax. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax. Updated September 2017. Accessed May 15, 2018.
Wright JG, Quinn CP, Shadomy S, Messonnier N, Centers for Disease Control and Prevention (CDC). Use of anthrax vaccine in the United States: recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep. 2010;59(RR-6):1-30.
5/12/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114804/Anthrax: Bradley JS, Peacock G, Krug SE, et al. Pediatric anthrax clinical management. Pediatrics. 2014;133(5):e1411-e1436.
Last reviewed May 2018 by David L. Horn, MD, FACP
Last Updated: 5/15/2018

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