Anthrax is the common name for a disease caused by a bacterium called Bacillus anthracis (bah-sill-us an-thra-sis). It is actually rare in humans in the United States. There are only about five cases per year. Mostly, animals that graze in areas where there is infected soil or who are fed infected feed get the disease. Working with animal carcasses and products such as contaminated wool, hides, leather or hair products (especially goat hair) typically causes the human cases. It is not a contagious disease in either animals or humans.

» How do you get anthrax?

There are three ways that anthrax can infect a person: through the skin (cutaneous) by way of a cut or other minor injury, by breathing it in (inhalation), and by eating food that is infected (gastrointestinal). Before 2001, cutaneous infection was the most common, and inhalation or gastrointestinal infection was very rare.

» Is one type more dangerous than another?

Anthrax infection is very rare, but all three types can lead to serious illness in humans. Skin infection is most easily treated and is rarely fatal. Inhalation (also known as pulmonary or respiratory) and gastrointestinal infections are more likely to result in death. However, both types are extremely rare. In fact, before the anthrax attacks of 2001 the last known case of inhalation anthrax in the U.S. was in 1976.

» How can infection be prevented?

Because infection other than in a bioterrorist attack is very rare, vaccination before exposure is the only way to prevent anthrax infection. Currently the human anthrax vaccine is available to military personnel and some workers who are at risk because of their laboratory, research, or agricultural jobs.

» How can anthrax infection be treated?

There are several antibiotics that work well to fight an anthrax infection. It is important that anthrax infection be diagnosed early for the antibiotics to work best. Now that doctors in our country are more aware of the possibility of anthrax infection, new cases will probably be identified more quickly than they were during the 2001 outbreak.

» What are some common symptoms of anthrax infection?

Anthrax infection is serious and can cause grave medical problems. Keep in mind that anthrax infection is extremely rare. Symptoms are different depending on the type of anthrax infection present.

Skin infection: This type of anthrax is contracted when the bacteria come into contact with a cut or abrasion on the skin. Symptoms usually develop within 1 to 2 days of contact with the anthrax. There may be swelling at the site of contact and a papule (a small solid bump on the skin) might develop. This bump may get bigger and turn into a round open sore. This can be followed by the appearance of small fluid filled blisters that ooze a clear fluid that contains the anthrax bacteria. This turns into a painless open sore that has a black dry scab in the center. This scab will dry out and fall off within a few weeks. Other symptoms that are not visible are a general sick feeling (malaise), low-grade fever and swelling of the lymph glands near the wound. This most common type of infection is highly treatable and rarely fatal.

Inhalation (pulmonary or respiratory) infection: In this case, spores must be small enough to be breathed into the depths of the lungs and deposited in the cells within. We do not know the minimum number of spores that are enough to cause illness. Spores in the lung cells may travel to the lymph nodes where they grow and multiply. They can also enter the blood stream and spread throughout the body. At this stage the bacteria release toxins (poisons) and the symptoms first become apparent. The first stage of symptoms is a general sick feeling (malaise), cough or sore throat and fatigue as well as fever and chills. These first symptoms can progress to severe breathing problems and shock. A bleeding infection of the brain (Hemorrhagic meningitis) may develop in about half of the cases. Death can occur within 24 hours of the appearance of the more serious symptoms.

Gastrointestinal infection: This form of anthrax, which has never been reported in the U.S., may happen if food contaminated with the bacteria is eaten. An acute inflammation of the intestinal tract occurs. Symptoms include nausea, vomiting and malaise, and move rapidly to bloody diarrhea, abdominal pain and infection of the blood. Gastrointestinal anthrax may result in death in 25 percent to 60 percent of cases.

» If anthrax is so rare, why should I worry?

Naturally occurring anthrax infection is nearly impossible to contract, unless you work in agriculture or with other animal products. Even in those circumstances there are only a handful of cases per year. However, as we saw in the fall of 2001, anthrax can be made into a weapon. We know that some countries, possess “weaponized” anthrax. The U.S. government is concerned enough about the threat that they routinely vaccinate U.S. troops. The possibility of anthrax infection should not be an everyday worry, but is wise to be aware of the possibility and educate oneself about the disease.

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