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Frequently Asked Questions
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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