Overview

Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. Anthrax can be found naturally in soil and commonly affects domestic and wild animals around the world. Although it is rare in the United States, people can get sick with anthrax if they come in contact with infected animals or contaminated animal products. Contact with anthrax can cause severe illness in both humans and animals.

Anthrax is not contagious, which means you can’t catch it like the cold or flu.

How do animals get infected with anthrax?

Domestic and wild animals such as cattle, sheep, goats, antelope, and deer can become infected when they breathe in or ingest spores in contaminated soil, plants, or water. In areas where domestic animals have had anthrax in the past, routine vaccination can help prevent outbreaks.

How do people get infected with anthrax?

People get infected with anthrax when spores get into the body. When anthrax spores get inside the body, they can be “activated.” When they become active, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness.

This can happen when people breathe in spores, eat food or drink water that is contaminated with spores, or get spores in a cut or scrape in the skin. It is very uncommon for people in the United States to get infected with anthrax.

Certain activities can also increase a person’s chances of getting infected. For more information, see How People Are Infected.

 Anthrax is rare in the United States, but sporadic outbreaks do occur in wild and domestic grazing animals such as cattle or deer. Anthrax is more common in developing countries and countries that do not have veterinary public health programs that routinely vaccinate animals against anthrax. In the United States, yearly vaccination of livestock is recommended in areas where animals have had anthrax in the past.

Title
Anthrax

Types

The type of illness a person develops depends on how anthrax enters the body. Typically, anthrax gets into the body through the skin, lungs, or gastrointestinal system. All types of anthrax can eventually spread throughout the body and cause death if they are not treated with antibiotics.

Cutaneous:
Most common form of anthrax infection, and is considered to be the least dangerous.
Infection usually develops from 1 to 7 days after exposure.

Inhalation:
Inhalation anthrax is considered to be the most deadly form of anthrax.
Infection usually develops within a week after exposure, but it can take up to 2 months

Gastrointestinal:
Gastrointestinal anthrax has rarely been reported in the United States.
Infection usually develops from 1 to 7 days after exposure.

Injection:
This type of infection has never been reported in the United States.

Symptoms

The symptoms of anthrax depend on the type of infection and can take anywhere from 1 day to more than 2 months to appear. All types of anthrax have the potential, if untreated, to spread throughout the body and cause severe illness and even death.

Cutaneous anthrax symptoms can include:

  • A group of small blisters or bumps that may itch
  • Swelling can occur around the sore
  • A painless skin sore (ulcer) with a black center that appears after the small blisters or bumps
    • Most often the sore will be on the face, neck, arms, or hands

Inhalation anthrax symptoms can include:

  • Fever and chills
  • Chest Discomfort
  • Shortness of breath
  • Confusion or dizziness
  • Cough
  • Nausea, vomiting, or stomach pains
  • Headache
  • Sweats (often drenching)
  • Extreme tiredness
  • Body aches

 Gastrointestinal anthrax symptoms can include:

  • Fever and chills
  • Swelling of neck or neck glands
  • Sore throat
  • Painful swallowing
  • Hoarseness
  • Nausea and vomiting, especially bloody vomiting
  • Diarrhea or bloody diarrhea
  • Headache
  • Flushing (red face) and red eyes
  • Stomach pain
  • Fainting
  • Swelling of abdomen (stomach)

Injection anthrax symptoms can include:

  • Fever and chills
  • A group of small blisters or bumps that may itch, appearing where the drug was injected
  • A painless skin sore with a black center that appears after the blisters or bumps
  • Swelling around the sore

Abscesses deep under the skin or in the muscle where the drug was injected

Causes

People get infected with anthrax when spores get into the body. When this happens, the spores can be activated and become anthrax bacteria. Then the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness. This can happen when people breathe in spores, eat food or drink water that is contaminated with spores, or get spores in a cut or scrape in the skin.

Anthrax is NOT Contagious

You cannot catch anthrax from another person the way you might catch a cold or the flu. In rare cases, person-to-person transmission has been reported with cutaneous anthrax, where discharges from skin lesions might be infectious.

Certain activities (described below) can increase a person’s chances of getting infected.

 Working with infected animals or animal products

Most people who get sick from anthrax are exposed while working with infected animals or animal products such as wool, hides, or hair.

Inhalation anthrax can occur when a person inhales spores that are in the air (aerosolized) during the industrial processing of contaminated materials, such as wool, hides, or hair.

Cutaneous anthrax can occur when workers who handle contaminated animal products get spores in a cut or scrape on their skin.

Eating raw or undercooked meat from infected animals

People who eat raw or undercooked meat from infected animals may get sick with gastrointestinal anthrax. This usually occurs in countries where livestock are not routinely vaccinated against anthrax and food animals are not inspected prior to slaughter.
In the United States, gastrointestinal anthrax has rarely been reported. This is because yearly vaccination of livestock is recommended in areas of the United States where animals have had anthrax in the past, and because of the examination of all food animals, which ensures that they are healthy at the time of slaughter.

 Injecting heroin

A newly discovered type of anthrax is injection anthrax. This type of anthrax has been seen in northern Europe in people injecting heroin. So far, no cases of injection anthrax have been reported in the United States.

Diagnosis

Doctors in the United States rarely see a patient with anthrax. CDC Guidance and case definitions are available to help doctors diagnose anthrax, take patient histories to determine how exposure may have occurred, and order necessary diagnostic tests.

If inhalation anthrax is suspected, chest X-rays or CT scans can confirm if the patient has mediastinal widening or pleural effusion, which are X-ray findings typically seen in patients with inhalation anthrax.
The only ways to confirm an Anthrax diagnosis are:

  • To measure antibodies or toxin in blood
  • To test directly for Bacillus anthracis in a sample
    • blood
    • skin lesion swab
    • spinal fluid
    • respiratory secretions

Samples must be taken before the patient begins taking antibiotics for treatment

Laboratory systems are set up in the United States to quickly confirm or rule out whether a patient has anthrax or whether the environment is contaminated with Bacillus anthracis, the type of bacteria that causes anthrax. These labs are vital to the early identification of anthrax, especially in the case of a bioterrorism attack using anthrax

Treatment

Doctors have several options for treating patients with anthrax, including antibiotics and antitoxin. Patients with serious cases of anthrax will need to be hospitalized. They may require aggressive treatment, such as continuous fluid drainage and help breathing through mechanical ventilation.

Antibiotics

All types of anthrax infection can be treated with antibiotics, including intravenous antibiotics (medicine given through the vein). If someone has symptoms of anthrax, it’s important to get medical care as quickly as possible to have the best chances of a full recovery. Doctors will select antibiotics that are best for treating anthrax and that are best for the patient based on their medical history.

Antitoxin

When anthrax spores get inside the body, they can be “activated.” When they become active, anthrax bacteria can multiply, spread out in the body, and produce toxins—or poisons. Anthrax toxins in the body cause severe illness.

After anthrax toxins have been released in the body, one possible treatment is antitoxin. Antitoxins target anthrax toxins in the body. Doctors must use antitoxin together with other treatment options.

Currently, there are a few types of antitoxins that can be used for treating anthrax

Prevention

Antibiotics can prevent anthrax from developing in people who have been exposed but have not developed symptoms. Ciprofloxacin and doxycycline are two of the antibiotics that could be used to prevent anthrax.

Each of these antibiotics offers the same protection against anthrax. Anthrax spores typically take 1 to 6 days to be activated, but some spores can remain inside the body and take up to 60 days or more before they are activated. Activated spores release toxins—or poisons—that attack the body, causing the person to become sick. That’s why people who have been exposed to anthrax must take antibiotics for 60 days. This will protect them from any anthrax spores in their body when the spores are activated