What is Anthrax?

Anthrax is a rare but very serious disease caused by Bacillus anthracis. Humans become infected through direct or indirect contact with animals. Infection with Bacillus anthracis results in an acute disease which is often lethal.

The greatest threat of anthrax today is through a bioterrorist attack.

What kind of bacteria is Bacillus anthracis?

Bacillus anthracis is a gram-positive, spore forming, rod-shaped aerobic bacteria. The spores of anthrax live in soil and they can survive in this condition for decades until they find their way into a host. Common hosts for anthrax are sheep, horses or goats.

The lethality of the anthrax disease is due to a poly-D-glutamic acid capsule and the anthrax toxin. The acid capsule protects the bacterium from phagocytosis from neutrophils of the host. The anthrax toxin is a mixture of three protein components: protective antigen, edema factor, and lethal factor. From protective antigen and lethal factor a lethal toxin is produced which causes death. From protective antigen and edema factor, edema toxin is produced which causes edema.

How do people get infected with Anthrax?

There are four ways how a person can get infected with Anthrax.

  • Direct contact with infected animals, where the spores of anthrax enter the body through a wound in the skin,
  • Consuming the meat of the infected animal,
  • Inhaling the spores of anthrax, and
  • Injection of illegal drugs.

There is no evidence that this disease is transmitted from human to human, but there is a possibility that lesions in the skin may be contagious through direct contact.

Signs and symptoms of Anthrax

Usually symptoms develop within 7 days of exposure to Bacillus anthracis. If the infection is as a result of inhaling the spores of the Bacillus anthracis, it may take weeks for symptoms to appear.

Depending from the way how the person got infected, anthrax could be:

Cutaneous anthrax – infection is from a wound in the skin. It is the most common route of infection. If diagnosed on time and with good treatment this form of anthrax is rarely lethal.  Signs and symptoms include a bump in the skin, which is raised and itchy. It looks like an insect bite, but this bump quickly develops into a painless sore with a black center.

Gastrointestinal anthrax – infection results from eating meat of an infected animal. Usually it is an undercooked meat. Signs and symptoms include: abdominal pain, nausea, vomiting, loss of appetite, fever, headache, sore throat and difficulty swallowing. In later stages of the disease, sever and bloody diarrhea develops.

Pulmonary anthrax – infection results from inhaling the spores of Bacillus anthracis. It is the most lethal way of contamination. Even with early diagnosis and proper treatment, it is often fatal. Signs and symptoms include: sore throat, painful swallowing, mild fever, chest discomfort, shortness of breath, nausea, cough, etc. As the disease progresses coughing of blood, high fever, difficulty breathing, shock and even meningitis can occur.

Today, a new way of anthrax infection has been discovered. So far, this way has only been reported in Europe. It is called injection anthrax, and infection results through injecting illegal drugs like heroine. Signs and symptoms include: redness in the area of injection and significant swelling. There is no black center in the injection area, like in the cutaneous anthrax. As the disease progresses, multiple organ failure, shock and meningitis may occur.

Persons who are at risk to get infected with anthrax include:

  • Military personnel who are deployed to an area with a high risk of exposure to anthrax
  • Scientists who work with anthrax in laboratories
  • Persons who work with animal skins, furs or wool
  • Persons who work in veterinary medicine
  • Drug addicts who use injection drugs like heroine.

Complications of Anthrax

The most serious complication of anthrax is hemorrhagic meningitis. The infection and inflammation from other parts of the body reach the membrane and the cerebrospinal fluid, leading to massive bleeding and death.

How is Anthrax diagnosed?

Tests that confirm an infection with Anthrax include:

  • Skin testing – a sample of fluid in the affected area or biopsy of a small tissue will help diagnose cutaneous anthrax
  • Blood tests -
  • Stool testing – a sample of stool is taken to the laboratory to check for the anthrax bacteria
  • Lumbar puncture – a sample of cerebrospinal fluid will help diagnose anthrax meningitis. This is done by inserting a needle into the spinal canal and taking a small amount of the fluid.
  • Chest X-Ray or CT (computerized tomography) – are used to diagnose inhalation anthrax.

How is Anthrax treated?

The most lethal form is inhalation anthrax, while cutaneous anthrax is the mildest form of this disease.

Standard treatment for anthrax consists of 60 days treatment with antibiotics like Ciprofloxacin Doxycycline or Levofloxacin. If the treatment will be successful or not depends from the way of infection, the time when the disease is diagnosed, the age of the affected person, overall health and many other factors.

It is very important to diagnose anthrax on time and start the medication as soon as possible. Although some cases of anthrax respond to antibiotic therapy, advanced cases of the disease may not. In later stages of the disease it is impossible to treat it with antibiotics, because the bacteria produced more toxins that antibiotics can eliminate.

A surgical removal of the infected tissue resulted successful in some cases with injection anthrax.

Can Anthrax be prevented?

When travelling to a country where anthrax is common like Turkey, Iran, Iraq or Pakistan be very careful what you eat. Avoid eating undercooked meat.

Persons who work with animals, meat, wool, fur or animal skin, should be very careful during the working process.

Antibiotic therapy with Ciprofloxacin, Doxycycline or Levofloxacin is recommended for people who were exposed to the spores of anthrax. This will prevent the infection.

Is there a vaccine for anthrax?

Yes, there is a vaccine for anthrax. This vaccine is not for general use and it is not recommended for children and elderly people. The vaccine of anthrax is only recommended for people who are at greater risk of getting infected like scientist who work in laboratories, military personnel, etc.