|
Anthrax
-- Frequently Asked Questions
1.
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.
2.
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.
3.
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.
4.
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.
5.
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.
6.
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.
7.
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.
8.
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.
9.
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.
10.
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).
Pregnant
women should be vaccinated only if absolutely necessary
11.
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.
12.
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.
13.
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.
14.
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.
15.
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).
SOURCE:
Center for Disease Control and Prevention (CDC)
|
