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What is anthrax?
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?
How is anthrax transmitted?
What are the symptoms of anthrax?
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?
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.
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.
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How to get help with your questions
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
Q: Is there an approved treatment for anthrax?
A: Yes. Three types of antiobiotics are approved for anthrax: ciprofloxacin, tetracyclines (including doxycycline), and penicillins. For people who have been exposed to anthrax but do not have symptoms, 60 days of one of these antibiotics is given to reduce the risk or progression of disease due to inhaled anthrax.
Q: Does the government have a plan in place to make Cipro available if there were mass exposure to anthrax?
A: Yes. Under emergency plans, the Federal government would ship appropriate antibiotics from its stockpile to wherever they are needed.
Q: Should individual consumers ask their physicians to write a prescription for Cipro, so they have it on hand in case it's needed?
A: No. Any needed antibiotics from the current stockpile will be made available if they are needed. In the meantime, Cipro should not be prescribed unless there is a clearly indicated need, so that the drug will be available as the need arises for the standard infections for which it is used.
Q: What is FDA telling physicians and other health professionals about prescriptions for Cipro?
A: Although FDA does not regulate the practice of medicine, the agency is strongly recommending that physicians not prescribe Cipro for individual patients to have on hand for possible use against inhaled anthrax. In addition to the potential influence on supply of the drug, indiscriminate prescribing and widespread use of Cipro could hasten the development of drug-resistant organisms