Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It occurs naturally in soil and commonly affects domestic and wild animals around the world. People can get sick with anthrax if they come in contact with infected animals or contaminated animal products. Anthrax can cause severe illness in both humans and animals.
Anthrax is not contagious, which means you can’t catch it from another person like the cold or flu.
How 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.” The bacteria can then multiply, spread out in the body, produce toxins, and cause severe illness.
This can happen when people breathe in spores, eat food or drink water 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.
How animals get infected with anthrax
Domestic and wild animals can become infected when they breathe in or ingest spores in contaminated soil, plants, or water. These animals can include cattle, sheep, goats, antelope, and deer. In areas where domestic animals have had anthrax in the past, routine vaccination can help prevent outbreaks.
Where anthrax is found
Anthrax is most common in agricultural regions of
- Central and South America,
- sub-Saharan Africa,
- central and southwestern Asia,
- southern and eastern Europe, and
- the Caribbean.
Anthrax is rare in the United States. However, sporadic outbreaks do occur in wild and domestic grazing animals such as cattle or deer. Anthrax is more common in countries that do not have programs that routinely vaccinate animals against anthrax. In the United States, veterinarians recommend yearly vaccination of livestock in areas where animals have had anthrax in the past.
Types of Anthrax
Cutaneous anthrax
Cutaneous anthrax is the most common form of anthrax infection, and it is also considered to be the least dangerous. Infection usually develops from 1 to 7 days after exposure.
When anthrax spores get into the skin, usually through a cut or scrape, a person can develop cutaneous anthrax. This can happen when a person handles infected animals or contaminated animal products like wool, hides, or hair. Cutaneous anthrax is most common on the head, neck, forearms, and hands. It affects the skin and tissue around the site of infection.
Without treatment, up to 20% of people with cutaneous anthrax die. However, with proper treatment, almost all patients with cutaneous anthrax survive.
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.
When a person breathes in anthrax spores, they can develop inhalation anthrax. People who work in places such as wool mills, slaughterhouses, and tanneries may breathe in the spores when working with infected animals or contaminated animal products from infected animals. Inhalation anthrax starts primarily in the lymph nodes in the chest before spreading throughout the rest of the body, ultimately causing severe breathing problems and shock.
Without treatment, inhalation anthrax is almost always fatal. However, with aggressive treatment, about 55% of patients survive.
Gastrointestinal anthrax has rarely been reported in the United States. Infection usually develops from 1 to 7 days after exposure.
When a person eats raw or undercooked meat from an animal infected with anthrax, they can develop gastrointestinal anthrax. Once ingested, anthrax spores can affect the upper gastrointestinal tract (throat and esophagus), stomach, and intestines, causing a wide variety of symptoms.
Without treatment, more than half of patients with gastrointestinal anthrax die. However, with proper treatment, 60% of patients survive.
This type of infection has never been reported in the United States.
Recently, another type of anthrax infection has been identified in heroin-injecting drug users in northern Europe.
Symptoms may be similar to those of cutaneous anthrax, but there may be infection deep under the skin or in the muscle where the drug was injected. Injection anthrax can spread throughout the body faster and be harder to recognize and treat. Lots of other more common bacteria can cause skin and injection site infections, so a skin or injection site infection in a drug user does not necessarily mean the person has anthrax.
Symptoms of Anthrax
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 hand
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
Injection anthrax symptoms are similar to those of cutaneous anthrax, but injection anthrax can spread throughout the body faster and be harder to recognize and treat than cutaneous anthrax. Skin and injection site infections associated with injection drug use are common and do not necessarily mean the person has anthrax
Treatment of Anthrax Infection
Doctors have several options for treating patients with anthrax, including antibiotics and antitoxin. Patients with serious cases of anthrax need to be hospitalized. They may require aggressive treatment, such as continuous fluid drainage and help breathing through mechanical ventilation.
For people who have been exposed to anthrax but do not yet have symptoms, certain antibiotics can be used to prevent illness from developing.
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
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