Global InformationAnthrax information
 | The examples and perspective in this article may not represent a worldwide view of the subject. (October 2021) |
| Anthrax | |
|---|---|
 | |
| A skin lesion with black eschar characteristic of anthrax | |
| Specialty | Infectious disease |
| Symptoms | Skin form: small blister with surrounding swelling Inhalational form: fever, chest pain, shortness of breath Intestinal form: nausea, vomiting, diarrhea, abdominal pain Injection form: fever, abscess[1] |
| Usual onset | 1 day to 2 months post contact[1] |
| Causes | Bacillus anthracis[2] |
| Risk factors | Working with animals; travelers, postal workers, military personnel[3] |
| Diagnostic method | Based on antibodies or toxin in the blood, microbial culture[4] |
| Prevention | Anthrax vaccination, antibiotics[3][5] |
| Treatment | Antibiotics, antitoxin[6] |
| Prognosis | 20–80% die without treatment[5][7] |
| Frequency | >2,000 cases per year[8] |
Anthrax is an infection caused by the bacterium Bacillus anthracis.[2] Infection typically occurs by contact with the skin, inhalation, or intestinal absorption.[9] Symptom onset occurs between one day and more than two months after the infection is contracted.[1] The skin form presents with a small blister with surrounding swelling that often turns into a painless ulcer with a black center.[1] The inhalation form presents with fever, chest pain and shortness of breath.[1] The intestinal form presents with diarrhea (which may contain blood), abdominal pains, nausea and vomiting.[1]
According to the Centers for Disease Control and Prevention in the United States, the first clinical descriptions of cutaneous anthrax were given by Maret in 1752 and Fournier in 1769. Before that anthrax had been described only through historical accounts. The Prussian scientist Robert Koch (1843–1910) was the first to identify Bacillus anthracis as the bacterium that causes anthrax.
Anthrax is spread by contact with the bacterium's spores, which often appear in infectious animal products.[10] Contact is by breathing or eating or through an area of broken skin.[10] It does not typically spread directly between people.[10] Risk factors include people who work with animals or animal products, and military personnel.[3] Diagnosis can be confirmed by finding antibodies or the toxin in the blood or by culture of a sample from the infected site.[4]
Anthrax vaccination is recommended for people at high risk of infection.[3] Immunizing animals against anthrax is recommended in areas where previous infections have occurred.[10] A two-month course of antibiotics such as ciprofloxacin, levofloxacin and doxycycline after exposure can also prevent infection.[5] If infection occurs, treatment is with antibiotics and possibly antitoxin.[6] The type and number of antibiotics used depend on the type of infection.[5] Antitoxin is recommended for those with widespread infection.[5]
A rare disease, human anthrax is most common in Africa and central and southern Asia.[11] It also occurs more regularly in Southern Europe than elsewhere on the continent and is uncommon in Northern Europe and North America.[12] Globally, at least 2,000 cases occur a year, with about two cases a year in the United States.[8][13] Skin infections represent more than 95% of cases.[7] Without treatment the risk of death from skin anthrax is 23.7%.[5] For intestinal infection the risk of death is 25 to 75%, while respiratory anthrax has a mortality of 50 to 80%, even with treatment.[5][7] Until the 20th century anthrax infections killed hundreds of thousands of people and animals each year.[14] In herbivorous animals infection occurs when they eat or breathe in the spores while grazing.[11] Animals may become infected by killing and/or eating infected animals.[11]
Anthrax has been developed as a weapon by a number of countries.[7] Anthrax has been used in biowarfare and bioterrorism since 1914. However, in 1975 the Biological Weapons Convention prohibited the "development, production and stockpiling" of biological weapons. It has since been used in bioterrorism. Likely delivery methods of weaponized anthrax include aerial dispersal or dispersal through livestock; notable bioterrorism uses include the 2001 anthrax attacks and an incident in 1993 by the Aum Shinrikyo group in Japan.
- ^ a b c d e f "Symptoms". CDC. 23 July 2014. Archived from the original on 11 May 2016. Retrieved 14 May 2016.
- ^ a b "Basic Information What is anthrax?". CDC. 1 September 2015. Archived from the original on 17 May 2016. Retrieved 14 May 2016.
- ^ a b c d "Who Is at Risk". CDC. 1 September 2015. Archived from the original on 11 May 2016. Retrieved 14 May 2016.
- ^ a b "Diagnosis". CDC. 1 September 2015. Archived from the original on 11 May 2016. Retrieved 14 May 2016.
- ^ a b c d e f g Hendricks KA, Wright ME, Shadomy SV, Bradley JS, Morrow MG, Pavia AT, et al. (February 2014). "Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults". Emerging Infectious Diseases. 20 (2). doi:10.3201/eid2002.130687. PMC 3901462. PMID 24447897.
- ^ a b "Treatment". CDC. 14 January 2016. Archived from the original on 11 May 2016. Retrieved 14 May 2016.
- ^ a b c d "Anthrax". FDA. 17 June 2015. Archived from the original on 7 May 2016. Retrieved 14 May 2016.
- ^ a b Anthrax: Global Status. GIDEON Informatics Inc. 2016. p. 12. ISBN 9781498808613. Archived from the original on 10 September 2017.
- ^ "Types of Anthrax". CDC. 21 July 2014. Archived from the original on 11 May 2016. Retrieved 14 May 2016.
- ^ a b c d "How People Are Infected". CDC. 1 September 2015. Archived from the original on 26 December 2016. Retrieved 14 May 2016.
- ^ a b c Turnbull P (2008). Anthrax in humans and animals (PDF) (4th ed.). Geneva, Switzerland: World Health Organization. pp. 20, 36. ISBN 9789241547536. Archived (PDF) from the original on 30 November 2016.
- ^ Schlossberg D (2008). Clinical Infectious Disease. Cambridge University Press. p. 897. ISBN 9781139576659. Archived from the original on 10 September 2017.
- ^ "Anthrax". CDC. National Center for Emerging and Zoonotic Infectious Diseases. 26 August 2009. Archived from the original on 26 December 2016. Retrieved 14 May 2016.
- ^ Cherkasskiy BL (August 1999). "A national register of historic and contemporary anthrax foci". Journal of Applied Microbiology. 87 (2): 192–5. doi:10.1046/j.1365-2672.1999.00868.x. PMID 10475946. S2CID 6157235.