Anthrax

Definition

Anthrax is an infectious disease caused due to a bacterium called Bacillus anthracis. Infection in humans most often involves the skin, gastrointestinal tract, or lungs.

Causes

Anthrax commonly affects hoofed animals such as sheep, cattle, and goats. Humans who come into contact with infected animals can get sick with anthrax as well.

There are three main routes of anthrax infection: skin (cutaneous), lung (inhalation), and mouth (gastrointestinal).

Cutaneous anthrax occurs when anthrax spores touch a cut or scrape on the skin.

Inhalation anthrax develops when anthrax spores enter the lungs through the airways. It is most commonly contracted when workers breathe in airborne anthrax spores during processes such as tanning hides and processing wool.

Breathing in spores means a person has been exposed to anthrax. But it does not mean the person will have symptoms.

Gastrointestinal anthrax occurs when someone eats anthrax-tainted meat.

Injection anthrax can occur in someone who injects heroin. 

Anthrax may be used as a biological weapon or for bioterrorism.

Symptoms

Symptoms of anthrax differ depending on the type of anthrax.

Symptoms of cutaneous anthrax start 1 to 7 days after exposure:

Symptoms of inhalation anthrax:

Symptoms of gastrointestinal anthrax usually occur within 1 week and may include:

Symptoms of injection anthrax are similar to those of cutaneous anthrax. In addition, the skin or muscle beneath the injection site may get infected.

Exams and Tests

The health care provider will perform a physical examination.

The tests to diagnose anthrax depend on the type of disease that is suspected.

A culture of the skin, and sometimes a biopsy, are done on the skin sores. The sample is looked at under a microscope to identify the anthrax bacterium.

Tests may include:

More tests may be done on fluid or blood samples.

Treatment

Antibiotics are usually used to treat anthrax. Antibiotics that may be prescribed include penicillin, doxycycline, and ciprofloxacin.

Inhalation anthrax is treated with a combination of antibiotics such as ciprofloxacin plus another medicine. They are given by IV (intravenously). Antibiotics are usually taken for 60 days because it can take spores that long to germinate.

Cutaneous anthrax is treated with antibiotics taken by mouth, usually for 7 to 10 days. Doxycycline and ciprofloxacin are most often used.

Outlook (Prognosis)

When treated with antibiotics, cutaneous anthrax is likely to get better. But some people who do not get treated may die if anthrax spreads to the blood.

People with second-stage inhalation anthrax have a poor outlook, even with antibiotic therapy. Many cases in the second stage are fatal.

Gastrointestinal anthrax infection can spread to the bloodstream and may result in death.

When to Contact a Medical Professional

Call your provider if you think you have been exposed to anthrax or if you develop symptoms of any type of anthrax.

Prevention

There are two main ways to prevent anthrax.

For people who have been exposed to anthrax (but have no symptoms of the disease), doctors may prescribe preventive antibiotics, such as ciprofloxacin, penicillin, or doxycycline, depending on the strain of anthrax.

An anthrax vaccine is available to military personnel and some members of the general public. It is given in a series of 5 doses over 18 months.

There is no known way to spread cutaneous anthrax from person to person. People who live with someone who has cutaneous anthrax do not need antibiotics unless they have also been exposed to the same source of anthrax.


Review Date: 5/18/2017
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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