Anthrax Sources and Treatment

by CDC

(Page 10 of 10)

Anthrax Sources

How long do anthrax spores live?

Anthrax spores can survive for decades in soil.

What is the importance of knowing the genetic information about anthrax?

Genetic information about B. anthracis, particularly to determine genetic similarity among strains, is an important part of a disease investigation, but it is not immediately required for taking action to prevent or treat anthrax in those who may have been exposed to or infected by B. anthracis. Genetic information is often used to determine the similarity of strains if a common source is suspected.

Anthrax Treatment

What is the treatment for patients with inhalation and cutaneous anthrax?

CDC made treatment recommendations for cases of inhalation and cutaneous anthrax associated with the bioterrorism attack of 2001.

How do doctors treat inhalation anthrax to reduce the risk of death in patients?

When inhalation anthrax is suspected, physicians prescribe antibiotics to treat the disease. To be effective, antibiotic therapy should be initiated as soon as possible after exposure. Other treatment includes supportive care in hospital. Bacillus anthracis usually responds effectively to several antibiotics including penicillin, doxycycline, and fluoroquinolones (such as ciprofloxacin).

What drugs are FDA-approved for treatment of anthrax?

Ciprofloxacin, doxycycline and penicillin are FDA-approved for the treatment of anthrax in adults and children.

What if I develop side effects from antibiotics that I'm taking?

If you develop side effects from the antibiotic, call your healthcare provider immediately. Depending on the type of side effects, you may be able to continue taking the medicine, or may be switched to an alternative antibiotic. If necessary, your physician may contact your State Department of Health for consultation on possible alternate antibiotics.

What are the risks of using tetracyclines and fluoroquinolones (such as ciprofloxacin) in children? Are alternatives available?

Risks of using tetracyclines and fluoroquinolones in children must be weighed carefully against the risk for developing a life-threatening disease due to Bacillus anthracis. Both agents can have adverse health reactions in children. If adverse reactions are suspected, therapy may be changed to amoxicillin or penicillin.

Are there different strains of B. anthracis? Do they all respond to antibiotics?

Yes, there are different strains of Bacillus anthracis. Some strains of B. anthracis may be naturally resistant to certain antibiotics and not others. In addition, there may be biologically mutant strains that are engineered to be resistant to various antibiotics. A laboratory analysis can help to define which strain of B. anthracis is present and which antibiotic would be the most effective in treating the resulting anthrax.

Does a patient have immunity after recovering from anthrax infection?

We do not have enough data at this time to make this determination. However, it is theoretically possible to gain post-infection immunity.

Anthrax Vaccination

Is the anthrax vaccine available to the public?

A vaccine has been developed for anthrax that is protective against invasive disease, but it is currently only recommended for high-risk populations. CDC and academic partners are continuing to support the development of the next generation of anthrax vaccines.

Who should be vaccinated against anthrax?

The Advisory Committee on Immunization Practices (ACIP) has recommended 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; while incidence is low in the United States, 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.

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.

Is there a vaccination for anthrax?

A protective vaccine has been developed for anthrax; however, it is primarily given to military personnel. Vaccination is recommended only for those at high risk, such as workers in research laboratories that handle anthrax bacteria routinely. The antibiotics used in post exposure prophylaxis are very effective in preventing anthrax disease from occurring after an exposure.

Anthrax and Influenza

Influenza (flu) and inhalation anthrax can have similar symptoms. Does CDC recommend that I get a flu shot to help diagnose anthrax?

You should get a flu shot only to prevent the flu. CDC does not recommend you get the flu shot so doctors can tell whether you have the flu or anthrax. Many illnesses (including anthrax) begin with flu-like symptoms, which include fever, body aches, tiredness, and headaches. In fact, most illnesses with flu-like symptoms are not either the flu or anthrax.

The flu vaccine is the best protection you can get to prevent the flu and its severe complications, especially among those who are at the highest risk (e.g., people older than 65 years old or younger people with chronic disease such as diabetes or heart disease). The flu shot can prevent 70%-90% of flu infections, but it will not prevent illnesses with flu-like symptoms caused by anything other than influenza.

Is there a way to distinguish between early inhalation anthrax and flu?

Early inhalation anthrax symptoms can be similar to those of much more common infections. However, a runny nose is a rare feature of anthrax. This means that a person who has a runny nose along with other common influenza-like symptoms is by far more likely to have the common cold than to have anthrax.

In addition, most people with inhalation anthrax have high white blood cell counts and no increase in the number of lymphocytes. On the other hand, people with infections such as flu usually have low white blood cell counts and an increase in the number of lymphocytes.

Chest X-rays are also critical diagnostic tools. Chest X-rays showed that all patients with inhalation anthrax have some abnormality, although for some patients, the abnormality was subtle. CT scans can confirm these abnormalities.

Is there a quick test that doctors can do to tell whether I have anthrax or an illness like the flu?

Some influenza detection tests give results fairly quickly. However, these tests are not perfect and are not appropriate for every patient. Rapid influenza tests can provide results within 24 hours; viral culture provides results in 3-10 days. However, as many as 30% of samples that test positive for influenza by viral culture may give a negative rapid test result. And, some rapid test results may indicate influenza when a person is not infected with influenza.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.