Anthrax

Anthrax, also called wool-sorter’s disease or ragpicker’s disease, is an acute bacterial infection that occurs most commonly in hoofed animals, such as cattle, sheep, goats, and horses. It can also affect people who come in contact with contaminated animals or the hides, bones, fur, hair, or wool of contaminated animals. Anthrax is also used as an agent for bioterrorism and biological warfare.

Anthrax occurs worldwide, but is most common in developing countries. In humans, anthrax occurs in three forms, depending on the mode of transmission: cutaneous, inhalational, and GI.

At least 17 nations are thought to have a biological weapons program, but it is not known how many nations or groups are currently working with anthrax. Bioterrorism experts believe it is difficult to use anthrax effectively as a weapon on a large scale.

Causes

Anthrax is caused by the bacteria Bacillus anthracis, which exists in the soil as spores that can live for years. Transmission to humans usually occurs through exposure to or handling of infected animals or animal products. Anthrax spores can enter the body through abraded or broken skin (cutaneous anthrax), by inhalation (inhalational anthrax), or through ingestion of undercooked meat from an infected animal (GI anthrax). Anthrax is rarely spread from person to person.

Complications

Cutaneous anthrax can spread to the bloodstream, causing septicemia. Inhalational anthrax can cause hemorrhagic meningitis, pleural effusions, mediastinitis, shock, and acute respiratory distress syndrome. GI anthrax can cause hemorrhage and shock. All three forms of anthrax can lead to death in cases of severe or untreated infection.

Assessment Findings

Signs and symptoms of infection usually occur within 1 to 7 days after exposure but may take as long as 60 days to appear. The signs and symptoms of anthrax depend on the form that is acquired.

Cutaneous anthrax is the most common form, with 95% of infections occurring when the spore enters a break in the skin. Skin infection may begin as a small, elevated, itchy lesion that develops into a vesicle in 1 to 2 days and ultimately becomes a small, painless ulcer with a necrotic center. A scab usually develops and then drops off within 2 weeks (although complete healing may take longer). Enlarged lymph glands in the surrounding area are common. Without treatment, mortality from cutaneous anthrax is 20%. (See Cutaneous anthrax infection.)

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