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by Scholten A

Definition

Anthrax is a rare, life-threatening infection. It leads to swelling, bleeding, and tissue death.

Anthrax Can Enter the Body Through the Lungs
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Causes

Certain bacteria and its spores cause anthrax. They are found in soil and animals. The spores can get into the body in several ways:

  • Cutaneous—from breaks in the skin
  • Inhalation—by breathing them in
  • Gastrointestinal—by eating raw or undercooked meat that has spores

Once in the body, the spores multiply and release toxins.

Risk Factors

The risk of anthrax is higher in those who:

  • Live in or travel to places where it is common, such as:
    • sub-Saharan Africa
    • Asia
    • the Caribbean
    • Southern and Eastern Europe
    • South and Central America
  • Work with animals and animal hides
  • Work with the bacteria in labs
  • Are exposed to criminal or terrorist acts

Symptoms

Symptoms start within a few days after infection.

Cutaneous symptoms may be:

  • A raised, round, itchy bump, like an insect bite
  • Skin ulcers with a black center—they make a clear or pinkish fluid
  • Swelling around the wound
  • Swollen, painful lymph nodes

Inhalation symptoms start with:

  • Cough
  • Tiredness or weakness
  • Soreness and swelling in the throat
  • Swollen lymph nodes
  • Fever and chills
  • Headache and muscle aches

Other symptoms begin later such as:

  • Severe breathing problems
  • Chest pain
  • Sweating
  • Confusion
  • Death

Gastrointestinal symptoms can be:

  • In the mouth or throat, with:
    • Fever
    • Swelling in the neck
    • Whitish ulcers
  • In the intestines, with:
    • Nausea and vomiting
    • Fever
    • Belly pain
    • Bloody diarrhea

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam may be done. The doctor may give tests to rule out other causes.

Tests to diagnose anthrax may be:

  • Blood tests
  • Tests of fluids, stool, wounds, or tissues
  • Imaging tests such as chest x-rays

Treatment

Treatment will start right away. It will involve:

  • Antibiotics—to treat the infection
  • Antibodies—to target bacteria (inhalation anthrax)
  • Cleaning and bandaging skin lesions
  • Supportive care—to maintain heart function, blood pressure, and oxygen

Prevention

The risk of anthrax may be reduced by:

  • Avoiding contact with infected animals and their products
  • Not touching anthrax wounds
  • Handling suspicious mail carefully

A vaccine may be given to some people at high risk for anthrax.

RESOURCES

Centers for Disease Control and Prevention  https://www.cdc.gov 

Military Health System  https://health.mil 

CANADIAN RESOURCES

Alberta Health  https://www.alberta.ca 

Public Health Agency of Canada  https://www.canada.ca 

References

Anthrax. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/anthrax. Accessed February 2, 2021.

Anthrax. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/anthrax Accessed February 2, 2021.

Anthrax. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax. Accessed February 2, 2021.

Bower WA, Schiffer J, et al. Use of anthrax vaccine in the United States: recommendations of the advisory committee on immunization practices, 2019. MMWR Recomm Rep. 2019;68(4):1-14.

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