The disease Anthrax is caused by the bacteria Bacillus anthracis. Anthrax is normally found in sheep, cattle and horses but can be transmitted to humans who contact infected animals or their products. Usually humans acquire the disease by skin contact with the bacteria or by inhaling the bacterial spores found in sheep wool.
As an agent of biological warfare (BW), it is expected that a cloud of Anthrax spores would be released at a strategic location to be inhaled by the personnel under attack. As such, the symptoms of Anthrax encountered in BW would follow those expected for inhalation of spores,as opposed to those expected for skin contact or ingestion of the bacteria. These symptoms are discussed in the sections below.
Disinfection of contaminated articles may be accomplished using a 0.05% hypochlorite solution (1 tbps. bleach per gallon of water). Spore destruction requires steam sterilization.
The military chemical protective mask is effective against inhalation of all Biological Warfare Agents.
About 1-6 days after inhaling Bacillus anthracis spores there would be a gradual onset of vague symptoms of illness such as fatigue, fever, mild discomfort in the chest and a possibly a dry cough. The symptoms would improve for a few hours or 2-3 days. Then, there would be sudden onset of difficulty in breathing, profuse sweating, cyanosis (blue colored skin), shock and death in 24-36 hours.
These symptoms are essentially those of Woolsorter's disease, which is caused by inhalation of Bacillus anthracis spores rather than contact with the bacterium through the skin. Contact through the skin is the most common "naturally" occurring form of Anthrax and is characterized by swelling and boils on the skin. Skin symptoms would not necessarily be expected with Anthrax resulting from inhaled spores in BW.
There is a licensed human Anthrax vaccine that consists of a series of six doses with yearly boosters. The first vaccine of the series must be given at least four weeks before exposure to the disease. This vaccine protects against Anthrax that is acquired through the skin in an occupational environment. It is believed that it would also be effective against inhaled spores in a BW situation.
For unvaccinated individuals, antibiotics are given if the individual is exposed to Anthrax. Pencillin is the drug of choice. Antibiotic treatment is known to lessen the severity of the illness in workers who acquire Anthrax through the skin. Inhaled Anthrax was formerly thought to be nearly 100% fatal despite antibiotic treatment, particularly if treatment is started after symptoms appear. A recent Army study resulted in successful treatment of monkeys with antibiotic therapy after being exposed to Anthrax spores. The antibiotic therapy was begun one day after exposure. This study implies antibiotic therapy may be useful in a BW setting if begun soon after the attack.
There is no evidence of person-to person transmission of Anthrax. Quarantine of affected individuals is not recommended. Anthrax spores may survive in the soil, water and on surfaces for many years. Spores can only be destroyed by steam sterilization or burning, but not by disinfectants. An infection of local animal populations such as sheep and cattle could follow a biological attack with spores. Infected animals could then transmit the disease to humans through the human's skin, mouth or nose. Veterinarians should be made aware of this possibility. Local health officials should take appropriate measures (published elsewhere) to prevent Anthrax outbreak among animals and an ensuing human epidemic.
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