Click to question
What is anthrax and how is it caught?
Anthrax is a bacterial infection caused by bacillus anthracis, which normally attacks cattle and goats in Asia, Africa, South and Central America and some parts of Europe. There is little trace of the disease in animals in the United States or Britain.
The bacteria - of which there are 150 strains occuring naturally - is extremely durable and can resist drying and heat, often lying dormant in soil for decades. The infection can take three forms, with victims contracting the disease through cuts and bruises, inhalation or eating infected meat that has not been cooked properly. Once the bacteria enters the bloodstream the disease is often fatal.
Cutaneous or skin anthrax is the most common form of the disease, accounting for 95 per cent of cases and often being contracted by workers at abbatoirs or tanneries. However, it is the easiest form of the disease to prevent and treat. Five per cent of victims die.
Pulmonary anthrax is, by contrast, very dangerous, killing nine in ten victims. Intestinal anthrax is also usually fatal but it is very rare.
What are the symptoms?
One of the reasons pulmonary anthrax is so difficult to treat is because its symtoms can be confused with several illnesses, from flu to meningitis. The spores must be between one and five microns in size to penetrate the alveoli in the lungs (tiny sacks of air that allow for the transfer of oxygen to the bloodstream).
A patient who has inhaled anthrax spores may complain of a fever, headache, cough and extreme tiredness. Between two and four days after the initial symptoms are noticed, respiratory failure will occur, causing acute pain and probable death.
Cutaneous anthrax is frequently found on hands, forearms and the face, and is caused when existing cuts and lesions are infected. It manifests itself three days after exposure with a raised, itchy and inflamed pimple which swells and blisters. Two to six days later the infection will turn into a black scab. Left untreated it will eventually kill the victim.
Gastro-intestinal anthrax is accompanied by severe abdominal pain, nausea, vomiting and diarrhoea. Within three days the bacteria can reach the bloodstream, after which the disease is usually fatal.
Is it contagious?
Anthrax is an infectious disease and is not contagious. As a result, only those who have been directly exposed to the spores should be treated and patients do not need to be quarantined.
Is there any treatment?
Anthrax can be treated with antibiotics but it is essential to recognise the disease's early symptoms. The Public Health Laboratory Service recommends that cutaneous anthrax is treated with a seven-day course of ciprofloxacin which, if effective, can be changed to penicillin.
Pulmonary and ingested anthrax should be treated with an eight-week course of ciprofloxacin. A vaccine is available and 93 per cent effective, according to the US Centre for Disease Control. It is cell-free, which means that it contains no dead or live bacteria.
However, public health organisations recommend that only those who deal with anthrax frequently - such as laboratory technicians or the emergency services - should be given the vaccine.
What should I do if...?
If a patient thinks they have anthrax they should consult their doctor immediately. If tests are positive the doctor will contact the relevant authorities (in Britain the Consultant for Communicable Disease Control) which will then enact emergency procedures to deal the with disease, including confirmation tests and establishing who else may have been exposed to the spores.