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64 - Anthrax

from Part IV - Current Topics

Published online by Cambridge University Press:  15 December 2009

David M. Stier
Affiliation:
Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Jennifer C. Hunter
Affiliation:
Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Olivia Bruch
Affiliation:
Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Karen A. Holbrook
Affiliation:
Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION

Anthrax is an acute infection caused by Bacillus anthracis, a large, gram-positive, spore-forming, aerobic, encapsulated, rod-shaped bacterium. Spores germinate and form bacteria in nutrient-rich environments, whereas bacteria form spores in nutrient-poor environments. The anthrax bacillus produces high levels of two toxins: Edema toxin causes massive edema at the site of germination, and lethal toxin leads to sepsis. Severity of anthrax disease depends on the route of infection and the presence of complications, with case fatality ranging from 5% to 95% if untreated.

The Working Group for Civilian Biodefense considers B. anthracis to be one of the most serious biological threats. Anthrax has been weaponized and used. It can be fairly easily disseminated and causes illness and death. Of the ways that B. anthracis could potentially be used as a biological weapon, an aerosol release would be expected to have the most severe medical and public health outcomes.

EPIDEMIOLOGY

Anthrax as a Biological Weapon

Anthrax was successfully used as a biological weapon in the United States in October 2001. Cases resulted from direct or indirect exposure to mail that was deliberately contaminated with anthrax spores. In total, 22 cases were identified, 11 with inhalational (five fatal) and 11 with cutaneous anthrax (seven confirmed, four suspected).

Several countries, including the United States, have had anthrax weaponization programs in the past.

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Publisher: Cambridge University Press
Print publication year: 2008

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References

Bales, M E, Dannenberg, A L, Brachman, P S, et al. Epidemiologic response to anthrax outbreaks: field investigations, 1950–2001. Emerg Infect Dis 2002;8(10):1163–74.CrossRefGoogle ScholarPubMed
Bell, D M, Kozarsky, P E, Stephens, D S. Clinical issues in the prophylaxis, diagnosis, and treatment of anthrax. Emerg Infect Dis 2002;8(2):222–5.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention (CDC). Additional options for preventive treatment for persons exposed to inhalational anthrax. MMWR 2001;50(50):1142.
Centers for Disease Control and Prevention (CDC). Anthrax Q and A: Anthrax and animal hides. 2006. Available at: http://www.bt.cdc.gov/agent/anthrax/faq/pelt.asp.
Centers for Disease Control and Prevention (CDC). Emergency preparedness and response. anthrax: images: cutaneous anthrax. Available at: http://www.bt.cdc.gov/agent/anthrax/anthrax-images/cutaneous.asp.
Centers for Disease Control and Prevention (CDC). Inhalation anthrax associated with dried animal hides – Pennsylvania and New York City, 2006. MMWR 2006;55(10):280–2.
Centers for Disease Control and Prevention (CDC). Investigation of anthrax associated with intentional exposure and interim public health guidelines, October 2001. MMWR 2001;50(41):889–93.
Centers for Disease Control and Prevention (CDC). Investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001. MMWR 2001:50(42):909–19.
Centers for Disease Control and Prevention (CDC). Suspected cutaneous anthrax in a laboratory worker – Texas 2002. MMWR 2002;51(13):279–81.
Centers for Disease Control and Prevention (CDC). Use of anthrax vaccine in response to terrorism: supplemental recommendations of the Advisory Committee on Immunization Practices. MMWR 2002;51(45):1024–6.
Food and Drug Administration (FDA). Levaquin (levofloxacin) information. 2005. Retrieved March 20, 2007, from http://www.fda.gov/cder/drug/infopage/levaquin/default.htm.
Freedman, A, Afonja, O, Chang, M W, et al. Cutaneous anthrax associated with microangiopathic hemolytic anemia and coagulopathy in a 7-month-old infant. JAMA 2002;287(7):869–74.CrossRefGoogle Scholar
Holty, J E, Kim, R Y, Bravata, D MSystematic review: a century of inhalational anthrax cases from 1900 to 2005. Ann Intern Med 2006;144(4):270–80.CrossRefGoogle ScholarPubMed
Howell, J M, Mayer, T A, Hanfling, D, et al. Screening for inhalational anthrax due to bioterrorism: evaluating proposed screening protocols. Clin Infect Dis 2004;39(12):1842–7.CrossRefGoogle ScholarPubMed
Jernigan, J A, Stephens, D S, Ashford, D A, et al., Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. Emerg Infect Dis 2001;7(6):933–44.CrossRefGoogle ScholarPubMed
Kadanali, A, Tasyaran, M A, Kadanali, S. Anthrax during pregnancy: case reports and review. Clin Infect Dis 2003;36(10):1343–6.CrossRefGoogle ScholarPubMed
Meyerhoff, A, Murphy, D. Guidelines for treatment of anthrax. JAMA 2002;288(15):1848–9; author reply 1848–9.22.CrossRefGoogle ScholarPubMed
Sejvar, J J, Tenover, F C, Stephens, D S. Management of anthrax meningitis. Lancet Infect Dis 2005;5(5):287–95.CrossRefGoogle ScholarPubMed
Sirisanthana, T, Brown, A E. Anthrax of the gastrointestinal tract. Emerg Infect Dis 2002;8(7):649–51.CrossRefGoogle ScholarPubMed
Swartz, M N. Recognition and management of anthrax – an update. N Engl J Med 2001;345(22):1621–6.CrossRefGoogle ScholarPubMed
Center for Infectious Disease Research and Policy. Anthrax: Current, comprehensive information on pathogenesis, microbiology, epidemiology, diagnosis, treatment, and prophylaxis. 2006. CIDRAP. Retrieved January 17, 2007, from http://www.cidrap.umn.edu/cidrap/content/bt/anthrax/biofacts/anthraxfactsheet.html.
Dixon, T C, Meselson, M, Guillemin, J. et al. Anthrax. N Engl J Med 1999;341(11):815–26.CrossRefGoogle ScholarPubMed
Inglesby, T V, O'Toole T, , Henderson, D A, et al. Anthrax as a biological weapon, 2002: updated recommendations for management. JAMA 2002;287(17):2236–52.CrossRefGoogle ScholarPubMed
Lucey D. Chapter 205 – Bacillus anthracis (Anthrax). In: Mandell, G L, Bennett, J E, Dolin, R, eds, Principles and practice of infectious diseases (6th ed). New York: Churchill Livingstone, 2005.Google Scholar
Lucey D. Chapter 324 – Anthrax. In: Mandell, G L, Bennett, J E, Dolin, R, eds, Principles and practice of infectious diseases (6th ed). New York: Churchill Livingstone, 2005.Google Scholar

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  • Anthrax
    • By David M. Stier, Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Jennifer C. Hunter, Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Olivia Bruch, Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Karen A. Holbrook, Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.065
Available formats
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Anthrax
    • By David M. Stier, Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Jennifer C. Hunter, Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Olivia Bruch, Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Karen A. Holbrook, Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.065
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Anthrax
    • By David M. Stier, Medical Epidemiologist, Medical Director, Adult Immunization and Travel Clinic, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Jennifer C. Hunter, Research Assistant, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Olivia Bruch, Health Program Coordinator, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA, Karen A. Holbrook, Medical Epidemiologist, Communicable Disease Control and Prevention Section, San Francisco Department of Public Health, San Francisco, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.065
Available formats
×