Anthrax: Background and Current Issues

Bacillus anthracis Background

• Anthrax is a serious infectious disease
• Agricultural workers, who work with infected animals are often exposed
• Non-industrial workers, such as lab workers handling contaminated materials are also exposed
• Industrial workers, dealing with certain animal products, are at risk
• Bioterrorist attacks can involve deliberate exposure through mail
• There are recorded cases in the U.S. from 1951 to 2000 (N = 409)

Anthrax: Current Issues

• Surveillance is key to identifying anthrax attacks
• Identifying vulnerable populations, especially those exposed, is essential for prevention strategies
• Epidemiological investigations, including environmental examinations, are vital to track exposure

Anthrax Bioterrorism Issues

• Surveillance for cutaneous and inhalational anthrax is required
• Prevention strategies must target quickly identifying exposed populations
• Epidemiological investigations and environmental testing are used to trace routes of exposure
• Providing postexposure prophylaxis
• Tracing the source

Anthrax Bioterrorism Issues (2)

• Environmental assessments are needed to pinpoint exposure sources.
• Decontamination protocols are essential

Threat Assessment

• Clinicians and lab workers should be vigilant for Bacillus species
• Rapidly progressive respiratory illnesses or skin ulcers in previously healthy individuals should raise suspicion
• Contacting healthcare providers and state public health departments is necessary for suspected cases
• Utilizing the Laboratory Response Network for Bioterrorism is important to facilitate rapid identification of suspected anthrax

Exposure Situation Management

• Antimicrobial prophylaxis for people potentially exposed

Environmental sampling

• Surface swabs and nasal swabs from possibly impacted individuals, within seven days of exposure, may be collected

Anthrax: Definition and Classification

• Confirmed case: Clinically compatible illness identified by isolating B. anthracis or other laboratory evidence
• Suspected case: Clinically compatible illness with one supportive lab test
• Exposure classification includes laboratory confirmation with environmental exposure, or exposure without lab confirmation but linked to possible environmental exposure

Anthrax: Clinical Information

• Cutaneous anthrax: Begins as a papule, progressing to a depressed ulcer; edema; redness/necrosis without ulceration.

• Inhalational anthrax: A short prodrome ("viral-like" illness with myalgia, fever, possible respiratory symptoms), followed by hypoxia and dyspnea, possibly mediastinal widening

• Gastrointestinal anthrax: Abdominal distress with bloody vomiting/diarrhea, fever, septicemia

• Incubation periods and fatality rates vary based on anthrax type and treatment received.

Differential Diagnosis

• Cutaneous Anthrax: Spider bite, ecthyma gangrenosum, ulceroglandular tularemia, plague, staphylococcal cellulitis, herpes simplex virus
• Inhalational Anthrax: Mycoplasmal pneumonia, Legionnaires' disease, psittacosis, tularemia, Q fever, viral pneumonia, etc.
• Gastrointestinal Anthrax: Acute appendicitis, ruptured viscus, diverticulitis.

Recommended Postexposure Prophylaxis

• Treatment protocols for cutaneous and inhalational anthrax cases, both linked to bioterrorism events, exist.

Anthrax: Diagnosis

• Diagnosis usually involves blood cultures or oral swab collection

Laboratory Information

• Includes specimen collection information and procedures

Laboratory Response Network (LRN)

• Links and connects advanced laboratories with state and local public health laboratories to expedite response to anthrax cases.

Disinfection and Disposal

• Proper procedures are essential for safe material handling and decontamination of contaminated surfaces and equipment

Explore the serious infectious disease anthrax, its exposure risks for various workers, and its implications in bioterrorism. This quiz covers background information, current issues in surveillance, and prevention strategies associated with anthrax. Test your knowledge on epidemiological investigations and environmental examinations related to this disease.