Anthrax Transmission
Anthrax can manifest itself in three different forms: cutaneous (skin), inhalation, and gastrointestinal. Humans can transfer the spores to themselves by handling contaminated animal products. They can also become infected by inhaling the spores from animal products, or eating contaminated undercooked meat. The majority (95%) of people who become infected with anthrax, usually come into contact with the spores through a cut or abrasion, obtained when handling contaminated wool, hides, hair, or leather products. Spores have the ability to live in soil for many years. However, anthrax transmission from person to person is extremely unlikely. People should not be concerned about being infected upon treating or visiting those who are ill with anthrax.

To help stop transmission, livestock should be vaccinated. The vaccine is 93% effective in prevention infection. In countries where animals are less likely to be vaccinated, it is recommended that humans should avoid contact with livestock and animal products and avoid eating meat that has not been properly slaughtered and cooked.

Symptoms
Symptoms vary depending on the form of anthrax. Symptoms usually start to show up about seven days after exposure.

Cutaneous: Skin infection begins as a raised itchy bump that resembles an insect bite. Within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black necrotic (dying) area in the center. Lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy.

Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal.

Intestinal: The intestinal disease form of anthrax may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases.

Diagnosis
Anthrax is diagnosed by isolating the B. anthracis bacteria by performing culture and sensitivity tests on the affected area (the tissue within a lesion, respiratory secretions, and blood.

Treatment
Antibiotic therapy is the only treatment for anthrax. There is a higher rate of recovery in cases when treatment is started early. If left untreated, the disease is usually fatal.

Anthrax Vaccination
The Advisory Committee on Immunization Practices has recommend anthrax vaccination for the following groups:

  -Laboratory workers who will come into direct contact with anthrax bacteria.
  -People who work with imported animals and animal products.
  -Persons who handle potentially infected animal products in high-incidence areas. (Incidence is low in the United States, but veterinarians who travel to work in other countries where incidence is higher should consider being vaccinated.)
  -Military personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare weapon).
  -The anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office can be reached at 1-877-GETVACC (1-877-438-8222). http://www.anthrax.osd.mil

Pregnant women should be vaccinated only if absolutely necessary.

Vaccination Protocol
The immunization consists of three subcutaneous injections given 2 weeks apart followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are recommended thereafter.

Adverse Vaccine Reactions
On the average, 30% of the recipients will develop a mild local reaction, which consists of redness and tenderness at the injection site. Severe local reactions are rare, and consist of extensive swelling of the forearm in addition to the local reaction. Systemic reactions occur in fewer than 0.2% of recipients.

                                Source:CDC (Center for Disease Control and Prevention)