Anthrax has gained a notorious reputation among deadly pathogens. In 2001, shortly after the September 11 attacks, anthrax in powdered form was placed in letters and sent to media organizations and senators in the United States. This resulted in 22 individuals being infected with anthrax, and five of them lost their lives.
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As a consequence, the US government and several European countries implemented anthrax preparedness plans, which involved scanning numerous pieces of mail.
The standard treatment for anthrax involves the use of antibiotics like ciprofloxacin or doxycycline. Due to the potential activation of spores taking up to two months, individuals need to take antibiotics for an extended period to ensure protection.
Anthrax, an ancient bacterium believed to have originated in Egypt and Mesopotamia, has been mentioned in historical texts. Greek poet Homer referred to it as the “burning plague” in The Iliad around 700 BC, and some researchers speculate that anthrax may have been responsible for the plague that contributed to the decline of ancient Rome.
Recently, Sierra Leone reported its first anthrax outbreak in 28 years, resulting in the death of over 200 livestock in the country’s northwestern region. Although bioterrorism and grazing livestock may seem unrelated, the bacterium causing anthrax is responsible for a zoonotic disease that can cause extensive devastation.
Anthrax has the potential to be highly lethal, as demonstrated by an epidemic in 1770 that claimed the lives of 15,000 people in what is now Haiti. This outbreak is believed to have been caused by intestinal anthrax transmitted through the consumption of uncooked beef.
Here’s what you need to know about the disease.
1. Anthrax can stay hidden for years
Anthrax is caused by a bacterium called Bacillus anthracis that occurs naturally in soil. One of the reasons it is such a threat is because the bacteria can stay dormant as highly resistant spores in the soil that can be brought to the surface by rain or tilling the fields. When these spores are eaten by animals they cause an outbreak.
2. It spreads via spores
Anthrax is not contagious, which means an infected person can’t pass it on to others like a cold or flu. However, people can get sick with anthrax if they come into contact with infected animals or contaminated animal products, and spores get into cuts or scrapes on the person’s skin. Thus it often infects veterinarians, agricultural workers, livestock producers or butchers. Eating raw or undercooked meat from an infected animal or drinking contaminated water can cause the disease. Anthrax can spread through the air, where the spores are inhaled, which can happen in places like slaughterhouses and tanneries.
In the current Sierra Leone outbreak, for example, this means that livestock farms are under quarantine until the outbreak is under control, animals will be vaccinated, and people living nearby will be made aware of the risks. Health authorities are intensifying their surveillance of any cases emerging in animals or humans.
3. Breathing it in is mostly fatal
There are different types of anthrax symptoms depending on whether the spores enter the skin (cutaneous anthrax), are breathed in (inhalation anthrax), are eaten or drunk (gastrointestinal anthrax), or injected (injection anthrax).
When anthrax spores get inside the body, the bacterium goes from dormant to active and multiplies, spreading through the body, producing toxins.
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Symptoms of cutaneous anthrax include blisters and sores on the skin, inhaling the spores can cause chest pains, shortness of breath and cough, and gastrointestinal anthrax can mean a swelling of the neck, sore throat, bloody vomiting or diarrhoea.
Inhaled anthrax usually develops a few weeks after exposure but it can take up to two months. Without treatment, most people die – even with aggressive treatment, it kills one in two people.
Without treatment, up to 20% of people with cutaneous anthrax die. If left untreated, more than half of patients with gastrointestinal anthrax die. However, treatment can save 60% of people.
4. It’s a deadly bioweapon
Anthrax spores are not only easily found in nature, they can be produced in a lab. The spores can be made into powders, sprays or dissolved into water or food, and can be impossible to detect through smell or taste.
Anthrax has been deployed as a weapon around the world for nearly a century, and was used in both World Wars.
5. It can be prevented by a vaccine and treated by antibiotics
The standard treatment for anthrax is an antibiotic such as ciprofloxacin or doxycycline. Since some spores can take up to two months to be activated, people need to take antibiotics for that long to be sure they are protected.
The anthrax vaccine adsorbed (AVA) can be given as a preventive for people who are particularly high risk, and can also be given post-exposure along with antibiotics.