Anthrax
What We Don't Know About Anthrax as an Illness
No one knows for sure when treatment must begin to be successful. Some believe antibiotics must start within hours, others say days.
Physicians do not know if children or specific ethnic groups are more vulnerable to anthrax than the general population.
There is still debate about how many spores are needed to infect a person.
Treatment
All three types of anthrax can be treated with antibiotics. Though ciprofloxacin was first used as a treatment for anthrax during 2001, doxycycline is now the preferred antibiotic for anthrax infection. The reason for this is to prevent other bacteria from developing resistance to ciprofloxacin.
- Antibiotics are prescribed for 60 days.
- Treatment must begin as soon as possible after exposure to be successful because the bacteria produce a toxin in the body that poisons the system quickly and sometimes irreversibly. Antibiotics kill the bacteria but cannot remove the toxin or lessen the effects of any toxin already in the body. There is no antitoxin for the anthrax toxin.
- Those with inhalational anthrax normally have to be hospitalized and on a ventilator to help with breathing.
- Anthrax patients do not have to be isolated since the illness cannot be passed from person to person.
- Which antibiotic is prescribed depends on a patient's age and health, the number of cases in the area being treated, and what is available at the hospital and/or through the Strategic National Stockpile.
- Additional antibiotics for treatment of anthrax are being studied in animal efficacy trials.
Vaccine
- The vaccine is used as a preventive measure for those in high-risk populations, including:
Lab workers
Members of the armed forces deployed to countries suspected of having biological weapons programs
- The current anthrax vaccine is not available to the general public but might be used if an anthrax attack occurs.
- The vaccine is given as a series—three shots administered two weeks apart.
- Subsequent injections are given at 6, 12, and 18 months;annual boosters follow.
- The current vaccine can have side effects:
Mild side effects may include soreness, itching, or a lump where the shot was administered; muscle or joint aches; fatigue; or headache
Severe side effects may include a severe allergic reaction (very rare)
There is no evidence that the vaccine has long-term adverse side effects - In October 2004, HHS awarded a contract to VaxGen Inc. for the manufacture of 75 million doses of a new anthrax vaccine for the Strategic National Stockpile. Evidence from laboratory and animal research has shown that the new vaccine, which uses purified recombinant protective antigen, is effective in providing protection against aerosol exposure to anthrax spores (HHS 2004).
- More information on the clinical trials for new anthrax vaccines, anthrax diagnostic tests, and new antibiotics for anthrax treatment is available at NIAID's website.
Prevention
Although anthrax cannot be spread from person to person, the spores can travel widely. Following are steps that can be taken to minimize the risk to people who have come into contact with anthrax spores:
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