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When anthrax appeared in the mail, CDC’s disease detectives faced a daunting challenge: tracing the cause and stemming the spread of a disease that may have been introduced deliberately - in other words, a biological attack. |
An anxious nation on edge learned about the first case of inhalational anthrax on October 4, 2001. Reported by CDC and state and local public health authorities in Florida, the incident was the first of many in Florida, New York, Washington D.C. and Connecticut that presented both a health threat and a crime scene. In the months that followed, 22 cases of anthrax were confirmed, resulting in five deaths. More than 2,000 CDC employees were involved in responding to the crisis - the largest rapid mobilization of CDC staff for a single public health issue in the agency’s history.
What exactly is anthrax? Anthrax is caused by the spore-forming bacterium Baccillus anthracis. It is primarily found in animals like cattle, goats and sheep, but it can also occur in humans when they are exposed to infected animals or to tissue from infected animals, or when anthrax spores are used as a bioterrorist weapon.
There are three clinical forms of anthrax: cutaneous (skin), inhalational and gastrointestinal. If left untreated, anthrax in all forms can lead to septicemia (blood poisoning) and death.
Cutaneous anthrax is acquired after a person’s skin comes into direct contact with B. anthracis spores, such as those found in letters in the U.S. postal system in late 2001. Skin infection begins as a raised bump that looks like a spider bite, but within one to two days it develops into a vesicle (small blister) and then a painless ulcer with a characteristic black necrotic (dying) area in the center. About 20 percent of untreated cases of cutaneous anthrax are fatal, but deaths are rare if patients are given appropriate antibiotics.
Inhalational anthrax, caused by inhaling airborne B. anthracis spores, is the most lethal form of anthrax. At first, it resembles the flu - initial symptoms include sore throat, mild fever, muscle aches and malaise. These symptoms may progress to respiratory failure and shock, with meningitis frequently developing. Inhalation anthrax is usually fatal.
Gastrointestinal anthrax is acquired by eating raw or undercooked contaminated meat. Initial signs of nausea, loss of appetite, vomiting and fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Gastrointestinal anthrax results in death in 25 to 60 percent of all cases.
Symptoms vary depending on how anthrax is contracted, symptons usually occur within seven days after exposure. Here’s what to look for:
- Fever (temperature greater than 100 degrees Fahrenheit), accompanied by chills or night sweats
- Flu-like symptoms, although a runny nose is rare
- Cough, chest discomfort, shortness of breath, fatigue, muscle aches
- Sore throat, followed by difficulty swallowing, enlarged lymph nodes, headache, nausea, loss of appetite, abdominal distress, vomiting or diarrhea
- A sore, especially on your face, arms or hands, that starts as a raised bump and develops into a painless ulcer with a black area in the center
Anthrax is not contagious. Early antibiotic treatment of anthrax is essential - a delay lessens chances for survival. An anthrax vaccine also can prevent infection, although it is not recommended or available for the general public.
If your doctor confirms that you do have a form of anthrax, he or she should immediately report the case to your local or state public health department. If local or state health department officials suspect that cases of illness may be linked to bioterrorism, they’ll notify CDC and an investigation will be conducted. If the investigation confirms that a bioterrorism incident has occurred - or is probable - the FBI will be notified. Public health officials will also involve other response partners.
Will we ever be able to prevent or curb future anthrax attacks? While there is no guarantee, CDC is taking a number of steps to protect us. For example, CDC and the U.S. Postal Service are collaborating to ensure that all mail handlers and postal workers are protected against exposure to anthrax. Additionally, CDC continues to work closely with state and local health departments and other federal agencies to facilitate anthrax investigations as needed.
To help support CDC in responding to public health and safety crises like Anthrax, the CDC Foundation established an Emergency Preparedness & Response Fund to provide CDC workers with quick access to flexible funds in times of crises. The Foundation enables individuals and organizations from across the nation to help bridge gaps in federal funding for emergency preparedness.