Anthrax is a disease caused by Bacillus anthracis. 1,2 While it is primarily a disease of animals, cases of anthrax in humans occur through contact with infected animals or animal products or through intentional spread of B. anthracis spores as a biowarfare or bioterrorism agent.
Bacillus anthracis spores introduced through the lungs lead to inhalational anthrax.9
Inhalational anthrax is particularly deadly in humans.9 Untreated, the mortality rate exceeds 90%.10 Despite the medical care administered to victims of the 2001 attacks in the US, which included multidrug regimens, pleural fluid drainage, and intensive care support, the associated fatality rate was approximately 45%.11,12
The median incubation period is 10 days (range 2 – 43 days).2,13 The disease develops in two phases; initially, patients experience a period of flu-like symptoms with a median duration of 3.9 days (range, 3.5 to 4.4 days).11 Nonspecific symptoms reported in this phase including fever, malaise, sweats, cough, dyspnea, altered mental state, nausea and vomiting, headache, and muscle aches.1 A transition to severe illness follows abruptly, with high fever, dyspnea, diaphoresis, and shock.2
Chest imaging reveals widening of the mediastinum, mediastinal lymphadenopathy, infiltrates, and pleural effusions.1
Because the progression from non-specific to severe, life-threatening symptoms is rapid; the treatment window for inhalational anthrax is brief.
Hospitalization is warranted for all patients with suspected inhalational anthrax.9 The CDC guidance for treatment is summarized here.
Antibiotics target Bacillus anthracis but have no direct effect on toxins that have been released, or the systemic damage they cause. Antitoxins are a class of FDA-approved drugs that complement antibiotics for anthrax treatment by preventing toxins from entering cells and exerting their deleterious effects.
Pre-exposure prophylaxis
Currently, FDA-approved options for the pre-exposure prevention of anthrax include a vaccine and antitoxins (immediate prophylaxis only).
Post-exposure prophylaxis
For persons who may have been exposed to aerosolized B. anthracis spores but are not showing signs or symptoms of anthrax infection, recommended post-exposure prophylaxis includes antimicrobial therapy or vaccine administration combined with antimicrobial therapy. When alternative therapies are not available or appropriate antitoxins can be used. In this situation, antitoxins would be expected to maintain their treatment effectiveness by preventing toxin formation.
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You are now leaving www.Elusys.com, a site provided by Elusys Therapeutics, Inc. This link will take you to a website to which this Privacy Policy does not apply. We encourage you to read the Privacy Policy of every website you visit. Elusys Therapeutics, Inc. does not endorse and/or influence the content found on websites not owned/operated by Elusys Therapeutics, Inc.