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Anthrax Threats

What is anthrax?

Anthrax is an acute disease caused by a spore-forming bacterium (Bacillus anthracis).  Anthrax most commonly occurs in hoofed mammals (cattle and sheep) in agricultural regions but can also infect humans.  It is important to note however, that anthrax is not spread from person to person. 

 How common is anthrax and who can get it?

Anthrax is most common in undeveloped agricultural regions outside of the United States including South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East where it occurs in animals. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products.  Anthrax infection can occur in three ways: 

(1)   through breaks/cuts in the skin (cutaneous),

(2)   inhalation of spores (pulmonary), and

(3)   ingestion (intestinal). 

 What are the symptoms of anthrax?

 Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.

Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals. Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually ½  to 1 ½  inches in diameter, with a characteristic black area in the center.  If left untreated, other symptoms such as swollen glands, fever and malaise often develop after several days. About 20% of untreated cases of cutaneous anthrax will result in death, but deaths are rare with appropriate antibiotics.

 Inhalation: Initial symptoms may resemble a common cold and include a cough, chills and aches.  After several days however, the symptoms may progress to severe breathing problems and shock.  Left untreated, inhalation anthrax is usually fatal.

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

Can anthrax be spread from person-to-person?

Infection with anthrax requires direct contact with the bacterial spores.  Person-to-person spread of anthrax has not been known to occur and is extremely unlikely.  Communicability is not a concern in managing or visiting with patients with pulmonary (inhaled) anthrax.

How is anthrax diagnosed?

Anthrax is diagnosed by isolating B. anthracis from the blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood of persons with suspected cases.

Is there a treatment for anthrax?

Doctors can prescribe effective antibiotics. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.

Is there a way to prevent infection?

Avoiding contact of contaminated animals or other items containing the bacterial spores can prevent infection.  Avoid eating meat that has not been properly slaughtered and cooked.  If a documented exposure to anthrax has occurred, early treatment with antibiotics can prevent the development of symptoms and the disease. 

What about the anthrax vaccine?

An anthrax vaccine has been licensed for use in humans.  However it is currently only available to persons who work directly with the organism in the laboratory and military personnel deployed to areas with high risk for exposure to the organism.

This is an official CDC Health Advisory

Distributed via Health Alert Network      October 12, 2001, 21:00 EDT (9:00 PM EDT)


 Many facilities in communities around the country have received anthrax threat letters. Most were empty envelopes; some have contained powdery substances. The purpose of these guidelines is to recommend procedures for handling such incidents.


  1. Anthrax organisms can cause infection in the skin, gastrointestinal system, or the lungs.  To do, so the organism must be rubbed into abraded skin, swallowed, or inhaled as a fine, aerosolized mist.  Disease can be prevented after exposure to the anthrax spores by early treatment with the appropriate antibiotics. Anthrax is not spread from one person to another person.
  2. For anthrax to be effective as a covert agent, it must be aerosolized into very small particles. This is difficult to do, and requires a great deal of technical skill and special equipment. If these small particles are inhaled, life-threatening lung infection can occur, but prompt recognition and treatment are effective.


Suspicious unopened letter or package marked with a threatening message such as “ANTHRAX”.  


1.      Do not shake, open or empty the contents of any suspicious envelope or package.

2.      PLACE the envelope or package in a plastic bag or some other type of container to prevent leakage of contents.

3.      If you do not have any container, then COVER the envelope or package with anything (e.g., clothing, paper, trash can, etc.) and do not remove this cover.

4.      Then LEAVE the room and CLOSE the door, or section off the area to prevent others from entering (i.e., keep others away).

5.      WASH your hands with soap and water to prevent spreading any powder to your face.

6.      What to do next…

§        If you are at work, then report the incident to your building security official or an available supervisor who should notify police and other authorities.

§        If you are at home, then report the incident to local police.

7.   LIST all people who were in the room or area when this suspicious letter or package was recognized. Give this list to both the local public health authorities and law enforcement officials for follow-up investigations and advice.


How likely is it that someone would receive anthrax or other terrorist-related biological agents in the mail? 

 Data from the US Postal Service shows that over 200 billion pieces of mail are delivered each year.  During the last year, of these billions of pieces of mail, they only received approximately 60 threats or hoaxes which included anthrax, hoof and mouth disease, the Klingerman virus hoax and others.

 Local, state, and Federal health and emergency program officials are prepared to deal with terrorist activities involving release of anthrax spores.  The Postal Service is coordinating with these officials to ensure quick and effective response to any such activities. The remote, but real, possibility that anthrax will be introduced into the mail stream requires that the above outlined procedures be strictly followed.

 What constitutes a “suspicious parcel”?

 Some typical characteristics Postal Inspectors have detected over the years, which ought to trigger suspicion, include parcels that: 

·        are unexpected or from someone unfamiliar to you.

·        are addressed to someone no longer with your organization or are otherwise outdated.

·        have no return address, or have one that can't be verified as legitimate.

·        are of unusual weight, given their size, or are lopsided or oddly shaped.

·        are marked with restrictive endorsements, such as “Personal” or “Confidential.”

·        have protruding wires, strange odors or stains.

·        show a city or state in the postmark that doesn't match the return address.

 If you encounter a suspicious looking mail piece(s), follow the procedures outlined and report it to your supervisor/manager immediately.