What Is Anthrax?Anthrax is a potentially fatal disease caused by the bacterium Bacillus anthracis. It is well known for its role in the 2001 bioterrorist attacks, in which the lethal bacteria were spread deliberately through the U.S. mail. Twenty-two people became ill, and five died.WHAT ARE THE TYPES OF ANTHRAX?Anthrax is a serious disease caused by the bacterium Bacillus anthracis. The three major types of anthrax are: Cutaneous Anthrax, About 95 percent of anthrax infections are cutaneous anthrax. Transmission occurs when Bacillus anthracis enters a cut or abrasion on the skin, which can happen when handling contaminated wool, hides, leather, or hair products (especially goat hair) of infected animals. A cutaneous anthrax skin infection begins as a raised, itchy bump that resembles an insect bite, but within one to two days develops into a blister. This blister then turns into a painless ulcer with a characteristic black necrotic (dying) area in the center. Lymph glands in the adjacent area may swell, too.About 20 percent of untreated cases of cutaneous anthrax will result in death. Deaths from this anthrax type are rare when appropriate treatment is received. Inhalation Anthrax, Inhalation anthrax is caused by breathing in the anthrax bacteria or spores. Most of the time, this occurs by breathing in spores from infected animal products. It can also occur if anthrax was used as a biological weapon. Initial anthrax symptoms may resemble a common cold. After several days, the symptoms may worsen, to severe breathing problems and shock. This type of anthrax is usually fatal, Gastrointestinal anthrax occurs with the consumption of contaminated meat. This anthrax type is characterized by an acute inflammation of the intestinal tract. Symptoms can include: Nausea, Loss of appetite, Bloody diarrhea, Fever, Severe stomach pain, Vomiting blood. Gastrointestinal anthrax results in death in 25 to 60 percent of cases.What Causes Anthrax?The cause ofanthraxis the bacterium known asBacillus anthracis. Bacillus anthracis is a bacterium that lives in soil. The anthrax bacterium is different from many other bacteria because it can form spores, a survival tactic that has allowed it to survive for extended periods under the harshest of conditions. A Bacillus anthracis spore is very hardy; it is able to withstand extreme heat, cold, and drought without nutrients or air. When environmental conditions are favorable, the spores will germinate into thriving colonies of bacteria. For example, a grazing animal may ingest spores that begin to grow, spread, and eventually kill the animal. The bacteria will form spores in the carcass and then return to the soil to infect other animals in the future. Bacillus anthracis is an aerobic bacterium, meaning that it needs oxygen to survive and grow.TYPES OF ANTHRAX AND THEIR CAUSESAs mentioned above, regardless of the type, the cause of anthrax is Bacillus anthracis. However, how the anthrax bacteria enter the body will determine the type of anthrax. Cutaneous anthrax infections occur when the anthrax bacteria enter a cut or abrasion on the skin. This may occur when a person handles contaminated wool, hides, leather, or hair products (especially goat hair) of infected animals. Inhalation anthrax is caused by breathing in the anthrax bacteria or spores. Gastrointestinal anthrax is caused by eating meat contaminated with anthrax bacteria or their spores.SIGNS AND SYMPTOMS OF ANTHRAX: AN OVERVIEWSymptoms of anthrax will vary depending on the type of anthrax. For all three types, symptoms can appear within 7 days of coming in contact with the anthrax bacteria (Bacillus anthracis). For inhalation anthrax (also known as pulmonary anthrax), symptoms can appear within a week or can take up to 42 days to appear.CUTANEOUS ANTHRAXThe first symptom of cutaneous anthrax is a small raised sore that resembles an insect bite, but within days develops into a blister. The blister then develops into a skin ulcer with a black area in the center. The sore, blister, and ulcer do not hurt. Swollen lymph nodes may also occur. About 20 percent of untreated cases of cutaneous anthrax will result in death. Deaths are rare when appropriate anthrax treatment is administered.GASTROINTESTINAL ANTHRAXSymptoms of gastrointestinal anthrax can include: Nausea, Loss of appetite, Bloody diarrhea, Fever, Bad stomach pain, Vomiting blood. Gastrointestinal anthrax results in death in 25 to 60 percent of cases.INHALATION ANTHRAXThe first inhalation anthrax symptoms are similar to cold or flu symptoms and can include: A sore throat, Mild fever, Chills, Night sweats, Muscle aches. Later symptoms include: Cough, Chest discomfort, Tiredness, Shortness of breath, Muscle aches, Severe breathing problems, Death.Diagnosing Anthrax With TestsCertain tests that the doctor may order to help make a diagnosis of anthrax include: Specimen tests, such as blood tests Chest x-ray.Specimen TestsIn order to make a diagnosis, the doctor will take a sample of fluid, and look at it under a microscope for evidence of the anthrax bacteria(Bacillus anthracis).The fluid examined will depend on the type of anthrax the doctor suspects:Cutaneous anthrax-- fluid from the skin blister and blood Inhalation anthrax(also known as pulmonary anthrax) -- blood and cerebrospinal fluid Gastrointestinal anthrax-- blood.Other blood tests will be ordered to confirm that your body is fighting an infection.Chest X-rayA chest x-ray can be used to help diagnose inhalation anthrax in people who are experiencinganthrax symptoms. It is not useful as a test for determining anthrax exposure, or for people with no symptoms.Treating Anthrax With AntibioticsAntibiotics used to treat anthrax in both adults and children include: Ciprofloxacin Doxycycline Penicillin.A doctor may prescribe these medications individually or in combination.There are different types of the anthrax bacteria, known as strains. Some strains may be naturally resistant to certain antibiotics and not others. In addition, there may be biologically altered strains that are engineered to be resistant to various antibiotics. A laboratory analysis can help define which strain of anthrax is present and which antibiotic would be the most effective for anthrax treatment.Also, as with all medicines, side effects can occur with these antibiotics. Some of these side effects are more common in children. Risks of using doxycycline or ciprofloxacin in children must be weighed carefully against the risks anthrax presents.Supportive CareSupportive care foranthraxinvolves treating symptoms and complications that develop. The specific supportive treatment will depend on a number of factors, but can include: Admission to the hospital Intravenous (IV) fluids Oxygen Breathing support from a ventilator Prevention of secondary infections Good nursing care.Providing Anthrax Treatment Before Symptoms BeginIn the event that people are exposed to potentially aerosolized anthrax spores, preventative treatment for anthrax involves 60 days of oral antibiotics, along with a three-dose regimen (0 weeks, 2 weeks, and 4 weeks) of theanthrax vaccine. This combination may help to prevent the development ofinhalation anthrax.Sixty days of antibiotics are recommended because it takes anthrax spores an average of seven days to grow into the harmful form of the bacteria, but it can take longer.