1.  What is anthrax?Anthrax is a serious infectious disease caused by a bacteria called Bacillus anthracis. It is a disease most commonly seen in animals, especially hoofed animals such as cows, sheep, goats and horses. Humans occasionally become infected with anthrax when they eat meat or handle the wool, hair or bones of an animal infected with anthrax. There are 2,000-5,000 cases of anthrax worldwide, and about 5 cases a year in the United States. Experts believe that anthrax is among the diseases which could be used as a biological weapon.
  2. Is anthrax fatal?
    Early treatment of cutaneous anthrax is usually curative, and early treatment of all forms is important for recovery. Patients with cutaneous anthrax have reported case fatality rates of 20% without antibiotic treatment and less than 1% with it. Although case-fatality estimates for inhalational anthrax are based on incomplete information, the rate is extremely high, approximately 75%, even with all possible supportive care including appropriate antibiotics. Estimates of the impact of the delay in post-exposure prophylaxis or treatment on survival are not known. For gastrointestinal anthrax, the case-fatality rate is estimated to be 25%-60% and the effect of early antibiotic treatment on that case-fatality rate is not defined.
  3. How do I protect myself and others from exposure to anthrax?
    Take off the clothes you were wearing when you were exposed and place them in a sealed plastic bag. These clothes can either be thrown away, or they can be washed in hot water and soap. People who handle the contaminated clothes before laundering should be sure to wear gloves and protective clothing. Avoid shaking the clothes when placing them in the plastic bag or in the washing machine. Take a shower and clean your skin and hair thoroughly with warm water and soap to remove anthrax bacteria.

    Once you take these steps, you will pose no risk to others. If you subsequently develop a sore on your skin, cover the sore with clothing or a bandage and see your health care provider immediately. If you are recommended for preventive treatment, please be sure to follow the treatment advice exactly.
  4. How is exposure to anthrax treated?
    The preventive treatment for anthrax consists of antibiotic treatment for 30-60 days.
  5. What are the signs and symptoms of exposure to Anthrax?
    The symptoms (warning signs) of anthrax are different depending on the type of the disease. View the following page for more information: Anthrax Exposure Signs
  6. How do I determine if I was exposed to anthrax?
    The illness a person gets when they are infected with Bacillus anthracis depends on how the bacteria got into the person's body. For more information, visit the following page: Anthrax Illness
  7. What do I do if I suspect I was exposed to anthrax?
    Law enforcement and Public Health authorities determine if an anthrax threat or suspicious substance represents a credible threat and is potentially dangerous. If so, the letter or parcel involved can tested for anthrax. Treatment of persons exposed in such circumstances is usually postponed until laboratory results are available. There is no laboratory test to test for anthrax before symptoms begin. Nasal swabs are sometimes obtained during investigations of confirmed or likely anthrax exposures, but are not useful or available outside of these circumstances. Persons with a documented or likely anthrax exposure always receive preventive antibiotics.

    If you develop any of the illness symptoms, get medical attention immediately and notify Public Health. Bring this sheet or mention you have been exposed to anthrax when you seek medical care. Report all cases to Public Health by calling 206-296- 4774.
  8. Is anthrax contagious? Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is no need to immunize or treat contacts of persons ill with anthrax, such as household contacts, friends, or coworkers, unless they also were also exposed to the same source of infection.
  9. Is there a vaccine or antidote for exposure to anthrax?
    Anthrax vaccination is not available for the general public. The US has limited supplies of anthrax vaccine that is currently being used by the military. When treatment is necessary, antibiotics taken for 30-60 days can be used to treat or prevent anthrax.

    A protective vaccine has been developed for anthrax; however, it is primarily given to military personnel. Vaccination is recommended only for those at high risk, such as workers in research laboratories that handle anthrax bacteria routinely. The antibiotics used in post-exposure prophylaxis are very effective in preventing anthrax disease from occurring after an exposure.

    A vaccine has been developed for anthrax that is protective against invasive disease, but it is currently only recommended for high-risk populations. CDC and academic partners are continuing to support the development of the next generation of anthrax vaccines. For more information, visit the following page: Anthrax Vaccination
  10. How does exposure to anthrax occur?
    Humans can become infected with anthrax by handling products from infected animals or by breathing in anthrax spores from infected animal products (like wool, for example). People also can become infected with gastrointestinal anthrax by eating undercooked meat from infected animals.

    Anthrax also can be used as a weapon. This happened in the United States in 2001. Anthrax was deliberately spread through the postal system by sending letters with powder containing anthrax. This caused 22 cases of anthrax infection.
  11. Where is anthrax found?
    Anthrax can be found globally. It is more common in developing countries or countries without veterinary public health programs. Certain regions of the world (South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East) report more anthrax in animals than others.

    Anthrax is most common in agricultural regions where it occurs in animals. These include South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products. Workers who are exposed to dead animals and animal products from other countries where anthrax is more common may become infected with B. anthracis (industrial anthrax). Anthrax in wild livestock has occurred in the United States.

    In the United States, incidence of naturally-acquired anthrax is extremely rare (about 1-2 cases of cutaneous disease per year). Gastrointestinal anthrax is rare, but may occur as explosive outbreaks associated with ingestion of infected animals. Worldwide, the incidence is unknown, though B. anthracis is present in most of the world. Unreliable reporting makes it difficult to estimate the true incidence of human anthrax worldwide. However, in fall 2001, 22 cases of anthrax (11 inhalation, 11 cutaneous) were identified in the United States following intentional contamination of the mail. In the United States, the annual occurrences of naturally-occurring human anthrax declined from estimated 130 cases annually in the early 1900s to 2 cases each in 2000, 2001, and 2002.
  12. What is the likelihood that anthrax could be used?
    Anthrax has been used in the past and may be used again.
  13. What other risks are there for exposure to anthrax?
    Mild local reactions to the vaccine occur in 30% of recipients and consist of slight tenderness and redness at the injection site. Severe local reactions are infrequent and consist of extensive swelling of the forearm in addition to the local reaction. Systemic reactions occur in fewer than 0.2% of recipients.
  14. Are there any historical uses or accidents involving anthrax?
    Most 2001 cases can be traced to contaminated letters handled by postal workers or media employees.
  15. How can people get more information about anthrax?
    People can contact the agencies listed on this page: More Information About Anthrax