Anthrax is an infection caused by the bacterium Bacillus anthracis. It can occur in four forms: skin, lungs, intestinal, and injection. Symptom onset occurs between one day and more than two months after the infection is contracted. The skin form presents with a small blister with surrounding swelling that often turns into a painless ulcer with a black center. The inhalation form presents with fever, chest pain and shortness of breath. The intestinal form presents with diarrhea (which may contain blood), abdominal pains, nausea and vomiting. The injection form presents with fever and an abscess at the site of drug injection.According to the Centers for Disease Control the first clinical descriptions of cutaneous anthrax were given by Maret in 1752 and Fournier in 1769. Before that anthrax had been described only through historical accounts. The Prussian scientist Robert Koch (1843–1910) was the first to identify Bacillus anthracis as the bacterium that causes anthrax. Anthrax is spread by contact with the bacteriums spores, which often appear in infectious animal products. Contact is by breathing or eating or through an area of broken skin. It does not typically spread directly between people. Risk factors include people who work with animals or animal products, travelers, and military personnel. Diagnosis can be confirmed by finding antibodies or the toxin in the blood or by culture of a sample from the infected site.Anthrax vaccination is recommended for people at high risk of infection. Immunizing animals against anthrax is recommended in areas where previous infections have occurred.
Without treatment, about 20% of cutaneous skin infection cases progress to toxemia and death.Before 2001, fatality rates for inhalation anthrax were 90%; since then, they have fallen to 45%. People that progress to the fulminant phase of inhalational anthrax nearly always die, with one case study showing a death rate of 97%. Anthrax meningoencephalitis is also nearly always fatal.GI infections can be treated, but usually result in fatality rates of 25% to 60%, depending upon how soon treatment commences. This form of anthrax is the rarest. Epidemiology
Globally, at least 2,000 cases occur a year. United States
The last fatal case of natural inhalational anthrax in the United States occurred in California in 1976, when a home weaver died after working with infected wool imported from Pakistan. To minimize the chance of spreading the disease, the body was transported to UCLA in a sealed plastic body bag within a sealed metal container for autopsy.Gastrointestinal anthrax is exceedingly rare in the United States, with only two cases on record. The first case was reported in 1942, according to the Centers for Disease Control and Prevention. During December 2009, the New Hampshire Department of Health and Human Services confirmed a case of gastrointestinal anthrax in an adult female. In 2007 two cases of cutaneous anthrax were reported in Danbury, Connecticut. The case involved the maker of traditional African-style drums who was working with a goat hide purchased from a dealer in New York City which had been previously cleared by Customs.