Who Is At Risk of Anthrax
Most people will never be exposed to anthrax. However, there are activities that can put some people at greater risk of exposure than others.
Anthrax is not contagious, which means you can’t catch it from another person like the cold or flu.
Laboratory professionals
Laboratory workers who handle anthrax may be at risk for being exposed if proper safety precautions aren’t followed.
People who handle animal products
Although rare, people can get anthrax after having contact with infected animals or their products, such as wool, hides, or hair. For this reason, people in certain occupations, like veterinarians, farmers, livestock producers, and others who handle animals and animal products may have an increased risk of exposure.
Mail handlers, military personnel, and response workers
Certain workers could be exposed to anthrax in the event of a bioterrorist attack, either during the attack or when responding to the emergency. Workers who could be at risk include mail handlers (if spores are sent through the mail), law enforcement personnel, healthcare workers, decontamination workers, and critical infrastructure workers who could be exposed to airborne (aerosolized) spores, depending on how the spores were spread.
Travelers
Anthrax can be found naturally in soil and commonly affects domestic and wild animals around the world, but it is most common in agricultural regions of Central and South America, Sub-Saharan Africa, Central and southwestern Asia, Southern and eastern Europe, and the Caribbean. Travelers should be mindful of what they eat and handle, as well as the souvenirs they bring home. Avoid eating raw or undercooked meat, and avoid contact with livestock, animal products and animal carcasses. Vaccination against anthrax is not recommended for travelers and is not available for civilian travelers.
Symptoms of Anthrax
The symptoms of anthrax depend on the type of infection and can take anywhere from 1 day to more than 2 months to appear. All types of anthrax have the potential, if untreated, to spread throughout the body and cause severe illness and even death.
Cutaneous anthrax symptoms can include:
- A group of small blisters or bumps that may itch
- Swelling can occur around the sore
- A painless skin sore (ulcer) with a black center that appears after the small blisters or bumps
- Most often the sore will be on the face, neck, arms, or hand
Inhalation anthrax symptoms can include:
- Fever and chills
- Chest Discomfort
- Shortness of breath
- Confusion or dizziness
- Cough
- Nausea, vomiting, or stomach pains
- Headache
- Sweats (often drenching)
- Extreme tiredness
- Body aches
Gastrointestinal anthrax symptoms can include:
- Fever and chills
- Swelling of neck or neck glands
- Sore throat
- Painful swallowing
- Hoarseness
- Nausea and vomiting, especially bloody vomiting
- Diarrhea or bloody diarrhea
- Headache
- Flushing (red face) and red eyes
- Stomach pain
- Fainting
- Swelling of abdomen (stomach)
Injection anthrax symptoms can include:
- Fever and chills
- A group of small blisters or bumps that may itch, appearing where the drug was injected
- A painless skin sore with a black center that appears after the blisters or bumps
- Swelling around the sore
- Abscesses deep under the skin or in the muscle where the drug was injected
Injection anthrax symptoms are similar to those of cutaneous anthrax, but injection anthrax can spread throughout the body faster and be harder to recognize and treat than cutaneous anthrax. Skin and injection site infections associated with injection drug use are common and do not necessarily mean the person has anthrax.
What to Do if You Think You Have Been Exposed to Anthrax
If you think you may have been exposed to anthrax, you need to go to a doctor right away and explain why you think you may have been exposed. Doctors can prescribe antibiotics to prevent you from getting sick. There is no test a doctor can give you that determines if you have been exposed to anthrax. The only way exposures can be determined is through a public health investigation.
If you already have symptoms of anthrax, it’s important to get medical care as quickly as possible to have the best chances for a full recovery.
How to Prevent Anthrax
Antibiotics to Prevent Anthrax After Exposure
Antibiotics can prevent anthrax from developing in people who have been exposed but have not developed symptoms. Antibiotics work in two main ways, by killing the anthrax or by stopping the anthrax from growing. When the anthrax can’t grow anymore, it dies. Two of the antibiotics that could be used to prevent anthrax are:
- Ciprofloxacin
- Doxycycline
Each of these antibiotics offers the same protection against anthrax. Anthrax spores typically take 1 to 7 days to be activated, but some spores can remain inside the body and take up to 60 days or more before they are activated. Activated spores release toxins—or poisons—that attack the body, causing the person to become sick. That’s why people who have been exposed to anthrax must take antibiotics for 60 days. This will protect them from any anthrax spores in their body when the spores are activated.
Vaccine to Prevent Anthrax
Anthrax Vaccine Adsorbed (AVA) protects against anthrax. It does not contain any anthrax bacteria and cannot give people anthrax. It is not typically available to the general public. The vaccine is approved by the Food and Drug Administration (FDA) for two different situations: routine occupational use (before possible exposure) and post-event emergency use (after possible exposure).
Routine occupational use (before possible exposure)
Anthrax vaccine is approved for use in three groups of adults 18 to 65 years of age who may be at risk of coming in contact with anthrax because of their job.
These at-risk adults will receive the vaccine before exposure:
- Certain laboratory workers who work with anthrax
- Some people who handle animals or animal products, such as some veterinarians
- Some members of the United States military
To build up protection against anthrax, these groups should get 5 shots of anthrax vaccine over 18 months. To stay protected, they should get annual boosters. The shots are injected into a muscle (intramuscular).
People who should NOT get the anthrax vaccine for routine occupational use include:
- Pregnant women.
- Anyone who has had a serious allergic reaction to a previous dose of anthrax vaccine.
- Anyone who has a severe allergy to any component of the anthrax vaccine.
- Anyone with severe allergies, including allergy to latex, should tell their doctor.
Anyone with a moderate or severe illness might be asked by their doctor to wait until they recover to get the vaccine. People with mild illness can usually be vaccinated.