ANTHRAX SUMMARY
Signs and Symptoms: Incubation period is generally 1-6 days, although longer
periods have been noted. Fever, malaise, fatigue, cough and mild chest
discomfort progresses to severe respiratory distress with dyspnea, diaphoresis,
stridor, cyanosis, and shock. Death typically occurs within 24-36 hours after
onset of severe symptoms.
Diagnosis: Physical findings are non-specific. A widened mediastinum may be
seen on CXR in later stages of illness. The organism is detectable by Gram stain
of the blood and by blood culture late in the course of illness.
Treatment: Although effectiveness may be limited after symptoms are present,
high dose antibiotic treatment with penicillin, ciprofloxacin, or doxycycline should
be undertaken. Supportive therapy may be necessary.
Prophylaxis: Oral ciprofloxacin or doxycycline for known or imminent exposure.
An FDA-licensed vaccine is available. Vaccine schedule is 0.5 ml SC at 0, 2, 4
weeks, then 6, 12, and 18 months (primary series), followed by annual boosters.
Isolation and Decontamination: Standard precautions for healthcare workers.
After an invasive procedure or autopsy is performed, the instruments and area
used should be thoroughly disinfected with a sporicidal agent (hypochlorite).
[
US Army Medical Research Institute of Infectious Disease; USAMRIID's MEDICAL MANAGEMENT OF BIOLOGICAL CASUALTIES HANDBOOK Fourth Edition February 2001 ]