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Anthrax: A Student-Doctor Sheds Light

Q: What are the different types of anthrax?
A: Although Anthrax naturally, usually occurs in hoofed mammals such as cows and sheep, when they ingest spores, three types of human infections exist after coming into contact with spores: cutaneous (skin via touch), inhalational (lungs via breathing), and ingestional (digestive tract via ingesting). The classic human cases of the disease involve animal skin workers that contract the skin form.

Q: How does anthrax affect you?
A: Cutaneous: The spores enter the skin via cuts or abrasions. In the skin the bacteria manufacture a toxin that damages the skin around the infection site. Unless the infection is treated with antibiotics, patients then develop sepsis, an infection of the blood, internal bleeding, shock, and possibly, death. People not developing a systemic infection recover well. Unless appropriately treated with antibiotics, the mortality rate for cutaneous anthrax is about 20¡

Inhalational: The spores enter the lungs by being breathed in. The fact that anthrax spores tend to clump together may be protective because the spores might not be able to get deep within a victim’s lungs.

This “clumping” is one of the difficulties in manufacturing anthrax as a biological weapon. After being inhaled, anthrax infection is a two stage illness. The first stage resembles a bad flu, including symptoms such as fever, aches, chills, weakness, cough, and vomiting, and lasts from 2 to 40 days. The second stage develops suddenly, and patients develop severe fever, difficulty breathing, and shock. Unless treated, this leads to sepsis, internal bleeding, shock, and potentially death, sometimes as soon as within a few hours after the start of the second stage. Unless appropriately treated with antibiotics, the mortality rate for inhalational anthrax is about 90¡

Ingestional: After being swallowed the bacteria causes an ulcer followed by a mix of gastrointestinal symptoms such as abdominal pain, nausea, vomiting, and bloody stools. Subsequently, the bacteria cause sepsis leading to internal bleeding, shock, and possibly, death. Due to difficulties diagnosing the ingested form of Anthrax, this form of the disease is less likely to be diagnosed and treated early, and is therefore often deadly.

As of 1999, there had never been a reported case of human-to-human transmission of anthrax.

Q: How can anthrax be counteracted?
A: In its early stages, anthrax can usually be treated with commonly available antibiotics. It may be prevented with the vaccine.

Q: What about the anthrax vaccine? Why does everyone in the military complain about it so much?
A: A vaccine exists, but it’s expensive and difficult to manufacture. It is protective at first, although the efficacy decreases with time.

Q: If anthrax isn’t so communicable, why is it a viable biological warfare weapon? Shouldn’t they be using the Bubonic Plague or Ebola? Is anthrax much easier to find or produce?
A: Anthrax is a good weapon because humans have so much experience with it–research on using anthrax as a biological weapon began over 80 years ago, and over 17 countries are believed to have it in their offensive biological weapons programs. It’s also quite potent–according to a 1999 Biodefense Consensus Report, 100 kg of anthrax spores released over an urban area could cause more deaths than a hydrogen bomb.

Some other weapons include Smallpox and Bubonic plague (Yersinia Pestis). These weapons could potentially be far worse than anthrax because of their high mortality rates, difficulty in diagnosis and treatment, and, most importantly, the fact that they are contagious.
I do not know of Filoviruses such as Ebola that are being used as biological weapons.

October 22, 2001
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