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Disease Name: Anthrax


Quick Links

Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Variety of topics and situations pertaining to Anthrax and Anthrax emergencies- http://www.cdc.gov/anthrax/


Overview / Case Definition

Bacillus anthracis is an aerobic, gram-positive, encapsulated, spore-forming, nonhemolytic, nonmotile rod. B anthracis has 3 major virulence factors: an antiphagocytic capsule and 2 exotoxins, called lethal and edema toxins. The toxins are responsible for the substantial morbidity and clinical manifestation of hemorrhage, edema, and necrosis.

Cutaneous Anthrax

 An acute illness, or post-mortem examination revealing a painless skin lesion developing over 2 to 6 days from a papular through a vesicular stage into a depressed black eschar with surrounding edema. Fever, malaise and lymphadenopathy may accompany the lesion.

Inhalation Anthrax

An acute illness or post-mortem examination revealing a prodrome resembling a viral respiratory illness, followed by hypoxia, dyspnea or acute respiratory distress with resulting cyanosis and shock. Radiological evidence of mediastinal widening or pleural effusion is common.

Gastrointestinal Anthrax

An acute illness, or post-mortem examination revealing severe abdominal pain and tenderness, nausea, vomiting, hematemesis, bloody diarrhea, anorexia, fever, abdominal swelling, and septicemia.

Oropharyngeal Anthrax

An acute illness or post-mortem examination revealing a painless mucosal lesion in the oral cavity or oropharynx, with cervical adenopathy, edema, pharyngitis, fever, and possibly septicemia.

Meningeal Anthrax

An acute illness, or post-mortem examination revealing fever, convulsions, coma or meningeal signs. Signs of another form will likely be evident as this syndrome is usually secondary to the above syndromes.


Restrictions

None


Reporting

Immediately, at time of identification.

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable:

Reporting Timeframe: Immediately, at time of identification



Diagnosis / Testing

Identification of B. anthracis from clinical specimens by the Laboratory Response Network (LRN) is done through the following:

Information on collection of specimens:
http://www.cdc.gov/anthrax/specificgroups/lab-professionals/recommended-specimen.html

Initial testing is provided through the Idaho State Bureau of Laboratories. 

Specific labeling and shipping protocols must be followed:
http://healthandwelfare.idaho.gov/Health/Labs/SentinelLabs/tabid/2153/Default.aspx


Treatment

tel:+18006328000 CDC recommendation for prevention and treatment of Anthrax in Adults:
http://wwwnc.cdc.gov/eid/article/20/2/13-0687-techapp1.pdf

Prescribing information for Anthrax Immune Globulin, used in the treatment of inhalational anthrax in adult and pediatric patients:
http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM439812.pdf

Pediatric Anthrax clinical management:
http://pediatrics.aappublications.org/content/pediatrics/early/2014/04/22/peds.2014-0564.full.pdf

Treatment of Anthrax in pregnant and postpartum women:
http://wwwnc.cdc.gov/eid/article/20/2/13-0611-techapp1.pdf

Anthrax antitoxin

If antitoxin is required, contact the Idaho state epidemiologist at (208) 334-5939 during normal business hours, or request they be paged from (800) 632-8000.

If contamination with B. anthracis spores is identified, the following article provides information on decontamination:
http://wwwnc.cdc.gov/eid/article/9/6/02-0377_article

Military recruits may receive anthrax vaccine.  More information on this practice can be accessed at: http://www.vaccines.mil/Anthrax


Additional Information

Variety of topics and situations pertaining to Anthrax and Anthrax emergencies- http://www.cdc.gov/anthrax/


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