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Anthrax is an infection caused by the bacterium Bacillus anthracis.[1] It can occur in four forms: skin, lungs, intestinal, and injection.[2] Although a rare disease, human anthrax, when it occurs, is most common in Africa and central and southern Asia.[3]

Signs and symptoms 1

Anthrax of the skin presents as a boil that eventually forms an ulcer with a black center. The black center often shows up as a large, painless, necrotic ulcer, beginning as an irritating and itchy skin lesion at the site of infection.[4]

Signs and symptoms 2

Inhalation anthrax usually develops within the first few days of exposure, most people have fever, chills, and fatigue. These symptoms may be accompanied by cough, shortness of breath, chest pain, and nausea or vomiting, making inhalation anthrax difficult to distinguish from influenza or community-acquired pneumonia.[5]

Signs and symptoms 3

Gastrointestinal infection is most often caused by eating infected meat and is characterized by diarrhea, potentially with blood, abdominal pains, and loss of appetite.[6]


Bacillus anthracis is a Gram-positive and rod-shaped bacterium. It is the only permanent pathogen within the genus Bacillus.[7]


Anthrax can be contracted by handling infected animals, their wool, or their hides.[8] Anthrax can enter the body through the intestines (ingestion), lungs (inhalation), or skin (cutaneous). However, anthrax does not usually spread between people.[9]


The lethality is due to the bacteriums two principal virulence factors: the poly-D-glutamic acid capsule, which protects the bacterium from phagocytosis by host neutrophils, and the tripartite protein toxin, called anthrax toxin. Anthrax toxin is a mixture of three protein components: protective antigen (PA), edema factor (EF), and lethal factor (LF).[10]


Various techniques may be used for the direct identification of B. anthracis in clinical material. Firstly, specimens may be Gram stained. Bacillus spp. are quite large in size, 3 to 4 micrometers long, they may grow in long chains, and they stain Gram-positive. To confirm the organism is B. anthracis, rapid diagnostic techniques such as polymerase chain reaction-based assays and immunofluorescence microscopy may be used.[11]

Prevention 1

Vaccines against anthrax for use in livestock and humans are available. The French scientist Louis Pasteur developed the first effective vaccine.[12]

Prevention 2

Preventive antibiotics are recommended in those who have been exposed, ciprofloxacin is recommended if someone who has breathed in anthrax.[13]


Treatment includes large doses of antibiotics, such as fluoroquinolones, doxycycline, erythromycin, or vancomycin.[14] In 2012, the FDA approved raxibacumab for inhalational anthrax. Raxibacumab is a monoclonal antibody that neutralizes toxins produced by B. anthracis.[15]


  1. "Basic Information What is anthrax?". CDC. 1 September 2015. Archived from the original on 17 May 2016. Retrieved 14 May 2016.
  2. "Types of Anthrax". CDC. 21 July 2014. Archived from the original on 11 May 2016. Retrieved 14 May 2016.
  3. Turnbull, Peter (2008). Anthrax in humans and animals (PDF) (4 ed.). Geneva, Switzerland: World Health Organization. pp. 20, 36. ISBN 9789241547536. Archived (PDF) from the original on 30 November 2016.
  4. "Anthrax Q & A: Signs and Symptoms". Emergency Preparedness and Response. Centers for Disease Control and Prevention. 2003. Archived from the original on 5 April 2007. Retrieved 19 April 2007.
  5. "Anthrax - Chapter 4 - 2020 Yellow Book | Travelers' Health | CDC". Retrieved 15 June 2022.
  6. "Gastrointestinal Anthrax". Centers for Disease Control and Prevention. 23 August 2013. Archived from the original on 11 February 2015. Retrieved 10 February 2015.
  7. Spencer, R C (1 March 2003). "Bacillus anthracis". Journal of Clinical Pathology. 56 (3): 182–187. doi:10.1136/jcp.56.3.182. PMC 1769905. PMID 12610093.
  8. "How People Are Infected". Centers for Disease Control. 1 September 2015. Archived from the original on 26 December 2016. Retrieved 26 December 2016.
  9. "Anthrax". Centers for Disease Control. 26 August 2009. Archived from the original on 26 December 2016. Retrieved 26 December 2016.
  10. Mu Gao (27 April 2006). "Molecular Basis for Anthrax Intoxication". University of Illinois at Urbana-Champaign. Archived from the original on 26 December 2016. Retrieved 26 December 2016.
  11. Levinson, W. (2010). Review of Medical Microbiology and Immunology (11th ed.).
  12. David V. Cohn (11 February 1996). "Life and Times of Louis Pasteur". School of Dentistry, University of Louisville. Archived from the original on 8 April 2008. Retrieved 13 August 2008.
  13. "Anthrax Emergency: How to Take Ciprofloxacin to Prevent Anthrax | CDC". 18 November 2020. Retrieved 21 June 2022.
  14. "CDC Anthrax Q & A: Treatment". Archived from the original on 5 May 2011. Retrieved 4 April 2011.
  15. "FDA approves raxibacumab to treat inhalational anthrax". Food and Drug Administration. Archived from the original on 17 December 2012. Retrieved 14 December 2012.