Anthrax after September 11th 2001- What to look for and how to treat it

Abstract

Anthrax is a serious bacterial infection with a particularly high mortality in its gastrointestinal, pulmonary, and meningitic forms with a worldwide distribution, although it is most common in the developing world. Gastrointestinal and pulmonary anthrax results in death within hours or a few days of the onset of serious symptoms and the diagnosis is usually made post-mortem. Treatment of wild type anthrax is usually with penicillin in high dose. The production of anthrax for large scale bioterrorism is difficult and requires sophisticated facilities. There is a greater risk that anthrax used as a bioterrorist weapon will be antibiotic resistant and ciprofloxacin is a more appropriate antibiotic choice until the antibiotic sensitivity of the anthrax strain being deployed becomes known. Post exposure prophylaxis should be continued for two months due to the long delay that sometimes occurs before spores germinate once within the human host. A live vaccine is available but requires a large number of injections and its use is largely limited to military personnel.