When to seek medical advice
How would you know if you've been exposed to anthrax?
For anthrax spores to be used as a biological weapon, they must be processed into a fine, white, powder-like form that disperses in the air. Powder that contains anthrax spores can be mailed in a letter and dispersed when the letter is opened. However, a lot of innocuous substances in our environment come in powder form, from sugar to plaster dust.
If you believe that you're at risk of anthrax exposure for example, you work in an environment where anthrax has been detected immediately notify authorities for testing and see a doctor for evaluation and care. If you develop signs and symptoms of the disorder after exposure to animals or animal products in parts of the world where anthrax exists, seek prompt medical attention.
Screening and diagnosis
The damage of a large-scale anthrax attack if it were to happen wouldn't be immediately and readily apparent. It would take one or many people seeking treatment for symptoms of anthrax to raise suspicion of an attack.
If authorities suspect exposure to anthrax, field tests can help determine whether a substance contains anthrax spores or whether an area such as a mailroom, desk or ventilation system may be contaminated.
In addition, various tests can help doctors determine if a person has the disease.
Wearing protective suits, the team collects samples of the substance and samples from surfaces that may have been contaminated. The samples are then checked for signs of Bacillus anthracis bacteria.
Testing for anthrax occurs in stages. Initial screening tests may be performed in community hospital laboratories. But these tests aren't definitive. A confirmation test must be performed in one of the more specialized state and large metropolitan public health laboratories in the LRN. This involves incubating a sample in a lab dish containing special nutrients that spur any bacteria growth. If anthrax is found, scientists then use a DNA fingerprinting technique to identify the specific strain of anthrax, which gives clues to the geographic origin of an anthrax attack. The entire process can take many days.
A variety of rapid field tests could speed up the confirmation process, including one developed by researchers at Mayo Clinic, Rochester, Minn., and Roche Diagnostics of Indianapolis. This rapid test uses polymerase chain reaction (PCR) technology to detect the DNA of anthrax bacteria in samples collected from people or potentially contaminated areas in less than an hour. However, these tests have yet to receive approval from the Centers for Disease Control and Prevention (CDC) or the Food and Drug Administration (FDA), so they must be used in conjunction with certified confirmatory tests.
If anthrax is found in the environment, then the contaminated areas such as a mailroom, desk or ventilation system are sterilized with special washes.
Should you have your home or office checked for anthrax? Probably not. Hand-held home test kits for anthrax can't provide definitive results. Some U.S. companies have hired private firms to test their buildings for anthrax. But, overall, scientists say that random checking of homes and offices is neither necessary nor practical.
Your doctor will want to rule out other, much more common conditions that may be causing your symptoms, such as flu (influenza) or pneumonia. He or she may use a rapid flu test to quickly diagnose a case of influenza.
Tests to detect and diagnose anthrax include:
Because there's no definitive test for exposure to anthrax in the absence of signs and symptoms, doctors may prescribe antibiotics for anyone who may have been exposed to a contaminated area to prevent the disease.
If a case of anthrax is suspected or confirmed, doctors have been advised to contact local and state health officials immediately. This helps alert government and health leaders and the public of a possible outbreak.
To help local governments prepare for an anthrax attack, the U.S. Department of Health and Human Services has provided states, cities and territories with some funding. These funds are helping to assemble emergency response teams and to build better systems for detecting an anthrax attack.
Treatment for all three forms of anthrax centers on oral or intravenous (IV) antibiotics. Treatment is most effective when started as early as possible.
Some strains of anthrax may be more responsive to one type of antibiotic than to another. Ciprofloxacin (Cipro), doxycycline and amoxicillin are FDA approved for treatment of anthrax. However, your doctor may prescribe other antibiotics or a combination of antibiotics, including:
Antibiotics work by killing the anthrax bacteria. However, antibiotics may fail in inhalation anthrax once symptoms become severe because, by that time, the bacteria already have released large amounts of toxin that aren't affected by antibiotics. Scientists are working to develop an anthrax antitoxin that unlike antibiotics could neutralize the toxin produced by anthrax bacteria.
If you've been exposed to anthrax, your doctor will likely prescribe a 60-day course of antibiotics. If you have inhalation anthrax, you'll likely be hospitalized and treated with high-dose antibiotics.
Anthrax isn't spread person to person. So a person with anthrax doesn't have to be quarantined or isolated. If you were in contact with someone with anthrax, you'll need to be treated only if you were exposed to a source of anthrax infection.