The naturally occurring bacterium that causes anthrax has plagued animals and humans for thousands of years. Recent threats, however, involve the element of bioterrorism - the use, or threatened use, of biological agents, such as anthrax, to promote or spread fear or intimidation among a population.

Anxiety about the use of anthrax as a biological weapon spread throughout the country, when it was confirmed that a Florida photo editor had contracted the disease. He became the first American in 25 years to die from inhalation anthrax. Since then, incidences of potential anthrax exposure have widened to several places across the country, and people have asked how they can protect themselves.

To help allay the community's fears, the Atlantic County Division of Public Health has compiled information from a variety of sources to answer commonly asked questions.

What is anthrax?
Anthrax is an acute, infectious disease caused by the spore-forming bacterium Bacillus anthracis. The cutaneous form (contracted through the skin) is the most common and is less deadly than the inhalation, or pulmonary, form (contracted through inhaling the spores).

How do I get it?
Traditionally, it is transmitted by humans handling products from infected animals or contaminated materials, by inhaling anthrax spores, or by spores entering cuts or other breaks in the skin.

Is anthrax contagious?
There is no evidence of direct person-to-person spread of anthrax.

What are the symptoms of anthrax infection?
Symptoms of the disease vary depending on how the disease was contracted.

Cutaneous: Most (about 95%) anthrax infections occur when the bacterium enters a cut or abrasion on the skin, or when handling contaminated wool, hides, leather or hair products of infected animals. Skin infections begin as a raised itchy bump that resembles an insect bite but within 1 to 2 days develops into a blister and then a painless ulcer with a black, necrotic (dying) area, or eschar (scab), in the center. Lymph glands in nearby areas may swell.

Inhalation: Initial symptoms may resemble the common cold or flu. After several days, the symptoms may progress to severe breathing problems and shock. Gastrointestinal: Infection may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial sighs of nausea, loss of appetite, vomiting and fever, are followed by abdominal pain and severe diarrhea.

When do symptoms appear?
Symptoms usually appear within seven days of exposure to the anthrax bacteria, but can appear as late as 60 days after the exposure.

How common is anthrax?
Anthrax is most common in agricultural regions around the world, where it occurs in animals. When anthrax affects humans, it is usually due to an occupational exposure to infected animals or their products. Anthrax in wild livestock has occurred in the United States, but it is rare.

Can the disease be treated?
Yes. Treatment with appropriate antibiotics is effective, but timing is crucial: a delay of even hours can inhibit effectiveness. People who have been exposed to anthrax but do not have symptoms should consult with a medical professional who will determine the best course of action for recovery.

Should I ask my doctor to write a prescription for antibiotics so that I can take them as a precautionary measure?
No. The Centers for Disease Control and Prevention (CDC) recommends against taking unnecessary antibiotics for possible anthrax exposure. Taking antibiotics will not make you immune to the disease and could lower your ability to fight other illnesses. Widespread use of antibiotics could also lead to organisms developing resistance to these drugs, making them ineffective. Federal health officials have ample supplies of needed drugs and medical supplies they can deliver anywhere in the United States within 12 hours of a request for assistance.

Is a vaccine available?
An anthrax vaccine was licensed by the Food and Drug Administration (FDA) in 1970 for at-risk veterinary and laboratory workers and livestock handlers. The Department of Defense also reserves a stockpile of the vaccine for military use and for some anthrax researchers. The vaccine is in short supply and not available to the general public.

Is anthrax easy to use as a biological weapon?
The spores have to be turned into a microscopically fine powder of a certain size to be absorbed by the lungs and released in a certain way in order to be effective. This is difficult to do.

Does the government have a plan in place to make antibiotics available in the event of mass exposure?
Yes. The CDC's National Pharmaceutical Stockpile is available to any community in need of additional medicinal support in response to an event involving any biological agent. It consists of several tons of the necessary pharmaceutical supplies and equipment, strategically located throughout the Unites States, that will be delivered to the local community within 12 hours of an event taking place. The Federal Response Plan does not need to be activated in order for the stockpile to be utilized by a local community.

What shall I do if I suspect that a biological agent has been released into the air?
You should:
1. Turn off fans or ventilation units in the area.

2. Leave the area immediately.

3. Close the door, or section off the area to prevent others from entering.

4. Next…
· If you are home, call 9-1-1 to report the incident to local police. They will notify the FBI and other appropriate authorities.
· If you are at work, call 9-1-1 to report the incident to local police who in turn will notify the FBI and other appropriate authorities. Also, notify your building security official or an available supervisor.

5. Shut down the air handling system in the building, if possible.

6. If possible, list all the people who were in the room or area. Give this list to both the local public health authorities so that proper instructions can be given for medical follow-up, and to law enforcement officials for further investigation.

Should I buy a gas mask?
No. The CDC does not recommend the purchase of a gas mask. In the event of a public health emergency, local and state health departments will inform the public about the actions individuals need to take.All questions and concerns should be directed to the Atlantic County Division of Public Health at 645-5931, or your doctor. If you are worried about anthrax exposure, don't start taking antibiotics unless advised to do so by your doctor or by health authorities

REFERENCES
Information compiled from the Centers for Disease Control and Prevention, the center for Civilian Biodefense at Johns Hopkins University, the U.S. Department of Health and Human Services, the American National Red Cross (2001) and the New Jersey Department of Health and Senior Services.

FOR FURTHER INFORMATION
Centers for Disease Control and Prevention (800) 311-3435 www.cdc.gov
New Jersey Department of Health and Senior Services http://www.state.nj.us/health/
United States Postal Service (800) ASK-USPS www.usps.gov