ANTHRAX

Anthrax is naturally occurring and most often is seen in herbivores. Anthrax may have killed over a million sheep in Iran in 1945. Gastrointestinal anthrax (from vegitative spores) is reported in Africa and Asia from eating uncooked contaminated meat.

In September of 2001 Bacillus anthracis was sent through the US Postal System. Five of the 11 inhalational cases of anthrax died. Six inhalational cases and another 11 cases of cutaneous anthrax were treated successfully. All of the anthrax containing letters were mailed in Trenton NJ. The anthrax powder in the 2001 letter is thought to have contained 100 billion to 1 trillion spores per gram. Senator Daschle’s letter may have contained 2 g of powder.

In the US, 224 cases of cutaneous anthrax were reported from 1944-1994. There were no cases of inhalational anthrax in the US from 1976-2001

In 1979, an accidental aerosol release of anthrax occurred at a Soviet weapons plant in Sverdlovsk resulting in about 250 cases with 100 deaths (estimated from several reports). Onset of illness was between 2 and 43 days after exposure. Persons with onset of disease more than 30 days after the release had a better outcome. Monkeys have developed fatal disease as long as 58 days after intentional exposure. Viable spores have been found in mediastinal lymph nodes as long as 100 days after exposure.

In fatal cases of inhalational anthrax the interval between onset of symptoms and death may be as little as 3 days. In 2001, care was sought about 3.5 days after symptom onset.