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Health Issues Brief
Facts about Bioterrorism, Anthrax, and Smallpox

December 2001

What is anthrax?

Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax is rare in humans and the inhalation and gastrointestinal forms CANNOT BE TRANSMITTED FROM PERSON TO PERSON. The skin (cutaneous) form can be transmitted to another person by direct contact, but THIS IS VERY RARE. It only happens if the infected person has touched another individual prior to washing his or her hands after touching the infected area. Anthrax can appear as a crystalline or powdery substance that may or may not be seen.

How is anthrax transmitted?

Anthrax organisms can cause infection in the skin, gastrointestinal system or lungs. To cause infection, the organism must enter through a cut or abrasion on the skin, be swallowed, or be inhaled as a fine, aerosolized mist.

Types and symptoms of anthrax:

Skin (cutaneous) anthrax is the least serious form of anthrax. The first symptom is a small, painless sore that develops into a blister. One or two days later, the blister develops a black scab in the center. Gastrointestinal anthrax is more serious than skin anthrax. The initial symptoms are nausea, loss of appetite, and fever, followed by severe abdominal pain. This is the least common form of anthrax. Inhalation anthrax is the most serious form. This illness begins with symptoms similar to those for a cold or the flu (fever, chills, sweats, muscle pain, tiredness, vomiting, chest discomfort and dry cough). If caught early, it can be treated successfully with antibiotics. If it isn't caught early enough and more serious symptoms develop such as difficulty breathing, inhalation anthrax can result in death. Most cold and flu symptoms are not anthrax. All three types of anthrax are treatable with antibiotics if exposure is detected early. A number of antibiotics are available and are very effective in preventing a person from getting the disease once they've been exposed. It is not necessary to buy or stock up on antibiotics as a preventative measure. Antibiotics can have an adverse affect on healthy individuals.

Influenza (flu) and Anthrax:

Many people have asked if they should get a flu shot so they can tell whether they have the flu or an anthrax-related illness. The Centers for Disease Control & Prevention (CDC) does not recommend that individuals get flu shots for this purpose - but to get flu shots simply to prevent the flu. The flu shot can prevent 70 - 90 percent of flu illnesses, but it does not prevent illnesses other than the influenza virus. Many viruses and bacteria infections begin with flu-like symptoms, like fever, body aches, tiredness and headaches. Therefore, if you have these symptoms don't panic unless you believe you've come in contact with anthrax. Remember that one of the differentiating symptoms between the flu and anthrax is difficulty breathing, so if you have breathing problems, call your doctor.

What to do if you receive a suspicious package or letter at work or home?

• Do not shake or empty the contents.
• Do not carry the package or envelope, show it to others or allow others to examine it.
• Put the package or envelope on a stable surface; do not sniff, touch, taste or look closely at it or any contents that may have spilled.
• Alert others in the area about the suspicious package or envelope. Leave the area, close any doors and take actions to prevent others from entering the area. If possible, shut off the ventilation system.
• Wash hands with soap and water to prevent spreading potentially infectious material to face or skin. Seek additional instructions for exposed or potentially exposed persons.
• If at work, notify a supervisor, a security officer, or a law enforcement official. If at home, call 911.
• If possible, create a list of persons who were in the room or area when this suspicious package or envelope was recognized and a list of persons who also may have handled it. Give these lists to both the local public health and law enforcement authorities.

What is smallpox?

Smallpox is caused by the variola virus. Initial symptoms include high fever, head and severe backaches, as well as fatigue. It is characterized by a deep-seated rash that starts around the face and neck and is most prominent on the face, arms and legs. The rash starts with flat red lesions that appear all at once and do not appear in crops as with chickenpox. The lesions become pus-filled and begin to crust early in the second week.

Is smallpox contagious?

Smallpox is spread by infected saliva droplets during face-to-face contact. Persons with smallpox are most infectious during the first week of illness.

Is there treatment available for smallpox?

In people exposed to smallpox, the smallpox vaccine (obtained by the CDC) can lessen the severity of or even prevent illness if given within four days after exposure. The majority of patients with smallpox recover, but death can occur in up to 30 percent of cases.

More Information:

For more information or questions about anthrax or smallpox, please call the Orange County Citizens Hotline at 407/836-9053 or the Florida Anthrax Hotline at 1/800-342-3557. Visit the following websites for additional information: www.bt.cdc.gov; www.orchd.com, or www.floridahospital.com.

Sources:

Centers for Disease Control & Prevention
U.S. Postal Service
The Florida Department of Health
Orange County Health Department
Seminole County Health Department

This Health Issues release is located on the Internet at: http://www.floridahospital.org/

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