Guidance on anthrax: frequently asked questions
A. Anthrax is a disease caused by a bacterium called Bacillus anthracis. It is a disease which has existed for hundreds of years and which still occurs naturally in both animals and humans in many parts of the world, including Asia, southern Europe, sub-Sahelian Africa and parts of Australia. Anthrax bacteria can survive in the environment by forming spores. In its most common natural form, it creates dark sores on the skin, from which it derives its name. Anthrax is Greek for coal.
A. WHO posts updated situation reports whenever there is an outbreak of anthrax or any other infectious disease on its Web site.
A. There are three types of anthrax, each with different symptoms:
Cutaneous, or skin, anthrax is the most common form. It is usually contracted when a person with a break in their skin, such as a cut or abrasion, comes into direct contact with anthrax spores. The resulting itchy bump rapidly develops into a black sore. Some people can then develop headaches, muscle aches, fever and vomiting. Cutaneous anthrax must be treated quickly. Appropriate medical evaluation and treatment are essential.
Gastrointestinal anthrax is caught from eating meat from an infected animal. It causes initial symptoms similar to food poisoning but these can worsen to produce severe abdominal pain, vomiting of blood and severe diarrhoea. Appropriate medical evaluation and treatment are essential.
The most severe form of human anthrax is called inhalation or pulmonary anthrax. Though the rarest, it is the form of human anthrax causing the most current concern. This form of the disease is caused when a person is directly exposed to a large number of anthrax spores suspended in the air, and breathes them in. The first symptoms are similar to those of a common cold, but this can rapidly progress to severe breathing difficulties and shock. Appropriate medical evaluation and treatment are essential.
A. Anthrax responds well to antibiotic treatment. Antibiotics must be prescribed and taken with medical advice. Nobody should attempt to use antibiotics or any other drugs to treat or protect themselves without first getting medical advice.
A. There is a vaccine against anthrax, but it is not approved for widespread use because it has never been comprehensively tested in human trials. The vaccine is sometimes given to people who are likely to be exposed to anthrax through their occupation, for example, tannery workers, or to military personnel. It is not widely available, nor is its use for mass immunization recommended.
A. Inhalation anthrax cannot be transmitted from person to person. That is, a person with inhalation anthrax cannot transfer the disease to someone else. Therefore, there is no need to worry about catching the disease from anyone else. Inhalation anthrax can only be contracted by directly inhaling anthrax spores. In the case of cutaneous anthrax, there is a small risk of direct infection from the lesions on another person's body.
A. Only people who have been directly exposed to the spores can catch anthrax. If you feel unwell, you should get medical advice in exactly the same way as you normally would. In most places, that means going to the doctor. If you are ill, the doctor will then be able to prescribe the most appropriate treatment.
A. Any doctor or medical practitioner is trained to diagnose infectious diseases and has access to the necessary tests. If required, you will be given the tests you need. It is not necessary to go to a hospital.
A. Nobody should take antibiotics without first getting medical advice. Antibiotics are very powerful and effective tools, but they are designed to work against the bacteria that cause specific diseases. Unless you are taking the correct antibiotic, it may not be the best way to treat the disease you have.
A. Common sense is critical in dealing with this unfamiliar situation. Unopened envelopes or packages present a low risk. The risk of exposure is greatest after a suspicious package or letter is opened. Some countries have produced guidelines on what to do if you receive a suspicious package or letter. These are available on the Internet. Some key points are summarized below.
A. Some typical characteristics which ought to trigger suspicion include letters or parcels that:
Have any powdery substance on the outside. Are unexpected or from someone unfamiliar to you. Have excessive postage, handwritten or poorly typed address, incorrect titles or titles with no name, or misspellings of common words. Are addressed to someone no longer at your workplace or home or are otherwise outdated. Have no return address, or have one that can't be verified as legitimate. Are of unusual weight, given their size, or are lopsided or oddly shaped. Have an unusual amount of tape. Are marked with restrictive endorsements, such as "Personal" or "Confidential." Have strange odors or stains.
A. Do not handle the mail piece or package suspected of contamination. Make sure that damaged or suspicious packages are isolated and the immediate area cordoned off. Ensure that all persons who have touched the mail piece wash their hands with soap and water. List all persons who have touched the letter and/or envelope. Include contact information and have this information available for the authorities. Place all items worn when in contact with the suspected mail piece in plastic bags and have them available for authorities. As soon as practical, shower with soap and water. Notify your local health officials.