Anthrax

Anthrax is an infection caused by the bacterium Bacillus anthracis.^[2] It can occur in four forms: skin, lungs, intestinal, and injection.^[9] Symptoms begin between one day and two months after the infection is contracted.^[1] The skin form presents with a small blister with surrounding swelling that often turns into a painless ulcer with a black center.^[1] The inhalation form presents with fever, chest pain, and shortness of breath.^[1] The intestinal form presents with diarrhea which may contain blood, abdominal pains, and nausea and vomiting.^[1] The injection form presents with fever and an abscess at the site of drug injection.^[1]
Anthrax is spread by contact with the bacterium's spores, which often appear in infectious animal products.^[10] Contact is by breathing, eating, or through an area of broken skin.^[10] It does not typically spread directly between people.^[10] Risk factors include people who work with animals or animal products, travelers, postal workers, and military personnel.^[3] Diagnosis can be confirmed based on finding antibodies or the toxin in the blood or by culture of a sample from the infected site.^[4]
Anthrax vaccination is recommended for people who are at high risk of infection.^[3] Immunizing animals against anthrax is recommended in areas where previous infections have occurred.^[10] Two months of antibiotics such as ciprofloxacin, levofloxacin, and doxycycline after exposure can also prevent infection.^[5] If infection occurs treatment is with antibiotics and possibly antitoxin.^[6] The type and number of antibiotics used depends on the type of infection.^[5] Antitoxin is recommended for those with widespread infection.