Anthrax The last case of inhalational (pulmonary) anthrax in England and Wales was in 1974, and this was the last time that anyone in England and Wales died from anthrax. In the past twenty years there have been fourteen cases of skin (cutaneous) anthrax and all of these people recovered. What's anthrax? Anthrax is a bacterial infection caused by the organism Becillus anthracis. The bacterium can be found in grass-eating wild and domestic animals such as cows and sheep, most often in the agriculture regions of Europe (Southern and Eastern). The bacterium forms spores that can survive and lay dormant in the environment, for example, in the soil. These spores need a suitable environment to germinate and cause anthrax infection. This environment may be in the skin, lungs, or the intestine. There are three different types of Anthrax: 1. Cutaneous —the commonest form This is the most common type and accounts for approximately 95% of eases. These people handing dead animals, such as abattoir workern and tanners, are at most risk of developing cutaneous anthrax, which is nicknamed 'woolsorter's disease'. When animal products such as wool, hides, or leather of infected animals are handled infection occurs when the bacterium comes into direct contact with a cut or abrasion in the skin. At first the skin itches. This is soon followed by appearance of a small raised itchy bump that looks like an insect bite. This skin lesion is commonly located on the head, forearms, or hands. Within 1-2 days the skin lesion develops into a vesicle and then becomes a painless ulcer. This is usually around 1-3 centimeters in diameter and after 2-6 days the black dying central area of the ulcer that is characteristic of cutaneous anthrax is apparent. Left untreated cutaneous anthrax infection can spread and cause blood poisoning, which is fatal in around 5-20% of cases. However, with effective antibiotic treatment, very few deaths occur. 2. Inhalatioanl —very rare When inhaled the larger spores lodge in the windpipe or threat whilst smaller ones lodge further down the respiratory tract in the lungs. The anthrax bacteria produce toxins that are able to enter the bloodstream and cause haemorrhaging and tissue decay. Initial symptoms of inhalational anthrax are mild and non-specific, and are similar to the symptoms include tiredness, weakness, fever, mild non-productive cough, and chest pain, If not treated, over the next 2-6 days this mild phase becomes very severe causing shortness of breath and difficulty breathing, sepsis, and bleeding. By the time the infection has reached this stage if is usually fatal. 3. Intestinal —the most rare form This form. of the disease may follow the ingestion of contaminated meat and is a very rare form. of food poisoning. Initial symptoms of the illness are nausea, vomiting, loss of appetite, and fever. As the infection becomes more severe, abdominal pain, vomiting of blood, and severe diarrhea occur. Very often intestinal anthrax is fatal. Treatment Successful treatment of anthrax infection can be achieved when the disease is identified early on. Treatment is with a course of antibiotics. It is not necessary to quarantine patients with confirmed anthrax since it is extremely unusual for anthrax to be transmitted from person to person. Commonly asked questions How long does someone have the infection before symptoms of anthrax develop? Usually between 1-7 days, but the incubation period can be up to 60 days. Who is most at risk of contracting anthrax? Anthrax is an occupational hazard of workers who process animal hides, hair, bone and bone products agricultural workers vets and those working with anthrax in specialist laboratories. Do I need to be vaccinated? A vaccination against anthrax is