---

Background
Anthrax is a zoonotic infectious disease caused by Bacillus anthracis. It primarily affects wild and domestic mammals, including goats, sheep, cattle, horses and pigs. Humans get infection through contact with infected animals or contaminated animal products, and a few through respiratory or gastrointestinal tract. There are three types of anthrax in humans: cutaneous, gastrointestinal, and pulmonary. The symptoms of anthrax depend on the type of infection. Anthrax can be treated with antibiotics. Because the spores are infectious, which could persist in the environment for a long time, anthrax is considered one of the serious bio-terrorism or bio-threat agents.

Epidemiology
Anthrax mainly occurs in animals, especially herbivores. The endemic areas include the United States, southern and eastern Europe, Asia, Africa, the Caribbean, the Middle East and Australia. Humans generally acquire the disease from infected animals or as a result of occupational exposure to contaminated animal products. Most of the naturally acquired cases of anthrax are cutaneous.
Bacillus anthracis is recognized as one of the most serious bio-weapon because of the spores that persist in the environment and infects via inhalation. Anthrax has been used as a bio-weapon around the world for nearly a century. Bacillus anthracis spores were distributed through the U.S. mail in 2001 after the 911 terrorist attack.
In Taiwan, the last human case was diagnosed as cutaneous anthrax in 1972 in Matsu. Until now, no human cases have been reported. The last animal case was a horse, with unclear source of infection.

Anthrax Surveillance in Taiwan

1. Taiwan National Infectious Disease Statistics System- Anthrax
2. Fever screening at international airports and seaports.
3. Self–reporting through the toll–free 1922 hotline or local public health authority.

Prevention and Control
There are several antibiotics for treating patients with anthrax.
Prevention measures include:

1. Wear water-proof gloves, take personal precautions and practice standard operation procedure when skinning or handling animal carcasses.
2. Meats must be thoroughly cooked before consumption.
3. People working in animal production industry are at risk for contracting anthrax, and they should take protection measures and adhere to the standard operation procedures to ward off infection.
4. Patients with anthrax should be isolated during an outbreak. However, the opportunity of person-to-person transmission is rare.

FAQs

1. What is the transmission pathway in human cases?
   • Humans can become infected through contact with infected animals or contaminated animal products, and a few through respiratory or gastrointestinal tract.
2. Why would anthrax be used as a weapon?
   • Anthrax could be used for biological agents because anthrax spores are easily found in nature, can be produced in a laboratory, and can last for a long time in the environment. And the spore can be released quietly and without anyone knowing.
3. What are the treatments?
   • Anthrax can be treated with several antibiotics. Patients with serious cases of anthrax may require aggressive treatment such as continuous fluid drainage and help breathing through mechanical ventilation.
4. What are prevention measures to reduce anthrax infection?
   • (1)Wear water-proof gloves, take personal precautions and practice standard operation procedure when skinning or handling animal carcasses.
   • (2)Meats must be thoroughly cooked before consumption.
   • (3)People working in animal production industry are high risk group of contracting anthrax, and they should take advanced protection and adhere to the standard operation procedures.
   • (4)Patients with anthrax should be isolated during an outbreak. However, person-to-person transmission is rare.

 

More information
WHO/anthrax
USA CDC/anthrax