PUBLIC SAFETY TOPICS

 

Anthrax

 

Symptoms of disease vary depending on how the disease was contracted, but usually occur within 7 days after exposure. The serious forms of human anthrax are inhalation anthrax, cutaneous anthrax, and intestinal anthrax.

 

Initial symptoms of inhalation anthrax infection may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is often fatal.

 

The intestinal disease form of anthrax may follow the consumption of contaminated food and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, and fever are followed by abdominal pain, vomiting of blood, and severe diarrhea.

 

Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is no need to immunize or treat contacts of persons ill with anthrax, such as household contacts, friends, or coworkers, unless they also were also exposed to the same source of infection.

 

In persons exposed to anthrax, infection can be prevented with antibiotic treatment. Early antibiotic treatment of anthrax is essential-delay lessens chances for survival. Anthrax usually is susceptible to penicillin, doxycycline, and fluoroquinolones.

 

An anthrax vaccine also can prevent infection. Vaccination against anthrax is not recommended for the general public to prevent disease and is not available.

 

Pneumonic Plaque

 

Pneumonic plague occurs when Y. pestis infects the lungs. The first signs of illness in pneumonic plague are fever, headache, weakness, and cough productive of bloody or watery sputum. The pneumonia progresses over 2 to 4 days and may cause septic shock and, without early treatment, death.

 

Person-to-person transmission of pneumonic plague occurs through respiratory droplets, which can only infect those who have face-to-face contact with the ill patient.

 

Early treatment of pneumonic plague is essential. Several antibiotics are effective, including streptomycin, tetracycline, and chloramphenicol.

 

There is no vaccine against plague.

 

Prophylactic antibiotic treatment for 7 days will protect persons who have had face-to-face contact with infected patients.
This material has been developed by the Centers for Disease Control and Prevention. Reuse or reproduction of this material is authorized. Information updated, September, 2001.

 

Smallpox

 

Smallpox is caused by variola virus. The incubation period is about 12 days (range: 7 to 17 days) following exposure. Initial symptoms include high fever, fatigue, and head and back aches. A characteristic rash, most prominent on the face, arms, and legs, follows in 2-3 days. The rash starts with flat red lesions that evolve at the same rate. Lesions become pus-filled and begin to crust early in the second week. Scabs develop and then separate and fall off after about 3-4 weeks. The majority of patients with smallpox recover, but death occurs in up to 30% of cases.

 

Smallpox is spread from one person to another by infected saliva droplets that expose a susceptible person having face-to-face contact with the ill person. Persons with smallpox are most infectious during the first week of illness, because that is when the largest amount of virus is present in saliva. However, some risk of transmission lasts until all scabs have fallen off.

 

Routine vaccination against smallpox ended in 1972. The level of immunity, if any, among persons who were vaccinated before 1972 is uncertain; therefore, these persons are assumed to be susceptible.

 

Vaccination against smallpox is not recommended to prevent the disease in the general public and therefore is not available.

 

In people exposed to smallpox, the vaccine can lessen the severity of or even prevent illness if given within 4 days after exposure. Vaccine against smallpox contains another live virus called vaccinia. The vaccine does not contain smallpox virus.

 

The United States currently has an emergency supply of smallpox vaccine.

 

There is no proven treatment for smallpox but research to evaluate new antiviral agents is ongoing. Patients with smallpox can benefit from supportive therapy (intravenous fluids, medicine to control fever or pain, etc.) and antibiotics for any secondary bacterial infections that occur.

 

This material has been developed by the Centers for Disease Control and Prevention. Reuse or reproduction of this material is authorized. Information updated, September, 2001.

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