What is bioterrorism?

Bioterrorism is the use of bacteria, viruses or germs to cause illness and spread fear. Bioterrorism is used to attack and intimidate people, governments and countries. In bioterrorist attacks, only a small number of people may be injured or affected, but many more become afraid and change their behavior because of their fear.

What is anthrax?

Anthrax is an infection caused by the spores of a bacterium called Bacillus anthracis. Anthrax most commonly occurs in hooved animals such as cattle and sheep. It is rare in humans and is usually seen only in people who have contact with infected animals or who work with animal products such as wool, hair or hides. Anthrax can be a form of bioterrorism if someone deliberately spreads the bacteria in public places.

Anthrax takes 3 forms in humans, all of which are caused by the same bacteria. The form of anthrax infection depends on how the bacteria enter the body:

• Cutaneous (skin) infection is caused by touching infected animal products, contaminated soil containing anthrax spores or the spores themselves.
• Gastrointestinal (stomach and intestine) infection is caused by eating undercooked meat that is contaminated with anthrax spores.
• Inhalation infection is caused by breathing in anthrax spores.

Is anthrax contagious?

No. None of the forms of anthrax can be spread from one person to another. Anthrax can be caused only by direct exposure to the anthrax spores. It is unlikely that the general public is in danger of anthrax exposure.

How can I tell if it's anthrax?

The symptoms of anthrax infection can be similar to other illnesses. If you have the symptoms listed below, don't panic. Call your family doctor. If your family doctor thinks there is a possibility your symptoms are caused by anthrax, he or she will ask about your job and any travel. This information, plus an exam and possibly some lab tests or X-rays, will help your doctor decide whether you have anthrax infection.

• Cutaneous anthrax is the most common type of anthrax. It starts out as a red area on the skin, similar to an insect or spider bite. It may itch. Over just a few days, the area becomes larger and blisters may form, followed by a deep, black scab. The area is usually painless.
• Gastrointestinal anthrax typically causes vomiting, nausea, fever and loss of appetite, then is followed by severe stomach pain, bloody diarrhea and vomiting with blood.
• Inhalation anthrax starts out like the flu, with a fever, sore throat, dry cough and muscle aches. (Unlike the flu, inhalation anthrax usually does not cause a runny nose.) The symptoms are usually mild for a few days (and may even get better), and then the symptoms get much worse. People who have inhalation anthrax often have stomach pain and can within a few days have difficulty breathing and go into shock.

Can anthrax be treated?

Yes, anthrax infection can be treated with antibiotics. The treatment and the likelihood of cure depend on the form of anthrax. Cutaneous anthrax is the least serious form, and people can sometimes recover even without treatment. Gastrointestinal and inhalation anthrax are more serious and may cause death if not treated.

Is anthrax the only germ used in bioterrorism?

No. Anthrax has been in the news the most, but other agents with bioterrorism potential include botulism, plague and smallpox. Some other agents have also been studied for use as biological weapons, such as tularemia, brucellosis, Q fever and viral hemorrhagic fevers. Of these, smallpox is thought to be the most likely after anthrax to be used in a terrorist action.

What is smallpox?

Smallpox is an illness caused by the variola virus. Symptoms include fever, headache, fatigue, diarrhea, vomiting and a specific rash. The rash starts out as flat red spots that then turn into blisters. The blisters contain clear liquid and then pus, as the disease progresses. Routine vaccination for smallpox was stopped in 1972 in the United States because it was thought that the disease had been wiped out and receiving the vaccine had some risks.

Is smallpox contagious?

Yes. Smallpox can be spread from person to person, usually once a fever and rash have developed.

If I was vaccinated before 1972, am I still protected?

Probably not. The vaccine appears to be most effective for about 10 years.

How is smallpox treated?

There is no specific drug to treat smallpox. However, a vaccine given even a few days after exposure may prevent death. So it's important to get prompt medical attention if you think you've been exposed to smallpox. If you have concerns, call your family doctor.

Are vaccines commercially available for anthrax or smallpox?

Neither of these vaccines is commercially available at this time. Vaccines for smallpox have been made so that supplies are available if they are needed.

Because there are some risks with the smallpox vaccine, the Centers for Disease Control and Prevention determines on an individual basis if the vaccine should be given. The anthrax vaccine is controlled by the U.S. Department of Defense and at this time is available only for military personnel at high risk of exposure in combat settings and people who work with anthrax in a laboratory setting.