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Mayo Clinic provides some good basic information on Anthrax.

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Mayo Clinic provides some good basic information on Anthrax.

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Overview

Anthrax is a rare but serious illness caused by a spore-forming bacterium, Bacillus anthracis. Anthrax mainly affects livestock and wild game. Humans can become infected through direct or indirect contact with sick animals.

There's no evidence that anthrax is transmitted from person to person, but it's possible that anthrax skin lesions may be contagious through direct contact or through contact with a contaminated object (fomite). Usually, anthrax bacteria enter the body through a wound in the skin. You can also become infected by eating contaminated meat or inhaling the spores.

Signs and symptoms, which depend on how you're infected, can include skin sores, vomiting and shock. Prompt treatment with antibiotics can cure most anthrax infections. Inhaled anthrax is more difficult to treat and can be fatal.

Anthrax is very rare in the developed world. However, the illness remains a concern because the bacteria have been used in bioterrorism attacks in the United States.

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Symptoms

There are four common routes of anthrax infection, each with different signs and symptoms. In most cases, symptoms develop within six days of exposure to the bacteria. However, it's possible for inhalation anthrax symptoms to take more than six weeks to appear.

Cutaneous anthrax

A skin-related (cutaneous) anthrax infection enters your body through your skin, usually through a cut or other sore. It's by far the most common route of the disease. It's also the mildest. With appropriate treatment, cutaneous anthrax is seldom fatal. Signs and symptoms include:

A raised, itchy bump resembling an insect bite that quickly develops into a painless sore with a black center

Swelling in the sore and nearby lymph glands

Sometimes, flu-like symptoms including fever and headache

Gastrointestinal anthrax

A gastrointestinal anthrax infection results from eating undercooked meat from an infected animal. It can affect your gastrointestinal tract from your throat to your colon. Signs and symptoms include:

Nausea

Vomiting

Abdominal pain

Headache

Loss of appetite

Fever

Severe, bloody diarrhea in the later stages of the disease

Sore throat and difficulty swallowing

Swollen neck

Inhalation anthrax

Inhalation anthrax develops when you breathe in anthrax spores. It's the most deadly form of the disease, and is often fatal, even with treatment. Initial signs and symptoms include:

Flu-like symptoms for a few hours or days, such as sore throat, mild fever, fatigue and muscle aches

Mild chest discomfort

Shortness of breath

Nausea

Coughing up blood

Painful swallowing

High fever

Trouble breathing

Shock - an acute medical condition involving collapse of the circulatory system

Meningitis

Injection anthrax

This recently identified route of anthrax infection has so far been reported only in Europe. It's contracted through injecting illegal drugs. Initial signs and symptoms include:

Redness at the area of injection (without an area that changes to black)

Significant swelling

Shock

Multiple organ failure

Meningitis

When to see a doctor

Many common illnesses start with symptoms that resemble the flu. The chances that your sore throat and aching muscles are due to anthrax are extremely small.

If you think you may have been exposed - for example, if you work in an environment where anthrax is likely to occur - see a doctor immediately for evaluation and care. If you develop signs and symptoms of the disorder after exposure to animals or animal products in parts of the world where anthrax is common, seek prompt medical attention. Early diagnosis and treatment are crucial.

Causes

Anthrax spores are formed by anthrax bacteria that occur naturally in soil in most parts of the world. The spores can remain dormant for years until they find their way into a host. Common hosts for anthrax include wild or domestic livestock, such as sheep, cattle, horses and goats.

Although rare in the United States, anthrax is still common throughout the developing world, in places such as Central America and South America, sub-Saharan Africa, Central Asia and southwestern Asia, southern Europe and Eastern Europe, and the Caribbean.

Most human cases of anthrax occur as a result of exposure to infected animals or their meat or hides. In the United States, a few people have developed anthrax while making traditional African drums from the skins of infected animals.

One of the few known instances of nonanimal transmission was a bioterrorism attack that occurred in the United States in 2001. Twenty-two people developed anthrax after being exposed to spores sent through the mail, and five of those infected died.

More recently, in two separate outbreaks, heroin users in Europe contracted anthrax through injecting illegal drugs. A total of 40 people died. Heroin sold in Europe likely comes from areas where naturally occurring anthrax is more common.

Risk factors

To contract anthrax, you must come in direct contact with anthrax spores. This is more likely if you:

Are in the military and deployed to an area with a high risk of exposure to anthrax

Work with anthrax in a laboratory setting

Handle animal skins, furs or wool from areas with a high incidence of anthrax

Work in veterinary medicine, especially if you deal with livestock

Handle or dress game animals - while anthrax is rare in the United States, there are occasional outbreaks in domestic cattle and wild animals such as deer

Inject illegal drugs, such as heroin

Complications

The most serious complications of anthrax include:

Your body being unable to respond to infection normally, leading to damage of multiple organ systems (sepsis)

Inflammation of the membranes and fluid covering the brain and spinal cord, leading to massive bleeding (hemorrhagic meningitis) and death

Prevention

To prevent infection after being exposed to anthrax spores, the Centers for Disease Control and Prevention recommends:

A 60-day treatment with antibiotics - ciprofloxacin, doxycycline and levofloxacin are approved for adults and children

A three-dose series of anthrax vaccine

In some cases, treatment with monoclonal antibodies - raxibacumab and obiltoxaximab

Anthrax vaccine

An anthrax vaccine is available for certain groups of people. The vaccine doesn't contain live bacteria and can't lead to infection. However, the vaccine can cause side effects, ranging from soreness at the injection site to more-serious allergic reactions.

The vaccine isn't intended for the general public. Instead, it's reserved for military personnel, scientists working with anthrax and people in other high-risk professions.

Avoiding infected animals

If you live or travel in a country where anthrax is common and herd animals aren't routinely vaccinated, avoid contact with livestock and animal skins as much as possible. Also avoid eating meat that hasn't been properly cooked.

Even in developed countries, it's important to handle any dead animal with care and to take precautions when working with or processing imported hides, fur or wool.

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Anthrax is a rare but serious illness caused by a spore-forming bacterium, Bacillus anthracis. Anthrax mainly affects livestock and wild game. Humans can become infected through direct or indirect contact with sick animals. There's no evidence that anthrax is transmitted from person to person, but it's possible that anthrax skin lesions may be contagious through direct contact or through contact with a contaminated object (fomite).

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Anthrax is a infectious disease caused by Bacillus anthracis, this is a type of bacteria. Humans usually can contract this disease through contact with diseased cattle and other livestock, the spores are resilient and infect easily. Luckily, this disease is not contagious.

Anthrax is usually found in developing countries where the livestock is not properly vaccinated against Bacillus anthracis spores. The spores are found in the soil and are eaten by grazing animals, this is how they get infected. Unfortunately, this bacteria is found worldwide and is believed to have originated somewhere around Egypt. Fun fact, they believe anthrax is mentioned in Genesis as one of the 10 plagues.

Infectious disease: A disease caused by the entrance into the body of pathogenic agents or microorganisms which grow and multiply there.

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This was a major source for the information I shared in the post above.

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What is anthrax?

Anthrax (AN-thraks) is an infectious disease caused by exposure to Bacillus anthracis bacteria. The bacteria are dormant, or inactive, in soil. Anthrax mostly affects animals that graze on land that has the bacteria.

People can become infected through inhaled bacteria spores, contaminated food or water, or skin wounds. Antibiotics are the first line of treatment for this potentially deadly infection. There are other treatments, including a vaccine.

How common is anthrax?

Anthrax is found all over the world, although the disease is extremely rare in the United States. Disease outbreaks tend to occur in developing countries that don't vaccinate livestock against the infection. These areas include:

Caribbean islands.

Central America.

Central and southwest Asia.

South America.

Sub-Saharan Africa.

Who might get anthrax?

Certain people are more at risk for exposure to anthrax, including:

Farmers and livestock handlers.

Military members and travelers to countries known to have problems with anthrax.

Researchers and laboratory workers who study the bacteria.

Veterinarians who work with infected livestock.

Wool mill, tannery and slaughterhouse workers.

Drum makers who use animal hides.

Heroin users.

What are the types of anthrax?

The types of anthrax reflect the different ways the bacteria enter the body. Anthrax types include:

Cutaneous (skin): Bacteria infect the body through a wound in the skin. Cutaneous anthrax is the most common and least deadly form. Veterinarians and people who handle animal wool, hides or hair are at highest risk.

Gastrointestinal: This type affects people who eat undercooked or raw meat from an infected animal. The bacteria affect the esophagus, throat, stomach and intestines. Gastrointestinal anthrax is rare in the United States. U.S. producers vaccinate livestock against anthrax and identify sick animals before slaughter.

Inhalation: People who breathe in anthrax spores can develop this deadly form of anthrax. It can cause severe breathing problems and death. Inhalation anthrax is sometimes called woolsorter's disease because people who work in wool mills - as well as slaughterhouse and tannery workers - may inhale spores from infected animals.

Injection: People who inject heroin can get injection anthrax. This type is more common in northern Europe and hasn't been reported in the United States. Injection anthrax causes infection deep under the skin or in muscle.

Is anthrax a biological weapon?

A bioterrorism attack using anthrax spores is a possibility. In 2001, a U.S. military researcher mailed envelopes containing anthrax spores to members of Congress and the media. Five of the 22 people who developed cutaneous or inhalation anthrax died. Federal agencies continue to work to prevent a future anthrax attack.

What causes anthrax?

Bacillus anthracis bacteria cause anthrax. The bacteria produce spores that can live in the ground for years. Wild animals like deer, and livestock such as cattle or sheep, can inhale or ingest the dormant (inactive) spores while grazing.

After mixing with bodily fluids, anthrax bacteria activate, multiply and spread throughout the body. The bacteria cause a toxic, potentially deadly reaction. The same process happens to people who inhale, ingest or come into skin contact with the spores.

What are the symptoms of anthrax?

Anthrax symptoms vary depending on the type. Symptoms typically appear within one week of exposure. Sometimes, signs of inhalation anthrax aren't noticeable for two months. Depending on the type, symptoms include:

Is anthrax contagious?

Anthrax isn't contagious like chickenpox or the flu. You can't catch anthrax from being around someone who is infected. Rarely, people develop cutaneous anthrax after coming into direct contact with another person's infected skin lesion.

Last reviewed by a Cleveland Clinic medical professional on 08/19/2020.

References

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Anthrax: Bacillus anthracis, Symptoms, Types, Causes, Treatment

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Anthrax (AN-thraks) is an infectious disease caused by exposure to Bacillus anthracis bacteria. The bacteria are dormant, or inactive, in soil. Anthrax mostly affects animals that graze on land that has the bacteria. People can become infected through inhaled bacteria spores, contaminated food or water, or skin wounds.

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While Anthrax did originate in the Middle East and African area, there are cases of outbreaks that span around the whole world. Due to this diseases ability to travel along with cattle and untreated products made from cattle it has made its way to about every country. At different periods in time there are outbreaks in different areas.

Luckily, there are ways to help prevent Anthrax. Products are treated for Bacillus anthracis spores, a process that destroys the spores. This has decreased the severalty of cases in many countries.

Wars have a big impact on this disease. Since products must be treated for Bacillus anthracis, there are times, in war, when countries cannot have products treated. This is due to having strenuous relationships between countries and goods must be purchased from alternative sources or when goods cannot be transported to places where they are properly treated. There are also times when Anthrax has been used to infect people during war, like a bioweapon.

In outbreaks of Anthrax, there are varying results when it comes to recovery. What is consistent is that there are always casualties as a result of these outbreaks. In the 20th century there were large outbreaks that resulted in a lot of casualties. In the link provided, there is a quick timeline of the spread and outbreaks of Anthrax. There is also some information on it's use as a bioweapon as well.

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Anthrax is very virulent, though there are some cases where the spores are more virulent than others. There is Cutaneous anthrax which is a less virulent form of Anthrax while systemic anthrax can result in sudden death and had mortality rate close to 100%. Luckily, Cutaneous anthrax is far more common and can be treated. Unfortunately, this disease has maintained it's high virulence due to being a zoonosis and doesn't take part in human-to-human transmission. This disease is targeted for grazing herbivores and thus, will continue to have high virulence for humans since we are not a target host. The link provided leads to an article that talks about the toxins generated by Bacillus anthracis and the symptoms caused by the disease.

As time has passed and we have developed ways to lessen exposure to Bacillus anthracis spores, there have been less cases of systemic anthrax cases.

Virulence: The ability of a pathogen to overcome the host's defenses and cause damage or harm to the host. Can be seen through signs or symptoms caused by the pathogen.

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There are multiple ways to treat for Anthrax, depending on the way in which an individual is infected and on the persons age and health. Usually, the treatment involves antibiotics (ciprofloxacin, doxycycline, and/or levofloxacin) for a designated amount of time (~60 days). For inhalation there are a couple antitoxin therapies (raxibacumab and obiltoxaximab) that are now being used, before there was no way to treat for the inhalation of Bacillus anthracis. This type of treatment targets the toxins that the spores create rather than targeting the spores themselves. There has been some tests on how to treat people who are injected with Anthrax by the removal of infected tissue.

Some tests, in the past, have need done on a working Anthrax vaccine, there is currently only one vaccine available.

It is best to keep in mind that, for the best chances of survival, seek treatment as soon as possible. If someone is severely infected by Anthrax there is no guarantee that any treatments available will help.

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Diagnosis

Your doctor will first want to rule out other, more common conditions that may be causing your signs and symptoms, such as flu (influenza) or pneumonia. You may have a rapid flu test to quickly diagnose a case of influenza. If other tests are negative, you may have further tests to look specifically for anthrax, such as:

Skin testing. A sample of fluid from a suspicious lesion on your skin or a small tissue sample (biopsy) may be tested in a lab for signs of cutaneous anthrax.

Blood tests. You may have a small amount of blood drawn that's checked in a lab for anthrax bacteria.

Chest X-ray or computerized tomography (CT) scan. Your doctor may request a chest X-ray or CT scan to help diagnose inhalation anthrax.

Stool testing. To diagnose gastrointestinal anthrax, your doctor may check a sample of your stool for anthrax bacteria.

Spinal tap (lumbar puncture). In this test, your doctor inserts a needle into your spinal canal and withdraws a small amount of fluid. A spinal tap is usually done only to confirm a diagnosis of anthrax meningitis.

More Information

Show more related information

Treatment

The standard treatment for anthrax is a 60-day course of an antibiotic, such as ciprofloxacin (Cipro) or doxycycline (Monodox, Vibramycin, others). Which single antibiotic or combination of antibiotics will be most effective for you depends on how you were infected with anthrax, your age, your overall health and other factors. Treatment is most effective when started as soon as possible.

Although some cases of anthrax respond to antibiotics, advanced inhalation anthrax may not. By the later stages of the disease, the bacteria have often produced more toxins than drugs can eliminate.

Since the 2001 attacks in the United States, antitoxin therapies have been developed. Instead of going after the bacteria that causes the disease, these medications help eliminate the toxins caused by the infection. These medications are still considered experimental.

Some cases of injection anthrax were successfully treated with the surgical removal of infected tissue.

Preparing for your appointment

Symptoms of anthrax often come on suddenly and can be very serious. If you've been exposed to anthrax or develop symptoms after a possible exposure, immediately go to the emergency room. If your situation is less urgent, set up an appointment with your doctor as soon as possible.

If you have time before you go:

Write down any symptoms you're experiencing, including any that seem unrelated to anthrax exposure.

Write down key personal information. Have you recently traveled to a part of the world where anthrax is endemic? Are you exposed to livestock, game animals or animal skins in your work or hobbies?

Make a list of all medications, vitamins and supplements that you're taking.

Take a family member or friend along, if possible. Sometimes it can be difficult to recall the information provided to you in the hospital or during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Write down questions to ask your doctor. For instance, if you're diagnosed with anthrax, you will want to know the route of infection, the proposed treatment and your prognosis.

Show references

1. Wilson KH. Clinical manifestations and diagnosis of anthrax. http://www.uptodate.com/home. Accessed Jan. 18, 2017.

2. Longo DL, et al., eds. Microbial bioterrorism. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. Accessed Jan. 18, 2017.

3. Anthrax. Merck Manual Professional Version. https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax. Accessed Jan. 18, 2017.

4. Wilson KH. Microbiology, pathogenesis, and epidemiology of anthrax. http://www.uptodate.com/home. Accessed Jan. 18, 2017.

5. Wilson KH. Prevention of anthrax. http://www.uptodate.com/home. Accessed Jan. 18, 2017.

6. Wilson KH. Treatment of anthrax. http://www.uptodate.com/home. Accessed Jan. 18, 2017.

7. Stone CK, et al., eds. Nuclear, biologic, and chemical agents; weapons of mass destruction. In: Current Diagnosis & Treatment Emergency Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com. Accessed Jan. 18, 2017.

8. Hall JB, et al., eds. Biological warfare. In: Principles of Critical Care. 4th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://www.accessmedicine.com. Accessed Jan. 18, 2017.

9. Anthrax vaccine: What you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/anthrax.html. Accessed Jan. 18, 2017.

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Your doctor will first want to rule out other, more common conditions that may be causing your signs and symptoms, such as flu (influenza) or pneumonia. You may have a rapid flu test to quickly diagnose a case of influenza. If other tests are negative, you may have further tests to look specifically for anthrax, such as: Skin testing.

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There are work space instructions in place to deal with the event of Bacillus anthracis spores. This is outlined in OSHA guidelines provided for those who work in such places. In an event where the general public is exposed to Anthrax, on a large scale, there are precautions to supply antibiotics to places in the community called points of dispensing (PODs) where everyone is able to get the help they need.

There are cases, in the past, Anthrax has been used as a bioweapon. In such cases there are monitoring systems that look for the release of diseases into the public, such as unusual patterns of illness. Once a outbreak is confirmed the proper antibiotics would be sent out to PODs.

By looking at the preparations I have found for an Anthrax outbreak, it seems to be a decent setup. While it would be nice to think that there are ways to monitor or prevent Anthrax from getting to that point, that is not an option. An outbreak cannot be foretold without it being preplanned.

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Control and Prevention

Infection with Bacillus anthracis, (BA), which causes anthrax, occurs through direct exposure to active bacteria or bacterial spores. Measures for protecting workers from exposure to BA depend on the type of work performed and knowledge of exposure risk, including potential for spore release from an accidental or intentional event. Adaptation of infection control strategies based on a thorough hazard assessment is necessary for implementing infection prevention and control measures, including engineering and administrative controls, safe work practices, and personal protective equipment (PPE).

This page provides information both for workers and employers of workers whose potential BA exposures fall into two categories:

BA exposure associated with work tasks - Workers and employers who may be involved in emergency response and recovery operations or related activities during or following releases of BA or who otherwise have a particularly high risk of exposure due to certain job tasks (e.g., working with BA in laboratories or handling mail).

BA exposure similar to the general public - Workers and employers who may be exposed during releases of BA or other emergency scenarios but who do not have emergency response roles or do not otherwise have a particularly high risk of exposure.

BA EXPOSURE RISK ASSOCIATED WITH WORK TASKS BA EXPOSURE RISK SIMILAR TO THE GENERAL PUBLIC
Employers whose workers will be involved in emergency response operations for releases of, or substantial threats of releases of, hazardous substances (including BA) regardless of the location of the hazard must comply with OSHA's HAZWOPER standard ( 29 CFR 1910.120). This may include emergency response following an anthrax incident. Instruction CPL 02-02-073 describes OSHA enforcement procedures under the relevant provisions of the HAZWOPER standard.

The U.S. Environmental Protection Agency (EPA) has promulgated a standard applying OSHA's HAZWOPER standard to state and local government workers in states where there is no OSHA-approved State Plan. See 40 CFR Part 311.

OSHA's HAZWOPER Safety and Health Topics page explains requirements of the OSHA HAZWOPER standard, including required worker training. The OSHA Biological Agents Safety and Health Topics page also provides information for emergency response and clean-up workers.

In addition to the guidance provided for general businesses, this page provides specific information for categories of workers OSHA has identified as having a higher risk of exposure to BA.

General Guidance for Workers at Risk of BA Exposure Due to Specific Work Tasks

1. Standard Precautions

2. Cleaning & Disinfection

3. Personal Protective Equipment

4. Infectious Waste

5. Reporting Illness

6. Worker Training

7. Employee Medical Program Requirements

8. If You Think You Have Been Exposed

A. Standard Precautions
Follow good infection control practices (e.g., standard precautions) for preventing contact with BA. Standard precautions include hand hygiene and use of appropriate PPE to avoid direct contact with BA. Standard precautions also include safe waste management and cleaning and disinfection of surfaces and equipment.

Practice good hand hygiene protocols to avoid exposure resulting from touching contaminated objects or other contaminated environmental surfaces. Hand hygiene consists of washing with soap and water. Keeping cuts and abrasions covered with bandages will also help prevent BA spores from entering those wounds. The World Health Organization's (WHO) Guidelines on Hand Hygiene in Healthcare suggest that washing hands with either non-antimicrobial soap or antimicrobial soap and water reduced the amount of B. atrophaeus (a surrogate or stand-in germ used in experiments where it is unsafe to test for BA directly) on hands, while alcohol-based hand rubs do not. The effectiveness of washing hands with soap and water is likely due to the mechanical friction involved when rubbing the hands together. Perform hand hygiene after performing any job task with the potential for BA contamination, including contact with contaminated material that may contain BA spores, and before putting on and promptly after removal of PPE, including gloves.
B. Cleaning & Disinfection
BA is persistent in the environment for long periods of time, and small particles can stay suspended in the air or be re-aerosolized by agitation and air currents within buildings and other environments. This creates the potential for BA transmission from contaminated environmental surfaces or fomites (objects that can spread germs) and the need for effective cleaning and decontamination strategies.

Selection of chemicals for disinfection and sterilization when BA is a contaminant of concern depend on the situation:

For more routine uses, such as when cleaning healthcare or laboratory environments, there are available products that are Environmental Protection Agency (EPA)-registered, but not specifically for BA, that have been shown to be effective at inactivating (i.e., killing) the bacteria. Data suggest that current disinfection and sterilization practices are appropriate for disinfecting environmental surfaces potentially contaminated through activities such as evaluation of patients after exposure to aerosolized BA. For example, chlorine and chlorine compounds, such as sodium hypochlorite (i.e., bleach), can be used for surface disinfection. There are also EPA-registered disinfectants specifically marketed as effective against BA, including Diklor-G Chlorine Dioxide Sterilant Precursor. Use of this product is restricted to Federal On-Scene Coordinators (FOSCs) and contractors; other trained federal, state, and local response personnel under a FOSC's supervision; trained U.S. military personal and contractors under their supervision; and other individuals specifically trained by the and determined to be competent by the registrant (or its contactor).
In some instances, including supplementing other disinfectants, ultraviolet light also may be used, but its effectiveness may be limited by shading and ability of the light to reach spores.

In instances where a healthcare facility, laboratory, or other workplace is the site of a bioterrorist attack, environmental decontamination might require special decontamination procedures. Because no antimicrobial products are registered for decontamination of biologic agents after a bioterrorist attack, EPA has developed an Emergency Exemption Database.
Technologies that may be suitable for use in decontaminating large areas or buildings contaminated with BA spores include electron beams and chemical disinfectants (e.g., glutaraldehyde, chlorine dioxide gas, and vaporized hydrogen peroxide). Some of these chemical disinfectants are included in the EPA Emergency Exemption Database.

In some instances, including supplementing other disinfectants, ultraviolet light also may be used, but its effectiveness may be limited by shading and ability of the light to reach spores.

Cleaning and disinfection may require the use of more than one method. The EPA Technology Innovation Office (TIO) has developed an information clearinghouse to collect and disseminate information about decontamination technologies and also for technology vendors to provide information. Regardless of the method(s) used, all require special equipment, training, and expertise for safe and efficient use.

Annex 3 of Anthrax in Humans and Animals, 4th edition, provides more detailed discussion on disinfectants and fumigants effective against BA spores.

Regardless of the situation, effectiveness at inactivating BA may also be determined based on data associated with inactivating similar or hardier (i.e., more difficult to inactivate) spore-producing bacteria.

Protect workers from exposure when tasked with cleaning surfaces and equipment potentially contaminated with BA. This may include using engineering controls, such as ventilation, along with administrative controls, safe work practices, and PPE, such as chemical-resistant or -impermeable garments and a respirator with an N95 particulate/chemical combination cartridge. See the Personal Protective Equipment section below for additional information.
C. Personal Protective Equipment
PPE includes appropriate respiratory protection, protective garments (e.g., coveralls, boot covers, chemical-resistant or -impermeable suits), eye and face protection, and gloves (nitrile or vinyl). Employers should base the use of PPE on the situation and tasks involved, including to the degree of contamination, risk of exposure, exposure pathway, and anticipated level of exposure. Select PPE for workers based on the worst-case exposure scenario and in accordance with OSHA's PPE standards ( 29 CFR 1910 Subpart I). PPE must be sufficient for the type and level of exposure anticipated.

Base the choice of glove material (e.g., nitrile, vinyl) on the chemical manufacturer's information. However, factors to consider also include safety, fit, durability, and comfort. If necessary, use vinyl or nitrile gloves under heavier gloves (e.g., leather, heavy cotton) for operations with potential for glove tearing or for protection against hand injury.

Thoroughly wash hands with soap and water upon removing gloves, before eating, and when replacing torn or worn gloves. Remove gloves prior to leaving the work area and place them in areas specifically designated for storage, washing, decontamination, or disposal (depending on the glove type).

Replace disposable gloves as soon as feasible when they are contaminated; immediately if they are cracked, torn, or punctured; whenever removing or changing other PPE; and upon task completion.

Decontaminate non-disposable gloves if intact. Do not wash or decontaminate disposable gloves for reuse (although this recommendation does not preclude washing disposable gloves before removing them from the hands). To prevent spreading the contamination to the worker's skin, never wash torn or punctured disposable gloves prior to removal.

OSHA's standards for PPE cover glove selection and use ( 29 CFR 1910.132) as well as hand protection ( 29 CFR 1910.138).

Whether or not respirators are required depends on the potential for inhalation exposure to BA, including aerosolized spores. During emergency response, recovery and clean-up operations, work in a Yellow or Red Zone as defined in the OSHA Anthrax Risk Reduction Matrix may require an appropriate (i.e., properly-fitted, NIOSH-certified N95 or greater) respirator. The matrix provides additional details about respirator selection, including information about when higher levels of respiratory protection may be required.

However, if workers request respirators, and employers provide only filtering facepiece respirators (FFRs) for voluntary use by workers, employers must provide workers with the information contained in Appendix D - Information for Employees Using Respirators When Not Required Under the Standard to OSHA's Respiratory Protection standard ( 29 CFR 1910.134). OSHA provides videos with information that explain voluntary use of respirators.

In cases where employers must provide respiratory protection from BA and BA spores (e.g., where a respiratory hazard exists, such as from an ongoing release or activities that could re-aerosolize spores), use NIOSH-approved respirators that are at least as protective as an N95 FFR. (Note that OSHA recommends higher levels of respiratory protection for workers involved in response, sampling, and decontamination activities where exposure to BA spores is possible; see specific sections for those workers, below, for more details on the recommended respiratory protection.) Ensure that the selection of respiratory protection takes into account the agents used for decontamination and provides combination cartridge respirators where both particulate and chemical hazards may be present. Cartridges must be able to withstand moisture levels in the work environment, or be changed on an appropriate schedule, so that their filtration capabilities are not compromised. If organic vapor cartridges are used, implement a cartridge change schedule. Employers should ensure that workers have suitable respiratory and eye and face protection that work in conjunction with one another and that eye protection does not compromise respirator fit.

Work tasks, including cleaning and decontamination activities, that involve an increase in moisture and spray may adversely affect disposable N95 respirators and certain other respirators. In such instances, combination particulate/chemical cartridges may be necessary to protect workers from exposure to the chemicals in addition to BA spores. Consider providing a supplied-air respirator (SAR) to improve worker protection. Loose-fitting powered air-purifying respirators (PAPRs) and SARs may also improve worker comfort when wearing respirators for long periods. In addition, provide workers performing tasks in areas where oil mist from machinery is present with respirators equipped with P-type filters (P95 or P100) to prevent the oil mist from degrading the filter.

At worksites with mandatory use of respirators, employers must implement a comprehensive respiratory protection program that complies with the provisions of OSHA's Respiratory Protection standard ( 29 CFR 1910.134). This includes compliance with the standard's requirements for obtaining medical clearance for wearing the respirator and for conducting fit testing prior to actual use of respirators. These requirements of a written respiratory protection program also apply to voluntary use of any respirators other than FFRs.

To achieve proper fit, workers with facial hair (beards and/or large moustaches) may require the use of alternative respirators, such as hooded PAPRs, or SARs.

OSHA's Respiratory Protection e-Tool provides detailed information on establishing a respiratory protection program.

Although BA and its spores are not considered a bloodborne pathogen (BBP), employers still must comply with OSHA's BBP standard ( 29 CFR 1910.1030) to protect workers with occupational exposure to blood or other potentially infectious materials. Occupational exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral (i.e., elsewhere in/on the body) contact with human blood or other potentially infectious materials that may result from the performance of a worker's duties. OSHA's Bloodborne Pathogens and Needlestick Prevention Safety and Health Topics page provides information on the standard.
D. Infectious Waste
Worker protection from exposure to infectious agents, including BA, is necessary when work tasks involve handling, treatment, transport, and disposal of medical, laboratory and other potentially contaminated waste. Mishandled contaminated waste may pose a risk to workers.

Use an autoclave to inactivate infectious material (i.e., kill all associated infectious agents) in all waste prior to disposal, or develop and follow procedures for safely transporting waste off site for treatment and disposal if on-site autoclaving is not possible. Adhere to applicable federal, state, and local regulations when disposing of laboratory waste, including the U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR, 49 CFR 171-180) if transporting waste off-site for treatment and disposal. Under the HMR, waste potentially contaminated with BA generally does not contain a Category A infectious substance unless it includes cultures of BA. State and local requirements may also apply.
E. Reporting Illness
Ensure that supervisors and all potentially exposed workers are aware of the symptoms of anthrax.

Workers potentially exposed to BA or who develop symptoms of anthrax should seek medical evaluation. While symptoms of anthrax usually occur within seven days of exposure, some cases presented symptoms after only one day while others presented symptoms later than two months after exposure.

Under OSHA's Recordkeeping and Reporting Requirements, including the agency's standard on Reporting Fatalities, Hospitalizations, Amputations, and Losses of an Eye as a Result of Work-related Incidents to OSHA (29 CFR 1904.39), all employers must report all work-related fatalities within 8 hours and all work-related inpatient hospitalizations, all amputations and all losses of an eye within 24 hours. Only fatalities occurring within 30 days of the work-related incident require reporting to OSHA. For an in-patient hospitalization, amputation, or loss of an eye, these incidents are reportable to OSHA only if they occur within 24 hours of the work-related incident.

Where required, report an incident to OSHA by:

Calling OSHA's free and confidential number at 1-800-321-OSHA (6742).

Calling the closest Area Office during normal business hours.

Using the new online form.

Physicians, employers, and/or workers may also contact their state or local health departments to notify them of any symptomatic workers or suspected exposure incidents. Some states may require these incidents to be reported.

Workers may continue working after exposure if able since anthrax is not contagious, and transmission primarily occurs through contact with the BA spores.

See the Medical Information page for more information on symptoms and anthrax transmission.
F. Worker Training
Although OSHA's HAZWOPER standard ( 29 CFR 1910.120) may not apply to non-emergency response workers impacted by a BA release, other OSHA standards may contain applicable training requirements. It is important for employers to:

Train workers in advance of an emergency occurring and clarify worker roles and responsibilities for emergency situations, including when workers are sheltering in place or evacuating.

Regularly review and reinforce knowledge of procedures, facilities, systems, and equipment.

Establish and maintain clear procedures for organizational coordination and communications.

Practice and analyze emergency procedures to identify weaknesses and resource gaps.

Evaluate policies, plans and procedures and the knowledge and skills of team members.

Comply with applicable federal, state, and local laws, codes, and regulations.

A training program is required under the HAZWOPER standard ( 29 CFR 1910.120), section (q) for workers involved in emergency response and clean-up operations. Employers shall provide training to all workers performing operations on the site, such as equipment operators, general site workers, and supervisors or managers potentially exposed to hazardous substances. Workers whose jobs put them at higher risk of exposure need more training than those who do lower-risk jobs. The HAZWOPER standard ( 29 CFR 1910.120) provides comprehensive information on training requirements for workers involved in emergency response from a terrorist/criminal act resulting in release of BA spores.

Train all emergency response workers to recognize and report early symptoms and signs of anthrax, understand the importance of immediate medical attention, know how to access emergency medical care, know about potential adverse effects and interactions with food and drugs if taking antibiotics, and understand the potential adverse effects of the anthrax vaccine and the amount of time necessary to develop an immune response if using the vaccine as a preventive measure.

OSHA's HAZWOPER Safety and Health Topics page explains requirements of the OSHA HAZWOPER standard, including the required worker training.

Training for workers required to use PPE includes when to use PPE; what PPE is necessary; how to properly don (put on), use, and doff (take off) PPE; how to properly dispose of or disinfect, inspect for damage and maintain PPE; and the limitations of PPE. These and other requirements are found in OSHA's PPE standards ( 29 CFR 1910 Subpart I), including the PPE (General Requirements) standard ( 29 CFR 1910.132), the Eye and Face Protection standard ( 29 CFR 1910.133), and the Respiratory Protection standard ( 29 CFR 1910.134). OSHA offers a variety of training videos on respiratory protection.

DOT's HMR provide additional training requirements for workers preparing contaminated materials or other hazardous materials for transport.

OSHA's Training and Reference Materials Library contains training and reference materials developed by the OSHA Directorate of Training and Education (DTE) as well as links to other related sites. The information about PPE and respiratory protection may provide additional material for employers to use in preparing training for their workers.

OSHA's Personal Protective Equipment Safety and Health Topics page also provides information on training in the use of PPE.
G. Employee Medical Program Requirements & Medical Monitoring
In bioterrorist/criminal acts involving anthrax, employers must develop workplace medical monitoring programs to address exposure for:
Short-Term Response Workers
Exposures are limited to a single episode or a few episodes within a brief period (fewer than 30 days). Local emergency medical personnel, police, and firefighters who are not expected to enter and/or re-enter contaminated areas over longer periods of time fall into this category.
Long-Term Response and Recovery Workers
These individuals have repeated exposures over longer periods of time (30 days or more). Environmental response team members and decontamination workers fall into this category. They may work at multiple sites (such as industrial hygienists conducting environmental sampling) or at a single site (such as contractors performing decontamination work).
Occupants, Workers, or Visitors at a Site Contaminated with Anthrax
Mail handling workers fall into this category. The medical program for this group covers the immediate post-exposure period and the period after clearance for unrestricted entry and occupancy. Employers also must conduct initial medical screening to identify exposed persons who should avoid taking antibiotics.

After clearance for unrestricted entry and occupancy, compile an initial medical history to screen for high-risk conditions (such as compromised immunity, skin conditions). Counsel high-risk persons and provide around-the-clock access to medical coverage for anthrax-like symptoms. Ensure the confidentiality of medical information.

Part of the workplace medical program includes medical monitoring. Establish a medical monitoring program to monitor persons exposed to BA for signs and symptoms of anthrax. The intent is to detect adverse effects on a worker's health at an early stage when prevention is possible or treatment is most effective. An effective medical screening program for anthrax includes:

Baseline medical screening to identify pre-existing conditions that may affect an individual worker's fitness for duty, and those who should avoid antibiotics or vaccines.

Periodic evaluations to reassess fitness for duty and to detect symptoms of the development of anthrax or adverse effects related to preventive measures (such as antibiotics).

Final evaluation when it is no longer necessary for a worker to re-enter a contaminated site, to identify changes from the baseline and any new risk factors.

Employers need to develop a plan to inform affected workers about available options for preventing anthrax and the risk and benefits of each option. Information about when exposure monitoring is required should also be included.

Inhalation exposure to a high concentration of BA spores may result in rapid death. Therefore, treat as a medical emergency any exposure to aerosolized powder potentially containing or known to contain BA spores.

After receiving clearance for re-occupancy, PPE and medical measures to prevent anthrax are no longer required. However, employers may find it prudent to implement a precautionary program of medical monitoring to ensure that anthrax is no longer a threat.

The Centers for Disease Control and Prevention provide further information about medical surveillance in BA Contaminated Sites. The HAZWOPER standard ( 29 CFR 1910.120) also details medical surveillance program requirements.
H. If You Think You Have Been Exposed
Any worker who thinks he or she may have been exposed to BA-including through handling a contaminated object or package, cleaning a contaminated environment, or contacting a sick animal - should take the following precautions:

Notify your employer immediately.

If possible, list any other workers in the room or area where the potential exposure occurred. Give this list to both the local public health authorities and law enforcement officials for follow-up investigations and advice.

Remove heavily contaminated clothing, place it in a plastic bag, and seal it.

Shower with soap and water as soon as possible.

Contact a physician immediately and report the details of the incident and possible exposure.

Carefully follow your doctor's recommended treatment and advice.

Specific Guidance for Workers and Employers with Elevated BA Exposure Risk

Guidance for Other Workers Exposed during Releases or Other Emergency Scenarios

Any worker or employer may be affected by a variety of emergency situations. Even though workers may not conduct emergency response or recovery operations-like rescue workers, law enforcement officers, or cleanup technicians-all employers and their workers should be prepared for emergency situations. This page includes information for general businesses on how to protect workers and others at the worksite or facility during an anthrax incident. Please visit the Getting Started - General Business Preparedness page for additional information on planning, preparing, equipping, and training for emergencies.

Accidental and intentional releases of BA increase the potential risk of exposure to BA for workers whose jobs would not ordinarily involve anthrax exposure. Use the OSHA Anthrax in the Workplace Risk Reduction Matrix to help identify workers' exposure risk levels and select appropriate controls to protect against BA exposure.

Employers whose workers will be involved in emergency response operations for releases of, or substantial threats of releases of, hazardous substances regardless of the location of the hazard must comply with OSHA's HAZWOPER standard ( 29 CFR 1910.120). This may include emergency response following an anthrax incident. Instruction CPL 02-02-073 describes OSHA enforcement procedures under the relevant provisions of the HAZWOPER standard. Information for these types of workers and employers is provided in the general guidance for workers and employers with elevated BA exposure risk and specific guidance for workers and employers with elevated BA exposure risk sections above; not in this section for other workers exposed during releases or other emergency scenarios.

OSHA's Biological Agent Emergency Preparedness and Response (EPR) page contains general information for addressing controls and emergency response relating to terrorist/criminal acts involving biological agents. The information presented here pertains specifically to BA.

A. Administrative Controls & Safe Work Practices

Add BA-specific information to the EAP or ERP if a facility falls into the Yellow/Red Zone on the Anthrax in the Workplace Risk Reduction Matrix and include the following information as applicable to the specific facility:

Emergency identification: Provide guidance on how to recognize a potential emergency situation (e.g., an anthrax threat or release, suspicious mail).

Initial actions: Isolate contaminated areas and minimize exposure to others; turn off local fans or ventilation units and shut down the air handling system in the building; compile a list of workers/visitors potentially exposed to BA spores and provide it to local public health authorities and law enforcement officials upon arrival; notify the proper authorities once the area has been isolated (i.e., call 911 for local fire and law enforcement assistance; call the Federal Protective Service at 1-877-4FPS-411 (1-877-437-7411) if a GSA-managed building; notify the National Response Center at 1-800-424-8802; contact the owner or operator of the facility).

Notification: Describe the alarm system in place to notify workers (including disabled workers) to evacuate and/or take other actions. When BA contamination is possible, notify personnel to stay away from affected area or worksite.

Evacuation policy: Outline evacuation policy, procedures, and escape route assignments so workers understand the persons authorized to order an evacuation, the conditions under which an evacuation is possible, how to evacuate, and what routes to take. OSHA's Evacuation Plans and Procedures e-Tool provides more information about evacuation procedures. Generally, employers and workers should evacuate and secure areas with possible BA contamination.

Employee tracking: Define procedures to account for workers after the evacuation to ensure that everyone vacates the facility.

Organizational structure: Define the roles and responsibilities of workers in the event of an emergency.

Employee training: Describe the method of communication used to inform workers about the contents of the EAP or ERP and the method for training workers in their roles and responsibilities.

Contact information: List the names, titles, departments, and phone numbers of workers to contact for further information or clarification about the plan.

Off-hour contacts: List key personnel to contact during off-hours emergencies.

Emergency drills: Describe how to conduct emergency drills and when to help ensure proper and safe implementation of the actions outlined in the EAP or ERP.

Emergency procedures, such as an EAP or ERP, should also include provisions to prevent further spread of the BA spores during an incident, including:

Turning off the air handling systems, if possible.

Allowing only trained and experienced responders to access the affected area.

OSHA and the Environmental Protection Agency (EPA) developed a Model Health & Safety Plan (HASP) for Clean-up of Facilities Contaminated with Anthrax Spores, which provides model language to help employers prepare an EAP.

The OSHA Evacuation Plans and Procedures Tool also provides information on how to write and implement an EAP (including OSHA's Expert System to help formulate an EAP).

See the Training section for information about worker training.

C. Personal Protective Equipment (PPE)

The Workplace Risk Pyramid - Anthrax provides detailed information on appropriate selection of PPE based on workplaces where contamination is unlikely (green zone), possible (yellow zone), or confirmed/strongly suspected (red zone). Most types of operations and workers not covered in the general guidance for workers and employers with elevated BA exposure risk or specific guidance for workers and employers with elevated BA exposure risk sections above are likely to fit in the green or yellow zones of the risk pyramid. No PPE is required for workplaces in the green or yellow zones. For workplaces and workers that fall into the red zone-workplaces where authorities have informed the employer that contamination with anthrax spores has been confirmed or is strongly suspected-protective actions, such as sheltering in place or evacuation, may be more appropriate than using PPE so workers can remain on the job.

If workers in operations not covered in the general guidance for workers and employers with elevated BA exposure risk or specific guidance for workers and employers with elevated BA exposure risk sections above must continue working in red-zone workplaces, decisions about when to use PPE and what level of protective equipment is needed should be based on the risk anticipated for the task workers will do. Employers and workers who must work in red-zone workplaces, instead of sheltering in place or evacuating, should follow guidance for PPE as described in the general guidance for workers and employers with elevated BA exposure risk and specific guidance for workers and employers with elevated BA exposure risk sections. In general, PPE may include impermeable gloves and properly fitted NIOSH-certified filtering facepiece respirators. PPE required for the red zone must adhere to the requirements under the HAZWOPER standard ( 29 CFR 1910.120).

Also see the OSHA Respiratory Protection e-Tool, the OSHA Respiratory Protection standard ( 29 CFR 1910.134), and the Getting Started - PPE for Emergency Response and Recovery Workers page for more information on PPE selection, use, care, and maintenance.

Employers who provide or allow workers to wear other PPE should be familiar and must comply with applicable requirements of OSHA's PPE standards ( 29 CFR 1910 Subpart I).

D. Medical Monitoring Program

In bioterrorist/criminal acts involving anthrax, employers must develop workplace medical monitoring programs to address exposure of:
Occupants, Workers, or Visitors at a Site Contaminated with Anthrax
Generally, workers in operations not covered by the General guidance for workers and employers with elevated BA exposure risk or Specific guidance for workers and employers with elevated BA exposure risk sections above fall into this category. The medical program for this group covers the immediate post-exposure period and the period after clearance for unrestricted entry and occupancy. Employers also must conduct initial medical screening to identify exposed persons who should avoid taking antibiotics.

After clearance for unrestricted entry and occupancy, compile an initial medical history to screen for high-risk conditions (such as compromised immunity, skin conditions). Counsel high-risk persons and provide around-the-clock access to medical coverage for anthrax-like symptoms. Ensure the confidentiality of medical information.

Part of the workplace medical program includes medical monitoring. Establish a medical monitoring program to watch persons exposed to BA for signs and symptoms of anthrax. The intent is to detect adverse effects on a worker's health at an early stage when prevention is possible or treatment is most effective. An effective medical screening program for anthrax includes:

Baseline medical screening to identify pre-existing conditions that may affect an individual worker's fitness for duty, and those who should avoid antibiotics or vaccines.

Periodic evaluations to reassess fitness for duty and to detect symptoms of the development of anthrax or adverse effects related to preventive measures (such as antibiotics).

Final evaluation when it is no longer necessary for a worker to re-enter a contaminated site, to identify changes from the baseline and any new risk factors.

Employers must develop a plan to inform affected workers about available options for preventing anthrax and the risk and benefits of each option. Information about when exposure monitoring is required should also be included.

Inhalation exposure to a high concentration of BA spores may result in rapid death. Therefore, treat as a medical emergency any exposure to aerosolized powder potentially containing or known to contain BA spores.

After receiving clearance for re-occupancy, PPE and medical measures to prevent anthrax are no longer required. However, employers may find it prudent to implement a precautionary program of medical monitoring to ensure that anthrax is no longer a threat.

The Centers for Disease Control and Prevention provide further information about medical surveillance in BA Contaminated Sites. The HAZWOPER standard ( 29 CFR 1910.120) also details medical surveillance program requirements.

E. Training

Hazard awareness training is also an important component of the workplace medical program. In addition to HAZWOPER training ( 29 CFR 1910.120), response workers will also need particular knowledge and information about anthrax and protective medical measures. The validity and reliability of symptom reports are only as good as the exposed worker's knowledge and understanding of the characteristics of anthrax and the risks of developing the disease. Successful treatment of anthrax will depend on the worker's understanding of the need for immediate medical attention if symptoms occur and their knowledge of how to access emergency medical care.

OSHA recommends that employers offer anthrax-specific hazard awareness training to help workers understand the health hazards of anthrax and the measures needed to prevent exposure to spores. Specific topics may include:

How workers might be exposed to spores, the signs and symptoms of infection, and medical conditions that could place them at increased risk (such as a compromised immune system),

Where contamination has been identified in the facility, and the status of decontamination of those areas, and

Steps being taken to minimize the risk of infection (e.g., specific standard operating procedures and controls, such as engineering controls, work practices, housekeeping, or PPE), and whether specific measures are expected to be temporary or permanent.

F. Cleaning and Disinfection

Most types of workers not covered in the general guidance for workers and employers with elevated BA exposure risk or specific guidance for workers and employers with elevated BA exposure risk should not undertake cleaning and disinfection operations after a release of BA that affects the worksite. While ensuring that a worksite is safely cleaned up after such an event is the employer's responsibility, employers should consult their state and local health authorities in addition to considering the exposure risk to workers, special expertise and equipment needed, and other issues related safely cleaning up contaminated worksites when deciding how whether to seek professional assistance with remediation operations.

In instances where workers in businesses impacted by a BA release are involved in clean-up operations, follow the general guidance for workers and employers with elevated BA exposure risk and specific guidance for clean-up workers, above. Those sections of this Web page provide more detailed information about selection of chemicals for disinfection and sterilization when BA is a contaminant of concern, and recommendations for protecting workers from exposure to BA and any chemical hazards associated with clean-up work.

BA is persistent in the environment for long periods of time, and small particles can stay suspended in the air or be re-aerosolized by agitation and air currents within buildings and other environments. This creates the potential for BA transmission from contaminated environmental surfaces or fomites (objects that can spread germs) and the need for effective cleaning and decontamination strategies.

G. Reporting Illness

Ensure that supervisors and all potentially exposed workers are aware of the symptoms of anthrax.

Workers potentially exposed to BA or who develop symptoms of anthrax should seek medical evaluation. While symptoms of anthrax usually occur within seven days of exposure, some cases presented symptoms after only one day while others presented symptoms later than two months after exposure.

Under OSHA's Recordkeeping and Reporting Requirements, including the agency's standard on Reporting Fatalities, Hospitalizations, Amputations, and Losses of an Eye as a Result of Work-related Incidents to OSHA (29 CFR 1904.39), all employers must report all work-related fatalities within 8 hours and all work-related inpatient hospitalizations, all amputations and all losses of an eye within 24 hours. Only fatalities occurring within 30 days of the work-related incident require reporting to OSHA. For an in-patient hospitalization, amputation, or loss of an eye, these incidents are reportable to OSHA only if they occur within 24 hours of the work-related incident.

Where required, report an incident to OSHA by:

Calling OSHA's free and confidential number at 1-800-321-OSHA (6742).

Calling the closest Area Office during normal business hours.

Using the new online form.

Physicians, employers, and/or workers may also contact their state or local health departments to notify them of any symptomatic workers or suspected exposure incidents. Some states may require these incidents to be reported.

Workers may continue working after exposure if able since anthrax generally is not transmissible from person to person (transmission primarily occurs through contact with the BA spores).

See the Medical Information page for more information on symptoms and anthrax transmission.

H. If You Think You Have Been Exposed

Any worker who thinks he or she may have been exposed to BA-including as a result of a BA release impacting his/her workplace-should take the following precautions:

Notify your employer immediately.

If possible, list any other workers in the room or area where the potential exposure occurred. Give this list to both the local public health authorities and law enforcement officials for follow-up investigations and advice.

Remove heavily contaminated clothing, place it in a plastic bag, and seal it.

Shower with soap and water as soon as possible.

Contact a physician immediately and report the details of the incident and possible exposure.

Carefully follow your doctor's recommended treatment and advice.

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Anthrax - Control and Prevention | Occupational Safety and Health Administration

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Control and Prevention Infection with Bacillus anthracis, (BA), which causes anthrax, occurs through direct exposure to active bacteria or bacterial spores. Measures for protecting workers from exposure to BA depend on the type of work performed and knowledge of exposure risk, including potential for spore release from an accidental or intentional event.

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As I have stated in earlier posts, Anthrax is a rare disease and fairly well prevented in today's society. For these reasons there are little effects on society as a result of Anthrax. There are some preventative measures if there was ever a widespread outbreak of this disease, but beyond that there are no other effects on society (that I have found as of yet).

Society has learned how to deal with preventing the spread of Bacillus anthracis to the human population. However, there have been some problems in the past with anthrax spreading due to a countries inability to get products properly treated during war times. This results in the countries having to take the time to find an alternate supplier that can properly treat products before they are shipped out.

There are also concerns of anthrax being used as a bioweapon. There is limited information about this topic, but from what I can gather the PODs I mentioned in the last post are the preventative measures to help people in cities that are infected by this disease.

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Throughout my course on the evolution of disease, I have come across many instances were I was excited to connect the content I was learning in class with what I was finding out about in this disease. It is easy to be told about how diseases in our world behave, it is a different experience to look into a specific disease and see how it's behavior has an effect. For example, looking into how infectious the disease is and how it is spread. I was intrigued by what I found and how the content I learned could be connected to my short research.

The most surprising thing I learned about when looking into the history of Anthrax is that it is suspected to be related to one of the plagues mentioned in the biblical book of Genesis. While I suspect it's not the same exact disease I do think, if its true, it is a ancestor to the modern Bacillus anthracis.

While the posts I created here about Anthrax cover quite a bit about the disease and treatment, it doesn't cover all the information out there about this disease. Looking back at this list of posts. I think it would have been interesting to include a section about how Anthrax was used as a bioweapon. Were there any modifications to the genome made by humans to make Anthrax a more efficient weapon? I don't have an answer here, but to anyone who is interested in the answer, it is up to you now to find it.