West Virginia Department of Health and Human Resources Anthrax: Information for Public Health Officials

Spore-forming bacteria

Unique Epidemiological Characteristics

  • No natural reservoir in West Virginia
  • A newly reported case should be urgently investigated considering:
    • travel
    • highly unusual exposure
    • BT.
  • Incubation: 1-60 days; with most cases occurring within the first week
  • No person-to-person transmission
  • Mortality: 60-100% for inhalation anthrax and 20% for cutaneous anthrax without therapy — dire emergency
  • Environmental: hardy for decades in the spore form
  • Treatment (Ciprofloxacin, doxycycline) effective in reducing mortality if begun early
  • Prophylaxis (Ciprofloxacin, doxycycline) effective in preventing disease

Laboratory confirmation

  • Screening tests should be completed by hospital laboratory; confirmation by OLS

Employee health considerations

  • Personal protective equipment / training required for persons doing environmental investigations
  • Prophylaxis required for employees who have been exposed.
  • Standard precautions for work with infected individuals

Life-saving interventions – in order

  1. Recognition / reporting / casefinding + early and appropriate therapy
  2. Risk factor and environmental investigation to establish source of exposure / population at risk AND rapid initiation of prophylaxis
  3. Antibiotic sensitivity testing of the isolate

Training considerations

  • Physicians: recognition / treatment / reporting
  • ICPs: reporting, active surveillance procedures
  • Labs: screening tests and procedure for referral to OLS
  • Local health departments, regional epidemiologists: NPS issues > investigation
  • IDEP / DSDC / BPH: employee health / investigation / priorities for control.
  • Environmental Health: personal protective equipment, environmental sampling

 

Related Links

CDC - Anthrax Page