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SECTION II

MEDICAL DEFENSE AGAINST BIOLOGICAL MATERIAL

SPECIFIC THREAT AGENTS

ANTHRAX

CLINICAL SYNDROME

Anthrax is a zoonotic disease caused by Bacillus anthracis.
Under natural conditions, humans become infected by contact
with infected animals or contaminated animal products.

Human anthrax usually is manifested by cutaneous lesions. A
biological warfare attack with anthrax spores delivered by
aerosol would cause inhalation anthrax, an extraordinarily rare
form of the naturally occurring disease.

Clinical Features: The disease begins after an incubation
period varying from 1-6 days, presumably dependent upon the
dose of inhaled organisms. Onset is gradual and nonspecific,
with fever, malaise, and fatigue, sometimes is association with
a non-productive cough and mild chest discomfort. In some
cases, there may be a short period of improvement. The initial
symptoms are followed in 2-3 days by the abrupt development of
severe respiratory distress with dyspnea, diaphoresis, stridor,
and cyanosis. Physical findings may include evidence of
pleural effusions, edema of the chest wall, and meningitis.
Chest X-ray reveals a dramatically widened mediastinum, often
with pleural effusions, but typically without infiltrates.
Shock and death usually follow within 24-36 hours of
respiratory distress onset.

DIAGNOSIS

Routine Laboratory Findings: Laboratory evaluation will
reveal a neutrophilic leukocytosis. When pleural effusions
and evidence of meningitis are present, pleural and
cerebrospinal fluids may be hemorrhagic.

Differential Diagnosis. An epidemic of inhalation
anthrax in its early stage with non-specific symptoms could


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