Anthrax

Anthrax


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Anthrax

The bacteria Anthrax (Bacillus anthracis) has become famous due to its connection with biological warfare and its potential to be used by Terrorists. Anthrax has a long history of involvement in biological warfare being deemed a suitable biological agent due to the variety of ways it can be spread and the extreme hardiness of its spores. It was the first disease agent to be purified, by a young German Doctor called Robert Koch in 1870. Anthrax naturally normally affects herbivorous animals such as sheep and cattle so cases due occur naturally among those involved in this industry. In cattle the symptoms are staggering and convulsions and then death within a few days. Human infection occurs when spores make contact with exposed skin or enter the lungs as airborne particles, infection can also occur by eating infected meat. Skin Anthrax and intestinal anthrax (from eating infected meat) have a mortality rate of 30-60% if left untreated, inhalation of anthrax spores has a much higher mortality rate if left untreated with around 90% of victims dying.
Each type of infection has different symptoms, skin or cuteous Anthrax appears as a large pus filled blister and possible inflammation of the lymph glands. Intestinal Anthrax brings on painful stomach cramps, acute inflammation of the intestinal tract and finally vomiting of blood and severe diarrhoea. Inhalation Anthrax which has the highest morality rate has initial symptoms similar to that of the common cold followed by breathing problems and then shock. Immunization is effective and the US began immunizing military staff in 1998. the vaccine is made up of a dead form of the bacteria and is given in three injections two weeks apart followed by boosters very 6 months for the first 18 months, Side effects are rare. The disease can be treated with antibiotics if caught in the early stages which is of course is very difficult for the inhalation infection due to the early symptoms.
Anthrax became more famous after British experiments in 1942. Test anthrax bombs were dropped on the Scottish island of Gruinard. the spores were so resilient that in 1986 over 40 years later the spores were still active and the island was decontaminated with hundreds of thousands of litres of Formaldehyde. The large scale use of Anthrax as a terror weapon by low tech terrorists is unlikely as although it has been used against media organisations throughout the world via mail deliveries this is far from an effective delivery method mostly resulting in easy to treat skin Anthrax cases. As with most biological weapons it is not production of the biological agent that is the problem for the terrorist but the development of an effective method of delivery in particular for an airborne agent.

Troops who refused anthrax vaccine paid a high price

/>U.S. Marines queue up to receive the Moderna coronavirus vaccine April 28 at Camp Hansen on Okinawa, Japan. The services have urged troops to take the shots, but haven’t forced them. (Carl Court/Getty Images)

During the first eight years that the Pentagon ran the anthrax vaccination program, hundreds of troops refused the vaccine due to perceived health risks or religious concerns — and many of them paid dearly for that decision.

The penalties ranged widely. Some kept on working, others received nonjudicial punishment, lost rank and pay, saw their careers ended or even faced brig time and dishonorable discharges.

Since then, an unknown fraction of those who were punished have sought to have their records corrected, but only a few have had success. Now, even more than 20 years later, some of those cases remain pending before military record corrections boards.

Numbers are hard to pin down, as service record corrections boards have not comprehensively tracked appeals specifically related to the anthrax vaccine. In many cases, those appeals were denied. But more recently, at least two corrections requests ­— one in 2019 and the other in 2020 — were granted by the Navy, which awarded two Marine veterans some backpay, rank restoration, discharge upgrades and access to veterans benefits.

The shadow of anthrax: The voluntary COVID-19 vaccination effort owes much to past failures

The voluntary COVID-19 vaccine effort stands in stark contrast to the Pentagon’s mandatory Anthrax Vaccine Immunization Program, which began in 1998. Those who refused often faced harsh penalties.

Retired Marine Maj. Dale Saran, a former JAG officer, represented one sailor and two Marines who refused the vaccine on Okinawa in 2000.

Saran stayed involved with the issue. He authored the book “United States v. Members of the Armed Forces: The Truth Behind the Department of Defense’s Anthrax Vaccine Immunization Program,” published in 2020. He also offered legal advice to attorneys with clients facing punishments for refusals.

Saran’s clients and many others were often top performers, some early in their careers and others nearing retirement. But once they refused the vaccine, their commands sought to punish them.

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Background

Anthrax is a disease caused by the bacterium Bacillus anthracis. This bacterium exists in nature in 2 forms: as an active growing cell (called the vegetative form) or as a dormant spore. The spores are very hardy and tolerant to extremes of temperature, humidity, and ultraviolet light. They can survive for long periods of time (even decades) in the environment without nutrients or water. When a spore enters a mammal host, the internal environment of the host-rich in water, sugars, and amino acids-induces that spore to germinate into a vegetative cell that leads to disease.

In nature, anthrax primarily affects herbivorous mammals such as cattle, sheep, and goats. 1 According to the World Health Organization (WHO), anthrax is enzootic in animal populations in much of sub-Saharan Africa and Asia as well as in some southern European countries, parts of the Americas, and some regions in Australia. Outbreaks in animals also occur sporadically in other countries around the world. Human cases of anthrax are much less frequent. 2

There are 4 forms of naturally occurring human anthrax infection:

  • Cutaneous anthrax is the result of spores entering the body through small breaks in the skin. This form of the disease is characterized by a sore at the point of infection that develops into a painless ulcer covered by a black scab (eschar). Cutaneous anthrax accounts for approximately 95% of all reported human anthrax cases. Cutaneous anthrax could also occur as a result of an aerosol attack.
  • Gastrointestinal anthrax typically occurs as a result of eating the meat of animals infected with B. anthracis. The intestinal tract, mouth, or throat (oropharyngeal anthrax) may be infected. 1 GI anthrax is normally thought to occur as a result of ingestion of vegetative bacteria rather than spores therefore, GI anthrax is not expected to result from exposure to aerosolized spores.
  • Inhalational anthrax is the result of breathing B. anthracis spores into the lungs. Inhalational infection is the form of anthrax that would be of most concern following an intentional aerosol attack with B. anthracis.
  • Injection related anthrax is a newly recognized entity. A number of cases have occurred recently in Europe in intravenous drug users. This is believed to be caused by injecting heroin that is contaminated with material containing B. anthracis spores. 3

The History of Anthrax

There are multiple different types of anthrax, all of which can be deadly if left untreated. Because of this the illness has been used for many acts of aggression over the last century.

But, anthrax didn’t just come about over the last 100 years.

The origins of anthrax are estimated to go back as far as 700 B.C. in Egypt and Mesopotamia. Rome and ancient Greece are also thought to have experienced the disease, with some considering anthrax to have played a part in Rome’s downfall.

The first official clinical descriptions were written by Maret in 1752 and retired physician Nicolas Fournier in 1769.

After millennia filled with cases, true study of the illness didn’t begin until the 1800s. These studies led to a breakthrough with the connection between anthrax and the animal hair industry. According to the CDC, this relationship even led to the name “wool sorters disease” for anthrax.

Rod-shaped bacterial bodies, eventually called Bacillus anthracis, provided the basis for major research from scientist Robert Koch in 1877. Through experimentation Koch found the life cycle of the bacteria and demonstrated “Koch’s postulates.” More than a breakthrough for anthrax, Koch’s postulates set a precedent for all diseases. By studying the illness, he created a set of guidelines that all infectious bacteria must meet.

After identifying the bacteria, researchers could work on a vaccine.

In 1881, famed French chemist Louis Pasteur began the research into a vaccine for anthrax. He injected 50 animals with live anthrax bacteria. While 25 of the creatures were given his experimental weakened bacteria immunization, 25 were not. Results were clear – the 25 unvaccinated animals died while the protected ones survived.

Around this time, anthrax began appearing as more than a natural illness.

Anthrax was first used as a weapon during World War I by the German army. They used the disease to infect neutral parties’ livestock and animal feed which was to be traded to Allied Nations. Further experimentation with the disease continued over the years, particularly during the Korean War.

The live spore vaccine for anthrax was created in 1937 by Max Sterne. This became a routine vaccination for animals, crucial to those who worked with livestock.

The spore strain of anthrax doesn’t spread through people, but by inhaling the particles. Exposure often occurs in humans who are cleaning infected animals with the bacteria in their fur. The vaccine then helped greatly reduce both general human and animal cases alike.

Over the next few decades several important events changed anthrax prevention.

In 1944 Penicillin became the main choice for the treatment of anthrax. The antibiotic quickly became the top treatment for anthrax. In the 1950s the first human anthrax vaccine was made and finally in 1970 this vaccination underwent great improvements. Despite many changes in vaccines in recent decades, that vaccine from 1970 is almost the same as what’s used in the modern day.

Blisters, bumps and sores are common for cutaneous anthrax. This may be a low-risk form of anthrax, it’s also fairly easy to catch. Cutaneous anthrax occurs when the spores get into an open cut or wound. Fever and chills, nausea, headache, extreme fatigue, confusion, dizziness and body aches are just a few of the possible symptoms of inhalation anthrax.

Gastrointestinal anthrax doesn’t require an open wound. Instead, this disease gets into the body via undercooked meat from an infected animal. The illness can lead to fever and chills, hoarseness, bloody vomiting, headache and fainting.

Finally, injection anthrax presents similar signs to cutaneous, but it spreads faster and can be harder to treat.

Did you know that there were four different types of anthrax? Did you know Louis Pasteur worked on an anthrax vaccination? Do you have any questions or thoughts about the illness? Let us know in the comments below, or via Facebook and Twitter.

Written for Passport Health by Katherine Meikle. Katherine is a freelance writer and proud first-generation British-American living in Florida, where she was born and raised. She has a passion for travel and a love of writing, which go hand-in-hand.


Anthrax - History

Source: BBC News, October 17, 2001.

Using anthrax as a weapon

By Nick Caistor, BBC News Online

Military interest in the use of anthrax as a weapon began in the First World War. The Germans used it to contaminate animal feed and livestock but, unlike chemical gases, it was not employed directly against enemy troops.

The first mass use of anthrax spores as a weapon is said to have taken place during the Japanese occupation of China from 1932 to 1945.

The Japanese allegedly experimented with the use of anthrax and other biological weapons in Manchuria, and some 10,000 deliberately infected prisoners are thought to have died as a result.

In the Second World War, the Germans did not launch the much-feared biological attack, although they and the Allied forces experimented with the possibilities of using anthrax or other agents.

The UK military tested spore delivery systems of anthrax on the tiny island of Gruinard off the Scottish coast.

These spores persisted and remained theoretically capable of infection for decades afterwards.

A massive decontamination effort, started in 1979 and completed in 1987, used 280 tonnes of formaldehyde and 2,000 tonnes of seawater to clean up the island.

After the Second World War, the US continued its biological weapon research into the 1950s, when Iowa State University produced the virulent "Ames strain" of anthrax which was later sold to many parts of the world.

In 1970, President Nixon ordered an end to the production of biological weapons in the United States, since when research there has been confined to developing means of defence against any biological attack.

In 1972, international concern led to a treaty banning the production and stockpiling of biological weapons. This was eventually signed by some 140 nations.

Although it was one of the treaty signatories, the Soviet Union continued researching and producing biological weapons - and in April 1979 an accidental release of anthrax spores from a military facility near Sverdlovsk caused 68 known deaths.

But the greatest fears that anthrax might be used as a weapon came during the 1991 Gulf War.

Iraq purchased anthrax spores from the United States in the 1980s, and was thought to be developing the capability to use them in warheads and in aerial attacks.

In the event, no biological weapons were used.

After the war, the UN Special Commission on Iraq (UNSCOM) destroyed the remaining production and stockpiling facilities for biological warfare in Iraq. "By 1998, we were able to establish that Iraq had no capability of producing biological weapons," a former UN inspector, Scott Ritter, told the BBC.

In the 1990s, the one publicised case of the use of anthrax for terrorist aims was by the Aum Shinrikyo group in Japan.

They are said to have tried unsuccessfully to release anthrax in Tokyo several times, leading them to change to sarin gas, with fatal results.

Producing large amounts of anthrax in powder form - necessary for its use as an effective large-scale weapon - is a complicated and expensive process.

It requires the use of large centrifuges for repeated washings, and then intensive drying to produce the concentrated or "military-grade" powder.

The cost of this technology has led some experts in the United States to argue that the instigators of the present campaign must be a country, with previous experience, stocks and the necessary biotechnological expertise.


Paper on Anthrax History

Paper on Anthrax History explains that Studies have shown that Anthrax is a severe bacterial infection transmitted from animals, and can cause bowel, skin, and lung disease and can also be deadly. (“Medicinet.com”) According to CDC, Anthrax is prevalent in agricultural regions of southern and eastern Europe, the Caribbean, Central and South America, central and southwestern Asia, and sub-Saharan Africa. This paper briefly explains the facts about Anthrax, as well as more information from CDC, WHO, and other literary sources. The research shows how Anthrax is contracted by the Animal from the soil and then infects humans. Additionally, it clearly points out the types of Anthrax and other commonest Anthrax. It was also understood that Anthrax can be treated and avoided. A brief explanation of the experiment carried out by scientist on Bacillus anthracis was highlighted as well as how Anthrax is a biological weapon. The research concludes that the provision of quality veterinary operations for animals must be taken seriously to avoid the Anthrax infection.

ANTHRAX

Anthrax is an infectious disease caused by the bacteria called Bacillus anthracis. Bacillus anthracis is a rod-shaped bacterium that produces toxin. Anthrax is a rare, but deadly disease. It is of different types, the cutaneous anthrax, inhalation anthrax, gastrointestinal anthrax, and the recently discovered, the injection anthrax. Its symptoms include fever, cold, sore throat, sores on the skin, dizziness, and many others.

Centers for Disease Control and Prevention (CDC) Information on Anthrax

According to CDC (Centers for Disease Control and Prevention), anthrax, which is caused by Bacillus anthracis, can be found in the soil and affects animals directly only. These animals get infected when they breathe-in soils infected with the bacteria. Hence, human beings are infected only if they come in contact with infected animals, either through breathing in, eating food, or drinking water contaminated with the bacteria.

Anthrax occurs more in countries that lack adequate health programs that provide vaccination for animals. In developed countries like the U.S, animals that have once had anthrax are required to be vaccinated every year. As deadly as anthrax is, its only fair feature is that it is not contagious.

World Health Organization (WHO) Information on Anthrax

According to World Health Organization, anthrax basically affects herbivorous warm blooded creatures, albeit different well evolved creatures and a few fowls have been known not it. People for the most part get the malady from infected animals or as a consequence of exposure to the sullied animal product. There are three types of anthrax in people, they include, cutaneous, gastrointestinal, and pulmonary.

The most common, being cutaneous is caused by anthrax spores contaminating a cut. Gastrointestinal anthrax is caused by the consumption of meat of an anthrax-infected animal. The last one, rarest and the most severe is the pulmonary or inhalation anthrax. People can contract the pulmonary anthrax when they breathe in air that has anthrax spores suspended in it.

Anthrax is not transmitted from individual to individual, and can be treated with antibiotics. These antibiotics must be taken only with medical advice. However, there is a vaccine that prevents anthrax, though not widely known because it has not been tested widely on humans, but the vaccines are sometimes given to people who have the highest risk of contracting the infection.

Literary Source by MARC LAFORCE on Anthrax

With various experiments, scientists were able to develop some theories about Bacillus anthracis, some of which are:

The presence of filiform bodies in the blood of animals dying of anthrax, the ability of anthrax to be transmitted to other animals by the introduction of the infected blood to their bodies, the stage of dormancy of the spores in the soil, the ‘sporulating gram-positive rod’ form of the bacterium, its non-motility, its ability to grow well on blood agar plates, et cetera.

Anthrax as a biological weapon – UPMC

It wouldn’t be out of the ordinary to know that anthrax is used as a biological weapon. With all its features and ways of contracting it, some of which include

  • -The accessibility to Bacillus anthracis in microbe banks all around the world and in endemic territories.
  • -The toughness of Bacillus anthracis spores in the earth might make Bacillus anthracis vaporized spread more compelling than numerous other potential specialists and more so, there is proof that methods for large scale manufacturing and vaporized spread of Bacillus anthracis have been produced. .
  • -Antibiotic-safe strains of B. anthracis exists in nature also, could be utilized as a part of a deliberate discharge which could result to inhalational anthrax and when inhalational anthrax is not treated on time, it can be deadly. Historically, anthrax has been used as a biological weapon

With all of these, bioterrorists have adopted anthrax as one of their weapon and is now one of the most critical bioterrorism agents. An example of this scenario is the event that took place in 1993 when Aum Shinrikyo, a Japanese cult, released aerosols containing Bacillus anthracis into the air in one of their attacks in Tokyo. Luckily, no one was hurt. Another attack also took place in October 2001 when mails were used as a medium in sending the anthrax spores. Seven envelopes were sent, though four were retrieved, but the remaining three worked effectively infecting twenty two and killing five people.

PREVENTION AND CURE of ANTHRAX

Anthrax can be prevented by having a standard veterinary supervision of animals, especially the herbivores. Veterinarians and all who work on or with animals should use and wear protective clothes and equipment. If they are at high risk, they should be vaccinated.

Anthrax can be treated with antibiotics as a basic treatment for the vegetative stage of anthrax not against its spores.


THE HISTORY OF ANTHRAX AND THE CURRENT THREAT

For centuries, anthrax has caused disease in animals and, although uncommonly, in humans throughout the world. Human anthrax in its various forms (inhalational, cutaneous, and gastrointestinal) is historically a disease of those with close contact with animals or animal products contaminated with B. anthracis spores. The disease is very well described in texts of antiquity, and it has been suggested that the famous Plague of Athens (430� bc ) was an epidemic of inhalational anthrax (4). In fact, the term anthrax is derived from the Greek word anthracites, meaning coal-like, referring to the typical black eschar seen in the cutaneous form of the disease.

Another excellent ancient description is that of the murrain of Noricum (the ancient Roman name for the Danube River delta and the eastern Alps) by the Roman poet Virgil (5). Virgil (70� bc ), most renowned for his Aeneid, also wrote four Georgics, didactic verse works on agriculture. The third Georgic is devoted to animal husbandry and contains a section on veterinary medicine. It details an epizootic that occurred in the Roman district of Noricum. The disease affected sheep, cattle, and horses, as well as dogs and other domestic and wild animals. The symptoms of anthrax are described in great detail, and although the narrative contains some errors and traces of poetic license, it includes much factual material, showing that Virgil indeed understood the hardiness of the infectious source, as well as the potential for transmission among animals and humans.

Anthrax continued to affect livestock and humans throughout the Middle Ages. During the 18th century, anthrax epidemics destroyed approximately half the sheep population in Europe (6). In Victorian England the disease became known as “woolsorters' disease” because it was frequently observed among mill workers exposed to animal fibers contaminated with B. anthacis spores. However, the name is somewhat a misnomer: the infection was more often a result of contact with goat hair or alpaca than with wool and sheep (7). Other names for the disease included “ragpickers' disease,” charbon, milzbrand, black bain, “tanners' disease,” and Siberian (splenic) fever.

In the 19th century, anthrax was a major point of interest in developing biomedical research. In 1850, Pierre Rayer and Casimir-Joseph Davaine discovered small filiform bodies �out twice the length of a blood corpuscle” in the circulation of sheep with anthrax (8). Initially, this discovery was not given any significance, as the filiform bodies were regarded as disease products. However, Davaine subsequently suggested that the corpuscles described were organisms causing the disease.

In the 1870s, anthrax was extensively studied by several researchers in Europe, including Robert Koch in Berlin and Louis Pasteur in Paris (Figure ​ (Figure1 1 ). In 1876, Koch, using suspended drop culture techniques, was able to trace the complete life cycle of the anthrax bacillus for the first time in history. He found that the bacillus formed spores that could remain viable for long periods even in unfavorable environmental conditions (8). Furthermore, he postulated that the anthrax bacillus could be transmitted from one host to another, and in 1877 he grew the organism in vitro and induced the disease in healthy animals by inoculating them with material from these bacterial cultures. Anthrax served as the prototype for Koch's famous postulates regarding the transmission of infectious diseases.

(a) Robert Koch and (b) Louis Pasteur. Courtesy of the Images from the History of Medicine database of the National Library of Medicine.

However, at the same time, Louis Pasteur felt that Koch's work was inconclusive and announced his goal to provide his own incontrovertible demonstration of infectious disease transmission. As one can imagine, this incited a long and acrimonious dispute between the two men. In May 1881, Louis Pasteur inoculated 25 cattle with his anthrax vaccine at a farm in Pouilly-le-Fort, a small village outside of Paris (8, 9). This first vaccine contained live attenuated organisms. Subsequently, Pasteur inoculated the vaccinated animals as well as other cattle with a virulent strain of B. anthracis. All the vaccinated animals survived however, the others died. To Pasteur, it was this experiment and not the work of Robert Koch that had proven the germ theory of disease.

From our perspective, it may seem insignificant whose work finally provided the proof for the germ theory of disease. Together, the work of both Koch and Pasteur, who were highly regarded medical authorities, led to a broad acceptance of their theories and opened possibilities for further work in medical microbiology.

In the early 1900s, human cases of anthrax continued to occur occasionally, and human cases of inhalational anthrax were reported in the USA among workers in the textile and tanning industries that processed goat hair, goat skin, and wool (7, 10, 11). With improvements in industrial hygiene practices and restrictions on imported animal products, the number of cases fell dramatically in the latter parts of the 20th century. However, death rates remained high (㺅%) when inhalational anthrax occurred. Among animal-processing workers and farmers, the decrease of anthrax was postulated to be due to vaccination of both animals and humans, together with improvements in animal husbandry and processing of animal products (9, 12). In the 1950s, a human anthrax vaccine was developed by the US Army Chemical Corps. After nearly 20 years of use, it was replaced by a new, improved, and licensed vaccine in 1970 (13). In 1997, the US armed forces mandated vaccination for all active and reserve troops. However, this resulted in some well-publicized refusals by military personnel to be vaccinated based on concerns about the vaccine's safety (13, 14).

Although naturally occurring human anthrax has significantly decreased over the past century, it remains fairly common worldwide, particularly in Asia and Africa, with an annual occurrence of 20,000 to 100,000 cases recorded during the first half of the 20th century. In addition, it remains common among herbivores worldwide, and large epidemics of animal anthrax are reported on occasion in Africa, Asia, and South America. During a large outbreak in Iran in 1945, 1 million sheep died (15).

In humans, cutaneous anthrax is now the most common form of anthrax worldwide, with an estimated 2000 cases reported annually (16). In the USA, 224 cases of cutaneous anthrax were reported between 1945 and 1994 (17). The largest reported epidemic occurred in Zimbabwe between 1979 and 1985, when more than 10,000 human cases of anthrax were reported, nearly all of them cutaneous. Gastrointestinal anthrax is a rather rare form of the disease in humans, with only a few cases being reported worldwide (16, 18, 19). However, outbreaks have been reported on occasion in Africa and Asia (20-23). Typically, gastrointestinal anthrax follows the consumption of insufficiently cooked contaminated meat. In 1982, 24 cases of oropharyngeal anthrax were reported from a rural area in northern Thailand, where the outbreak followed consumption of contaminated buffalo meat (20). In 1987, 14 cases of gastrointestinal and oropharyngeal anthrax were reported from northern Thailand (22). As mentioned before, the incidence of inhalational anthrax rapidly declined in the second half of the 20th century.

In 1980, Philip Brachman of the CDC published a review of inhalational anthrax (7). Only 18 cases were reported in the USA between 1900 and 1978, with the majority of those cases occurring in special risk groups, including goat hair mill or goatskin workers and wool and tannery workers. Two of these cases were laboratory-related accidents, and 16 cases were fatal (7). Brachman concluded with what was the common understanding in the western medical community: inhalational anthrax was “now primarily of historical interest.” This opinion was not to be borne out by subsequent events.

The conception of Koch's postulates and the development of modern microbiology during the 19th century made the production of stocks of specific pathogens possible, and several countries worked to develop these agents for biological warfare purposes (1). Substantial evidence suggests the existence of ambitious biological warfare programs in Germany, England, and France during World War I. These programs allegedly involved covert operations featuring agents such as B. anthracis (anthrax) and Pseudomonas pseudomallei (glanders) (1, 24, 25).

During World War II, some of the aforementioned countries, as well as other countries like Russia and Japan, began biological warfare research programs. Various allegations and countercharges clouded the events during and after World War II. Japan conducted biological weapons research in occupied Manchuria from approximately 1932 until the end of World War II (1). Again, B. anthracis was among the organisms most extensively researched and used. Although the German biowarfare program during World War II was small compared with that of other nations, medical researchers infected prisoners with disease-producing organisms like Rickettsia prowazeki, hepatitis A virus, and malaria (2, 26). Despite these efforts, which clearly lagged behind those of other countries, a German offensive biological weapons program never fully materialized.

On the other hand, German officials accused the Allies of using biological weapons. Some of these allegations were believable, since the British were experimenting with at least one organism of biological warfare: B. anthracis Dr. Paul Fildes headed the British effort at Porton Down in the 1940s. By November 1940 he had determined that the most effective way to use a biological warfare agent would be to disseminate an aerosol of particles that could be retained in the lungs. It appeared that the most suitable device for dissemination was a bursting ammunition filled with a liquid suspension of bacteria, so that effective concentrations of bacteria would be inhaled by everyone in the target area (27, 28). The British biological warfare program concentrated on B. anthracis, and bomb experiments of weaponized spores of B. anthracis were conducted on Gruinard Island near the northwest coast of Scotland (29). The so-called N bomb contained 106 special bomblets filled with anthrax spores. These experiments led to heavy contamination of the island with persistence of viable spores. Events toward the end of World War II overtook plans to put these efforts into operation. In 1986, Gruinard Island was finally decontaminated using formaldehyde and seawater, but it remains restricted from public access.

Anthrax would be unlikely to cause severe disruption to military operations, although residual contamination of the ground would occur (19). This has been shown by the experiments on Gruinard Island. Therefore, anthrax is more of a danger to the civilian population. In 1970, a World Health Organization (WHO) expert committee estimated that an aircraft release of 50 kg of anthrax over an urban, developed population of 5 million would result in 250,000 casualties, of whom 95,000 would be expected to die without treatment and an additional 125,000 would be severely incapacitated (30). The strain on medical resources in such a scenario would be tremendous, ultimately leading to hospital bed requirements for 13,000 people, antibiotics for 60 days for 125,000 people, and the disposal of 95,000 dead. This would almost certainly result in a rapid and total breakdown in medical resources and civilian infrastructures. Newer assessments, including those made by the US Congress Office of Technology Assessment in 1993, confirmed the original WHO data (31). The CDC developed an economic model suggesting a cost of $26.2 billion per 100, 000 persons exposed in a bioweapons attack with anthrax (32).

Prior to the bioterrorism-related occurrence of inhalational anthrax in the USA in 2001, only one case had been reported in the country in the 20th century (33). In addition, the only large-scale outbreak of (inhalational) anthrax during the 20th century occurred in the FSU. On April 2, 1979, an epidemic of anthrax occurred among the citizens of Sverdlovsk (now Ekaterinburg), a city of 1.2 million people, 1400 km east of Moscow. The epidemic occurred among those who lived and worked within a narrow downwind zone of a Soviet military microbiology facility known as Compound 19. In addition, a large number of livestock died of anthrax in the same area, out to a distance of 50 km (1, 34).

The first reports of the outbreak emerged in October 1979 by way of a Russian-language newspaper in Frankfurt, West Germany, that was close to the Soviet émigré community. It ran a brief report about a major germ accident in Russia leading to deaths estimated in the thousands (35). At the same time, early European and US intelligence suspected that this facility conducted biological warfare research and attributed the epidemic to an accidental release of anthrax spores. Later, in early February 1980, the widely distributed German newspaper Bild Zeitung carried a story about an accident in a Soviet military settlement in Sverdlovsk in which an anthrax cloud had resulted (36). Afterwards, other major western newspapers and magazines began to take an interest in the anthrax outbreak in Sverdlovsk. In an initial 1980 publication, Soviet officials attributed the disease outbreak in Sverdlovsk to cutaneous and gastrointestinal anthrax caused by the consumption of contaminated meat. Later that year several articles occurred in Soviet medical, veterinary, and legal journals reporting an anthrax outbreak among livestock.

Little further information was published until 1986, when Matthew Meselson (Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA) renewed previously unsuccessful requests to Soviet officials to bring independent scientists to Sverdlovsk to investigate the incident (1, 36). His request finally resulted in the invitation to come to Moscow to discuss the incident with four Soviet physicians who had gone to Sverdlovsk to deal with the outbreak. They concluded that further investigation of the epidemiologic and patho-anatomical data was needed. In 1988, two of these Soviet physicians accepted an invitation to come to the USA for further discussions of the incident with government and private specialists. The Soviet Union maintained that the anthrax outbreak was caused by consumption of contaminated meat that was purchased on the black market, and according to the account of these two Soviet scientists, contaminated animals and meat from an epizootic south of the city caused 96 cases of human anthrax. Of these cases, 79 were said to be gastrointestinal and 17 cutaneous, with 64 deaths among the first group and none among the latter (36).

After the collapse of the Soviet Union, Boris Yeltsin, then the president of Russia, directed his counselor for ecology and health to determine the origin of the epidemic in Sverdlovsk. In 1994, Meselson and his team returned to Russia to aid in these investigations (1, 36). They reviewed the studies of pathologists at a local hospital in Sverdlovsk. One of the lead authors, Dr. Faina Abramova, made available her private records from a series of 42 autopsies, representing the majority of the fatalities from the outbreak (37). Demographic, ecologic, and atmospheric data were also reviewed. The conclusion was that the pattern of these 42 cases of fatal anthrax bacteremia and toxemia was typical of inhalational anthrax as seen in experimentally infected nonhuman primates. In summary, the narrow zone of human and animal anthrax cases extending downwind from Compound 19 indicated that the outbreak resulted from an aerosol that originated there (36, 37). At the time of these investigations, several high-ranking officials in the FSU military and Biopreparat had defected to western countries. In his detailed account of the FSU bioweapons program, Ken Alibek (former chief deputy director of Biopreparat) described in detail the anthrax outbreak in Sverdlovsk, thus confirming the other investigations by US scientists and physicians (38).

After the Sverdlovsk incident, the FSU continued the anthrax research at a remote military facility in Stepnogorsk in Kazakhstan (1, 38, 39). As a result of this intensified research on anthrax, a new and more virulent strain of anthrax was produced in both powdered and liquid form. This strain was resistant to many commonly used antibiotics such as penicillin and streptomycin (38). It is clear from these revelations that the FSU demonstrated the ability to wage biological warfare on a scale matched by no other nation in history. After the final collapse of the FSU and the reorganization of its provinces and states, few of the installations of Biopreparat were subject to international disarmament procedures. The fate of some of the research and know-how remains unknown.

Before October 2001, the last case of inhalational anthrax in the USA occurred in 1976 (33). The identification of inhalational anthrax in a journalist in Florida on October 4, 2001, was the first confirmed case associated with the intentional release of the organism (40-42). The following 10 cases of cutaneous and inhalational anthrax were seen in postal workers who had handled contaminated mail. An additional case of cutaneous anthrax was reported in March 2002, in a laboratory worker processing B. anthracis samples for the CDC investigation of the above cases (9, 10). A thorough analysis of these cases suggested a domestic form of bioterrorism using the Ames strain of B. anthracis. The analysis of the cases also provided a better understanding of the pathogenesis and variable clinical presentation of inhalational anthrax. In contrast to previous studies indicating a death rate of 㺐%, the cases in 2001 suggested that survival can be markedly improved by early diagnosis, improved intensive care, and combination antimicrobial therapy (10). However, further studies will be needed to better define the antimicrobial regimens and to explore the role of adjunctive treatment modalities, such as immunoglobulin, antitoxin, corticosteroids, and other toxin inhibitors.


Can Infected Livestock Infect Humans?

This probably is an ineffective way of spreading anthrax to humans. Animal-to-animal is not a primary method of transmission. The general method is by inhaling or ingesting spores. However, caution should be exercised when handling carcasses of animals that have died of the disease because they contain large reservoirs of spores. The disease can also be transmitted by consuming undercooked meat. Should an outbreak be diagnosed in an area, great caution will be taken by the proper health authorities to ensure that affected animals are isolated, a vaccination program is put in place, and carcasses are disposed of properly.


Timeline: Anthrax through the ages

Anthrax is blamed for several devastating plagues that killed both humans and livestock. Soon after scientists learned more about it in the late 1800s, it emerged in World War I as a biological weapon.

Several countries, including Germany, Japan, the United States, the United Kingdom, Iraq and the former Soviet Union, are believed to have experimented with anthrax, but its use in warfare has been limited.

1500 B.C. -- Fifth Egyptian plague, affecting livestock, and the sixth, known as the plague of boils, symptomatic of anthrax

1600s -- "Black Bane," thought to be anthrax, kills 60,000 cattle in Europe

1876 -- Robert Koch confirms bacterial origin of anthrax

1880 -- First successful immunization of livestock against anthrax .

1915 -- German agents in the United States believed to have injected horses, mules, and cattle with anthrax on their way to Europe during World War I

1937 -- Japan starts biological warfare program in Manchuria, including tests involving anthrax

1942 -- United Kingdom experiments with anthrax at Gruinard Island off the coast of Scotland. It was only recently decontaminated.

1943 -- United States begins developing anthrax weapons

1945 -- Anthrax outbreak in Iran kills 1 million sheep

1950s and '60s -- U.S. biological warfare program continues after World War II at Fort Detrick, Maryland

1969 -- President Richard Nixon ends United States' offensive biological weapons program. Defensive work continues

1970 -- Anthrax vaccine approved by U.S. Food and Drug Administration

1972 -- International convention outlaws development or stockpiling of biological weapons

1978-80 -- Human anthrax epidemic strikes Zimbabwe, infecting more than 6,000 and killing as many as 100

1979 -- Aerosolized anthrax spores released accidentally at a Soviet Union military facility, killing about 68 people

1991 -- U.S. troops vaccinated for anthrax in preparation for Gulf War

1990-93 -- The terrorist group, Aum Shinrikyo, releases anthrax in Tokyo but no one is injured

1995 -- Iraq admits it produced 8,500 liters of concentrated anthrax as part of biological weapons program

1998 -- U.S. Secretary of Defense William Cohen approves anthrax vaccination plan for all military service members

2001 -- A letter containing anthrax spores is mailed to NBC one week after the September 11 terrorist attacks on the Pentagon and World Trade Center. It was the first of a number of incidents around the country. In Florida, a man dies after inhaling anthrax at the offices of American Media Inc.


The History of Anthrax

There are multiple different types of anthrax, all of which can be deadly if left untreated. Because of this the illness has been used for many acts of aggression over the last century.

But, anthrax didn’t just come about over the last 100 years.

The origins of anthrax are estimated to go back as far as 700 B.C. in Egypt and Mesopotamia. Rome and ancient Greece are also thought to have experienced the disease, with some considering anthrax to have played a part in Rome’s downfall.

The first official clinical descriptions were written by Maret in 1752 and retired physician Nicolas Fournier in 1769.

After millennia filled with cases, true study of the illness didn’t begin until the 1800s. These studies led to a breakthrough with the connection between anthrax and the animal hair industry. According to the CDC, this relationship even led to the name “wool sorters disease” for anthrax.

Rod-shaped bacterial bodies, eventually called Bacillus anthracis, provided the basis for major research from scientist Robert Koch in 1877. Through experimentation Koch found the life cycle of the bacteria and demonstrated “Koch’s postulates.” More than a breakthrough for anthrax, Koch’s postulates set a precedent for all diseases. By studying the illness, he created a set of guidelines that all infectious bacteria must meet.

After identifying the bacteria, researchers could work on a vaccine.

In 1881, famed French chemist Louis Pasteur began the research into a vaccine for anthrax. He injected 50 animals with live anthrax bacteria. While 25 of the creatures were given his experimental weakened bacteria immunization, 25 were not. Results were clear – the 25 unvaccinated animals died while the protected ones survived.

Around this time, anthrax began appearing as more than a natural illness.

Anthrax was first used as a weapon during World War I by the German army. They used the disease to infect neutral parties’ livestock and animal feed which was to be traded to Allied Nations. Further experimentation with the disease continued over the years, particularly during the Korean War.

The live spore vaccine for anthrax was created in 1937 by Max Sterne. This became a routine vaccination for animals, crucial to those who worked with livestock.

The spore strain of anthrax doesn’t spread through people, but by inhaling the particles. Exposure often occurs in humans who are cleaning infected animals with the bacteria in their fur. The vaccine then helped greatly reduce both general human and animal cases alike.

Over the next few decades several important events changed anthrax prevention.

In 1944 Penicillin became the main choice for the treatment of anthrax. The antibiotic quickly became the top treatment for anthrax. In the 1950s the first human anthrax vaccine was made and finally in 1970 this vaccination underwent great improvements. Despite many changes in vaccines in recent decades, that vaccine from 1970 is almost the same as what’s used in the modern day.

Blisters, bumps and sores are common for cutaneous anthrax. This may be a low-risk form of anthrax, it’s also fairly easy to catch. Cutaneous anthrax occurs when the spores get into an open cut or wound. Fever and chills, nausea, headache, extreme fatigue, confusion, dizziness and body aches are just a few of the possible symptoms of inhalation anthrax.

Gastrointestinal anthrax doesn’t require an open wound. Instead, this disease gets into the body via undercooked meat from an infected animal. The illness can lead to fever and chills, hoarseness, bloody vomiting, headache and fainting.

Finally, injection anthrax presents similar signs to cutaneous, but it spreads faster and can be harder to treat.

Did you know that there were four different types of anthrax? Did you know Louis Pasteur worked on an anthrax vaccination? Do you have any questions or thoughts about the illness? Let us know in the comments below, or via Facebook and Twitter.

Written for Passport Health by Katherine Meikle. Katherine is a freelance writer and proud first-generation British-American living in Florida, where she was born and raised. She has a passion for travel and a love of writing, which go hand-in-hand.