AnthraxModule information
Prevention
Screening
Diagnosis
Consultation for Diagnosis
Hospitalization
Therapy
Patient Education
Consultation for Management
Follow-up

Tables
Figures
References
Glossary
What's New
Patient Information
Guidelines and Systematic Reviews
References
1. Marano N, Plikaytis BD, Martin SW, Rose C, Semenova VA, Martin SK, et al.; Anthrax Vaccine Research Program Working Group. Effects of a reduced dose schedule and intramuscular administration of anthrax vaccine adsorbed on immunogenicity and safety at 7 months: a randomized trial. JAMA. 2008;300:1532-43. (PMID: 18827210)
2. Wright JG, Quinn CP, Shadomy S, Messonnier N; Centers for Disease Control and Prevention (CDC). Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep. 2010;59:1-30. (PMID: 20651644)
3. Brachman PS. Field evaluation of human anthrax vaccine. Am J Public Health. 1962;52:632-45.
4. Tresselt HB. An antigen prepared in vitro effective for immunization against anthrax. III. Immunization of monkeys against anthrax. J Infect Dis. 1954;96:207-302.
5. Turnbull PC, Broster MG, Carman JA, Manchee RJ, Melling J. Development of antibodies to protective antigen and lethal factor components of anthrax toxin in humans and guinea pigs and their relevance to protective immunity. Infect Immun. 1986;52:356-63. (PMID: 3084381)
6. Little SF, Knudson GB. Comparative efficacy of Bacillus anthracis live spore vaccine and protective antigen vaccine against anthrax in the guinea pig. Infect Immun. 1986;52:509-12. (PMID: 3084385)
7. Grabenstein JD. Anthrax vaccine: a review. Immunol Allergy Clin North Am. 2003;23:713-30. (PMID: 14753388)
8. Gilson RT, Schissel DJ. Recurrent, localized urticaria and erythema multiforme: a review and management of cutaneous anthrax vaccine-related events. Cutis. 2004;73:319-25. (PMID: 15186046)
9. Advisory Committee on Immunization Practices. Use of anthrax vaccine in the United States. MMWR Recomm Rep. 2000;49:1-20. (PMID: 11145529)
10. Pittman PR, Gibbs PH, Cannon TL, Friedlander AM. Anthrax vaccine: short-term safety experience in humans. Vaccine. 2001;20:972-8. (PMID: 11738765)
11. Wiesen AR, Littell CT. Relationship between prepregnancy anthrax vaccination and pregnancy and birth outcomes among US Army women. JAMA. 2002;287:1556-60. (PMID: 11911758)
12. Sever JL, Brenner AI, Gale AD, Lyle JM, Moulton LH, Ward BJ, et al. Safety of anthrax vaccine: an expanded review and evaluation of adverse events reported to the Vaccine Adverse Event Reporting System (VAERS). Pharmacoepidemiol Drug Saf. 2004;13:825-40. (PMID: 15386719)
13. Sulsky SI, Grabenstein JD, Delbos RG. Disability among U.S. Army personnel vaccinated against anthrax. J Occup Environ Med. 2004;46:1065-75. (PMID: 15602181)
14. Friedlander AM, Welkos SL, Pitt ML, Ezzell JW, Worsham PL, Rose KJ, et al. Postexposure prophylaxis against experimental inhalation anthrax. J Infect Dis. 1993;167:1239-43. (PMID: 8486963)
15. Vietri NJ, Purcell BK, Lawler JV, Leffel EK, Rico P, Gamble CS, et al. Short-course postexposure antibiotic prophylaxis combined with vaccination protects against experimental inhalational anthrax. Proc Natl Acad Sci U S A. 2006;103:7813-6. (PMID: 16672361)
16. Stepanov AV, Marinin LI, Pomerantsev AP, Staritsin NA. Development of novel vaccines against anthrax in man. J Biotechnol. 1996;44:155-60. (PMID: 8717399)
17. Choe CH, Bouhaouala SS, Brook I, Elliot TB, Knudson GB. In vitro development of resistance to ofloxacin and doxycycline in Bacillus anthracis Sterne. Antimicrob Agents Chemother. 2000;44:1766. (PMID: 10896651)
18. Meselson M, Guillemin J, Hugh-Jones M, Langmuir A, Popova I, Shelokov A, et al. The Sverdlovsk anthrax outbreak of 1979. Science. 1994;266:1202-8. (PMID: 7973702)
19. Shepard CW, Soriano-Gabarro M, Zell ER, Hayslett J, Lukacs S, Goldstein S, et al. Antimicrobial postexposure prophylaxis for anthrax: adverse events and adherence. Emerg Infect Dis. 2002;8:1124-32. (PMID: 12396927)
20. Fowler RA, Sanders GD, Bravata DM, Nouri B, Gastwirth JM, Peterson D, et al. Cost-effectiveness of defending against bioterrorism: a comparison of vaccination and antibiotic prophylaxis against anthrax. Ann Intern Med. 2005;142:601-10. (PMID: 15838066) [Full Text]
21. Bhatt KM, Bhatt SM. Anthrax revisited. East Afr Med J. 2002;79:364-7. (PMID: 12638831)
22. Bell JH. On anthrax and anthracaemia in wool-sorters, heifers, and sheep. Br Med J. 2011;2:656-7. (PMID: 20749691)
23. Dewan PK, Fry AM, Laserson K, Tierney BC, Quinn CP, Hayslett JA, et al. Inhalational anthrax outbreak among postal workers, Washington, D.C., 2001. Emerg Infect Dis. 2002;8:1066-72. (PMID: 12396917)
24. Inglesby TV, O’Toole T, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, et al. Anthrax as a biological weapon, 2002: updated recommendations for management. JAMA. 2002;287:2236-52. (PMID: 11980524)
25. Christie AB. The clinical aspects of anthrax. Postgrad Med J. 1973;49:5665-70. (PMID: 4799413)
26. Centers for Disease Control and Prevention. Update: Investigation of bioterrorism-related anthrax and interim guidelines for clinical evaluation of persons with possible anthrax. MMWR Morb Mortal Wkly Rep. 2001;50:941-8. Erratum in: MMWR Morb Mortal Wkly Rep 2001;50):991. (PMID: 11708591)
27. Freedman A, Afonja O, Chang MW, Mostashari F, Blaser M, Perez-Perez G, et al. Cutaneous anthrax associated with microangiopathic hemolytic anemia and coagulopathy in a 7-month-old infant. JAMA. 2002;287:869-74. (PMID: 11851579)
28. Jernigan JA, Stephens DS, Ashford DA, Omenaca C, Topiel MS, Galbraith M, et al. Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. Emerg Infect Dis. 2001;7:933-44. (PMID: 11747719)
29. Abramova FA, Grinberg LM, Yampolskaya OV, Walker DH. Pathology of inhalational anthrax in 42 cases from the Sverdlovsk outbreak of 1979. Proc Natl Acad Sci U S A. 1993;90:2291-4. (PMID: 8460135)
30. Kyriacou DN, Stein AC, Yarnold PR, Courtney DM, Nelson RR, Noskin GA, et al. Clinical predictors of bioterrorism-related inhalational anthrax. Lancet. 2004;364:449-52. (PMID: 15288744)
31. Grinberg LM, Abramova FA, Yampolskaya OV, Walker DH, Smith JH. Quantitative pathology of inhalational anthrax I: quantitative microscopic findings. Mod Pathol. 2001;14:482-95. (PMID: 11353060)
32. Jernigan DB, Raghunathan PL, Bell BP, Brechner R, Bresnitz EA, Butler JC, et al.; National Anthrax Epidemiologic Investigation Team. Investigation of bioterrorism-related anthrax, United States, 2001: epidemiologic findings. Emerg Infect Dis. 2002;8:1019-28. (PMID: 12396909)
33. Dutz W, Saidi F, Kohout E. Gastric anthrax with massive ascites. Gut. 1970;11:352-4. (PMID: 5428857)
34. Binkley CE, Cinti S, Simeone DM, Colletti LM. Bacillus anthracis as an agent of bioterrorism: a review emphasizing surgical treatment. Ann Surg. 2002;236:9-16. (PMID: 12131080)
35. Quinn CP, Semenova VA, Elie CM, Romero-Steiner S, Greene C, Li H, et al. Specific, sensitive, and quantitative enzyme-linked immunosorbent assay for human immunoglobulin G antibodies to anthrax toxin protective antigen. Emerg Infect Dis. 2002;8:1103-10. (PMID: 12396924)
36. Lucey D. Anthrax. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Churchill Livingstone; 2005:3618-24.
37. Quinn CP, Dull PM, Semenova V, Li H, Crotty S, Taylor TH, et al. Immune responses to Bacillus anthracis protective antigen in patients with bioterrorism-related cutaneous or inhalation anthrax. J Infect Dis. 2004;190:1228-36. (PMID: 15346332)
38. Kyriacou DN, Yarnold PR, Stein AC, Schmitt BP, Soltysik RC, Nelson RR, et al. Discriminating inhalational anthrax from community-acquired pneumonia using chest radiograph findings and a clinical algorithm. Chest. 2007;131:489-96. (PMID: 17296652)
39. De BK, Bragg SL, Sanden GN, Wilson KE, Diem LA, Marston CK, et al. A two-component direct fluorescent-antibody assay for rapid identification of Bacillus anthracis. Emerg Infect Dis. 2002;8:1060-5. (PMID: 12396916)
40. Bell DM, Kozarsky PE, Stephens DS. Clinical issues in the prophylaxis, diagnosis, and treatment of anthrax. Emerg Infect Dis. 2002;8:222-5. (PMID: 11897081)
41. Hoffmaster AR, Meyer RF, Bowen MD, Marston CK, Weyant RS, Thurman K, et al. Evaluation and validation of a real-time polymerase chain reaction assay for rapid identification of Bacillus anthracis [Letter]. Emerg Infect Dis. 2002;8:1178-82. (PMID: 12396935)
42. Williams R. Bacillus anthracis and other spore forming bacilli. In: Braude AI, ed. Infectious Disease and Microbiology. Philadelphia: WB Saunders Co; 1986:270-78.
43. Oncül O, Ozsoy MF, Gul HC, Koçak N, Cavuslu S, Pahsa A. Cutaneous anthrax in Turkey: a review of 32 cases. Scand J Infect Dis. 2002;34:413-6. (PMID: 12160166)
44. Carucci JA, McGovern TW, Norton SA, Daniel CR, Elewski BE, Fallon-Friedlander S, et al. Cutaneous anthrax management algorithm. J Am Acad Dermatol. 2001. (PMID: 11893970)
45. Ronaghy HA, Azadeh B, Kohout E, Dutz W. Penicillin therapy of human cutaneous anthrax. Curr Ther Res Clin Exp. 1972;14:721-5. (PMID: 4629110)
46. Kanafani ZA, Ghossain A, Sharara AI, Hatem JM, Kanj SS. Endemic gastrointestinal anthrax in 1960s Lebanon: clinical manifestations and surgical findings. Emerg Infect Dis. 2003;9:520-5. (PMID: 12737733)
47. Dixon TC, Meselson M, Guillemin J, Hanna PC. Anthrax. N Engl J Med. 1999;341:815-26. (PMID: 10477781)
48. Gerberding JL, Hughes JM, Koplan JP. Bioterrorism preparedness and response: clinicians and public health agencies as essential partners [Editorial]. JAMA. 2002;287:898-900. (PMID: 11851584)
49. Stern EJ, Uhde KB, Shadomy SV, Messonnier N. Conference report on public health and clinical guidelines for anthrax. Emerg Infect Dis. 2008;14:. (PMID: 18394267)
50. Barakat LA, Quentzel HL, Jernigan JA, Kirschke DL, Griffith K, Spear SM, et al. Fatal inhalational anthrax in a 94-year-old Connecticut woman. JAMA. 2002;287:863-8. (PMID: 11851578)
51. Doganay M, Metan G, Alp E. A review of cutaneous anthrax and its outcome. J Infect Public Health. 2010;3:98-105. (PMID: 20869669)
52. Holty JE, Bravata DM, Liu H, Olshen RA, McDonald KM, Owens DK. Systematic review: a century of inhalational anthrax cases from 1900 to 2005. Ann Intern Med. 2006;144:270-80. (PMID: 16490913)
53. Stevens DL, Gibbons AE, Bergstrom R, Winn V. The Eagle effect revisited: efficacy of clindamycin, erythromycin, and penicillin in the treatment of streptococcal myositis. J Infect Dis. 1988;158:23-8. (PMID: 3292661)
54. Li F, Nandy P, Chien S, Noel GJ, Tornoe CW. Pharmacometrics-based dose selection of levofloxacin as a treatment for postexposure inhalational anthrax in children. Antimicrob Agents Chemother. 2009;54:375-9. (PMID: 19858256)
55. Migone TS, Subramanian GM, Zhong J, Healey LM, Corey A, Devalaraja M, et al. Raxibacumab for the treatment of inhalational anthrax. N Engl J Med. 2009;361:135-44. (PMID: 19587338)
56. Centers for Disease Control and Prevention. Update: Investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001. MMWR Morb Mortal Wkly Rep. 2001;50:909-19. Erratum in: MMWR Morb Mortal Wkly Rep. 2001;50:962. (PMID: 11699843)
57. Kournikakis B. Risk assessment of anthrax threat letters. Defence Research Establishment Suffield. September 2001. Available at: http://www.dres.dnd.ca/Meetings/FirstResponders/tr01-048_annex.pdf.
58. Kournikakis B, Martinez KF, McCleery RE, Shadomy SV, Ramos G. Anthrax letters in an open office environment: effects of selected CDC response guidelines on personal exposure and building contamination. J Occup Environ Hyg. 2011;8:113-22. (PMID: 21253984)
59. Henderson DW, Peacock S, Belton FC. Observations on the prophylaxis of experimental pulmonary anthrax in the monkey. J Hyg (Lond). 1956;54:28-36. (PMID: 13319688)
60. Williams JL, Noviello SS, Griffith KS, Wurtzel H, Hamborsky J, Perz JF, et al. Anthrax postexposure prophylaxis in postal workers, Connecticut, 2001. Emerg Infect Dis. 2002;8:1133-7. (PMID: 12396928)
61. Zhanel GG, Ennis K, Vercaigne L, Walkty A, Gin AS, Embil J, et al. A critical review of the fluoroquinolones: focus on respiratory infections. Drugs. 2002;62:13-59. (PMID: 11790155)
62. Riond JL, Riviere JE. Pharmacology and toxicology of doxycycline. Vet Hum Toxicol. 1988;30:431-43. (PMID: 3055652)
63. Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, Friedlander AM, et al. Anthrax as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 1999;281:1735-45. (PMID: 10328075)
FAQs
The American College of Physicians is accredited by the Accreditation Council for continuing Medical Education (ACCME) to provide continuing education for physicians. The American College of Physicians designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity. Purpose: This activity has been developed for internists to facilitate the highest quality professional work in clinical applications, teaching, consultation, or research. Upon completion of the CME activity, participants should be able to demonstrate an increase in the skills and knowledge required to maintain competence, strengthen their habits of critical inquiry and balanced judgement, and to contribute to better patient care. Disclosures: Nicholas John Vietri, MD, MS has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.


The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP. Because all PIER modules are updated regularly, printed web pages or PDFs may rapidly become obsolete. Therefore, PIER users should compare the date of the last update on the website with any printout to ensure that the information being referred to is the most current available.
PIER is copyrighted © 2013 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.