Disease & Vaccine Information

Can Anthrax Cause Injury and Death?

Updated August 13, 2022


B. anthracis can invade the human bloodstream, multiply and spread to lymph nodes and many organs, and kill quickly. The bacteria, which produces a virulent toxin, can enter the bloodstream through a cut in the skin; by inhaling the anthrax spores through the nose; by swallowing the spores into the gastrointestinal system; or by injecting anthrax contaminated heroin. The cutaneous (skin) route is much less deadly than inhaling, swallowing, or injecting the organism.1   

Cutaneous (Skin) Anthrax:  If the anthrax exposure route is through the skin, symptoms include a formation of a small, red skin lesion(s) that become swollen, larger, and blackened over a week’s time. Spontaneous healing occurs in 80 to 90 percent of cases. Ten to 20 percent of untreated cutaneous anthrax cases develop fever, edema, bacteremia (massive bacterial infection of the blood), necrosis, shock, meningitis, and death.2 3 4 5      

Inhalation (Lungs) Anthrax:  Symptoms of inhalation anthrax are generally non-specific and can include shortness of breath, cough, fever, chills, extreme fatigue, head, and body aches, confusion, dizziness, nausea, vomiting, and stomach pain.6 Complications of inhalation include hypotension, severe breathing problems, toxemia, bacteremia, gastrointestinal disorders, meningitis, shock, and death can occur within 24 hours.7 Fifty-five percent of persons exposed to anthrax by inhalation during the 2001 bioterrorism attack in the U.S. survived. Without treatment, there is only a 10 to 15 percent survival rate.8 9

Gastrointestinal Anthrax: After swallowing anthrax spores, symptoms of gastrointestinal anthrax can include fever, nausea, vomiting, abdominal pain, diarrhea or bloody diarrhea, and sore throat, hoarseness, painful swallowing, and swelling of the neck or abdomen.10 Complications include bleeding, perforation, intestinal obstruction, sepsis, respiratory disease, toxemia, meningitis, increased abdominal girth, ascites, bowel perforation, shock, and death.11 12

Injection Anthrax: Symptoms of injection anthrax are like cutaneous anthrax; however, the infection may occur deeper in the skin or into the muscle.13 Complications include skin necrosis, septic shock, multi-organ failure, meningitis, and death.14 Approximately 33 percent of injection anthrax cases are fatal.15


References:

1 Goel AK. Anthrax: A disease of biowarfare and public health importance. World J Clin Cases Jan. 2015; 3(1): 20–33.

2 Meyer MA. Neurologic Complications of Anthrax A Review of the Literature. Arch Neurol. April 2003;60(4):483-488.

3 Doganay M, Metan G, Alp E. A review of cutaneous anthrax and its outcome. J Infect Public Health Sept. 2010;3(3):98‐105.

4 U.S. Centers for Disease Control and Prevention. Types of Anthrax. In: Anthrax. Nov. 20, 2020.

5 Sweeney DA, Hicks CW, Cui X et al. Anthrax infection. Am J Respir Crit Care Med. Dec. 2011;184(12):1333‐1341.

6 U.S. Centers for Disease Control and Prevention. Symptoms of Anthrax. In: Anthrax. Nov. 20, 2020.

7 Sweeney DA, Hicks CW, Cui X et al. Anthrax infection. Am J Respir Crit Care Med Dec. 2011;184(12):1333‐1341.

8 U.S. Centers for Disease Control and Prevention. Types of Anthrax. In: Anthrax. Nov. 20, 2020.

9 Holty JE, Bravata DM, Liu H, et al. Systematic review: a century of inhalational anthrax cases from 1900 to 2005. Ann Intern Med. Feb. 2006;144(4):270‐280.

10 U.S. Centers for Disease Control and Prevention. Symptoms of Anthrax. In: Anthrax. Nov. 20, 2020.

11 Kamal SM, Rashid AK, Bakar MA, et al. Anthrax: an update. Asian Pac J Trop Biomed. Dec. 2011;1(6):496‐501.

12 Sweeney DA, Hicks CW, Cui X et al. Anthrax infection. Am J Respir Crit Care Med. Dec. 2011;184(12):1333‐1341.

13 U.S. Centers for Disease Control and Prevention. Types of Anthrax. In: Anthrax. Nov. 20, 2020.

14 Grunow R, Verbeek L, Jacob D, et al. Injection anthrax--a new outbreak in heroin users. Dtsch Arztebl Int. Dec. 2012;109(49):843‐848.

15 Sweeney DA, Hicks CW, Cui X et al. Anthrax infectionAm J Respir Crit Care Med. Dec. 2011;184(12):1333‐1341.

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