Surprise anthrax case detected in Texas

The Centers for Disease Control and Prevention (CDC) has reported a surprising case of anthrax in a Texas rancher, who contracted the disease after preparing and eating lamb meat.^[]

The rancher reportedly came down with cutaneous anthrax—a subset of the disease that occurs when the infection enters a person’s wounds—not gastrointestinal anthrax, which can impact the digestive system and be more severe.

Anthrax: what is it and where does it come from?

Anthrax is a zoonotic disease usually caused by the Bacillus anthracis bacteria, which naturally occurs in soil.^[] This bacteria commonly affects wild animals or livestock, which have the potential to infect humans.

Human infection is rare but not unheard of, and risks have existed for years. In fact, anthrax appears to date back to Biblical times. While the word anthrax does not appear in the Bible, Shehin, one of the 10 plagues of Egypt, is characterized by the same clinical symptoms as anthrax.^[]

Anthrax symptoms

Clinical symptoms of human anthrax can surface anywhere between one day to two months after exposure and vary based on the type of anthrax a person is infected with. Forms of anthrax and their symptoms include: 

Cutaneous anthrax

Described as a less severe form of anthrax, cutaneous anthrax can occur when anthrax spores make contact with a person’s cut or scrape. This can happen if a person touches an infected animal while they have an open wound or lesion. Symptoms of cutaneous anthrax include:

• Groups of small blisters or bumps

• Swollen sores

• Painless sore with a black center on the face, neck, arms, or hands

Injection anthrax

In Europe, some cases of anthrax have been reported in people who injected heroin, which may have been contaminated.^[] Symptoms of injection anthrax can include:

• Deep sores under the skin or muscle at the injection site.

Inhalation anthrax

The most severe and deadly- form of anthrax, inhalation anthrax, can occur when a person breathes in anthrax spores. The disease starts primarily in the lymph nodes in the chest and then spreads to the rest of the body. Symptoms of inhalation anthrax can include

• Fever and chills

• Sweating

• Chest pain, cough, or shortness of breath

• Confusion or dizziness

• Nausea, vomiting, or stomach pain

• Headache or body aches

• Extreme fatigue 

Gastrointestinal anthrax

Gastrointestinal anthrax occurs when someone eats raw or undercooked meat from an infected animal. It can impact the throat, esophagus, stomach, and intestines. Symptoms of gastrointestinal anthrax can include:

• Fever and chills

• Swelling of the neck or neck glands

• Sore throat, hoarseness, and painful swallowing

• Nausea and vomiting, including bloody vomiting

• Diarrhea or bloody diarrhea

• Headache

• Red face and eyes

• Stomach pain and swelling

• Fainting

Anthrax diagnosis and treatment

There is no test for diagnosing anthrax, so providers will have to rely on symptoms and 

information about patients’ potential exposure to identify the illness. If diagnosed, a patient should start antibiotics to take care of current symptoms and prevent more from occurring. In some cases, people may be given a vaccine to help treat cases of anthrax.^[]

Anthrax prevention

To prevent anthrax in humans, it is important to vaccinate livestock against the disease. According to the CDC, there was “no clear history of routine vaccination against anthrax” in the Texas herd responsible for the rancher’s infection.^[] 

It is also important to be prepared to treat future cases should the disease surge. Despite the disease’s current rarity, the US government has its guard up for a potential increase in anthrax in the event of a bioterrorism attack. If this happens, the Food and Drug Administration plans to roll out antibiotics and emergency vaccines to fight infections.