Dr. MJ Bazos MD, Patient Handout

Bioterrorism: What you need to know

What is bioterrorism?

Bioterrorism is the use of bacteria, viruses or germs to cause illness and spread fear. In bioterrorist attacks, only a small number of people may be injured, but many more become afraid and change their behavior because of their fear.

What is anthrax?

Anthrax is an illness caused by the spores of a bacterium called Bacillus anthracis. Anthrax most commonly occurs in hooved animals. It is rare in humans and is usually only been seen in people who have contact with infected animals or who work with animal products such as wool, hair or hides.

Anthrax has 3 forms in humans, all of which are caused by the same bacteria. The form of anthrax depends on how the bacteria enter the body:

• Cutaneous infection is caused by touching infected animal products, contaminated soil containing spores or spores themselves.
• Gastrointestinal infection is caused by eating contaminated, undercooked meat.
• Inhalation infection is caused by breathing in anthrax spores.

Is anthrax contagious?

No. None of the forms of anthrax can be spread from one person to another. Anthrax can only be caused by direct exposure to the bacterium spores. It is unlikely that the general public is in danger of anthrax exposure.

How can I tell if it's anthrax?

Anthrax can look like other illnesses. If you have the symptoms listed below, don't panic. Call your family doctor. If your family doctor thinks there is a chance your symptoms are caused by anthrax, he or she will ask about your job and any travel. This information, plus an exam and possibly some lab tests or x-rays, will help your doctor decide if it's anthrax or another illness.

• Cutaneous anthrax starts out as a red area on the skin, similar to a spider bite. Over just a few days, the area becomes larger and blisters may form, followed by a deep, black scab. The area is usually painless and does not itch, unlike insect bites.
• Gastrointestinal anthrax typically causes vomiting, severe stomach pain and bloody diarrhea. Some people may also have a fever.
• Inhalation anthrax starts out like the flu, with fever, dry cough and muscle aches. (However, unlike the flu inhalation anthrax usually does not cause a runny nose.) People with inhalation anthrax also often have stomach pain and can quickly (within a few days) have difficulty breathing and go into shock.

Can anthrax be treated?

Yes. The treatment and the likelihood of cure depend on the form of anthrax. Cutaneous anthrax is the least serious form and even without treatment people recover. Gastrointestinal and inhalation anthrax are more serious and may cause death if not treated.

Is anthrax the only germ used in bioterrorism?

No. Anthrax has been in the news the most, but the Centers for Disease Control and Prevention (CDC) lists 3 other agents with bioterrorism potential. These include anthrax, botulism, plague and smallpox. Some other agents, such as tularemia, brucellosis, Q fever and viral hemorrhagic fever, have also been studied for use as biological weapons. Of these, smallpox is thought to be the most likely one after anthrax to be used in a terrorist action.

What is smallpox?

Smallpox is an illness caused by the variola virus. Symptoms include fever, aches, vomiting and a specific rash. Routine vaccination ("shots") for smallpox was stopped in 1972 in the United States because it was thought that the disease had been wiped out and the vaccine has some risks.

Is smallpox contagious?

Yes. Smallpox can be spread from person to person, usually once a fever and rash have developed.

If I was vaccinated before 1980, am I still protected?

Probably not. The vaccine appears to be most effective for about 10 years.

How is smallpox treated?

There is no specific drug to treat smallpox. However, a vaccine given even a few days after exposure may prevent death. So it's important to get prompt medical attention if you think you've been exposed to smallpox. If you have concerns, call your family doctor.

Are vaccines commercially available for anthrax or smallpox?

Neither of these vaccines is commercially available at this time. Vaccines are being made so that supplies will be available if they are needed.

Because there are some risks with the smallpox vaccine, the CDC is determining on an individual basis if the vaccine should be given. The anthrax vaccine is controlled by the Department of Defense and at this time is only available for military personnel at high risk of exposure in combat settings.

What can I do to be prepared for a bioterrorist attack?

Just as with a natural disaster such as a tornado or hurricane, you should take reasonable steps to prepare. It is a good idea to have enough food, water and supplies (including any regular medications you may need) on hand for 3 or 4 days in case you cannot leave your home. You should also keep emergency contact information at home, work and school. Right now these are the only steps you need to take.

Do not take antibiotics unless your doctor tells you to. Antibiotics cannot prevent illness and can have serious side effects. Inappropriate use can increase the risk of resistant forms of bacteria, which are more difficult to treat. Finally, antibiotics may interfere with medicines you are already taking.

You do not need to buy gas masks. They are intended only for very short-term use or at the time of a known release of an agent. They are impractical for use at all times and are only effective if properly fitted. Improper use can be dangerous and result in injury or suffocation, especially in people with heart or lung problems.

What if my fears about bioterrorism are affecting my family or work?

Since the attacks on September 11, 2001, many people have strong feelings of anxiety. Of course, some concern about your safety is normal. But if your fears keep you from participating in or enjoying your usual activities, significantly affect your sleep or interfere with your relationships, talk with your family doctor. He or she can help.