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Anthrax - Wikipedia

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<button aria-controls="toc-Signs_and_symptoms-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Signs and symptoms subsection</span> </button> <ul id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Skin" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Skin"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Skin</span> </div> </a> <ul id="toc-Skin-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Injection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Injection"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Injection</span> </div> </a> <ul id="toc-Injection-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lungs" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lungs"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Lungs</span> </div> </a> <ul id="toc-Lungs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Gastrointestinal" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gastrointestinal"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Gastrointestinal</span> </div> </a> <ul id="toc-Gastrointestinal-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Cause" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Cause"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Cause</span> </div> </a> <button aria-controls="toc-Cause-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Cause subsection</span> </button> <ul id="toc-Cause-sublist" class="vector-toc-list"> <li id="toc-Bacteria" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Bacteria"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Bacteria</span> </div> </a> <ul id="toc-Bacteria-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Exposure_and_transmission" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Exposure_and_transmission"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Exposure and transmission</span> </div> </a> <ul id="toc-Exposure_and_transmission-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Mechanism</span> </div> </a> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prevention</span> </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Prevention subsection</span> </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Vaccines" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Vaccines"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Vaccines</span> </div> </a> <ul id="toc-Vaccines-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Antibiotics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antibiotics"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Antibiotics</span> </div> </a> <ul id="toc-Antibiotics-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Treatment</span> </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Treatment subsection</span> </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Antibiotics_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Antibiotics_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Antibiotics</span> </div> </a> <ul id="toc-Antibiotics_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Monoclonal_antibodies" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Monoclonal_antibodies"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>Monoclonal antibodies</span> </div> </a> <ul id="toc-Monoclonal_antibodies-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Biologic_for_Drug-,_Antibody-_or_Vaccine-resistant_Anthrax" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Biologic_for_Drug-,_Antibody-_or_Vaccine-resistant_Anthrax"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3</span> <span>Biologic for Drug-, Antibody- or Vaccine-resistant Anthrax</span> </div> </a> <ul id="toc-Biologic_for_Drug-,_Antibody-_or_Vaccine-resistant_Anthrax-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Animals" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Animals</span> </div> </a> <ul id="toc-Animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Epidemiology</span> </div> </a> <button aria-controls="toc-Epidemiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Epidemiology subsection</span> </button> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> <li id="toc-United_States" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_States"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.1</span> <span>United States</span> </div> </a> <ul id="toc-United_States-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Croatia" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Croatia"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.2</span> <span>Croatia</span> </div> </a> <ul id="toc-Croatia-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-United_Kingdom" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#United_Kingdom"> <div class="vector-toc-text"> <span class="vector-toc-numb">10.3</span> <span>United Kingdom</span> </div> </a> <ul id="toc-United_Kingdom-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Discovery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Discovery"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.1</span> <span>Discovery</span> </div> </a> <ul id="toc-Discovery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-First_vaccination" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#First_vaccination"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.2</span> <span>First vaccination</span> </div> </a> <ul id="toc-First_vaccination-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Engineered_strains" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Engineered_strains"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.3</span> <span>Engineered strains</span> </div> </a> <ul id="toc-Engineered_strains-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>Society and culture</span> </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Society and culture subsection</span> </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Site_cleanup" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Site_cleanup"> <div class="vector-toc-text"> <span class="vector-toc-numb">12.1</span> <span>Site cleanup</span> </div> </a> <ul id="toc-Site_cleanup-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Biological_warfare" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Biological_warfare"> <div class="vector-toc-text"> <span class="vector-toc-numb">12.2</span> <span>Biological warfare</span> </div> </a> <ul id="toc-Biological_warfare-sublist" class="vector-toc-list"> <li id="toc-Sverdlovsk_incident_(2_April_1979)" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Sverdlovsk_incident_(2_April_1979)"> <div class="vector-toc-text"> <span class="vector-toc-numb">12.2.1</span> <span>Sverdlovsk incident (2 April 1979)</span> </div> </a> <ul id="toc-Sverdlovsk_incident_(2_April_1979)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Anthrax_bioterrorism" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Anthrax_bioterrorism"> <div class="vector-toc-text"> <span class="vector-toc-numb">12.2.2</span> <span>Anthrax bioterrorism</span> </div> </a> <ul id="toc-Anthrax_bioterrorism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Decontaminating_mail" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Decontaminating_mail"> <div class="vector-toc-text"> <span class="vector-toc-numb">12.2.3</span> <span>Decontaminating mail</span> </div> </a> <ul id="toc-Decontaminating_mail-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>Other animals</span> </div> </a> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">15</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">16</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Anthrax</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 87 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-87" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">87 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Miltsiekte" title="Miltsiekte – Afrikaans" lang="af" hreflang="af" data-title="Miltsiekte" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AC%D9%85%D8%B1%D8%A9_%D8%AE%D8%A8%D9%8A%D8%AB%D8%A9" title="جمرة خبيثة – Arabic" lang="ar" hreflang="ar" data-title="جمرة خبيثة" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Mal_de_banzo" title="Mal de banzo – Aragonese" lang="an" hreflang="an" data-title="Mal de banzo" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target"><span>Aragonés</span></a></li><li class="interlanguage-link interwiki-ast mw-list-item"><a href="https://ast.wikipedia.org/wiki/Carbuncu" title="Carbuncu – Asturian" lang="ast" hreflang="ast" data-title="Carbuncu" data-language-autonym="Asturianu" data-language-local-name="Asturian" class="interlanguage-link-target"><span>Asturianu</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Qarayara" title="Qarayara – Azerbaijani" lang="az" hreflang="az" data-title="Qarayara" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D9%82%D8%A7%D8%B1%D8%A7%DB%8C%D8%A7%D8%B1%D8%A7" title="قارایارا – South Azerbaijani" lang="azb" hreflang="azb" data-title="قارایارا" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%85%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%A8%E0%A6%A5%E0%A7%8D%E0%A6%B0%E0%A6%BE%E0%A6%95%E0%A7%8D%E0%A6%B8_(%E0%A6%B0%E0%A7%8B%E0%A6%97)" title="অ্যানথ্রাক্স (রোগ) – Bangla" lang="bn" hreflang="bn" data-title="অ্যানথ্রাক্স (রোগ)" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%A1%D1%96%D0%B1%D1%96%D1%80%D1%81%D0%BA%D0%B0%D1%8F_%D1%8F%D0%B7%D0%B2%D0%B0" title="Сібірская язва – Belarusian" lang="be" hreflang="be" data-title="Сібірская язва" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%A1%D1%96%D0%B1%D1%96%D1%80%D1%81%D0%BA%D0%B0%D1%8F_%D1%8F%D0%B7%D0%B2%D0%B0" title="Сібірская язва – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Сібірская язва" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D1%80%D0%B0%D0%BA%D1%81" title="Антракс – Bulgarian" lang="bg" hreflang="bg" data-title="Антракс" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-br mw-list-item"><a href="https://br.wikipedia.org/wiki/Serk" title="Serk – Breton" lang="br" hreflang="br" data-title="Serk" data-language-autonym="Brezhoneg" data-language-local-name="Breton" class="interlanguage-link-target"><span>Brezhoneg</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Carboncle_(malaltia)" title="Carboncle (malaltia) – Catalan" lang="ca" hreflang="ca" data-title="Carboncle (malaltia)" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Anthrax" title="Anthrax – Czech" lang="cs" hreflang="cs" data-title="Anthrax" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Anthracs" title="Anthracs – Welsh" lang="cy" hreflang="cy" data-title="Anthracs" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Miltbrand" title="Miltbrand – Danish" lang="da" hreflang="da" data-title="Miltbrand" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Milzbrand" title="Milzbrand – German" lang="de" hreflang="de" data-title="Milzbrand" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Siberi_katk" title="Siberi katk – Estonian" lang="et" hreflang="et" data-title="Siberi katk" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%86%CE%BD%CE%B8%CF%81%CE%B1%CE%BA%CE%B1%CF%82_(%CE%BD%CF%8C%CF%83%CE%BF%CF%82)" title="Άνθρακας (νόσος) – Greek" lang="el" hreflang="el" data-title="Άνθρακας (νόσος)" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Carbunco" title="Carbunco – Spanish" lang="es" hreflang="es" data-title="Carbunco" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Antrakso" title="Antrakso – Esperanto" lang="eo" hreflang="eo" data-title="Antrakso" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Lupu_beltz" title="Lupu beltz – Basque" lang="eu" hreflang="eu" data-title="Lupu beltz" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%DB%8C%D8%A7%D9%87%E2%80%8C%D8%B2%D8%AE%D9%85" title="سیاه‌زخم – Persian" lang="fa" hreflang="fa" data-title="سیاه‌زخم" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Maladie_du_charbon" title="Maladie du charbon – French" lang="fr" hreflang="fr" data-title="Maladie du charbon" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/An_tAntrasc" title="An tAntrasc – Irish" lang="ga" hreflang="ga" data-title="An tAntrasc" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Carb%C3%BAnculo" title="Carbúnculo – Galician" lang="gl" hreflang="gl" data-title="Carbúnculo" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%ED%83%84%EC%A0%80" title="탄저 – Korean" lang="ko" hreflang="ko" data-title="탄저" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%8D%D5%AB%D5%A2%D5%AB%D6%80%D5%A1%D5%AD%D5%BF" title="Սիբիրախտ – Armenian" lang="hy" hreflang="hy" data-title="Սիբիրախտ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%8F%E0%A4%82%E0%A4%A5%E0%A5%8D%E0%A4%B0%E0%A4%BE%E0%A4%95%E0%A5%8D%E0%A4%B8" title="एंथ्राक्स – Hindi" lang="hi" hreflang="hi" data-title="एंथ्राक्स" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Antraks_(bolest)" title="Antraks (bolest) – Croatian" lang="hr" hreflang="hr" data-title="Antraks (bolest)" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Antraxo" title="Antraxo – Ido" lang="io" hreflang="io" data-title="Antraxo" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Antraks" title="Antraks – Indonesian" lang="id" hreflang="id" data-title="Antraks" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Miltisbrandur" title="Miltisbrandur – Icelandic" lang="is" hreflang="is" data-title="Miltisbrandur" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Antrace" title="Antrace – Italian" lang="it" hreflang="it" data-title="Antrace" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%92%D7%97%D7%9C%D7%AA" title="גחלת – Hebrew" lang="he" hreflang="he" data-title="גחלת" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-jv mw-list-item"><a href="https://jv.wikipedia.org/wiki/Antraks" title="Antraks – Javanese" lang="jv" hreflang="jv" data-title="Antraks" data-language-autonym="Jawa" data-language-local-name="Javanese" class="interlanguage-link-target"><span>Jawa</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%A8%E0%B3%86%E0%B2%B0%E0%B2%A1%E0%B2%BF" title="ನೆರಡಿ – Kannada" lang="kn" hreflang="kn" data-title="ನೆರಡಿ" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%AF%E1%83%98%E1%83%9A%E1%83%94%E1%83%AE%E1%83%98" title="ჯილეხი – Georgian" lang="ka" hreflang="ka" data-title="ჯილეხი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%96%D0%B0%D0%BC%D0%B0%D0%BD%D0%B4%D0%B0%D1%82" title="Жамандат – Kazakh" lang="kk" hreflang="kk" data-title="Жамандат" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-kw mw-list-item"><a href="https://kw.wikipedia.org/wiki/Anthraks" title="Anthraks – Cornish" lang="kw" hreflang="kw" data-title="Anthraks" data-language-autonym="Kernowek" data-language-local-name="Cornish" class="interlanguage-link-target"><span>Kernowek</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Kimeta" title="Kimeta – Swahili" lang="sw" hreflang="sw" data-title="Kimeta" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%9A%D2%AF%D0%B9%D0%B4%D2%AF%D1%80%D0%B3%D2%AF" title="Күйдүргү – Kyrgyz" lang="ky" hreflang="ky" data-title="Күйдүргү" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Sib%C4%ABrijas_m%C4%93ris" title="Sibīrijas mēris – Latvian" lang="lv" hreflang="lv" data-title="Sibīrijas mēris" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lb mw-list-item"><a href="https://lb.wikipedia.org/wiki/M%C3%ABlzbrand" title="Mëlzbrand – Luxembourgish" lang="lb" hreflang="lb" data-title="Mëlzbrand" data-language-autonym="Lëtzebuergesch" data-language-local-name="Luxembourgish" class="interlanguage-link-target"><span>Lëtzebuergesch</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/L%C3%A9pfene" title="Lépfene – Hungarian" lang="hu" hreflang="hu" data-title="Lépfene" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D1%80%D0%B0%D0%BA%D1%81" title="Антракс – Macedonian" lang="mk" hreflang="mk" data-title="Антракс" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%86%E0%B4%A8%E0%B5%8D%E0%B4%A4%E0%B5%8D%E0%B4%B0%E0%B4%BE%E0%B4%95%E0%B5%8D%E0%B4%B8%E0%B5%8D" title="ആന്ത്രാക്സ് – Malayalam" lang="ml" hreflang="ml" data-title="ആന്ത്രാക്സ്" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%85%E0%A4%81%E0%A4%A5%E0%A5%8D%E0%A4%B0%E0%A5%85%E0%A4%95%E0%A5%8D%E0%A4%B8" title="अँथ्रॅक्स – Marathi" lang="mr" hreflang="mr" data-title="अँथ्रॅक्स" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D8%A7%D9%84%D8%AC%D9%85%D8%B1%D9%87_%D8%A7%D9%84%D8%AE%D8%A8%D9%8A%D8%AB%D9%87" title="الجمره الخبيثه – Egyptian Arabic" lang="arz" hreflang="arz" data-title="الجمره الخبيثه" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Antraks" title="Antraks – Malay" lang="ms" hreflang="ms" data-title="Antraks" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%92%E1%80%B1%E1%80%AB%E1%80%84%E1%80%B7%E1%80%BA%E1%80%9E%E1%80%94%E1%80%BA%E1%80%B8" title="ဒေါင့်သန်း – Burmese" lang="my" hreflang="my" data-title="ဒေါင့်သန်း" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Miltvuur" title="Miltvuur – Dutch" lang="nl" hreflang="nl" data-title="Miltvuur" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E7%82%AD%E7%96%BD%E7%97%87" title="炭疽症 – Japanese" lang="ja" hreflang="ja" data-title="炭疽症" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Miltbrann" title="Miltbrann – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Miltbrann" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Miltbrann" title="Miltbrann – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Miltbrann" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%86%E0%AC%A8%E0%AD%8D%E0%AC%A5%E0%AD%8D%E0%AC%B0%E0%AC%BE%E0%AC%95%E0%AD%8D%E0%AC%B8" title="ଆନ୍ଥ୍ରାକ୍ସ – Odia" lang="or" hreflang="or" data-title="ଆନ୍ଥ୍ରାକ୍ସ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-om mw-list-item"><a href="https://om.wikipedia.org/wiki/Antiraaksii" title="Antiraaksii – Oromo" lang="om" hreflang="om" data-title="Antiraaksii" data-language-autonym="Oromoo" data-language-local-name="Oromo" class="interlanguage-link-target"><span>Oromoo</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Kuydirgi" title="Kuydirgi – Uzbek" lang="uz" hreflang="uz" data-title="Kuydirgi" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%A7%D9%86%D8%AA%D8%B1%D8%A7%DA%A9%D8%B3" title="انتراکس – Pashto" lang="ps" hreflang="ps" data-title="انتراکس" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/W%C4%85glik" title="Wąglik – Polish" lang="pl" hreflang="pl" data-title="Wąglik" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Carb%C3%BAnculo" title="Carbúnculo – Portuguese" lang="pt" hreflang="pt" data-title="Carbúnculo" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Antrax" title="Antrax – Romanian" lang="ro" hreflang="ro" data-title="Antrax" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A1%D0%B8%D0%B1%D0%B8%D1%80%D1%81%D0%BA%D0%B0%D1%8F_%D1%8F%D0%B7%D0%B2%D0%B0" title="Сибирская язва – Russian" lang="ru" hreflang="ru" data-title="Сибирская язва" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%A1%D0%BE%D1%82%D1%83%D1%83%D0%BD_%D3%A9%D0%BB%D2%AF%D2%AF" title="Сотуун өлүү – Yakut" lang="sah" hreflang="sah" data-title="Сотуун өлүү" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target"><span>Саха тыла</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Antraksi" title="Antraksi – Albanian" lang="sq" hreflang="sq" data-title="Antraksi" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-scn mw-list-item"><a href="https://scn.wikipedia.org/wiki/Cravunchiu" title="Cravunchiu – Sicilian" lang="scn" hreflang="scn" data-title="Cravunchiu" data-language-autonym="Sicilianu" data-language-local-name="Sicilian" class="interlanguage-link-target"><span>Sicilianu</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Anthrax" title="Anthrax – Simple English" lang="en-simple" hreflang="en-simple" data-title="Anthrax" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Slezinov%C3%A1_sne%C5%A5" title="Slezinová sneť – Slovak" lang="sk" hreflang="sk" data-title="Slezinová sneť" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Vrani%C4%8Dni_prisad" title="Vranični prisad – Slovenian" lang="sl" hreflang="sl" data-title="Vranični prisad" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%AF%D9%88%D9%88%D9%85%DB%95%DA%B5" title="دوومەڵ – Central Kurdish" lang="ckb" hreflang="ckb" data-title="دوومەڵ" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%90%D0%BD%D1%82%D1%80%D0%B0%D0%BA%D1%81" title="Антракс – Serbian" lang="sr" hreflang="sr" data-title="Антракс" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Antraks" title="Antraks – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Antraks" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-su mw-list-item"><a href="https://su.wikipedia.org/wiki/Antraks" title="Antraks – Sundanese" lang="su" hreflang="su" data-title="Antraks" data-language-autonym="Sunda" data-language-local-name="Sundanese" class="interlanguage-link-target"><span>Sunda</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Pernarutto" title="Pernarutto – Finnish" lang="fi" hreflang="fi" data-title="Pernarutto" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Mj%C3%A4ltbrand" title="Mjältbrand – Swedish" lang="sv" hreflang="sv" data-title="Mjältbrand" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Anthrax" title="Anthrax – Tagalog" lang="tl" hreflang="tl" data-title="Anthrax" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%86%E0%AE%A8%E0%AF%8D%E0%AE%A4%E0%AF%8D%E0%AE%B0%E0%AE%BE%E0%AE%95%E0%AF%8D%E0%AE%B8%E0%AF%8D" title="ஆந்த்ராக்ஸ் – Tamil" lang="ta" hreflang="ta" data-title="ஆந்த்ராக்ஸ்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%A2%D2%AF%D0%BB%D3%99%D0%BC%D3%99" title="Түләмә – Tatar" lang="tt" hreflang="tt" data-title="Түләмә" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%81%E0%B8%AD%E0%B8%99%E0%B9%81%E0%B8%97%E0%B8%A3%E0%B8%81%E0%B8%8B%E0%B9%8C" title="แอนแทรกซ์ – Thai" lang="th" hreflang="th" data-title="แอนแทรกซ์" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%A1%D0%B8%D1%91%D2%B3%D0%B7%D0%B0%D1%85%D0%BC" title="Сиёҳзахм – Tajik" lang="tg" hreflang="tg" data-title="Сиёҳзахм" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/%C5%9Earbon" title="Şarbon – Turkish" lang="tr" hreflang="tr" data-title="Şarbon" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A1%D0%B8%D0%B1%D1%96%D1%80%D0%BA%D0%B0" title="Сибірка – Ukrainian" lang="uk" hreflang="uk" data-title="Сибірка" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%AC%D9%85%D8%B1%DB%81_(%D9%85%D8%B1%D8%B6)" title="جمرہ (مرض) – Urdu" lang="ur" hreflang="ur" data-title="جمرہ (مرض)" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/B%E1%BB%87nh_than" title="Bệnh than – Vietnamese" lang="vi" hreflang="vi" data-title="Bệnh than" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-war mw-list-item"><a href="https://war.wikipedia.org/wiki/Anthrax" title="Anthrax – Waray" lang="war" hreflang="war" data-title="Anthrax" data-language-autonym="Winaray" data-language-local-name="Waray" class="interlanguage-link-target"><span>Winaray</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E7%82%AD%E7%96%BD%E7%97%85" title="炭疽病 – Wu" lang="wuu" hreflang="wuu" data-title="炭疽病" data-language-autonym="吴语" data-language-local-name="Wu" 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vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-appearance.unpin">hide</button> </div> </div> </div> </nav> </div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Infection caused by Bacillus anthracis bacteria</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For other uses, see <a href="/wiki/Anthrax_(disambiguation)" class="mw-disambig" title="Anthrax (disambiguation)">Anthrax (disambiguation)</a>.</div> <p class="mw-empty-elt"> </p> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Globalize plainlinks metadata ambox ambox-content ambox-globalize" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img alt="Globe icon." src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/60px-Ambox_globe_content.svg.png" decoding="async" width="48" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/120px-Ambox_globe_content.svg.png 1.5x" data-file-width="350" data-file-height="290" /></span></span></div></td><td class="mbox-text"><div class="mbox-text-span">The examples and perspective in this article <b>may not represent a <a href="/wiki/Wikipedia:WikiProject_Countering_systemic_bias" title="Wikipedia:WikiProject Countering systemic bias">worldwide view</a> of the subject</b>.<span class="hide-when-compact"> You may <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Anthrax&amp;action=edit">improve this article</a>, discuss the issue on the <a href="/wiki/Talk:Anthrax" title="Talk:Anthrax">talk page</a>, or <a href="/wiki/Wikipedia:Article_wizard" title="Wikipedia:Article wizard">create a new article</a>, as appropriate.</span> <span class="date-container"><i>(<span class="date">October 2021</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Anthrax</th></tr><tr><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Anthrax_PHIL_2033.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5f/Anthrax_PHIL_2033.png/250px-Anthrax_PHIL_2033.png" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5f/Anthrax_PHIL_2033.png/330px-Anthrax_PHIL_2033.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5f/Anthrax_PHIL_2033.png/500px-Anthrax_PHIL_2033.png 2x" data-file-width="3072" data-file-height="2048" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">A skin lesion with black <a href="/wiki/Eschar" title="Eschar">eschar</a> characteristic of anthrax</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><b>Skin form</b>: small blister with surrounding swelling<br /><b>Inhalational form</b>: fever, chest pain, <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a><br /><b>Intestinal form</b>: nausea, vomiting, diarrhea, abdominal pain<br /><b>Injection form</b>: fever, <a href="/wiki/Abscess" title="Abscess">abscess</a><sup id="cite_ref-CDC2014Sym_1-0" class="reference"><a href="#cite_note-CDC2014Sym-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">1 day to 2 months post contact<sup id="cite_ref-CDC2014Sym_1-1" class="reference"><a href="#cite_note-CDC2014Sym-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><i><a href="/wiki/Bacillus_anthracis" title="Bacillus anthracis">Bacillus anthracis</a></i><sup id="cite_ref-CDC2015Bas_2-0" class="reference"><a href="#cite_note-CDC2015Bas-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Working with animals; travelers, postal workers, military personnel<sup id="cite_ref-CDC2015Risk_3-0" class="reference"><a href="#cite_note-CDC2015Risk-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on <a href="/wiki/Antibodies" class="mw-redirect" title="Antibodies">antibodies</a> or toxin in the blood, <a href="/wiki/Microbial_culture" class="mw-redirect" title="Microbial culture">microbial culture</a><sup id="cite_ref-CDC2015Diag_4-0" class="reference"><a href="#cite_note-CDC2015Diag-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data"><a href="/wiki/Anthrax_vaccine" title="Anthrax vaccine">Anthrax vaccination</a>, <a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">antibiotics</a><sup id="cite_ref-CDC2015Risk_3-1" class="reference"><a href="#cite_note-CDC2015Risk-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Hend2014_5-0" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Antibiotics, <a href="/wiki/Antitoxin" title="Antitoxin">antitoxin</a><sup id="cite_ref-CDC2016Tx_6-0" class="reference"><a href="#cite_note-CDC2016Tx-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">20–80% die without treatment<sup id="cite_ref-Hend2014_5-1" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-FDA2015_7-0" class="reference"><a href="#cite_note-FDA2015-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">&gt;2,000 cases per year<sup id="cite_ref-Glob2016_8-0" class="reference"><a href="#cite_note-Glob2016-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> <p><b>Anthrax</b> is an infection caused by the <a href="/wiki/Bacterium" class="mw-redirect" title="Bacterium">bacterium</a> <i><a href="/wiki/Bacillus_anthracis" title="Bacillus anthracis">Bacillus anthracis</a></i> or <a href="/wiki/Bacillus_cereus_biovar_anthracis" title="Bacillus cereus biovar anthracis"><i>Bacillus cereus</i> biovar <i>anthracis</i></a>.<sup id="cite_ref-CDC2015Bas_2-1" class="reference"><a href="#cite_note-CDC2015Bas-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Infection typically occurs by <a href="/wiki/Cutaneous_anthrax" class="mw-redirect" title="Cutaneous anthrax">contact with the skin</a>, inhalation, or intestinal absorption.<sup id="cite_ref-:4_9-0" class="reference"><a href="#cite_note-:4-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> Symptom onset occurs between one day and more than two months after the infection is contracted.<sup id="cite_ref-CDC2014Sym_1-2" class="reference"><a href="#cite_note-CDC2014Sym-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The skin form presents with a small blister with surrounding swelling that often turns into a painless <a href="/wiki/Skin_ulcer" class="mw-redirect" title="Skin ulcer">ulcer</a> with a black center.<sup id="cite_ref-CDC2014Sym_1-3" class="reference"><a href="#cite_note-CDC2014Sym-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The inhalation form presents with fever, chest pain, and <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a>.<sup id="cite_ref-CDC2014Sym_1-4" class="reference"><a href="#cite_note-CDC2014Sym-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The intestinal form presents with diarrhea (which may contain blood), abdominal pains, nausea, and vomiting.<sup id="cite_ref-CDC2014Sym_1-5" class="reference"><a href="#cite_note-CDC2014Sym-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> </p><p>According to the U.S. <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a>, the first clinical descriptions of <a href="/wiki/Cutaneous_anthrax" class="mw-redirect" title="Cutaneous anthrax">cutaneous anthrax</a> were given by Maret in 1752 and Fournier in 1769.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2025)">citation needed</span></a></i>&#93;</sup> Before that, anthrax had been described only in historical accounts. The German scientist <a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a> was the first to identify <i>Bacillus anthracis</i> as the bacterium that causes anthrax.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2025)">citation needed</span></a></i>&#93;</sup> </p><p>Anthrax is spread by contact with the bacterium's <a href="/wiki/Endospore" title="Endospore">spores</a>, which often appear in infectious animal products.<sup id="cite_ref-CDC2015Tran_10-0" class="reference"><a href="#cite_note-CDC2015Tran-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> Contact is by breathing or eating or through an area of broken skin.<sup id="cite_ref-CDC2015Tran_10-1" class="reference"><a href="#cite_note-CDC2015Tran-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> It does not typically spread directly between people.<sup id="cite_ref-CDC2015Tran_10-2" class="reference"><a href="#cite_note-CDC2015Tran-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> Risk factors include people who work with animals or animal products, and military personnel.<sup id="cite_ref-CDC2015Risk_3-2" class="reference"><a href="#cite_note-CDC2015Risk-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> Diagnosis can be confirmed by finding antibodies or the toxin in the blood or by <a href="/wiki/Microbial_culture" class="mw-redirect" title="Microbial culture">culture</a> of a sample from the infected site.<sup id="cite_ref-CDC2015Diag_4-1" class="reference"><a href="#cite_note-CDC2015Diag-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Anthrax_vaccine" title="Anthrax vaccine">Anthrax vaccination</a> is recommended for people at high risk of infection.<sup id="cite_ref-CDC2015Risk_3-3" class="reference"><a href="#cite_note-CDC2015Risk-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> Immunizing animals against anthrax is recommended in areas where previous infections have occurred.<sup id="cite_ref-CDC2015Tran_10-3" class="reference"><a href="#cite_note-CDC2015Tran-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> A two-month course of antibiotics such as <a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">ciprofloxacin</a>, <a href="/wiki/Levofloxacin" title="Levofloxacin">levofloxacin</a> and <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a> after exposure can also prevent infection.<sup id="cite_ref-Hend2014_5-2" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> If infection occurs, treatment is with <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> and possibly <a href="/wiki/Antitoxin" title="Antitoxin">antitoxin</a>.<sup id="cite_ref-CDC2016Tx_6-1" class="reference"><a href="#cite_note-CDC2016Tx-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> The type and number of antibiotics used depend on the type of infection.<sup id="cite_ref-Hend2014_5-3" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Antitoxin is recommended for those with widespread infection.<sup id="cite_ref-Hend2014_5-4" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p><p>A rare disease, human anthrax is most common in Africa and central and southern Asia.<sup id="cite_ref-WHOBook2008_11-0" class="reference"><a href="#cite_note-WHOBook2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> It also occurs more regularly in <a href="/wiki/Southern_Europe" title="Southern Europe">Southern Europe</a> than elsewhere on the continent and is uncommon in <a href="/wiki/Northern_Europe" title="Northern Europe">Northern Europe</a> and North America.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> Globally, at least 2,000 cases occur a year, with about two cases a year in the United States.<sup id="cite_ref-Glob2016_8-1" class="reference"><a href="#cite_note-Glob2016-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:5_13-0" class="reference"><a href="#cite_note-:5-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Skin infections represent more than 95% of cases.<sup id="cite_ref-FDA2015_7-1" class="reference"><a href="#cite_note-FDA2015-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> Without treatment the risk of death from skin anthrax is 23.7%.<sup id="cite_ref-Hend2014_5-5" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> For intestinal infection the risk of death is 25 to 75%, while respiratory anthrax has a mortality of 50 to 80%, even with treatment.<sup id="cite_ref-Hend2014_5-6" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-FDA2015_7-2" class="reference"><a href="#cite_note-FDA2015-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> Until the 20th century anthrax infections killed hundreds of thousands of people and animals each year.<sup id="cite_ref-Cherkasskiy1999_14-0" class="reference"><a href="#cite_note-Cherkasskiy1999-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup> In herbivorous animals infection occurs when they eat or breathe in the spores while grazing.<sup id="cite_ref-WHOBook2008_11-1" class="reference"><a href="#cite_note-WHOBook2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> Animals may become infected by killing and/or eating infected animals.<sup id="cite_ref-WHOBook2008_11-2" class="reference"><a href="#cite_note-WHOBook2008-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> </p><p>Several countries have <a href="/wiki/Anthrax_weaponization" title="Anthrax weaponization">developed anthrax as a weapon</a>.<sup id="cite_ref-FDA2015_7-3" class="reference"><a href="#cite_note-FDA2015-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> It has been used in <a href="/wiki/Biowarfare" class="mw-redirect" title="Biowarfare">biowarfare</a> and <a href="/wiki/Bioterrorism" title="Bioterrorism">bioterrorism</a> since 1914. In 1975, the <a href="/wiki/Biological_Weapons_Convention" title="Biological Weapons Convention">Biological Weapons Convention</a> prohibited the "development, production and stockpiling" of biological weapons. It has since been used in bioterrorism. Likely delivery methods of weaponized anthrax include aerial dispersal or dispersal through livestock; notable bioterrorism uses include the <a href="/wiki/2001_anthrax_attacks" title="2001 anthrax attacks">2001 anthrax attacks</a> and an incident in <a href="/wiki/Aum_Shinrikyo#Incidents_before_1995" title="Aum Shinrikyo">1993 by the Aum Shinrikyo group</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Etymology">Etymology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=1" title="Edit section: Etymology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The English name comes from <i>anthrax</i> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc">ἄνθραξ</span></span>), the <a href="/wiki/Greek_language" title="Greek language">Greek</a> word for coal,<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> possibly having <a href="/wiki/Egyptian_language" title="Egyptian language">Egyptian</a> etymology,<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> because of the characteristic black skin <a href="/wiki/Lesion" title="Lesion">lesions</a> people with a cutaneous anthrax infection develop. The central black <a href="/wiki/Eschar" title="Eschar">eschar</a> surrounded by vivid red skin has long been recognised as typical of the disease. The first recorded use of the word "anthrax" in English is in a 1398 translation of <a href="/wiki/Bartholomaeus_Anglicus" title="Bartholomaeus Anglicus">Bartholomaeus Anglicus</a>'s work <i><span title="Latin-language text"><i lang="la">De proprietatibus rerum</i></span></i> (<i>On the Properties of Things</i>, 1240).<sup id="cite_ref-de_Trevisa_1398_18-0" class="reference"><a href="#cite_note-de_Trevisa_1398-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> </p><p>Anthrax was historically known by a wide variety of names, indicating its symptoms, location, and groups considered most vulnerable to infection. They include Siberian plague, <a href="/wiki/Cumberland_County,_New_South_Wales" title="Cumberland County, New South Wales">Cumberland disease</a>, charbon, splenic fever, malignant edema, woolsorter's disease and <i><span title="French-language text"><i lang="fr"><a href="/wiki/Bradford" title="Bradford">la maladie de Bradford</a></i></span></i>.<sup id="cite_ref-Stark_2013_19-0" class="reference"><a href="#cite_note-Stark_2013-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=2" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Skin">Skin</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=3" title="Edit section: Skin"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Skin_reaction_to_anthrax.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Skin_reaction_to_anthrax.jpg/220px-Skin_reaction_to_anthrax.jpg" decoding="async" width="220" height="157" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Skin_reaction_to_anthrax.jpg/330px-Skin_reaction_to_anthrax.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Skin_reaction_to_anthrax.jpg/440px-Skin_reaction_to_anthrax.jpg 2x" data-file-width="640" data-file-height="458" /></a><figcaption>Skin lesion from anthrax</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg/250px-Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg" decoding="async" width="220" height="166" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg/330px-Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/37/Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg/500px-Cutaneous_anthrax_lesion_on_the_neck._PHIL_1934_lores.jpg 2x" data-file-width="2852" data-file-height="2154" /></a><figcaption>Anthrax skin lesion on the neck</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Riehl_Zumbusch_Tafel_IV_(2).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Riehl_Zumbusch_Tafel_IV_%282%29.jpg/250px-Riehl_Zumbusch_Tafel_IV_%282%29.jpg" decoding="async" width="220" height="218" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Riehl_Zumbusch_Tafel_IV_%282%29.jpg/330px-Riehl_Zumbusch_Tafel_IV_%282%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e8/Riehl_Zumbusch_Tafel_IV_%282%29.jpg/500px-Riehl_Zumbusch_Tafel_IV_%282%29.jpg 2x" data-file-width="851" data-file-height="845" /></a><figcaption>Anthrax skin lesion on the face</figcaption></figure> <p>Cutaneous anthrax, also known as hide-porter's disease, is when anthrax occurs on the skin. It is the most common (&gt;90% of cases) and least dangerous form (low mortality with treatment, 23.7% mortality without).<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Hend2014_5-7" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Cutaneous anthrax presents as a <a href="/wiki/Boil" title="Boil">boil</a>-like <a href="/wiki/Skin_lesion" class="mw-redirect" title="Skin lesion">skin lesion</a> that eventually forms an <a href="/wiki/Ulcer" title="Ulcer">ulcer</a> with a black center (<a href="/wiki/Eschar" title="Eschar">eschar</a>). The black eschar often shows up as a large, painless, <a href="/wiki/Necrotic" class="mw-redirect" title="Necrotic">necrotic</a> ulcer (beginning as an irritating and itchy skin lesion or blister that is dark and usually concentrated as a black dot, (somewhat resembling bread mold) at the site of infection. In general, cutaneous infections form within the site of spore penetration two to five days after exposure. Unlike <a href="/wiki/Bruise" title="Bruise">bruises</a> or most other lesions, cutaneous anthrax infections normally do not cause pain. Nearby lymph nodes may become infected, reddened, swollen, and painful. A scab forms over the lesion soon, and falls off in a few weeks. Complete recovery may take longer.<sup id="cite_ref-CDC-Anthrax_21-0" class="reference"><a href="#cite_note-CDC-Anthrax-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> Cutaneous anthrax is typically caused when <i>B. anthracis</i> spores enter through cuts on the skin. This form is found most commonly when humans handle infected animals and/or animal products.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Injection">Injection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=4" title="Edit section: Injection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In December 2009, an outbreak of anthrax occurred among injecting heroin users in the <a href="/wiki/Glasgow" title="Glasgow">Glasgow</a> and <a href="/wiki/Stirling" title="Stirling">Stirling</a> areas of Scotland, resulting in 14&#160;deaths.<sup id="cite_ref-:2_23-0" class="reference"><a href="#cite_note-:2-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> It was the first documented non-occupational human anthrax outbreak in the UK since 1960.<sup id="cite_ref-:2_23-1" class="reference"><a href="#cite_note-:2-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> The source of the anthrax is believed to have been dilution of the heroin with <a href="/wiki/Bone_meal" title="Bone meal">bone meal</a> in Afghanistan.<sup id="cite_ref-:3_24-0" class="reference"><a href="#cite_note-:3-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> Injected anthrax may have symptoms similar to cutaneous anthrax, with the exception of black areas,<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> and may also cause infection deep into the muscle and spread faster.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> This can make it harder to recognise and treat. </p> <div class="mw-heading mw-heading3"><h3 id="Lungs">Lungs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=5" title="Edit section: Lungs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Inhalation anthrax usually develops within a week after exposure, but may take up to 2 months.<sup id="cite_ref-Yellow2020_27-0" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> During the first few days of illness, most people have fever, chills, and fatigue.<sup id="cite_ref-Yellow2020_27-1" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> These symptoms may be accompanied by cough, shortness of breath, chest pain, and nausea or vomiting, making inhalation anthrax difficult to distinguish from <a href="/wiki/Influenza" title="Influenza">influenza</a> and <a href="/wiki/Community-acquired_pneumonia" title="Community-acquired pneumonia">community-acquired pneumonia</a>.<sup id="cite_ref-Yellow2020_27-2" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> This is often described as the prodromal period.<sup id="cite_ref-Yellow2020_27-3" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> </p><p>Over the next day or so, shortness of breath, cough, and chest pain become more common, and complaints not involving the chest such as nausea, vomiting, altered mental status, sweats, and headache develop in one-third or more of people.<sup id="cite_ref-Yellow2020_27-4" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> Upper respiratory tract symptoms occur in only a quarter of people, and muscle pains are rare.<sup id="cite_ref-Yellow2020_27-5" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> Altered mental status or shortness of breath generally brings people to healthcare and marks the fulminant phase of illness.<sup id="cite_ref-Yellow2020_27-6" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> </p><p>It infects the lymph nodes in the chest first, rather than the lungs themselves, a condition called hemorrhagic <a href="/wiki/Mediastinitis" title="Mediastinitis">mediastinitis</a>, causing bloody fluid to accumulate in the chest cavity, thereby causing shortness of breath. The second (pneumonia) stage occurs when the infection spreads from the lymph nodes to the lungs. Symptoms of the second stage develop suddenly within hours or days after the first stage. Symptoms include high fever, extreme shortness of breath, shock, and rapid death within 48 hours in fatal cases.<sup id="cite_ref-:0_28-0" class="reference"><a href="#cite_note-:0-28"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gastrointestinal">Gastrointestinal</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=6" title="Edit section: Gastrointestinal"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Gastrointestinal</a> (GI) infection is most often caused by consuming anthrax-infected meat and is characterized by diarrhea, potentially with blood, abdominal pains, acute inflammation of the intestinal tract, and loss of appetite.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup> Occasional <a href="/wiki/Hematemesis" title="Hematemesis">vomiting of blood</a> can occur. Lesions have been found in the intestines and in the mouth and throat. After the bacterium invades the gastrointestinal system, it spreads to the bloodstream and throughout the body, while continuing to make toxins.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=7" title="Edit section: Cause"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Bacteria">Bacteria</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=8" title="Edit section: Bacteria"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Bacillus_anthracis_Gram.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Bacillus_anthracis_Gram.jpg/250px-Bacillus_anthracis_Gram.jpg" decoding="async" width="220" height="148" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Bacillus_anthracis_Gram.jpg/330px-Bacillus_anthracis_Gram.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Bacillus_anthracis_Gram.jpg/500px-Bacillus_anthracis_Gram.jpg 2x" data-file-width="2892" data-file-height="1940" /></a><figcaption><a href="/wiki/Photomicrograph" class="mw-redirect" title="Photomicrograph">Photomicrograph</a> of a <a href="/wiki/Gram_stain" title="Gram stain">Gram stain</a> of the bacterium <i>Bacillus anthracis</i>, the cause of the anthrax disease</figcaption></figure> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Bacillus_anthracis" title="Bacillus anthracis">Bacillus anthracis</a></div> <p><i>Bacillus anthracis</i> is a rod-shaped, <a href="/wiki/Gram-positive" class="mw-redirect" title="Gram-positive">Gram-positive</a>, facultative anaerobe<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> bacterium about 1 by 9&#160;μm in size.<sup id="cite_ref-CDC2015Bas_2-2" class="reference"><a href="#cite_note-CDC2015Bas-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> It was shown to cause disease by <a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a> in 1876 when he took a blood sample from an infected cow, isolated the bacteria, and put them into a mouse.<sup id="cite_ref-pages_277-310_32-0" class="reference"><a href="#cite_note-pages_277-310-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> The bacterium normally rests in spore form in the soil, and can survive for decades in this state. Herbivores are often infected while grazing, especially when eating rough, irritant, or spiky vegetation; the vegetation has been hypothesized to cause wounds within the gastrointestinal tract, permitting entry of the bacterial spores into the tissues. Once ingested or placed in an open wound, the bacteria begin multiplying inside the animal or human and typically kill the host within a few days or weeks. The spores germinate at the site of entry into the tissues and then spread by the circulation to the lymphatics, where the bacteria multiply.<sup id="cite_ref-Widdicombe_33-0" class="reference"><a href="#cite_note-Widdicombe-33"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup> </p><p>The production of two powerful exotoxins and lethal toxin by the bacteria causes death. Veterinarians can often tell a possible anthrax-induced death by its sudden occurrence and the dark, nonclotting blood that oozes from the body orifices. Most anthrax bacteria inside the body after death are outcompeted and destroyed by anaerobic bacteria within minutes to hours <i>post mortem</i>, but anthrax vegetative bacteria that escape the body via oozing blood or opening the carcass may form hardy spores. These vegetative bacteria are not contagious.<sup id="cite_ref-Liu_34-0" class="reference"><a href="#cite_note-Liu-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> One spore forms per vegetative bacterium. The triggers for spore formation are not known, but oxygen tension and lack of nutrients may play roles. Once formed, these spores are very hard to eradicate.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> </p><p>The infection of herbivores (and occasionally humans) by inhalation normally begins with inhaled spores being transported through the air passages into the tiny air sacs (alveoli) in the lungs. The spores are then picked up by scavenger cells (<a href="/wiki/Macrophage" title="Macrophage">macrophages</a>) in the lungs and transported through small vessels (<a href="/wiki/Lymphatic_system" title="Lymphatic system">lymphatics</a>) to the <a href="/wiki/Lymph_nodes" class="mw-redirect" title="Lymph nodes">lymph nodes</a> in the central chest cavity (<a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a>). Damage caused by the anthrax spores and bacilli to the central chest cavity can cause chest pain and difficulty breathing. Once in the lymph nodes, the spores germinate into active bacilli that multiply and eventually burst the macrophages, releasing many more bacilli into the bloodstream to be transferred to the entire body. Once in the bloodstream, these bacilli release three proteins: <a href="/wiki/Anthrax_lethal_factor_endopeptidase" title="Anthrax lethal factor endopeptidase">lethal factor</a>, edema factor, and protective antigen. The three are not toxic by themselves, but their combination is incredibly lethal to humans.<sup id="cite_ref-Pimental04_36-0" class="reference"><a href="#cite_note-Pimental04-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> Protective antigen combines with these other two factors to form lethal toxin and edema toxin, respectively. These toxins are the primary agents of tissue destruction, bleeding, and death of the host. If antibiotics are administered too late, even if the antibiotics eradicate the bacteria, some hosts still die of toxemia because the toxins produced by the bacilli remain in their systems at lethal dose levels.<sup id="cite_ref-Sweeney_37-0" class="reference"><a href="#cite_note-Sweeney-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Bacillus_Anthracis.png" class="mw-file-description" title="Bacillus anthracis"><img alt="Bacillus anthracis" src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Bacillus_Anthracis.png/120px-Bacillus_Anthracis.png" decoding="async" width="120" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Bacillus_Anthracis.png/250px-Bacillus_Anthracis.png 1.5x" data-file-width="1200" data-file-height="1200" /></a></span></div> <div class="gallerytext"><i>Bacillus anthracis</i></div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Anthrax_color_enhanced_micrograph.JPG" class="mw-file-description" title="Color-enhanced scanning electron micrograph shows splenic tissue from a monkey with inhalational anthrax; featured are rod-shaped bacilli (yellow) and an erythrocyte (red)"><img alt="Color-enhanced scanning electron micrograph shows splenic tissue from a monkey with inhalational anthrax; featured are rod-shaped bacilli (yellow) and an erythrocyte (red)" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/31/Anthrax_color_enhanced_micrograph.JPG/120px-Anthrax_color_enhanced_micrograph.JPG" decoding="async" width="120" height="94" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/31/Anthrax_color_enhanced_micrograph.JPG/180px-Anthrax_color_enhanced_micrograph.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/31/Anthrax_color_enhanced_micrograph.JPG/240px-Anthrax_color_enhanced_micrograph.JPG 2x" data-file-width="1636" data-file-height="1279" /></a></span></div> <div class="gallerytext">Color-enhanced <a href="/wiki/Scanning_electron_microscope" title="Scanning electron microscope">scanning electron micrograph</a> shows <a href="/wiki/Spleen" title="Spleen">splenic tissue</a> from a <a href="/wiki/Monkey" title="Monkey">monkey</a> with inhalational anthrax; featured are rod-shaped <a href="/wiki/Bacilli" title="Bacilli">bacilli</a> (yellow) and an <a href="/wiki/Red_blood_cell" title="Red blood cell">erythrocyte</a> (red)</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Gram_Stain_Anthrax.jpg" class="mw-file-description" title="Gram-positive anthrax bacteria (purple rods) in cerebrospinal fluid: If present, a Gram-negative bacterial species would appear pink. (The other cells are white blood cells.)"><img alt="Gram-positive anthrax bacteria (purple rods) in cerebrospinal fluid: If present, a Gram-negative bacterial species would appear pink. (The other cells are white blood cells.)" src="//upload.wikimedia.org/wikipedia/commons/thumb/7/79/Gram_Stain_Anthrax.jpg/120px-Gram_Stain_Anthrax.jpg" decoding="async" width="120" height="81" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/79/Gram_Stain_Anthrax.jpg/180px-Gram_Stain_Anthrax.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/79/Gram_Stain_Anthrax.jpg/240px-Gram_Stain_Anthrax.jpg 2x" data-file-width="600" data-file-height="405" /></a></span></div> <div class="gallerytext">Gram-positive anthrax bacteria (purple rods) in <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">cerebrospinal fluid</a>: If present, a Gram-negative bacterial species would appear pink. (The other cells are <a href="/wiki/White_blood_cell" title="White blood cell">white blood cells</a>.)</div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Exposure_and_transmission">Exposure and transmission</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=9" title="Edit section: Exposure and transmission"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div><p> Anthrax can enter the human body through the intestines (gastrointestinal), lungs (pulmonary), or skin (cutaneous), and causes distinct clinical symptoms based on its site of entry.<sup id="cite_ref-:5_13-1" class="reference"><a href="#cite_note-:5-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Anthrax does not usually spread from an infected human to an uninfected human.<sup id="cite_ref-:5_13-2" class="reference"><a href="#cite_note-:5-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> If the disease is fatal to the person's body, its mass of anthrax bacilli becomes a potential source of infection to others and special precautions should be used to prevent further contamination.<sup id="cite_ref-:5_13-3" class="reference"><a href="#cite_note-:5-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Pulmonary anthrax, if left untreated, is almost always fatal.<sup id="cite_ref-:5_13-4" class="reference"><a href="#cite_note-:5-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Historically, pulmonary anthrax was called woolsorters' disease because it was an occupational hazard for <a href="/wiki/Wool_classing" title="Wool classing">people who sorted wool</a>.<sup id="cite_ref-:6_38-0" class="reference"><a href="#cite_note-:6-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> Today, this form of infection is extremely rare in industrialized nations.<sup id="cite_ref-:6_38-1" class="reference"><a href="#cite_note-:6-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> Cutaneous anthrax is the most common form of transmission but also the least dangerous of the three transmissions.<sup id="cite_ref-:4_9-1" class="reference"><a href="#cite_note-:4-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> Gastrointestinal anthrax is likely fatal if left untreated, but very rare.<sup id="cite_ref-:4_9-2" class="reference"><a href="#cite_note-:4-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup></p><figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Anthrax_-_inhalational.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Anthrax_-_inhalational.jpg/250px-Anthrax_-_inhalational.jpg" decoding="async" width="220" height="182" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Anthrax_-_inhalational.jpg/330px-Anthrax_-_inhalational.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/e/e6/Anthrax_-_inhalational.jpg 2x" data-file-width="343" data-file-height="284" /></a><figcaption>Inhalational anthrax, <a href="/wiki/Mediastinum" title="Mediastinum">mediastinal</a> widening</figcaption></figure><p>The spores of anthrax are able to survive in harsh conditions for decades or even centuries.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup> Such spores can be found on all continents, including Antarctica.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> Disturbed grave sites of infected animals have been known to cause infection after 70 years.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> In one such event, a young boy died from gastrointestinal anthrax due to the thawing of reindeer corpses from 75 years before contact.<sup id="cite_ref-:7_42-0" class="reference"><a href="#cite_note-:7-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> Anthrax spores traveled though groundwater used for drinking and caused tens of people to be hospitalized, largely children.<sup id="cite_ref-:7_42-1" class="reference"><a href="#cite_note-:7-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> Occupational exposure to infected animals or their products (such as skin, wool, and meat) is the usual pathway of exposure for humans.<sup id="cite_ref-:8_43-0" class="reference"><a href="#cite_note-:8-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> Workers exposed to dead animals and animal products are at the highest risk, especially in countries where anthrax is more common.<sup id="cite_ref-:8_43-1" class="reference"><a href="#cite_note-:8-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> Anthrax in <a href="/wiki/Livestock" title="Livestock">livestock</a> grazing on open range where they mix with wild animals still occasionally occurs in the U.S. and elsewhere.<sup id="cite_ref-:8_43-2" class="reference"><a href="#cite_note-:8-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> </p><p>Many workers who deal with wool and animal hides are routinely exposed to low levels of anthrax spores, but most exposure levels are not sufficient to produce infection.<sup id="cite_ref-:9_44-0" class="reference"><a href="#cite_note-:9-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> A lethal infection is reported to result from inhalation of about 10,000–20,000 spores, though this dose varies among host species.<sup id="cite_ref-:9_44-1" class="reference"><a href="#cite_note-:9-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=10" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The lethality of the anthrax disease is due to the bacterium's two principal virulence factors: the <a href="/wiki/Polyglutamic_acid" title="Polyglutamic acid">poly-D-glutamic acid capsule</a>, which protects the bacterium from phagocytosis by host neutrophils; and the tripartite protein toxin, called <a href="/wiki/Anthrax_toxin" title="Anthrax toxin">anthrax toxin</a>, consisting of protective <a href="/wiki/Antigen" title="Antigen">antigen</a> (PA), <a href="/wiki/Edema" title="Edema">edema</a> factor (EF), and lethal factor (LF).<sup id="cite_ref-toxin_45-0" class="reference"><a href="#cite_note-toxin-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> PA plus LF produces lethal toxin, and PA plus EF produces edema toxin. These toxins cause death and tissue swelling (<a href="/wiki/Edema" title="Edema">edema</a>), respectively. To enter the cells, the edema and lethal factors use another protein produced by <i>B. anthracis</i> called protective antigen, which binds to two surface receptors on the host cell. A cell <a href="/wiki/Protease" title="Protease">protease</a> then cleaves PA into two fragments: PA<sub>20</sub> and PA<sub>63</sub>. PA<sub>20</sub> dissociates into the extracellular medium, playing no further role in the toxic cycle. PA<sub>63</sub> then oligomerizes with six other PA<sub>63</sub> fragments forming a heptameric ring-shaped structure named a prepore. Once in this shape, the complex can competitively bind up to three EFs or LFs, forming a resistant complex.<sup id="cite_ref-Pimental04_36-1" class="reference"><a href="#cite_note-Pimental04-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> Receptor-mediated endocytosis occurs next, providing the newly formed toxic complex access to the interior of the host cell. The acidified environment within the endosome triggers the heptamer to release the LF and/or EF into the cytosol.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup> It is unknown how exactly the complex results in the death of the cell. </p><p>Edema factor is a <a href="/wiki/Calmodulin" title="Calmodulin">calmodulin</a>-dependent <a href="/wiki/Adenylate_cyclase" class="mw-redirect" title="Adenylate cyclase">adenylate cyclase</a>. Adenylate cyclase catalyzes the conversion of ATP into <a href="/wiki/Cyclic_AMP" class="mw-redirect" title="Cyclic AMP">cyclic AMP</a> (cAMP) and <a href="/wiki/Pyrophosphate" title="Pyrophosphate">pyrophosphate</a>. The complexation of adenylate cyclase with <a href="/wiki/Calmodulin" title="Calmodulin">calmodulin</a> removes calmodulin from stimulating calcium-triggered signaling, thus inhibiting the immune response.<sup id="cite_ref-Pimental04_36-2" class="reference"><a href="#cite_note-Pimental04-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> To be specific, LF inactivates <a href="/wiki/Neutrophil" title="Neutrophil">neutrophils</a> (a type of phagocytic cell) by the process just described so they cannot phagocytose bacteria. Throughout history, lethal factor was presumed to cause macrophages to make <a href="/wiki/TNF-alpha" class="mw-redirect" title="TNF-alpha">TNF-alpha</a> and <a href="/wiki/IL1B" class="mw-redirect" title="IL1B">interleukin 1 beta</a> (IL1B). TNF-alpha is a <a href="/wiki/Cytokine" title="Cytokine">cytokine</a> whose primary role is to regulate immune cells, as well as to induce inflammation and <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a> or programmed cell death. Interleukin 1 beta is another cytokine that also regulates inflammation and apoptosis. The overproduction of TNF-alpha and IL1B ultimately leads to <a href="/wiki/Septic_shock" title="Septic shock">septic shock</a> and death. However, recent evidence indicates anthrax also targets endothelial cells that line serious cavities such as the <a href="/wiki/Pericardial_cavity" class="mw-redirect" title="Pericardial cavity">pericardial cavity</a>, <a href="/wiki/Pleural_cavity" title="Pleural cavity">pleural cavity</a>, and <a href="/wiki/Peritoneal_cavity" title="Peritoneal cavity">peritoneal cavity</a>, lymph vessels, and blood vessels, causing vascular leakage of fluid and cells, and ultimately <a href="/wiki/Hypovolemic_shock" title="Hypovolemic shock">hypovolemic shock</a> and septic shock.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=11" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Septicaemic_anthrax_in_a_drug_user.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/ea/Septicaemic_anthrax_in_a_drug_user.png/250px-Septicaemic_anthrax_in_a_drug_user.png" decoding="async" width="218" height="148" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/ea/Septicaemic_anthrax_in_a_drug_user.png/330px-Septicaemic_anthrax_in_a_drug_user.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/ea/Septicaemic_anthrax_in_a_drug_user.png/500px-Septicaemic_anthrax_in_a_drug_user.png 2x" data-file-width="512" data-file-height="347" /></a><figcaption>Possible edema and necrosis in a case of injection anthrax.</figcaption></figure> <p>Various techniques may be used for the direct identification of <i>B. anthracis</i> in clinical material. Firstly, specimens may be <a href="/wiki/Gram_stain" title="Gram stain">Gram stained</a>. <i>Bacillus</i> spp. are quite large in size (3 to 4&#160;μm long), they may grow in long chains, and they stain Gram-positive. To confirm the organism is <i>B. anthracis</i>, rapid diagnostic techniques such as <a href="/wiki/Polymerase_chain_reaction" title="Polymerase chain reaction">polymerase chain reaction</a>-based assays and <a href="/wiki/Immunofluorescence" title="Immunofluorescence">immunofluorescence microscopy</a> may be used.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup> </p><p>All <i>Bacillus</i> species grow well on 5% sheep blood agar and other routine culture media. Polymyxin-lysozyme-EDTA-thallous acetate can be used to isolate <i>B. anthracis</i> from contaminated specimens, and bicarbonate agar is used as an identification method to induce capsule formation. <i>Bacillus</i> spp. usually grow within 24 hours of incubation at 35&#160;°C, in ambient air (room temperature) or in 5% CO<sub>2</sub>. If bicarbonate agar is used for identification, then the medium must be incubated in 5% CO<sub>2</sub>. <i>B. anthracis</i> colonies are medium-large, gray, flat, and irregular with swirling projections, often referred to as having a "<a href="/wiki/Medusa" title="Medusa">medusa head</a>" appearance, and are not hemolytic on 5% sheep blood agar. The bacteria are not motile, susceptible to penicillin, and produce a wide zone of lecithinase on egg yolk agar. Confirmatory testing to identify <i>B. anthracis</i> includes gamma bacteriophage testing, indirect hemagglutination, and enzyme-linked immunosorbent assay to detect antibodies.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> The best confirmatory precipitation test for anthrax is the <a href="/wiki/Alberto_Ascoli" title="Alberto Ascoli">Ascoli</a> test. </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=12" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Precautions are taken to avoid contact with the skin and any fluids exuded through natural body openings of a deceased body that is suspected of harboring anthrax.<sup id="cite_ref-:1_49-0" class="reference"><a href="#cite_note-:1-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> The body should be put in strict quarantine. A blood sample is collected and sealed in a container and analyzed in an approved laboratory to ascertain if anthrax is the cause of death. The body should be sealed in an airtight body bag and incinerated to prevent the transmission of anthrax spores. Microscopic visualization of the encapsulated bacilli, usually in very large numbers, in a blood smear stained with polychrome methylene blue (McFadyean stain) is fully diagnostic, though the culture of the organism is still the gold standard for diagnosis. Full isolation of the body is important to prevent possible contamination of others.<sup id="cite_ref-:1_49-1" class="reference"><a href="#cite_note-:1-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> </p><p>Protective, impermeable clothing and equipment such as <a href="/wiki/Rubber_glove" title="Rubber glove">rubber gloves</a>, rubber apron, and rubber boots with no perforations are used when handling the body. No skin, especially if it has any wounds or scratches, should be exposed. Disposable personal protective equipment is preferable, but if not available, decontamination can be achieved by autoclaving. Used disposable equipment is burned and/or buried after use. All contaminated bedding or clothing is isolated in double plastic bags and treated as biohazard waste.<sup id="cite_ref-:1_49-2" class="reference"><a href="#cite_note-:1-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> Respiratory equipment capable of filtering small particles, such the US <a href="/wiki/National_Institute_for_Occupational_Safety_and_Health" title="National Institute for Occupational Safety and Health">National Institute for Occupational Safety and Health</a>- and <a href="/wiki/Mine_Safety_and_Health_Administration" title="Mine Safety and Health Administration">Mine Safety and Health Administration</a>-approved high-efficiency respirator, is worn.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup> By addressing Anthrax from a <a href="/wiki/One_Health" title="One Health">One Health</a> perspective, we can reduce the risks of transmission and better protect both human and animal populations.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup> </p><p>The prevention of anthrax from the environmental sources like air, water, &amp; soil is disinfection used by <a href="/wiki/Effective_microorganisms" class="mw-redirect" title="Effective microorganisms">effective microorganisms</a> through spraying, and <a href="/wiki/Bokashi_(horticulture)" title="Bokashi (horticulture)">bokashi mudballs</a> mixed with effective microorganisms for the contaminated waterways. </p> <div class="mw-heading mw-heading3"><h3 id="Vaccines">Vaccines</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=13" title="Edit section: Vaccines"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Anthrax_vaccines" class="mw-redirect" title="Anthrax vaccines">Anthrax vaccines</a></div> <p>Vaccines against anthrax for use in livestock and humans have had a prominent place in the history of medicine. The French scientist <a href="/wiki/Louis_Pasteur" title="Louis Pasteur">Louis Pasteur</a> developed the first effective veterinary <a href="/wiki/Anthrax_vaccines" class="mw-redirect" title="Anthrax vaccines">vaccine</a> in 1881.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Mikesell1983_53-0" class="reference"><a href="#cite_note-Mikesell1983-53"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup> Human anthrax vaccines were developed by the <a href="/wiki/Soviet_Union" title="Soviet Union">Soviet Union</a> in the late 1930s and in the US and UK in the 1950s. The current FDA-approved US vaccine was formulated in the 1960s.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> </p><p>Currently administered human anthrax vaccines include <a href="/w/index.php?title=Acellular_vaccine&amp;action=edit&amp;redlink=1" class="new" title="Acellular vaccine (page does not exist)">acellular</a> <a href="/wiki/Subunit_vaccine" title="Subunit vaccine">subunit vaccine</a> (United States) and <a href="/wiki/Live_vaccine" class="mw-redirect" title="Live vaccine">live vaccine</a> (Russia) varieties. All currently used anthrax vaccines show considerable local and general <a href="/wiki/Reactogenicity" title="Reactogenicity">reactogenicity</a> (<a href="/wiki/Erythema" title="Erythema">erythema</a>, <a href="/wiki/Induration" class="mw-redirect" title="Induration">induration</a>, <a href="/wiki/Soreness" class="mw-redirect" title="Soreness">soreness</a>, <a href="/wiki/Fever" title="Fever">fever</a>) and serious adverse reactions occur in about 1% of recipients.<sup id="cite_ref-Splino_2005_56-0" class="reference"><a href="#cite_note-Splino_2005-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> The American product, BioThrax, is licensed by the FDA and was formerly administered in a six-dose primary series at 0, 2, 4 weeks and 6, 12, 18 months, with annual boosters to maintain immunity. In 2008, the FDA approved omitting the week-2 dose, resulting in the currently recommended five-dose series.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup> This five-dose series is available to military personnel, scientists who work with anthrax and members of the public who do jobs which cause them to be at-risk.<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup> New second-generation vaccines currently being researched include <a href="/wiki/Recombinant_live_vaccine" title="Recombinant live vaccine">recombinant live vaccines</a> and <a href="/wiki/Recombinant_subunit_vaccine" class="mw-redirect" title="Recombinant subunit vaccine">recombinant subunit vaccines</a>. In the 20th century the use of a modern product (<a href="/wiki/BioThrax" class="mw-redirect" title="BioThrax">BioThrax</a>) to protect American troops against the use of anthrax in <a href="/wiki/Biological_warfare" title="Biological warfare">biological warfare</a> was controversial.<sup id="cite_ref-anthraxmilitary_59-0" class="reference"><a href="#cite_note-anthraxmilitary-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Antibiotics">Antibiotics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=14" title="Edit section: Antibiotics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Preventive antibiotics are recommended in those who have been exposed.<sup id="cite_ref-Hend2014_5-8" class="reference"><a href="#cite_note-Hend2014-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Early detection of sources of anthrax infection can allow preventive measures to be taken. In response to the <a href="/wiki/2001_anthrax_attacks" title="2001 anthrax attacks">anthrax attacks of October 2001</a>, the <a href="/wiki/United_States_Postal_Service" title="United States Postal Service">United States Postal Service</a> (USPS) installed biodetection systems (BDSs) in their large-scale mail processing facilities. BDS response plans were formulated by the USPS in conjunction with local responders including fire, police, hospitals, and public health. Employees of these facilities have been educated about anthrax, response actions, and <a href="/wiki/Prophylaxis" class="mw-redirect" title="Prophylaxis">prophylactic</a> medication. Because of the time delay inherent in getting final verification that anthrax has been used, prophylactic antibiotic treatment of possibly exposed personnel must be started as soon as possible.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=15" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/220px--Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="220" height="124" data-durationhint="181" data-mwtitle="Anthrax_and_Antibiotics_-_Anthrax_is_Deadly,_Antibiotics_Could_Save_Your_Life.webm" data-mwprovider="wikimediacommons" resource="/wiki/File:Anthrax_and_Antibiotics_-_Anthrax_is_Deadly,_Antibiotics_Could_Save_Your_Life.webm"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.480p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="480p.vp9.webm" data-width="854" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.720p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="720p.vp9.webm" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm" type="video/webm; codecs=&quot;vp8, vorbis&quot;" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="256" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.240p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="240p.vp9.webm" data-width="426" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.360p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="360p.vp9.webm" data-width="640" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/9/9b/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm/Anthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm.360p.webm" type="video/webm; codecs=&quot;vp8, vorbis&quot;" data-transcodekey="360p.webm" data-width="640" data-height="360" /><track src="https://commons.wikimedia.org/w/api.php?action=timedtext&amp;title=File%3AAnthrax_and_Antibiotics_-_Anthrax_is_Deadly%2C_Antibiotics_Could_Save_Your_Life.webm&amp;lang=en&amp;trackformat=vtt&amp;origin=%2A" kind="subtitles" type="text/vtt" srclang="en" label="English ‪(en)‬" data-dir="ltr" /></video></span><figcaption>Anthrax, and antibiotics</figcaption></figure> <p>Anthrax cannot be spread from person to person, except in the rare case of skin exudates from cutaneous anthrax.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup> However, a person's clothing and body may be contaminated with anthrax spores. Effective decontamination of people can be accomplished by a thorough wash-down with <a href="/wiki/Antimicrobial" title="Antimicrobial">antimicrobial</a> soap and water. Wastewater is treated with bleach or another antimicrobial agent.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup> Effective decontamination of articles can be accomplished by boiling them in water for 30 minutes or longer. Chlorine bleach is ineffective in destroying spores and vegetative cells on surfaces, though <a href="/wiki/Formaldehyde" title="Formaldehyde">formaldehyde</a> is effective. Burning clothing is very effective in destroying spores. After decontamination, there is no need to immunize, treat, or isolate contacts of persons ill with anthrax unless they were also exposed to the same source of infection.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Antibiotics_2">Antibiotics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=16" title="Edit section: Antibiotics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Early antibiotic treatment of anthrax is essential; delay significantly lessens chances for survival. Treatment for anthrax infection and other bacterial infections includes large doses of intravenous and oral antibiotics, such as <a href="/wiki/Fluoroquinolone" class="mw-redirect" title="Fluoroquinolone">fluoroquinolones</a> (<a href="/wiki/Ciprofloxacin" title="Ciprofloxacin">ciprofloxacin</a>), <a href="/wiki/Doxycycline" title="Doxycycline">doxycycline</a>, <a href="/wiki/Erythromycin" title="Erythromycin">erythromycin</a>, <a href="/wiki/Vancomycin" title="Vancomycin">vancomycin</a>, or <a href="/wiki/Penicillin" title="Penicillin">penicillin</a>. FDA-approved agents include ciprofloxacin, doxycycline, and penicillin.<sup id="cite_ref-urlCDC_Anthrax_Q_&amp;_A:_Treatment_62-0" class="reference"><a href="#cite_note-urlCDC_Anthrax_Q_&amp;_A:_Treatment-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> In possible cases of pulmonary anthrax, early <a href="/wiki/Prophylaxis" class="mw-redirect" title="Prophylaxis">antibiotic prophylaxis</a> treatment is crucial to prevent possible death. Many attempts have been made to develop new drugs against anthrax, but existing drugs are effective if treatment is started soon enough.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Monoclonal_antibodies">Monoclonal antibodies</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=17" title="Edit section: Monoclonal antibodies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In May 2009, <a href="/wiki/Human_Genome_Sciences" title="Human Genome Sciences">Human Genome Sciences</a> submitted a <a href="/wiki/Biologic_license_application" class="mw-redirect" title="Biologic license application">biologic license application</a> (BLA, permission to market) for its new drug, <a href="/wiki/Raxibacumab" title="Raxibacumab">raxibacumab</a> (brand name ABthrax) intended for emergency treatment of inhaled anthrax.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup> On 14 December 2012, the US Food and Drug Administration approved raxibacumab injection to treat inhalational anthrax. Raxibacumab is a <a href="/wiki/Monoclonal_antibody" title="Monoclonal antibody">monoclonal antibody</a> that neutralizes toxins produced by <i>B. anthracis</i>.<sup id="cite_ref-urlFDA_approves_raxibacumab_to_treat_inhalational_anthrax_65-0" class="reference"><a href="#cite_note-urlFDA_approves_raxibacumab_to_treat_inhalational_anthrax-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup> In March 2016, FDA approved a second anthrax treatment using a monoclonal antibody which neutralizes the toxins produced by <i>B. anthracis</i>. <a href="/wiki/Obiltoxaximab" title="Obiltoxaximab">Obiltoxaximab</a> is approved to treat inhalational anthrax in conjunction with appropriate <a href="/wiki/Antibacterial" class="mw-redirect" title="Antibacterial">antibacterial</a> drugs, and for prevention when alternative therapies are not available or appropriate.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Biologic_for_Drug-,_Antibody-_or_Vaccine-resistant_Anthrax"><span id="Biologic_for_Drug-.2C_Antibody-_or_Vaccine-resistant_Anthrax"></span>Biologic for Drug-, Antibody- or Vaccine-resistant Anthrax</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=18" title="Edit section: Biologic for Drug-, Antibody- or Vaccine-resistant Anthrax"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treatment of multi-drug resistant, antibody- or vaccine-resistant Anthrax is also possible. Legler, et al.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> showed that pegylated CapD (capsule depolymerase) could provide protection against 5 LD50 exposures to lethal Ames spores without the use of antibiotics, monoclonal antibodies, or vaccines. The CapD enzyme removes the poly-D-glutamate (PDGA) capsular material from the bacteria, rendering it susceptible to the innate immune responses. The unencapsulated bacteria can then be cleared.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> </p> <figure class="mw-halign-center" typeof="mw:File/Thumb"><a href="/wiki/File:CapD.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/13/CapD.jpg/400px-CapD.jpg" decoding="async" width="400" height="192" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/13/CapD.jpg/600px-CapD.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/1/13/CapD.jpg 2x" data-file-width="797" data-file-height="383" /></a><figcaption><i>B. anthracis</i> Capsule Depolymerase (CapD) degrades the unusual PDGA capsule on the outer surface of the bacterium. The pegylated enzyme has been used in mice to protect against five LD50 challenges of lethal Ames spores.<sup id="cite_ref-pmid22257032_69-0" class="reference"><a href="#cite_note-pmid22257032-69"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup> The human enzyme (white surface) has been overlaid onto the bacterial CapD structure (PDB 3G9K,<sup id="cite_ref-Joachimiak_70-0" class="reference"><a href="#cite_note-Joachimiak-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> blue ribbon). In red is the substrate binding loop of HuGGT which CapD lacks. CapD binds polymers of D-glutamate. Original figure from Hu, Legler, et al.<sup id="cite_ref-pmid22257032_69-1" class="reference"><a href="#cite_note-pmid22257032-69"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=19" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Cutaneous anthrax is rarely fatal if treated,<sup id="cite_ref-bravata_71-0" class="reference"><a href="#cite_note-bravata-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> because the infection area is limited to the skin, preventing the <a href="/wiki/Anthrax_lethal_factor_endopeptidase" title="Anthrax lethal factor endopeptidase">lethal factor</a>, <a href="/wiki/Edema" title="Edema">edema</a> factor, and protective <a href="/wiki/Antigen" title="Antigen">antigen</a> from entering and destroying a <a href="/wiki/Vital_organ" class="mw-redirect" title="Vital organ">vital organ</a>. Without treatment, up to 20% of cutaneous skin infection cases progress to <a href="/wiki/Bacteremia" class="mw-redirect" title="Bacteremia">toxemia</a> and death.<sup id="cite_ref-Types_of_Anthrax_&#123;&#123;!&#125;&#125;_CDC_72-0" class="reference"><a href="#cite_note-Types_of_Anthrax_{{!}}_CDC-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> </p><p>Before 2001, fatality rates for inhalation anthrax were 90%; since then, they have fallen to 45%.<sup id="cite_ref-Yellow2020_27-7" class="reference"><a href="#cite_note-Yellow2020-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> People that progress to the <a href="/wiki/Fulminant" title="Fulminant">fulminant</a> phase of inhalational anthrax nearly always die, with one case study showing a death rate of 97%.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">&#91;</span>73<span class="cite-bracket">&#93;</span></a></sup> Anthrax meningoencephalitis is also nearly always fatal.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">&#91;</span>74<span class="cite-bracket">&#93;</span></a></sup> </p><p>Gastrointestinal anthrax infections can be treated, but usually result in fatality rates of 25% to 60%, depending upon how soon treatment commences. </p><p>Injection anthrax is the rarest form of anthrax, and has only been seen to have occurred in a group of heroin injecting drug users.<sup id="cite_ref-Types_of_Anthrax_&#123;&#123;!&#125;&#125;_CDC_72-1" class="reference"><a href="#cite_note-Types_of_Anthrax_{{!}}_CDC-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Animals">Animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=20" title="Edit section: Animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Anthrax, a bacterial disease caused by <i>Bacillus anthracis</i>, can have devastating effects on animals. It primarily affects herbivores such as cattle, sheep, and goats, but a wide range of mammals, birds, and even humans can also be susceptible. Infection typically occurs through the ingestion of spores in contaminated soil or plants. Once inside the host, the spores transform into active bacteria, producing lethal toxins that lead to severe symptoms. Infected animals often exhibit high fever, rapid breathing, and convulsions, and they may succumb to the disease within hours to days. The presence of anthrax can pose significant challenges to livestock management and wildlife conservation efforts, making it a critical concern for both animal health and public health, as it can occasionally be transmitted to humans through contact with infected animals or contaminated products. Infected animals may stagger, have difficulty breathing, tremble, and finally collapse and die within a few hours.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">&#91;</span>75<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=21" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Globally, at least 2,000 cases occur a year.<sup id="cite_ref-Glob2016_8-2" class="reference"><a href="#cite_note-Glob2016-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=22" title="Edit section: United States"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The last fatal case of natural inhalational anthrax in the United States occurred in California in 1976, when a home weaver died after working with infected wool imported from Pakistan. To minimize the chance of spreading the disease, the body was transported to <a href="/wiki/University_of_California,_Los_Angeles" title="University of California, Los Angeles">UCLA</a> in a sealed plastic body bag within a sealed metal container for autopsy.<sup id="cite_ref-Suffin1978_76-0" class="reference"><a href="#cite_note-Suffin1978-76"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> </p><p>Gastrointestinal anthrax is exceedingly rare in the United States, with only two cases on record. The first case was reported in 1942, according to the Centers for Disease Control and Prevention.<sup id="cite_ref-boston.com_77-0" class="reference"><a href="#cite_note-boston.com-77"><span class="cite-bracket">&#91;</span>77<span class="cite-bracket">&#93;</span></a></sup> During December 2009, the New Hampshire Department of Health and Human Services confirmed a case of gastrointestinal anthrax in an adult female. The <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">CDC</a> investigated the source and the possibility that it was contracted from an African drum recently used by the woman taking part in a <a href="/wiki/Drum_circle" title="Drum circle">drum circle</a>.<sup id="cite_ref-promedmail.org_78-0" class="reference"><a href="#cite_note-promedmail.org-78"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> The woman apparently inhaled anthrax, in spore form, from the hide of the drum. She became critically ill, but with gastrointestinal anthrax rather than inhaled anthrax, which made her unique in American medical history. The building where the infection took place was cleaned and reopened to the public and the woman recovered. The New Hampshire state epidemiologist, Jodie Dionne-Odom, stated "It is a mystery. We really don't know why it happened."<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2007 two cases of cutaneous anthrax were reported in <a href="/wiki/Danbury,_Connecticut" title="Danbury, Connecticut">Danbury, Connecticut</a>. The case involved a maker of traditional African-style drums who was working with a goat hide purchased from a dealer in New York City which had been previously cleared by Customs. While the hide was being scraped, a spider bite led to the spores entering the bloodstream. His son also became infected.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Croatia">Croatia</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=23" title="Edit section: Croatia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In July 2022, dozens of cattle in a nature park in <a href="/wiki/Lonjsko_Polje" title="Lonjsko Polje">Lonjsko Polje</a>, a flood plain by the <a href="/wiki/Sava" title="Sava">Sava</a> river, died of anthrax and 6 people have been hospitalized with light, skin-related symptoms.<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="United_Kingdom">United Kingdom</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=24" title="Edit section: United Kingdom"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In November 2008, a drum maker in the United Kingdom who worked with untreated animal skins died from anthrax.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">&#91;</span>82<span class="cite-bracket">&#93;</span></a></sup> In December 2009, an outbreak of anthrax occurred among heroin addicts in the <a href="/wiki/Glasgow" title="Glasgow">Glasgow</a> and <a href="/wiki/Stirling" title="Stirling">Stirling</a> areas of Scotland, resulting in 14&#160;deaths.<sup id="cite_ref-:2_23-2" class="reference"><a href="#cite_note-:2-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> The source of the anthrax is believed to have been dilution of the heroin with <a href="/wiki/Bone_meal" title="Bone meal">bone meal</a> in Afghanistan.<sup id="cite_ref-:3_24-1" class="reference"><a href="#cite_note-:3-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=25" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/List_of_anthrax_outbreaks" title="List of anthrax outbreaks">List of anthrax outbreaks</a></div> <div class="mw-heading mw-heading3"><h3 id="Discovery">Discovery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=26" title="Edit section: Discovery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Robert_Koch" title="Robert Koch">Robert Koch</a>, a German physician and scientist, first identified the bacterium that caused the anthrax disease in 1875 in <a href="/wiki/Wolsztyn" title="Wolsztyn">Wollstein</a> (now Wolsztyn, Poland).<sup id="cite_ref-pages_277-310_32-1" class="reference"><a href="#cite_note-pages_277-310-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Brock_83-0" class="reference"><a href="#cite_note-Brock-83"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup> His pioneering work in the late 19th century was one of the first demonstrations that <a href="/wiki/Germ_theory_of_disease" title="Germ theory of disease">diseases could be caused by microbes</a>. In a groundbreaking series of experiments, he uncovered the lifecycle and means of transmission of anthrax. His experiments not only helped create an understanding of anthrax but also helped elucidate the role of microbes in causing illness at a time when debates still took place over <a href="/wiki/Spontaneous_generation#Spontaneous_generation" title="Spontaneous generation">spontaneous generation</a> versus <a href="/wiki/Cell_theory" title="Cell theory">cell theory</a>. Koch went on to study the mechanisms of other diseases and won the 1905 <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a> for his discovery of the bacterium causing tuberculosis.<sup id="cite_ref-84" class="reference"><a href="#cite_note-84"><span class="cite-bracket">&#91;</span>84<span class="cite-bracket">&#93;</span></a></sup> </p><p>Although Koch arguably made the greatest theoretical contribution to understanding anthrax, other researchers were more concerned with the practical questions of how to prevent the disease. In Britain, where anthrax affected workers in the wool, <a href="/wiki/Worsted" title="Worsted">worsted</a>, <a href="/wiki/Hide_(skin)" title="Hide (skin)">hides</a>, and <a href="/wiki/Tanning_(leather)" title="Tanning (leather)">tanning</a> industries, it was viewed with fear. <a href="/wiki/John_Henry_Bell" title="John Henry Bell">John Henry Bell</a>, a doctor born &amp; based in <a href="/wiki/Bradford" title="Bradford">Bradford</a>, first made the link between the mysterious and deadly "woolsorter's disease" and anthrax, showing in 1878 that they were one and the same.<sup id="cite_ref-85" class="reference"><a href="#cite_note-85"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> In the early 20th century, <a href="/wiki/Friederich_Wilhelm_Eurich" title="Friederich Wilhelm Eurich">Friederich Wilhelm Eurich</a>, the <a href="/wiki/Germans" title="Germans">German</a> <a href="/wiki/Bacteriologist" title="Bacteriologist">bacteriologist</a> who settled in Bradford with his family as a child, carried out important research for the local Anthrax Investigation Board. Eurich also made valuable contributions to a <a href="/wiki/Home_Office" title="Home Office">Home Office</a> Departmental Committee of Inquiry, established in 1913 to address the continuing problem of industrial anthrax.<sup id="cite_ref-86" class="reference"><a href="#cite_note-86"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup> His work in this capacity, much of it collaboration with the factory inspector <a href="/w/index.php?title=G._Elmhirst_Duckering&amp;action=edit&amp;redlink=1" class="new" title="G. Elmhirst Duckering (page does not exist)">G. Elmhirst Duckering</a>, led directly to the <a href="/w/index.php?title=Anthrax_Prevention_Act&amp;action=edit&amp;redlink=1" class="new" title="Anthrax Prevention Act (page does not exist)">Anthrax Prevention Act</a> (1919). </p> <div class="mw-heading mw-heading3"><h3 id="First_vaccination">First vaccination</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=27" title="Edit section: First vaccination"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Anthrax_vaccines" class="mw-redirect" title="Anthrax vaccines">Anthrax vaccines</a></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg/250px-Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg" decoding="async" width="200" height="193" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg/330px-Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d6/Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg/500px-Pasteur_inoculating_sheep_against_anthrax._Wellcome_L0003758.jpg 2x" data-file-width="1412" data-file-height="1362" /></a><figcaption>Louis Pasteur inoculating sheep against anthrax</figcaption></figure> <p>Anthrax posed a major economic challenge in <a href="/wiki/France" title="France">France</a> and elsewhere during the 19th century. Horses, cattle, and sheep were particularly vulnerable, and national funds were set aside to investigate the production of a <a href="/wiki/Vaccine" title="Vaccine">vaccine</a>. French scientist <a href="/wiki/Louis_Pasteur" title="Louis Pasteur">Louis Pasteur</a> was charged with the production of a vaccine, following his successful work in developing methods that helped to protect the important wine and silk industries.<sup id="cite_ref-Jones_2010_87-0" class="reference"><a href="#cite_note-Jones_2010-87"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> </p><p>In May 1881, Pasteur – in collaboration with his assistants <a href="/wiki/Jean_Joseph_Henri_Toussaint" title="Jean Joseph Henri Toussaint">Jean-Joseph Henri Toussaint</a>, <a href="/wiki/Pierre_Paul_%C3%89mile_Roux" class="mw-redirect" title="Pierre Paul Émile Roux">Émile Roux</a> and others – performed a public experiment at <a href="/w/index.php?title=Pouilly-le-Fort&amp;action=edit&amp;redlink=1" class="new" title="Pouilly-le-Fort (page does not exist)">Pouilly-le-Fort</a> to demonstrate his concept of vaccination. He prepared two groups of 25 <a href="/wiki/Sheep" title="Sheep">sheep</a>, one <a href="/wiki/Goat" title="Goat">goat</a>, and several <a href="/wiki/Cow" class="mw-redirect" title="Cow">cattle</a>. The animals of one group were twice injected with an anthrax vaccine prepared by Pasteur, at an interval of 15 days; the control group was left unvaccinated. Thirty days after the first injection, both groups were injected with a culture of live anthrax bacteria. All the animals in the unvaccinated group died, while all of the animals in the vaccinated group survived.<sup id="cite_ref-88" class="reference"><a href="#cite_note-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> </p><p>After this apparent triumph, which was widely reported in the local, national, and international press, Pasteur made strenuous efforts to export the vaccine beyond France. He used his celebrity status to establish Pasteur Institutes across Europe and Asia, and his nephew, <a href="/wiki/Adrien_Loir" title="Adrien Loir">Adrien Loir</a>, travelled to <a href="/wiki/Australia" title="Australia">Australia</a> in 1888 to try to introduce the vaccine to combat anthrax in <a href="/wiki/New_South_Wales" title="New South Wales">New South Wales</a>.<sup id="cite_ref-Geison_2014_89-0" class="reference"><a href="#cite_note-Geison_2014-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> Ultimately, the vaccine was unsuccessful in the challenging climate of rural Australia, and it was soon superseded by a more robust version developed by local researchers <a href="/w/index.php?title=John_Gunn_(researcher)&amp;action=edit&amp;redlink=1" class="new" title="John Gunn (researcher) (page does not exist)">John Gunn</a> and <a href="/wiki/John_McGarvie_Smith" title="John McGarvie Smith">John McGarvie Smith</a>.<sup id="cite_ref-Stark_2012_90-0" class="reference"><a href="#cite_note-Stark_2012-90"><span class="cite-bracket">&#91;</span>90<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/Anthrax_vaccine_adsorbed" title="Anthrax vaccine adsorbed">human vaccine for anthrax</a> became available in 1954. This was a cell-free vaccine instead of the live-cell Pasteur-style vaccine used for veterinary purposes. An improved cell-free vaccine became available in 1970.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Engineered_strains">Engineered strains</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=28" title="Edit section: Engineered strains"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444" /><table class="plainlinks metadata ambox mbox-small-left ambox-notice" role="presentation" style="width: auto;"><tbody><tr><td class="mbox-image"><span typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/1/1d/Information_icon4.svg/20px-Information_icon4.svg.png" decoding="async" width="20" height="20" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/1/1d/Information_icon4.svg/40px-Information_icon4.svg.png 1.5x" data-file-width="620" data-file-height="620" /></span></span></td><td class="mbox-text" style="width: auto;"><div class="mbox-text-span">This list is <a href="/wiki/Wikipedia:WikiProject_Lists#Incomplete_lists" title="Wikipedia:WikiProject Lists">incomplete</a>; you can help by <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Anthrax&amp;action=edit">adding missing items</a>. <span class="date-container"><i>(<span class="date">April 2018</span>)</i></span></div></td></tr></tbody></table> <ul><li>The Sterne strain of anthrax, named after the <a href="/wiki/Trieste" title="Trieste">Trieste</a>-born immunologist <a href="/w/index.php?title=Max_Sterne&amp;action=edit&amp;redlink=1" class="new" title="Max Sterne (page does not exist)">Max Sterne</a>, is an attenuated strain used as a vaccine, which contains only the <a href="/wiki/Anthrax_toxin" title="Anthrax toxin">anthrax toxin</a> virulence plasmid and not the polyglutamic acid capsule expressing plasmid.</li> <li><a href="/wiki/Strain_836" class="mw-redirect" title="Strain 836">Strain 836</a>, created by the Soviet bioweapons program in the 1980s, was later called by the <i><a href="/wiki/Los_Angeles_Times" title="Los Angeles Times">Los Angeles Times</a></i> "the most virulent and vicious strain of anthrax known to man".<sup id="cite_ref-92" class="reference"><a href="#cite_note-92"><span class="cite-bracket">&#91;</span>92<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-93" class="reference"><a href="#cite_note-93"><span class="cite-bracket">&#91;</span>93<span class="cite-bracket">&#93;</span></a></sup></li> <li>The virulent <a href="/wiki/Ames_strain" title="Ames strain">Ames strain</a>, which was used in the <a href="/wiki/2001_anthrax_attacks" title="2001 anthrax attacks">2001 anthrax attacks</a> in the United States, has received the most news coverage of any anthrax outbreak. The Ames strain contains two virulence <a href="/wiki/Plasmids" class="mw-redirect" title="Plasmids">plasmids</a>, which separately encode for a three-protein toxin, called <a href="/wiki/Anthrax_toxin" title="Anthrax toxin">anthrax toxin</a>, and a polyglutamic acid <a href="/wiki/Bacterial_capsule" title="Bacterial capsule">capsule</a>.</li> <li>Nonetheless, the <a href="/wiki/Vollum_strain" title="Vollum strain">Vollum strain</a>, developed but never used as a <a href="/wiki/Biological_weapon" class="mw-redirect" title="Biological weapon">biological weapon</a> during the <a href="/wiki/Second_World_War" class="mw-redirect" title="Second World War">Second World War</a>, is much more dangerous. The Vollum (also incorrectly referred to as Vellum) strain was isolated in 1935 from a cow in <a href="/wiki/Oxfordshire" title="Oxfordshire">Oxfordshire</a>. This same strain was used during the <a href="/wiki/Gruinard_Island" title="Gruinard Island">Gruinard</a> bioweapons trials. A variation of Vollum, known as "Vollum 1B", was used during the 1960s in the US and UK bioweapon programs. Vollum 1B is widely believed<sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">&#91;</span>94<span class="cite-bracket">&#93;</span></a></sup> to have been isolated from William A. Boyles, a 46-year-old scientist at the <a href="/wiki/United_States_Army_Biological_Warfare_Laboratories" title="United States Army Biological Warfare Laboratories">US Army Biological Warfare Laboratories</a> at <a href="/wiki/Fort_Detrick" title="Fort Detrick">Camp (later Fort) Detrick</a>, <a href="/wiki/Maryland" title="Maryland">Maryland</a>, who died in 1951 after being accidentally infected with the Vollum strain.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=29" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Site_cleanup">Site cleanup</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=30" title="Edit section: Site cleanup"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Anthrax spores can survive for very long periods of time in the environment after release. Chemical methods for cleaning anthrax-contaminated sites or materials may use <a href="/wiki/Oxidizing_agent" title="Oxidizing agent">oxidizing agents</a> such as <a href="/wiki/Peroxides" class="mw-redirect" title="Peroxides">peroxides</a>, <a href="/wiki/Ethylene_oxide" title="Ethylene oxide">ethylene oxide</a>, Sandia Foam,<sup id="cite_ref-95" class="reference"><a href="#cite_note-95"><span class="cite-bracket">&#91;</span>95<span class="cite-bracket">&#93;</span></a></sup> chlorine dioxide (used in the <a href="/wiki/Hart_Senate_Office_Building" title="Hart Senate Office Building">Hart Senate Office Building</a>),<sup id="cite_ref-Wang_2015_96-0" class="reference"><a href="#cite_note-Wang_2015-96"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup><sup class="reference nowrap"><span title="Page / location: 8">&#58;&#8202;8&#8202;</span></sup> peracetic acid, ozone gas, hypochlorous acid, sodium persulfate, and liquid bleach products containing sodium hypochlorite. Nonoxidizing agents shown to be effective for anthrax decontamination include methyl bromide, formaldehyde, and metam sodium. These agents destroy bacterial spores. All of the aforementioned anthrax decontamination technologies have been demonstrated to be effective in laboratory tests conducted by the US EPA or others.<sup id="cite_ref-97" class="reference"><a href="#cite_note-97"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup> </p><p>Decontamination techniques for <i>Bacillus anthracis</i> spores are affected by the material with which the spores are associated, environmental factors such as temperature and humidity, and microbiological factors such as the spore species, anthracis strain, and test methods used.<sup id="cite_ref-98" class="reference"><a href="#cite_note-98"><span class="cite-bracket">&#91;</span>98<span class="cite-bracket">&#93;</span></a></sup> </p><p>A bleach solution for treating hard surfaces has been approved by the EPA.<sup id="cite_ref-99" class="reference"><a href="#cite_note-99"><span class="cite-bracket">&#91;</span>99<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Chlorine_dioxide" title="Chlorine dioxide">Chlorine dioxide</a> has emerged as the preferred biocide against anthrax-contaminated sites, having been employed in the treatment of numerous government buildings over the past decade.<sup id="cite_ref-rastogi_100-0" class="reference"><a href="#cite_note-rastogi-100"><span class="cite-bracket">&#91;</span>100<span class="cite-bracket">&#93;</span></a></sup> Its chief drawback is the need for <i><a href="/wiki/In_situ" title="In situ">in situ</a></i> processes to have the reactant on demand. </p><p>To speed the process, trace amounts of a nontoxic <a href="/wiki/Catalyst" class="mw-redirect" title="Catalyst">catalyst</a> composed of iron and tetroamido macrocyclic <a href="/wiki/Ligand" title="Ligand">ligands</a> are combined with <a href="/wiki/Sodium_carbonate" title="Sodium carbonate">sodium carbonate</a> and <a href="/wiki/Bicarbonate" title="Bicarbonate">bicarbonate</a> and converted into a spray. The spray formula is applied to an infested area and is followed by another spray containing <a href="/wiki/Tert-butyl_hydroperoxide" class="mw-redirect" title="Tert-butyl hydroperoxide">tert-butyl hydroperoxide</a>.<sup id="cite_ref-Pesticide_Disposal_Goes_Green_101-0" class="reference"><a href="#cite_note-Pesticide_Disposal_Goes_Green-101"><span class="cite-bracket">&#91;</span>101<span class="cite-bracket">&#93;</span></a></sup> </p><p>Using the catalyst method, complete destruction of all anthrax spores can be achieved in under 30 minutes.<sup id="cite_ref-Pesticide_Disposal_Goes_Green_101-1" class="reference"><a href="#cite_note-Pesticide_Disposal_Goes_Green-101"><span class="cite-bracket">&#91;</span>101<span class="cite-bracket">&#93;</span></a></sup> A standard catalyst-free spray destroys fewer than half the spores in the same amount of time. </p><p>Cleanups at a Senate Office Building, several contaminated postal facilities, and other US government and private office buildings, a collaborative effort headed by the <a href="/wiki/United_States_Environmental_Protection_Agency" title="United States Environmental Protection Agency">Environmental Protection Agency</a><sup id="cite_ref-Wang_2015_96-1" class="reference"><a href="#cite_note-Wang_2015-96"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup><sup class="reference nowrap"><span title="Page / location: 3">&#58;&#8202;3&#8202;</span></sup> showed decontamination to be possible, but time-consuming and costly. Clearing the Senate Office Building of anthrax spores cost $27&#160;million, according to the Government Accountability Office. Cleaning the Brentwood postal facility in Washington cost $130&#160;million and took 26 months. Since then, newer and less costly methods have been developed.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102"><span class="cite-bracket">&#91;</span>102<span class="cite-bracket">&#93;</span></a></sup> </p><p>Cleanup of anthrax-contaminated areas on ranches and in the wild is much more problematic. Carcasses may be burned,<sup id="cite_ref-103" class="reference"><a href="#cite_note-103"><span class="cite-bracket">&#91;</span>103<span class="cite-bracket">&#93;</span></a></sup> though often 3 days are needed to burn a large carcass and this is not feasible in areas with little wood. Carcasses may also be buried, though the burying of large animals deeply enough to prevent resurfacing of spores requires much manpower and expensive tools. Carcasses have been soaked in formaldehyde to kill spores, though this has environmental contamination issues. Block burning of vegetation in large areas enclosing an anthrax outbreak has been tried; this, while environmentally destructive, causes healthy animals to move away from an area with carcasses in search of fresh grass. Some wildlife workers have experimented with covering fresh anthrax carcasses with shadecloth and heavy objects. This prevents some scavengers from opening the carcasses, thus allowing the putrefactive bacteria within the carcass to kill the vegetative <i>B. anthracis</i> cells and preventing sporulation. This method also has drawbacks, as scavengers such as hyenas are capable of infiltrating almost any exclosure.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p><p>The experimental site at <a href="/wiki/Gruinard_Island" title="Gruinard Island">Gruinard Island</a> is said to have been decontaminated with a mixture of formaldehyde and seawater by the Ministry of Defence.<sup id="cite_ref-104" class="reference"><a href="#cite_note-104"><span class="cite-bracket">&#91;</span>104<span class="cite-bracket">&#93;</span></a></sup> It is not clear whether similar treatments had been applied to US test sites. </p> <div class="mw-heading mw-heading3"><h3 id="Biological_warfare">Biological warfare</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=31" title="Edit section: Biological warfare"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Anthrax_weaponization" title="Anthrax weaponization">Anthrax weaponization</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Colin_Powell_anthrax_vial._5_Feb_2003_at_the_UN.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/ba/Colin_Powell_anthrax_vial._5_Feb_2003_at_the_UN.jpg/220px-Colin_Powell_anthrax_vial._5_Feb_2003_at_the_UN.jpg" decoding="async" width="220" height="149" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/b/ba/Colin_Powell_anthrax_vial._5_Feb_2003_at_the_UN.jpg 1.5x" data-file-width="252" data-file-height="171" /></a><figcaption><a href="/wiki/Colin_Powell" title="Colin Powell">Colin Powell</a> giving a <a href="/wiki/Colin_Powell%27s_presentation_to_the_United_Nations_Security_Council" title="Colin Powell&#39;s presentation to the United Nations Security Council">presentation to the United Nations Security Council</a>, holding a model vial of supposed weaponized anthrax</figcaption></figure> <p>Anthrax spores have been used as a <a href="/wiki/Biological_warfare" title="Biological warfare">biological warfare</a> weapon. Its first modern incidence occurred when Nordic rebels, supplied by the <a href="/wiki/German_General_Staff" title="German General Staff">German General Staff</a>, used anthrax with unknown results against the <a href="/wiki/Imperial_Russian_Army" title="Imperial Russian Army">Imperial Russian Army</a> in Finland in 1916.<sup id="cite_ref-105" class="reference"><a href="#cite_note-105"><span class="cite-bracket">&#91;</span>105<span class="cite-bracket">&#93;</span></a></sup> Anthrax was first tested as a biological warfare agent by <a href="/wiki/Unit_731" title="Unit 731">Unit 731</a> of the Japanese Kwantung Army in <a href="/wiki/Manchuria" title="Manchuria">Manchuria</a> during the 1930s; some of this testing involved intentional infection of prisoners of war, thousands of whom died. Anthrax, designated at the time as Agent N, was also investigated by the Allies in the 1940s.<sup id="cite_ref-106" class="reference"><a href="#cite_note-106"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 1942, British scientists at <a href="/wiki/Porton_Down" title="Porton Down">Porton Down</a> began research on <a href="/wiki/Operation_Vegetarian" title="Operation Vegetarian">Operation Vegetarian</a>, an ultimately unused <a href="/wiki/Biological_warfare" title="Biological warfare">biowarfare</a> <a href="/wiki/Military_operation_plan" title="Military operation plan">military operation plan</a> which called for animal feed pellets containing <a href="/wiki/Flax" title="Flax">linseed</a> infected with anthrax spores of the <a href="/wiki/Vollum_strain" title="Vollum strain">Vollum-14578 strain</a> to be dropped by air over the countryside of <a href="/wiki/Nazi_Germany" title="Nazi Germany">Nazi Germany</a>. The pellets would be eaten by cattle, which would in turn be eaten by the human population and as such severely disrupt the German war effort. In the same year, bioweapons tests were carried out on the uninhabited <a href="/wiki/Gruinard_Island" title="Gruinard Island">Gruinard Island</a> in the <a href="/wiki/Scottish_Highlands" title="Scottish Highlands">Scottish Highlands</a>, with Porton Down scientists studying the effect of anthrax on the island's population of sheep. Ultimately, five million pellets were created, though plans to drop them over Germany using <a href="/wiki/Royal_Air_Force" title="Royal Air Force">Royal Air Force</a> bombers in 1944 were scrapped after the success of <a href="/wiki/Operation_Overlord" title="Operation Overlord">Operation Overlord</a> and the subsequent Allied liberation of France. All pellets were destroyed using incinerators in 1945.<sup id="cite_ref-107" class="reference"><a href="#cite_note-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-108" class="reference"><a href="#cite_note-108"><span class="cite-bracket">&#91;</span>108<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-109" class="reference"><a href="#cite_note-109"><span class="cite-bracket">&#91;</span>109<span class="cite-bracket">&#93;</span></a></sup> </p><p>Weaponized anthrax was part of the US stockpile prior to 1972, when the United States signed the <a href="/wiki/Biological_Weapons_Convention" title="Biological Weapons Convention">Biological Weapons Convention</a>.<sup id="cite_ref-110" class="reference"><a href="#cite_note-110"><span class="cite-bracket">&#91;</span>110<span class="cite-bracket">&#93;</span></a></sup> President <a href="/wiki/Richard_Nixon" title="Richard Nixon">Nixon</a> ordered the dismantling of US biowarfare programs in 1969 and the destruction of all existing stockpiles of bioweapons. In 1978–79, the <a href="/wiki/Rhodesia" title="Rhodesia">Rhodesian</a> government used anthrax against cattle and humans during its campaign against rebels.<sup id="cite_ref-111" class="reference"><a href="#cite_note-111"><span class="cite-bracket">&#91;</span>111<span class="cite-bracket">&#93;</span></a></sup> The Soviet Union created and stored 100 to 200 tons of anthrax spores at <a href="/wiki/Kantubek" title="Kantubek">Kantubek</a> on <a href="/wiki/Vozrozhdeniya_Island" title="Vozrozhdeniya Island">Vozrozhdeniya Island</a>; they were abandoned in 1992 and destroyed in 2002.<sup id="cite_ref-112" class="reference"><a href="#cite_note-112"><span class="cite-bracket">&#91;</span>112<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Military_of_the_United_States" class="mw-redirect" title="Military of the United States">American military</a> and <a href="/wiki/British_Army" title="British Army">British Army</a> personnel are no longer routinely vaccinated against anthrax prior to active service in places where biological attacks are considered a threat.<sup id="cite_ref-anthraxmilitary_59-1" class="reference"><a href="#cite_note-anthraxmilitary-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Sverdlovsk_incident_(2_April_1979)"><span id="Sverdlovsk_incident_.282_April_1979.29"></span>Sverdlovsk incident (2 April 1979)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=32" title="Edit section: Sverdlovsk incident (2 April 1979)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Sverdlovsk_anthrax_leak" title="Sverdlovsk anthrax leak">Sverdlovsk anthrax leak</a></div> <p>Despite signing the 1972 agreement to end bioweapon production, the government of the Soviet Union had an active bioweapons program that included the production of hundreds of tons of anthrax after this period. On 2 April 1979, some of the over one million people living in Sverdlovsk (now called <a href="/wiki/Ekaterinburg,_Russia" class="mw-redirect" title="Ekaterinburg, Russia">Ekaterinburg, Russia</a>), about 1,370 kilometres (850&#160;mi) east of Moscow, were exposed to an <a href="/wiki/Sverdlovsk_anthrax_leak" title="Sverdlovsk anthrax leak">accidental release of anthrax</a> from a biological weapons complex located near there. At least 94 people were infected, of whom at least 68 died. One victim died four days after the release, 10 over an eight-day period at the peak of the deaths, and the last six weeks later. Extensive cleanup, vaccinations, and medical interventions managed to save about 30 of the victims.<sup id="cite_ref-Guillemin_1999_275_113-0" class="reference"><a href="#cite_note-Guillemin_1999_275-113"><span class="cite-bracket">&#91;</span>113<span class="cite-bracket">&#93;</span></a></sup> Extensive cover-ups and destruction of records by the <a href="/wiki/KGB" title="KGB">KGB</a> continued from 1979 until Russian President <a href="/wiki/Boris_Yeltsin" title="Boris Yeltsin">Boris Yeltsin</a> admitted this anthrax accident in 1992. <a href="/wiki/Jeanne_Guillemin" title="Jeanne Guillemin">Jeanne Guillemin</a> reported in 1999 that a combined Russian and United States team investigated the accident in 1992.<sup id="cite_ref-Guillemin_1999_275_113-1" class="reference"><a href="#cite_note-Guillemin_1999_275-113"><span class="cite-bracket">&#91;</span>113<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-114" class="reference"><a href="#cite_note-114"><span class="cite-bracket">&#91;</span>114<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-115" class="reference"><a href="#cite_note-115"><span class="cite-bracket">&#91;</span>115<span class="cite-bracket">&#93;</span></a></sup> </p><p>Nearly all of the night-shift workers of a ceramics plant directly across the street from the biological facility (compound 19) became infected, and most died. Since most were men, some <a href="/wiki/NATO" title="NATO">NATO</a> governments suspected the Soviet Union had developed a sex-specific weapon.<sup id="cite_ref-Alibek_116-0" class="reference"><a href="#cite_note-Alibek-116"><span class="cite-bracket">&#91;</span>116<span class="cite-bracket">&#93;</span></a></sup> The government blamed the outbreak on the consumption of anthrax-tainted meat, and ordered the confiscation of all uninspected meat that entered the city. They also ordered all <a href="/wiki/Stray_dog" class="mw-redirect" title="Stray dog">stray dogs</a> to be shot and people not have contact with sick animals. Also, a voluntary evacuation and anthrax vaccination program was established for people from 18 to 55.<sup id="cite_ref-Meselson_117-0" class="reference"><a href="#cite_note-Meselson-117"><span class="cite-bracket">&#91;</span>117<span class="cite-bracket">&#93;</span></a></sup> </p><p>To support the <a href="/wiki/Cover-up" title="Cover-up">cover-up</a> story, Soviet medical and legal journals published articles about an outbreak in livestock that caused gastrointestinal anthrax in people having consumed infected meat, and cutaneous anthrax in people having come into contact with the animals. All medical and public health records were confiscated by the KGB.<sup id="cite_ref-Meselson_117-1" class="reference"><a href="#cite_note-Meselson-117"><span class="cite-bracket">&#91;</span>117<span class="cite-bracket">&#93;</span></a></sup> In addition to the medical problems the outbreak caused, it also prompted Western countries to be more suspicious of a covert Soviet bioweapons program and to increase their surveillance of suspected sites. In 1986, the US government was allowed to investigate the incident, and concluded the exposure was from aerosol anthrax from a military weapons facility.<sup id="cite_ref-118" class="reference"><a href="#cite_note-118"><span class="cite-bracket">&#91;</span>118<span class="cite-bracket">&#93;</span></a></sup> In 1992, President Yeltsin admitted he was "absolutely certain" that "rumors" about the Soviet Union violating the 1972 Bioweapons Treaty were true. The Soviet Union, like the US and UK, had agreed to submit information to the UN about their bioweapons programs, but omitted known facilities and never acknowledged their weapons program.<sup id="cite_ref-Alibek_116-1" class="reference"><a href="#cite_note-Alibek-116"><span class="cite-bracket">&#91;</span>116<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Anthrax_bioterrorism">Anthrax bioterrorism</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=33" title="Edit section: Anthrax bioterrorism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In theory, anthrax spores can be cultivated with minimal special equipment and a first-year collegiate <a href="/wiki/Microbiology" title="Microbiology">microbiological</a> education.<sup id="cite_ref-119" class="reference"><a href="#cite_note-119"><span class="cite-bracket">&#91;</span>119<span class="cite-bracket">&#93;</span></a></sup> To make large amounts of an <a href="/wiki/Aerosol" title="Aerosol">aerosol</a> form of anthrax suitable for biological warfare requires extensive practical knowledge, training, and highly advanced equipment.<sup id="cite_ref-120" class="reference"><a href="#cite_note-120"><span class="cite-bracket">&#91;</span>120<span class="cite-bracket">&#93;</span></a></sup> </p><p>Concentrated anthrax spores were used for bioterrorism in the <a href="/wiki/2001_anthrax_attacks" title="2001 anthrax attacks">2001 anthrax attacks</a> in the United States, delivered by mailing postal letters containing the spores.<sup id="cite_ref-121" class="reference"><a href="#cite_note-121"><span class="cite-bracket">&#91;</span>121<span class="cite-bracket">&#93;</span></a></sup> The letters were sent to several news media offices and two Democratic senators: <a href="/wiki/Tom_Daschle" title="Tom Daschle">Tom Daschle</a> of South Dakota and <a href="/wiki/Patrick_Leahy" title="Patrick Leahy">Patrick Leahy</a> of Vermont. As a result, 22 were infected and five died.<sup id="cite_ref-Pimental04_36-3" class="reference"><a href="#cite_note-Pimental04-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> Only a few grams of material were used in these attacks and in August 2008, the US Department of Justice announced they believed that <a href="/wiki/Bruce_Edwards_Ivins" title="Bruce Edwards Ivins">Bruce Ivins</a>, a senior biodefense researcher employed by the United States government, was responsible.<sup id="cite_ref-122" class="reference"><a href="#cite_note-122"><span class="cite-bracket">&#91;</span>122<span class="cite-bracket">&#93;</span></a></sup> These events also spawned many <a href="/wiki/Anthrax_hoaxes" title="Anthrax hoaxes">anthrax hoaxes</a>. </p><p>Due to these events, the US Postal Service installed <a href="/wiki/Autonomous_Detection_System" class="mw-redirect" title="Autonomous Detection System">biohazard detection systems</a> at its major distribution centers to actively scan for anthrax being transported through the mail.<sup id="cite_ref-123" class="reference"><a href="#cite_note-123"><span class="cite-bracket">&#91;</span>123<span class="cite-bracket">&#93;</span></a></sup> As of 2020, no positive alerts by these systems have occurred.<sup id="cite_ref-124" class="reference"><a href="#cite_note-124"><span class="cite-bracket">&#91;</span>124<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Decontaminating_mail">Decontaminating mail</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=34" title="Edit section: Decontaminating mail"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In response to the postal anthrax attacks and hoaxes, the United States Postal Service sterilized some mail using gamma <a href="/wiki/Irradiation" title="Irradiation">irradiation</a> and treatment with a proprietary <a href="/wiki/Enzyme" title="Enzyme">enzyme</a> formula supplied by Sipco Industries.<sup id="cite_ref-125" class="reference"><a href="#cite_note-125"><span class="cite-bracket">&#91;</span>125<span class="cite-bracket">&#93;</span></a></sup> </p><p>A scientific experiment performed by a high school student, later published in the <i>Journal of Medical Toxicology</i>, suggested a domestic <a href="/wiki/Ironing" title="Ironing">electric iron</a> at its hottest setting (at least 400&#160;°F (204&#160;°C)) used for at least 5 minutes should destroy all anthrax spores in a common postal envelope.<sup id="cite_ref-126" class="reference"><a href="#cite_note-126"><span class="cite-bracket">&#91;</span>126<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Other_animals">Other animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=35" title="Edit section: Other animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Anthrax is especially rare in dogs and cats, as is evidenced by a single reported case in the United States in 2001.<sup id="cite_ref-127" class="reference"><a href="#cite_note-127"><span class="cite-bracket">&#91;</span>127<span class="cite-bracket">&#93;</span></a></sup> Anthrax outbreaks occur in some wild animal populations with some regularity.<sup id="cite_ref-Dragon1999_128-0" class="reference"><a href="#cite_note-Dragon1999-128"><span class="cite-bracket">&#91;</span>128<span class="cite-bracket">&#93;</span></a></sup> </p><p>Russian researchers estimate arctic <a href="/wiki/Permafrost" title="Permafrost">permafrost</a> contains around 1.5&#160;million anthrax-infected reindeer carcasses, and the spores may survive in the permafrost for 105 years.<sup id="cite_ref-RevichPodolnaya2011_129-0" class="reference"><a href="#cite_note-RevichPodolnaya2011-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> A risk exists that <a href="/wiki/Global_warming_in_the_Arctic" class="mw-redirect" title="Global warming in the Arctic">global warming in the Arctic</a> can thaw the permafrost, releasing anthrax spores in the carcasses. In 2016, an anthrax outbreak in reindeer was linked to a 75-year-old carcass that defrosted during a heat wave.<sup id="cite_ref-130" class="reference"><a href="#cite_note-130"><span class="cite-bracket">&#91;</span>130<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-131" class="reference"><a href="#cite_note-131"><span class="cite-bracket">&#91;</span>131<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=36" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-CDC2014Sym-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-CDC2014Sym_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-CDC2014Sym_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-CDC2014Sym_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-CDC2014Sym_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-CDC2014Sym_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-CDC2014Sym_1-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/anthrax/basics/symptoms.html">"Symptoms"</a>. <i>CDC</i>. 23 July 2014. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160511071331/http://www.cdc.gov/anthrax/basics/symptoms.html">Archived</a> from the original on 11 May 2016<span class="reference-accessdate">. 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Retrieved <span class="nowrap">14 May</span> 2016</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=CDC&amp;rft.atitle=Basic+Information+What+is+anthrax%3F&amp;rft.date=2015-09-01&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fanthrax%2Fbasics%2Findex.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-CDC2015Risk-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-CDC2015Risk_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-CDC2015Risk_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-CDC2015Risk_3-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-CDC2015Risk_3-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/anthrax/risk/index.html">"Who Is at Risk"</a>. <i>CDC</i>. 1 September 2015. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160511091534/http://www.cdc.gov/anthrax/risk/index.html">Archived</a> from the original on 11 May 2016<span class="reference-accessdate">. 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Retrieved <span class="nowrap">14 March</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Anthrax+%E2%80%93+Chapter+4+%E2%80%93+2020+Yellow+Book+%7C+Travelers%27+Health&amp;rft.pub=CDC&amp;rft_id=https%3A%2F%2Fwwwnc.cdc.gov%2Ftravel%2Fyellowbook%2F2020%2Ftravel-related-infectious-diseases%2Fanthrax&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-:0-28"><span class="mw-cite-backlink"><b><a href="#cite_ref-:0_28-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFUSAMRIID2011" class="citation book cs1"><a href="/wiki/USAMRIID" class="mw-redirect" title="USAMRIID">USAMRIID</a> (2011). <a rel="nofollow" class="external text" href="http://www.usamriid.army.mil/education/bluebookpdf/USAMRIID%20BlueBook%207th%20Edition%20-%20Sep%202011.pdf"><i>USAMRIID's Medical Management of Biological Casualties Handbook</i></a> <span class="cs1-format">(PDF)</span> (7th&#160;ed.). <a href="/wiki/US_Government_Printing_Office" class="mw-redirect" title="US Government Printing Office">US Government Printing Office</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/9780160900150" title="Special:BookSources/9780160900150"><bdi>9780160900150</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150209044622/http://www.usamriid.army.mil/education/bluebookpdf/USAMRIID%20BlueBook%207th%20Edition%20-%20Sep%202011.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on 9 February 2015. <q>For the attacks of 2001, CFR was only 45%, while before this time CFRs for IA were &gt;85% (p. 37)</q></cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=USAMRIID%27s+Medical+Management+of+Biological+Casualties+Handbook&amp;rft.edition=7th&amp;rft.pub=US+Government+Printing+Office&amp;rft.date=2011&amp;rft.isbn=9780160900150&amp;rft.au=USAMRIID&amp;rft_id=http%3A%2F%2Fwww.usamriid.army.mil%2Feducation%2Fbluebookpdf%2FUSAMRIID%2520BlueBook%25207th%2520Edition%2520-%2520Sep%25202011.pdf&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-29">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/anthrax/types/gastrointestinal.html">"Gastrointestinal Anthrax"</a>. <i>Centers for Disease Control and Prevention</i>. 23 August 2013. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150211034003/http://www.cdc.gov/anthrax/types/gastrointestinal.html">Archived</a> from the original on 11 February 2015<span class="reference-accessdate">. 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Promedmail.org. 18 April 2010. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110927142617/http://www.promedmail.org/pls/otn/f?p=2400%3A1001%3A130058575417351%3A%3ANO%3A%3AF2400_P1001_BACK_PAGE%2CF2400_P1001_PUB_MAIL_ID%3A1000%2C82333">Archived</a> from the original on 27 September 2011<span class="reference-accessdate">. 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Retrieved <span class="nowrap">10 October</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Remediating+Indoor+and+Outdoor+Environments&amp;rft_id=http%3A%2F%2Fwww.epa.gov%2Fnhsrc%2Faboutdecon.html%23iodra&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-98"><span class="mw-cite-backlink"><b><a href="#cite_ref-98">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFWoodAdrion2019" class="citation journal cs1">Wood JP, Adrion AC (April 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547374">"Review of Decontamination Techniques for the Inactivation of Bacillus anthracis and Other Spore-Forming Bacteria Associated with Building or Outdoor Materials"</a>. <i>Environmental Science &amp; Technology</i>. <b>53</b> (8): <span class="nowrap">4045–</span>62. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2019EnST...53.4045W">2019EnST...53.4045W</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1021%2Facs.est.8b05274">10.1021/acs.est.8b05274</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547374">6547374</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30901213">30901213</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Environmental+Science+%26+Technology&amp;rft.atitle=Review+of+Decontamination+Techniques+for+the+Inactivation+of+Bacillus+anthracis+and+Other+Spore-Forming+Bacteria+Associated+with+Building+or+Outdoor+Materials&amp;rft.volume=53&amp;rft.issue=8&amp;rft.pages=%3Cspan+class%3D%22nowrap%22%3E4045-%3C%2Fspan%3E62&amp;rft.date=2019-04&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6547374%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F30901213&amp;rft_id=info%3Adoi%2F10.1021%2Facs.est.8b05274&amp;rft_id=info%3Abibcode%2F2019EnST...53.4045W&amp;rft.aulast=Wood&amp;rft.aufirst=JP&amp;rft.au=Adrion%2C+AC&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6547374&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-99"><span class="mw-cite-backlink"><b><a href="#cite_ref-99">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://ehso.com/bleach.htm">"Using Bleach to Destroy Anthrax and Other Microbes"</a>. 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Retrieved <span class="nowrap">13 August</span> 2008</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Using+Bleach+to+Destroy+Anthrax+and+Other+Microbes&amp;rft.pub=Society+for+Applied+Microbiology&amp;rft_id=http%3A%2F%2Fehso.com%2Fbleach.htm&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-rastogi-100"><span class="mw-cite-backlink"><b><a href="#cite_ref-rastogi_100-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFRastogiRyanWallaceSmith2010" class="citation journal cs1">Rastogi VK, Ryan SP, Wallace L, Smith LS, Shah SS, Martin GB (May 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869126">"Systematic evaluation of the efficacy of chlorine dioxide in decontamination of building interior surfaces contaminated with anthrax spores"</a>. <i>Applied and Environmental Microbiology</i>. <b>76</b> (10): 3343–3e51. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2010ApEnM..76.3343R">2010ApEnM..76.3343R</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1128%2FAEM.02668-09">10.1128/AEM.02668-09</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869126">2869126</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20305025">20305025</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Applied+and+Environmental+Microbiology&amp;rft.atitle=Systematic+evaluation+of+the+efficacy+of+chlorine+dioxide+in+decontamination+of+building+interior+surfaces+contaminated+with+anthrax+spores&amp;rft.volume=76&amp;rft.issue=10&amp;rft.pages=3343-3e51&amp;rft.date=2010-05&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2869126%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F20305025&amp;rft_id=info%3Adoi%2F10.1128%2FAEM.02668-09&amp;rft_id=info%3Abibcode%2F2010ApEnM..76.3343R&amp;rft.aulast=Rastogi&amp;rft.aufirst=VK&amp;rft.au=Ryan%2C+SP&amp;rft.au=Wallace%2C+L&amp;rft.au=Smith%2C+LS&amp;rft.au=Shah%2C+SS&amp;rft.au=Martin%2C+GB&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2869126&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-Pesticide_Disposal_Goes_Green-101"><span class="mw-cite-backlink">^ <a href="#cite_ref-Pesticide_Disposal_Goes_Green_101-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Pesticide_Disposal_Goes_Green_101-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation magazine cs1"><a rel="nofollow" class="external text" href="http://www.sciencenews.org/view/generic/id/5581/title/Pesticide_Disposal_Goes_Green">"Pesticide Disposal Goes Green"</a>. <i>Science News</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110629214707/http://www.sciencenews.org/view/generic/id/5581/title/Pesticide_Disposal_Goes_Green">Archived</a> from the original on 29 June 2011<span class="reference-accessdate">. Retrieved <span class="nowrap">8 June</span> 2009</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Science+News&amp;rft.atitle=Pesticide+Disposal+Goes+Green&amp;rft_id=http%3A%2F%2Fwww.sciencenews.org%2Fview%2Fgeneric%2Fid%2F5581%2Ftitle%2FPesticide_Disposal_Goes_Green&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-102"><span class="mw-cite-backlink"><b><a href="#cite_ref-102">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFWessnerDupontCharlesNeufeld2020" class="citation book cs1">Wessner D, Dupont C, Charles T, Neufeld J (3 December 2020). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=GzcDEAAAQBAJ&amp;dq=Cleaning+the+Brentwood+postal+facility+in+Washington+cost+%24130+million+and+took+26+months.+Since+then,+newer+and+less+costly+methods+have+been+developed.&amp;pg=PA264"><i>Microbiology</i></a>. 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class="citation web cs1"><a rel="nofollow" class="external text" href="http://siberiantimes.com/other/others/news/n0691-40-now-hospitalised-after-anthrax-outbreak-in-yamal-more-than-half-are-children/">"40 now hospitalised after anthrax outbreak in Yamal, more than half are children"</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160730185500/http://siberiantimes.com/other/others/news/n0691-40-now-hospitalised-after-anthrax-outbreak-in-yamal-more-than-half-are-children/">Archived</a> from the original on 30 July 2016.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=40+now+hospitalised+after+anthrax+outbreak+in+Yamal%2C+more+than+half+are+children&amp;rft_id=http%3A%2F%2Fsiberiantimes.com%2Fother%2Fothers%2Fnews%2Fn0691-40-now-hospitalised-after-anthrax-outbreak-in-yamal-more-than-half-are-children%2F&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> <li id="cite_note-131"><span class="mw-cite-backlink"><b><a href="#cite_ref-131">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFLuhn2016" class="citation magazine cs1">Luhn A (8 August 2016). <a rel="nofollow" class="external text" href="https://www.wired.com/2016/08/child-dead-climate-change-thawed-anthrax-infected-reindeer/">"Siberian Child Dies After Climate Change Thaws an Anthrax-Infected Reindeer"</a>. <i>Wired</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160817043745/http://www.wired.com/2016/08/child-dead-climate-change-thawed-anthrax-infected-reindeer/">Archived</a> from the original on 17 August 2016<span class="reference-accessdate">. Retrieved <span class="nowrap">19 August</span> 2016</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Wired&amp;rft.atitle=Siberian+Child+Dies+After+Climate+Change+Thaws+an+Anthrax-Infected+Reindeer&amp;rft.date=2016-08-08&amp;rft.aulast=Luhn&amp;rft.aufirst=A&amp;rft_id=https%3A%2F%2Fwww.wired.com%2F2016%2F08%2Fchild-dead-climate-change-thawed-anthrax-infected-reindeer%2F&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=37" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20161130153732/https://www.who.int/csr/resources/publications/anthrax_web.pdf"><i>Anthrax in humans and animals</i></a> <span class="cs1-format">(PDF)</span> (4th&#160;ed.). Geneva: World Health Organization. 2008. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/9789241547536" title="Special:BookSources/9789241547536"><bdi>9789241547536</bdi></a>. Archived from <a rel="nofollow" class="external text" href="https://www.who.int/csr/resources/publications/anthrax_web.pdf">the original</a> <span class="cs1-format">(PDF)</span> on 30 November 2016.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Anthrax+in+humans+and+animals&amp;rft.place=Geneva&amp;rft.edition=4th&amp;rft.pub=World+Health+Organization&amp;rft.date=2008&amp;rft.isbn=9789241547536&amp;rft_id=https%3A%2F%2Fwww.who.int%2Fcsr%2Fresources%2Fpublications%2Fanthrax_web.pdf&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://books.google.com/books?id=YIE9AQAAIAAJ">"Earthworms and Anthrax"</a>. <i><a href="/wiki/Scientific_American" title="Scientific American">Scientific American</a></i>: 57. 23 July 1881.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Scientific+American&amp;rft.atitle=Earthworms+and+Anthrax&amp;rft.pages=57&amp;rft.date=1881-07-23&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DYIE9AQAAIAAJ&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnthrax" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anthrax&amp;action=edit&amp;section=38" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid 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/></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q129104" class="extiw" title="d:Q129104">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-11" title="ICD-11">11</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1321303663">1B97</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/A22">A22</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=022">022</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D000881">D000881</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb1203.htm">1203</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/409498004">409498004</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/001325.htm">001325</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/148-overview">med/148</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/anthrax">Anthrax</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Biological_warfare_and_bioterrorism296" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><style 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abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Bioterrorism" title="Template:Bioterrorism"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Bioterrorism" title="Template talk:Bioterrorism"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Bioterrorism" title="Special:EditPage/Template:Bioterrorism"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Biological_warfare_and_bioterrorism296" style="font-size:114%;margin:0 4em"><a href="/wiki/Biological_warfare" title="Biological warfare">Biological warfare</a> and <a href="/wiki/Bioterrorism" title="Bioterrorism">bioterrorism</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Modern incidents</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Unit_731#Biological_warfare" title="Unit 731">Unit 731</a></li> <li><a href="/wiki/1984_Rajneeshee_bioterror_attack" title="1984 Rajneeshee bioterror attack">1984 Rajneeshee bioterror attack</a></li> <li><a href="/wiki/1989_California_medfly_attack" title="1989 California medfly attack">1989 California medfly attack</a></li> <li><a href="/wiki/2001_anthrax_attacks" title="2001 anthrax attacks">2001 anthrax attacks</a></li> <li><a href="/wiki/Wood_Green_ricin_plot" title="Wood Green ricin plot">Wood Green ricin plot</a></li> <li><a href="/wiki/2003_ricin_letters" title="2003 ricin letters">2003 ricin letters</a></li> <li><a href="/wiki/April_2013_ricin_letters" title="April 2013 ricin letters">2013 ricin letters</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Prevention<br />and response</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Australia_Group" title="Australia Group">Australia Group</a></li> <li><a href="/wiki/Caribbean_Public_Health_Agency" title="Caribbean Public Health Agency">Caribbean Public Health Agency</a></li> <li><a href="/wiki/Center_for_Health_Security" class="mw-redirect" title="Center for Health Security">Center for Health Security</a></li> <li><a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a></li> <li><a href="/wiki/Chinese_Center_for_Disease_Control_and_Prevention" title="Chinese Center for Disease Control and Prevention">Chinese Center for Disease Control and Prevention</a></li> <li><a href="/wiki/Council_of_Europe_Convention_on_the_Prevention_of_Terrorism" title="Council of Europe Convention on the Prevention of Terrorism">Council of Europe Convention on the Prevention of Terrorism</a></li> <li><a href="/wiki/DARPA" title="DARPA">Defense Advanced Research Projects Agency</a></li> <li><a href="/wiki/Defense_Threat_Reduction_Agency" title="Defense Threat Reduction Agency">Defense Threat Reduction Agency</a></li> <li><a href="/wiki/European_Centre_for_Disease_Prevention_and_Control" title="European Centre for Disease Prevention and Control">European Centre for Disease Prevention and Control</a></li> <li><a href="/wiki/Global_Health_Security_Initiative" title="Global Health Security Initiative">Global Health Security Initiative</a></li> <li><a href="/wiki/Health_Threat_Unit_(European_Commission)" class="mw-redirect" title="Health Threat Unit (European Commission)">Health Threat Unit</a></li> <li><a href="/wiki/Laboratory_Response_Network" title="Laboratory Response Network">Laboratory Response Network</a></li> <li><a href="/wiki/Ministry_of_Health_and_Family_Welfare" title="Ministry of Health and Family Welfare">India's Ministry of Health and Family Welfare</a></li> <li><a href="/wiki/National_Biodefense_Analysis_and_Countermeasures_Center" title="National Biodefense Analysis and Countermeasures Center">National Biodefense Analysis and Countermeasures Center</a></li> <li><a href="/wiki/National_Science_Advisory_Board_for_Biosecurity" title="National Science Advisory Board for Biosecurity">National Science Advisory Board for Biosecurity</a></li> <li><a href="/wiki/United_Nations_Office_for_Disarmament_Affairs" title="United Nations Office for Disarmament Affairs">United Nations Office for Disarmament Affairs</a></li> <li><a href="/wiki/United_States_Army_Medical_Research_Institute_of_Infectious_Diseases" title="United States Army Medical Research Institute of Infectious Diseases">United States Army Medical Research Institute of Infectious Diseases</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Biological_agent" title="Biological agent">Biological agents</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Anthrax</a></li> <li><a href="/wiki/Avian_influenza" title="Avian influenza">Avian influenza</a></li> <li><a href="/wiki/Botulinum_toxin" title="Botulinum toxin">Botulinum toxin</a></li> <li><a href="/wiki/Brucellosis" title="Brucellosis">Brucellosis</a></li> <li><a href="/wiki/Burkholderia_pseudomallei" title="Burkholderia pseudomallei">Burkholderia pseudomallei</a></li> <li><a href="/wiki/Chlamydophila_psittaci" class="mw-redirect" title="Chlamydophila psittaci">Chlamydophila psittaci</a></li> <li><a href="/wiki/Coxiella_burnetii" title="Coxiella burnetii">Coxiella burnetii</a></li> <li><a href="/wiki/Ebola" title="Ebola">Ebola</a></li> <li>Equine encephalitis <small>(<a href="/wiki/Eastern_equine_encephalitis_virus" class="mw-redirect" title="Eastern equine encephalitis virus">Eastern</a></small></li> <li><small><a href="/wiki/Western_equine_encephalitis_virus" title="Western equine encephalitis virus">Western</a></small></li> <li><small><a href="/wiki/Venezuelan_equine_encephalitis_virus" title="Venezuelan equine encephalitis virus">Venezuelan</a>)</small></li> <li><a href="/wiki/Foodborne_illness" title="Foodborne illness">Foodborne illness</a></li> <li><a href="/wiki/Fungus" title="Fungus">Fungi</a></li> <li><a href="/wiki/Glanders" title="Glanders">Glanders</a></li> <li><a href="/wiki/Hantavirus" class="mw-redirect" title="Hantavirus">Hantavirus</a></li> <li><a href="/wiki/Henipavirus" title="Henipavirus">Henipavirus</a></li> <li><a href="/wiki/Legionnaires%27_disease" title="Legionnaires&#39; disease">Legionnaires' disease</a></li> <li><a href="/wiki/Marburg_virus" title="Marburg virus">Marburg virus</a></li> <li><a href="/wiki/Mold_(fungus)" class="mw-redirect" title="Mold (fungus)">Mold</a></li> <li><a href="/wiki/Bubonic_plague" title="Bubonic plague">Plague</a></li> <li><a href="/wiki/Prion#Weaponization" title="Prion">Prion</a></li> <li><a href="/wiki/Ricin" title="Ricin">Ricin</a></li> <li><a href="/wiki/Salmonella_enterica" title="Salmonella enterica">Salmonella enterica</a></li> <li><a href="/wiki/Salmonellosis" title="Salmonellosis">Salmonellosis</a></li> <li><a href="/wiki/Typhoid_fever" title="Typhoid fever">Salmonella typhi</a></li> <li><a href="/wiki/Smallpox" title="Smallpox">Smallpox</a></li> <li><a href="/wiki/Staphylococcus" title="Staphylococcus">Staphylococcus</a></li> <li><a href="/wiki/Tularemia" title="Tularemia">Tularemia</a></li> <li><a href="/wiki/Typhus" title="Typhus">Typhus</a></li> <li><a href="/wiki/Viral_hemorrhagic_fever" title="Viral hemorrhagic fever">Viral hemorrhagic fever</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related concepts</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Agro-terrorism" title="Agro-terrorism">Agro-terrorism</a></li> <li><a href="/wiki/Anthrax_hoaxes" title="Anthrax hoaxes">Anthrax hoaxes</a></li> <li><a href="/wiki/Psychochemical_weapon" class="mw-redirect" title="Psychochemical weapon">Psychochemical weapons</a></li> <li><a href="/wiki/Bacteria" title="Bacteria">Bacteria</a></li> <li><a href="/wiki/Biocontainment" title="Biocontainment">Biocontainment</a></li> <li><a href="/wiki/Biological_hazard" title="Biological hazard">Biological hazard</a></li> <li><a href="/wiki/Biological_warfare_in_popular_culture" title="Biological warfare in popular culture">Biological warfare in popular culture</a></li> <li><a href="/wiki/Ethnic_bioweapon" title="Ethnic bioweapon">Ethnic bioweapon</a></li> <li><a href="/wiki/Human_decontamination" title="Human decontamination">Decontamination</a></li> <li><a href="/wiki/Entomological_warfare" title="Entomological warfare">Entomological warfare</a></li> <li><a href="/wiki/Infection" title="Infection">Infectious disease</a></li> <li><a href="/wiki/Virus" title="Virus">Virus</a></li> <li><a href="/wiki/Toxin" title="Toxin">Toxin</a></li> <li><a href="/wiki/Terrorism" title="Terrorism">Terrorism</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">International law</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Geneva_Protocol" title="Geneva Protocol">Geneva Protocol</a></li> <li><a href="/wiki/Biological_Weapons_Convention" title="Biological Weapons Convention">Biological Weapons Convention</a></li> <li><a href="/wiki/United_Nations_Security_Council_Resolution_1540" title="United Nations Security Council Resolution 1540">United Nations Security Council Resolution 1540</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><a href="https://en.wiktionary.org/wiki/Bioterrorism" class="extiw" title="wiktionary:Bioterrorism">Wiktionary definition</a></li> <li><a href="https://commons.wikimedia.org/wiki/Category:Bioterrorism" class="extiw" title="commons:Category:Bioterrorism">Wikimedia Commons</a></li> <li><a href="https://en.wikisource.org/wiki/Category:Bioterrorism" class="extiw" title="wikisource:Category:Bioterrorism">Wikisource</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="*_Bacillota_(low-G+C)_Infectious_diseases_*_Bacterial_diseases:_G+200" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Gram-positive_firmicutes_diseases" title="Template:Gram-positive firmicutes diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Gram-positive_firmicutes_diseases" title="Template talk:Gram-positive firmicutes diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Gram-positive_firmicutes_diseases" title="Special:EditPage/Template:Gram-positive firmicutes diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="*_Bacillota_(low-G+C)_Infectious_diseases_*_Bacterial_diseases:_G+200" style="font-size:114%;margin:0 4em"> <ul><li><a href="/wiki/Bacillota" title="Bacillota">Bacillota</a> (low-<a href="/wiki/GC-content" title="GC-content">G+C</a>) <a href="/wiki/Infection" title="Infection">Infectious diseases</a></li> <li><a href="/wiki/Pathogenic_bacteria" title="Pathogenic bacteria">Bacterial diseases</a>: <a href="/wiki/Gram-positive_bacterial_infection" class="mw-redirect" title="Gram-positive bacterial infection">G+</a></li></ul> </div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bacilli" title="Bacilli">Bacilli</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lactobacillales" class="mw-redirect" title="Lactobacillales">Lactobacillales</a><br />(<a href="/wiki/Catalase" title="Catalase">Cat-</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Streptococcus" title="Streptococcus">Streptococcus</a></i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Alpha-hemolytic_streptococci" class="mw-redirect" title="Alpha-hemolytic streptococci">α</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Optochin" title="Optochin">optochin</a> susceptible</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Streptococcus_pneumoniae" title="Streptococcus pneumoniae">S. pneumoniae</a></i> <ul><li><a href="/wiki/Pneumococcal_infection" title="Pneumococcal infection">Pneumococcal infection</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">optochin resistant</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Viridans_streptococci" title="Viridans streptococci">Viridans streptococci</a>: <i><a href="/wiki/Streptococcus_mitis" title="Streptococcus mitis">S. mitis</a></i></li> <li><i><a href="/wiki/Streptococcus_mutans" title="Streptococcus mutans">S. mutans</a></i></li> <li><i><a href="/wiki/Streptococcus_oralis" title="Streptococcus oralis">S. oralis</a></i></li> <li><i><a href="/wiki/Streptococcus_sanguinis" title="Streptococcus sanguinis">S. sanguinis</a></i></li> <li><i><a href="/wiki/Streptococcus_sobrinus" title="Streptococcus sobrinus">S. sobrinus</a></i></li> <li><a href="/wiki/Streptococcus_anginosus_group" title="Streptococcus anginosus group"><i>S. anginosus</i> group</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Beta-hemolytic_streptococci" class="mw-redirect" title="Beta-hemolytic streptococci">β</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Group_A_streptococcal_infection" title="Group A streptococcal infection">A</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bacitracin" title="Bacitracin">bacitracin</a> susceptible: <i><a href="/wiki/Streptococcus_pyogenes" title="Streptococcus pyogenes">S. pyogenes</a></i> <ul><li><a href="/wiki/Group_A_streptococcal_infection" title="Group A streptococcal infection">Group A streptococcal infection</a></li> <li><a href="/wiki/Streptococcal_pharyngitis" title="Streptococcal pharyngitis">Streptococcal pharyngitis</a></li> <li><a href="/wiki/Scarlet_fever" title="Scarlet fever">Scarlet fever</a></li> <li><a href="/wiki/Erysipelas" title="Erysipelas">Erysipelas</a></li> <li><a href="/wiki/Rheumatic_fever" title="Rheumatic fever">Rheumatic fever</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Group_B_streptococcal_infection" title="Group B streptococcal infection">B</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>bacitracin resistant, <a href="/wiki/CAMP_test" title="CAMP test">CAMP test</a>+: <i><a href="/wiki/Streptococcus_agalactiae" title="Streptococcus agalactiae">S. agalactiae</a></i> <ul><li><a href="/wiki/Group_B_streptococcal_infection" title="Group B streptococcal infection">Group B streptococcal infection</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">ungrouped</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Streptococcus_iniae" title="Streptococcus iniae">Streptococcus iniae</a></i> <ul><li><a href="/wiki/Cutaneous_Streptococcus_iniae_infection" title="Cutaneous Streptococcus iniae infection">Cutaneous Streptococcus iniae infection</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hemolysis_(microbiology)#Gamma" title="Hemolysis (microbiology)">γ</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Streptococcus#Group_D_(enterococci)_*variable_in_hemolysis" title="Streptococcus">D</a></li> <li><a href="/wiki/Bile_esculin_agar" title="Bile esculin agar">BEA</a>+: <i><a href="/wiki/Streptococcus_bovis" title="Streptococcus bovis">Streptococcus bovis</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Enterococcus" title="Enterococcus">Enterococcus</a></i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bile_esculin_agar" title="Bile esculin agar">BEA</a>+: <i><a href="/wiki/Enterococcus_faecalis" title="Enterococcus faecalis">Enterococcus faecalis</a></i> <ul><li><a href="/wiki/Urinary_tract_infection" title="Urinary tract infection">Urinary tract infection</a></li></ul></li> <li><i><a href="/wiki/Enterococcus_faecium" title="Enterococcus faecium">Enterococcus faecium</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bacillales" title="Bacillales">Bacillales</a><br />(<a href="/wiki/Catalase" title="Catalase">Cat+</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Staphylococcal_infection" title="Staphylococcal infection">Staphylococcus</a></i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Coagulase" title="Coagulase">Cg+</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Staphylococcus_aureus" title="Staphylococcus aureus">S. aureus</a></i> <ul><li><a href="/wiki/Staphylococcal_scalded_skin_syndrome" title="Staphylococcal scalded skin syndrome">Staphylococcal scalded skin syndrome</a></li> <li><a href="/wiki/Toxic_shock_syndrome" title="Toxic shock syndrome">Toxic shock syndrome</a></li> <li><a href="/wiki/Methicillin-resistant_Staphylococcus_aureus" title="Methicillin-resistant Staphylococcus aureus">MRSA</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Coagulase" title="Coagulase">Cg-</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Novobiocin" title="Novobiocin">novobiocin</a> susceptible</i> <ul><li><i><a href="/wiki/Staphylococcus_epidermidis" title="Staphylococcus epidermidis">S. epidermidis</a></i></li></ul></li> <li><i>novobiocin resistant</i> <ul><li><i><a href="/wiki/Staphylococcus_saprophyticus" title="Staphylococcus saprophyticus">S. saprophyticus</a></i></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Bacillus" title="Bacillus">Bacillus</a></i></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Bacillus_anthracis" title="Bacillus anthracis">Bacillus anthracis</a></i> <ul><li><a class="mw-selflink selflink">Anthrax</a></li></ul></li> <li><i><a href="/wiki/Bacillus_cereus" title="Bacillus cereus">Bacillus cereus</a></i> <ul><li><a href="/wiki/Foodborne_illness" title="Foodborne illness">Food poisoning</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Listeria" title="Listeria">Listeria</a></i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Listeria_monocytogenes" title="Listeria monocytogenes">Listeria monocytogenes</a></i> <ul><li><a href="/wiki/Listeriosis" title="Listeriosis">Listeriosis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Clostridia" title="Clostridia">Clostridia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Clostridium" title="Clostridium">Clostridium</a></i> (<a href="/wiki/Endospore" title="Endospore">spore</a>-forming)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><i>motile:</i></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Clostridium_botulinum" title="Clostridium botulinum">Clostridium botulinum</a></i> <ul><li><a href="/wiki/Botulism" title="Botulism">Botulism</a></li></ul></li> <li><i><a href="/wiki/Clostridium_tetani" title="Clostridium tetani">Clostridium tetani</a></i> <ul><li><a href="/wiki/Tetanus" title="Tetanus">Tetanus</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i>nonmotile:</i></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Clostridium_perfringens" title="Clostridium perfringens">Clostridium perfringens</a></i> <ul><li><a href="/wiki/Gas_gangrene" title="Gas gangrene">Gas gangrene</a></li> <li><a href="/wiki/Clostridial_necrotizing_enteritis" title="Clostridial necrotizing enteritis">Clostridial necrotizing enteritis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Clostridioides" title="Clostridioides">Clostridioides</a></i> (<a href="/wiki/Endospore" title="Endospore">spore</a>-forming)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Clostridioides_difficile" title="Clostridioides difficile">Clostridioides difficile</a></i> [<i>Clostridium difficile</i>] <ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous colitis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i><a href="/wiki/Finegoldia" title="Finegoldia">Finegoldia</a></i> (non-spore forming)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Finegoldia" title="Finegoldia">Finegoldia magna</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mollicutes" title="Mollicutes">Mollicutes</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mycoplasmataceae" title="Mycoplasmataceae">Mycoplasmataceae</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Ureaplasma_urealyticum" title="Ureaplasma urealyticum">Ureaplasma urealyticum</a></i> <ul><li><a href="/wiki/Ureaplasma_infection" class="mw-redirect" title="Ureaplasma infection">Ureaplasma infection</a></li></ul></li> <li><i><a href="/wiki/Mycoplasma_genitalium" title="Mycoplasma genitalium">Mycoplasma genitalium</a></i></li> <li><i><a href="/wiki/Mycoplasma_pneumoniae" title="Mycoplasma pneumoniae">Mycoplasma pneumoniae</a></i> <ul><li><a href="/wiki/Mycoplasma_pneumonia" title="Mycoplasma pneumonia">Mycoplasma pneumonia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anaeroplasmatales" class="mw-redirect" 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