What is Anthrax?
This flow chart from the CDC explains the life cycle of Bacillus anthracis inside an organism.
This flow chart from the CDC explains the life cycle of Bacillus anthracis inside an organism.

Anthrax is a life threatening infection caused by the gram-positive bacterium Bacillus anthracis, which forms spores. It is found naturally in soil and has detrimental effects on warm-blooded animals throughout the world. Animals become infected by ingesting or breathing in spores from contaminated soil, water, or plants.[1] These types of cases are called gastrointestinal and inhalation anthrax, respectively. Humans are infected with the disease in a similar manner – inhaling or eating spores from contaminated food. Cases of Bacillus anthracis spores infecting an open wound have also been documented.[2] This is referred to as cutaneous anthrax.

According to the Centers for Disease Control and Prevention (CDC), B. anthracis is most commonly found in agricultural areas of Central and South America, central and southwestern Asia, sub-Saharan Africa, southern and eastern Europe, and the Carribean.[1]

The video below from HowStuffWorks explains the biological implications of B. anthracis spore inhalation:

History of Naturally Occurring Anthrax in Society

An image based timeline of Anthrax's history.  From CDC.gov
An image based timeline of Anthrax's history. From CDC.gov

1250 BCE – The first known accounts of a possible anthrax bacterium originate from ancient Egypt and Mesopotamia. Descriptions of maladies that affected domestic animals mirror those of anthrax infection. Anthrax has also been described in ancient Greek writings and may have contributed to the fall of the Roman Empire.[5] In fact, the name anthrax derives from the Greek “anthracis,” which stands for coal.[6]

1752 – The first clinical descriptions of anthrax are made.

1877 – Robert Koch studies Bacillus anthracis and makes some important discoveries, including spore formation, and survival rates. Koch was also the first man to grow B. anthracis in culture, and subsequently inject animals with it to study the disease.

1881 – Following in the footsteps of Koch, Louis Pasteur creates the first anthrax vaccine.[5]

1937 – Routine animal vaccinations for anthrax significantly decrease the amount of human cases. There were only 18 documented cases of anthrax in the United States during the 20th century. [3]

1950s – The first anthrax vaccine for humans is created and determined to be 92.5% effective.[3]

2006 – The first case of naturally occurring anthrax reported in 30 years is recorded in a drum maker in New York City. He inhaled anthrax while creating hand drums out of untreated goat hides from Africa.[3]

2009 – A women becomes ill with anthrax while participating in an indoor drum circle. Several of the drum skins test positive for anthrax.

2010 – The term “injection anthrax” is coined based on a small outbreak in the U.K. and Germany. Heroin users became sick with anthrax infections that were not like any seen before. Doctors believe that the anthrax was in the heroin that they injected into their veins.

The Role of Anthrax in Bioterrorism

Anthrax decontamination.  From blogspot.com
Anthrax decontamination. From blogspot.com

According to the CDC, should a biological attack occur in the United States, Bacillus anthracis would be one of the most likely agents to be used. This is mainly because anthrax was the agent involved in the most serious bioterrorism attack on the U.S. in October and November 2001. In addition, B. anthracis spores are readily available in nature, can be easily cultivated, and survive for extended periods of time. They also make a tactical weapon because they are released in a very secretive way; the spores can be hidden in powders, food, or water and are not noticed by any of the senses.[7]

B. anthracis is considered a Category A agent, meaning that it “presents the greatest risk of deliberate misuse with significant potential for mass casualties or devastating effect to the economy, critical infrastructure, or public confidence, and pose a severe threat to public health and safety.”[7] Category A is the highest threat level that a biological agent can have.

Anthrax Bioterrorism Timeline:
An image of a cutaneous anthrax infection.  From willamette.edu
An image of a cutaneous anthrax infection. From willamette.edu

1877 – Robert Koch’s experiments create a scientific knowledge base for how to cultivate large stocks of Bacillus anthracis bacteria.

1917 – During WWI the German army secretly infected livestock and animal feed that was destined to be traded to the Allies. This caused the death of 200 mules.[3]

1932 – Japan experiments with B. anthracis and other pathogens in Manchuria, killing at least 10,000 prisoners-of-war. Following experimentation, Japan attacks at least 11 Chinese cities with biological agents.[6]

1942 – The U.S. starts a bioweapons program, conducting experiments with anthrax and other biological agents in Mississippi and Utah. Over 5,000 anthrax-laden bombs are prepared for response against Germany.
Great Britain also began to experiment with anthrax for bioweapons on a small island off the coast of Scotland called Gruinard Island. They tested the widespread release of anthrax by releasing bombs containing the germ over the island, where 80 sheep had been placed. All of the sheep died from anthrax. One of the most important findings from this experiment was how long anthrax stays in the environment after a release. The island remained uninhabitable until 1986, when Great Britain decided to decontaminate it by killing all of the anthrax spores. After a year of soaking the island in a mixture of formaldehyde and seawater, the island was considered disinfected.” (CDC.gov/anthrax[3])

1953 – The U.S. expands its bioweapons program during the Korean War. Vaccines and serums are developed to protect U.S. troops, and a new bioweapons production facility is opened in Pine Bluff, Arkansas. This allowed for whole-sale production and weaponization of microorganisms.[6]

1969 – President Nixon terminates the U.S. bioweapons program, ordering a stop to offensive-minded research and the destruction of all weapon stocks. The country also adopts a policy that says biological weapons will never be used under any circumstances.

1972 – A treaty to prohibit the development and possession of biological weapons, along with the ordered destruction of current stocks of weapons is ratified by over 100 countries, including the U.S., Soviet Union, and Great Britain.

1979 – An anthrax epidemic breaks out near a Soviet military microbiology facility in Sverdlovsk, Russia, causing 96 cases of human anthrax. The Soviet government reports 79 of the cases to be gastrointestinal, and the remainder cutaneous; the result of eating tainted meat and being in contact with infected animals. In 1986 a group of American scientists investigate and determine that all of the cases were inhalation anthrax, from a wind-borne spread from the microbiology facility.[5]
A letter mailed to Senate Majority Lead Tom Daschle containing anthrax powder that killed two postal workers.  From wikipedia.org
A letter mailed to Senate Majority Lead Tom Daschle containing anthrax powder that killed two postal workers. From wikipedia.org

2001 – In October 2001, just a month after the attacks of September 11th, the most significant biological attack is waged on the United States. A terrorist or terrorist group mailed powdered anthrax spores throughout the country. Four letters were covered with powdered anthrax that could be inhaled. Spores are so small that it’s possible they leaked out of the microscopic holes in the sealed envelop as well. A total of 11 cases of inhalation anthrax and seven cases of cutaneous anthrax were reported, resulting in five deaths. The FBI conducted an elaborate and thorough investigation that became dubbed “Amerithrax”. This name was given because of evidence that the spores may have came from one of the U.S. government’s own labs.

Frontline has an engaging episode about the FBI's investigation of the 2001 Amerithrax attacks available here.


Prevention of naturally occurring anthrax infection is fairly straightforward. B. anthracis is a bacterium, so treatment of infected individuals relies on antibiotics. Ciprofloxacin, doxycycline, and levofloxacin are the recommended antibiotics approved by the FDA for post-anthrax exposure.[8]

A vaccine has also been approved for humans. It does not contain live B. anthracis bacteria, so it cannot cause an anthrax infection, although side-effects ranging from soreness to severe allergic reactions have been documented.[8] The vaccine is reserved for military personnel, anthrax researchers, and those who work with potentially infected animals.
The number of research facilities storing anthrax worldwide, as of 2001.  From news.bbc.co.uk/
The number of research facilities storing anthrax worldwide, as of 2001. From news.bbc.co.uk/

Those who are traveling to countries or areas with a higher prevalence of the bacteria should avoid contact with animals and be sure that meat is thoroughly cooked before consumption. Since several cases of anthrax exposure have been documented from people playing drums made of animal hides, such musicians should be weary. Although they may not be viewed as authentic, buying instruments made in the U.S.A. is the best way to avoid contamination from drums.

In terms of prevention of another bioterrorism attack using anthrax, there is not much the government can do, aside from preparing for the aftermath. The CDC is working with many federal and local agencies to help the country prepare for an anthrax attack. These agencies work to:[9]
  • Provide funds and guidance to local health departments to strengthen their response to an incident
  • Provide training to public health employees and healthcare providers
  • Coordinate response activities and provide resources
  • Regulate the research and transport of anthrax throughout the country
  • Fund research that focuses on post-anthrax exposure
  • Make sure precautionary supplies are distributed to hospitals throughout the country

[1] "Anthrax Basics." CDC. N.p., n.d. Web. 25 Feb. 2014. http://www.cdc.gov/anthrax/basics/
[2] "Fact Sheet on Cutaneous Anthrax." New York Department of Health. 21 Oct. 2001. Web. 25 Feb. 2014. http://www.health.ny.gov/environmental/emergency/cutaneous.htm
[3] "A History of Anthrax." CDC. N.p., n.d. Web. 25 Feb. 2014. http://www.cdc.gov/anthrax/historyindex.html
[4] "Robert Koch - Biographical." Nobelprize.org. Nobel Media AB 2013. Web. 25 Feb. 2014. http://www.nobelprize.org/nobel_prizes/medicine/laureates/1905/koch-bio.html
[5] Sternbach, G. The history of anthrax, The Journal of Emergency Medicine, Volume 24, Issue 4, May 2003, Pages 463-467, ISSN 0736- 4679, http://dx.doi.org/10.1016/S0736-4679(03)00079-9.
[6] "History of Anthrax - Anthrax Through the Ages." Texas Department of State Health Services. 19 Aug. 2010. Web. 25 Feb. 2014. https://www.dshs.state.tx.us/preparedness/bt_public_history_anthrax.shtm
[7] "Anthrax The Threat." CDC. N.p., n.d. Web. 25 Feb. 2014. http://www.cdc.gov/anthrax/bioterrorism/threat.html
[8] "Anthrax Prevention." Mayo Clinic. 9 Jun. 2011. Web. 1 Mar. 2014 http://www.mayoclinic.org/diseases-conditions/anthrax/basics/prevention/con-20022705
[9] "Anthrax What the CDC is Doing to Prepare." CDC. N.p., n.d. Web. 1 Mar. 2014. http://www.cdc.gov/anthrax/bioterrorism/cdcation.html