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May stop additional isolation when:
N/A
Symptoms
Fever, malaise, fatigue, cough, respiratory distress (dsypnea,
diaphoresis, stridor, cyanosis), shock, and/or death within 24 –36
hours of severe symptoms.
Comments:
Caused by Bacillus anthracis, a gram positive encapsulated spore
forming non-motile bacteria. Pulmonary anthrax is almost universally
fatal, even with antibiotic therapy. A widened mediastinum is
classic on CXR.
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Incubation Period
1 – 50 days, if exposure is continued through contact with a
contaminated environment.
Period of Communicability
Cutaneous: non-infectious 24 hours after start of effective therapy
Pulmonary: person to person is not described. Pulmonary infection
requires the inhalation of aerosolized spores.
Cohort (Inf. with Inf./Exp. with Exp./Non-Exp. with Non-Exp.)
Not Required
Transport Issues
None
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Who’s susceptible
Non-immunes. Cutaneous exposure does provide protective immunity.
Vaccine is being used in US military, although not FDA approved.
Who’s exposed
Cutaneous: skin exposure to spores (persons performing autopsies)
Pulmonary: inhalation of spores
Gastrointestinal: ingestion of contaminated food product
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Exclusion of symptomatic personnel from duty
Yes. Personnel infected will be gravely ill, and may require
ventilator support.
Exclusion of exposed susceptible personnel from duty
Not required
Isolation of exposed susceptible asymptomatic patients
Not required
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Prophylaxis for exposed
Ciprofloxacin 500 mg PO BID x 8 weeks OR Doxycycline 100mg PO BID x 8
weeks OR Amoxicillin 500 mg q8. All who are exposed should also be
vaccinated if vaccine is available.
Treatment for ill
Ciprofloxin 400 mg IV q12, or PCNG 4 million units IV q4, or
Doxycyline 100 mg IV q12 (all for 60 days) – depends on susceptibility
testing
Military/Institutional Populations Special Issues
Military personnel may work if exposed but not ill. Must report
cases immediately to chain of command.
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