The Medical Management of Biological Casualties

-Local skin involvement after direct contact with spores
-Painless papule (often pruritic) that becomes vesicular with surrounding edema; subsequent development of necrotic ulcer with progression to a coal-black scabbed lesion (eschar) often within 7 to 10 days of the initial lesion
-Fever, malaise, headache (systemic symptoms may not be present with early lesions)

-Ciprofloxacin (500 mg PO bid) or doxycycline (100 mg PO bid) for 7-10 days
-May switch to amoxicillin (500 mg PO tid) if sensitive
-If severe symptoms, use IV antibiotics (see Pulmonary Anthrax)
-Post-exposure prophylaxis: 10-14 days of ciprofloxacin or doxycycline may be considered if no aerosol exposure; if aerosol exposure, see Pulmonary Anthrax

Standard precautions. A 5% hypochlorite solution will kill spores. Autoclaving, steam sterilizing, or burning is required for complete eradication of spores. Avoid direct contact with wound or wound drainage. Decontamination of patients using soap and water is sufficient. Not communicable person-to-person.