Pulmonary Anthrax
| Incubation Period | 1-6 days (or up to 43 days; longer in animal studies) |
| Bio Safety Levels |
-Initial phase: Non-specific symptoms: low-grade fever, nonproductive cough, malaise, headache, fatigue, myalgias, profound sweats, chest discomfort (upper respiratory tract symptoms such as rhinorrhea are rare). 1-5 days in duration.
-Subsequent phase: May be preceded by 1–3 days of apparent improvement. Abrupt onset of high fever and severe respiratory distress (dyspnea, stridor, cyanosis), symptoms of meningitis (may be subclinical). Shock, death within 24–36 hours of onset of severe symptoms.
-Early initiation of appropriate antibiotics is paramount for patient survival
-Ciprofloxacin (400 mg IV q12hr) or doxycycline (200 mg IV loading dose, followed by 100 mg IV q12hr) plus one or two additional antibiotics effective against anthrax (e.g. clindamycin, rifampin, vancomycin)
-Drainage of pleural fluid
-Post-exposure prophylaxis: Ciprofloxacin (500 mg PO bid) or doxycycline (100 mg PO bid) for 60 days. In the U.S., Anthrax Vaccine Adsorbed is available under IND for post-exposure use in conjunction with above drug therapy (contact USAMRIID for details)
Standard Precautions. A 5% hypochlorite solution will kill spores. Autoclaving, steam sterilizing, or burning is required for complete eradication of spores. Decontamination of patients using soap and water is sufficient. Not communicable person-to-person.