Anthrax infection

General: It is important to consult a doctor once symptoms of anthrax infection occur so that treatment can be started immediately.

Antibiotics: Ciprofloxacin (Cipro ®), doxycycline, and penicillin are approved by the U.S. Food and Drug Administration (FDA) for the treatment of anthrax in adults and children. The medications work by killing anthrax bacteria. However, antibiotics may not be sufficient treatment for treating inhalation anthrax once symptoms become severe because the bacteria may have already developed resistance. People infected with inhalation anthrax usually will be hospitalized and treated with intravenous antibiotics. The Centers for Disease Control and Prevention (CDC) does not recommend stockpiling antibiotics since the federal government may ship medications to wherever they are needed. Only individuals exposed to anthrax will need antibiotics, and only healthcare professionals should make that decision.

Note : Currently, there is insufficient evidence available on the safety or effectiveness of integrative therapies for the prevention or treatment of anthrax infection. The integrative therapies listed below should be used only under the supervision of a qualified healthcare provider and should not be used in replacement of other proven therapies or preventive measures.

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Pokeweed: Theoretical evidence suggests pokeweed may be used as a treatment for anthrax. High quality clinical study is needed in this area to determine safety and effectiveness.

Avoid if allergic/hypersensitive to pokeweed, its constituents or any member of the Phytolaccaceae family. Avoid pokeweed root, leaf and berry in all patients (adults, children, pregnant or lactating women) due to reports of toxicity. Use cautiously with liver disorders and HIV. Dosing and efficacy are unclear based on currently available literature. Use cautiously if taking antihypertensive medication or herbs, anti-inflammatory drugs or herbs, antiviral medications, cardiac glycoside drugs and herbs, diuretics, or heparin or other hydrophobic drugs or herbs. Avoid if pregnant or breastfeeding.

Red yeast rice: Theoretical evidence suggests red yeast rice may be used to treat anthrax infections. However, human studies are necessary before a conclusion may be drawn.

Avoid if allergic or hypersensitive to red yeast. Use cautiously with bleeding disorders. Avoid with liver disease, or if pregnant or breastfeeding.

The Centers for Disease Control and Prevention (CDC) recommends 60 days of oral antibiotics along with a three-dose regimen of BioThraxT anthrax vaccine (zero, two weeks, four weeks) as an emergency public health intervention for people exposed to anthrax. Ciprofloxacin (Cipro®) and doxycycline are approved in adults and children for post exposure prophylaxis (preventing infection in people exposed to anthrax). Levofloxacin (Levaquin®) is approved for post exposure prophylaxis in adults 18 and older. Common side effects of Cipro® include upset stomach, vomiting, diarrhea, fatigue, dizziness, or headache. Patients taking doxycycline should be aware of the following side effects: upset stomach, vomiting, and diarrhea. Additionally, doxycycline and ciprofloxacin should not be taken with antacids, calcium supplements, and dairy products. These may bind with the medications, decreasing their effectiveness. Common side effects of Levaquin® include nausea, vomiting, diarrhea, stomach pain, headache, drowsiness, and dizziness. Vaccine side effects include tenderness and redness at the injection site.

Areas where anthrax is reportedly more common in animals include South and Central America, Southern and Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. People should avoid eating undercooked meat in these regions.

The Advisory Committee on Immunization Practices has recommended anthrax vaccination for prevention in the following populations: individuals working directly with anthrax in the laboratory, people who work with imported animal hides or furs in areas where measures are inadequate to prevent anthrax exposure, individuals handling potentially infected animal products in high-incidence areas, and military personnel in regions with high risk of anthrax exposure. The immunization consists of three subcutaneous injections (injections given beneath or under the skin) given two weeks apart followed by three additional injections at six, twelve, and eighteen months. Yearly booster shots are recommended after this.

The CDC has provided the following helpful guidelines for recognizing and handling suspicious packages: recognize inappropriate or unusual labeling (excessive postage, strange return address, etc.), and identification of a powdery substance felt through the package or envelope. Ultimately, when there is doubt regarding a suspicious envelope, it is best to contact the police and refrain from opening the package.

If a package is accidentally opened, then the area should be left immediately and the doors should be closed. Appropriate measures should be taken to ensure individuals do not enter the area. The hands should be washed with soap and water to prevent spreading the suspected anthrax to the face or skin. Additionally, the local law enforcement agency should be alerted to the situation.