Materiały źródłowe

• #1 Prevention | Anthrax | CDC

  https://www.cdc.gov/anthrax/prevention/index.html

  Getting a vaccine or taking certain antibiotics after exposure to anthrax can help prevent illness. This is called post-exposure prophylaxis. […] Sometimes anthrax vaccine is recommended for people who may have been exposed to anthrax. The Food and Drug Administration (FDA) has approved emergency use of the vaccine after a possible anthrax exposure. This is called post-exposure prophylaxis (PEP). […] Anthrax vaccine is approved for use after exposure in people aged 18 to 65. In these situations, the vaccine is given after anthrax exposure to prevent the disease (post-exposure prophylaxis, or PEP). […] The bacteria that cause anthrax can be prevented by taking certain antibiotics after exposure. This is another form of PEP. […] If there is an anthrax emergency, you will likely be given an antibiotic because you may have breathed in anthrax bacteria. You may receive doxycycline or ciprofloxacin. These medicines reduce your chance of getting sick and dying. […] People who may have breathed in anthrax bacteria should take one of the medicines twice a day for up to 60 days.

• #1 Anthrax Treatment & Management: Approach Considerations, Cutaneous Anthrax, Prehospital Care

  https://emedicine.medscape.com/article/212127-treatment

  For PEP in adults, the CDC recommends vaccination and the use of oral fluoroquinolones (ciprofloxacin, 500 mg bid; levofloxacin, 500 mg qd; or ofloxacin, 400 mg bid). Doxycycline is an acceptable alternative. Prophylaxis should continue until exposure to B anthracis is excluded or for a period of 4 weeks if exposure is confirmed. […] The monoclonal antibodies raxibacumab and obiltoxaximab are indicated for prophylaxis of inhalational anthrax when alternative therapies are not available or not appropriate. They should be used as part of a combination regimen with appropriate antibiotic drugs. […] Three doses of vaccine should be administered during the 4-week period (at 0, 2, and 4 weeks post exposure). If a vaccine is not available, the antibiotic treatment should continue for at least 60 days. A second option is treatment for 100 days. A third option is 100 days of antibiotic prophylaxis with vaccine. […] The indication for anthrax vaccine adsorbed (BioThrax) was expanded in November 2015 to include postexposure use following suspected or confirmed B anthracis exposure in combination with antimicrobial therapy. It was originally approved for pre-exposure prophylaxis in high-risk individuals.

• #1 Anthrax – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax

  An anthrax vaccine, composed of a cell-free culture filtrate containing protective antigen protein, is available for people at high risk (eg, military personnel, veterinarians, laboratory technicians, employees of textile mills processing imported goat hair). The vaccine contains no dead or live bacteria. A separate veterinary vaccine is also available. […] Repeated preexposure vaccination with a 5-dose intramuscular series is required to ensure protection. The anthrax vaccine is approximately 93% effective for people who complete the primary series and maintain the booster vaccinations. […] Postexposure measures include antibiotics, vaccination, and monoclonal antibodies. […] Asymptomatic people (including pregnant women and children) exposed to inhaled anthrax require prophylaxis with one of the following oral antibiotics, given for 60 days: Ciprofloxacin 500 mg (10 to 15 mg/kg for children) every 12 hours, Doxycycline 100 mg (2.5 mg/kg for children) every 12 hours, Levofloxacin 750 mg every 24 hours, Moxifloxacin 400 mg every 24 hours, Clindamycin 600 mg every 8 hours.

• #1 Anthrax | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/zoonosis-control/zoonosis-control-diseases-and-conditions/anthrax

  Ciprofloxacin 500 mg bid po or doxycycline 100 mg bid po should be given for 4 weeks if the patient is vaccinated. […] If unvaccinated, patients should receive vaccine according to the schedule above. If vaccine is unavailable, antibiotic therapy should be continued for 60 days. […] Prophylaxis can be administered to children with ciprofloxacin 10-15 mg/kg po q 12 h (not to exceed 1 g per day) for 60 days, doxycycline: […] If penicillin sensitivity is established, prophylactic therapy can be switched to amoxicillin 500 mg q8h po.

• #1 Treatment and prophylaxis – Anthrax in Humans and Animals – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK310491/

  In the USA, in response to biopreparedness initiatives, ciprofloxacin and doxycycline were approved by the Food and Drug Administration (FDA) in 2000 and 2001, respectively, for use in antimicrobial prophylaxis against anthrax. […] Prolonged antibiotic prophylaxis is only a recommendation for persons known to have been, or strongly suspected of having been, exposed to very substantial doses of aerosolized spores in a deliberate release scenario. Antibiotics should not be administered in that way for other situations. Antibiotics should only be used for treatment, not prophylaxis, unless there is a real danger of a very substantial exposure having taken place.

• #1 Anthrax | FDA

  https://www.fda.gov/vaccines-blood-biologics/vaccines/anthrax

  FDA has approved two vaccines, BioThrax and Cyfendus, to prevent disease in persons 18 through 65 years of age following suspected or confirmed Bacillus anthracis exposure, when administered in conjunction with recommended antibacterial drugs. […] BioThrax is also approved for pre-exposure prophylaxis of disease in persons 18 through 65 years of age who are at high risk of exposure. […] The vaccines have been purchased by the federal government and are stored in the Strategic National Stockpile (SNS) to be used for post-exposure prophylaxis with antibiotics in the event of a terrorist attack with anthrax. […] Likewise, because of biological warfare threats, the military has an active vaccination program against anthrax for personnel going to specific arenas around the world. […] FDA has approved Anthrasil, an Anthrax Immune Globulin Intravenous (Human) for the treatment of inhalational anthrax in adult and pediatric patients in combination with appropriate antibacterial drugs.

• #1 Anthrax | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/anthrax/

  While there is a vaccine licensed to prevent anthrax, it is not typically available for the general public. Anthrax vaccine is routinely used in three groups of adults 18 to 65 years of age who may be at risk of coming in contact with anthrax because of their job: […] To build up protection against anthrax, these groups should get 5 shots of anthrax vaccine over 18 months. To stay protected, they should get annual boosters. The shots are injected into the muscle (intramuscular). […] Prevention of naturally acquired human anthrax begins with prevention and control in animals. Effective control centers around vaccinating livestock, treatment of symptomatic animals and proper disposal of carcasses. In addition, educate employees who handle potentially contaminated animal products about the signs and symptoms of anthrax infection. Use extreme caution when handling dead animals that may be infected with anthrax. Other prevention methods include controlling dust and providing good air circulation when working with animal hides, fur, hair, or wool. In addition, have workers wear protective clothing and provide a place to shower and change clothes after work.

• #1 Anthrax – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anthrax/symptoms-causes/syc-20356203

  To prevent infection after being exposed to anthrax spores, the Centers for Disease Control and Prevention recommends: […] A three-dose series of anthrax vaccine […] An anthrax vaccine is available for certain groups of people. The vaccine doesn’t contain live bacteria and can’t lead to infection. However, the vaccine can cause side effects, ranging from soreness at the injection site to more-serious allergic reactions. […] If you live or travel in a country where anthrax is common and herd animals aren’t routinely vaccinated, avoid contact with livestock and animal skins as much as possible. Also avoid eating meat that hasn’t been properly cooked. […] Even in developed countries, it’s important to handle any dead animal with care and to take precautions when working with or processing imported hides, fur or wool.

• #1 Anthrax | Health.mil

  https://www.health.mil/MHSHome/Military-Health-Topics/Health-Readiness/Immunization-Healthcare/Vaccine-Preventable-Diseases/Anthrax?type=Policies&page=2

  Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It forms spores that can be found naturally in soil, commonly affecting domestic and wild animals around the world. Although it is rare in the United States, people can get sick with anthrax if they come in contact with infected animals or contaminated animal products. […] When anthrax spores get inside the body, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness. Anthrax can enter the body through the skin (cutaneous); through ingesting contaminated food or water (gastrointestinal); intravenously (rare); or by inhalation, the deadliest form of the disease and the one most likely to be used as a biological weapon. […] The anthrax vaccine has been licensed in the U.S. since 1970, and has been proven safe and effective at preventing anthrax disease, regardless of the route of exposure. The immunization is required for deployment to U.S. Central Command and the Korean Peninsula, as well as for designated NORTHCOM personnel, emergency response and other units. It is given in a five-dose series at 0, 4 weeks, 6 months, 12 months and 18 months, with yearly boosters to maintain immunity. […] Vaccination and antibiotics, such as ciprofloxacin, doxycycline, and amoxicillin, are the most important therapeutic interventions for any form of anthrax exposure.

• #1 Anthrax in Animals – Infectious Diseases – Merck Veterinary Manual

  https://www.merckvetmanual.com/infectious-diseases/anthrax/anthrax-in-animals

  In addition to treatment and vaccination, specific control procedures are necessary to contain the disease and prevent its spread. […] Human infection is controlled by reduction of infection in production animals, veterinary supervision of animal production and slaughter to reduce human contact with potentially infected production animals or animal products, and, in some settings, either pre- or postexposure prophylaxis. […] Routine vaccination against anthrax is indicated for individuals engaged in work involving large quantities or concentrations of Bacillus anthracis cultures or activities with a high potential for aerosol production. […] For humans, postexposure prophylaxis is recommended after an aerosol exposure to Bacillus anthracis spores. Prophylaxis may consist of antimicrobial therapy, a combination of antimicrobial therapy and vaccination, and sometimes monoclonal antibodies.

• #1 Anthrax – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/400_499/0483.html

  Aetna considers anthrax immunization a medically necessary preventive service for indications recommended by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP). The ACIP recommends pre-exposure anthrax vaccination for the following groups: […] The immunization consists of 2 intramuscular injections given 4 weeks apart followed by 3 additional subcutaneous injections given at 6, 12, and 18 months. The ACIP recommends annual booster injections of the vaccine thereafter. […] Aetna considers post-exposure anthrax vaccination medically necessary according to the ACIP guidelines. The ACIP guidelines recommend post-exposure anthrax vaccination for the following indications: […] Aetna considers raxibacumab injection medically necessary for the prevention and treatment of inhalational anthrax.

• #1 Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3901460/

  Clinical recommendations for the prevention and treatment of anthrax among pregnant women are updated. […] Given the severity of anthrax, P/PP/L women should receive the same postexposure prophylaxis (PEP) and treatment regimens as nonpregnant adults, unless there are compelling reasons for these recommendations to differ. These regimens would include antimicrobial drug treatment and vaccine for P/PP/L women who have had direct exposure to anthrax spores and antimicrobial drug treatment for women with a clinical or laboratory diagnosis of anthrax. […] In addition to vaccination, antimicrobial drugs are an essential component of prophylaxis, and combination antimicrobial drug therapy is the mainstay of treatment for anthrax, with the exception of cutaneous cases without systemic involvement, which are treated with single-agent therapy.

• #1 Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3901460/

  Antimicrobial drug use in pregnant women in the setting of anthrax must be viewed in the context of the high mortality risk and the benefits of treatment for the mother and fetus, as well as possible effects on the fetus resulting from the infection or from administration of antimicrobial drugs to the mother. […] The guidance for nonpregnant adults specifies that anthrax antimicrobial drug PEP should be administered for 60 days, whether recipients are unvaccinated, partially vaccinated, or fully vaccinated. This recommendation should also apply to P/PP/L women; there is no evidence to suggest a change in the duration of antimicrobial drug prophylaxis is necessary. […] Similar to prophylactic considerations, the recommendations for anthrax treatment of P/PP/L women should be the same as for nonpregnant adults. No evidence supports extending the duration of antimicrobial drug treatment for P/PP/L women. […] Antimicrobial drugs that likely cross the placenta in adequate quantities include ciprofloxacin, levofloxacin, amoxicillin, and penicillin.

• #1 Anthrax – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/400_499/0483.html

  The ACIP guidelines recommend anthrax vaccine as a component of post-exposure prophylaxis in pregnant women exposed to aerosolized B. anthracis spores. […] The FDA approved intravenous human anthrax immune globulin (Anthrasil, Cangene Corp, Winnipeg, Canada) to treat patients with inhalational anthrax in combination with appropriate antibacterial drugs.

• #1 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  Infection with Bacillus anthracis (BA), which causes anthrax, occurs through direct exposure to active bacteria or bacterial spores. Measures for protecting workers from exposure to BA depend on the type of work performed and knowledge of exposure risk, including potential for spore release from an accidental or intentional event. […] Employers whose workers will be involved in emergency response operations for releases of, or substantial threats of releases of, hazardous substances (including BA) regardless of the location of the hazard must comply with OSHA’s HAZWOPER standard (29 CFR 1910.120). This may include emergency response following an anthrax incident. […] Follow good infection control practices (e.g., standard precautions) for preventing contact with BA. Standard precautions include hand hygiene and use of appropriate PPE to avoid direct contact with BA.

• #1 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  BA is persistent in the environment for long periods of time, and small particles can stay suspended in the air or be re-aerosolized by agitation and air currents within buildings and other environments. This creates the potential for BA transmission from contaminated environmental surfaces or fomites (objects that can spread germs) and the need for effective cleaning and decontamination strategies. […] Protect workers from exposure when tasked with cleaning surfaces and equipment potentially contaminated with BA. This may include using engineering controls, such as ventilation, along with administrative controls, safe work practices, and PPE, such as chemical-resistant or -impermeable garments and a respirator with an N95 particulate/chemical combination cartridge. […] PPE includes appropriate respiratory protection, protective garments (e.g., coveralls, boot covers, chemical-resistant or -impermeable suits), eye and face protection, and gloves (nitrile or vinyl). Employers should base the use of PPE on the situation and tasks involved, including to the degree of contamination, risk of exposure, exposure pathway, and anticipated level of exposure.

• #1 Anthrax – IAFFAnthrax – IAFF

  https://www.iaff.org/infectious-disease/diseases/anthrax/

  Anthrax may be prevented through several methods: […] Anthrax vaccine […] Available to military personnel and those at increased risk of contracting anthrax […] Post-exposure preventive antibiotics […] These may be given to exposed individuals who have not yet developed symptoms […] Antibiotics are effective against the bacteria but not against the toxins which cause the complications of the infection. […] Use Universal Precautions […] Nitrile or vinyl gloves will protect workers from cutaneous anthrax exposure […] OSHA does not recommend respirators for the vast majority of workers. However, when effective protection from anthrax spores [is needed], the CDC recommends the use of NIOSH-approved respirators that are at least as protective as an N95 respirator. […] You should contact your infection control officer and seek medical attention if you have been exposed or suspect exposure to anthrax or if you develop symptoms of anthrax. Anthrax can be treated with various antibiotics, including penicillin, doxycycline and ciprofloxacin.

• #1 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  Worker protection from exposure to infectious agents, including BA, is necessary when work tasks involve handling, treatment, transport, and disposal of medical, laboratory and other potentially contaminated waste. […] Ensure that supervisors and all potentially exposed workers are aware of the symptoms of anthrax. […] Workers potentially exposed to BA or who develop symptoms of anthrax should seek medical evaluation. […] Train all emergency response workers to recognize and report early symptoms and signs of anthrax, understand the importance of immediate medical attention, know how to access emergency medical care, know about potential adverse effects and interactions with food and drugs if taking antibiotics, and understand the potential adverse effects of the anthrax vaccine and the amount of time necessary to develop an immune response if using the vaccine as a preventive measure. […] Establish a medical monitoring program to monitor persons exposed to BA for signs and symptoms of anthrax. The intent is to detect adverse effects on a worker’s health at an early stage when prevention is possible or treatment is most effective.

• #1 Anthrax in Animals – Infectious Diseases – Merck Veterinary Manual

  https://www.merckvetmanual.com/infectious-diseases/anthrax/anthrax-in-animals

  Anthrax is controlled through vaccination programs, rapid detection and reporting, quarantine, treatment of subclinically affected animals (postexposure prophylaxis), and burning or burial of suspect and confirmed cases. […] In production animals, anthrax can be controlled largely by annual vaccination of all grazing animals in the endemic area and by implementation of control measures during epizootics. The nonencapsulated Sterne-strain vaccine is used almost universally for production animal vaccination. Vaccination should be done at least 24 weeks before the season when outbreaks may be expected. […] Early treatment and vigorous implementation of a preventive program are essential to reduce losses among production animals. Animals at risk should be immediately treated with a long-acting antimicrobial to stop all potential incubating infections, followed by vaccination ~7-10 days after treatment.

• #1 Anthrax – WOAH – World Organisation for Animal Health

  https://www.woah.org/en/disease/anthrax/

  In humans, anthrax manifests itself in three distinct patterns (cutaneous, gastrointestinal and inhalational). The most common is a skin infection, where people become infected handling animals or animal products that contain spores. This can happen to veterinarians, agricultural workers, livestock producers or butchers dealing with sick animals, or when infection has been spread by wool or hides. […] Anthrax is a preventable disease by vaccines and can be treated with antibiotics, however specific control procedures on carcasses disposal are necessary to contain the disease and prevent its spread. […] In addition to antibiotic therapy and immunisation, specific control procedures are necessary to contain the disease and prevent its spread. In particular: the proper disposal of dead animals is critical; the carcass should not be opened, since exposure to oxygen will allow the bacteria to form spores; premises are to be quarantined until all susceptible animals are vaccinated and all carcasses disposed of preferably by incineration or alternatively by deep burial with quick lime.

• #1 Anthrax FAQs | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/zoonosis-control/zoonosis-control-diseases-and-conditions/anthrax/anthrax-faqs

  A vaccine for livestock is frequently used in areas where anthrax is common, but the vaccine must be used before the animal is infected with the bacteria. […] An effective anthrax vaccine for livestock and horses can be purchased through private veterinary practitioners, feed stores, or animal health product distributors. The injection can be administered by private veterinary practitioners or rancher personnel and is recommended for: livestock residing in or near an area where anthrax often occurs; and animals that will be moved into the area, such as horses transported to trail rides. […] To protect yourself, wear long sleeves and gloves, and do not move or open carcasses, as this could further release the bacteria into the environment, causing further disease to spread.

• #1

  https://www.gov.uk/guidance/anthrax-how-to-spot-and-report-the-disease

  Anthrax is a notifiable animal disease. If you suspect it you must report it immediately by calling the Defra Rural Services Helpline on 03000 200 301. In Wales, contact 0300 303 8268. In Scotland, contact your local Field Services Office. Failure to do so is an offence. […] You can also help to prevent anthrax by practising strict biosecurity on your premises. […] If you suspect anthrax: contact your local APHA office immediately and isolate the animal or carcass; do not move, skin or open the carcass of any suspect animal; disinfect blood or other fluids from any suspect animal, as soon as possible, with a Defra approved disinfectant; do not kill or bleed any sick animals; watch any animals that have been in contact with the suspect animal, and isolate them if they show signs of infection; pay particular attention to cows, as humans can be infected by drinking contaminated milk. […] If anthrax is confirmed, there are legal powers to control the spread of the disease during an outbreak. […] If you think your animals will be continually exposed to anthrax, for example, after an outbreak, talk to your vet about using an antibiotic or a vaccine.

• #1 Anthrax – WOAH – World Organisation for Animal Health

  https://www.woah.org/en/disease/anthrax/

  Vaccination in endemic areas is very important. WOAH spells out the requirements for the manufacture and quality control of animal vaccines, in the WOAH Manual of Diagnostic Tests and Vaccines. Although vaccination will prevent outbreaks, Veterinary Services sometimes fail to vaccinate when the disease has not appeared for several years. But because the spores survive for such lengthy periods, the risk is always present. […] Early detection of outbreaks, quarantine of affected premises, destruction of diseased animals and fomites, and implementation of appropriate sanitary procedures at abattoirs and dairy factories will ensure the safety of products of animal origin intended for human consumption.

• #1

  https://dph.illinois.gov/topics-services/emergency-preparedness-response/public-health-care-system-preparedness/anthrax.html

  Antibiotics are used to treat anthrax. Early identification and treatment are important. Treatment is different for a person who comes into contact with anthrax, but is not yet displaying symptoms (fever, sweating, low blood pressure, dizziness). […] Prevention of illness after contact: Health care providers can give out antibiotics that can be taken at home. […] If you think that you or someone you know may have come into contact with any type of anthrax, call your health care provider and contact the local county health department right away.

• #1 Clinical Overview of Anthrax | Anthrax | CDC

  https://www.cdc.gov/anthrax/hcp/clinical-overview/index.html

  Prophylactic antibiotics should be administered immediately to patients who might have been exposed to anthrax. […] Anthrax vaccine is also recommended for unvaccinated people of all ages who have been exposed to anthrax. These people should get 3 doses of anthrax vaccine together with recommended antibiotic drugs. […] Antibiotics can be used for post-exposure prophylaxis (PEP) to prevent anthrax from developing in people who have been exposed but have not developed symptoms. All types of anthrax infection can be treated with antibiotics. […] Therefore, PEP for anthrax includes 60 days of antibiotics. […] After anthrax toxins, which are released when anthrax spores are activated, have been released in the body, one possible treatment is anthrax antitoxin. Doctors must use antitoxin together with other treatment options, including antibiotics.

• #1 Anthrax prevention – wikidoc

  https://www.wikidoc.org/index.php/Anthrax_prevention

  Prevention of anthrax infection can be achieved with post-exposure prophylaxis antibiotics and vaccination. The US Advisory Committee on Immunization Practices recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection. […] Postexposure prophylaxis of asymptomatic persons should start as soon as possible after exposure because its effectiveness decreases with delay in implementation. […] Everyone exposed to aerosolized B. anthracis spores should receive a full 60 days of post-exposure prophylaxis antimicrobial drugs, whether they are unvaccinated, partially vaccinated, or fully vaccinated. […] Well-timed and effective postexposure prophylaxis can potentially save thousands of lives. […] After exposure to anthrax, it is recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection.

• #1 2 Antibiotics for Anthrax Postexposure Prophylaxis | Prepositioning Antibiotics for Anthrax | The National Academies Press

  https://nap.nationalacademies.org/read/13218/chapter/4

  To be maximally effective in preventing morbidity and mortality, PEP for inhalational anthrax should be administered during the incubation period (before the onset of symptoms). […] Timely administration of PEP also hinges on prompt detection and confirmation of the threat through environmental monitoring systems and astute clinical diagnosis and surveillance.

• #1 Anthrax – Symptoms, Treatment and Prevention | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/what-is-anthrax

  Avoid sick animals and animal products, such as souvenirs made of their hair or skin. Moreover, it is advisable to refrain from drinking unpasteurized milk or eating potentially contaminated meats, especially improperly cooked ones. […] Those exposed to anthrax bacteria without developing symptoms should take doxycycline or quinolone for 60 days for post-exposure prophylaxis (PEP).

• #1 Centre for Health Protection – Anthrax

  https://www.chp.gov.hk/en/healthtopics/content/24/12.html

  Hospitalization is required. Anthrax can be treated with antibiotics. The disease may be prevented after exposure to anthrax spores by early treatment with appropriate antibiotics. […] There are vaccines to prevent anthrax, but completion of the whole course of vaccination requires multiple doses. Human vaccines are used primarily for protection of selected individuals with possible occupational exposure to anthrax. […] To prevent anthrax, members of the public are also advised to: Maintain good personal, food and environmental hygiene. Perform hand hygiene frequently, wash hands thoroughly with liquid soap and water before handling food or eating. Clean the broken skin immediately and cover properly with waterproof adhesive dressings. Wash hands before and after touching wounds. Avoid contact with infected animal and contaminated animal product. Thorough washing and cooking of food before consumption.

• #1 Anthrax (Bacillus Anthracis): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/10853-anthrax

  The anthrax vaccine is 90% effective at preventing infection. The vaccine is only available to people between the ages of 18 and 65 who work in high-risk professions, such as farmers and livestock handlers, military members, researchers who study the bacteria, veterinarians and others as listed above. You receive five doses of the vaccine over 18 months. Afterward, you’ll need an annual booster shot. The vaccine also stops infection if you’ve knowingly been exposed to anthrax. […] If you think you’ve been exposed to anthrax, call your healthcare provider to start antibiotics or other therapies immediately. Untreated anthrax can be deadly. Fast treatment can prevent severe infection and life-threatening symptoms, improving your odds of a full recovery.

• #1 Anthrax – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/anthrax/anthrax+-+including+symptoms+treatment+and+prevention

  Anthrax vaccines exist for use in livestock in Australia, but are not currently registered for use in humans. They have been used for protection of military personnel who are considered to be at risk of exposure to biological weapons. […] Even a single case of human anthrax is so unusual in Australia that it should be reported urgently to public health authorities. Anthrax spores have been used in bioterrorist attacks in the United States of America and it is important that sources of any infections are identified quickly so that control measures may be put into place.

• #1 Inhalational anthrax, part 2: Prevention and treatment

  https://www.patientcareonline.com/view/inhalational-anthrax-part-2-prevention-and-treatment

  When untreated, inhalational anthrax typically results in a rapidly fatal illness. Evidence suggests that both the anthrax vaccine and prophylaxis with ciprofloxacin or doxycycline are effective in preventing illness after inhalational anthrax exposure. […] The CDC recommends at least 60 days of antibiotic prophylaxis. […] Animal studies suggest that ciprofloxacin and doxycycline are equally effective in preventing symptomatic infection after inhalational exposure. […] The CDC’s ACIP recommends that prophylaxis may be discontinued 7 to 14 days after the administration of 3 doses of anthrax vaccine (0, 2, and 4 weeks). […] Antimicrobial prophylaxis in combination with anthrax vaccination is highly cost-effective.

• #1 Anthrax: Developing Drugs for Prophylaxis of Inhalational Anthrax Guidance for Industry | FDA

  https://www.fda.gov/regulatory-information/search-fda-guidance-documents/anthrax-developing-drugs-prophylaxis-inhalational-anthrax-guidance-industry

  The purpose of this guidance is to assist sponsors in the development of drugs for the indication of prophylaxis of inhalational anthrax in persons who have or may have inhaled aerosolized Bacillus anthracis spores but who have not yet manifested clinical evidence of disease. […] The indication also applies to persons with anticipated exposure to B. anthracis spores (e.g., first responders for anthrax incidents); in such cases, initiation of antibacterial therapy would begin immediately before entering the B. anthracis-contaminated environment.

• #1 2 Antibiotics for Anthrax Postexposure Prophylaxis | Prepositioning Antibiotics for Anthrax | The National Academies Press

  https://nap.nationalacademies.org/read/13218/chapter/4

  CDC recommends that levofloxacin be reserved as a second-line agent, as safety data on its use in treatment for longer than 28 days are limited. […] Because of the potential for serious adverse events, however, CDC recommends off-label use of amoxicillin as the preferred PEP agent if the anthrax strain is proven to be susceptible to that drug. […] A material threat determination (MTD) was issued by the Secretary of the Department of Homeland Security on September 22, 2006, specifically for multi-drug-resistant (MDR) anthrax. […] Given the current focus on doxycycline (a tetracycline-class antibiotic) as a first-line PEP treatment, an explicit analysis of the potential impact of doxycycline-resistant Bacillus anthracis is warranted. […] Prepositioning of a single type of antibiotic (or class of antibiotics) would reduce flexibility to respond to the release of an antibiotic-resistant strain of anthrax, a biothreat recognized by the U.S. Department of Homeland Security.

• #1 Anthrax Prevention – Risks vs. Benefits – Domestic Preparedness

  https://www.domprep.com/articles/anthrax-prevention-risks-vs-benefits

  Consequently, the NBSB was asked by Lurie to engage all stakeholders in the issues involved. […] Lurie also specifically requested the NBSB, in fact: (a) to directly address the challenges involved in administering the vaccine under an Investigational New Drug (IND) research protocol after an anthrax event; and (b) to compare those challenges with the ethical considerations involved in attempting to gather sufficient data in the absence of a confirmed anthrax release. […] However, when the lack of a clear and present threat is coupled with an assurance that any anthrax encountered will be sensitive to antibiotics, there is very little, if any, motivation to expose children to what might plausibly seem to be an unnecessary immunization. […] In MDR anthrax, the contribution provided by antibiotics is, by definition, resisted.

• #1

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/anthrax.aspx

  Public health priority: Urgent. […] Appropriate antibiotics under direction of treating doctor. Identify likely source of infection. […] Assess and control risk in others exposed to the same source of infection. […] To monitor the epidemiology of anthrax and so inform the development of better prevention strategies. […] The response to a notification will normally be carried out in collaboration with the case’s health carers, but regardless of who does the follow-up PHU staff should ensure that action has been taken to: identify likely source of infection (whether natural or deliberate). […] The case or relevant caregiver should be informed about the nature of the infection and the mode of transmission. In particular, emphasis should be placed on careful handling of soiled dressings and contaminated clothing. Education on the handling of carcasses and products of potentially infected animals should be a priority.

• #1 Health: Infectious Disease Epidemiology & Prevention Division: Anthrax

  https://www.in.gov/health/idepd/zoonotic-and-vectorborne-epidemiology-entomology/zoonotic-diseases/anthrax/

  Anthrax is a disease caused by the bacterium Bacillus anthracis, which can affect both humans and animals. […] Anthrax can be treated with antibiotics. […] Certain people are at greater risk of exposure, such as international travelers, laboratory workers, veterinarians, livestock producers and people who handle animal products. […] NOTICE: Anthrax is an immediately reportable disease in Indiana and is required to be reported upon identification by a healthcare provider, hospital, or laboratory. Specific reporting requirements for anthrax can be found here.

• #1

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/anthrax.aspx

  Where inhalational exposure to a deliberate release of anthrax spores is considered credible, then recommend post exposure prophylaxis (see Therapeutic Guidelines: Antibiotic) and seek expert medical advice. […] Post exposure prophylaxis for cutaneous anthrax should be considered for contacts of a confirmed anthrax exposure who were not using personal protective equipment and whose skin was contaminated with fluids from the carcass. […] An anthrax vaccine is not licensed for civilian use in Australia.

• #2 Treatment and prophylaxis – Anthrax in Humans and Animals – NCBI BookshelfTwitterFacebookLinkedInGitHubNCBI Insights BlogTwitterFacebookYoutube

  https://www.ncbi.nlm.nih.gov/books/NBK310491/

  Anthrax in its natural state being primarily a disease of herbivorous animals, its control in both animals and humans depends to a very great extent on its prevention in livestock, good hygienic practices when an animal dies of anthrax and antibiotic treatment when a case occurs, at least in a human. Livestock anthrax vaccines are available in almost all countries that experience outbreaks or sporadic cases on an annual basis. These are comprised of live spores of attenuated strains. […] Analogous live spore vaccines are produced for human use in China and in the Russian Federation. Cell-free vaccines containing anthrax protective antigen are produced and licensed for human use in the United Kingdom and the USA. Fundamentally, these vaccines are targeted at persons in occupations with a high risk of exposure to the disease.

• #2 Clinical Overview of Anthrax | Anthrax | CDC

  https://www.cdc.gov/anthrax/hcp/clinical-overview/index.html

  Prophylactic antibiotics should be administered immediately to patients who might have been exposed to anthrax. […] Anthrax vaccine is also recommended for unvaccinated people of all ages who have been exposed to anthrax. These people should get 3 doses of anthrax vaccine together with recommended antibiotic drugs. […] Antibiotics can be used for post-exposure prophylaxis (PEP) to prevent anthrax from developing in people who have been exposed but have not developed symptoms. All types of anthrax infection can be treated with antibiotics. […] Therefore, PEP for anthrax includes 60 days of antibiotics. […] After anthrax toxins, which are released when anthrax spores are activated, have been released in the body, one possible treatment is anthrax antitoxin. Doctors must use antitoxin together with other treatment options, including antibiotics.

• #2 Anthrax – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax

  An anthrax vaccine, composed of a cell-free culture filtrate containing protective antigen protein, is available for people at high risk (eg, military personnel, veterinarians, laboratory technicians, employees of textile mills processing imported goat hair). The vaccine contains no dead or live bacteria. A separate veterinary vaccine is also available. […] Repeated preexposure vaccination with a 5-dose intramuscular series is required to ensure protection. The anthrax vaccine is approximately 93% effective for people who complete the primary series and maintain the booster vaccinations. […] Postexposure measures include antibiotics, vaccination, and monoclonal antibodies. […] Asymptomatic people (including pregnant women and children) exposed to inhaled anthrax require prophylaxis with one of the following oral antibiotics, given for 60 days: Ciprofloxacin 500 mg (10 to 15 mg/kg for children) every 12 hours, Doxycycline 100 mg (2.5 mg/kg for children) every 12 hours, Levofloxacin 750 mg every 24 hours, Moxifloxacin 400 mg every 24 hours, Clindamycin 600 mg every 8 hours.

• #2 Anthrax – Symptoms, Treatment and Prevention | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/what-is-anthrax

  Avoid sick animals and animal products, such as souvenirs made of their hair or skin. Moreover, it is advisable to refrain from drinking unpasteurized milk or eating potentially contaminated meats, especially improperly cooked ones. […] Those exposed to anthrax bacteria without developing symptoms should take doxycycline or quinolone for 60 days for post-exposure prophylaxis (PEP).

• #2 2 Antibiotics for Anthrax Postexposure Prophylaxis | Prepositioning Antibiotics for Anthrax | The National Academies Press

  https://nap.nationalacademies.org/read/13218/chapter/4

  CDC recommends that levofloxacin be reserved as a second-line agent, as safety data on its use in treatment for longer than 28 days are limited. […] Because of the potential for serious adverse events, however, CDC recommends off-label use of amoxicillin as the preferred PEP agent if the anthrax strain is proven to be susceptible to that drug. […] A material threat determination (MTD) was issued by the Secretary of the Department of Homeland Security on September 22, 2006, specifically for multi-drug-resistant (MDR) anthrax. […] Given the current focus on doxycycline (a tetracycline-class antibiotic) as a first-line PEP treatment, an explicit analysis of the potential impact of doxycycline-resistant Bacillus anthracis is warranted. […] Prepositioning of a single type of antibiotic (or class of antibiotics) would reduce flexibility to respond to the release of an antibiotic-resistant strain of anthrax, a biothreat recognized by the U.S. Department of Homeland Security.

• #2 ACOG: When possible, use amoxicillin for anthrax prevention in pregnant women | CIDRAP

  https://www.cidrap.umn.edu/anthrax/acog-when-possible-use-amoxicillin-anthrax-prevention-pregnant-women

  Doxycycline use in pregnant women should generally be avoided because it can cause problems in fetuses, including staining of teeth and impeded bone growth, the ACOG statement says. […] ACOG said prophylactic treatment for anthrax should be limited to women who have been exposed to confirmed environmental contamination or a high-risk source as determined by public health authorities. […] The initial recommended treatment is 500 mg of ciprofloxacin every 12 hours for 60 days. Once the anthrax is found to be penicillin-sensitive, treatment should be changed to 500 mg of amoxicillin three times a day for 60 days. […] If a woman has started taking ciprofloxacin and then finds out she is pregnant, she should continue the treatment, but she should switch to amoxicillin when the anthrax is found to be penicillin-sensitive.

• #2 Anthrax prevention – wikidoc

  https://www.wikidoc.org/index.php/Anthrax_prevention

  To ensure adequate and continued protection, everyone exposed to aerosolized Bacillus anthracis spores should receive a full 60 days of postexposure prophylaxis antibiotic drugs, whether they are unvaccinated, partially vaccinated, or fully vaccinated. […] Despite the existence of a vaccine licensed to prevent anthrax, it is not typically available for the general public. […] The vaccine should be administered subcutaneously at diagnosis, and 2 and 4 weeks later. […] Anthrax vaccine is indicated for the following risk groups of adults: Laboratory workers who work with anthrax, People who handle animals or animal products, Members of the United States military. […] Note: Duration of Therapy is 60 days after exposure. […] Note: Duration of therapy is 60 days from exposure.

• #2 Anthrax | FDA

  https://www.fda.gov/vaccines-blood-biologics/vaccines/anthrax

  FDA has approved two vaccines, BioThrax and Cyfendus, to prevent disease in persons 18 through 65 years of age following suspected or confirmed Bacillus anthracis exposure, when administered in conjunction with recommended antibacterial drugs. […] BioThrax is also approved for pre-exposure prophylaxis of disease in persons 18 through 65 years of age who are at high risk of exposure. […] The vaccines have been purchased by the federal government and are stored in the Strategic National Stockpile (SNS) to be used for post-exposure prophylaxis with antibiotics in the event of a terrorist attack with anthrax. […] Likewise, because of biological warfare threats, the military has an active vaccination program against anthrax for personnel going to specific arenas around the world. […] FDA has approved Anthrasil, an Anthrax Immune Globulin Intravenous (Human) for the treatment of inhalational anthrax in adult and pediatric patients in combination with appropriate antibacterial drugs.

• #2

  https://content.govdelivery.com/accounts/USFDA/bulletins/3678ac8

  FDA approves Cyfendus, a vaccine for post-exposure prophylaxis of disease following suspected or confirmed exposure to Bacillus anthracis (anthrax) in persons 18 through 65 years of age when administered in conjunction with recommended antibacterial drugs. […] On July 20, 2023, FDA approved Cyfendus, a vaccine for post-exposure prophylaxis of disease following suspected or confirmed exposure to Bacillus anthracis (anthrax) in persons 18 through 65 years of age when administered in conjunction with recommended antibacterial drugs.

• #2 Anthrax – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax

  The Centers for Disease Control and Prevention (CDC) recommend that the anthrax vaccine be administered with antibiotic prophylaxis to patients exposed to anthrax spores. The CDC recommends a 3-dose vaccine series given subcutaneously at 0, 2, and 4 weeks with antimicrobial therapy for at least 60 days. […] Raxibacumab and obiltoxaximab are monoclonal antibodies indicated for prophylaxis of inhalation anthrax when alternative therapies are not available or are not appropriate.

• #2 Anthrax – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/400_499/0483.html

  Aetna considers anthrax immunization a medically necessary preventive service for indications recommended by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP). The ACIP recommends pre-exposure anthrax vaccination for the following groups: […] The immunization consists of 2 intramuscular injections given 4 weeks apart followed by 3 additional subcutaneous injections given at 6, 12, and 18 months. The ACIP recommends annual booster injections of the vaccine thereafter. […] Aetna considers post-exposure anthrax vaccination medically necessary according to the ACIP guidelines. The ACIP guidelines recommend post-exposure anthrax vaccination for the following indications: […] Aetna considers raxibacumab injection medically necessary for the prevention and treatment of inhalational anthrax.

• #2 Anthrax – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/400_499/0483.html

  Aetna considers obiltoxaximab (Anthim) injection in combination with appropriate anti-bacterial drugs medically necessary for the treatment of inhalational anthrax. […] Aetna considers intravenous human anthrax immune globulin (Anthrasil) medically necessary to treat persons with inhalational anthrax in combination with appropriate antibacterial drugs. […] Anthrax pre-exposure prophylaxis consists of 2 intramuscular injections given 4 weeks apart followed by 3 additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are recommended thereafter. […] The ACIP recommends post-exposure prophylaxis against Bacillus anthracis following an aerosol exposure to Bacillus anthracis spores. […] The ACIP recommends 60 days of anti-microbial prophylaxis in conjunction with 3 doses of anthrax vaccine for optimal protection of previously unvaccinated persons after exposure to aerosolized B. anthracis spores.

• #2 Anthrax – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/400_499/0483.html

  The ACIP guidelines recommend anthrax vaccine as a component of post-exposure prophylaxis in pregnant women exposed to aerosolized B. anthracis spores. […] The FDA approved intravenous human anthrax immune globulin (Anthrasil, Cangene Corp, Winnipeg, Canada) to treat patients with inhalational anthrax in combination with appropriate antibacterial drugs.

• #2 Anthrax | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/anthrax/

  While there is a vaccine licensed to prevent anthrax, it is not typically available for the general public. Anthrax vaccine is routinely used in three groups of adults 18 to 65 years of age who may be at risk of coming in contact with anthrax because of their job: […] To build up protection against anthrax, these groups should get 5 shots of anthrax vaccine over 18 months. To stay protected, they should get annual boosters. The shots are injected into the muscle (intramuscular). […] Prevention of naturally acquired human anthrax begins with prevention and control in animals. Effective control centers around vaccinating livestock, treatment of symptomatic animals and proper disposal of carcasses. In addition, educate employees who handle potentially contaminated animal products about the signs and symptoms of anthrax infection. Use extreme caution when handling dead animals that may be infected with anthrax. Other prevention methods include controlling dust and providing good air circulation when working with animal hides, fur, hair, or wool. In addition, have workers wear protective clothing and provide a place to shower and change clothes after work.

• #2 Anthrax | Health.mil

  https://www.health.mil/MHSHome/Military-Health-Topics/Health-Readiness/Immunization-Healthcare/Vaccine-Preventable-Diseases/Anthrax?type=Policies&page=2

  Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It forms spores that can be found naturally in soil, commonly affecting domestic and wild animals around the world. Although it is rare in the United States, people can get sick with anthrax if they come in contact with infected animals or contaminated animal products. […] When anthrax spores get inside the body, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness. Anthrax can enter the body through the skin (cutaneous); through ingesting contaminated food or water (gastrointestinal); intravenously (rare); or by inhalation, the deadliest form of the disease and the one most likely to be used as a biological weapon. […] The anthrax vaccine has been licensed in the U.S. since 1970, and has been proven safe and effective at preventing anthrax disease, regardless of the route of exposure. The immunization is required for deployment to U.S. Central Command and the Korean Peninsula, as well as for designated NORTHCOM personnel, emergency response and other units. It is given in a five-dose series at 0, 4 weeks, 6 months, 12 months and 18 months, with yearly boosters to maintain immunity. […] Vaccination and antibiotics, such as ciprofloxacin, doxycycline, and amoxicillin, are the most important therapeutic interventions for any form of anthrax exposure.

• #2 Anthrax Facts – MN Dept. of Health

  https://www.health.state.mn.us/diseases/anthrax/anthrax.html

  Can anthrax be treated? […] All forms of anthrax can be treated with antibiotics. Its important to start treatment as soon as possible. It may be possible to prevent the disease if exposed people begin treatment soon enough. […] […] Can anthrax be prevented? […] Early treatment with antibiotics, for people who may have been exposed to anthrax, is the best preventive measure. […] There is also a vaccine for anthrax, which is used by the military. It takes six shots to provide protection, followed by a yearly booster. However, supplies of the vaccine are limited, and it isnt available to civilian doctors. Like any vaccine, it carries some risks. There is also no way to know when or where limited supplies of the vaccine might be needed to respond to an attack. For those reasons, vaccination of the general public is not currently recommended.

• #2 Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3901460/

  Antimicrobial drug use in pregnant women in the setting of anthrax must be viewed in the context of the high mortality risk and the benefits of treatment for the mother and fetus, as well as possible effects on the fetus resulting from the infection or from administration of antimicrobial drugs to the mother. […] The guidance for nonpregnant adults specifies that anthrax antimicrobial drug PEP should be administered for 60 days, whether recipients are unvaccinated, partially vaccinated, or fully vaccinated. This recommendation should also apply to P/PP/L women; there is no evidence to suggest a change in the duration of antimicrobial drug prophylaxis is necessary. […] Similar to prophylactic considerations, the recommendations for anthrax treatment of P/PP/L women should be the same as for nonpregnant adults. No evidence supports extending the duration of antimicrobial drug treatment for P/PP/L women. […] Antimicrobial drugs that likely cross the placenta in adequate quantities include ciprofloxacin, levofloxacin, amoxicillin, and penicillin.

• #2 ACOG: When possible, use amoxicillin for anthrax prevention in pregnant women | CIDRAP

  https://www.cidrap.umn.edu/anthrax/acog-when-possible-use-amoxicillin-anthrax-prevention-pregnant-women

  Pregnant and lactating women who may have been exposed to anthrax should be treated prophylactically with amoxicillin rather than ciprofloxacin when the anthrax strain is found to be penicillin-sensitive, the American College of Obstetricians and Gynecologists (ACOG) recommends. […] The recommendation is based on the more established safety record for amoxicillin use during pregnancy, according to Charles M. Lockwood, MD, chair of ACOG’s Committee on Obstetric Practice. […] ACOG concurs with the Centers for Disease Control and Prevention (CDC) that pregnant or lactating women who may have been exposed to anthrax should be started on a 60-day course of ciprofloxacin, the organization said. […] „However, ACOG advises physicians to switch such women from ciprofloxacin to amoxicillin, if and when public health officials determine that the strains of anthrax bacteria in the particular exposure are penicillin-sensitive,” the press release says.

• #2 Anthrax – IAFFAnthrax – IAFF

  https://www.iaff.org/infectious-disease/diseases/anthrax/

  Anthrax may be prevented through several methods: […] Anthrax vaccine […] Available to military personnel and those at increased risk of contracting anthrax […] Post-exposure preventive antibiotics […] These may be given to exposed individuals who have not yet developed symptoms […] Antibiotics are effective against the bacteria but not against the toxins which cause the complications of the infection. […] Use Universal Precautions […] Nitrile or vinyl gloves will protect workers from cutaneous anthrax exposure […] OSHA does not recommend respirators for the vast majority of workers. However, when effective protection from anthrax spores [is needed], the CDC recommends the use of NIOSH-approved respirators that are at least as protective as an N95 respirator. […] You should contact your infection control officer and seek medical attention if you have been exposed or suspect exposure to anthrax or if you develop symptoms of anthrax. Anthrax can be treated with various antibiotics, including penicillin, doxycycline and ciprofloxacin.

• #2 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  BA is persistent in the environment for long periods of time, and small particles can stay suspended in the air or be re-aerosolized by agitation and air currents within buildings and other environments. This creates the potential for BA transmission from contaminated environmental surfaces or fomites (objects that can spread germs) and the need for effective cleaning and decontamination strategies. […] Protect workers from exposure when tasked with cleaning surfaces and equipment potentially contaminated with BA. This may include using engineering controls, such as ventilation, along with administrative controls, safe work practices, and PPE, such as chemical-resistant or -impermeable garments and a respirator with an N95 particulate/chemical combination cartridge. […] PPE includes appropriate respiratory protection, protective garments (e.g., coveralls, boot covers, chemical-resistant or -impermeable suits), eye and face protection, and gloves (nitrile or vinyl). Employers should base the use of PPE on the situation and tasks involved, including to the degree of contamination, risk of exposure, exposure pathway, and anticipated level of exposure.

• #2

  https://dph.illinois.gov/topics-services/emergency-preparedness-response/public-health-care-system-preparedness/anthrax.html

  Antibiotics are used to treat anthrax. Early identification and treatment are important. Treatment is different for a person who comes into contact with anthrax, but is not yet displaying symptoms (fever, sweating, low blood pressure, dizziness). […] Prevention of illness after contact: Health care providers can give out antibiotics that can be taken at home. […] If you think that you or someone you know may have come into contact with any type of anthrax, call your health care provider and contact the local county health department right away.

• #2 Anthrax – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/anthrax/anthrax+-+including+symptoms+treatment+and+prevention

  Anthrax is an acute infectious disease caused by bacteria called Bacillus anthracis. The anthrax bacterium produces spores (small resistant cells) which are capable of surviving for many years in the environment. […] Anthrax is a very rare disease in Australia, and usually occurs in farmers or other people who have close contact with animals or their products, especially wool, animal hair or skins. […] Treatment with antibiotics is essential, particularly for inhalational anthrax. In some situations preventative antibiotics may also be given to people who are suspected to have been exposed to anthrax spores. […] Control of anthrax in livestock herds is essential for prevention of its spread to humans. Animals dying from anthrax usually die suddenly, with only a brief illness preceding death. By law, a farmer who suspects anthrax in an animal must notify a government veterinary officer immediately. If anthrax is suspected the farm will be isolated and herds vaccinated, and the dead animal disposed of appropriately so that contamination of the soil is minimised.

• #2

  https://www.gov.uk/guidance/anthrax-how-to-spot-and-report-the-disease

  Anthrax is a notifiable animal disease. If you suspect it you must report it immediately by calling the Defra Rural Services Helpline on 03000 200 301. In Wales, contact 0300 303 8268. In Scotland, contact your local Field Services Office. Failure to do so is an offence. […] You can also help to prevent anthrax by practising strict biosecurity on your premises. […] If you suspect anthrax: contact your local APHA office immediately and isolate the animal or carcass; do not move, skin or open the carcass of any suspect animal; disinfect blood or other fluids from any suspect animal, as soon as possible, with a Defra approved disinfectant; do not kill or bleed any sick animals; watch any animals that have been in contact with the suspect animal, and isolate them if they show signs of infection; pay particular attention to cows, as humans can be infected by drinking contaminated milk. […] If anthrax is confirmed, there are legal powers to control the spread of the disease during an outbreak. […] If you think your animals will be continually exposed to anthrax, for example, after an outbreak, talk to your vet about using an antibiotic or a vaccine.

• #2 Anthrax – WOAH – World Organisation for Animal Health

  https://www.woah.org/en/disease/anthrax/

  In humans, anthrax manifests itself in three distinct patterns (cutaneous, gastrointestinal and inhalational). The most common is a skin infection, where people become infected handling animals or animal products that contain spores. This can happen to veterinarians, agricultural workers, livestock producers or butchers dealing with sick animals, or when infection has been spread by wool or hides. […] Anthrax is a preventable disease by vaccines and can be treated with antibiotics, however specific control procedures on carcasses disposal are necessary to contain the disease and prevent its spread. […] In addition to antibiotic therapy and immunisation, specific control procedures are necessary to contain the disease and prevent its spread. In particular: the proper disposal of dead animals is critical; the carcass should not be opened, since exposure to oxygen will allow the bacteria to form spores; premises are to be quarantined until all susceptible animals are vaccinated and all carcasses disposed of preferably by incineration or alternatively by deep burial with quick lime.

• #2 Anthrax – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/anthrax/

  If a person has been exposed to anthrax but is not yet sick, healthcare providers will prescribe antibiotics to prevent infection. A vaccine to prevent anthrax is available to those at higher risk of routine exposure to anthrax, including certain members of the U.S. armed forces, lab workers, and workers who may enter or re-enter contaminated areas. […] People who are at an occupational risk of exposure should use appropriate safety precautions. Travelers to anthrax endemic countries should avoid contact with animal carcasses. […] In the event of an attack using anthrax as a weapon, anyone exposed to anthrax would likely get the vaccine.

• #2 Anthrax Treatment & Management: Approach Considerations, Cutaneous Anthrax, Prehospital Care

  https://emedicine.medscape.com/article/212127-treatment

  For PEP in adults, the CDC recommends vaccination and the use of oral fluoroquinolones (ciprofloxacin, 500 mg bid; levofloxacin, 500 mg qd; or ofloxacin, 400 mg bid). Doxycycline is an acceptable alternative. Prophylaxis should continue until exposure to B anthracis is excluded or for a period of 4 weeks if exposure is confirmed. […] The monoclonal antibodies raxibacumab and obiltoxaximab are indicated for prophylaxis of inhalational anthrax when alternative therapies are not available or not appropriate. They should be used as part of a combination regimen with appropriate antibiotic drugs. […] Three doses of vaccine should be administered during the 4-week period (at 0, 2, and 4 weeks post exposure). If a vaccine is not available, the antibiotic treatment should continue for at least 60 days. A second option is treatment for 100 days. A third option is 100 days of antibiotic prophylaxis with vaccine. […] The indication for anthrax vaccine adsorbed (BioThrax) was expanded in November 2015 to include postexposure use following suspected or confirmed B anthracis exposure in combination with antimicrobial therapy. It was originally approved for pre-exposure prophylaxis in high-risk individuals.

• #2 2 Antibiotics for Anthrax Postexposure Prophylaxis | Prepositioning Antibiotics for Anthrax | The National Academies Press

  https://nap.nationalacademies.org/read/13218/chapter/4

  2 Antibiotics for Anthrax Postexposure Prophylaxis […] This chapter reviews the use of antibiotics for postexposure prophylaxis (PEP) for inhalational anthrax, focusing specifically on factors that impact the design of distribution and dispensing plans, including prepositioning. […] Four antibiotics are FDA-approved for use for PEP following exposure to aerosolized spores of Bacillus anthracis: doxycycline, ciprofloxacin, levofloxacin, and parenteral procaine penicillin G. […] For adults ages 18 to 65 who have potentially been exposed to aerosolized spores of Bacillus anthracis, the Centers for Disease Control and Prevention (CDC) recommends 60 days of treatment with either ciprofloxacin or doxycycline plus a three-dose series of anthrax vaccine adsorbed (AVA) starting as soon as possible after exposure.

• #2 Centre for Health Protection – Anthrax

  https://www.chp.gov.hk/en/healthtopics/content/24/12.html

  Hospitalization is required. Anthrax can be treated with antibiotics. The disease may be prevented after exposure to anthrax spores by early treatment with appropriate antibiotics. […] There are vaccines to prevent anthrax, but completion of the whole course of vaccination requires multiple doses. Human vaccines are used primarily for protection of selected individuals with possible occupational exposure to anthrax. […] To prevent anthrax, members of the public are also advised to: Maintain good personal, food and environmental hygiene. Perform hand hygiene frequently, wash hands thoroughly with liquid soap and water before handling food or eating. Clean the broken skin immediately and cover properly with waterproof adhesive dressings. Wash hands before and after touching wounds. Avoid contact with infected animal and contaminated animal product. Thorough washing and cooking of food before consumption.

• #2 Anthrax Prevention – Risks vs. Benefits – Domestic Preparedness

  https://www.domprep.com/articles/anthrax-prevention-risks-vs-benefits

  Since the terrorist attacks against the United States on 11 September 2001, significant activity and demonstrable gains have been made in the effort to improve U.S. homeland security. […] A major ongoing concern is that the current anthrax biodefense policy is based primarily on the use of antibiotics (with or without vaccination) following an attack an approach that appears to ignore and/or downplay the threat posed by multi-drug resistant (MDR) anthrax. […] Here, a point in fact is the scenario selected, earlier this year, for the 7-8 July deliberations of the National Biodefense Science Board (NBSB) on the use of Anthrax Vaccine Adsorbed (AVA; Biothrax) to protect children and special-needs populations. […] Today there is no FDA-licensed indication for the use of AVA after exposure in any person of any age, and there also is no FDA-licensed indication for use of the vaccine in children and/or seniors (older than 65) either pre- or post-exposure.

• #2 Anthrax Prevention – Risks vs. Benefits – Domestic Preparedness

  https://www.domprep.com/articles/anthrax-prevention-risks-vs-benefits

  If, on the other hand, the threat posed by MDR anthrax is acknowledged, the risk-to-benefit ratio for anthrax vaccination is no longer undefined. […] In MDR anthrax, therefore, the risk of vaccination pales in comparison to the probable benefit. […] It seems reasonable to suggest, therefore, that there may well be no better time than the present to shift planning from a post-exposure response capability to preventive immunization especially for those personnel who are needed to preserve civil order and maintain continuity of operations and government.

• #2 Health: Infectious Disease Epidemiology & Prevention Division: Anthrax

  https://www.in.gov/health/idepd/zoonotic-and-vectorborne-epidemiology-entomology/zoonotic-diseases/anthrax/

  Anthrax is a disease caused by the bacterium Bacillus anthracis, which can affect both humans and animals. […] Anthrax can be treated with antibiotics. […] Certain people are at greater risk of exposure, such as international travelers, laboratory workers, veterinarians, livestock producers and people who handle animal products. […] NOTICE: Anthrax is an immediately reportable disease in Indiana and is required to be reported upon identification by a healthcare provider, hospital, or laboratory. Specific reporting requirements for anthrax can be found here.

• #2

  https://www.health.vic.gov.au/infectious-diseases/anthrax

  Anthrax is an urgent notifiable condition that must be notified immediately to the department by medical practitioners and pathology services. […] An anthrax vaccine is available, but not for civilian use in Australia. […] At present, anthrax vaccine is not available for civilian use in Australia. Subject to the availability of a vaccine in the future, it will only be provided under the Special Access Scheme administered by the Therapeutic Goods Administration for those groups at highest risk of infection with B. anthracis (that is, laboratory staff working with cultures of the organism). […] Although there is no person-to-person transmission, the department will trace and follow up anyone who may have been exposed to the same source as the case, and it may be recommended that such people take antibiotics (post-exposure prophylaxis).

• #2

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/anthrax.aspx

  Where inhalational exposure to a deliberate release of anthrax spores is considered credible, then recommend post exposure prophylaxis (see Therapeutic Guidelines: Antibiotic) and seek expert medical advice. […] Post exposure prophylaxis for cutaneous anthrax should be considered for contacts of a confirmed anthrax exposure who were not using personal protective equipment and whose skin was contaminated with fluids from the carcass. […] An anthrax vaccine is not licensed for civilian use in Australia.

• #2 Anthrax prevention – wikidoc

  https://www.wikidoc.org/index.php/Anthrax_prevention

  Prevention of anthrax infection can be achieved with post-exposure prophylaxis antibiotics and vaccination. The US Advisory Committee on Immunization Practices recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection. […] Postexposure prophylaxis of asymptomatic persons should start as soon as possible after exposure because its effectiveness decreases with delay in implementation. […] Everyone exposed to aerosolized B. anthracis spores should receive a full 60 days of post-exposure prophylaxis antimicrobial drugs, whether they are unvaccinated, partially vaccinated, or fully vaccinated. […] Well-timed and effective postexposure prophylaxis can potentially save thousands of lives. […] After exposure to anthrax, it is recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection.

• #3 Anthrax – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/anthrax/symptoms-causes/syc-20356203

  To prevent infection after being exposed to anthrax spores, the Centers for Disease Control and Prevention recommends: […] A three-dose series of anthrax vaccine […] An anthrax vaccine is available for certain groups of people. The vaccine doesn’t contain live bacteria and can’t lead to infection. However, the vaccine can cause side effects, ranging from soreness at the injection site to more-serious allergic reactions. […] If you live or travel in a country where anthrax is common and herd animals aren’t routinely vaccinated, avoid contact with livestock and animal skins as much as possible. Also avoid eating meat that hasn’t been properly cooked. […] Even in developed countries, it’s important to handle any dead animal with care and to take precautions when working with or processing imported hides, fur or wool.

• #3 Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3901460/

  Antimicrobial drug use in pregnant women in the setting of anthrax must be viewed in the context of the high mortality risk and the benefits of treatment for the mother and fetus, as well as possible effects on the fetus resulting from the infection or from administration of antimicrobial drugs to the mother. […] The guidance for nonpregnant adults specifies that anthrax antimicrobial drug PEP should be administered for 60 days, whether recipients are unvaccinated, partially vaccinated, or fully vaccinated. This recommendation should also apply to P/PP/L women; there is no evidence to suggest a change in the duration of antimicrobial drug prophylaxis is necessary. […] Similar to prophylactic considerations, the recommendations for anthrax treatment of P/PP/L women should be the same as for nonpregnant adults. No evidence supports extending the duration of antimicrobial drug treatment for P/PP/L women. […] Antimicrobial drugs that likely cross the placenta in adequate quantities include ciprofloxacin, levofloxacin, amoxicillin, and penicillin.

• #3 2 Antibiotics for Anthrax Postexposure Prophylaxis | Prepositioning Antibiotics for Anthrax | The National Academies Press

  https://nap.nationalacademies.org/read/13218/chapter/4

  2 Antibiotics for Anthrax Postexposure Prophylaxis […] This chapter reviews the use of antibiotics for postexposure prophylaxis (PEP) for inhalational anthrax, focusing specifically on factors that impact the design of distribution and dispensing plans, including prepositioning. […] Four antibiotics are FDA-approved for use for PEP following exposure to aerosolized spores of Bacillus anthracis: doxycycline, ciprofloxacin, levofloxacin, and parenteral procaine penicillin G. […] For adults ages 18 to 65 who have potentially been exposed to aerosolized spores of Bacillus anthracis, the Centers for Disease Control and Prevention (CDC) recommends 60 days of treatment with either ciprofloxacin or doxycycline plus a three-dose series of anthrax vaccine adsorbed (AVA) starting as soon as possible after exposure.

• #3 New Anthrax Vaccine Added to Arsenal of Defense Against Bioterrorism | NETEC

  https://netec.org/2023/11/09/new-anthrax-vaccine-added-to-arsenal-of-defense-against-bioterrorism/

  Anthrax continues to pose a significant public health concern due to its potential use as a bioterrorism agent and its ability to cause severe illness in humans. […] The newly approved vaccine Cyfendus (Anthrax Vaccine Adsorbed, Adjuvanted) is indicated for people with suspected or confirmed inhalational exposure to anthrax. The vaccine is intended to be given in two intramuscular doses over two weeks, in combination with antibiotic prophylaxis, which often involves two months of treatment with ciprofloxacin, levofloxacin, or doxycycline. […] For post-exposure prophylaxis, Cyfendus provides more rapid protection than its predecessor, BioThrax. […] Infection control measures are critical to prevent the spread of anthrax in health care settings. This includes the isolation of infected patients and strict adherence to standard and contact precautions. Routine vaccination against anthrax is recommended for health care personnel who may be at risk of occupational exposure.

• #3 Anthrax | Health.mil

  https://www.health.mil/MHSHome/Military-Health-Topics/Health-Readiness/Immunization-Healthcare/Vaccine-Preventable-Diseases/Anthrax?type=Policies&page=2

  Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It forms spores that can be found naturally in soil, commonly affecting domestic and wild animals around the world. Although it is rare in the United States, people can get sick with anthrax if they come in contact with infected animals or contaminated animal products. […] When anthrax spores get inside the body, the bacteria can multiply, spread out in the body, produce toxins (poisons), and cause severe illness. Anthrax can enter the body through the skin (cutaneous); through ingesting contaminated food or water (gastrointestinal); intravenously (rare); or by inhalation, the deadliest form of the disease and the one most likely to be used as a biological weapon. […] The anthrax vaccine has been licensed in the U.S. since 1970, and has been proven safe and effective at preventing anthrax disease, regardless of the route of exposure. The immunization is required for deployment to U.S. Central Command and the Korean Peninsula, as well as for designated NORTHCOM personnel, emergency response and other units. It is given in a five-dose series at 0, 4 weeks, 6 months, 12 months and 18 months, with yearly boosters to maintain immunity. […] Vaccination and antibiotics, such as ciprofloxacin, doxycycline, and amoxicillin, are the most important therapeutic interventions for any form of anthrax exposure.

• #3 Anthrax – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax

  An anthrax vaccine, composed of a cell-free culture filtrate containing protective antigen protein, is available for people at high risk (eg, military personnel, veterinarians, laboratory technicians, employees of textile mills processing imported goat hair). The vaccine contains no dead or live bacteria. A separate veterinary vaccine is also available. […] Repeated preexposure vaccination with a 5-dose intramuscular series is required to ensure protection. The anthrax vaccine is approximately 93% effective for people who complete the primary series and maintain the booster vaccinations. […] Postexposure measures include antibiotics, vaccination, and monoclonal antibodies. […] Asymptomatic people (including pregnant women and children) exposed to inhaled anthrax require prophylaxis with one of the following oral antibiotics, given for 60 days: Ciprofloxacin 500 mg (10 to 15 mg/kg for children) every 12 hours, Doxycycline 100 mg (2.5 mg/kg for children) every 12 hours, Levofloxacin 750 mg every 24 hours, Moxifloxacin 400 mg every 24 hours, Clindamycin 600 mg every 8 hours.

• #3 ACOG: When possible, use amoxicillin for anthrax prevention in pregnant women | CIDRAP

  https://www.cidrap.umn.edu/anthrax/acog-when-possible-use-amoxicillin-anthrax-prevention-pregnant-women

  Doxycycline use in pregnant women should generally be avoided because it can cause problems in fetuses, including staining of teeth and impeded bone growth, the ACOG statement says. […] ACOG said prophylactic treatment for anthrax should be limited to women who have been exposed to confirmed environmental contamination or a high-risk source as determined by public health authorities. […] The initial recommended treatment is 500 mg of ciprofloxacin every 12 hours for 60 days. Once the anthrax is found to be penicillin-sensitive, treatment should be changed to 500 mg of amoxicillin three times a day for 60 days. […] If a woman has started taking ciprofloxacin and then finds out she is pregnant, she should continue the treatment, but she should switch to amoxicillin when the anthrax is found to be penicillin-sensitive.

• #3 Anthrax – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/anthrax/control-prevention

  Worker protection from exposure to infectious agents, including BA, is necessary when work tasks involve handling, treatment, transport, and disposal of medical, laboratory and other potentially contaminated waste. […] Ensure that supervisors and all potentially exposed workers are aware of the symptoms of anthrax. […] Workers potentially exposed to BA or who develop symptoms of anthrax should seek medical evaluation. […] Train all emergency response workers to recognize and report early symptoms and signs of anthrax, understand the importance of immediate medical attention, know how to access emergency medical care, know about potential adverse effects and interactions with food and drugs if taking antibiotics, and understand the potential adverse effects of the anthrax vaccine and the amount of time necessary to develop an immune response if using the vaccine as a preventive measure. […] Establish a medical monitoring program to monitor persons exposed to BA for signs and symptoms of anthrax. The intent is to detect adverse effects on a worker’s health at an early stage when prevention is possible or treatment is most effective.

• #3 Anthrax – WOAH – World Organisation for Animal Health

  https://www.woah.org/en/disease/anthrax/

  In humans, anthrax manifests itself in three distinct patterns (cutaneous, gastrointestinal and inhalational). The most common is a skin infection, where people become infected handling animals or animal products that contain spores. This can happen to veterinarians, agricultural workers, livestock producers or butchers dealing with sick animals, or when infection has been spread by wool or hides. […] Anthrax is a preventable disease by vaccines and can be treated with antibiotics, however specific control procedures on carcasses disposal are necessary to contain the disease and prevent its spread. […] In addition to antibiotic therapy and immunisation, specific control procedures are necessary to contain the disease and prevent its spread. In particular: the proper disposal of dead animals is critical; the carcass should not be opened, since exposure to oxygen will allow the bacteria to form spores; premises are to be quarantined until all susceptible animals are vaccinated and all carcasses disposed of preferably by incineration or alternatively by deep burial with quick lime.

• #3 Anthrax FAQs | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/zoonosis-control/zoonosis-control-diseases-and-conditions/anthrax/anthrax-faqs

  A vaccine for livestock is frequently used in areas where anthrax is common, but the vaccine must be used before the animal is infected with the bacteria. […] An effective anthrax vaccine for livestock and horses can be purchased through private veterinary practitioners, feed stores, or animal health product distributors. The injection can be administered by private veterinary practitioners or rancher personnel and is recommended for: livestock residing in or near an area where anthrax often occurs; and animals that will be moved into the area, such as horses transported to trail rides. […] To protect yourself, wear long sleeves and gloves, and do not move or open carcasses, as this could further release the bacteria into the environment, causing further disease to spread.

• #3 2 Antibiotics for Anthrax Postexposure Prophylaxis | Prepositioning Antibiotics for Anthrax | The National Academies Press

  https://nap.nationalacademies.org/read/13218/chapter/4

  To be maximally effective in preventing morbidity and mortality, PEP for inhalational anthrax should be administered during the incubation period (before the onset of symptoms). […] Timely administration of PEP also hinges on prompt detection and confirmation of the threat through environmental monitoring systems and astute clinical diagnosis and surveillance.

• #3 Anthrax Prevention – Risks vs. Benefits – Domestic Preparedness

  https://www.domprep.com/articles/anthrax-prevention-risks-vs-benefits

  Consequently, the NBSB was asked by Lurie to engage all stakeholders in the issues involved. […] Lurie also specifically requested the NBSB, in fact: (a) to directly address the challenges involved in administering the vaccine under an Investigational New Drug (IND) research protocol after an anthrax event; and (b) to compare those challenges with the ethical considerations involved in attempting to gather sufficient data in the absence of a confirmed anthrax release. […] However, when the lack of a clear and present threat is coupled with an assurance that any anthrax encountered will be sensitive to antibiotics, there is very little, if any, motivation to expose children to what might plausibly seem to be an unnecessary immunization. […] In MDR anthrax, the contribution provided by antibiotics is, by definition, resisted.

• #3

  https://www.health.vic.gov.au/infectious-diseases/anthrax

  Anthrax is an urgent notifiable condition that must be notified immediately to the department by medical practitioners and pathology services. […] An anthrax vaccine is available, but not for civilian use in Australia. […] At present, anthrax vaccine is not available for civilian use in Australia. Subject to the availability of a vaccine in the future, it will only be provided under the Special Access Scheme administered by the Therapeutic Goods Administration for those groups at highest risk of infection with B. anthracis (that is, laboratory staff working with cultures of the organism). […] Although there is no person-to-person transmission, the department will trace and follow up anyone who may have been exposed to the same source as the case, and it may be recommended that such people take antibiotics (post-exposure prophylaxis).

• #3 Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3901460/

  Clinical recommendations for the prevention and treatment of anthrax among pregnant women are updated. […] Given the severity of anthrax, P/PP/L women should receive the same postexposure prophylaxis (PEP) and treatment regimens as nonpregnant adults, unless there are compelling reasons for these recommendations to differ. These regimens would include antimicrobial drug treatment and vaccine for P/PP/L women who have had direct exposure to anthrax spores and antimicrobial drug treatment for women with a clinical or laboratory diagnosis of anthrax. […] In addition to vaccination, antimicrobial drugs are an essential component of prophylaxis, and combination antimicrobial drug therapy is the mainstay of treatment for anthrax, with the exception of cutaneous cases without systemic involvement, which are treated with single-agent therapy.

• #3 Livestock owners’ anthrax prevention practices and its associated factors in Sekota Zuria district, Northeast Ethiopia | BMC Veterinary Research | Full Text

  https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-020-2267-0

  Positive attitude towards the prevention of the disease was one of the main factors identified to have a significant association with the anthrax prevention practice. […] The odds of appropriate anthrax prevention practice were higher among livestock owners who received health education about anthrax prevention practices compared to those who didn’t receive. […] This finding suggests that providing continuous health education for livestock owners has a vital role in improving anthrax prevention practices in their areas. […] In Sekota Zuria district, only one-quarter of the livestock owners appropriately prevented anthrax. […] Thus, providing continuous health education and creating awareness on the prevention by veterinary professionals would be crucial to improve anthrax prevention practices of livestock owners.

• #4 Anthrax prevention – wikidoc

  https://www.wikidoc.org/index.php/Anthrax_prevention

  Prevention of anthrax infection can be achieved with post-exposure prophylaxis antibiotics and vaccination. The US Advisory Committee on Immunization Practices recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection. […] Postexposure prophylaxis of asymptomatic persons should start as soon as possible after exposure because its effectiveness decreases with delay in implementation. […] Everyone exposed to aerosolized B. anthracis spores should receive a full 60 days of post-exposure prophylaxis antimicrobial drugs, whether they are unvaccinated, partially vaccinated, or fully vaccinated. […] Well-timed and effective postexposure prophylaxis can potentially save thousands of lives. […] After exposure to anthrax, it is recommended 60 days of antibiotic drug prophylaxis for immediate protection and a 3-dose series of Anthrax Vaccine Adsorbed (AVA) for long-term protection.

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