Bacillus anthracis is an aerobic, spore-forming bacterium that causes anthrax disease. Anthrax occurs globally, especially in agricultural areas that do not have a livestock vaccination program. Naturally occurring anthrax is rare in the United States, which has successful vaccination programs among livestock and strict importation regulations. In 2001, anthrax bacteria were used in bioterrorism attacks involving the postal system and government buildings. Regardless of the cause, all suspected cases of anthrax must be reported to the local health department for investigation.
Anthrax bacteria infect people and animals when spores are inhaled, ingested, or enter the body through a break in the skin. Once inside the body, the spores replicate and produce three proteins: edema factor (EF), lethal factor (LF), and protective antigen (PA). It is the combination of these proteins that is believed to cause tissue damage, shock, and death. Sometimes there is a delayed onset of anthrax disease. This is because anthrax spores can remain in the lungs for weeks without replicating. Antibiotics do not kill the spores. When the spores finally do replicate, anthrax disease develops.
There are three forms of anthrax disease:
Antibiotics, such as ciprofloxacin, doxycycline, and amoxicillin, are the most important therapeutic interventions for any form of anthrax. A combination of antibiotics needs to be started as soon as the disease is suspected. In addition, aggressive supportive care will be needed.
In 1991, DoD Service members deploying for the Persian Gulf War received one or two doses of anthrax vaccine, labeled Vaccine A or Vacc A. Other abbreviations for anthrax vaccine include AVA and ANT. Before November 2008, the vaccine was given as a 6-dose series. Research on the vaccine showed, however, that five doses are as effective as six doses in preventing anthrax. So, in November 2008, the primary series of anthrax vaccine was changed to five doses. See "Dose/Schedule" for more information.
Product: Biothrax® (Anthrax Vaccine Adsorbed)
Manufacturer: Emergent BioDefense Operations Lansing Inc
Year licensed: 1970
Pregnant women who have received the anthrax vaccine during pregnancy should receive regular prenatal care and should discuss their anthrax vaccination with their healthcare provider and/or obstetrician. IHB has the latest information regarding pregnancy and vaccination, as well as adverse event research. IHB also offers pregnancy monitoring for women inadvertently vaccinated during pregnancy. For more information, please visit the Pregnancy page or contact IHB.
In addition to the Department of Defense, other agencies and groups advocate or support the use of the anthrax vaccine. The Food & Drug Administration licensed the anthrax vaccine in 1970. The Centers for Disease Control & Prevention, the World Health Organization, the Defense Health Board, and many other respected public health organizations support use for people at risk or exposed to Bacillus anthracis. Information about the AVIP is available on the Internet (a variety of DoD web sites as well as the Centers for Disease Control & Prevention (www.cdc.gov) and the Food & Drug Administration web sites), which includes facts about the anthrax vaccine, history, side effects, purpose for immunizations and more. [See the Q&A page on independent scientific reviews.] Evidence for the efficacy of the anthrax vaccine is sufficient for it to be included in standard medical reference books in the United States and around the world. These references include: