Questions About Anthrax

Q: What is anthrax?
A: Anthrax is an infectious disease caused by a bacteria, which is capable of forming spores that can travel through the air. There are three forms of anthrax infection. Anthrax can be contracted through the skin (cutaneous), lungs (inhalation), or stomach and intestines (gastrointestinal system). Skin (cutaneous) anthrax is the most common type, and is usually not fatal unless left untreated. Cutaneous anthrax can occur if the spores are in contact with an area of skin that is not intact, such as a cut or sore. It is marked by a boil-like lesion that eventually forms an ulcer with a black center. The symptoms of gastrointestinal anthrax usually are nausea, vomiting, diarrhea and fever. Lung (inhalation) anthrax is the most serious form, which results from breathing in the spores. Inhalation anthrax is associated with fever and flu-like symptoms (cough, fatigue, muscle aches). The incubation period for anthrax is usually less than 7 days, and in most cases, symptoms appear within 48 hours of exposure.

Q: Is anthrax contagious?
A: No. Inhalation anthrax is not spread from person to person. In cutaneous anthrax, the drainage from an open sore presents a low risk of infection to others. The only way cutaneous anthrax can be transmitted is by direct contact with the drainage from an open sore. Anthrax is not spread from person to person by casual contact, sharing office space, or by coughing or sneezing.

Q: What should I do if my child is exposed to anthrax?
A: If your child is exposed to anthrax, contact your child's pediatrician immediately. Early diagnosis is important, since inhalation anthrax responds better to antibiotics if treatment is started before significant symptoms begin. Your child’s pediatrician will begin testing and treatment in consultation with public health authorities. Parents should rely on their pediatricians and public health officials for testing and treatment advice in the event of exposure.

Q: What antibiotics are used to treat anthrax in children?
A: Ciprofloxacin (Cipro) and doxycycline are recommended to treat anthrax, but both these drugs may cause significant side effects in children. If lab tests show the strain of anthrax is susceptible to other antibiotics (like amoxicillin), those drugs may be used instead. 

Q: Should I get antibiotics now? 
A: It is recommended that you do not obtain antibiotics for current or future use. Giving antibiotics to a child who does not need them may be harmful. Also, it could lead to the development of drug-resistant strains of bacteria. NYU Medical Center has a stockpile of antibiotics for treatment of patients exposed to anthrax. The national and New York City stockpile of antibiotics also is rapidly available if needed.

Q: Can my child be vaccinated against anthrax?
A: No. The anthrax vaccine is not recommended for children under the age of 18, and it has not been studied in children. At this time, the anthrax vaccine is available only to the military. 

Q: What about smallpox?
A: Smallpox is a serious illness caused by a virus. Smallpox was eradicated worldwide in the 1970s. However, there are concerns that terrorists may have obtained the virus. Smallpox can easily be spread from person to person. There is no known cure for smallpox. 

Q: Can my child be vaccinated against smallpox? 
A: No. Smallpox vaccine is not available, and your child’s pediatrician cannot get the vaccine. The government has an emergency stockpile of smallpox vaccine, and they are in the process of contracting for development of more vaccine. The benefits and risks of re-introducing the smallpox vaccine are currently under review by public health officials.Sources: New York City Department of Health, American Academy of Pediatrics