Chapter 29 – Anthrax

The fear of Bacillus anthracis has been heightened in recent years as a result of the terrorist events in 2001 and the increase in acts of terrorism worldwide. There are few infectious agents that are more notorious than B. anthracis. B. anthracis would be an ideal weapon for a terror attack because of its potent and lethal nature in the course of causing anthrax disease. Once inside the host, the organism can proliferate and spread rapidly, resulting in systemic infection and release of soluble toxin factors; anthrax produces a high mortality rate if left undiagnosed and untreated. To complicate matters, the bacillus responsible for anthrax infection can survive long-term outside of its host as a dormant spore. Additionally, host animals and humans infected by the bacterium and its anthrax toxins can display general symptoms characteristic of numerous infections or disease states, prolonging the time required for immediate diagnosis to initiate early treatment. This chapter provides a structured and comprehensive insight into the history, pathogenesis, toxicity, toxicokinetics, mechanisms of action, risk assessment, and treatment of anthrax. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the US Army or the US Food and Drug Administration.