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Anthrax

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Anthrax



 
 
Anthrax is an acute disease
Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
 in humans and animals caused by the bacterium Bacillus anthracis
Bacillus anthracis

Bacillus anthracis is a very large bacterium compared to others. It is a Gram-positive spore-forming rod-shaped bacterium, with a width of 1-1.2?m and a length of 3-5?m....
, which is highly lethal in some forms. There are effective vaccines against anthrax, and some forms of the disease respond well to antibiotic treatment.

The anthrax bacillus
Bacillus

Bacillus is a genus of rod-shaped bacterium and a member of the division Firmicutes. Bacillus species are either obligate or facultative aerobes, and test positive for the enzyme catalase....
 is one of only a few that can form long-lived spore
Endospore

An endospore is a dormancy, tough, and non-reproductive structure produced by bacteria from the Firmicute phylum. Examples include Bacillus and Clostridium....
s: in a hostile environment, caused perhaps by the death of an infected host or extremes of temperature, the bacteria become inactive dormant spores which can remain viable for many decades and perhaps centuries.






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Encyclopedia


Anthrax is an acute disease
Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
 in humans and animals caused by the bacterium Bacillus anthracis
Bacillus anthracis

Bacillus anthracis is a very large bacterium compared to others. It is a Gram-positive spore-forming rod-shaped bacterium, with a width of 1-1.2?m and a length of 3-5?m....
, which is highly lethal in some forms. There are effective vaccines against anthrax, and some forms of the disease respond well to antibiotic treatment.

The anthrax bacillus
Bacillus

Bacillus is a genus of rod-shaped bacterium and a member of the division Firmicutes. Bacillus species are either obligate or facultative aerobes, and test positive for the enzyme catalase....
 is one of only a few that can form long-lived spore
Endospore

An endospore is a dormancy, tough, and non-reproductive structure produced by bacteria from the Firmicute phylum. Examples include Bacillus and Clostridium....
s: in a hostile environment, caused perhaps by the death of an infected host or extremes of temperature, the bacteria become inactive dormant spores which can remain viable for many decades and perhaps centuries. Spores are found on all continents except Antarctica
Antarctica

Antarctica is Earth's southernmost continent, overlying the South Pole. It is situated in the Antarctica of the southern hemisphere, almost entirely south of the Antarctic Circle, and is surrounded by the Southern Ocean....
. When spores are inhaled, ingested, or come into contact with a skin lesion on a host they reactivate and multiply rapidly.

Anthrax most commonly infects wild and domesticated herbivorous mammals which ingest or inhale the spores while eating grass or browsing. Ingestion is assumed to be the most common route by which herbivores contract anthrax, but this is yet to be proven. Carnivores living in the same environment may ingest infected animals and become infected themselves. Anthrax can also infect human
Human

A human being, also human or man, is a member of a species of bipedalism primates in the family Hominidae . Mitochondrial DNA evidence indicates that modern humans originated in east Africa about 200,000 years ago....
s when they are exposed to blood and other tissues from infected animals (via inhalation or direct inoculation through broken skin), eat tissue from infected animals, or are exposed to a high density of anthrax spore
Endospore

An endospore is a dormancy, tough, and non-reproductive structure produced by bacteria from the Firmicute phylum. Examples include Bacillus and Clostridium....
s from an animal's fur
Fur

Fur is a Hair of any non-human mammal, also known as the pelage. It may consist of short ground hair, long guard hair, and, in some cases, medium awn hair....
, hide
Hides

Hides are skins obtained from animals for human use. Examples of animal hide sources are deer and cattle typically used for producing leather, alligator skins, snake skins for shoes and fashion accessories and wild cats, minks and bears, whose skins are primarily sought for their fur....
, or wool
Wool

Wool is the fiber derived from the specialized skin cells, called follicles, of animals in the Caprinae family, principally domestic sheep, but the hair of certain species of other Mammalia such as cashmere goat, llamas, rabbits and keeshonds may also be called wool....
.

Anthrax spores can be grown in vitro
In vitro

In vitro refers to the technique of performing a given procedure in a controlled environment outside of a living organism. Some may argue that in vitro refers to a process that is created in a "test tube"; however, Robert Kail and John Cavanaugh on page 58 in the 4th edition of Human Development: A Life-Span View cite that in fact th...
 and used as a biological weapon. Anthrax does not spread directly from one infected animal or person to another, but spores can be transported by clothing, shoes etc.; and the body of a mammal that died of anthrax can be a very dangerous source of anthrax spores.

The name anthrax comes from anthrakitis, the Greek
Greek language

Greek is an Indo-European languages native to the southern Balkan peninsula, the language of the Greek people. It forms an independent branch within Indo-European....
 word for anthracite (coal), in reference to the black skin lesion
Lesion

A lesion is any abnormal tissue found on or in an organism, usually damaged by disease or trauma. Lesion is derived from the Latin word laesio which means injury....
s victims develop in a cutaneous skin infection
Infection

An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host resources to multiply ....
.

Overview

Anthrax is one of the oldest recorded diseases of grazing animals such as sheep and cattle and is believed to be the Sixth
Plagues of Egypt

The Plagues of Egypt , the Biblical Plagues or the Ten Plagues are the ten calamities imposed upon Ancient Egypt by Names of God in Judaism in the Bible , in order to convince Pharaoh of the Exodus to let the poorly treated Israelite slaves go...
 Plague
Plagues of Egypt

The Plagues of Egypt , the Biblical Plagues or the Ten Plagues are the ten calamities imposed upon Ancient Egypt by Names of God in Judaism in the Bible , in order to convince Pharaoh of the Exodus to let the poorly treated Israelite slaves go...
 mentioned in the Book of Exodus
Exodus

Exodus is the second book of the Jewish Torah and of the Christian Old Testament. It tells how Moses leads the Israelites out of Egypt and through the wilderness to the Mountain of God Sinai....
 in the Bible
Bible

The Bible is the central religious text of Judaism and Christianity. The exact Books of the Bible is dependent on the religious traditions of specific denominations....
. Anthrax is also mentioned by Greek and Roman authors such as Homer
Homer

Homer is traditionally held to be the author of the ancient Greek language epic poems the Iliad and the Odyssey, as well as of the Homeric Hymns....
 (in The Iliad
ILiad

The iLiad is an electronic handheld device, or e-book device, which can be used for document reading and editing. Like the Sony Reader or Amazon Kindle, the iLiad makes use of an electronic paper display....
), Virgil
Virgil

Publius Vergilius Maro was a classical Roman poet, best known for three major works?the Bucolics , the Georgics and the Aeneid?although several Appendix Vergiliana are also attributed to him....
 (Georgics
Georgics

The Georgics, published in 29 BCE, is the second major work by the Latin poet Virgil. Its ostensible subject is rural life and farming. It is generally described as Didacticism....
), and Hippocrates
Hippocrates

Hippocrates of Cos II or Hippokrates of Kos - ancient Greek: ; Hippokr?tes was an Ancient Greece physician of the Age of Pericles, and was considered one of the most outstanding figures in the history of medicine....
. Anthrax can also infect humans, usually as the result of coming into contact with infected animal hides, fur, wool ("Woolsorter's disease"), leather or contaminated soil. Anthrax ("siberian ulcer" ) is now fairly rare in humans, although it still regularly occurs in ruminants, such as cattle
Cattle

Cattle, colloquially referred to as cows, are domestication ungulates, a member of the subfamily Bovinae of the family Bovidae. They are raised as livestock for meat , dairy products , leather and as draft animals ....
, sheep
Sheep

#REDIRECT Domestic sheep...
, goat
Goat

The domestic goat is a subspecies of goat domesticated from the wild goat of southwest Asia and Eastern Europe. The goat is a member of the Bovidae family and is closely related to the sheep: both are in the goat-antelope subfamily Caprinae....
s, camel
Camel

Camels are even-toed ungulates within the genus Camelus. The dromedary, one-humped or Arabian camel has a single hump and is well known for its healthy low fat milk, and the Bactrian camel has two humps....
s, wild buffalo
Bovid

A bovid is any of almost 140 species of cloven-hoofed mammals belonging to the family Bovidae. The family is widespread, being native to all continents except South America, Australia and Antarctica, and diverse: members include domestic cattle, bison, water buffalo, antelopes, gazelles, sheep, goats and the muskox....
, and antelope
Antelope

Antelope are ruminant hoofed mammals of the family Bovidae in the order of even-toed ungulates. These animals are spread relatively evenly throughout the various subfamily of Bovidae and many are more closely related to cows or goats than to each other....
s, in hind-gut fermenters such as zebras and rhinos, and in other wildlife such as elephants and lions in certain endemic areas of the world.

Bacillus anthracis bacteria spores are soil-borne and because of their long lifetime, they are still present globally and at animal burial sites of anthrax-killed animals for many decades; spores have been known to have reinfected animals over 70 years after burial sites of anthrax-infected animals were disturbed.

Until the twentieth century, anthrax infections killed many hundreds and thousands of animals and hundreds or thousands of people each year in Europe, Asia, Africa, Australia, and Southern Vietnam, specifically in the concentration camps during WWI, and North America. French scientist Louis Pasteur
Louis Pasteur

Louis Pasteur was a France chemist and microbiologist best known for his remarkable breakthroughs in the causes and prevention of disease. His experiments supported the germ theory of disease, also reducing mortality from puerperal fever , and he created the first vaccine for rabies....
 developed the first effective vaccine for anthrax in 1881. Thanks to over a century of animal vaccination programs, sterilization of raw animal waste materials and anthrax eradication programs in North America, Australia, New Zealand, Russia, Europe and parts of Africa and Asia, anthrax infection is now relatively rare in domestic animals with normally only a few dozen cases reported every year. Anthrax is even rarer in dogs and cats: there had only ever been one documented case in dogs in the USA by 2001, although the disease affects livestock. Anthrax typically does not cause disease in carnivores and scavengers, even when these animals consume anthrax-infected carcasses. Anthrax outbreaks do occur in some wild animal populations with some regularity. The disease is more common in developing countries without widespread veterinary or human public health programs.

There are 89 known strains
Strain (biology)

In biology, strain is a low-level taxonomic rank used in three related ways....
 of anthrax, the most widely recognized being the virulent Ames strain
Ames strain

The Ames strain is one of 89 strain of the anthrax bacterium . It was isolated from a diseased cow that died in Texas in 1981. Researchers at the time mistakenly believed the strain came from Ames, Iowa and mislabeled the specimen....
 used in the 2001 anthrax attacks
2001 anthrax attacks

The 2001 anthrax attacks in the United States, also known as Amerithrax from its Federal Bureau of Investigation case name, occurred over the course of several weeks beginning on September 18, 2001....
 in the United States, when people were sent anthrax in the mail. The Ames strain is extremely dangerous, though not quite as virulent as the Vollum strain which was successfully developed as a biological weapon during the Second World War, but never used. The Vollum (also incorrectly referred to as Vellum) strain was isolated in 1935 from a cow in Oxfordshire
Oxfordshire

Oxfordshire is a county in the South East England region, bordering on Northamptonshire, Buckinghamshire, Berkshire, Wiltshire, Gloucestershire, and Warwickshire....
, UK
United Kingdom

The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom , the UK or Britain,is a sovereign state located off the northwestern coast of continental Europe....
. This is the same strain that was used during the Gruinard
Gruinard Island

Gruinard Island is a small, oval-shaped Scotland island approximately 2 kilometres long by 1 km wide, located in Gruinard Bay, about halfway between Gairloch and Ullapool....
 bioweapons trials. A variation of Vollum known as "Vollum 1B" was used during the 1960s in the US and UK bioweapon programs. Vollum 1B was isolated from William A. Boyles, a 46-year-old USAMRIID scientist who died in 1951 after being accidentally infected with the Vollum strain. The Sterne strain, named after a South African researcher, is an attenuated strain used as a vaccine.

Description of the bacterium

Gram Stain Anthrax
Bacillus anthracis is a rod-shaped Gram-positive
Gram-positive

Gram-positive Bacteria are those that are stained dark blue or violet by Gram staining. This is in contrast to Gram-negative bacteria, which cannot retain the crystal violet stain, instead taking up the counterstain and appearing red or pink....
 bacterium, about 1 by 9 micrometers in size. It was shown to cause disease by Robert Koch
Robert Koch

Heinrich Hermann Robert Koch was a German physician. He became famous for isolating Bacillus anthracis , the Mycobacterium tuberculosis and the Vibrio cholerae and for his development of Koch's postulates....
 in 1877. The bacterium normally rests in endospore
Endospore

An endospore is a dormancy, tough, and non-reproductive structure produced by bacteria from the Firmicute phylum. Examples include Bacillus and Clostridium....
 form in the soil, and can survive for up to decades in this state. Herbivores are often infected whilst grazing or browsing, especially when eating rough, irritant or spiky vegetation: the vegetation has been hypothesized to cause wounds within the gastrointestinal tract
Gastrointestinal tract

The digestive tract is the system of Organ s within multicellular animals that takes in food, digestion it to extract energy and nutrients, and expels the remaining waste....
 permitting entry of the bacterial endo-spores into the tissues, though this has not been proven. Once ingested or placed in an open cut, the bacterium begins multiplying inside the animal or human and typically kills the host within a few days or weeks. The endo-spores germinate at the site of entry into the tissues and then spread via the circulation to the lymphatics, where the bacteria multiply. It is the production of two powerful exo-toxins (edema toxin and lethal toxin) by the bacteria that causes death. Veterinarians can often tell a possible anthrax-induced death by its sudden occurrence, and by the dark, non-clotting blood that oozes from the body orifices. Most anthrax bacteria inside the body after death are out-competed and destroyed by anaerobic bacteria within minutes to hours post-mortem. However, anthrax vegetative bacteria that escape the body via oozing blood or through the opening of the carcass may form hardy spores. One spore forms per one vegetative bacterium. The triggers for spore formation are not yet known, though oxygen tension and lack of nutrients may play roles. Once formed, these spores are very hard to eradicate.

The infection of herbivores (and occasionally humans) via the inhalational route normally proceeds as follows: once the spores are inhaled, they are transported through the air passages into the tiny air sacs (alveoli) in the lungs. The spores are then picked up by scavenger cells (macrophage
Macrophage

Macrophages are white blood cells within tissues, produced by the division of monocytes. Human macrophages are about 21 micrometres in diameter....
s) in the lungs and are transported through small vessels (lymphatics
Lymphatic system

The lymphatic system in vertebrates is a network of conduits that carry a clear fluid called lymph. It also includes the lymphoid tissue through which the lymph travels....
) to the lymph nodes in the central chest cavity (mediastinum
Mediastinum

The mediastinum is a non-delineated group of structures in the thorax , surrounded by loose connective tissue. It is the central compartment of the thoracic cavity....
). Damage caused by the anthrax spores and bacilli to the central chest cavity can cause chest pain and difficulty breathing. Once in the lymph nodes, the spores germinate into active bacilli which multiply and eventually burst the macrophages, releasing many more bacilli into the bloodstream to be transferred to the entire body. Once in the blood stream these bacilli release three substances: lethal factor, oedema factor and protective antigen. Protective antigen combines with these other two factors to form lethal toxin and oedema toxin, respectively. These toxins are the primary agents of tissue destruction, bleeding, and death of the host. If antibiotics are administered too late, even if the antibiotics eradicate the bacteria, some hosts will still die. This is because the toxins produced by the bacilli remain in their system at lethal dose levels.

In order to enter the cells, the edema and lethal factors use another protein produced by B. anthracis, protective antigen. Oedema factor inactivates neutrophils (a type of phagocytic cell) so that they cannot phagocytose bacteria. Historically, it was believed that lethal factor caused macrophages to make TNF-alpha and interleukin 1, beta
IL1B

Interleukin 1, beta, also known as IL1B, is a cytokine protein which in humans is encoded by the IL1B gene. IL-1? precursor is cleaved by caspase 1 ....
 (IL1B), both normal components of the immune system used to induce an inflammatory reaction, ultimately leading to septic shock
Septic shock

Septic shock is a serious medicine condition caused by decreased tissue perfusion and oxygen delivery as a result of infection and sepsis, though the microbe may be systemic or localized to a particular site....
 and death. However, recent evidence indicates that anthrax also targets endothelial cells (cells that lines serous cavities, lymph vessels, and blood vessels), causing vascular leakage of fluid and cells, and ultimately hypovolemic shock (low blood volume), and septic shock.

The virulence of a strain of anthrax is dependent on multiple factors, primarily the poly-D-glutamic acid capsule that protects the bacterium from phagocytosis by host neutrophils and its toxins
Anthrax toxin

Anthrax toxin refers to three proteins secreted by virulent strains of the bacterium Bacillus anthracis. These three proteins act together in a synergistic way in which they are endocytosis and translocated into the cytoplasm of a macrophage, where it disrupts cellular signaling and induces cell death, allowing the bacteria to evade the i...
, edema toxin and lethal toxin.

Exposure

Occupational exposure to infected animals or their products (such as skin wool and meat) is the usual pathway of exposure for humans. Workers who are exposed to dead animals and animal products are at the highest risk, especially in countries where anthrax is more common. Anthrax in livestock grazing on open range where they mix with wild animals still occasionally occurs in the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
 and elsewhere. Many workers who deal with wool and animal hides are routinely exposed to low levels of anthrax spores but most exposures are not sufficient to develop anthrax infections. Presumably, the body’s natural defenses can destroy low levels of exposure. These people usually contract cutaneous anthrax if they catch anything. Historically, the most dangerous form of inhalational anthrax was called Woolsorters' disease because it was an occupational hazard for people who sorted wool. Today this form of infection is extremely rare as there are almost no infected animals any more. The last fatal case of natural inhalational anthrax in the United States occurred in California in 1976, when a home weaver died after working with infected wool imported from Pakistan. The autopsy was done at UCLA hospital. To minimize the chance of spreading the disease, the deceased was transported to UCLA in a sealed plastic body bag within a sealed metal container.

In November 2008, a drum maker in the United Kingdom who worked with untreated animal skins became the latest person to die from anthrax.

Mode of infection

Anthrax   Inhalational
Anthrax can enter the human body through the intestines (ingestion), lungs (inhalation), or skin (cutaneous) and causes distinct clinical symptoms based on its site of entry. An infected human will generally be quarantined. However, anthrax does not usually spread from an infected human to a noninfected human. But if the disease is fatal the person’s body and its mass of anthrax bacilli becomes a potential source of infection to others and special precautions should be used to prevent further contamination. Inhalational anthrax, if left untreated until obvious symptoms occur.

Anthrax can be contracted in laboratory accidents or by handling infected animals or their wool or hides. It has also been used in biological warfare
Biological warfare

Biological warfare , also known as germ warfare, is the use of pathogens as biological weapons . Using nonliving toxic products, even if produced by living organisms , is considered chemical warfare under the provisions of the Chemical Weapons Convention....
 agents and by terrorists
Terrorism

Terrorism, according to the Merriam-Webster online dictionary, is the systematic use of terror, "violent or destructive acts committed by groups in order to intimidate a population or government into granting their demands." At present, there is no internationally agreed upon definition of terrorism....
 to intentionally infect humans, as occurred in, for example, the 2001 anthrax attacks
2001 anthrax attacks

The 2001 anthrax attacks in the United States, also known as Amerithrax from its Federal Bureau of Investigation case name, occurred over the course of several weeks beginning on September 18, 2001....
.

Pulmonary (pneumonic, respiratory, or inhalational) anthrax


Respiratory infection in humans initially presents with cold or flu-like symptoms for several days, followed by severe (and often fatal) respiratory collapse. This disease can rarely be treated, even if caught in early stages of infection; mortality is nearly 100%. A lethal infection is reported to result from inhalation of about 10,000–20,000 spores, though this dose varies amongst host species. Like all diseases there is probably a wide variation to susceptibility with evidence that some people may die from much lower exposures; there is little documented evidence to verify the exact or average number of spores needed for infection. Inhalational anthrax is also known as woolsorters' or ragpickers' disease as these professions were more susceptible to the disease due to their exposure to infected animal products. Other practices associated with exposure include the slicing up of animal horns for the manufacture of buttons, the handling of hair bristles used for the manufacturing of brushes, and the handling of animal skins. Whether these animal skins came from animals that died of the disease or from animals that had simply laid on ground that had spores on it is unknown. This mode of infection is used as a bioweapon.

Gastrointestinal (gastroenteric) anthrax

Gastrointestinal infection in humans is most often caused by eating anthrax-infected meat and is characterized by serious gastrointestinal difficulty, vomiting
Vomiting

Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Undesired vomiting may result from many causes, ranging from gastritis or poisoning to brain tumors, or elevated intracranial pressure....
 of blood, severe diarrhea, acute inflammation of the intestinal tract, and loss of appetite. Some lesions have been found in the intestines and in the mouth and throat. After the bacteria invades the bowel system, it spreads through the bloodstream throughout the body, making even more toxins on the way. Gastrointestinal infections can be treated but usually result in fatality rates of 25% to 60%, depending upon how soon treatment commences.

Cutaneous (skin) anthrax


Cutaneous (on the skin) anthrax infection in humans shows up as a boil-like skin lesion that eventually forms an ulcer with a black centre (eschar). The black eschar often shows up as a large, painless necrotic ulcer (beginning as an irritating and itchy skin lesion or blister that is dark and usually concentrated as a black dot, somewhat resembling bread mold) at the site of infection. Cutaneous infections generally form within the site of spore penetration between 2 and 5 days after exposure. Unlike bruises or most other lesions, cutaneous anthrax infections normally do not cause pain.

Cutaneous anthrax is rarely fatal if treated, but without treatment about 20% of cutaneous skin infection cases progress to toxemia
Toxemia

Toxaemia is a generic term for the presence of toxins in the blood. It may refer to:* Bacteremia, bacterial toxins in the blood* Pre-eclampsia, a serious condition in pregnancy, one symptom of which is abnormal protein metabolism....
 and death.

Treatment and prevention

Anthrax cannot be spread directly from person to person, but a patient’s clothing and body may be contaminated with anthrax spores. Effective decontamination of people can be accomplished by a thorough wash down with antimicrobial
Antimicrobial

An antimicrobial is a substance that kills or inhibits the growth of microbes such as bacteria, fungi, protozoals or viruses. Antimicrobial drugs either kill microbes or prevent the growth of microbes ....
 effective soap and water. Waste water should be treated with bleach or other anti-microbial agent. Effective decontamination of articles can be accomplished by boiling contaminated articles in water for 30 minutes or longer. Chlorine bleach is ineffective in destroying spores and vegetative cells on surfaces, though formaldehyde is effective. Burning clothing is very effective in destroying spores. After decontamination, there is no need to immunize, treat or isolate contacts of persons ill with anthrax unless they were also exposed to the same source of infection. Early antibiotic treatment of anthrax is essential—delay seriously lessens chances for survival. Treatment for anthrax infection and other bacterial infections includes large doses of intravenous and oral antibiotic
Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
s, such as fluoroquinolone
Quinolone

The quinolones are a family of chemical synthesis broad-spectrum antibiotics. The wikt:parent compound of the group is nalidixic acid. The majority of quinolones in clinical use belong to the subset of fluoroquinolones, which have a fluorine atom attached the central ring system, typically at the 6-position....
s, like ciprofloxacin
Ciprofloxacin

Ciprofloxacin is a synthetic chemotherapeutic agent used to treat severe and life threatening bacterial infections. Ciprofloxacin is commonly referred to as a fluoroquinolone drug and is a member of the quinolone class of antibacterials....
 (cipro), doxycycline
Doxycycline

Doxycycline is a member of the tetracycline antibiotics group and is commonly used to treat a variety of infections. Doxycycline is a semi-synthetic tetracycline invented and clinically developed in the early 1960s by Pfizer and marketed under the brand name Vibramycin....
, erythromycin
Erythromycin

Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins....
, vancomycin
Vancomycin

Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacterium. It has traditionally been reserved as a drug of last resort, used only after treatment with other antibiotics had failed, although the emergence of vancomycin-resistant organisms means that it is increasingly being...
 or penicillin
Penicillin

Penicillin is a group of antibiotics derived from Penicillium fungi. They are Beta-lactam antibiotics used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms....
. In possible cases of inhalation anthrax, early antibiotic prophylaxis
Prophylaxis

Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. Roughly, prophylactic measures are divided between primary prophylaxis and secondary prophylaxis ....
 treatment is crucial to prevent possible death. If death occurs from anthrax the body should be isolated to prevent possible spread of anthrax germs. Burial does not kill anthrax spores.

If a person is suspected as having died from anthrax, every precaution should be taken to avoid skin contact with the potentially contaminated body and fluids exuded through natural body openings. The body should be put in strict quarantine. A blood sample taken in a sealed container and analyzed in an approved lab should be used to ascertain if anthrax is the cause of death. Microscopic visualization of the encapsulated bacilli, usually in very large numbers, in a blood smear stained with polychrome methylene blue (McFadyean stain) is fully diagnostic, though culture of the organism is still the gold standard for diagnosis. Full isolation of the body is important to prevent possible contamination of others. Protective, impermeable clothing and equipment such as rubber glove
Rubber glove

A rubber glove is a glove made out of rubber. Its primary purpose is protection of the hands while performing tasks involving chemicals. Rubber gloves are worn during dishwashing to protect the hands from detergent and allow the use of hotter water....
s, rubber apron, and rubber boots with no perforations should be used when handling the body. No skin, especially if it has any wounds or scratches, should be exposed. Disposable personal protective equipment is preferable, but if not available, decontamination can be achieved by autoclaving. Disposable personal protective equipment and filters should be autoclaved, and/or burned and buried. Bacillus anthracis bacillii range from 0.5-5.0 µm in size. Anyone working with anthrax in a suspected or confirmed victim should wear respiratory equipment capable of filtering this size of particle or smaller. The US National Institute for Occupational Safety and Health
National Institute for Occupational Safety and Health

The National Institute for Occupational Safety and Health is the United States federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness....
 (NIOSH) and Mine Safety and Health Administration
Mine Safety and Health Administration

The Mine Safety and Health Administration is an agency of the United States Department of Labor which administers the provisions of the Federal Mine Safety and Health Act of 1977 to enforce compliance with mandatory safety and health standards as a means to eliminate fatal accidents, to reduce the frequency and severity of nonfatal accide...
 (MSHA) approved high efficiency-respirator, such as a half-face disposable respirator with a high-efficiency particulate air (HEPA) filter, is recommended. All possibly contaminated bedding or clothing should be isolated in double plastic bags and treated as possible bio-hazard waste. The victim should be sealed in an airtight body bag. Dead victims that are opened and not burned provide an ideal source of anthrax spores. Cremating victims is the preferred way of handling body disposal. No embalming or autopsy should be attempted without a fully equipped biohazard lab and trained and knowledgeable personnel.

Delays of only a few days may make the disease untreatable and treatment should be started even without symptoms if possible contamination or exposure is suspected. Animals with anthrax often just die without any apparent symptoms. Initial symptoms may resemble a common cold – sore throat, mild fever, muscle aches and malaise. After a few days, the symptoms may progress to severe breathing problems and shock and ultimately death. Death can occur from about two days to a month after exposure with deaths apparently peaking at about 8 days after exposure. Antibiotic-resistant strains of anthrax are known.

In recent years there have been many attempts to develop new drugs against anthrax, but existing drugs are effective if treatment is started soon enough.

Early detection of sources of anthrax infection can allow preventative measures to be taken. In response to the anthrax attacks of October, 2001 the United States Postal Service
United States Postal Service

The United States Postal Service is an Independent agencies of the United States government responsible for providing postal service in the United States....
 (USPS) installed BioDetection Systems (BDS) in their large scale mail cancellation facilities. BDS response plans were formulated by the USPS in conjunction with local responders including fire, police, hospitals and public health. Employees of these facilities have been educated about anthrax, response actions and prophylactic
Prophylaxis

Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. Roughly, prophylactic measures are divided between primary prophylaxis and secondary prophylaxis ....
 medication. Because of the time delay inherent in getting final verification that anthrax has been used, prophylactic antibiotic
Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
 treatment of possibly exposed personnel must be started as soon as possible.

The most effective form of prevention is vaccination
Anthrax vaccine

Anthrax vaccines are vaccines against the infectious disease anthrax. Anthrax is caused by the spore-forming bacterium Bacillus anthracis, that most commonly occurs in wild and domestic mammals....
 against infection but this must be done well in advance of exposure to the bacillus, and does not protect indefinitely.

Components of tea
Tea

Tea refers to the agricultural products of the leaves, leaf buds, and internodes of the Camellia sinensis plant, prepared and cured by various methods....
, such as polyphenol
Polyphenol

Polyphenols are a group of chemical substances found in plants, characterized by the presence of more than one phenol unit or building block per molecule....
s, have the ability to inhibit the activity both of bacillus anthracis and its toxin considerably; spores, however, are not affected. The addition of milk to the tea completely inhibits its antibacterial activity against anthrax. Activity against the anthrax bacillum in the laboratory
Laboratory

A laboratory is a facility that provides controlled conditions in which science research, experiments, and measurement may be performed. The title of laboratory is also used for certain other facilities where the processes or equipment used are similar to those in scientific laboratories....
 does not prove that drinking tea affects the course of an infection.

Anthrax vaccines

An FDA-licensed vaccine, produced from one non-virulent strain of the anthrax bacterium, is manufactured by BioPort Corporation, subsidiary of Emergent BioSolutions. The trade name is BioThrax, although it is commonly called Anthrax Vaccine Adsorbed (AVA). It is administered in a six-dose primary series at 0,2,4 weeks and 6,12,18 months; annual booster injections are required thereafter to maintain immunity. The injections are typically very painful, and may leave the area of injection with swelling; this area may be painful for several days.

Unlike the West, the Soviets developed and used a live spore anthrax vaccine, known as the STI vaccine, produced in Tbilisi, Georgia. Its serious side effects restrict use to healthy adults.

Site cleanup

Anthrax spores can survive for long periods of time in the environment after release. Methods for cleaning anthrax-contaminated sites commonly use oxidizing agent
Oxidizing agent

An oxidizing agent can be defined as either:#a chemical compound that readily transfers oxygen atoms, or#a substance that gains electrons in a redox chemical reaction...
s such as peroxides, ethylene oxide, Sandia Foam, chlorine dioxide (used in Hart Senate office building), and liquid bleach products containing sodium hypochlorite. These agents slowly destroy bacterial spores. A bleach solution for treating hard surfaces has been approved by the EPA. It can be prepared by mixing one part bleach (5.25%-6.00%) to one part white vinegar to eight parts water. Bleach and vinegar must not be combined together directly, as doing so could produce chlorine
Chlorine

Chlorine...
 gas. Rather some water must first be added to the bleach (e.g., two cups water to one cup of bleach), then vinegar (e.g., one cup), and then the rest of the water (e.g., six cups). The pH of the solution should be tested with a paper test strip; and treated surfaces must remain in contact with the bleach solution for 60 minutes (repeated applications will be necessary to keep the surfaces wet).

Chlorine dioxide
Chlorine dioxide

Chlorine dioxide is a chemical compound with the formula ClO2. This reddish-yellow gas crystallizes as orange crystals at -59 ?C. As one of several oxides of chlorine, it is a potent and useful oxidizing agent used in water treatment and in bleaching....
 has emerged as the preferred biocide against anthrax-contaminated sites, having been employed in the treatment of numerous government buildings over the past decade. Its chief drawback is the need for in situ
In situ

In situ is a Latin phrase meaning in the place. It is used in many different contexts....
 processes to have the reactant on demand.

To speed the process, trace amounts of a non-toxic catalyst composed of iron
Iron

Iron is a chemical element with the symbol Fe and atomic number 26. Iron is a Group 8 element and period 4 element. Iron is lustrous and silvery in color....
 and tetro-amido macrocyclic ligand
Ligand

In chemistry, a ligand is either an atom, ion, or molecule that bonds to a central metal, generally involving formal donation of one or more of its electrons....
s are combined with sodium carbonate
Sodium carbonate

Sodium carbonate , , is a sodium salt of carbonic acid. It most commonly occurs as a crystalline heptahydrate, which readily efflorescence to form a white powder, the monohydrate....
 and bicarbonate
Bicarbonate

In inorganic chemistry, bicarbonate is an intermediate form in the deprotonation of carbonic acid. Its chemical formula is HCO3−....
 and converted into a spray. The spray formula is applied to an infested area and is followed by another spray containing tertiary-butyl hydroperoxide.

Using the catalyst method, a complete destruction of all anthrax spores takes 30 minutes. A standard catalyst-free spray destroys fewer than half the spores in the same amount of time. They can be heated, exposed to the harshest chemicals, and they do not easily die.

Cleanups at a Senate office building, several contaminated postal facilities and other U.S. government and private office buildings showed that decontamination is possible, but it is time-consuming and costly. Clearing the Senate office building of anthrax spores cost $27 million, according to the Government Accountability Office. Cleaning the Brentwood postal facility outside Washington cost $130 million and took 26 months. Since then newer and less costly methods have been developed.

Clean up of anthrax-contaminated areas on ranches and in the wild is much more problematic. Carcasses may be burned, though it often takes up to three days to burn a large carcass and this is not feasible in areas with little wood. Carcasses may be buried, though the burying of large animals deeply enough to prevent resurfacing of spores requires much manpower and expensive tools. Carcasses have been soaked in formaldehyde to kill spores, though this has obvious environmental contamination issues. Block burning of vegetation in large areas enclosing an anthrax outbreak has been tried; this, while environmentally destructive, causes healthy animals to move away from an area with carcasses in search of fresh graze and browse. Some wildlife workers have experimented with covering fresh anthrax carcasses with shadecloth and heavy objects. This prevents some scavengers from opening the carcasses, thus allowing the putrefactive bacteria within the carcass to kill the vegetative B. anthracis cells and preventing sporulation. This method also has drawbacks, as scavengers such as hyenas are capable of infiltrating almost any exclosure. The occurrence of previously dormant anthrax, stirred up from below the ground surface by wind movement in a drought-stricken region with depleted grazing and browsing, may be seen as a form of natural culling and a first step in rehabilitation of the area.

History


Discovery

Robert Koch
Robert Koch

Heinrich Hermann Robert Koch was a German physician. He became famous for isolating Bacillus anthracis , the Mycobacterium tuberculosis and the Vibrio cholerae and for his development of Koch's postulates....
, a German physician and scientist, first identified the bacteria which caused the anthrax disease in 1875. His pioneering work in the late nineteenth century was one of the first demonstrations that diseases could be caused by microbes. In a groundbreaking series of experiments he uncovered the life cycle and means of transmission of anthrax. His experiments not only helped create an understanding of anthrax, but also helped elucidate the role of microbes in causing illness at a time when debates were still held over spontaneous generation
Spontaneous generation

Spontaneous generation or Equivocal generation is an obsolete theory regarding the origin of life from inanimate matter, which held that this process was a commonplace and everyday occurrence, as distinguished from Univocal generation, or reproduction from parent....
 versus cell theory
Cell theory

Cell theory refers to the idea that Cell s are the basic unit of structure in every living thing. Development of this theory#Science during the mid 1600s was made possible by advances in microscopy....
. Koch went on to study the mechanisms of other diseases and was awarded the 1905 Nobel Prize in Physiology or Medicine for his discovery of the bacteria causing tuberculosis. Koch is today recognized as one of history's most important biologists and a founder of modern bacteriology.

First vaccination

In May 1881 Louis Pasteur
Louis Pasteur

Louis Pasteur was a France chemist and microbiologist best known for his remarkable breakthroughs in the causes and prevention of disease. His experiments supported the germ theory of disease, also reducing mortality from puerperal fever , and he created the first vaccine for rabies....
 performed a public experiment to demonstrate his concept of vaccination. He prepared two groups of 25 sheep
Sheep

#REDIRECT Domestic sheep...
, one goat and several cows. The animals of one group were injected with an anti-anthrax vaccine
Vaccine

A vaccine is a biological preparation that establishes or improves immunity to a particular disease.Vaccines can be prophylaxis , or Medication ....
 prepared by Pasteur twice, at an interval of 15 days; the control group was left unvaccinated. Thirty days after the first injection both groups were injected with a culture of live anthrax bacteria. All the animals in the non-vaccinated group died, while all of the animals in the vaccinated group survived.

After mastering method of vaccination Pasteur applied the concept to rabies
Rabies

Rabies is a virus zoonotic neurotropic virus disease that causes acute encephalitis in mammals. It is most commonly caused by a bite from an infected animal, but occasionally by other forms of contact....
. He went on to develop vaccines against small pox, cholera
Cholera

Cholera, sometimes known as Asiatic or epidemic cholera, is an infectious gastroenteritis caused by enterotoxin-producing strains of the bacterium Vibrio cholerae....
, and swine erysipelas.

The human vaccine for anthrax became available in 1954. This was a cell-free vaccine instead of the live-cell Pasteur-style vaccine used for veterinary purposes. An improved cell-free vaccine became available in 1970.

Biological warfare


"Anthrax was first tested as a biological warfare agent by Unit 731 of the Japanese Kwantung Army in Manchuria during the 1930s; some of this testing involved intentional infection of prisoners of war, thousands of whom died. Anthrax, designated at the time as Agent N, was also investigated by the allies in the 1940s. The British army tested experimental anthrax weapons on Gruinard Island, off the northwest coast of Scotland, in 1943. Gruinard was burned over at least once, yet as of the late 1980s, it was still too heavily contaminated with spores to allow unprotected human access, indicating the hardiness of anthrax spores. Weaponized anthrax was part of the U.S. stockpile prior to its destruction in 1972."

Powell Anthrax Vial
Anthrax spores can and have been used as a biological warfare
Biological warfare

Biological warfare , also known as germ warfare, is the use of pathogens as biological weapons . Using nonliving toxic products, even if produced by living organisms , is considered chemical warfare under the provisions of the Chemical Weapons Convention....
 weapon. Its first modern incidence occurred when Scandinavian "freedom fighters" (the rebel groups) supplied by the German General Staff used anthrax with unknown results against the Imperial Russian Army in Finland in 1916. There is a long history of practical bioweapons research in this area. For example, in 1942 British
United Kingdom

The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom , the UK or Britain,is a sovereign state located off the northwestern coast of continental Europe....
 bioweapons trials severely contaminated Gruinard Island
Gruinard Island

Gruinard Island is a small, oval-shaped Scotland island approximately 2 kilometres long by 1 km wide, located in Gruinard Bay, about halfway between Gairloch and Ullapool....
 in Scotland
Scotland

conventional_long_name = ScotlandAlba|common_name= Scotland|image_flag = Flag of Scotland.svg|flag_width = 130px...
 with anthrax spores of the Vollum-14578 strain, making it a no-go area until it was decontaminated in 1990. The Gruinard trials involved testing the effectiveness of a submunition of an "N-bomb"—a biological weapon. Additionally, five million "cattle cakes" impregnated with anthrax were prepared and stored at Porton Down
Porton Down

Porton Down is an UK government and military science park. It is situated slightly northeast of Porton near Salisbury, England in Wiltshire, England....
 in 'Operation Vegetarian'—an anti-livestock weapon intended for attacks on Germany
Germany

Germany , officially the Federal Republic of Germany , is a country in Central Europe. It is bordered to the north by the North Sea, Denmark, and the Baltic Sea; to the east by Poland and the Czech Republic; to the south by Austria and Switzerland; and to the west by France, Luxembourg, Belgium, and the Netherlands....
 by the Royal Air Force
Royal Air Force

The Royal Air Force is the United Kingdom's air force, the oldest independent air force in the world. Formed on 1 April 1918, the RAF has taken a significant role in British military history ever since, playing a large part in World War II and in more recent conflicts....
 The infected cattle cakes were to be dropped on Germany in 1944. However neither the cakes nor the bomb were used; the cattle cakes were incinerated in late 1945.

More recently the Rhodesia
Rhodesia

Rhodesia was the name adopted when the formerly British colonies of Southern Rhodesia declared itself independent on 11 November 1965. The name was also used with the establishment of Zimbabwe Rhodesia in 1979....
n government used anthrax against cattle and humans in the period 1978–1979 during its war with black nationalists.

American military
Military of the United States

The United States Armed Forces are the overall unified armed forces of the United States. The United States military was first formed by the second Second Continental Congress to defend the new nation against the British Empire in the American Revolutionary War....
 and British Army
British Army

The British Army is the Army branch of the British Armed Forces. It came into being with the unification of the Kingdoms of Kingdom of England and Kingdom of Scotland into the Kingdom of Great Britain in 1707....
 personnel are routinely vaccinated against anthrax prior to active service in places where biological attacks are considered a threat. The anthrax vaccine
Anthrax vaccine

Anthrax vaccines are vaccines against the infectious disease anthrax. Anthrax is caused by the spore-forming bacterium Bacillus anthracis, that most commonly occurs in wild and domestic mammals....
, produced by BioPort Corporation, contains non-living bacteria, and is approximately 93% effective in preventing infection.

Weaponized stocks of anthrax in the US were destroyed in 1971–72 after President Nixon
Richard Nixon

Richard Milhous Nixon was the List of Presidents of the United States President of the United States and the only president to resign the office....
 ordered the dismantling of US biowarfare programs in 1969 and the destruction of all existing stockpiles of bioweapons. Research is known to continue in the United States on ways to counteract bioweapons attacks.

The Soviet Union created and stored 100 to 200 tons of anthrax spores on Vozrozhdeniya Island
Vozrozhdeniya Island

This article is about the island. For the album by folk metal band Arkona , see Vozrozhdeniye.Vozrozhdeniya Island, also known as Rebirth Island , is a former List of islands in lakes, now a peninsula, in the Aral Sea....
. They were abandoned in 1992 and destroyed in 2002.

Soviet accident: April 2, 1979


Despite signing the 1972 agreement to end bioweapon production the government of the Soviet Union had an active bioweapons program that included the production of hundreds of tons of weapons-grade anthrax after this period. On April 2, 1979 some of the over one million people living in Sverdlovsk (now called Ekaterinburg, Russia), about 850 miles east of Moscow, were exposed to an accidental release of anthrax
Sverdlovsk anthrax leak

The Sverdlovsk anthrax leak is an incident when spores of anthrax were accidentally released from a military facility in the city of Sverdlovsk 900 miles east of Moscow on April 2, 1979....
 from a biological weapons complex located near there. At least 94 people were infected, of whom at least 68 died. One victim died four days after the release, ten over an eight-day period at the peak of the deaths, and the last six weeks later. Extensive cleanup, vaccinations and medical interventions managed to save about 30 of the victims. Extensive cover-ups and destruction of records by the KGB
KGB

KGB is the Russian language abbreviation of Committee for State Security , which was the official name of the umbrella organization serving as the Soviet Union's premier security agency, secret police, and intelligence agency, from 1954 to 1991....
 continued from 1979 until Russian President Boris Yeltsin
Boris Yeltsin

Boris Nikolayevich Yeltsin was the first President of the Russian Federation, serving from 1991 to 1999.Yeltsin came to power with a wave of high expectations....
 admitted this anthrax accident in 1992. Jeanne Guillemin reported in 1999 that a combined Russian and United States team investigated the accident in 1992.

Nearly all of the night shift workers of a ceramics plant directly across the street from the biological facility (compound 19) became infected, and most died. Since most were men, there were suspicions by Western governments that the Soviet Union had developed a sex-specific weapon. The government blamed the outbreak on the consumption of anthrax-tainted meat and ordered the confiscation of all uninspected meat that entered the city. They also ordered that all stray dog
Stray dog

Stray dog or stray dogs may refer to:Dogs:* Any sort of feral dog* Pariah dog, a certain type of feral dogMusic:*Stray Dogs , a 2003 album by the Norwegian singer/songwriter Thomas Dybdahl...
s be shot and that people not have contact with sick animals. There was also a voluntary evacuation and anthrax vaccination program established for people from 18–55.

To support the cover-up
Cover-up

A cover-up is an attempt, whether successful or not, to concealment evidence of wrong-doing, error, incompetence or other embarrassment information....
 story Soviet medical and legal journals published articles about an outbreak in livestock that caused GI anthrax in people who consumed infected meat, and cutaneous anthrax in people who came into contact with the animals. All medical and public health records were confiscated by the KGB. In addition to the medical problems that the outbreak caused, it also prompted Western countries to be (justifiably) more suspicious of a covert Soviet Bioweapons program and to increase their surveillance of suspected sites. In 1986 the US government was allowed to investigate the incident, and concluded that the exposure was from aerosol anthrax from a military weapons facility. In 1992, President Yeltsin admitted that he was "absolutely certain" that "rumors" about the Soviet Union violating the 1972 Bioweapons Treaty were true. The Soviet Union, like the US and UK, had agreed to submit information to the UN about their bioweapons programs but omitted known facilities and never acknowledged their weapons program.

Anthrax bioterrorism


Theoretically anthrax spores can be cultivated with minimal special equipment and a first-year collegiate microbiological
Microbiology

Microbiology is the study of microorganisms, which are unicellular or cell-cluster microscopic organisms. This includes eukaryote such as fungi and protists, and prokaryotes, which are bacteria and archaea....
 education, but in practice the procedure is difficult and dangerous. To make large amounts of an aerosol
Particulate

Particulates, alternatively referred to as particulate matter or fine particles, are tiny particles of solid or liquid suspended in a gas or liquid....
 form of anthrax suitable for biological warfare, extensive practical knowledge, training and highly advanced equipment are required.

Concentrated anthrax spores were used for bioterrorism
Bioterrorism

Bioterrorism is terrorism by intentional release or dissemination of biological agents ; these may be in a naturally-occurring or in a human-modified form....
 in the 2001 anthrax attacks
2001 anthrax attacks

The 2001 anthrax attacks in the United States, also known as Amerithrax from its Federal Bureau of Investigation case name, occurred over the course of several weeks beginning on September 18, 2001....
 in the United States, delivered by mailing postal letters containing the spores. Only a few grams of material were used in these attacks and in August 2008 the US Department of Justice announced they believed that Dr. Bruce Ivins
Bruce Edwards Ivins

Bruce Edwards Ivins was a microbiologist, vaccine, senior biodefense researcher at the United States Army Medical Research Institute of Infectious Diseases in Fort Detrick, Maryland and a key investigator in the 2001 anthrax attacks....
, a senior biodefense researcher, was responsible. These events also spawned many anthrax hoaxes
Anthrax hoaxes

The following hoaxes have been perpetrated using anthrax as an implied threat.*April 24, 1997: A petri dish containing red slurry labeled Anthracis Yersinia was sent to B'nai B'rith international offices headquartered in Washington DC....
.

Decontaminating mail

In response to the postal anthrax attacks and hoaxes the US Postal Service sterilized some mail using a process of gamma irradiation
Irradiation

Irradiation is the process by which an item is exposed to radiation. The exposure can be intentional, sometimes to serve a specific purpose, or it can be accidental....
 and treatment with a proprietary enzyme
Enzyme

Enzymes are biomolecules that catalysis chemical reactions. Almost all enzymes are proteins. In enzymatic reactions, the molecules at the beginning of the process are called Substrate , and the enzyme converts them into different molecules, the products....
 formula supplied by Sipco Industries Ltd.

A scientific experiment performed by a high school student, later published in The Journal of Medical Toxicology, suggested that a domestic electric iron
Ironing

File:Bundesarchiv B 145 Bild-F001163-0012, K?ln, Textilfabrik Bierbaum-Proenen.jpgIroning or smoothing is the work of using a heated tool, or tools, to remove wrinkles from fabric....
 at its hottest setting (at least ) used for at least 5 minutes should destroy all anthrax spores in a common postal envelope.

See also


External links

  • , Centers for Disease Control and Prevention
    Centers for Disease Control and Prevention

    The Centers for Disease Control and Prevention is an agency of the United States United States Department of Health and Human Services based in Atlanta, Georgia, United States adjacent to the campus of Emory University and northeast of downtown Atlanta....
     (CDC)*, Center for Biosecurity
    Center for Biosecurity

    The Center for Biosecurity is an independent, nonprofit organization of the University of Pittsburgh Medical Center that is dedicated to improving the country?s resilience to major biological threats....
  • in convenient form.