Q:   What is anthrax?

A:   First discovered in 1500 B.C. by the Egyptians, anthrax is an acute infectious disease caused by a spore forming bacterium called "Bacillus anthracis." The spores are designed to hibernate until conditions are conducive for growth and reproduction at which time they produce a fatal toxin. The spores can be eaten in contaminated meat, breathed in, or simply infect the skin directly through human to animal contact. Anthrax most commonly occurs in mammals such as cattle, sheep, goats, camels and antelopes, but can also occur in humans when they are exposed to such infected animals. Tests have shown that anthrax spores can survive for up to sixty (60) years in the soil.

Q:   How does anthrax spread?

A:   The anthrax spores can spread by inhalation (the most fatal form), ingestion or contact with an abrasion, cut or open wound on the skin. Only eight thousand (8,000) spores, roughly enough to cover a snowflake, are needed to cause pulmonary disease when incubated in the warm and humid conditions of the human lung.

Q:   Is anthrax contagious?

A:   No. Anthrax is NOT contagious and cannot be spread from person to person the way a common cold might. This is because anthrax is a bacteria rather than a virus. However, someone who has been recently exposed to anthrax may carry spores on their person that can fall off during normal body movement. These loose spores could possibly infect another person, although this scenario is not very likely due to the minimum amount of exposure from a few spores.

Q:   Are there different types of anthrax infections?

A:   Yes. There are three (3) types or ways that anthrax can affect the human body, these are: "cutaneous", "gastrointestinal" and "inhalation". The cutaneous type of infection represents about ninety percent (90%) of the reported anthrax cases. Each is explained further, together with their symptoms, in the next question and answer.

Q:   What are the symptoms of anthrax?

A:   What makes anthrax dangerous is that the symptoms are often difficult to distinguish from other, less serious illnesses such as the flu or food poisoning. A person infected with anthrax will usually show symptoms within two to seven (2-7) days after the initial exposure. An infection by "inhalation" or breathing anthrax into the lungs can start out like a common cold before more severe symptoms such as breathing problems and shock are encountered. An infection by "gastrointestinal" or ingesting contaminated food is characterized by inflammation of the intestinal tract, causing nausea, loss of appetite, vomiting and fever, and leading to vomiting of blood and severe diarrhea. A "cutaneous" or skin infection can look like an insect bite at first but within days may develop into an ulcer with a characteristic black center (from which anthrax gets its name). If this type of anthrax infection is left untreated it can cause blood poisoning.

Q:   Can a person infected with anthrax be cured?

A:   Yes. The survivability rate of a person infected with anthrax through either the cutaneous or gastrointestinal form of the infection, if caught early, is promisingly high. Antibiotics, such as ciprofloxacin (Cipro, manufactured by Bayer who currently holds the patent), doxycycline or penicillin, are used to treat the infected person for a period of about sixty (60) days to allow all of the anthrax spores to germanate and die. Treatment with antibiotics has a greater success rate if started prior to the onset of symptoms and includes an anthrax vaccination prior to discontinuing the prescribed antibiotics. If the person was infected through inhalation and anthrax lodges deep into the person's lungs, the survivability rate is relatively low. A delay in the use of antibiotics lessens the infected person's chances for survival.

Q:   What is the fatality rate of anthrax?

A:   Fatality rates vary based upon the particular type of anthrax that the person has been exposed to. "Cutaneous Anthrax" is fatal between five and twenty percent (5%-20%) of the "untreated" cases. This form of anthrax, however, is rarely fatal if caught early and proper medication is prescribed. "Gastrointestinal Anthrax" is fatal between twenty-five and sixty percent (25%-60%) of the time. "Inhaliation Anthrax" is the nastiest form of all, and is fatal in about ninety percent (90%) of the cases. Untreated cases and cases where the spores have lodged themselves deep in the lungs are almost always fatal.

Q:   Is there an anthrax vaccine?

A:   Yes. There is an anthrax vaccine. However, because of its limited supply, it is usually reserved for military personnel, meat industry workers and others who are in "high risk" industries that are most likely to come into contact with anthrax. The vaccine is manufactured using a cell-free filtrate method, which means that no dead or live bacteria was used in its creation. The vaccine is about ninety-three percent (93%) effective but does come with some side effects. BioPort Corp. of Lansing, Michigan, is the sole U.S. manufacturer and licensee for the anthrax vaccine, but has not produced any vaccine since winning the exclusive contract in 1998. However, they have said that they stand ready to produce the vaccine in mass quantities if called upon to do so.

Q:   How common is anthrax?

A:   Anthrax is a naturally occuring disease that is most common in agricultural regions where it affects livestock and other animals. Humans infected with anthrax usually have been exposed to infectious animals or their bi-products through their occupations, such as tannery or meat industry workers. Workers who are exposed to dead animals and animal products from other countries where anthrax is more common may become infected as well.

Q:   Where is anthrax usually found?

A:   Anthrax is a global disease but is more commonly found in developing countries or countries without veterinary public health programs. Regions such as South America, Central America, Southern Europe, Eastern Europe, Asia, Africa, the Caribbean, and the Middle East report a higher rate of anthrax in animals than do other regions of the world.

Q:   Can anthrax be traced?

A:   Yes, in most cases. Each strain of anthrax carries its own individual trait just as humans do with their DNA. If a strain is used as a biological weapon, it can be easily traced back to the original strain. Most strains of anthrax are keep under tight security and precautions are always taken to prevent an unauthorized release.

Q:   Why is anthrax the bio-weapon of choice amoung terrorists?

A:   Anthrax is believed to be a favorite bio-weapon of larger terrorist groups because it is highly lethal (it contains 100 million lethal doses per gram of anthrax material which is 100,000 times stronger than the deadliest chemical warfare agent); the cost to make anthrax is relatively low compared to other bio-weapons; anthrax is low-tech and knowledge of it is widely available; it is easy to produce in large quantities; it is extremely stable; it can be stored almost indefinitely as a dry powder; and it is easy to weaponize.

Q:   Does anthrax make a good biological weapon?

A:   It depends. Anthrax is among the most feared of the biological weapons, but in fact, this is because it has been released so seldom, that very little is known about its potential and much of the data is still incomplete. The culturing of large quantities of anthrax spores is a complicated task that is beyond the capacity of most individuals and smaller terrorist groups. For instance, the Japanese cult, Aum Shinri Kyo, responsible for releasing the fatal Sarin nerve gas in Tokyo's subway system in 1995, previously released large amounts of anthrax into populated Japanese areas on no less than eight (8) occassions. Japan's health agencies reported that not a single person died as a result of those attacks. However, in contrast, the former Soviet Union saw sixty-eight (68) people die in 1979, after one (1) tiny gram of anthrax was accidently released from a military research laboratory near Sverdlovsk. All of those infected lived some four (4) kilometers (2 1/2 miles) downwind of the facility. As the incidents in Japan have demonstrated, causing a widespread outbreak of anthrax is not as simple and straightforward as many terrorists would like, but when developed on a national level, as the Soviet case demonstrated, the effects can be severe and deadly.

Q:   Why bio-terrorism as opposed to other forms of terrorism?

A:   "Terrorism has changed," says Brad Roberts of the U.S. Government backed Institute for Defense Analysis in Virginia. "Traditional terrorists wanted political concessions," he says. "But now, some groups say their main aim is mass casualties. That makes biological weapons appealing." Part of that appeal may include the economic hardship, which would be inflicted on the target country. A recent Centers for Disease Control (CDC) report, entitled "The Economic Impact of a Bio-terrorist Attack" conservatively estimates the costs of dealing with the aftermath of an anthrax incident at $26.2 billion per one hundred thousand (100,000) people exposed. They also estimate, based upon that same one hundred thousand (100,000) people, that the death toll from such an anthrax attack would be over thirty two thousand (32,000) souls lost, with another fifty thousand (50,000) people diseased.

Q:   What would be a worse case scenario for a terrorist anthrax attack?

A:   In 1970, the World Health Organization estimated that, 50 kilograms (110 lbs.) of anthrax released from an aircraft over an urban population of five million (5,000,000) would result in approximately two hundred fifty thousand (250,000) cases of anthrax. A similar 1993 report estimated that releasing a cloud of 100 kilograms (220 lbs.) of anthrax spores upwind of Washington, D.C. could cause between one hundred thirty thousand (130,000) and three million (3,000,000) deaths. Production of these quantities of anthrax would be a significant undertaking and would require the use of a sophisticated bio-tech laboratory and an original source of anthrax bacteria to begin the culturing process, as well as substantial funding - on a national level. The deadliness of an anthrax attack depends obviously on the quantity of spores and the effectiveness of a delivery system. Reports linking the World Trade Center attackers with inquiries about crop-dusting planes certainly suggest they might have been looking for a delivery system, but experts say that these types of planes would not have been suitable for the task.

Q:   What kind of delivery system would be needed to expose an entire city to anthrax?

A:   According to Dr. Ken Alibek, a former Soviet Colonel and 1st Deputy Chief of the secret Soviet germ warfare program who defected to the United States in 1992, the former Soviet Union has developed a spray technique based upon the use of spray tanks installed on medium range bombers. In the 1980's, they also started development on a new type of delivery system based on the use of "a low flying, high-speed object" comparable to a U.S. cruise missile.

Q:   Can anthrax be genetically altered to be immune from antibiotics?

A:   Yes. According to Dr. Ken Alibek (see above), the former Soviet Union has developed genetically altered, antibiotic resistant, strains of anthrax, plague, tularemia, and glanders disease. After the Soviet break up, some scientists familiar with thier bio-weapon technology went to work for some of the so-called "rogue states" such as Iraq, Afghanistan, Iran, Sudan, Yemen, and Africa.