Burning Questions

By Alice Park

What is anthrax?

Anthrax is a disease caused by the rod-shaped bacterium Bacillus anthracis. When not actively infecting sheep or moose or people, the bug forms hard-shelled spores and goes into a kind of hibernation. These spores are hardy little things, resistant to sunlight, heat and disinfectant. They have been known to survive in soil for 80 years.

How do you catch it?

You can contract anthrax by inhaling a lot of spores (at least 8,000 to 10,000), by eating contaminated meat or by coming into contact with the bacterium through an open wound. The same bug causes all three forms of the disease, but anthrax caused by inhaling is by far the most dangerous.

Is anthrax contagious?

Rarely. Transmission requires direct contact with the spores. Even people who get inhalation anthrax do not exhale spores.

If somebody sent me anthrax in a letter or package, would I be able to see it?

Generally, yes. For anthrax spores to be used as a weapon, they need to be dried and processed into a stable, powder-like form that will disperse in the air. The most refined bacterial spores form a fine, white dust. Cruder preparations have a brownish tint and are heavier; these spores tend to clump together and drop to the ground, making them less effective terror weapons.

Is anthrax treatable?

Yes, to varying degrees. Contact and ingested forms respond best to treatment, with any of the antibiotics currently on the market--penicillin, tetracycline, doxycycline and fluoroquinolones such as Levaquin and Cipro. Cipro gets the most press because it is the only one specifically approved by the Food and Drug Administration (FDA) to treat anthrax. But unless you are exposed to one of the strains genetically engineered to be resistant to other antibiotics, you don't need Cipro. Inhalation cases can be treated with the same antibiotics if treatment is begun soon after infection, but as we saw in Florida, patients often die even after treatment.

Is there a shortage of Cipro?

Yes, in certain cities, notably New York. Bayer, Cipro's manufacturer, is pumping up production by 25%, probably in part to meet potential demand from the military for treating U.S. troops abroad.

Can I get vaccinated against anthrax?

No. BioPort, the only manufacturer licensed by the FDA to make an anthrax vaccine, has stopped shipments because its facility did not meet FDA standards. BioPort began renovating its plant in 1999 and expects to begin filling orders again by the end of the year. The company's vaccine is available only to military and laboratory personnel and is not 100% effective. It can also have serious side effects. Without a real and present danger of a widespread anthrax attack, health experts believe it would be counterproductive to vaccinate the U.S. population.

Should I start taking antibiotics to protect myself?

No, because taking antibiotics without an active infection--or taking too short a course of antibiotics--only opens the door for bacteria to become resistant, rendering the medications ineffective. In addition, physicians should not be prescribing Cipro so people can stockpile the drug. Shortages could occur, and patients with legitimate, urgent medical need for the antibiotic would not be able to get the pills.

Should I get tested for anthrax if I have a fever and flulike symptoms?

Most health-care personnel at local hospitals are able to conduct the proper tests to detect Bacillus anthracis. If you are worried, it makes sense to get tested, but odds are that you have not been exposed to anthrax. If you have flu symptoms, you probably have the flu.

--By Alice Park