While you are sorting through the day's mail, you slit open an envelope containing not only a letter, but a fine white powder. What should be your next move? Reseal and re-address the envelope to your favorite in-law? Not a good idea. Attempt to identify this powder by sniffing and tasting it? Nope. Although I don't have any experience here, I would seal the envelope and its contents in a zip-lock plastic bag and look for the nearest FBI office.

Anthrax is a life-threatening infectious disease caused by Bacillus anthracis that is usually seen in animals, especially ruminants (cattle, goats, sheep, and horses). Though rare in humans, anthrax can be transmitted by contact with infected animals or their products.

In the soil, wool or animal hair where they live, anthrax organisms exist in a dormant form called spores which have been known to survive for decades.

Human infection can be acquired by:

Cutaneous (skin) anthrax, the most common, is usually acquired by contact with infected animals or spore-contaminated animal products. This form usually progresses from a red-brown raised spot, which blisters and hardens. It will ulcerate and drain a blood-tinged liquid and then form a black crust called an eschar. This will usually resolve in a few weeks, but without appropriate antibiotics, could be fatal.

Gastrointestinal or ingestion anthrax, rare, is the result of eating undercooked, contaminated meat. The bacteria may invade through the bowel wall and spread through the body through the bloodstream (septicemia).

Inhalation anthrax is caused by inhaling spores, usually due to occupational exposure to contaminated animal products (eg. hides) and is almost always fatal. The first symptoms are subtle, gradual and flu-like. This may progress to severe respiratory distress with shortness of breath and chest pain. Death may occur even if one receives appropriate antibiotics, for though the antibiotics are effective in killing the bacteria, they do not destroy the deadly toxins that have already been released.

In most cases of cutaneous anthrax, early treatment with common antibiotics will result in a cure. The pulmonary (inhalation) form of anthrax, however, is a medical emergency. In a bioterrorism attack, those exposed to anthrax will hopefully be given antibiotics before they become sick. In addition to these antibiotics, a three-dose series of anthrax vaccine should be started as soon as possible after exposure. With the exception of such unimaginable times, this vaccine is available for folks at high risk such as veterinarians, lab technicians, employees of textile mills processing imported goat hair (I seriously doubt that this is a concern to many of us around here.) and members of the armed forces.

I feel certain that all will remember that in September 2001, a week after the September 11 attacks, letters containing anthrax spores were mailed to several news media offices and two U.S. Senators, killing five people and infecting 17 others. That sent to the news media appeared as a clumped coarse brown granular material looking like dog food, whereas that in the Senate letters was a highly refined dry powder, having been “weaponized” with silica. Silicon would make the anthrax more capable of penetrating the lungs. Weaponized anthrax is a fine powder of spores that can float in the air like flour dust. It looks like a very fine white powder. Years after the attack, several anthrax victims reported lingering health problems including fatigue, shortness of breath and memory loss.

In 2004, Congress passed the Project Bioshield Act, which provides $5.6 billion over 10 years for the purchase of new vaccines and drugs. These vaccines included the – get this, now, for there may be a pop test coming – the monoclonal antibody Raxibacumab, which treats anthrax as well as an Anthrax Vaccine Adsorbed, BioThrax, and Anthrasil, all of which are stockpiled by the U.S. government. Now, with the addition of antibiotics, not only will the bacterium be eradicated, but the toxins produced by it will be targeted and neutralized.

Dr. William McKell is a Northsider.

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