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Anthrax (Bacillus anthracis)

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An illness with acute onset characterized by several distinct clinical forms including:

Cutaneous: a skin lesion evolving over 2 to 6 days from a papule, through a vesicular stage, to a depressed black eschar
Inhalation: a brief prodrome resembling a viral respiratory illness followed by development of hypoxia and dyspnea, with x-ray evidence of mediastinal widening
Intestinal: severe abdominal distress followed by fever and signs of septicemia
Oropharyngeal: mucosal lesion in the oral cavity or oropharynx, cervical adenopathy and edema, and fever

Isolation of Bacillus anthracis from a clinical specimen, or
Fourfold or greater rise in either the anthrax enzyme-linked immunosorbent assay (ELISA) or electrophoretic immunotransblot (EITB) titer between acute- and convalescent-phase serum specimens obtained greater than or equal to 2 weeks apart, or
Anthrax ELISA titer greater than or equal to 64 or an EITB reaction to the protective antigen and/or lethal factor bands in one or more serum samples obtained after onset of symptoms, or
Demonstration of B. anthracis in a clinical specimen by immunofluorescence

Confirmed: a clinically compatible illness that is laboratory confirmed