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
Laboratory criteria for diagnosis
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
Case classification
Confirmed: a clinically compatible
illness that is laboratory confirmed