Occupational respiratory diseases. Merchant JA, Bochlecke BA, Taylor G, eds. Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 86-102, 1986 Sep; :693-697
The etiology, epidemiology, and pathology of inhalation anthrax is described. Anthrax, or wool sorter's disease, is defined as a zoonotic disease caused by Bacillus-anthracis which occurs in three forms: cutaneous, inhalation, and gastrointestinal. Over 95 percent of the cases in the United States are of the cutaneous form. Approximately five percent of the reported cases are inhalation anthrax resulting from the inhalation of bacillus spores with subsequent development of hemorrhagic mediastinitis, toxemia, septicemia, and death. Cases are usually related to the industrial processing of contaminated animal products. Of 17 cases cited since 1900, the source of contamination was presumed to have been imported goat hair in 9, tanneries in 3, contact with imported wool in 1, and from exposure in a bacteriology laboratory in 1. The contaminated imported products were primarily from Asian, Middle Eastern, and African countries. The disease has a biphasic course consisting of an initial nonspecific phase with symptoms of mild respiratory illness followed by the sudden development of severe respiratory distress. Death usually occurs within 24 hours of the onset of the second phase. Early treatment with large doses of antibiotics and supportive therapy can reverse the disease process. Methods of prevention include the administration of an available and effective animal vaccine on a regular basis in the countries at high risk, the mandatory vaccination of humans handling contaminated animal products, and effective ventilation.