Anthrax: What You Need to Know

The soldiers defecting from North Korea to the south have been interesting subjects of medical study. The defector who was shot several times was found to have tapeworms up to 11 inches long in his intestines. Fleeing soldiers or civilians are often malnourished and have been denied a lot of basic healthcare. However, the most recent discovery could be indicative of something more serious — a defector was reportedly found with anthrax antibodies in his system.

This would be a good indicator of North Korea possibly having some weaponized version of anthrax in their arsenal. Anthrax is not particularly difficult to manufacture, and while making the aerosol form can be difficult, it is certainly possible for a country like North Korea to have the infrastructure to develop such a weapon.

Color-enhanced scanning electron micrograph shows splenic tissue from a monkey with inhalational anthrax; featured are rod-shaped bacilli (yellow) and an erythrocyte (red) | *Wikimedia Commons*

The culprit behind infectious disease is the bacterium known as Bacillus anthracis. There are several ways it can hit the human body: via the skin, intestines, lungs or through injection. The injection method has been found with heroin users in places in Europe, but there haven’t been any cases of this in the United States. The other methods express themselves with a variety of symptoms, from black, painless lesions on the skin to the patient having difficulty breathing. The worst of these is inhalation anthrax (through the lungs), and according to the CDC, without treatment, “only about 10 – 15% of patients with inhalation anthrax survive. However, with aggressive treatment, about 55% of patients survive.”

In the United States, there are an average of around two cases a year of anthrax — however, naturally occurring anthrax spores are not what the general population is concerned about. The problem isn’t that anthrax travels through an infected person coming in contact with another — coughing or sneezing onto an unaffected person won’t spread it the way the flu spreads. The problem is that the spores are very small and easy to move around, making it plausible that the infected still have some spores on their person, be it on their clothes or in their car or at their workplace. The CDC says that,

An anthrax attack could take many forms. For example, it could be placed in letters and mailed, as was done in 2001, or it could be put into food or water. Anthrax also could be released into the air from a truck, building, or plane. This type of attack would mean the anthrax spores could easily be blown around by the wind or carried on people’s clothes, shoes, and other objects. It only takes a small amount of anthrax to infect a large number of people.

“If anthrax spores were released into the air, people could breathe them in and get sick with anthrax. Inhalation anthrax is the most serious form and can kill quickly if not treated immediately. If the attack were not detected by one of the monitoring systems in place in the United States, it might go unnoticed until doctors begin to see unusual patterns of illness among sick people showing up at emergency rooms.”

To reiterate: anthrax is NOT contagious (with a few exceptions, like touching an open anthrax lesion with your own broken skin), rather, it gets spread by the spores themselves. Those spores could be dispersed from a high location like a missile, tall building or a plane, or could be used where lots of people are bumping into each other, like the subway or on a crowded city street.

A hazardous materials unit worker is hosed down on Capitol Hill in this Tuesday, Oct. 23, 2001 file photo where authorities continued inspecting buildings and offices for anthrax contamination. | *AP Photo/Ron Thomas*

According to the San Francisco Department of Public Health,

Lung Anthrax or Pneumonia is the most likely form of disease after an intentional release of anthrax and occurs by breathing in anthrax spores. After exposure, it usually takes 2-7 days (but sometimes up to 2 months) until illness starts. First there are a few days of symptoms like headache, cough, and muscle aches. But there is usually no runny nose. Then after a few days, there can be trouble breathing, chest pain, large lymph glands, worse headache, stomach pain, and vomiting or diarrhea. With lung anthrax, bacteria almost always enters the bloodstream, leading to severe illness or death.”

When most people in the U.S. think of an anthrax attack, they often think of the one referred to by the CDC above — the attack in 2001. In this incident, 22 people were intentionally infected by anthrax, and five of the infected died. Letters were sent in the mail targeting two Democratic senators and many news stations. The situation implicated a microbiologist by the name of Bruce Ivins, but that investigation is mired in controversy and misinformation. Ivins was found dead by a reported suicide in 2008.

Since then, many imitation-type hoaxes have been carried out.

While anthrax can be found in nature, it is no longer very common in places like the United States. According to the San Francisco Department of Public Health (Communicable Disease Control and Prevention section), California hasn’t seen a case of naturally occurring anthrax in humans since 1983. They also said that “1 person in New York in 2006 and 2 people in Connecticut in 2007 were exposed to anthrax while making drums from imported animal skins. The skins contained anthrax spores.”