Overview

This fourth edition of the anthrax guidelines encompasses a systematic review of the extensive new scientific literature and relevant publications up to end 2007 including all the new information that emerged in the 3–4 years after the anthrax letter events.

This updated edition provides information on the disease and its importance, its etiology and ecology, and offers guidance on the detection, diagnostic, epidemiology, disinfection and decontamination, treatment and prophylaxis procedures, as well as control and surveillance processes for anthrax in humans and animals.

Contents

• Acknowledgements
• Development of these guidelines
• Preface
• [Dedication]
• Summary
• 1. The disease and its importance
  • 1.1 The natural disease
  • 1.2 Deliberate release – bioaggression
• 2. Etiology and ecology
  • 2.1 Spores and vegetative forms
  • 2.2 Seasonality
  • 2.3 Strains and ecoepidemiology
  • 2.4 Anomalies of history
• 3. Anthrax in animals
  • 3.1 Host range, susceptibility and infectious dose
  • 3.2 Incidence of anthrax in animals
  • 3.3 Transmission, exacerbating factors and epidemiology in animals
  • 3.4 Clinical manifestations; incubation periods
  • 3.5 Diagnosis
• 4. Anthrax in humans
  • 4.1 Human incidence
  • 4.2 Susceptibility: data for risk assessments
  • 4.3 Epidemiology and transmission: the forms of anthrax
  • 4.4 Clinical disease in humans
• 5. Pathogenesis and pathology
  • 5.1 Events after entry through a lesion
  • 5.2 Events after entry by inhalation
  • 5.3 Events after entry by ingestion
  • 5.4 The role of phagocytosis
  • 5.5 Virulence factors
• 6. Bacteriology
  • 6.1 Description
  • 6.2 Detection and isolation
  • 6.3 Identification and confirmation
  • 6.4 Molecular composition
  • 6.5 Spores
  • 6.6 Other surface antigens: anthrax-specific epitopes and detection methodology
  • 6.7 Transport of clinical and environmental samples
• 7. Treatment and prophylaxis
  • 7.1 Overview
  • 7.2 Response to outbreaks in animals
  • 7.3 Treatment of humans
• 8. Control
  • 8.1 Introduction
  • 8.2 Discontinuation of infection source
  • 8.3 Disposal of anthrax (animal) carcasses
  • 8.4 Human cases: infection control in management
  • 8.5 Fumigation, disinfection, decontamination
  • 8.6 Prophylaxis
  • 8.7 Decisions on treatment and/or vaccination of livestock
  • 8.8 Duration of veterinary vaccination programmes
  • 8.9 Intersectoral issues: the question of eradication
  • 8.10 Control in wildlife
• 9. Anthrax surveillance
  • 9.1 Introduction
  • 9.2 Objectives
  • 9.3 Surveillance reporting outline
  • 9.4 Human surveillance
  • 9.5 Veterinary surveillance
  • 9.6 Communication of disease data
  • 9.7 Templates for control programmes from the Model Country Project
• Annexes
  • Annex 1 Laboratory procedures for diagnosis of anthrax, and isolation and identification of Bacillus anthracis
  • Annex 2 Media, diagnostic phage and stains
  • Annex 3 Disinfection, decontamination, fumigation, incineration
  • Annex 4 Terrestrial Animal Health Code
  • Annex 5 Vaccines and therapeutic sera
  • Annex 6 Contingency plan for the prevention and control of anthrax
  • Annex 7 Sampling plans for environmental testing of potentially contaminated sites
• References

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