Grazing animals contract spores from the vegetation. Biting flies in sub-Saharan Africa may also transmit anthrax to humans. Also, humans can contract spores from inhalation of aerosolized spores released during a BW attack. Endemic infectious disease is contracted by inhalation, cutaneous exposure, oropharyngeal exposure, and ingestion. It may possibly be introduced by biting flies.
Cutaneous anthrax features a painless necrotic ulcer with a black eschar and local edema.
The case fatality rate for untreated cutaneous anthrax is up to 20 percent, but with early, effective therapy is reduced to less than 5 percent. The clinical features of oropharyngeal and GI anthrax are discussed in paragraph 2-6. Inhalation anthrax occurs when individuals working with animal hides, wool, or bonemeal inhale the spores. Also, inhalation anthrax may occur from inhalation of aerosolized spores released during a BW attack. The clinical features of inhalation anthrax are discussed in paragraph 2-6.