Chest radiograph during the preterminal stage may show widened mediastinum and pleural effusions. Meningitis occurs in as many as half the cases. Although the drugs of choice for natural anthrax include high-dose penicillin, ciprofloxacin, and doxycycline, strains manufactured for biological warfare may have been altered for resistance to standard antibiotics. The existing vaccine has not been tested for efficacy in humans, but has been shown to protect rhesus monkeys against inhalational anthrax after 2 doses. Well-fitting M17 or M40 gas masks provide respiratory protection from exposure.
Postexposure treatment involves prolonged administration of antibiotics and concomitant vaccination.
Identifying an outbreak early is the key to initiating life-saving treatment, and emergency personnel will be key players in surveillance for clusters of cases. This review serves as an excellent introduction to the topic, and is important reading. The complete text of this article is available on-line. Further information about anthrax is available from the U.S. Army , the Department of the Navy the Department of Defense , and the Nuclear, Biological, and Chemical Web Page . ABC News has a large feature on terrorism , and Salon Magazine has a discussion on whether Iraq could have biologically engineered anthrax that is resistant to traditional antibiotics.