Anthrax as a biological weapon

In the 2001 anthrax attacks, terrorists contaminated five letters with powder containing anthrax spores, and sent the letters from Trenton, New Jersey to Florida, New York City, and Washington DC. Three years after the attack, authorities had not yet discovered the sonrce of the anthrax nsed to contaminate the letters. One of the letters, sent to Senator Daschle s office, contained 2g of the powder. Although the source of the report is unclear, a New York Daily News article reported that the powder contained between 100 billion and 1 trillion spores per gram (4). 

Topical exposure to anthrax spores can result in cutaneous anthrax, especially in areas with previous cuts or abrasions. Uncovered areas, such as the arms, hands, face, and neck are the most likely sites for cutaneous anthrax. Unlike inhalational anthrax, experience does not reflect a prolonged latency period, and in Sverdlovsk, no cutaneous cases occurred more than 12 days after the aerosol release (4,5). 

Given the rapid transit of food through the gastrointestinal system, it is unlikely that exposure to spores could cause gastrointestinal anthrax. Instead, gastrointestinal 

1 Continued antimicrobial prophylaxis for inhalational anthrax for 60 days if aerosol exposure to B. anthrads is known or suspected (2). 

Update investigation of bioterrorism-related anthrax and interim guidelines for exposure management and antimicrobial therapy, October 2001. MMWR 2001 50 909-19. 

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Inglesby, T. V., D. A. Henderson, J. G. Bartlett, et al., Anthrax as a Biological Weapon Medical and Public Health Management, ... 

Inglesby, T. V., Henderson, D. A., Bartlett, J. G., Ascher, M. S., Eitzen, E., Friedlander, A. M., et al., for the Working Group on Civilian Biodefense. (1999). Anthrax as a biological weapon Medical and public health management. Journal of the American Medical Association, 281, 1735-1745. 

Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, Friedlander AM, Hauer J, McDade J, Osterholm MT, O Toole T, Parker G, Perl TM, Russell PK, Tonat K. Anthrax as a biological weapon medical and public health management. Working Group on Civilian Biodefense. JAMA 1999 281(18) 1735-45. 

Inglesby, TV, O Toole, T, Henderson, DA. Anthrax as a Biological Weapon, 2002. Updated Recommendations for Management. JAMA, 287(17) 2236-2252, 2002... 

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