Prevention of Anthrax

Prevention of anthrax with vaccine is successful and vaccination is recommended if you are at risk of developing anthrax. Prevention of anthrax is required in risky population because if untreated anthrax is almost 100% fatal for inhalational anthrax and more than 20% fatal for cutaneous anthrax. Inhalational anthrax is the form most likely to be responsible for death in a setting of a bioterrorist attack. Patients with inhalational anthrax are not contagious and do not require special isolation.

The first successful anthrax vaccine was developed by Louis Pasteur in 1881 for animals. At present anthrax vaccine is produced from the cell-free culture supernatant of an attenuated, nonencapsulated strain of B. anthracis (known as anthrax vaccine adsorbed or AVA) and is licensed for human use.

As an alternative to AVA, clinical trials for safety in humans and efficacy in animals are currently under way to evaluate the role of recombinant protective antigen of B. anthracis toxins. In preventing the development of clinical disease and death in a post-exposure setting in non-human primates a 2 week trial course of AVA + ciprofloxacin was found to be superior to ciprofloxacin alone.

Chemoprophylaxis: The current recommendation for postexposure prophylaxis is 60 days of antibiotics (Ciprofloxacin or doxycycline); it would be better to include immunization with anthrax vaccine (AVA) if available. There is a potential for B. anthracis to engineer and express penicillin resistance, and due to that, the empirical regimen of antibiotics of choice in this setting is either ciprofloxacin or doxycycline.

The prevention of bioterrorist attacks is the responsibility of the Govt. and not discussed here. But support of the general public is must for the Govt. to prevent bioterrorist attacks successfully.  

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