Military Concern

Anthrax is especially concerning for the U.S. military because of its potential use as a weapon. In fact, vaccination against anthrax is mandatory for all uniformed personnel, emergency essential designated civilians, contractor personnel performing mission- essential services (with the provision in their contract), some Naval Forces afloat, and civilian and some mariners traveling or assigned (or deploying within 120 days) to the U.S. CENTCOM area of responsibility and the Korean Peninsula for 15 or more consecutive days, as well some special units.

Vaccination is voluntary for nonemergency essential DOD civilians; contractors not performing mission-essential services and accompanying U.S. citizen family members who reside in the CENTCOM area of responsibility and Korean Peninsula for 15 or more consecutive days or for uniformed and civilian personnel no longer deployed to the US CENTCOM AOR or Korean Peninsula who have received at least one dose previously.

Prior to vaccination, all recipients are required to review a copy of information about the anthrax vaccine, including safety concerns.

In a recent update to its information on anthrax, the CDC noted that the disease can be acquired from infected animals or contaminated animal products such as wool, meat or hides, as well as through bioterrorism. The agency explained that the bacteria is not spread from person to person but instead is transmitted one of four ways, and signs and symptoms can vary, depending on how anthrax enters the body:

  • Through breaks in the skin. Cutaneous anthrax causes blisters or bumps on the skin, swelling around the sore and an ulcer with a black center. The sore is usually on the face, neck, arms or hands.

  • From eating infected meat. Ingestion anthrax can cause fever and chills. It can affect the upper part of the gastrointestinal tract, the lower part of the GI tract, or both. When it affects the upper part, there is swelling of the neck or neck glands, sore throat and painful swallowing or difficulty breathing. When it affects the lower GI tract, nausea and vomiting, stomach pain and swelling, and diarrhea may be present. The patient also may look flushed, have red eyes or faint.

  • From inhaling spores of the bacteria that causes anthrax. Inhalation anthrax can cause shortness of breath, cough, chest discomfort, confusion, nausea or vomiting, stomach ache, sweats and dizziness.

  • From injecting heroin. Injection anthrax can result in swelling at the injection site, nausea, vomiting and sweats.

In addition to causing fever, chills, fatigue and headache, anthrax can spread throughout the body and cause severe illness, including brain infections and even death, if left untreated, the guidance pointed out.

The Defense Health Agency, meanwhile, pointed out that the fatality rate for inhalation anthrax is estimated to be approximately 45% to 90%. “Methods of early diagnosis and aggressive medical interventions learned from the 1979 and 2001 bioterrorism attack have improved survival rates,” according to a recent information paper.

The vaccine is approved by the FDA for adults 18 through 65 years of age who are at risk of exposure to anthrax bacteria, including:

  • Certain laboratory workers who work with Bacillus anthracis;

  • People who handle potentially infected animals or their carcasses;

  • Some military personnel (determined by the Department of Defense); and

  • Some emergency and other responders whose response activities might lead to exposure.

Three doses of anthrax vaccine are required, followed by booster doses for ongoing protection. Three doses of the vaccine is also recommended for unvaccinated people of all ages who have been exposed to anthrax. Patients should also receive recommended antibiotics, according to public health officials.

The vaccine is not recommended in those who are allergic, are pregnant, have weakened immune systems or a history of anthrax disease.

Common reactions are tenderness, redness, itching or a lump or bruise where the shot is given; muscle aches or short-term trouble moving the arm and headaches or fatigue. The DoD said, in its experience, women have experienced more adverse reactions than men.

  1. Steenbergen J, Tanaka SK, Miller LL, Halasohoris SA, Hershfield JR. In Vitro and In Vivo Activity of Omadacycline against Two Biothreat Pathogens, Bacillus anthracis and Yersinia pestis. Antimicrobial Agents and Chemotherapy Apr 2017, 61 (5) e02434-16; DOI: 10.1128/AAC.02434-16