Anthrax

Rock band

For the Record…

Enter Belladonna

Hip-Hop Change-up

Regrouped After Fire

The Bush Administration

Selected discography

Sources

Cemented by their mutual interest in hardcore punk and heavy metal, comic books and skateboarding, guitarist Scott Ian, bassist Dan Lilker, singer Neil Turbin, guitarist Greg Walls, and drummer Greg D’Angelo in 1981 sparked a blaze that would set the heavy metal/thrash world on fire. Their first step beyond the musical framework of the genre combined the fast and furious pace of hardcore with the slightly more melodic sound of heavy metal. Such stylistic experimentation would later become a habit that would contribute to Anthrax’s longevity.

Anthrax toured small-town clubs and rehearsed nonstop during its first two years. In that interim, guitarist Dan Spitz, whose brother David played in Black Sabbath, replaced Walls, and drummer Charlie Benante replaced D’Angelo. Benante became the band’s primary songwriter, occasional guitarist, and art director. Then, in 1983, after getting managers Jon and Martha Zazula to listen to their demo, they signed with Megaforce Records and released the single “Soldiers of Metal.”

For the Record…

Members include Frank Bello (born July 9, 1965; replaced Dan Lilker, 1984), bass; Charlie Benante (replaced Greg D’Angelo, early 1980s), drums; John Bush (replaced Joey Belladonna [born October 30, in Oswego, NY; replaced Neil Turbin, 1984), 1992), vocals; Scott Ian (born Scott Ian Rosenfeld), guitar; and Dan Spitz (replaced Greg Walls, early 1980s), guitar.

Band formed in New York, NY, 1981; signed with Megaforce Records, 1983, and released debut album, Fistful of Metal, 1984; signed with Island Records, and released Spreading the Disease, 1986; signed with Elektra Entertainment, 1992, and released Sound of White Noise, 1993.

Awards: Sound of White Noise named best metal album in Guitar Player’s Readers Poll, 1994.

Addresses: Record company —Elektra Entertainment, 345 North Maple Dr., Ste. 123, Beverly Hills, CA 90210.

They continued to tour small venues, performing with fellow thrashers Metallica and Manowar.

Anthrax struggled with touring, recording, and promotion for three years before they released their first album, Fistful of Metal, in 1984 on Megaforce in the U.S. and Music for Nations in Europe. The album attracted a small following, who generally believed they had discovered the fastest metal music ever heard.

Benante and guitarist Ian also used those lean years to develop a concurrent splinter group, Stormtroopers of Death (SOD), an even faster hardcore outfit marked by a hearty sense of humor. SOD also released its debut, Speak English or Die, in 1984.

Enter Belladonna

Also that year, bass player Lilker decided to part ways with Anthrax, later going on to join thrash combo Nuclear Assault. Roadie Frank Bello took over for Lilker. And in August, while the group was in the studio working on the follow-up to Fistful of Metal, Ian fired singer Neil Turbin. Joey Belladonna stepped into the vocal slot, giving a new range, style, and polish to Anthrax’s sound.

With the new lineup in place, Anthrax finished recording the five-song EP Armed and Dangerous in 1985. The mini-album included a cover of punk heroes the Sex Pistols’ “God Save the Queen.” The set earned Anthrax the interest of Island Records, which signed the band and put them to work with producer Carl Canedy on their second full-length album, Spreading the Disease.

Reaching Number 113 on Billboard’s pop chart, Spreading the Disease, spurred on by the single “Madhouse,” spread Anthrax’s popularity across the world the following year; in 1986 the band played their first U.K. show at London’s Hammersmith Palais. They went on to tour Europe and Scandinavia with up-and-coming headbangers Metallica.

The band left their New York City dwellings behind to record their next album in Miami and the Bahamas with producer Eddie Kramer. Anthrax released Among the Living in May of 1987. Lyrics included topics ranging from American Indians to comic-book character Judge Dredd. The disc hit the U.S. charts at Number 62 and the U.K. charts at 18, then earned the band their first gold album. Three singles nurtured Among the Living’s success—“I Am the Law,” “Indians,” and the heavy metal/rap hybrid “I’m the Man.”

Hip-Hop Change-up

“I’m the Man” was a leap beyond the musical boundaries of heavy metal. Though Anthrax had enjoyed a glancing relationship with hip-hop for some time, the stylistic synthesis was a daring move. Soon the band’s ascent in the rock world paralleled the revival of the comic-book heroes depicted in their lyrics.

Anthrax had finally hit the surface of worldwide visibility, but they refused to let go of their heavy metal designation in spite of the borders they continued to cross. “We’re a heavy metal band, that’s what we are,” Ian told Melody Maker. “We just don’t like people to think we’re a heavy metal band like all those other bands. We want people to take notice of the fact that we’re different.”

Their identity firmly entrenched, Anthrax ventured further down the road toward mass success in 1988 with the release of another, three-song EP, I’m the Man. They recorded the set at a show in Dallas in 1987; it eventually went double platinum. Later in the year, the band released their next record, State of Euphoria. The title suggested the condition of fans as they left an Anthrax performance.

Euphoria included “Make Me Laugh,” a tirade against television evangelism; a cover of the French rock band Trust’s “Antisocial”; “Now It’s Dark,” inspired by the David Lynch film Blue Velvet; and “Misery Loves Company,” penned in response to the Stephen King novel Misery.

Aside from the pantheon of popular culture, the band focused on social and political upheaval, while still managing to maintain the comic appeal they had begun to develop earlier. Ian outlined his personal agenda for social renewal to Melody Maker, venturing, “I think there should be a limited number of zombies in circulation, so that people could give vent to their frustrations by beating them up with bats. I think that could be socially useful.”

In an effort to prevent exhaustion and their own frustrations, Anthrax took a three-month vacation from recording, touring, and each other to regain their creative energies—the first in three years. Then, just as they began their next project, a major setback hit the band: in January of 1990, Anthrax narrowly escaped injury in a serious fire at their studio. The bandmembers formed a human chain to try to save their equipment, but the conflagration ultimately caused more than $100,000 worth of damage to Anthrax’s gear and destroyed the entire studio.

Regrouped After Fire

Picking up the pieces, the band moved their recording sessions to Los Angeles in late February to finish the work they’d begun on the new album. Persistence of Time hit the street in 1990. The Salvador Dali painting “Persistence of Memory” had inspired Charlie Benante’s cover design for the album. Persistence of Time would be nominated for a Grammy Award in the best heavy metal performance category in 1991. In the meantime, Anthrax hit the road supporting heavy metal giants Iron Maiden on their “No Prayer on the Road” tour.

Their next step beyond the heavy metal norm was taken a year later and gained the band recognition, admiration, and a whole lot of press; Anthrax released yet another, so-called EP—despite its ten-song length—of covers and B-sides called The Attack of The Killer B’s. The disc included covers of Kiss’s “Parasite,” Trust’s “Sects,” and Discharge’s “Protest and Survive.” But the most notable offering was “Bring the Noise,” by rebel rappers Public Enemy. Public Enemy’s Chuck D joined Anthrax in the studio and later onstage, contributing his trademark commanding vocals. Billboard declared the union “a stroke of brilliance,” and reported, “The combination of hip-hop grooves, turntable scratching and crunching guitar riffs and rolling drums is mind blowing.”

Anthrax then left Island to sign a multimillion-dollar contract with the Elektra label. Almost before the ink on the deal was dry, the band canned singer Joey Belladonna, citing “creative differences,” and a year later hired singer John Bush, formerly of the heavy metal band Armored Saint.

The Bush Administration

“It was frightening to replace a frontman,” Benante told RIP magazine. “It was frightening to risk sitting there for a year, not being able to get anyone. It was frightening to have done it after signing this big contract with Elektra. But, that makes it all the more worth it. If we’d stayed in one place, I doubt I’d still be in this band. I doubt there’d even be a band! Then, again, we’ve never been afraid to try out different things, though we never seem to get credit. Like, we wore shorts and thermals in the past, and now that’s accepted fashion. But when we did it, people hated us for it!”

Anthrax released Sound of White Noise, their first record with their new singer, in 1993. Their sound was markedly transformed by Bush’s vocals and writing. “For us, it’s a big deal to make a record where you don’t know what you’re getting,” Ian said in a 1993 Elektra press biography. “These tracks are completely different from each other, yet it’s all Anthrax. It shows the types of music and ideas that we’re into.”

The set included “Potter’s Field,” about abortion, “Only” and “A Thousand Points of Hate,” about interpersonal relations, and “Black Lodge,” inspired by another David Lynch work, the television series Twin Peaks. In fact, Twin Peaks composer Angelo Badalamenti made a guest appearance on the song. “It’s just different enough to remind you that within the circumscribed parameters of thrash etiquette, Anthrax has always taken chances,” Rolling Stone said of the album. “And, how many bands in any genre have successfully reinvented themselves a decade into their career? In that sense, Sound of White Noise is a powerful comeback from a group that never went away.”

After more than ten grueling years of thrashing across the world, Anthrax insisted that their endurance comes from the faith of their fans. “We’re following the Iron Maiden path,” guitarist Spitz declared in Screamer. “We don’t rely on radioplay or videos or album sales. We rely on touring and word-of-mouth. We play what we like to play and write what we like to write. We don’t have to change for anybody. That’s why the kids believe in us.” Nonetheless, with a darkly compelling video of Black Lodge, by award-winning director Mark Pellington, dominating MTV’s Headbanger’s Ball in the fall of 1993, it seemed clear that Anthrax was poised to move well beyond their diehard core of believers.

Selected discography

Fistful of Metal, Megaforce, 1984.

Armed and Dangerous (EP; includes “God Save the Queen”), Megaforce, 1985.

Spreading the Disease (includes “Madhouse”), Island, 1986.

Among the Living (includes “I Am the Law,” “Indians,” and “I’m the Man”), Island, 1987.

I’m the Man (EP), Island, 1988.

State of Euphoria (includes “Make Me Laugh,” “Antisocial,” “Now It’s Dark,” and “Misery Loves Company”), Island, 1988.

Persistence of Time, Island, 1990.

Attack of the Killer B’s (EP; includes “Parasite,” “Sects,” “Protest and Survive,” and “Bring the Noise”), Island, 1991.

Sound of White Noise (includes “Potter’s Field,” “Only,” “A Thousand Points of Hate,” and “Black Lodge”), Elektra, 1993.

Sources

Books

Rees, Dafydd, and Luke Crampton, Rock Movers & Shakers, ABC/CLIO, 1991.

Periodicals

Billboard, May 29, 1993.

Circus, December 31, 1988.

Guitar Player, July 1993.

Hit Parader, September 1993.

Melody Maker, November 28, 1987; September 17, 1988; February 11, 1989; February 10, 1990; August 18, 1990; August 25, 1990; June 22, 1991; December 21, 1991.

Metro Times (Detroit), July 7, 1993.

Modern Drummer, June 1993.

Pulse!, July 1993; September 1993.

RIP, August 1993.

Rolling Stone, May 13, 1993; June 24, 1993.

Screamer, November 1988; April 1990; September 1990.

Spin, July 1993.

Additional information for this profile was obtained from Elektra Records press materials, 1993.

—Sonya Shelton

Anthrax

Heavy metal group

For the Record…

Enter Belladonna

Hip-Hop Change-up

Regrouped after Fire

The Bush Administration

Left Elektra

Selected discography

Sources

Cemented by their mutual interest in hard-core punk and heavy metal, comic books and skateboarding, guitarist Scott Ian, bassist Dan Lilker, singer Neil Turbin, guitarist Greg Walls, and drummer Greg D’Angelo in 1981 sparked a blaze that would set the heavy metal/thrash world on fire. Their first step beyond the musical framework of the genre combined the fast and furious pace of hard-core with the slightly more melodic sound of heavy metal. Such stylistic experimentation would later become a habit that would contribute to Anthrax’s longevity.

Anthrax toured small-town clubs and rehearsed nonstop during its first two years. In that interim, guitarist Dan Spitz, whose brother David played in Black Sabbath, replaced Walls, and drummer Charlie Benante replaced D’Angelo. Benante became the band’s primary songwriter, occasional guitarist, and art director. Then, in 1983, after getting managers Jon and Martha Zazula to listen to their demo, they signed with Megaforce Records and released the single “Soldiers of Metal.” They continued to tour small venues, performing with fellow thrashers Metallica and Manowar.

Anthrax struggled with touring, recording, and promotion for three years before they released their first

For the Record…

Members include Joey Belladonna (born on October 30, in Oswego, NY; group member, 1984–92), vocals; Frank Bello (born on July 9, 1965; joined group, 1984), bass; Charlie Benante (joined group, early 1980s), drums, guitar; John Bush (joined group, 1992), vocals; Rob Caggiano (joined group, 2002), guitar; Greg D’Angelo (left group, early 1980s), drums; Scott Ian (born Scott Ian Rosenfeld), rhythm guitar; Dan Lilker (group member, 1981–84), bass; Dan Spitz (group member, early 1980s–1995), guitar; Neil Turbin (group member, 1981–84), vocals; Greg Walls (left group, early 1980s), guitar.

Group formed in New York, NY, 1981; signed with Megaforce Records, 1983; released debut album, Fistful of Metal, 1984; signed with Island Records, released Spreading the Disease, 1986; signed with Elektra Entertainment, 1992; released Sound of White Noise, 1993, and Stomp 442, 1995; left Elektra; released Volume 8: The Thread is Real on Ignition/Tommy Boy Records, 1998; released greatest hits collection Return of the Killer A’s: The Best Of, 1999; released We’ve Come For You All, 2003.

Awards: Sound of White Noise named Best Metal Album in Guitar Player’s Readers Poll, 1994.

Addresses: Record company —Nuclear Blast, Oeschstr. 40, 73072 Donzdorf, Germany, website: http://www.nuclearblast.de. Website —Anthrax Official Website: http://www.anthrax.com.

album, Fistful of Metal, in 1984 on Megaforce in the United States and Music for Nations in Europe. The album attracted a small following, who generally believed they had discovered the fastest metal music ever heard. Benante and guitarist Ian also used those lean years to develop a concurrent splinter group, Stormtroopers of Death (SOD), an even faster hardcore outfit marked by a hearty sense of humor. SOD also released its debut, Speak English or Die, in 1984.

Enter Belladonna

Also that year, bass player Lilker decided to part ways with Anthrax, later going on to join thrash combo Nuclear Assault. Roadie Frank Bello took over for Lilker. And in August, while the group was in the studio working on the follow-up to Fistful of Metal, Ian fired singer Neil Turbin. Joey Belladonna stepped into the vocal slot, giving a new range, style, and polish to Anthrax’s sound.

With the new lineup in place, Anthrax finished recording the five-song EP Armed and Dangerous in 1985. The mini-album included a cover of punk heroes the Sex Pistols’ “God Save the Queen.” The set earned Anthrax the interest of Island Records, which signed the band and put them to work with producer Carl Canedy on their second full-length album, Spreading the Disease.

Reaching number 113 on Billboard’s pop chart, Spreading the Disease, spurred on by the single “Madhouse,” spread Anthrax’s popularity across the world the following year; in 1986 the band played their first United Kingdom show at London’s Hammersmith Palais. They went on to tour Europe and Scandinavia with up-and-coming headbangers Metallica.

The band left their New York City dwellings behind to record their next album in Miami and the Bahamas with producer Eddie Kramer. Anthrax released Among the Living in May of 1987. Lyrics included topics ranging from American Indians to comic-book character Judge Dredd. The disc hit the United States charts at number 62 and the United Kingdom charts at 18, then earned the band their first gold album. Three singles nurtured Among the Living’s success—“I Am the Law,” “Indians,” and the heavy metal/rap hybrid “I’m the Man.”

Hip-Hop Change-up

“I’m the Man” was a leap beyond the musical boundaries of heavy metal. Though Anthrax had enjoyed a glancing relationship with hip-hop for some time, the stylistic synthesis was a daring move. Soon the band’s ascent in the rock world paralleled the revival of the comic-book heroes depicted in their lyrics.

Anthrax had finally hit the surface of worldwide visibility, but they refused to let go of their heavy metal designation in spite of the borders they continued to cross. “We’re a heavy metal band, that’s what we are,” Ian told Melody Maker. “We just don’t like people to think we’re a heavy metal band like all those other bands. We want people to take notice of the fact that we’re different.”

Their identity firmly entrenched, Anthrax ventured further down the road toward mass success in 1988 with the release of the three-song EP I’m the Man. They recorded the set at a show in Dallas in 1987; it eventually went platinum. Later in the year, the band released their next record, State of Euphoria. The title suggested the condition of fans as they left an Anthrax performance.

Euphoria included “Make Me Laugh,” a tirade against television evangelism; a cover of the French rock band Trust’s “Antisocial”; “Now It’s Dark,” inspired by the David Lynch film Blue Velvet; and “Misery Loves Company,” penned in response to the Stephen King novel Misery.

Aside from the pantheon of popular culture, the band focused on social and political upheaval, while still managing to maintain the comic appeal they had begun to develop earlier. Ian outlined his personal agenda for social renewal to Melody Maker, venturing, “I think there should be a limited number of zombies in circulation, so that people could give vent to their frustrations by beating them up with bats. I think that could be socially useful.”

In an effort to prevent exhaustion and their own frustrations, Anthrax took a three-month vacation from recording, touring, and each other to regain their creative energies—the first in three years. Then, just as they began their next project, a major setback hit the band: in January of 1990, Anthrax narrowly escaped injury in a serious fire at their studio. The bandmembers formed a human chain to try to save their equipment, but the conflagration ultimately caused more than $100,000 worth of damage to Anthrax’s gear and destroyed the entire studio.

Regrouped after Fire

Picking up the pieces, the band moved their recording sessions to Los Angeles in late February to finish the work they’d begun on the new album. Persistence of Time hit the street in 1990. The Salvador Dali painting “Persistence of Memory” had inspired Charlie Benante’s cover design for the album. Persistence of Time would be nominated for a Grammy Award in the Best Heavy Metal Performance category in 1991. In the meantime, Anthrax hit the road supporting heavy metal giants Iron Maiden on their “No Prayer on the Road” tour.

Their next step beyond the heavy metal norm was taken a year later and gained the band recognition, admiration, and a whole lot of press; Anthrax released yet another, so-called EP—despite its ten-song length—of covers and B-sides called The Attack of The Killer B’s. The disc included covers of Kiss’ “Parasite,” Trust’s “Sects,” and Discharge’s “Protest and Survive.” But the most notable offering was “Bring the Noise,” by rebel rappers Public Enemy. Public Enemy’s Chuck D joined Anthrax in the studio and later onstage, contributing his trademark commanding vocals. Billboard declared the union “a stroke of brilliance,” and reported, “The combination of hip-hop grooves, turntable scratching and crunching guitar riffs and rolling drums is mind blowing.”

Anthrax then left Island to sign a $10 million contract with the Elektra label. Almost before the ink on the deal was dry, the band canned singer Joey Belladonna, citing “creative differences,” and a year later hired singer John Bush, formerly of the heavy metal band Armored Saint.

The Bush Administration

“It was frightening to replace a frontman,” Benante told RIP magazine. “It was frightening to risk sitting there for a year, not being able to get anyone. It was frightening to have done it after signing this big contract with Elektra. But, that makes it all the more worth it. If we’d stayed in one place, I doubt I’d still be in this band. I doubt there’d even be a band! Then, again, we’ve never been afraid to try out different things, though we never seem to get credit. Like, we wore shorts and thermals in the past, and now that’s accepted fashion. But when we did it, people hated us for it!”

Anthrax released Sound of White Noise, their first record with their new singer, in 1993. Their sound was markedly transformed by Bush’s vocals and writing. “For us, it’s a big deal to make a record where you don’t know what you’re getting,” Ian said in a 1993 Elektra press biography. “These tracks are completely different from each other, yet it’s all Anthrax. It shows the types of music and ideas that we’re into.”

The set included “Potter’s Field,” about abortion, “Only” and “A Thousand Points of Hate,” about interpersonal relations, and “Black Lodge,” inspired by another David Lynch work, the television series Twin Peaks. In fact, Twin Peaks composer Angelo Badalamenti made a guest appearance on the song. “It’s just different enough to remind you that within the circumscribed parameters of thrash etiquette, Anthrax has always taken chances,” Rolling Stone said of the album. “And, how many bands in any genre have successfully reinvented themselves a decade into their career? In that sense, Sound of White Noise is a powerful comeback from a group that never went away.”

After more than ten grueling years of thrashing across the world, Anthrax insisted that their endurance came from the faith of their fans. “We’re following the Iron Maiden path,” guitarist Spitz declared in Screamer. “We don’t rely on radioplay or videos or album sales. We rely on touring and word-of-mouth. We play what we like to play and write what we like to write. We don’t have to change for anybody. That’s why the kids believe in us.” Spitz was voted out of the group in 1995.

Left Elektra

Anthrax released Stomp 442 on Elektra in 1995. The band felt that the label did not promote the album with as much fervor as Sound of White Noise, and left. “It just turned into a terrible situation. It just kind of took two years out of our lives,” Ian told Steve Knopper in Billboard. The group signed with Ignition Records, a joint venture with Tommy Boy Records, and released Volume 8: The Threat Is Real in 1998. According to Knopper, the album was “even more intense and thrashing than usual” and contained “some strange new experiments” for the group. Ian told Knopper that on the album “there are a lot of dynamics and a lot of ups and downs, yet there’s a cohesiveness. It all sounds like Anthrax. We’ve never had a record with that much diversity and this much cohesiveness. I know that sounds like a contradiction, but it works.”

Anthrax participated briefly in a package tour that included Mötley Crüe and Megadeath in 2000 and began recording another album in 2001. Guitarist Rob Cag-giano joined the group in 2002, and We’ve Come For You All was released in 2003; the group planned to tour in Europe and the United States.

With the threat of national anthrax attacks following the terrorist attacks on September 11, 2001, the band acknowledged its association, by name, with the infectious disease on its website: “In the 20 years we’ve been know as ‘Anthrax,’ we never thought the day would come that our name would actually mean what it really means… Before the tragedy of September 11th… (m)ost people associated the name Anthrax with the band, not the germ. Now in the wake of those events, our name symbolizes fear, paranoia, and death… To be associated with these things we are against is a strange and stressful situation.” The band said that they hoped future events would not make changing their name necessary.

Selected discography

Fistful of Metal, Megaforce, 1984.

Armed and Dangerous (EP), Megaforce, 1985.

Spreading the Disease, Island, 1986.

Among the Living, Island, 1987.

I’m the Man (EP), Island, 1988.

State of Euphoria, Island, 1988.

Persistence of Time, Island, 1990.

Attack of the Killer B’s, Island, 1991.

(Contributor) Last Action Hero (soundtrack), Sony, 1993.

Sound of White Noise, Elektra, 1993.

(Contributor) Airheads (soundtrack), Arista, 1994.

Live: The Island Years, Island, 1994.

Stomp 442, Elektra, 1995.

Volume 8: The Threat Is Real, Tommy Boy, 1998.

Return of the Killer A’s: The Best Of, Beyond, 1999.

(Contributor) Twisted Forever, Koch, 2001.

We’ve Come For You All, Nuclear Blast, 2003.

Sources

Books

Graff, Gary, and Daniel Durchholz, editors, MusicHound Rock: The Essential Album Guide, Visible Ink Press, 1999.

Rees, Dafydd, and Luke Crampton, Rock Movers & Shakers, ABC/CLIO, 1991.

Periodicals

Billboard, May 29, 1993; June 20, 1998.

Circus, December 31, 1988.

Guitar Player, July 1993.

Hit parader, september 1993.

Melody Maker, November 28, 1987; September 17, 1988; February 11, 1989; February 10, 1990; August 18, 1990; August 25, 1990; June 22, 1991; December 21, 1991.

Metro Times (Detroit, Ml), July 7, 1993.

Modern Drummer, June 1993.

Pulse!, July 1993; September 1993.

RIP, August 1993.

Rolling Stone, May 13, 1993; June 24, 1993.

Screamer, November 1988; April 1990; September 1990.

Spin, July 1993.

Online

“Anthrax,” All Music Guide, http://www.allmusic.com (February 27, 2003).

Anthrax Official Website, http://www.anthrax.com (February 27, 2003).

Nuclear Blast Records, http://www.nuclearblast.de (February 27, 2003).

Additional information was obtained from Elektra Records press materials, 1993.

—Sonya Shelton

Anthrax

Definition

Anthrax is an infection caused by the bacterium Bacillus anthracis that primarily affects livestock but that can occasionally spread to humans, affecting either the skin, intestines, or lungs. In humans, the infection can often be treated, but it is almost always fatal in animals.

Description

Anthrax is most often found in the agricultural areas of South and Central America, southern and eastern Europe, Asia, Africa, the Caribbean, and the Middle East. In the United States, anthrax is rarely reported; however, cases of animal infection with anthrax are most often reported in Texas, Louisiana, Mississippi, Oklahoma, and South Dakota. The bacterium and its associated disease get their name from the Greek word meaning "coal" because of the characteristic coal-black sore that is the hallmark of the most common form of the disease.

During the 1800s, in England and Germany, anthrax was known either as "wool-sorter's" or "ragpicker's" disease because workers contracted the disease from bacterial spores present on hides and in wool or fabric fibers. Spores are the small, thick-walled dormant stage of some bacteria that enable them to survive for long periods of time under adverse conditions. The first anthrax vaccine was perfected in 1881 by Louis Pasteur.

The largest outbreak ever recorded in the United States occurred in 1957 when nine employees of a goat hair processing plant became ill after handling a contaminated shipment from Pakistan. Four of the five patients with the pulmonary form of the disease died. Other cases appeared in the 1970s when contaminated goatskin drumheads from Haiti were brought into the U.S. as souvenirs.

Today, anthrax is rare, even among cattle, largely because of widespread animal vaccination. However, some serious epidemics continue to occur among animal herds and in human settlements in developing countries due to ineffective control programs. In humans, the disease is almost always an occupational hazard, contracted by those who handle animal hides (farmers, butchers, and veterinarians) or sort wool. There are no reports of the disease spreading from one person to another.

Anthrax as a weapon

There has been a great deal of recent concern that the bacteria that cause anthrax may be used as a type of biological warfare, since it is possible to become infected simply by inhaling the spores, and inhaled anthrax is the most serious form of the disease. The bacteria can be grown in laboratories, and with a great deal of expertise and special equipment, the bacteria can be altered to be usable as a weapon.

The largest-ever documented outbreak of human anthrax contracted through spore inhalation occurred in Russia in 1979, when anthrax spores were accidentally released from a military laboratory, causing a regional epidemic that killed 69 of its 77 victims. In the United States in 2001, terrorists converted anthrax spores into a powder that could be inhaled and mailed it to intended targets, including news agencies and prominent individuals in the federal government. Because the United States government considers anthrax to be of potential risk to soldiers, the Department of Defense has begun systematic vaccination of all military personnel against anthrax. For civilians in the United States, the government has instituted a program called the National Pharmaceutical Stockpile program in which antibiotics and other medical materials to treat two million people are located so that they could be received anywhere in the country within twelve hours following a disaster or terrorist attack.

Causes and symptoms

The naturally occurring bacterium Bacillus anthracis produces spores that can remain dormant for years in soil and on animal products, such as hides, wool, hair, or bones. The disease is often fatal to cattle, sheep, and goats, and their hides, wool, and bones are often heavily contaminated.

The bacteria are found in many types of soil, all over the world, and usually do not pose a problem for humans because the spores stay in the ground. In order to infect a human, the spores have to be released from the soil and must enter the body. They can enter the body through a cut in the skin, through consuming contaminated meat, or through inhaling the spores. Once the spores are in the body, and if antibiotics are not administered, the spores become bacteria that multiply and release a toxin that affects the immune system. In the inhaled form of the infection, the immune system can become overwhelmed and the body can go into shock.

Symptoms vary depending on how the disease was contracted, but the symptoms usually appear within one week of exposure.

KEY TERMS

Antibody— A specific protein produced by the immune system in response to a specific foreign protein or particle called an antigen.

Antitoxin— An antibody that neutralizes a toxin.

Bronchitis— Inflammation of the mucous membrane of the bronchial tubes of the lung that can make it difficult to breathe.

Cutaneous— Pertaining to the skin

Meningitis— Inflammation of the membranes covering the brain and spinal cord called the meninges.

Pulmonary— Having to do with the lungs or respiratory system.

Spore— A dormant form assumed by some bacteria, such as anthrax, that enable the bacterium to survive high temperatures, dryness, and lack of nourishment for long periods of time. Under proper conditions, the spore may revert to the actively multiplying form of the bacteria.

Cutaneous anthrax

In humans, anthrax usually occurs when the spores enter a cut or abrasion, causing a skin (cutaneous) infection at the site. Cutaneous anthrax, as this infection is called, is the mildest and most common form of the disease. At first, the bacteria cause an itchy, raised area like an insect bite. Within one to two days, inflammation occurs around the raised area, and a blister forms around an area of dying tissue that becomes black in the center. Other symptoms may include shivering and chills. In most cases, the bacteria remain within the sore. If, however, they spread to the nearest lymph node (or, in rare cases, escape into the bloodstream), the bacteria can cause a form of blood poisoning that rapidly proves fatal.

Inhalation anthrax

Inhaling the bacterial spores can lead to a rare, often-fatal form of anthrax known as pulmonary or inhalation anthrax that attacks the lungs and sometimes spreads to the brain. Inhalation anthrax begins with flulike symptoms, namely fever, fatigue, headache, muscle aches, and shortness of breath. As early as one day after these initial symptoms appear, and as long as two weeks later, the symptoms suddenly worsen and progress to bronchitis. The patient experiences difficulty breathing, and finally, the patient enters a state of shock. This rare form of anthrax is often fatal, even if treated within one or two days after the symptoms appear.

Intestinal anthrax

Intestinal anthrax is a rare, often-fatal form of the disease, caused by eating meat from an animal that died of anthrax. Intestinal anthrax causes stomach and intestinal inflammation and sores or lesions (ulcers), much like the sores that appear on the skin in the cutaneous form of anthrax. The first signs of the disease are nausea and vomiting, loss of appetite, and fever, followed by abdominal pain, vomiting of blood, and severe bloody diarrhea.

Diagnosis

Anthrax is diagnosed by detecting B. anthracis in samples taken from blood, spinal fluid, skin lesions, or respiratory secretions. The bacteria may be positively identified using biochemical methods or using a technique whereby, if present in the sample, the anthrax bacterium is made to fluoresce. Blood samples will also indicate elevated antibody levels or increased amounts of a protein produced directly in response to infection with the anthrax bacterium. Polymerase chain reaction (PCR) tests amplify trace amounts of DNA to show that the anthrax bacteria are present. Additional DNA-based tests are also currently being perfected.

Treatment

In the early stages, anthrax is curable by administering high doses of antibiotics, but in the advanced stages, it can be fatal. If anthrax is suspected, health care professionals may begin to treat the patient with antibiotics even before the diagnosis is confirmed because early intervention is essential. The antibiotics used include penicillin, doxycycline, and ciprofloxacin. Because inhaled spores can remain in the body for a long time, antibiotic treatment for inhalation anthrax should continue for 60 days. In the case of cutaneous anthrax, the infection may be cured following a single dose of antibiotic, but it is important to continue treatment so as to avoid potential serious complications, such as inflammation of the membranes covering the brain and spinal cord (meningitis ). In the setting of potential bioterrorism, cutaneous anthrax should be treated with a 60-day dose of antibiotics.

Research is ongoing to develop new antibiotics and antitoxins that would work against the anthrax bacteria and the toxins they produce. One Harvard professor, Dr. R. John Collier, and his team have been testing two possible antitoxins on rats. A Stanford microbiologist and a Penn State chemist have also been testing their new antibiotic against the bacteria that cause brucellosis and tularemia, as well as the bacteria that cause anthrax. All of these drugs are still in early investigational stages, however, and it is still unknown how these drugs would affect humans.

Prognosis

Untreated anthrax is often fatal, but death is far less likely with appropriate care. Ten to twenty percent of patients will die from anthrax of the skin (cutaneous anthrax) if it is not properly treated. All patients with inhalation (pulmonary) anthrax will die if untreated. Intestinal anthrax is fatal 25-75% of the time.

Prevention

Anthrax is relatively rare in the United States because of widespread animal vaccination and practices used to disinfect hides or other animal products. Anyone visiting a country where anthrax is common or where herd animals are not often vaccinated should avoid contact with livestock or animal products and avoid eating meat that has not been properly prepared and cooked.

Other means of preventing the spread of infection include carefully handling dead animals suspected of having the disease, burning (instead of burying) contaminated carcasses, and providing good ventilation when processing hides, fur, wool, or hair.

In the event that exposure to anthrax spores is known, such as in the aftermath of a terrorist attack, a course of antibiotics can prevent the disease from occurring.

In the case of contaminated mail, as was the case in the 2001 attacks, the U.S. postal service recommends certain precautions. These precautions include inspecting mail from an unknown sender for excessive tape, powder, uneven weight or lumpy spots, restrictive endorsements such as "Personal," or "Confidential," a postmark different from the sender's address, or a sender's address that seems false or that cannot be verified. Handwashing is also recommended after handling mail. In order to decontaminate batches of mail before being opened, machines that use bacteria-killing radiation could be used to sterilize the mail. These machines are similar to systems already in place on assembly lines for sterile products, such as bandages and medical devices, but this technique would not be practical for large quantities of mail. In addition, the radiation could damage some of the mail's contents, such as undeveloped photographic film. Microwave radiation or the heat from a clothes iron is not powerful enough to kill the anthrax bacteria.

For those in high-risk professions, an anthrax vaccine is available that is 93% effective in protecting against infection. To provide this immunity, an individual should be given an initial course of three injections, given two weeks apart, followed by booster injections at six, 12, and 18 months and an annual immunization thereafter.

Approximately 30% of those who have been vaccinated against anthrax may notice mild local reactions, such as tenderness at the injection site. Infrequently, there may be a severe local reaction with extensive swelling of the forearm, and a few vaccine recipients may have a more general flu-like reaction to the shot, including muscle and joint aches, headache, and fatigue. Reactions requiring hospitalization are very rare. However, this vaccine is only available to people who are at high risk, including veterinary and laboratory workers, livestock handlers, and military personnel. The vaccine is not recommended for people who have previously recovered from an anthrax infection or for pregnant women. Whether this vaccine would protect against anthrax used as a biological weapon is, as yet, unclear.

Resources

ORGANIZATIONS

Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. 〈http://www.cdc.gov〉.

National Institute of Allergies and Infectious Diseases, Division of Microbiology and Infectious Diseases. Building 31, Room. 7A-50, 31 Center Drive MSC 2520, Bethesda, MD 20892. 〈http://www.niaid.nih.gov〉.

World Health Organization, Division of Emerging and Other Communicable Diseases Surveillance and Control. Avenue Appia 20, 1211 Geneva 27, Switzerland. (+00 41 22) 791 21 11. 〈http://www.who.int〉.

OTHER

"Anthrax." New York State Department of Health Communicable Disease Fact Sheet. 〈http://www.health.state.ny.us/nysdoh/consumer/anthrax.htm〉.

"Bacillus anthracis (Anthrax)." 〈http://web.bu.edu/COHIS/infxns/bacteria/anthrax.htm〉.

Begley, Sharon and Karen Springen. "Anthrax: What You Need to Know: Exposure doesn't guarantee disease, and the illness is treatable." Newsweek October 29, 2001: 40.

Centers for Disease Control. 〈http://www.cdc.gov〉.

Kolata, Gina. "Antibiotics and Antitoxins." New York Times October 23, 2001: Section D, page 4, second column.

Park, Alice. "Anthrax: A Medical Guide." Time 158, no. 19 (October 29, 2001): 44.

Shapiro, Bruce. "Anthrax Anxiety." The Nation 273, no. 4 (November 5, 2001): 4.

Wade, Nicholas. "How a Patient Assassin Does Its Deadly Work." New York Times October 23, 2001: Section D, page 1.

Anthrax

Introduction

Disease History, Characteristics, and Transmission

Scope and Distribution

Treatment and Prevention

Impacts and Issues

BIBLIOGRAPHY

Introduction

Anthrax is an infection caused by the bacterium Bacillus anthracis. Its name comes from the black spots that can appear on the body in the cutaneous (skin) form of the disease; to suggest the color of the spots, doctors used the Greek word for coal, “anthrax.” Anthrax is usually transmitted through hardy spores that can survive in soil for decades. Anthrax exists naturally in many parts of the world as an infection of herbivores (plant-eating animals), such as cattle and sheep. Because its spores are small enough to become airborne, anthrax can be contracted by humans as a lung infection. In this form it is fatal in at least 95% of cases that do not receive immediate antibiotic treatment. Because of the high fatality rate of the inhaled form of the disease, anthrax has been developed as a biological weapon by several major nations, including Japan, Russia, the United Kingdom, and the United States. No nation is known today to retain stocks of weaponized anthrax, but there is concern that terrorists might use anthrax as a weapon.

Disease History, Characteristics, and Transmission

History

Anthrax is a naturally occurring disease afflicting live-stock and occasionally, through contact with livestock, humans. Records show that in Europe in the 1600s, a cattle disease that was almost certainly anthrax, called the Black Bane, killed about 60,000 cattle. Until the development of antibiotics and an effective veterinary vaccine for anthrax in the mid-twentieth century, anthrax was one of the most common causes of death for cattle, goats, horses, pigs, and sheep.

In 1876, the German physician Robert Koch (1843–1910) showed that a bacterium was responsible for the disease, making anthrax one of the first diseases to be identified as having a bacterial cause. Koch, who was awarded a Nobel Prize in Medicine in 1905, also discovered the bacterial causes of tuberculosis and cholera. Cattle were first successfully in oculated against anthrax in 1880 by the French biologist Louis Pasteur (1822–1895).

WORDS TO KNOW

CUTANEOUS: Pertaining to the skin.

ENTERIC: Involving the intestinal tract or relating to the intestines.

HYPERENDEMIC: A disease that is endemic (commonly present) in all age groups of a population is hyperendemic. A related term is holoendemic, meaning a disease that is present more in children than in adults.

SPORE: A dormant form assumed by some bacteria, such as anthrax, that enable the bacterium to survive high temperatures, dryness, and lack of nourishment for long periods of time. Under proper conditions, the spore may revert to the actively multiplying form of the bacteria.

The use of anthrax in modern warfare began in 1915 during World War I, when a German-American agent working for the Imperial German Government set up a secret laboratory in Washington, D.C., to produce anthrax bacteria. These were then used to infect cattle and draft animals being shipped to the Allied armies in Europe. Several hundred Allied military personnel were infected by the anthrax-ridden cattle.

During World War II (1939–1945), anthrax was developed as a major weapon by several countries. A biological warfare unit, Unit 731, was formed in the Japanese Imperial Army, which carried out experiments on thousands of Chinese prisoners of war in the 1930s. In one facility, about 4,000 prisoners were killed by biological agents, mostly anthrax. By 1945, Japan had prepared about 880 lb (400 kg) of powdered anthrax spores for use in fragmentation bombs intended to spread the spores in the air to be inhaled. Japan surrendered before using anthrax bombs, but historians estimate that Japan may have killed over a half a million Chinese civilians using other forms of biological warfare. All members of Unit 731 were granted amnesty by the United States after the war in exchange for full disclosure of their wartime activities.

Japan was not the only country to place anthrax in bombs during World War II. In the United States, a major of fensive bio war program was established at the Army's Camp Detrick, Maryland, in 1942. Anthrax and a number of other agents were developed as weapons there, and a plant for producing biological weapons was constructed near Terre Haute, Indiana. Thousands of anthrax bombs were produced, but none were used during the war. The British government, which was cooperating with the United States and Canada in developing anthrax as a weapon, contaminated the Scottish island of Gruinard with anthrax spores in 1942. Due to the long-lived nature of the spores, the island was off-limits for 48 years afterward, when it was finally decontaminated. The difficulty of decontaminating Gruinard shows how a large-scale attack with anthrax spores might render large areas of land uninhabitable. Decontamination of the small island involved soaking it in 308 tons (280 metric tons) of formaldehyde diluted in seawater and the removal of tons of topsoil in sealed containers.

IN CONTEXT: CULTURAL CONNECTIONS

The description of the sooty “morain” in the Book of Exodus is reminiscent of anthrax, and the disease is probably the “burning wind of plague” in Homer's Iliad. The mass death of horses and cattle (the primary targets of anthrax infection, along with sheep) during the Eurasian campaign of the Huns in 80 AD was also likely due to anthrax.

The Soviet Union also instituted a biological warfare program during World War II, focusing on anthrax and other agents. The Soviet program continued for decades after the war, as did the U.S. program. In 1979, one of the worst anthrax outbreaks of the twentieth century occurred in the Ural Mountains in western Russia. The official toll was 96 people infected, resulting in 66 deaths, but the actual toll was probably higher. The Soviet government claimed that the outbreak was natural, but the United States and others accused the Soviets of violating the 1972 Biological and Toxic Weapons Convention. This treaty had been designed to ban the manufacture and stockpiling of biological and poison-gas weapons. In the early 1990s, after the breakup of the Soviet Union, Russian and American scientists were able to study the 1979 outbreak in detail. They concluded that it was caused by an accidental release of anthrax spores from a military facility on the outskirts of the city Sverdlovsk (now called Yekaterinburg). All the cases in cattle and humans occurred in narrow oval pattern downwind of the facility.

In response to a 1969 decision by President Richard Nixon (1913–1994), the U.S. army destroyed all its anti-personnel biological warfare stocks, including anthrax, in 1971 and 1972.

The potential of even a small quantity of anthrax to disrupt a society and drain its resources was shown in 2001, when attacks were carried out through the U.S. mail using anthrax spores. The attacks began on September 18, a week after the attacks on the World Trade Center and Pentagon. Letters containing anthrax spores in powder form were mailed from a public mailbox in Princeton, New Jersey, and received by several TV networks, the newspaper the New York Post, and the offices of two senators, Tom Daschle (D-SD) and Patrick Leahy (D-VT). Five people were killed by the anthrax and seventeen others were made ill. (Neither of the senators was infected.) As of early 2007, no group or individual had claimed responsibility for the attacks, and the case remained unsolved.

Early news reports characterized the 2001 anthrax powder as weapons-grade, but, in 2006, the U.S. Federal Bureau of Investigation (FBI) confirmed that the powder did not have any of the special technical features (such as a coating on the spores to keep them from sticking together) that would identify it as coming from a military facility.

Anthrax, like other biological weapons, has little value as a battlefield weapon. It has several disadvantages for combat use:

1. No disease acts quickly enough to be decisive in combat.
2. Wind and other factors make it difficult to deliver spores or viruses in a controlled way to enemy troops.
3. Soldiers are the best-defended of any target group, often being equipped with protective clothing, filter masks, and immunizations.

Biological weapons, whether employed by nationstates or smaller organizations, are therefore primarily a terror threat to civilian populations. The U.S. National Academy of Sciences estimated in 2003 that 2.2 lb (1 kg) of anthrax spores sprayed aerially over a large city could kill over 100,000 people. Anthrax spores could also render hundreds of square miles uninhabitable for a many decades by lodging in the soil, causing immense economic damage.

Characteristics

Anthrax bacteria in their vegetative form are shaped like rods about 1 millionth of a meter (1 μm) wide and 6 μm long. The vegetative form multiplies inside a host animal. When conditions are not right for anthrax to grow and multiply—namely, when temperature, acidity, humidity, and nutrient levels are outside the favorable range—some of the vegetative anthrax bacteria sporulate, that is, take on a spore form. A spore is an extremely small, one-celled reproductive unit that is usually able to survive extreme environmental conditions. Unlike a seed, a spore does not store a significant amount of nutrients. Anthrax spores can survive in soil or as a dry powder for many years and are the most common source of anthrax infection.

Once in the body, anthrax spores germinate and multiply. Toxins released by the bacteria cause the immune system to break down. In the final phase of infection, the bacteria build rapidly in the blood, doubling in number every 0.75–2 hours. At death, there may be more than 10⁸ (100,000,000) anthrax bacteria per milliliter of blood. (A milliliter is about the size of a small drop.) Toxins from the bacteria break down the blood vessels, causing death by internal bleeding.

After death, the bacteria continue to multiply in the carcass. Large numbers of spores are shed to the surrounding soil. The anthrax life cycle is continued when other creatures either eat the flesh of the dead animal or ingest enough of the spores.

There are three basic types of anthrax infection: pulmonary, cutaneous, and gastrointestinal (also called enteric, meaning of the intestines) anthrax. Pulmonary or lung infection with anthrax is caused by inhalation of spores; cutaneous or skin infection is caused by entry of spores or bacteria into cuts or sores; and gastrointestinal infection is caused by eating anthrax-contaminated meat.

Transmission

Anthrax is usually contracted either by taking spores or bacteria into the body through a lesion (cut or open sore), through the bite of a fly, by eating the flesh of an anthrax-infected animal, or by inhaling spores. Direct transmission of anthrax between humans is extremely rare.

Humans are moderately resistant to anthrax. The infectious dose for inhalation anthrax, measured by spore count, is probably between 2,500 and 760,000 spores, the range recorded for non-human primates. The U.S. Department of Defense estimates that 8,000–10,000 spores is the anthrax LD50 for humans; LD50 stands for “lethal dose 50,” the amount of an agent that will be fatal in about 50% of cases. Scientists have shown that in contaminated industrial settings, people can inhale over 1,000 anthrax spores per day without contracting the disease. When anthrax is developed as a weapon, it is meant to be delivered in extremely large quantities. For example, 220 lb (100 kg) of spores, often cited as a working figure in discussions of possible large-scale military use, contain about 10¹³ (10,000,000,000,000 or ten trillion) LD50 doses—about 1,500 times the population of the world. However, most of the spores distributed by a weapon would not end up being inhaled.

Scope and Distribution

As a naturally occurring disease, anthrax mostly afflicts cattle. In humans, it is relatively rare. Persons in agricultural settings in poor nations, who are likelier to contract the disease from livestock, account for the great majority of human anthrax cases worldwide. Natural anthrax remains hyperendemic or epidemic in about 14 countries today, including Burma (also known as Myanmar), Chad, Niger, Turkey, and Zambia. It is endemic in China, India, Indonesia, much of Latin America and Africa, and sporadic in most of the rest of the world, including Australia, the United States, and Europe. (A sporadic disease occurs only occasionally; an endemic disease coexists normally with its host population; a hyperendemic disease co-exists with its host population at a high rate; and an epidemic disease is one that episodically occurs at a high rate.) Human case rates are highest today in central and southern Asia, the Middle East, and Africa.

The human anthrax rate normally depends on the livestock anthrax rate in a given area. There is about one human cutaneous anthrax case for every 10 anthrax-infected livestock carcasses processed and one enteric case for every 100–200 cutaneous cases. Inhalation anthrax is relatively rare.

IN CONTEXT: TERRORISM AND BIOLOGICAL WARFARE

Accompanying the antiquity of anthrax is the exploitation of the disease as a weapon. Hundreds of years ago, diseased bodies were dumped into wells, to poison the enemy's drinking water supply, or were launched over the barricading walls of the fortified cities of the enemy.

IN CONTEXT: EFFECTIVE RULES AND REGULATIONS

Project BioShield gives the National Institutes of Health funding to expedite research into the most promising new drug treatments and allows the Food and Drug Administration (FDA) to make promising drugs widely available in emergency situations. In particular, procedures are used to speed up the funding process for grant proposals for research into new drug therapies for chemical, biological, and radiological diseases. Some of the innovations developed under Project BioShield may become important in the treatment of naturally occurring diseases.

Treatment and Prevention

Prevention of anthrax is based on breaking the cycle of infection, which primarily means controlling its appearance in livestock. The World Health Organization (WHO) of the United Nations is trying to set up a global network of anthrax experts and diagnostic laboratories to better monitor and respond to anthrax outbreaks worldwide. WHO says that the following steps must be rigorously implemented when dealing with anthrax-infected livestock:

1. Correct disposal of carcasses of animals with anthrax. This means deep burial, heat treatment, or incineration without a post-mortem (to avoid releasing spores).
2. Disinfection and disposal of all contaminated materials. This includes the processing of possibly infected animal hides before export, the incineration or burial of dung, the chemical sterilization of tools, and the thorough washing of hands.
3. Vaccination of susceptible animals and humans in at-risk occupations, such as those processing meat, hides, and wool.

IN CONTEXT: CULTURAL CONNECTIONS

An often-overlooked aspect of the use of anthrax as a terrorist weapon is the economic hardship that the dispersal of a small amount of the spores would exact. A report from the Centers for Disease Control and Prevention (CDC), entitled The Economic Impact of a Bioterrorist Attack, estimated the costs of dealing with an anthrax incident at a minimum of US$26 billion per 100,000 people. In just a few months in 2001 alone, a flurry of hoax anthrax incidents following the real attacks cost the U.S. government millions of dollars.

Vaccination is not universal for livestock because of its expense. It is not universal for humans because of the expense and the risk of presently available anthrax vaccines. The only anthrax vaccine that is approved by the government for use in the United States—trade name Biothrax, first licensed in 1970—involves giving the subject six injections over 18 months. This vaccine is mandatory for some categories of U.S. military personnel and civilian defense contractors. However, because the potency of the vaccine varies greatly, some scientists argue that many military personnel have suffered health damage from the vaccine.

For persons in contact with human anthrax patients, prophylactic (preventative) antibiotics are given. Treatment of anthrax infection is with large doses of anti-biotics, both swallowed (oral) and injected directly into the bloodstream (intravenous). Especially for inhalation anthrax, treatment must begin soon after infection— generally within a day and before symptoms are seen.

Impacts and Issues

In countries where anthrax is naturally present, it exacts a steady human and economic toll. Persons contracting the disease may die or live with a decreased quality of life. Animals that contract the disease must be destroyed, and their carcasses are economically worthless.

The mere threat of the use of anthrax as a weapon has caused the U.S. government to undertake extraordinary preventive efforts in addition to its military vaccination program. In 2004, as part of a $5.6 billion program called Project BioShield, intended to protect the public from biological threats, the federal government ordered 75 million doses ($877 million worth) of a new anthrax vaccine from a private company, VaxGen Inc., to be stockpiled in case of an anthrax attack on the United States. The new vaccine was to have required no more than three separate injections. The U.S. Department of Health and Human Services (HHS) has also stockpiled over a billion antibiotic tablets, enough to treat 20 million people for two months. The new anthrax vaccine was to be delivered in 2006, but the program was delayed. In December 2006, HHS cancelled its contract with VaxGen because the company was not able to start human clinical trials of its new vaccine on time. This leaves Project Bioshield without a plan for producing an emergency stock of anthrax vaccine for public use.

See AlsoBiological Weapons Convention; Bioterrorism; Koch's Postulates; War and Infectious Disease; Zoonoses.

BIBLIOGRAPHY

Books

Sarasin, Philipp, and Giselle Weiss. Anthrax: Bioterror as Fact and Fantasy. Cambridge, MA: Harvard University Press, 2006.

Periodicals

Broad, William J. “Anthrax Not Weapons Grade, Official Says.” New York Times (September 26, 2006).

Enserink, Martin, and Jocelyn Kaiser. “Accidental Anthrax Shipment Spurs Debate Over Safety.” Nature 304 (2004): 1726–1727.

Hilts, Philip J. “79 Anthrax Traced to Soviet Military.” New York Times (November 18, 1994).

Lipton, Eric. “Bid to Stockpile Bioterror Drugs Stymied by Setbacks.” New York Times (September 18, 2006).

Rosovitz, M.J., and Stephen H. Leppla. “Virus Deals Anthrax a Killer Blow.” Nature 418 (2002): 825–826.

Web Sites

British Broadcasting Corporation. “Britain's ‘Anthrax Island.”’ July 25, 2001. <http://news.bbc.co.uk/2/low/uk_news/scotland/1457035.stm> (accessed January 30, 2007).

World Health Organization. “Guidelines for the Surveillance and Control of Anthrax in Humans and Animals.” <http://www.who.int/csr/resources/publications/anthrax/WHO_EMC_ZDI_98_6/en/> (accessed January 30, 2007).

World Health Organization. “World Anthrax Data Site.” September 30, 2003. <http://www.vetmed.lsu.edu/whocc/mp_world.htm> (accessed January 30, 2007).

Anthrax

Resources

Anthrax refers to a pulmonary disease that is caused by the bacterium Bacillus anthracis. This disease has been present since antiquity. It may be the sooty “morain” in the Book of Exodus, and is probably the “burning wind of plague” that begins Homer’s Iliad. Accounts by the Huns during their sweep across Eurasia in AD 80 describe mass deaths among their horses and cattle attributed to anthrax. These animals, along with sheep, are the primary targets of anthrax. Indeed, loss to European livestock in the eighteenth and nineteenth centuries stimulated the search for a cure. In 1876, Robert Koch identified the causative agent of anthrax.

The use of anthrax as a weapon is not a new phenomenon. In ancient times, diseased bodies were used to poison wells, and were catapulted into cities under siege. In modern times, research into the use of anthrax as a weapon was carried out during World War I and World War II. In World War II, Japanese and German prisoners were subjects of medical research, including their susceptibility to anthrax. Allied efforts in Canada, the United States, and Britain to develop anthrax-based weapons were also active. Britain actually produced five million anthrax cakes at the Porton Down facility to be dropped on Germany to infect the food chain.

In non-deliberate settings, humans acquire anthrax from exposure to the natural reservoirs of the microorganism, from livestock such as sheep or cattle or wild animals. Anthrax has been acquired by workers engaged in shearing sheep, for example.

Human anthrax can occur in three major forms. Cutaneous anthrax refers to the entry of the organism through a cut in the skin. Gastrointestinal anthrax occurs when the organism is ingested in food or water. Finally, inhalation anthrax occurs when the organism is inhaled.

All three forms of the infection are serious, even lethal, if not treated. With prompt treatment, the cutaneous form is often cured. Gastrointestinal anthrax, however, can still be lethal in 25–75% of people who contract it. Inhalation anthrax is almost always fatal.

The inhalation form of anthrax can occur because of the changing state of the organism. Bacillus anthracis can live as a large “vegetative” cell, which undergoes cycles of growth and division, or the bacterium can wait out the nutritionally bad times by forming a spore and becoming dormant. The spore is designed to protect the genetic material of the bacterium during hibernation. When conditions are conducive for growth and reproduction, the spore resuscitates and active life goes on again. The spore form can be easily inhaled. Only 8,000 spores, hardly enough to cover a snowflake, are sufficient to cause the pulmonary disease when they resuscitate in the warm and humid conditions deep within the lung.

The dangers of an airborne release of anthrax spores are well known. British open-air testing of anthrax weapons in 1941 on Gruinard Island in Scotland rendered the island uninhabitable for five

KEY TERMS

Antibody— A molecule created by the immune system in response to the presence of an antigen (a foreign substance or particle). It marks foreign microorganisms in the body for destruction by other immune cells.

Bronchitis— Inflammation of the mucous membrane of the bronchial tubes of the lung that can make it difficult to breathe.

Cutaneous— Pertaining to the skin.

Meningitis— Inflammation of the meninges; membranes covering the brain and spinal cord.

Pulmonary— Having to do with the lungs or respiratory system.

Spore— A dormant form assumed by some bacteria, such as anthrax, that enable the bacterium to survive high temperatures, dryness, and lack of nourishment for long periods of time. Under proper conditions, the spore may revert to the actively multiplying form of the bacteria.

decades. In 1979, an accidental release of a minute quantity of anthrax spores occurred at a bioweapons facility near the Russian city of Sverdlovsk. At least 77 people were sickened and 66 died. All the affected were some 2.5 miles (4 km) downwind of the facility. Sheep and cattle up to 31 miles (50 km) downwind became ill.

Three components of Bacillus anthracis are the cause of anthrax. First, the bacterium can form a capsule around itself. The capsule helps shield the bacterium from being recognized by the body’s immune system as an invader and helps fend off the antibodies and immune cells that try to deal with the bacterium. This can allow the organism to multiply to large numbers that overwhelm the immune system. The capsule also contains an antigen that has been designated a protective antigen. The antigen is protective, not to the host being infected, but to the bacterium. The protective antigen dissolves protein, which can allow the bacterium to “punch” through the membrane surrounding cells of the host, such as the epithelial cells that line the lung. Once inside the cells, a bacterium is safe from the host’s immune defenses. A second toxic component, which is called lethal factor, destroys the immune cells of the host. Finally, a third toxic factor is known as edema factor (named because it results in the accumulation of fluid at the site of infection). Edema factor disables a molecule in the host called calmodulin, which is used to regulate many chemical reactions in the body. The end result of the activity of the toxic factors of Bacillus anthracis is to quell the immune response and so to allow the infection to spread.

As the bacteria gain a foothold, toxins enter the bloodstream and circulate throughout the body, causing destruction of blood cells and tissues. The damage can prove to be overwhelming to treatment efforts, and death occurs.

Anthrax infections are difficult to treat because the initial symptoms are similar to other, less serious infections, such as the flu. By the time the diagnosis is made, the infection can be too advanced to treat. A vaccine for anthrax does exist, but to date, only those at high risk for infection (soldiers, workers in meat-processing plants, anthrax research scientists) have received the vaccine, due to the possible serious side effects that can occur. Work to establish a safer vaccine is underway. The edema factor may be a potential target of a vaccine. Another promising target is the protective antigen of the capsule. If the action of this antigen could be blocked, the bacteria would not be able to hide inside host cells and could be more effectively dealt with by the immune response and with antibiotics.

In 2001, the United States experienced several deliberate releases of anthrax spores through the mailing of contaminated letters. As of 2006, those responsible for the incidents have not been identified. These incidents led to the call for a nationwide immunization program against a possible airborne bioterrorist release of the anthrax spores. However, whether the vaccine would provide complete protection against anthrax used as a biological weapon is, as yet, unclear.

See also Biological warfare.

Resources

PERIODICALS

Cole, Leonard A. The Antrax Letters: A Medical Detective Story. Washington, D.C.: National Academy of Science, 2003.

Decker, Janet M. Anthrax (Deadly Diseases and Epidemics). Key West, FL: Chelsea House Publishers, 2003.

Holmes, Chris. Spores, Plagues and History: The Stroy of Anthrax. Dallas: Durban House, 2003.

Sarasin, Philipp and Giselle Weiss. Anthrax: Bioterror as Fact and Fantasy. Boston: Harvard University press, 2006.

Pannifer, A. D., T. Y. Wong, R. Schwarzenbacher, et al. “Crystal Structure of the Anthrax Lethal Factor.” Nature 414 (November 2001): 229–233.

Brian Hoyle