Anthrax (Bacillus anthracis)

Clinical criteria
Any person with at least one of the following clinical forms:

Cutaneous anthrax
At least one the following two:

• Papular or vesicular lesion
• Depressed black eschar with surrounding oedema

Gastrointestinal anthrax

- Fever or feverishness
AND at least one of the following two:
- Severe abdominal pain
- Diarrhoea

Inhalational anthrax

- Fever or feverishness
AND at least one of the following two:
- Acute respiratory distress
- Radiological evidence of mediastinal widening

Meningeal/meningoencephalitic anthrax

- Fever
AND at least one of the following three:
- Convulsions
- Loss of consciousness
- Meningeal signs

Anthrax septicaemia

Laboratory criteria

• Isolation of Bacillus anthracis from a clinical specimen
• Detection of Bacillus anthracis nucleic acid in a clinical specimen

Positive nasal swab without clinical symptoms does not contribute to a confirmed diagnosis of a case.

Epidemiological criteria
At least one of the following three epidemiological links:

• Animal to human transmission (only for person meeting clinical criteria for cutaneous case)
• Exposure to a common source
• Exposure to contaminated food/drinking water

Case classification

A. Possible case
NA
B. Probable case
Any person meeting the clinical criteria and with an epidemiological link
C. Confirmed case
Any person meeting the clinical and the laboratory criteria

Current as of: 7 March 2019