How to Prevent Anthrax after a Bioterrorism Event

Key points

  • The U.S. government has a plan to rapidly distribute antibiotics to prevent anthrax in the event of a bioterrorism attack.
  • Know what to do to protect yourself and your family if there is an anthrax event.
  • Anthrax can cause serious disease, but treatment immediately following an exposure helps prevent illness.
doctors discussing results

Overview

Anthrax is rare, and most people will never be exposed to it. Anthrax is not contagious, which means you can’t catch it from another person like the cold or flu. However, people can be exposed to anthrax during a bioterrorism attack. Anthrax can be deadly if not treated quickly after exposure. It is important to know how to protect yourself and others around you if you are exposed to anthrax during a bioterrorism event.

Preventing anthrax in a bioterrorism emergency

Vaccine

Sometimes anthrax vaccine is recommended for people who may have been exposed to anthrax. does not have anthrax bacteria in the vaccine, and it cannot give you anthrax. The Food and Drug Administration (FDA) has approved post-event emergency use of the vaccine after a possible anthrax exposure. There are two types of anthrax vaccines approved by the FDA for people ages 18 to 65 after possible anthrax exposure:

  • Anthrax Vaccine Adsorbed (AVA), which consists of 3 shots of anthrax vaccine over 4 weeks
  • AVA adjuvanted, which consists of 2 shots given 2 weeks apart.

In both cases, people exposed to anthrax will also get antibiotics for up to 60 days.

In an emergency, the only people who shouldn't get the vaccine are people with a past serious allergic reaction to the anthrax vaccine. These individuals should take antibiotics for 60 days.

Antibiotics

Anthrax is caused by a bacteria called Bacillus anthracis, which can be effectively treated with antibiotics.

During an anthrax emergency, you will likely be given an antibiotic because you may have breathed in anthrax bacteria. You may receive doxycycline (DOX-i-SYE-kleen) or ciprofloxacin (sip-roe-FLOX-a-sin). These medicines reduce your chance of getting sick and dying.

Public health officials will provide information on who should get the medicine. It's important to take one of these medicines as soon as possible after the emergency starts. If you have questions, talk to a healthcare provider.

People who may have breathed in anthrax bacteria should take one of the medicines twice a day for up to 60 days. Most people will be given a 10-day supply to start. Public health officials will tell you whether you need more and how to get it. To reduce your chance of getting sick, take the medicine as long as you are directed and don't stop it early.

Instructions for taking doxycycline

Pills

  • For children weighing 76 pounds (35 kg) or more and adults aged 18 years or older, take one 110 mg pill in the morning and one 100 mg pill in the evening with a full glass of water.
  • The morning and evening doses should be taken 12 hours apart each day for as long as directed.
  • Doxycycline works just as well whether you take it with or without food, but it may upset your stomach if you don't take it with food.

Liquids and Slurries

For children weighing less than 76 pounds (35 kg), the dose of doxycycline is based on weight. Follow instructions on the liquid doxycycline label, if provided.

If you do not have access to liquid doxycycline for children, you can create an antibiotic slurry. To make the slurry, you crush antibiotics and mix it into liquid or foods like applesauce or pudding. It can also be helpful if an adult has difficulty swallowing pills. Get detailed instructions to create an antibiotic slurry.

More about doxycycline‎

For more information about doxycycline, including side effects, what an allergic reaction looks like, and more, visit Emergency Use of Doxycycline.

Instructions for taking ciprofloxacin

Adults and children 67 pounds (31kg) or more

  • Take 1 pill (500 mg) in the morning with a full glass of water.
  • Twelve (12) hours later, take 1 pill (500 mg) in the evening with a full glass of water.
  • You can take ciprofloxacin with or without food.

Children under 67 pounds (31kg)

  • Follow instructions provided on the liquid ciprofloxacin label.
  • Shake the liquid very well for about 15 seconds before each use.
  • Take the same amount in the morning and evening (12 hours apart) each day for as long as healthcare providers or officials recommend you should take it.

More about ciprofloxacin‎

For more information about ciprofloxacin, including side effects, what an allergic reaction looks like, and more, visit Emergency Use of Ciprofloxacin.

Resources

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); About Division of High-Consequence Pathogens and Pathology