Anthrax culture (Photo: masks offer protection against SARS infection (Photo: Michel Depardieu/INSERM)

Anthrax is primarily a zoonotic disease in herbivores caused by a bacterium called Bacillus anthracis. Humans generally acquire the disease directly or indirectly from infected animals, or through occupational exposure to infected or contaminated animal products. Anthrax in humans is not generally regarded as contagious, although rare records of person-to-person transmission exist. Anthrax bacteria can survive in the environment for decades by forming spores. In its most common natural form called cutaneous anthrax (over 95% of cases), it creates dark sores on the skin, from which it derives its name, after the Greek word for coal.

Worldwide, the estimated incidence of human anthrax decreased from between 20,000 - 100,000 cases per year in 1958, to 2,000 per year during the 1980s. In the Eastern Mediterranean region outbreaks of human anthrax have been reported from Afghanistan, the Islamic Republic of Iran, Iraq, Morocco, Pakistan and Sudan. Additionally, Bacillus anthracis has always been high on the list of potential agents with respect to biological warfare and bioterrorism, having been used in that context on at least two occasions.

Control of anthrax among humans depends on the integration of veterinary and human health surveillance and control programmes. Routine cross-notification between the veterinary and human health surveillance systems and close collaboration between the two health sectors is particularly important during epidemiological and outbreak investigations.