Anthrax Prevention Primary prevention Primary prevention is based on limiting exposure to anthrax spores. If occupational exposure is expected
(e.g., contact with animals or their products), protective clothing should be worn. As inhalation anthrax has
been linked to the large-scale preparation of animal hides and wool, measures to maximise ventilation in
these professional settings is recommended.
Anthrax vaccine adsorbed (AVA), a non-infectious vaccine developed from an avirulent nonencapsulated
strain of
Bacillus anthracis , is recommended for pre-exposure prophylaxis. It is administered as 5
intramuscular doses given at 0, 1, 6, 12, and 18 months, followed by an annual booster. Use should be
limited to the following groups of adults aged 18 to 65 years who are at risk of exposure:
• People who work with anthrax in a laboratory setting
• People who handle potentially infected animals or animal products in endemic regions
• Active duty military personnel.
The vaccine is not recommended in pregnant women, people with a severe allergy to any component of the
vaccine, or people with a history of severe allergy to a previous dose of the anthrax vaccine.
[38]
[39]
[40]
AVA is only available in the US. Other anthrax vaccines may be available in other countries, but the
formulation and dose schedule may differ. For example, in the UK, a 4-dose intramuscular regimen is
recommended.
[41]
Local guidance should be consulted.
Screening There is no rapid screening test for infection due to anthrax. A nasal swab for culture can be performed to
define an area of anthrax exposure in the event of spore aerosolisation. However, current recommendations
suggest that these cultures are for epidemiological purposes only; nasal swabs should not be used
to diagnosis anthrax, to replace environmental sampling, or to determine the need for antimicrobial
prophylaxis.
[34]