Anthrax--update on diagnosis and management.

Human anthrax is difficult to contain. This is primarily because it is a zoonotic disease and the disease has never been contained in the livestock of India due to lack of adequate vaccination facilities. Animal anthrax is very common in many parts of India. The problem of anthrax is further compounded by lack of awareness on the part of village folk who unwittingly handle the hide and share the dead animal meat and this causes cutaneous and gastrointestinal forms of anthrax respectively. Hemorrhagic meningitis and pulmonary anthrax, the other forms of anthrax, carry a risk of nearly cent percent mortality. Characteristic gram positive rods abundantly found in the smear of the cerebrospinal fluid, blood etc. make diagnosis certain in most of the cases. Resistance to penicillin, the drug of choice, now being occasionally reported, may become a confounding factor while attempting successful control of the disease. Other antibiotics which are found to be very effective are doxycycline and ciprofloxacin. Fear of use of anthrax spores as a biological weapon has also given a new dimension to the problem.