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Review of the Literature

Mark E. Beatty, MD, MPH; David A. Ashford, DVM, MPH, DSc; Patricia M. Griffin, MD; Robert V. Tauxe, MD; Jeremy Sobel, MD, MPH

Arch Intern Med. 2003;163:2527-2531.

Recent events have drawn attention to cases of inhalational and cutaneous anthrax associated with contaminated mail. Gastrointestinal anthrax, the disease caused by ingestion of Bacillus anthracis organisms, has rarely been reported in the United States. This review provides background information on the gastrointestinal form of the disease. We describe the clinical course of gastrointestinal anthrax, outline current therapy, review the microbiology of B anthracis, examine the epidemiology of natural outbreaks, discuss considerations regarding deliberate contamination, and summarize existing literature on the inactivation of spores present in food and water.

From the Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office (Dr Beatty), the Foodborne and Diarrheal Diseases Branch (Drs Beatty, Griffin, Tauxe, and Sobel), and the Meningitis and Special Pathogens Branch (Dr Ashford), the Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga. The authors have no relevant financial interest in this article.

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