Transmission
By spores entering through:

• Broken skin
• Inhalation
• Ingestion

Symptoms
Malignant pustules – on exposed area of skin
Pulmonary anthrax – through inhalation, typical influenza symptoms
Intestinal anthrax – through ingestion, severe stomach pain, vomiting and diarrhoea



Sources
Historically horse hair, and has been used in construction, usually as an admixture of plaster, but occasionally on ceilings as an insulant.



Refurbishment of Historic buildings
Although regulations to combat anthrax were introduced in 1907, they were virtually ineffectual until the outbreak of the Second World War.  Thus, architects or those involved in refurbishment of historic buildings should be aware that sampling and analysis would be prudent in buildings over 50 years old to establish whether or not there is a problem.



Hazard Group
Bacillus anthracis is in Hazard Group 3, i.e. it is a biological agent that can cause severe human disease and present a serious hazard to employees; it may present a risk of spreading to the community but there is usually effective prophylaxis or treatment available.



Control

• Removal of infected material similar to asbestos removal.
• Disposal by incineration and the standard followed should be same as clinical waste.
• Following incineration the residue may be disposed to landfill.
  
  
• Seek expert advice and briefing as follows:
• Briefing to contractor and all involved on site should cover risk to health, HSE involvement, reservoirs, incidence, transmission, occupations, activities, personal hygiene, MS(B)3 carry card on anthrax, cautionary notice, clinical diagnosis, immunisation, legislation, safety procedures, signing permit to work, records, sampling methodology and emergency procedures.

Further Information
1. HSE Guidance Note EH23, 1979
2. The Occupational Zoonoses, 1993
3. Immunisation against infectious diseases Chapter 25, Joint Committee on Vaccination and Immunisation. DoH, HMSO Publ. ISBN 0 11 3215150