Anthrax

Reportable by Laboratories and Providers

About this Reportable Disease

This is an immediately reportable condition. Please contact the Tennessee Department of Health at 615-741-7247 and ask to speak to the epidemiologist on call. 

Infectious agent:  Bacillus anthracis

Description of illness: An infectious disease that is found naturally in soil and commonly affects domestic and wild animals. Illness depends on the type of anthrax , such as cutaneous, inhalation, gastrointestinal, and injection. Injection of anthrax has been identified in Europe, but has never been reported in the United States. Symptoms vary based on types of exposure but can include fever and chills, headache, blisters/bumps, stomach pain, and body aches. Injection anthrax is similar to cutaneous anthrax, but injection spreads through the body faster. The bacteria in anthrax have also been used in biological attacks.

Laboratory Reporting for this Disease

Bacillus anthracis

TEST NAME Bacillius anthracis
DISEASE/DISORDER
  • Cutaneous anthrax
  • Inhalation anthrax 
  • Gastrointestinal anthrax 
  • Injection anthrax 
ALTERNATE NAME(S) Anthrax
METHODOLOGY PCR
SPECIAL INSTRUCTIONS
  • Isolate Submission REQUIRED.
  • Contact Bioterrorism laboratory before submission. 
ORDERING INFORMATION TDH DLS Requisition:  PH-4263 Clinical Select Agent Rule-Out Submission Requisition

Specimen Requirements

Patient Preparation
  • None

Specimen Collection
  • Acceptable Specimen Sources/Type(s) for Submission

-  Culture isolate

- Whole blood  

- Serum

- Plasma

- Pleural fluid

- Respiratory Specimens

- Cerebrospinal fluid (CSF)

- Clinical swabs
Specimen Labeling
  • Specimen must be labeled with at least two unique patient identifiers and match accompanying PH-4263 Clinical Select Agent Rule-Out Submission Requisition.
Specimen Processing
  • None
Specimen Storage and Preservation
  • Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols.
Specimen Transportation
  • Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols.
Specimen Acceptability and Rejection
  • Contact Bioterrorism laboratory prior to shipment to determine appropriate specimen handling based on LRN protocols.
Testing Location
  • Nashville
  • Knoxville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • Anthrax can cause severe illness and death if not treated quickly after symptoms develop.
  • Prophylactic antibiotics should be administered immediately to patients who might have been exposed to anthrax.
  • Anthrax exposure is rare in the U.S., but some activities can put people at greater exposure risk.
  • Anthrax is not contagious.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What It Is

Anthrax is a serious infectious disease caused by Bacillus anthracis bacteria or other Bacillus-expressing anthrax toxin. It occurs naturally in soil and commonly affects domestic and wild animals around the world. People can also contract anthrax if they are exposed during a bioterrorism event.

Anthrax is not contagious, and it can cause severe illness in both people and animals. It is very uncommon for people in the United States to be exposed to and become ill with anthrax.

Types

The type of illness a person develops when they have anthrax depends on how anthrax enters the body: through the skin, lungs, or the gastrointestinal tract. All types of anthrax can eventually cause systemic illness and death without antibiotic treatment.

Signs and Symptoms

The symptoms of anthrax depend on the type of infection and can take anywhere from one day to more than two months to present. All types of anthrax have the potential, if untreated, to spread throughout the body and cause severe illness and death.

 

Treatment

Patients with serious cases of anthrax require hospitalization. They may require aggressive treatment and supportive care, including continuous fluid drainage and mechanical ventilation.

Anthrax vaccine is approved by the Food and Drug Administration (FDA) and recommended for adults 18 through 65 years of age who are at risk of exposure to anthrax bacteria. These people should get 3 doses of anthrax vaccine, followed by booster doses for ongoing protection.

Antibiotics can be used for post-exposure prophylaxis (PEP) to prevent anthrax from developing in people who have been exposed but have not developed symptoms. All types of anthrax infection can be treated with antibiotics.

Severe illness can occur if treatment is delayed because the patient didn't know they were exposed to anthrax. After anthrax toxins, which are released when anthrax spores are activated, have been released in the body, one possible treatment is to use anthrax antitoxin together with other treatment options, including antibiotics.

This Page Last Updated: March 25, 2026 at 8:53 PM