Table 1.

Human anthrax: Common routes of transmission, risk factors and clinical presentations.

TRANSMISSION OF THE INFECTION	COMMENTS
Contact with dying or dead animals	Slaughtering and skinning, handling and processing of dead animals. The disposal of contaminated carcasses
Contact with contaminated animal products	Wool coats, shaving brushes, leather (e.g., drumheads made of animal skin) and bone meal (e.g., fertilizer).
Ingestion of contaminated meat	Eating contaminated, uncooked, improperly cooked meat, traditional raw food or meat products.
Self-injection	Injection of contaminated, illegal heroin
Nosocomial transmission	Human to human spread is rare
RISK FACTORS
Living in an endemic area
Agricultural occupations	Herdsman, butchers, skinners, slaughterhouse workers, diary workers, veterinarians
Industrial occupations	Tanners, leather gift makers, furriers, shoemakers, drum makers, carpet weavers, wool spinners, bone meal processers, wool textile factory workers
Illegal drug use	Injection of contaminated materials
CLINICAL PRESENTATIONS	COMPLICATIONS *
Cutaneous anthrax	Sepsis Meningoencephalitis Pneumonia
Gastrointestinal Anthrax   Oropharyngeal   Intestinal
Inhalation anthrax

* Sepsis, meningitis or pneumonia may occur due to the pathogen spreading from the primary site of infection.