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NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Clinical Description

An illness with acute onset characterized by several distinct clinical forms, including the following:

  • Cutaneous: a skin lesion evolving during a period of 2-6 days from a papule, through a vesicular stage, to a depressed black eschar
  • Inhalation: a brief prodrome resembling a viral respiratory illness, followed by development of hypoxia and dyspnea, with radiographic evidence of mediastinal widening
  • Intestinal: severe abdominal distress followed by fever and signs of septicemia
  • Oropharyngeal: mucosal lesion in the oral cavity or oropharynx, cervical adenopathy and edema, and fever

Laboratory Criteria For Diagnosis

  • Isolation of Bacillus anthracis from a clinical specimen, OR
  • Anthrax electrophoretic immunotransblot (EITB) reaction to the protective antigen and/or lethal factor bands in one or more serum samples obtained after onset of symptoms, OR
  • Demonstration of B. anthracis in a clinical specimen by immunofluorescence

Case Classification


A clinically compatible case that is laboratory confirmed

Related Case Definition(s)