Confirmed Case - clinical illness* with laboratory confirmation of infection:
- isolation of Bacillus anthracis from an appropriate clinical specimen OR
- demonstration of B. anthracis in a clinical specimen by immunofluorescence.
* Clinical illness presents in various forms:
a. Cutaneous: Clinical illness is characterized by the appearance of small, painless but often pruritic papules. As the papule enlarges, it becomes vesicular and, within two days, ulcerates to form a distinctive black eschar, with surrounding edema.
b. Inhalation: Clinical illness is characterized by an upper-respiratory 'flu-like' syndrome that, after a few days, takes a fulminant course, manifested by dyspnea, cough, chills and a high-grade bacteremia.
c. Gastrointestinal: Clinical illness is characterized by abdominal pain, fever and signs of septicemia.