Three related cases of cutaneous anthrax in France: clinical and laboratory aspects

Anthrax is an acute bacterial infection caused by Bacillus anthracis. The infection is cutaneous in about 95% of human cases and respiratory in about 5%. Approximately 2000 cases of cutaneous anthrax are reported annually worldwide. This disease became exceptional in Europe thanks to strict veterinarian monitoring. The last human cases of anthrax indicated in France were in 1997. We report 3 new related cases of naturally acquired cutaneous anthrax that occurred in France in 2008. The unique features of these cases include the atypical clinical presentation and the contribution of the rapid and specific diagnosis techniques by polymerase chain reaction.In cutaneous forms of anthrax, although the local course is not influenced by the treatment, antibiotic therapy is necessary to control any bacterial distribution. A case of exposure similar to that of a confirmed human case or an exposure identified by epidemiologic inquiry should usually result in chemoprophylaxis. Chemoprophylaxis for the close relations of a patient or for health workers is unnecessary since person-to-person transmission has not been reported.