As the new year begins, health officials have reported a new case of a perplexing and deadly infectious disease. On January 1, the Centers for Disease Control and Prevention, along with Louisiana state health officials, announced a case involving a young metalworker contracting 'welder’s anthrax,' a rare and often lethal condition first identified in 2022.
The incident occurred in September 2024, involving an otherwise healthy 18-year-old male from Louisiana with no pre-existing health issues or typical risk factors such as smoking, vaping, or excessive alcohol consumption. Just one week after developing a cough, he was admitted to an intensive care unit suffering from severe pneumonia and respiratory failure, necessitating intubation and mechanical ventilation.
Blood tests revealed the presence of a bacterium from the Bacillus cereus group, known to include species responsible for classic anthrax. Physicians quickly connected this finding to his occupation. For the previous six months, he had worked as a welder’s apprentice in the shipbuilding and repair industry, performing shielded metal arc welding.
Rare Cases
Suspecting welder’s anthrax, doctors swiftly obtained an anthrax antitoxin from the US Strategic National Stockpile, typically reserved for bioterror threats. Combined with a customized antibiotic treatment, the patient made a rapid recovery, coming off ventilation within 72 hours. The doctors' prompt response likely saved his life; out of the eight previous welder’s anthrax cases, six proved fatal.
While this case concluded positively, it underscores a troubling and unexplained trend of metalworkers contracting this highly rare and otherwise deadly infection.
Traditional anthrax, caused by Bacillus anthracis, is known to be transmitted through skin contact, ingestion, or inhalation. Its virulence is due to its immune-evasive capsule and its production of lethal anthrax toxins, which cause cell death and inflammation. Over the past 20 years, there have been only nine anthrax cases reported in the United States.
Nevertheless, B. anthracis is part of the broader Bacillus cereus group, which also includes B. cereus and the newly recognized B. tropicus. These species are also capable of harboring and generating anthrax toxins. Both can be found in soils, with B. cereus being prevalent in the environment.