With the new year comes a new report of a deadly, puzzling infectious disease.
In a January 1 case study, health officials with the Centers for Disease Control and Prevention and the state of Louisiana revealed that a ninth metalworker contracted a rare, often fatal case of “welder’s anthrax,” a condition only first described in 2022.
The case occurred in September 2024 in an otherwise healthy 18-year-old male in Louisiana. He had no underlying health conditions or even any risk factors, such as smoking, vaping, or heavy alcohol use. But, just a week after developing a cough, the teen was admitted to an intensive care unit with severe pneumonia and respiratory failure, requiring intubation and mechanical ventilation.
Blood tests were positive for a bacterium in the Bacillus cereus group—which includes the species that causes classic anthrax—and his doctors quickly put the finding together with his work. For six months prior to his cough, he was working as a welder’s apprentice, doing shielded metal arc welding in the shipbuilding and repair industry.
Rare cases
Doctors suspected it was a case of welder’s anthrax and quickly got access to an anthrax antitoxin from the US Strategic National Stockpile—where it’s kept in case of a bioterror attack. Along with a tailored antibiotic regimen, the teen rapidly improved and was off ventilation 72 hours later. The doctors’ quick thinking likely saved his life; of the previous eight cases of welder’s anthrax, six were fatal.
While the report has a happy ending, it adds to a concerning and unexplained pattern of metalworkers contracting the otherwise deadly and extremely rare infection.
Standard anthrax is caused by Bacillus anthracis, which can be contracted through skin contact, ingestion, or inhalation. Its killer skills include creating an immune-evading capsule and pumping out lethal anthrax toxins, which cause cell death and swelling. In the past 20 years, there have been only nine anthrax cases in the US.
However, B. anthracis is part of the larger Bacillus cereus group, which also includes B. cereus and B. tropicus, a newly recognized species. And these species can also carry and produce anthrax toxins. Both can be found in soils, and B. cereus is considered ubiquitous in the environment.