How is anthrax transmitted to humans? Anthrax: symptoms in humans, how it is transmitted, routes of infection, treatment
What's happened anthrax?
Anthrax is serious illness, the causative agent of which is a spore-forming bacterium. A bacterium is a microscopic organism consisting of a single cell. Many bacteria can cause disease. A spore is a cell that is dormant, but it can become active under certain conditions.
There are three forms of anthrax:
cutaneous
pulmonary
gastrointestinal
How does anthrax infection occur?
Anthrax is not transmitted from one person to another.
Infection from animals. People can become infected with anthrax by handling products derived from infected animals or by inhaling anthrax spores from contaminated animal products (such as wool). You can also become infected with the gastrointestinal form of anthrax through eating the meat of sick animals that have been insufficiently cooked.
Anthrax as a weapon. Anthrax can also be used as a weapon. This took place in the United States in 2001. Anthrax was deliberately spread through the postal system - in letters containing powder containing pathogenic spores. As a result, 22 cases of anthrax infection were recorded.How dangerous is anthrax?
The Centers for Disease Control and Prevention has adopted a classification of agents with generally recognized bioterrorism potential. According to this classification, there are three categories of priorities -, and. Anthrax is a category agent. Category A includes agents who:
pose the greatest threat to public health
can spread over a large area; public notification of the threat is required
require serious planning to protect public health
In most cases, cutaneous anthrax can be treated with timely use of antibiotics. Even in the absence of treatment, 80% of cases cutaneous form anthrax does not die. The gastrointestinal form of the disease poses a more serious threat, with one quarter to more than half of infections resulting in death. Pulmonary anthrax is a much more serious form of the disease. In 2001, more than half of the people who contracted pulmonary anthrax died.
What are the symptoms?
The symptoms ("warning signals") of anthrax vary depending on the type of disease:
Skin form: The first symptom is a small inflamed area that turns into a blister. The blister in turn develops into a skin ulcer with a black area in the center. The inflamed area, blister and ulcer do not cause pain.
Gastrointestinal form: The first symptoms are nausea, loss of appetite, bloody diarrhea, fever, then strong pain in a stomach.
Pulmonary form: The first symptoms of pulmonary anthrax are similar to those of a cold or flu - sore throat, slight increase fever and muscle pain. Subsequent symptoms include cough, chest discomfort, shortness of breath, fatigue and muscle pain. (Caution: Do not mistake common cold or flu symptoms for symptoms of inhalational anthrax.)
How long does it take for infected people to get sick?
Symptoms may appear within 7 days of exposure to any of the three types of anthrax bacteria. At pulmonary form Anthrax symptoms may appear within a week or within 42 days.
How is anthrax treated?
Antibiotics are used to treat all three forms of anthrax. Great importance has timely detection and treatment of the disease.
Preventive measures after contact with a source of infection. Therapeutic measures for a person who has been exposed to anthrax but has not yet become ill, differ from the treatment for those who become ill with anthrax. To prevent anthrax infection, professional medical workers use antibiotics (such as ciprofloxacin, levofloxacin, doxycycline, or penicillin) in combination with the anthrax vaccine.
Treatment after infection. Treatment is usually a 60-day course of antibiotics. The success of treatment depends on the form of anthrax and the timeliness of the start of treatment measures.
Can anthrax be prevented? Vaccination. A vaccine exists to prevent anthrax, but it is not yet available to the public. Anyone who may be exposed to the virus, including some members of the military, laboratory workers and workers who periodically travel to contaminated areas, can be vaccinated. In the event of an attack using anthrax as a weapon, people who were in contact with the source of infection will also receive the vaccine.
What should I do if I have reason to believe that I have anthrax?
If you experience symptoms of anthrax infection, call your doctor immediately.
What should I do if I have reason to believe that I have been exposed to anthrax?
Contact law enforcement immediately if you believe you have been exposed to anthrax. Contact with a suspicious package or envelope containing any powder should also be considered a possible contact with a source of infection.
What measures does it take in the event of an anthrax attack?
Among the measures taken are the following:
Developing plans and procedures to respond to anthrax attacks.
Train and equip emergency response teams to assist state and local governments with infection control, sample collection, and testing. Informing health care professionals, the media, and the public about actions to take in the event of an anthrax attack.
Work closely with health departments, veterinarians and laboratories to ensure timely detection of anthrax cases. Development of a nationwide electronic database to track possible anthrax cases.
Ensuring operation sufficient quantity laboratories capable of testing in cases of possible anthrax infection.
Collaborating with hospitals, laboratories, first responders and medical professionals to ensure they have the supplies they need in the event of an attack.
Anthrax - known since ancient times infectious disease, previously bore other names “sacred fire”, “Persian fire”.
The causative agent of the pathology was described in 1849-1850 by three researchers: A. Pollender, F. Brawell and K. Daven. In 1876, R. Koch identified it as pure culture. Of all the bacteria pathogenic to humans, the causative agent of anthrax was the first to be discovered.
Therapist: Azalia Solntseva ✓ Article checked by doctor
Anthrax in humans
Rare, but serious illness, caused by the bacterium Bacillus anthracis, which is capable of forming spores. Anthrax mainly affects livestock and wild animals. People can become infected through direct or indirect contact with sick animals, wool, meat or skins.
It has not yet been proven that anthrax is transmitted between people, but it is possible that skin lesions with this pathology can be infectious through direct contact. Bacteria typically enter the body through wounds in the skin, by eating contaminated meat, or by inhaling spores.
Most cases of the disease are cutaneous (95%), the rest are inhalation (5%) and gastrointestinal (<1%). Признаки и симптомы сибирской язвы у человека могут варьироваться от язвочек на поверхности до рвоты и шока. Быстрое лечение антибиотиками может помочь в большинстве случаев инфекций.
But many people don't know they have the disease until it's too late. A vaccine has been developed to prevent anthrax. It is given to military personnel and other people at high risk.
Anthrax, caused by inhalation of the spores (inhalation), is usually fatal, and symptoms often begin within a few days of exposure to the bacilli.
Many Europeans are familiar with this pathology due to a case of biological terrorism. The attack happened in 2001. In the attack, someone deliberately spread anthrax throughout the United States through the mail. 5 people died and 22 fell ill.
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The causative agent of this pathology
The pathology is caused by the bacterium Bacillus anthracis, which is rod-shaped, usually straight, but can be slightly curved. The diameter of the microbe is 1-1.5 microns, and the length is 3-10 microns. Bacilli on solid nutrient media tend to form long chains (colonies), which consist of individual threads of microorganisms, forming the so-called “lion’s mane”.
Bacillus anthracis, the causative agent of the disease, produces a jelly-like capsule that can be easily seen under a microscope using methylene blue as a dye. Bacilli grow best in carbon dioxide. Since these bacteria are anaerobes.
Outside the body and under unfavorable conditions, they are capable of forming spores that do not exceed the size of the bacterial cell wall. Bacteria produce dangerous substances - toxins, which are the main cause of death in patients. These substances cause swelling and tissue death in humans.
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What symptoms a person has is controversial
Depending on the route of entry of the spores, patients may complain of skin, respiratory or gastrointestinal manifestations of the pathology. The incubation period differs for each form of infection.
Skin form of the disease:
- symptoms appear 1-7 days (usually 2-5) after infection;
- lesions most often develop in lacerations, abrasions, or insect bites on exposed areas of the upper extremities and, to a lesser extent, the head and neck;
- begins as an itchy papule (nodule), which enlarges over 24-48 hours, forming vesicles (bubbles) measuring 1 cm, and then becomes an ulcer surrounded by a ring of swelling;
- lesions are usually up to 2-3 cm in diameter and have a round raised edge;
- formations are painless, but sometimes slightly itchy;
- swelling of the lymph nodes closest to the site of infection appears;
- the ulcer and surrounding swelling develop into a black scab within 7-10 days and lasts up to 1-2 weeks before breaking off and leaving a permanent scar;
- If the neck is affected, swelling and swelling of the lymph nodes can put pressure on the trachea and cause breathing difficulties.
Oropharyngeal form of the disease:
- an infectious disease develops 2-7 days after ingestion of microbes;
- fever and neck swelling are observed;
- the lesion begins as a swollen area that becomes necrotic and forms a scab within 2 weeks;
- there is a sore throat, difficulty swallowing, breathing and bleeding from the mouth;
- soft tissue swelling and an increase in the size of the cervical lymph nodes appear.
Intestinal form of the disease:
- develops 2-5 days after spores enter the digestive system;
- abdominal pain and fever, nausea and vomiting, malaise, anorexia, bloody or watery diarrhea appear;
- shock begins.
The inhalational (respiratory) form of the disease begins suddenly, usually 1-3 days after infection, and occurs in two phases.
Initial manifestations include the following:
- myalgia;
- malaise;
- fatigue;
- nonproductive cough;
- a feeling of compression behind the sternum;
- fever.
After the first few days there may be improvement, followed by rapid deterioration in which the following signs and symptoms may be present:
- heat;
- severe shortness of breath;
- rapid breathing;
- cyanosis on the skin;
- increased sweating;
- bloody vomiting;
- severe chest pain that may mimic myocardial infarction;
- clouding of consciousness, shock and coma.
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Spores of a dangerous disease
Bacteria are spore-forming rods. Spores promote long-term survival and spread. The development of spores is helped by nitrogen, which is found in large quantities in the soil. An acidic soil environment, above 6 units, and an ambient temperature of more than 15 °C help their growth.
Spores can exist indefinitely in the environment. Optimal growth conditions, as described above, lead to the vegetative phase (rod formation) and bacterial proliferation. Precipitation can cause anthrax spores to germinate. At this time, flies and crows actively spread them. So the anthrax bacillus can affect any person.
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Microbiology of anthrax
Anthrax is primarily an infectious disease of herbivores (eg, cattle, sheep, goats, and horses). Pigs are also not protected, but they are more resilient, like dogs and cats. Throughout their life cycle, pets are at constant risk.
Birds, as a rule, do not suffer from this pathology. Crows can transmit spores through their claws and beaks, but are not susceptible to the bacteria themselves. Infection of humans from birds is extremely rare. Experiments in the science of microbiology have shown that the capsule that surrounds the bacillus is vital in its danger to organisms.
Humans are slightly more resistant to skin infection by the bacilli, but the microbes can gain access to tissue through microscopic or normal breaks and wounds. A pustule (nodule) develops at the site of infection. In its central part, an area of suppuration forms with an ulcer surrounded by blisters filled with bloody or clear liquid. Extensive swelling surrounds the lesion.
Microscopic organisms multiply locally in the wound and can spread to the bloodstream or other organs (such as the spleen) through the lymphatic vessels. The bacteria remain in the capillaries of the engulfed organs, and the bad effects of the infection occur due to the toxins that the microbes produce.
Spread from the liver, spleen and kidneys back into the bloodstream can lead to bacteremia (presence of large numbers of bacilli in the blood).
The inhalation form occurs after a person inhales spores into the lungs. The incubation period is 1-6 days. The spores are then transported to the thoracic and mediastinal lymph nodes, germinate and begin producing toxin.
Anthrax in the lungs does not cause pneumonia, but hemorrhagic mediastinitis (inflammation of mediastinal tissue) and pulmonary edema appear. Bloody pleural effusions often accompany the inhalation form of the disease. Once the lymph nodes are no longer able to contain the spread of infection, bacteremia quickly occurs and death occurs in approximately 95% of cases.
In the intestines, the virus primarily affects the middle part of the digestive system, similar to the lesions that occur with the skin form of the disease. The spores penetrate the mucous membrane. Sometimes tissue necrosis and ulceration at the site of infection lead to hemorrhage from the intestinal vessels.
When the spores are transported to the mesenteric lymph nodes, reproduction and bacteremia begin. Ascites appears, with the formation of turbid fluid mixed with leukocytes and erythrocytes. The stomach and intestines become swollen.
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Nursing care for infection
Patients can be hospitalized in a regular hospital ward of the infectious diseases department, or treated in a clinic. Health care workers must wear masks and gloves. If it is necessary to prevent contamination, it is recommended to use splash protection and a closed respirator with high-efficiency air purifying filters or self-contained breathing apparatus.
People who are potentially contaminated with spores should wash with soap and water. Clothes are placed in triple plastic bags. If infection is confirmed, then to disinfect any materials and surfaces, cleaning with soap and water is not enough; it is necessary to use special disinfectant solutions.
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Treatment - how to effectively overcome the virus
Treatment of patients with cutaneous anthrax is carried out in the clinic, since nursing care is very important, using doxycycline tablets or capsules for 7-14 days. Any antibiotic from the fluoroquinolone group can serve as a replacement. Before the procedures begin, a detailed diagnosis is carried out.
Penicillin is most often prescribed for the treatment of inhalation type and meningitis due to anthrax. To prevent respiratory complications, use doxycycline, ciprofloxacin or levofloxacin for 60 days.
Raxibacumab is an antibody aimed at protecting against bacteria. The drug was approved in December 2012 for the treatment of inhalational anthrax or for prevention when other treatments are unavailable or inappropriate.
Antimicrobial therapy has a detrimental effect on microorganisms within a few hours, but the fatal effect of the pathology is associated with the effect of the toxin on the body.
Patients with shock (end-stage disease) should be kept in the intensive care unit and may require mechanical ventilation.
Despite early treatment, people infected with inhalational and gastrointestinal anthrax have a very poor prognosis. Prevention and vaccination provide almost complete protection, but are carried out only upon request.
- all people who have inhaled spores , must complete a 60-day course of antimicrobials regardless of their vaccination status;
- antimicrobial therapy with several drugs at once is more likely to lead to a cure;
- ciprofloxacin and doxycycline should be given first;
- uncomplicated skin form of the pathology can only be treated with tablets.
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How the bacillus is transmitted - the main routes of infection
Anthrax spores are formed by bacteria that occur naturally in soil in most areas of the world. They can remain dormant for many years until they find their way into a living organism. Common hosts for anthrax bacilli include wild or domestic livestock such as sheep, cows, horses and goats.
The pathology remains common throughout the developing world, for example in Iran, Iraq, Turkey, Pakistan and sub-Saharan Africa. The main outbreaks of infection occur in underdeveloped countries. Since the disease is transmitted through contact with infected livestock.
Most human cases of infection occur through contact with infected animals or their meat or skins.
One of the few known cases of transmission occurred in the United States in 2001, when 22 people became ill after exposure to spores sent through the mail. Five victims died.
More recently, heroin addicts in Europe became infected after intravenous injections of illicit drugs. Eighteen people died. Heroin sold in Europe is most likely produced in regions where anthrax spores and bacillus are found.
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Skin form of the disease
Develops 1-7 days after exposure to bacteria. The spores enter the body through wounds, cuts or other imperfections in the skin. The most commonly affected areas are the exposed areas of the upper extremities and, to a lesser extent, the head or neck. This is the most common route of infection.
The symptoms of this form are mild and with appropriate treatment, the disease rarely leads to death. Manifestations of cutaneous anthrax include an insect-bite-like itch that quickly develops into a painless nodule with a black center; Swelling appears at the site of spore penetration and in the area of nearby lymph nodes.
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Vaccine against infection
The drug does not contain live bacteria and cannot lead to infection. The vaccine often causes side effects, ranging from soreness at the injection site to more serious allergic reactions.
It is not intended for the general public, but only for military personnel and scientists working with anthrax, and for people in various high-risk professions.
Vaccination of livestock is mandatory.
It should be noted that after eating meat products infected with anthrax bacillus, a pathological process can develop in the oropharynx. In this case, the patient will experience a lesion resembling a skin ulcer at the entrance to the oropharynx.
In rare cases, anthrax can be transmitted through vector-borne transmission due to the spread of spores by flies or horse flies.
Symptoms of anthrax
The symptoms of anthrax will depend on the clinical form of the disease. The following forms of anthrax exist:
- cutaneous form;
- pulmonary form;
- intestinal form;
- septic form.
Cutaneous form
This form of the disease occurs in almost 99% of all cases of anthrax. The anthrax bacterium enters the human body through damaged skin, for example, through cracks, scratches or cuts. Most often, this form of the disease affects open areas of the skin of the upper extremities and face, and to a lesser extent - the area of the neck, torso and lower extremities. Usually, the formation of one carbuncle is observed on the skin, but it happens that their number can increase to twenty or more. When the head, neck and face are affected, anthrax is most severe. The location of the carbuncle in the neck or face is dangerous because the developed tissue swelling can spread to the upper respiratory tract, which will lead to breathing problems and subsequent suffocation.The disease usually develops two to five days after the infection penetrates the skin, but the incubation period can last up to seven days.
The cutaneous form of anthrax includes the following varieties:
- carbunculous;
- edema;
- bullous;
- erysipeloid.
This type of cutaneous anthrax is the most common. After infection, a red-blue spot appears at the site of infection, reaching a diameter of three millimeters, which does not cause any pain. After some time, a bright red nodule forms at the site of the spot. During this period of time, the patient begins to feel a burning sensation and itching. Increasing in size, the nodule transforms into a vesicle within 24–48 hours, inside of which there is initially serous and then hemorrhagic fluid. After some time, the blister bursts on its own or as a result of scratching, and in its place an ulcer with a black-brown bottom, surrounded by a swollen halo, forms. Due to tissue necrosis, the bottom of the ulcer hardens and gradually covers its entire cavity, turning into a dense crust ( scab). New bubbles continue to form around the scab, which, merging and bursting, increase the crust in size. The size of an anthrax skin lesion is usually approximately two to three centimeters in diameter ( can reach up to ten sentiments) and has a round, hyperemic and raised edge above the skin level.
Edematous type of cutaneous form
Initially, the patient experiences severe swelling at the site of infection. Later, the area of edema is replaced by the formation of a large carbuncle. This type of disease is rare, but is more severe than the carbunculous form.
Bullous type of cutaneous form
It is characterized by the fact that at the site of infection, infiltration is observed, on the surface of which large bubbles subsequently form. The blisters contain hemorrhagic fluid. As a rule, after about five to ten days, the blisters open, and in their place extensive ulcerative elements are formed, within which tissue necrosis is observed.
Erysipeloid type of cutaneous form
With this form of the disease, the patient initially experiences the formation of several or more blisters filled with serous fluid. Subsequently, their opening leads to the formation of ulcers, followed by covering with a dense black crust. This variety is less common than all others and is characterized by a milder course of the disease.
A deterioration in the general condition of a patient with cutaneous anthrax can be observed starting from the second or third day of illness, but it will depend on the severity of the disease. The cutaneous form can be mild or severe.
| Mild form of the disease | Severe form of the disease |
| Occurs in approximately eighty percent of cases. The general condition of the patient, as a rule, is not disturbed. Body temperature may remain within normal limits, or there may be a slight increase in the range of 37 - 37.9 degrees, which lasts for approximately five to six days. Signs of intoxication of the body during this period are moderate. With timely treatment within ten to fourteen days, the patient experiences a rejection of the scab with the opening of an ulcerative surface, after healing of which a dense scar will remain on the affected area of the skin. | Occurs in approximately twenty percent of cases. The patient has a significant increase in body temperature to 39 - 40 degrees, and also shows signs of intoxication of the body ( for example, headache, weakness, loss of appetite). After five to six days, the patient's condition may improve. Within two to four weeks, the scab is rejected. The danger of a severe course of the disease is that it can be complicated by anthrax sepsis, which can subsequently lead to the death of the patient. |
Pulmonary form
Patients with pulmonary anthrax initially exhibit vague signs of the disease, which include fever, myalgia ( muscle pain), weakness, runny nose and cough. At an early stage, patients may complain of discomfort in the chest. This form is characterized by rapid progression. This leads to the fact that in a short time ( one to three days) there is a deterioration in the clinical manifestations of the disease.The patient may experience the following symptoms:
- high body temperature ( 39 – 40 degrees);
- severe chills;
- pronounced signs of intoxication of the body;
- tachypnea ( increase in respiratory rate, more than eighteen per minute);
- severe shortness of breath;
- cyanotic ( cyanosis) skin.
The pulmonary form of the disease is dangerous due to its rapid progression. The severe course of this form can lead to the development of cardiovascular failure, as well as pulmonary edema, which within two to three days can cause the death of the patient.
Intestinal form
The intestinal form of anthrax is extremely rare, but of all forms of the disease it is the most severe. The disease occurs within two to five days after consuming contaminated food.Initially, the patient may experience the following signs of the disease:
- increased body temperature;
- vomiting with bile and blood;
- loss of appetite;
- bloody diarrhea.
Due to the accumulation of fluid in the abdominal cavity, an increase in the size of the abdomen is observed. Later, the patient may develop intestinal obstruction due to intestinal paresis.
It should also be noted that ingestion of contaminated food can lead to damage to the oropharynx. As a rule, two days after consuming contaminated meat, the patient experiences an increase in body temperature, as well as symptoms characteristic of a sore throat ( for example, sore throat, weakness, headache). Later, swelling of the neck develops due to carbuncles forming in the oropharynx and enlargement of regional lymph nodes ( submandibular and cervical lymph nodes). The skin becomes cyanotic, and the vessels on the sclera become bright red.
Due to the progression of the infectious process, the patient later experiences dysphagia ( swallowing disorder), bleeding from the oral cavity, as well as respiratory failure, which can subsequently lead to asphyxia and death of the patient.
Septic form
The septic form of anthrax is quite rare and can develop as a result of a severe course of any of the above forms of the disease. This form is characterized by the circulation of anthrax bacillus and its toxins through the circulatory system, as well as damage to various organs and systems. Due to the negative effects of anthrax bacillus exotoxins, the patient may develop infectious-toxic shock.A patient with septic form experiences the following symptoms:
- elevated body temperature ( up to 39 – 41 degrees);
- severe chills;
- severe shortness of breath;
- increase in the number of breathing movements;
- pain in the chest area;
- cough with foamy sputum mixed with blood;
- abdominal pain;
- nausea and vomiting mixed with blood;
- bloody, loose stools.
Diagnosis of anthrax
The diagnosis of anthrax is based on a careful collection of anamnesis, especially epidemiological, and on the basis of the patient’s clinical signs characteristic of each form of the disease. Also, an important role in establishing a diagnosis is played by the conduct and analysis of laboratory test results.Diagnosis of cutaneous anthrax
| Research method | Description |
| Patient's complaints | At the initial stage of the disease, the patient may have complaints about an itchy spot appearing on a healthy area of the skin, which quickly transforms into a blister and then into an ulcer. Two to three days after the onset of the disease, complaints of deterioration in general health may appear ( increased body temperature, weakness, malaise). |
| History taking | Initially, the doctor collects a life history, in which the patient gives his brief biographical data, and then an anamnesis of the disease, thanks to which it is possible to identify when and how the disease occurred and its first symptoms. Particularly informative are the results of collecting an epidemiological history, in which the doctor finds out:
|
| Examination of the patient | Single or multiple ulcerative skin lesions are found on the patient’s body, in the center of which there is a compacted black crust. Around the ulcerative defect there is pronounced swelling and hyperemia of the surrounding tissues. Stefansky's symptom in this case will be positive. It is determined thanks to a special hammer, with the help of which blows are applied to the area of edematous tissue, causing them to jelliedly tremble. |
| Differential diagnosis |
|
Diagnosis of pulmonary anthrax
| Research method | Description |
| Patient's complaints | At an early stage of the disease, there may be complaints regarding cough, runny nose, and increased body temperature. Later, the patient complains of foamy-bloody sputum and severe chest pain. |
| History taking | After collecting a history of life and illness, the doctor pays special attention to the epidemiological history. It is necessary to clarify the patient’s professional activity, whether he was near the corpses of dead animals, or whether there was contact with any dusty objects. |
| Examination of the patient | The patient has:
|
| Differential diagnosis | A differential diagnosis is made with the following diseases:
|
Diagnosis of intestinal anthrax
| Research method | Description |
| Patient's complaints | The patient complains of acute cutting pain in the abdomen and lower back, nausea and vomiting, fever, and bloody loose stools. If the oropharynx is affected, the patient will complain of severe pain, as well as shortness of breath ( due to swelling of the neck). |
| History taking | The doctor collects the necessary information about life and the existing disease. It is also important to collect a complete epidemiological history, which should include information about whether the patient consumed meat or milk from sick animals. |
| Examination of the patient | During examination, the patient may reveal the following signs:
|
| Differential diagnosis | A differential diagnosis is made with the following diseases:
|
Also, in all forms of the disease, blood is drawn from the patient for a hemogram ( general blood analysis).
With anthrax, the following changes will be observed in the general blood test:
- leukopenia ( decreased white blood cell count);
- lymphocytosis ( increase in the number of lymphocytes);
- accelerated ESR ( erythrocyte sedimentation rate) .
Laboratory diagnostics
The following diagnostic methods are used to detect anthrax:- bacterioscopic method;
- bacteriological method;
- immunofluorescence method;
- skin allergy test.
Characterized by the detection of pathogenic microorganisms in materials collected from the patient. This research method can be carried out using a simple and fluorescent microscope.
The following materials can be collected to diagnose anthrax:
- blood (using a sterile syringe, three to five milliliters of blood are drawn from the ulnar vein);
- contents of vesicles, carbuncle (First, the skin around the damaged area is treated with cotton wool and alcohol, after which the material is collected using a swab or syringe);
- rejected scab (examine the separated scab);
- sputum (secreted during a coughing attack, collected in a sterile container with a tight-fitting lid);
- feces and vomit (the material is collected in a sterile vessel).
Bacteriological method
This method consists of isolating and identifying pathogenic microorganisms by inoculating pathological material on various nutrient media, where colonies subsequently grow.
When cultivated, anthrax bacillus is unpretentious; it grows on simple nutrient media, for example, meat peptone agar or broth, at a temperature of 34 - 35 degrees Celsius. The colonies they form have jagged, fringed edges.
The following materials can be collected for bacteriological research:
- contents of a carbuncle or vesicle;
- sputum;
- blood;
- fecal matter.
When carrying out the bacteriological method, the following requirements must be observed:
- collection of pathological material should be carried out before starting antibiotic therapy;
- collection of material must be carried out under sterile conditions and using sterile medical material;
- the material must be in sufficient quantity;
- the collected material must be transported in special environments, in a short time, and also at a special temperature.
This method makes it possible to detect antibodies, as well as antigens of anthrax bacillus. The essence of the immunofluorescent method is that the pathological material taken from the patient is applied as a smear on glass, after which a special fluorochrome dye is applied on top, and microscopy is performed using a fluorescent microscope.
The immunofluorescence research method can be carried out in the following ways:
- Direct reaction. Pathological material is applied to a glass slide, and then a fluorochrome is applied on top ( contains labeled antibodies). Anthrax bacillus proteins, combining with fluorochrome serum, form an immune complex in the form of a greenish glow, which is detected by smear microscopy.
- Indirect reaction. It is characterized by the application of a fluorochrome containing antigens of the anthrax bacillus to the smear, which subsequently bind to antibodies found in the test material. Then a substance containing anti-immunoglobulins is applied to the smear, which bind to antibodies to form an immune luminous complex.
- Competitive reaction. It is carried out by adding antibodies, as well as labeled antigens, to the test material. Labeled antigens, combining with antibodies, begin to compete with unlabeled antigens. Subsequently, the formed immune complexes begin to glow, which is detected using microscopy of the examined smear.
This research method is carried out to identify the body's sensitivity to the administered allergen. For anthrax, 0.1 ml of anthraxin is injected intradermally into the patient's middle forearm. The preparation used contains hydrolyzate of vegetative forms of Bacillus anthracis.
After 1 - 2 days the results are read:
- the result is considered negative if the skin reaction in diameter does not exceed 0.9 cm;
- the result is considered weakly positive if the skin reaction varies from one to three centimeters;
- the reaction is considered positive if the skin reaction is three to six centimeters.
Recently, this diagnostic method is rarely used, only as an additional research method.
Treatment of anthrax
Treatment for anthrax includes:
- infusion therapy;
- antibiotic therapy;
- administration of anti-anthrax immunoglobulin.
Infusion therapy
Infusion therapy is characterized by intravenous infusion of liquid solutions, the task of which is to replenish and maintain the volume and composition of the vascular, extracellular and cellular fluid of the body.For anthrax, the following groups of solutions can be administered:
- colloidal solutions;
- crystalloid solutions;
- blood products.
| Group | Name of solution | Characteristic |
| Colloidal solutions | Poliglyukin | This drug contains 6% dextran and 0.9% sodium chloride. Produces an anti-shock effect, and also replenishes fluid volume in case of dehydration, plasma loss and blood loss. The dosage is set individually; as a rule, polyglucin is administered intravenously in an amount of 400–1000 ml. |
| Reopoliglyukin | Contains 10% dextran, as well as a 0.9% sodium chloride solution or a five percent glucose solution. When introduced into the body, it replenishes the volume of circulating blood, improves blood circulation in small vessels and reduces the risk of thrombosis. The drug is administered intravenously in a dose of 500 ml, however, in case of severe intoxication of the body, the amount can be increased to 1200 ml. | |
| Crystalloid solutions | Sodium chloride solution (0.9%) | It is an isotonic solution. The concentration of sodium chloride in the body corresponds to 0.9%, which allows maintaining the required level of osmotic pressure of plasma and extracellular fluid. Therefore, the administration of this drug allows you to replenish the required level of sodium and chlorine during plasma loss. The total dose of solution administered per day is up to two liters. |
| Ringer's solution | This solution contains sodium, chlorine, potassium and calcium. It is used for plasma loss, as well as loss of intercellular fluid. The total dose of the drug is up to three liters per day ( for mild or moderate conditions - from 500 ml to one liter). | |
| Glucose solution (5%) | It is a hypotonic solution containing 5% dextrose solution. It is used for detoxification, as well as replenishing fluid volume in the body. When administered, the solution improves the contractile activity of the heart, metabolism, as well as redox processes in the body. The total dose of the drug is up to three liters per day. | |
| Blood products | Fresh frozen plasma | Contains factors of the hemostasis system, proteins, as well as carbohydrates, salts and fats. It is used for plasma loss or blood loss and severe intoxication of the body. When infused, it is a source of immunoglobulins, replenishes the volume of circulating blood, has a detoxification effect and ensures hemostasis ( preservation of blood fluid composition). Before administering the drug, it is necessary to conduct a blood group compatibility test. The dose of administration is determined individually depending on the available indications ( can be administered from 100 ml to two liters). |
| Albumen | Albumin is a protein contained in blood plasma and is involved in maintaining its colloid osmotic pressure. Available in the form of five, ten or twenty percent solutions. When administered, this drug helps to increase the volume of circulating blood by attracting and retaining fluid in the vessels. Albumin also provides protein nutrition to the body, which is necessary for its normal functioning. As a rule, a drug at a concentration of 20% is administered in a single dose in an amount of 100 ml, solutions of 5% or 10% are shown in an amount of 200 - 300 ml ( up to one liter). |
Antibiotic therapy
Antibiotics are used as the main treatment for anthrax, aimed at eliminating the cause of the disease. The main group of drugs to which anthrax is sensitive is penicillin. However, if the patient is intolerant to penicillin, drugs from groups of antibacterial agents such as tetracyclines, macrolides or fluoroquinolones can be prescribed.| Name of the drug | Characteristic | Mode of application |
| Penicillin | Pharmacological group – penicillin. It is a broad-spectrum antibacterial drug that produces a bactericidal effect on bacteria ( has a detrimental effect). | For the skin form of the disease, the drug is prescribed intravenously or intramuscularly at a dose of two to four million units per day. In the septic form, the dose increases to 16 - 20 million units per day. The duration of treatment is seven to ten days. |
| Tetracycline | Pharmacological group – tetracycline. It is a broad-spectrum antibiotic that has a bacteriostatic effect on bacteria ( stops growth and development). | Take 500 mg every six hours ( four times a day) within seven to ten days. |
| Erythromycin | Pharmacological group – macrolides. The drug has a bacteriostatic effect on pathogenic microorganisms. | The recommended dose is 500 mg four times a day for seven to ten days. |
| Ciprofloxacin | Pharmacological group – fluoroquinolones. A broad-spectrum antibiotic that produces a bactericidal effect on bacteria. | The drug is prescribed intravenously, 400 mg twice ( every twelve hours) - three ( every eight hours) once a day, for seven to fourteen days. |
| Levofloxacin | Pharmacological group – fluoroquinolones. A broad-spectrum drug that has a destructive effect on pathogenic microorganisms. | The drug must be administered intravenously at a dose of 500 mg once or twice a day. Take 500 mg orally once a day for seven to fourteen days. |
| Doxycycline | Pharmacological group – tetracycline. The product has a wide spectrum of action. Affects bacteria, stopping their growth and development. | In the first days of treatment, take 200 mg orally four times a day, in subsequent days the dose is reduced to 100 mg four times a day. The drug is administered intravenously at a dose of 200 mg twice a day. |
In severe cases of the disease, the patient may also be prescribed glucocorticosteroids ( eg prednisolone, dexamethasone) in the form of tablets in the amount of 90 – 120 mg per day. For septic anthrax, the dose of prednisolone is increased to 800 mg per day.
Anti-anthrax immunoglobulin
The drug contains immunoglobulins ( ready-made antibodies), which are obtained from the blood plasma of a previously vaccinated horse. The purpose of administering immunoglobulin is to create and maintain immunity to the anthrax pathogen. When administered, the drug has a detrimental effect on the anthrax bacillus and also produces an antitoxic effect.Used to treat the disease, as well as as an urgent preventative measure.
As a treatment, the drug is prescribed in the following doses:
- up to twenty milliliters per day for mild forms of the disease;
- from twenty to forty milliliters per day, for moderate illness;
- from sixty to eighty milliliters per day, in severe forms of the disease.
The drug is injected intramuscularly into the upper outer quadrant of the buttock.
It should be noted that before administering the drug in a therapeutic dose, a sensitivity test to horse protein is initially performed. Immunoglobulin is diluted ( 1:100 ) and inject the finished product intradermally into the inner part of the forearm. After twenty minutes the result of the reaction is read. If the skin reaction is negative ( up to 0.9 cm), then the required dose of the drug is administered in two to three stages every ten to fifteen minutes.
However, if the skin test is positive, the drug is administered only in particularly severe cases of the disease and after strict administration of glucocorticosteroids ( for example, prednisolone).
When treating anthrax, the drug is used in conjunction with antibiotic therapy.
As an urgent preventive measure, anthrax immunoglobulin is prescribed in the following cases:
- if a person has been in contact with a sick animal;
- if a person has been in contact with a material or product containing anthrax spores;
- if a person butchered the meat of a sick animal;
- if a person has consumed the meat of a sick animal.
- adults twenty - twenty-five millimeters;
- teenagers- twelve millimeters;
- children under fourteen years of age- five to eight millimeters.
Anthrax vaccine
Since anthrax is a serious disease that often leads to the death of the patient, a vaccine was created back in the eighteenth century that helps reliably prevent the development of this disease. The following types of vaccines exist:
- Inactivated vaccine. Contains a weakened anthrax bacillus, unable to reproduce. This vaccine is rarely used for certain groups of people.
- Live vaccine. Contains weakened anthrax spores ( with reduced virulence), capable of multiplying and causing a disease that occurs in a mild form without pronounced clinical signs. After suffering an infectious process, a person develops a strong immunity.
- Combined vaccine. Consists of inactivated and live vaccine.
| Live vaccine | Combination vaccine |
| Available in dry form .Prevention of anthrax Prevention of anthrax includes:
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Anthrax is a serious disease that often ends in human death. The main source of infection is livestock and wild animals. In today's article we will look at the main symptoms of this terrible disease, preventive measures and treatment methods.
Causes and causative agent of the disease
Anthrax is a disease that occurs in animals. It is from them that spores are transmitted to humans. Experts have found that the infection, as a rule, penetrates the skin if there are open wounds or other injuries.
The causative agent of anthrax is spores of the bacterium Bacillus anthracis.
They develop only under favorable conditions:
- presence of moist soil;
- air temperature +12 degrees.
At high temperatures, the spores of the infectious agent die. They are also “terrified” of any disinfectants.
The source of anthrax is wild animals and often livestock. They pose a danger to humans from the first day of infection and for another 7 days after death. In this case, under no circumstances should you cut up an animal carcass. The fur of a sick individual is contagious for another 3-5 years.
How is anthrax transmitted?
Animals can become infected with the disease in several ways:
- By drinking contaminated water or writing. Especially often, such problems arise with domestic animals that are taken out to pasture.
- For insect bites that have had contact with an infected animal.
The routes of transmission of anthrax to humans are somewhat different:
- Air. Together with dust, people inhale anthrax spores. With weak immunity, cells do not react in any way to “foreign” particles. The bacteria enter the lungs and then “attack” the lymph nodes. After this, they actively multiply, spread through the bloodstream throughout the body, affecting internal organs.
- Domestic. In this case, the person must have close contact with the infected animal. Infection often occurs during butchering of livestock carcasses.
- Food. If the meat of an infected animal gets into a dish without sufficient heat treatment, a person develops an intestinal form of anthrax.
- Transmissible. In case of a bite from a sick animal.
It is characterized by the following symptoms:
- Literally in the first few hours after infection, ulcers form on the human body. They may look different. As a rule, these are wounds with jagged, inflamed edges, in the center of which there is a dark spot (scab). In this case, there are no painful sensations. There are also common cases when a large blister with blood content is observed on the skin;
- around the ulcers you can see blisters that look like purulent boils;
- the lymph nodes in the neck become enlarged and painful;
- body temperature rises. But critical levels (above 39 degrees) are rare.
If treatment for cutaneous anthrax is started in time, the chances of a successful prognosis are quite high.
In the pulmonary form, the following clinical picture can be observed:
- chest pain;
- on the first day there is a dry cough, which only grows over time;
- increase in body temperature up to 38 degrees;
- enlarged cervical lymph nodes.
If treatment is not started at this stage, the patient’s condition will only worsen every hour. This will lead to severe shortness of breath, cyanosis, and pulmonary edema. Without timely treatment, the patient's death occurs within 3 days.
The intestinal form is considered the most severe and fastest-growing.
The signs are as follows:
- increase in body temperature up to 40 degrees;
- sharp pain in the abdominal area;
- bloody diarrhea;
- vomit;
- loss of consciousness.
The chances of saving the patient are 1-2%.
Anthrax is a disease that is not to be trifled with. A delay of several hours can cost a person his life. Therefore, at the first signs of illness, you should immediately consult a doctor.
Diagnostics
To diagnose the disease, the following specialists should be involved:
- infectious disease specialist;
- therapist;
- surgeon;
- dermatologist.
After the initial examination, specialists are required to send the patient to the hospital, where he will undergo a series of tests:
- general detailed analysis of blood and urine;
- puncture;
- chest x-ray;
- Ultrasound of the abdominal cavity.
Each case is considered individually. To confirm the diagnosis, the doctor may prescribe additional examinations.
How to treat anthrax
Anthrax in humans can only be treated in a hospital setting under the constant supervision of doctors.
The following types of drugs are prescribed:
- antibiotics. Administered intravenously for 7-14 days. Penicillin-based products are mainly used;
- drugs to maintain the general condition of the patient and those that can prevent intoxication of the body;
- glucocorticoids. Necessary in case of damage to the central nervous system, with edema.
There are several varieties of it:
- purified. Canker spores were grown in laboratory conditions and then killed using heat treatment. With such a vaccination, the risks of complications are minimal;
- live vaccine. Anthrax spores are injected into humans in small quantities. Immune cells attack the “enemy”. At the same time, long-term immunity to the disease is developed;
- combined.
Experts advise using purified vaccines.
But still, do not forget that after vaccination the following side effects may occur:
- severe weakness, up to loss of consciousness;
- migraine;
- enlarged and painful lymph nodes.
Vaccination is prohibited in the following cases:
- pregnancy and lactation;
- oncology and AIDS;
- serious chronic diseases;
- skin ailments.
Remember, anthrax is fatal in most cases, so vaccination is a necessary measure if you have close contact with livestock and wild animals.
Prevention measures
How can you protect yourself from anthrax infection?
Prevention methods are as follows:
- Mandatory vaccination of animals.
- Expert control over livestock.
- Scheduled testing of animals.
- Vaccination of people who are at risk (farmers).
- Proper storage of meat products.
- Burning infected animal carcasses.
Anthrax is a disease that is not so common in developed countries. But, unfortunately, isolated cases do occur. That is why it is very important to know the routes of infection and the symptoms of the disease.
If you experience signs of anthrax, be sure to consult a doctor. Delay can lead to serious complications and death.
In connection with the latest events in the Russian Federation, I think it will be useful for many to know how anthrax is carried and transmitted. We decided to devote an entire article to this.
This disease is usually contracted through airborne dust and food. Transmission of anthrax bacilli to humans can occur through the secretions of sick animals, their skin, corpses, and meat products. Water, soil, and various environmental objects that are infected with anthrax spores can also serve as sources of infection. Animal burial grounds are also dangerous.
Person-to-person transmission of anthrax is virtually impossible.
In summer, blood-sucking insects and flies can be carriers of the infection and the main cause of transmission of anthrax. There are professional-agricultural, professional-industrial and domestic types of the disease. Most often, workers in meat processing plants, spinning factories and other workers who care for sick animals, bury and skin the corpses of dead animals fall ill with anthrax. occur when processing raw or eating poorly cooked meat from animals suffering from anthrax. There have been cases of human infection through various products and materials of infected animals, these could be shaving brushes, clothing, fur mittens, collars, hats, etc. The highest incidence in rural areas is observed in the summer. The immunity of those who have recovered from anthrax is stable, but not absolute.
Forms of anthrax
There are three forms of anthrax - cutaneous, when the infection enters through lesions on the skin, intestinal - when transmission occurs through food prepared from the meat of sick animals. The most dangerous form is the pulmonary form, which is infected by pathogenic spores. Once in the blood or on the mucous membrane of the respiratory tract, the spores produce anthrax bacteria. can last from several hours to a week. In the pulmonary form, the symptoms are similar to those of acute respiratory infections, then pneumonia occurs, the temperature rises sharply, and hemoptysis begins. If you delay treatment with the necessary antibiotics, rapid death can occur. Anthrax vaccinations are associated with serious complications.
Prevention of anthrax
Prevention consists of identifying and eliminating foci of infection by veterinary workers. People who are at risk of contracting anthrax (at leather, wool, and meat processing enterprises, veterinarians, and laboratory workers studying anthrax pathogens) are given preventive vaccinations with a live dry vaccine (LDV). Before vaccination, the ampoule with the dry vaccine is opened, one milliliter of 30% glycerin solution is injected into it with a syringe and shaken to achieve a uniform suspension. In the upper area of the shoulder, treat the skin with alcohol or shoulder ether and apply two drops of the vaccine, making incisions through each drop.
Sick people are placed in a separate room and undergo ongoing disinfection. Discharge of recovered patients occurs after epithelization of ulcers.
People who have been in contact with sick animals and are at risk of infection are placed under medical observation for six months.
