How is anthrax transmitted to humans. Anthrax: symptoms in humans, how it is transmitted, ways of infection, treatment

What anthrax?

Anthrax is serious illness, the causative agent of which is a bacterium that forms spores. A bacterium is a microscopic organism consisting of a single cell. Many bacteria can cause disease. A spore is a cell that is in a dormant state, but it is able to become active under certain conditions.

There are three forms of anthrax:
skin
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 coming into contact with products derived from infected animals, or by inhaling anthrax spores from contaminated animal products (such as wool). It is also possible to become infected with the gastrointestinal form of anthrax through the consumption of meat from sick animals that have undergone insufficient heat treatment.

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 disease-causing spore powder. 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 recognized bioterrorist 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 alert required
require serious public health planning

In most cases, cutaneous anthrax is treatable with timely antibiotics. Even in the absence of treatment, 80% of patients skin form anthrax do not die. The gastrointestinal form of the disease poses a more serious threat, with one-quarter to more than one-half of infections resulting in death. The pulmonary type of anthrax is a much more serious form of the disease. In 2001, more than half of the people who contracted inhalational 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, turns 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 inhalational anthrax are similar to those of a cold or flu, such as a sore throat, slight increase temperature 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 after a week or up to 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 in contact with a source of anthrax infection, but has not yet become ill, differ from the treatment of anthrax cases. 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 therapeutic measures.

Can anthrax be prevented? Vaccination. There is a vaccine to prevent anthrax, but it is not yet available to the public. Anyone who may come into contact with sources of infection, including certain members of the armed forces, laboratory workers and workers who periodically visit contaminated areas, can be vaccinated. In the event of an attack using anthrax as a weapon, people who have been 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 have symptoms of anthrax infection, call your doctor right away.

What should I do if I have reason to believe that I have been in contact with an anthrax source?

Contact law enforcement immediately if you believe you have been in contact with an anthrax source. Possible contact with the source of infection should also be considered contact with a suspicious bag or envelope in which there was any powder.

What measures does he take in case of an anthrax attack?

Measures taken include:
Develop plans and procedures for responding to anthrax attacks.
Training and equipping Rapid Response Teams to assist state and local governments in infection control, sample collection and testing. Informing medical professionals, the media and the public about the actions to be taken in the event of an anthrax attack.
Working closely with health departments, veterinarians and laboratories to detect cases of anthrax in a timely manner. Development of a nationwide electronic database to track possible anthrax cases.
Ensuring the functioning enough laboratories capable of testing in cases of possible anthrax contamination.
Collaborate with hospitals, laboratories, first responders, and medical professionals to provide them with 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 pathology was described in 1849-1850 by three researchers: A. Pollender, F. Brawell and K. Daven. In 1876, R. Koch identified him as pure culture. Of all the bacteria pathogenic to humans, the causative agent of anthrax was the first to be discovered.

Therapist: Azaliya Solntseva ✓ Article checked by Dr.


Anthrax in humans

rare but serious illness caused by the bacterium Bacillus anthracis, which is capable of producing spores. Anthrax mainly affects livestock and wild animals. Humans 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 in this pathology can be contagious by direct contact. Typically, bacteria enter the body through wounds in the skin, as well as by eating contaminated meat or by inhaling spores.

Most of the cases are dermal (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 the military and other people at high risk.

Anthrax caused by inhalation of spores (inhalation) is usually fatal, and symptoms often begin a few days after exposure to the bacilli.

Many Europeans are familiar with this pathology because of a case of biological terrorism. The attack happened in 2001. In the course of 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 may 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 strands of microorganisms, forming the so-called "lion's mane".

Bacillus anthracis, the causative agent, produces a jelly-like capsule that can be easily seen under a microscope using methylene blue as a stain. Bacilli grow best in a carbon dioxide environment. Since these bacteria are anaerobes.

Outside the body and under adverse conditions, they are able to form spores that do not exceed the size of the bacterial cell wall. Bacteria secrete dangerous substances - toxins, which are the main cause of death of patients. These substances cause swelling and necrosis of tissues in humans.

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What symptoms cause controversy in a person

Depending on the route of entry of the spores, patients may complain of skin, respiratory or gastrointestinal manifestations of the pathology. The incubation period is different for each form of infection.

Cutaneous 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;
  • starts as an itchy papule (nodule) that enlarges over 24-48 hours, forming vesicles (vesicles) 1 cm in size, and then becomes an ulcer surrounded by an edematous ring;
  • lesions are usually up to 2-3 cm in diameter and have a round raised edge;
  • the formations are painless, but sometimes slightly itchy;
  • there is swelling of the lymph nodes closest to the site of infection;
  • the ulcer and surrounding swelling develop into a black eschar within 7-10 days and persist for up to 1-2 weeks before separating and leaving a permanent scar;
  • if the neck is affected, swelling and swelling of the lymph nodes can compress the trachea and cause breathing difficulties.

Oropharyngeal form of the disease:

  • infectious disease develops 2-7 days after ingestion of microbes;
  • fever and swelling of the neck;
  • the lesion begins as an edematous area that becomes necrotic and forms a scab within 2 weeks;
  • there is a sore throat, impaired swallowing, breathing and bleeding from the oral cavity;
  • there is swelling of the soft tissues and an increase in the size of the cervical lymph nodes.

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;
  • shock begins.

The inhalation (respiratory) form of the disease begins suddenly, usually 1-3 days after infection, and passes in two phases.

Initial manifestations include the following:

  • myalgia;
  • malaise;
  • fatigue;
  • unproductive cough;
  • feeling of pressure in the chest;
  • fever.

After the first few days, improvement may occur, followed by a 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;
  • hematemesis;
  • severe chest pain, which can mimic myocardial infarction;
  • clouding of consciousness, shock and coma.

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Spores of a dangerous disease

Bacteria are spore-forming rods. Spores contribute to 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. The optimal conditions for growth, as described above, lead to the vegetative phase (rod formation) and bacterial growth. Precipitation can cause the germination of anthrax spores. 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 resistant, as are dogs with cats. Throughout their life cycle, pets are at constant risk.

Birds, as a rule, do not suffer from this pathology. Ravens can transmit spores through their claws and beaks, but are themselves not susceptible to the bacteria. Human infection from birds is extremely rare. Experiments in the science of microbiology have shown that the capsule that surrounds the bacillus is of vital importance in its danger to organisms.

Humans are slightly more resistant to skin infection with bacilli, but microbes can gain access to tissues through microscopic or normal tears and wounds. A pustule (nodule) develops at the site of infection. In its central part, an area of ​​​​suppuration with an ulcer is formed, surrounded by vesicles filled with a bloody or clear liquid. The lesion is surrounded by extensive edema.

Microscopic organisms multiply in situ in a wound and can spread to the bloodstream or other organs (eg, spleen) via lymphatics. Bacteria remain in the capillaries of the invaded organs, and the bad effects of infection are due to the toxins that the microbes produce.

Spread from the liver, spleen, and kidneys back into the bloodstream can lead to bacteremia (large numbers of bacilli in the blood).

The inhalation form occurs after a person inhales the spores into the lungs. The incubation period is 1-6 days. The spores are then carried to the thoracic and mediastinal lymph nodes, germinate, and begin to produce the toxin.

Anthrax in the lungs does not cause pneumonia, but hemorrhagic mediastinitis (inflammation of the 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 sets in and death occurs, in about 95% of cases.

In the intestine, the virus predominantly affects the middle part of the digestive system, similar to lesions that occur in the cutaneous form of the disease. Spores penetrate the mucous membrane. Sometimes tissue necrosis and ulceration at the site of infection lead to hemorrhage from the intestinal vessels.

When spores are transferred to the lymph nodes of the mesentery, they begin to reproduce and bacteremia. Ascites appears, with the formation of a cloudy liquid with an admixture of 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 polyclinic. Health workers must wear masks and gloves. If contamination is to be prevented, splash protection and a closed respirator with high-performance air-purifying filters or self-contained breathing apparatus are recommended.

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 cleaning with soap and water is not enough to disinfect any materials and surfaces; special disinfectant solutions must be used.

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Treatment - how to effectively overcome the virus

Therapy 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 group of fluoroquinolones can serve as a replacement. Before the start of the procedure, a detailed diagnosis is carried out.

Penicillin is more commonly prescribed to treat the inhalation type and meningitis in anthrax. For the prevention of respiratory complications, doxycycline, ciprofloxacin or levofloxacin is used for 60 days.

Raxibacumab is an antibody directed against bacteria. It was approved in December 2012 for the treatment of inhaled anthrax or for prophylaxis when other therapies are unavailable or not suitable.

Antimicrobial therapy has a detrimental effect on microorganisms for several hours, but the lethal effect of the pathology is associated with the action of the toxin on the body.

Patients in shock (end-stage disease) should be in an 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 provides almost complete protection, but is carried out only on demand.

  • all the people who breathed 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 pathology can be treated only with pills.

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How the bacillus is transmitted - the main ways of infection

Anthrax spores are formed by bacteria that occur naturally in the soil in most parts of the world. They can remain dormant for many years until they find their way into a living organism. Common hosts of anthrax bacilli are wild or domestic livestock such as sheep, cows, horses and goats.

The pathology is still prevalent throughout the developing world, such as 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 infections result from contact with infected animals, their meat or skins.

One of the few known cases of transmission occurred in the United States in 2001, when 22 people fell ill after coming into contact with mailed spores. Five victims have died.

Most 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 spores and anthrax are found.

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Skin form of the disease

It develops 1-7 days after the action of bacteria. The spores enter the body through wounds, cuts, or other imperfections in the skin. The exposed areas of the upper extremities are most commonly affected and, to a lesser extent, the head or neck. This is the most common route of infection.

Symptoms of this form are unexpressed and with appropriate treatment, the disease rarely leads to death. Manifestations of cutaneous anthrax include itching, resembling an insect bite, which quickly develops into a painless nodule with a black center; swelling appears at the site of penetration of the spores 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 severe 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, a pathological process can develop in the oropharynx. In this case, the patient at the site of entry into the oropharynx will experience damage resembling a skin ulcer.
Rarely, anthrax can be transmitted through the spread of spores by flies or horseflies.

Symptoms of anthrax

Symptoms of anthrax will depend on the clinical form of the disease.

There are the following forms of anthrax:

  • skin form;
  • pulmonary form;
  • intestinal form;
  • septic form.

Skin 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 the open areas of the skin of the upper extremities and face, 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. With the defeat of the head, neck and face, anthrax is most severe. The location of the carbuncle in the neck or face is dangerous because the developed tissue edema can pass to the upper respiratory tract, which will lead to respiratory failure and subsequent suffocation.

The disease develops, as a rule, two to five days after penetration into the skin of the infection, but the incubation period can last up to seven days.

The cutaneous form of anthrax includes the following varieties:

  • carbuncle;
  • edematous;
  • bullous;
  • erysipeloid.
Carbunculous variety of the skin form
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 a while, a bright red nodule forms at the site of the spot. The patient in this period of time begins to feel a burning sensation and itching. Increasing in size, the nodule transforms into a vesicle within 24-48 hours, inside which is initially serous, and then hemorrhagic fluid. After some time, the vesicle bursts on its own or as a result of scratching, and an ulcer with a black-brown bottom, surrounded by an edematous halo, forms in its place. Due to tissue necrosis, the bottom of the ulcer hardens and gradually covers its entire cavity, turning into a dense crust ( scab). Around the scab, new bubbles continue to form, which, merging and bursting, increase the crust in size. Anthrax skin lesions are usually approximately two to three centimeters in diameter ( can reach up to ten centimeters) and has a round, hyperemic and raised edge above the skin level.

Edematous variety of the skin form
Initially, the patient has a pronounced edema 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 it is more severe than the carbuncle form.

Bullous variety of the skin form
It is characterized by the fact that infiltration is observed at the site of infection, on the surface of which large blisters subsequently form. The blisters contain hemorrhagic fluid. As a rule, after about five to ten days, the blisters open, and extensive ulcerative elements form in their place, inside of which tissue necrosis is observed.

Erysipeloid variety of the skin form
With this form of the disease, the patient initially observed the formation of several or more vesicles that are filled with serous fluid. Subsequently, their opening leads to the formation of ulcers, followed by a dense black crust. This variety is less common than all the others, and is characterized by a milder course of the disease.

Deterioration of 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 course of the disease. The cutaneous form can be mild or severe.

Mild form of the disease Severe disease
Occurs in about 80% of cases. The general condition of the patient, as a rule, is not disturbed. Body temperature may remain within the normal range, or there is a slight increase in the range of 37 - 37.9 degrees, which lasts for about five to six days. Signs of intoxication of the body in this period are moderately expressed. With timely treatment for ten to fourteen days, the patient has a rejection of the scab with the opening of the ulcerative surface, after healing of which a dense scar will remain on the affected area of ​​the skin. Occurs in about twenty percent of cases. The patient has a significant increase in body temperature up to 39 - 40 degrees, as well as signs of intoxication of the body ( e.g. headache, weakness, decreased appetite). After five to six days, the patient's condition may improve. Within two to four weeks, the scab is shed. 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 present with 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 worsening of 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 ( an increase in the frequency of respiratory movements, more than eighteen per minute);
  • severe shortness of breath;
  • cyanosis ( cyanosis) skin.
The patient has increased pain in the chest area, which may resemble acute myocardial infarction, and there is also an increase in coughing with the release of liquid foamy-bloody sputum. Enlarged mediastinal lymph nodes can lead to partial compression of the trachea, which can lead to respiratory failure and suffocation.

The pulmonary form of the disease is dangerous because of its rapid progression. The severe course of this form can lead to the development of cardiovascular insufficiency, 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 consumption of contaminated food.

Initially, the patient may experience the following symptoms of the disease:

  • increase in body temperature;
  • vomiting with bile and an admixture of 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 infected food can lead to damage to the oropharynx. As a rule, two days after consumption of infected meat, the patient has an increase in body temperature, as well as symptoms characteristic of a sore throat ( e.g. sore throat, weakness, headache). Later, swelling of the neck develops due to carbuncles formed 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 develops 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 and its toxins through the circulatory system, as well as damage to various organs and systems. Due to the negative impact of anthrax exotoxins, a patient may develop an infectious-toxic shock.

A patient with a septic form has the following symptoms:

  • elevated body temperature ( up to 39 - 41 degrees);
  • severe chills;
  • severe shortness of breath;
  • increase in the number of respiratory movements;
  • pain in the chest area;
  • cough with frothy sputum mixed with blood;
  • pain in the abdomen;
  • nausea and vomiting with an admixture of blood;
  • bloody stools of a liquid nature.

Diagnosis of anthrax

The diagnosis of anthrax is based on a thorough history taking, 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 the diagnosis is played by the conduct and analysis of the results of laboratory tests.

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 that has appeared on a healthy area of ​​the skin, which quickly transforms into a vesicle, and then into an ulcer. Two to three days after the onset of the disease, complaints of a deterioration in general health may appear ( fever, weakness, malaise).
Collection of anamnesis Initially, the doctor collects an anamnesis of life, 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.

The results of collecting an epidemiological history, in which the doctor finds out:

  • place of work of the patient;
  • whether the patient had contact with food products of animal origin;
  • whether the person has been in contact with sick animals;
  • whether there was contact with the skin, hair or fur of the animal.
Examination of the patient On the body of the patient, single or multiple ulcerative lesions of the skin are found, in the center of which there is a compacted black crust. Around the ulcer there is a 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 tissues, causing their gelatinous trembling.
Differential Diagnosis
  • Bubonic plague (characterized by the appearance of blisters filled with hemorrhagic fluid at the site of the lesion, after opening of which tissue necrosis is observed);
  • furuncle (purulent inflammation of the hair follicle) or carbuncle ( purulent-necrotic inflammation of several hair follicles located nearby);
  • glanders (there is a development of a vesicle containing hemorrhagic-purulent fluid, after opening of which an ulcer is formed);
  • primary syphilis (hard chancre is a local ulceration of the skin, but, unlike anthrax carbuncle, is not surrounded by an edematous halo);
  • erysipelas (erysipelas of the skin).
It should be noted that a feature of the cutaneous form of anthrax is that the area of ​​the carbuncle does not cause pain in the patient ( even with a needle prick). This is an important fact in making a diagnosis. Also, unlike the above diseases, in patients with cutaneous anthrax, which occurs without complications, there is no pronounced change in the general condition.

Diagnosis of the pulmonary form of anthrax

Research method Description
Patient's complaints At an early stage of the disease, there may be complaints regarding cough, runny nose, and fever. Later, the patient complains of frothy-bloody sputum and severe retrosternal pain.
Collection of anamnesis After collecting an anamnesis of life and disease, the doctor pays special attention to the epidemiological anamnesis. It is necessary to clarify the professional activity of the patient, whether he was near the corpses of dead animals, whether there was contact with any dusty objects.
Examination of the patient The patient has:
  • increased body temperature;
  • cough;
  • hemoptysis;
  • participation of auxiliary muscles in the act of breathing;
  • dyspnea;
  • cyanosis of the skin;
  • tachypnea;
  • low blood pressure.
On auscultation ( listening) in the lungs, moist, medium and coarse bubbling rales are heard, as well as a pleural friction rub. On percussion ( tapping) zones with dullness of percussion sound can be traced.
Differential Diagnosis A differential diagnosis is made with the following diseases:
  • pneumonic plague;
  • bacterial mediastinitis;
With this form of the disease, laboratory tests help to make an accurate diagnosis ( e.g. bacteriological examination of sputum, serological examination of blood).

Diagnosis of the intestinal form of anthrax

Research method Description
Patient's complaints The patient complains of sharp cutting pains 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 neck swelling).
Collection of anamnesis The doctor collects the necessary information about life and the existing disease. It is also important to collect a complete epidemiological history, in which it should be clarified whether the patient consumed the meat or milk of sick animals.
Examination of the patient During the examination, the patient may reveal the following signs:
  • increased body temperature;
  • dyspnea;
  • pronounced swelling of the neck;
  • hematemesis;
  • bloody loose stools;
  • on palpation of the epigastric region, the patient feels a sharp pain ( cutting nature);
  • tachycardia;
  • pronounced signs of intoxication of the body.
Differential Diagnosis A differential diagnosis is made with the following diseases:
  • abdominal tularemia.
It is quite difficult to make a diagnosis of the intestinal form of anthrax. Diagnosis of the disease helps to conduct a series of laboratory tests that allow you to accurately determine the presence of anthrax in the patient's body.

Also, in all forms of the disease, the patient undergoes a blood sampling for a hemogram ( general blood analysis).

With anthrax, the following changes will be observed in the general blood test:

  • leukopenia ( decrease in the level of leukocytes);
  • lymphocytosis ( an increase in the number of lymphocytes);
  • accelerated ESR ( sedimentation rate of erythrocytes) .

Laboratory diagnostics

The following diagnostic methods are used to detect anthrax:
  • bacterioscopic method;
  • bacteriological method;
  • immunofluorescent method;
  • skin allergy test.
Bacterioscopic method
It is characterized by the detection of pathogenic microorganisms in the materials collected from the patient. This research method can be carried out using a simple and fluorescent microscope.

The following materials may be collected for the diagnosis of anthrax:

  • blood (using a sterile syringe from the cubital vein, three to five milliliters of blood is drawn);
  • contents of vesicles, carbuncle (first, the skin around the damaged area is treated with a cotton swab with alcohol, after which material is collected using a swab or syringe);
  • sloughed scab (examining the detached scab);
  • sputum (released during a coughing fit, collected in a sterile container with a tight-fitting lid);
  • feces and vomit (the material is collected in a sterile vessel).
The collected material is applied using a special loop and distributed on a prepared glass slide. If the pathological material is of a dense consistency, then a drop of saline is dripped on top of it. The prepared smear is dried on its own or with a burner to fix the material to the glass, and then stained with a special dye ( the dye is applied to the dried smear). After staining, the material is again thoroughly dried and then microscoped. The advantage of this method of research is the simplicity of its implementation, as well as obtaining results in a short time.

Bacteriological method
This method consists in the isolation and identification of pathogenic microorganisms by sowing pathological material on various nutrient media, where colonies subsequently grow.

When cultivating, the anthrax bacillus is unpretentious, it grows on simple nutrient media, for example, on meat-peptone agar or broth, at a temperature of 34-35 degrees Celsius. The colonies they form have irregular fringed edges.

The following materials may be collected for bacteriological examination:

  • the contents of the carbuncle or vesicle;
  • sputum;
  • blood;
  • faecal matter.

When conducting a bacteriological method, the following requirements must be observed:

  • sampling of pathological material should be carried out before the start of antibiotic therapy;
  • the sampling of the 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, as well as under special temperature conditions.
Immunofluorescence method
This method allows to detect antibodies, as well as anthrax antigens. The essence of the immunofluorescent method is that the pathological material taken from the patient is applied in the form of a smear on glass, after which a special fluorochrome dye is applied on top, and microscopy is performed using a fluorescent microscope.

The immunofluorescent method of research can be carried out in the following ways:

  • direct reaction. Pathological material is applied to a glass slide, and then a fluorochrome ( contains labeled antibodies). Anthrax proteins, when combined 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 to a smear of a fluorochrome containing anthrax antigens, which subsequently bind to the antibodies in the test material. Then a substance containing anti-immunoglobulins is applied to the smear, which, by binding to antibodies, form an immune luminous complex.
  • competitive response. It is carried out by adding antibodies to the test material, as well as labeled antigens. Labeled antigens, when combined with antibodies, begin to compete with unlabeled antigens. Subsequently, the formed immune complexes begin to glow, which is detected by microscopy of the studied smear.
Skin allergy test
This method of research is carried out in order to identify the sensitivity of the organism to the injected allergen. With anthrax, 0.1 ml of anthraxin is injected intradermally into the middle region of the forearm. The preparation used contains a 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.
The developed skin reaction persists for a long time and manifests itself in the form of an infiltrate with the possible formation of tissue necrosis.

Recently, this diagnostic method is rarely used, only as an additional research method.

Anthrax Treatment

Treatment for anthrax includes:
  • infusion therapy;
  • antibiotic therapy;
  • introduction 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 body fluids.

With anthrax, the following groups of solutions can be administered:

  • colloidal solutions;
  • crystalloid solutions;
  • blood products.
Group Solution name Characteristic
Colloidal solutions Poliglukin This medicine contains 6% dextran and 0.9% sodium chloride. It produces an anti-shock effect, and also replenishes the volume of fluid during dehydration of the body, 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 solution of sodium chloride 0.9% or 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, with 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 you to maintain the required level of osmotic pressure of plasma and extracellular fluid. Therefore, the introduction of this drug allows you to replenish the required level of sodium and chlorine during plasma loss. The total dose of the solution 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 the loss of intercellular fluid. The total dose of the drug is up to three liters per day ( in conditions of mild or moderate severity - from 500 ml to one liter).
Glucose solution (5%) It is a hypotonic solution, which includes a 5% dextrose solution. It is used for detoxification, as well as replenishing the volume of fluid 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 in its composition 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 detoxifying effect and provides hemostasis ( preservation of the liquid composition of the blood). Before the introduction of the drug, it is necessary to conduct a compatibility test for blood group. The dose of administration is determined individually depending on the available indications ( can be injected 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 maintaining fluid in the vessels. Albumin also provides protein nutrition to the body, necessary for its normal functioning. As a rule, the drug at a concentration of 20% in a single dose is administered 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 that caused the disease. The main group of drugs to which anthrax is sensitive is penicillin. However, if the patient has intolerance to penicillin, drugs from such groups of antibacterial agents as tetracyclines, macrolides or fluoroquinolones may 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 ( acts destructively). In the cutaneous form of the disease, the drug is administered 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. A dose of 500 mg four times a day for seven to ten days is indicated.
Ciprofloxacin Pharmacological group - fluoroquinolones. A broad-spectrum antibiotic that produces a bactericidal effect on bacteria. The drug is administered intravenously in drops of 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 detrimental effect on pathogenic microorganisms. The drug must be administered intravenously in drops of 500 mg once or twice a day. Inside, 500 mg is taken once a day for seven to fourteen days.
Doxycycline Pharmacological group - tetracycline. The tool has a wide spectrum of action. It affects bacteria, stopping their growth and development. In the first days of treatment, take 200 mg orally four times a day, in the following days the dose is reduced to 100 mg four times a day. Intravenously, the drug is administered by drip 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. In the septic form of anthrax, the dose of prednisolone is increased to 800 mg per day.

Anthrax immunoglobulin

The drug contains immunoglobulins ( finished antibodies), which are obtained from the blood plasma of a previously vaccinated horse. The purpose of the introduction of immunoglobulin is to create and maintain immunity to the anthrax pathogen. When administered, the agent has a detrimental effect on anthrax, and also produces an antitoxic effect.

It is used to treat the disease, as well as an urgent preventive measure.

As a treatment, the drug is prescribed in the following doses:

  • up to twenty milliliters per day with a mild form of the disease;
  • from twenty to forty milliliters per day, with a moderate disease;
  • from sixty to eighty milliliters per day, with a severe form of the disease.

The drug is injected intramuscularly into the upper outer quadrant of the buttock.

It should be noted that before the introduction of the drug in a therapeutic dose, a test for sensitivity 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 turned out to be positive, then the drug is administered only in especially severe cases of the disease and after strict administration of glucocorticosteroids ( e.g. prednisolone).

In the treatment of anthrax, the drug is used in conjunction with antibiotic therapy.

As an urgent preventive measure, anthrax immunoglobulin is prescribed in the following cases:

  • if the person was 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 eaten the meat of a sick animal.
Prophylactically, the drug is administered in the following dosage:
  • adults twenty - twenty five millimeters;
  • teenagers- twelve millimeters;
  • children under fourteen- 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 to reliably prevent the development of this disease.

There are the following types of vaccines:

  • inactivated vaccine. Contains a weakened anthrax, 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 provoking a disease that occurs in a mild form without pronounced clinical signs. After the transferred infectious process, a person develops a strong immunity.
  • Combined vaccine. Consists of inactivated and live vaccines.
In Russia, two types of vaccines are used - live and combined.
live vaccine Combined vaccine

produced dry.

.

Anthrax Prevention

Anthrax prevention includes:
  • preventive measures aimed at preventing the development of the disease;
  • anti-epidemic measures aimed at preventing the spread of the disease.
There are the following preventive measures:
  • people at increased risk of infection should be vaccinated ( anthrax vaccine);
  • control of veterinary services for domestic animals;
  • animal vaccination;
  • improving working conditions by providing workers with protective masks, gloves and gowns;
  • sanitary and veterinary control of transportation, storage, and processing of meat products;
  • carrying out sanitary and educational work.
There are the following anti-epidemic measures:
  • early detection of anthrax patients;
  • registration and emergency notification in case of detection of a disease;
  • transportation by special sanitary transport, which is disinfected after the transportation of the patient;
  • timely hospitalization of the patient;
  • discharge from the hospital only after the patient has recovered, as well as after conducting control studies;
  • carrying out current and final disinfection in the patient's ward ( also chamber disinfection should be subjected to products made of wool, fur and leather);
  • identification and isolation of contact persons ( in two weeks);
  • carriers must be isolated, and in case of impossibility - destroyed ( animals, infected meat);
  • early detection and isolation of sick animals;
  • meat, as well as fur, wool and skin of infected animals is prohibited to use;
  • corpses of sick animals must be burned ( opening is not performed);
  • people who died from anthrax are not subject to autopsy;
  • the corpse of a deceased person from this disease is wrapped in oilcloth ( to avoid contact with the skin of the deceased), previously dry bleach is poured onto the bottom of the coffin.

Anthrax is a serious disease that often ends in death. The main source of infection is livestock and wild animals. In today's article, we will consider the main symptoms of a terrible disease, preventive measures and methods of treatment.

Causes and causative agent of the disease

Anthrax is a disease that occurs in animals. It is from them that disputes are transmitted to humans. Experts have found that the infection, as a rule, penetrates the skin if they have open wounds or other damage.

Anthrax is caused by spores of the bacterium Bacillus anthracis.

They develop only under favorable conditions:

  • the 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 7 more days after death. In this case, it is impossible to cut the carcass of an animal in any case. The coat of a sick individual is contagious for another 3-5 years.

How is anthrax transmitted

Animals can become infected in several ways:

  1. Drinking contaminated water or writing. Especially often, such problems arise with domestic animals that are taken to pastures.
  2. When bitten by insects that have had contact with an infected animal.

The ways of transmission of anthrax to humans are somewhat different:

  1. Air. Together with dust, a person inhales anthrax spores. With weak immunity, cells do not react in any way to “foreign” particles. Bacteria enter the lungs, then "attack" the lymph nodes. After that, they actively multiply, are carried by the bloodstream throughout the body, affecting the internal organs.
  2. Domestic. In this case, a person must have close contact with an infected animal. Often, infection occurs during the butchering of livestock carcasses.
  3. Food. If the meat of an infected animal gets into the dish, while sufficient heat treatment has not been completed, a person has an intestinal form of anthrax.
  4. Transmissible. In the event of a bite from a sick animal.

It is characterized by the following features:

  • 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 uneven, inflamed edges, in the center of which there is a dark spot (eschar). In this case, there are no painful sensations. There are also common cases when a large blister with blood contents is observed on the skin;
  • around the ulcers you can see bubbles that outwardly resemble purulent boils;
  • lymph nodes in the neck enlarge, become painful;
  • body temperature rises. But critical levels (above 39 degrees) are rare.

If the treatment of cutaneous anthrax is started on time, the chances of a favorable prognosis are quite high.

In the pulmonary form, the following clinical picture can be observed:

  • chest pain;
  • on the first day, dry cough, which only increases with time;
  • increase in body temperature up to 38 degrees;
  • enlargement of the 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 of the integument, pulmonary edema. Without timely treatment, the death of the patient occurs within 3 days.

The intestinal form is considered the most severe and rapidly developing.

The signs are the following:

  • an increase in body temperature up to 40 degrees;
  • sharp pain in the abdomen;
  • diarrhea with an admixture of blood;
  • 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 their life. Therefore, at the first signs of the disease, 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, the specialists without fail 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;
  • Abdominal ultrasound.

Each case is considered individually. To confirm the diagnosis, the doctor may prescribe additional examinations.

How to treat anthrax

Anthrax in humans is treated only in a hospital under the constant supervision of doctors.

The following types of drugs are prescribed:

  • antibiotics. They are administered intravenously for 7-14 days. Mostly used means based on penicillin;
  • 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. The canker spores were grown in the laboratory and then killed by heat treatment. With such a vaccination, the risks of complications are minimal;
  • live vaccine. Anthrax spores are administered to 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 there may be the following side effects:

  • severe weakness, up to loss of consciousness;
  • migraine;
  • enlargement and soreness of the lymph nodes.

Vaccination is prohibited in the following cases:

  • pregnancy and lactation;
  • oncology and AIDS;
  • serious chronic diseases;
  • skin ailments.

Remember, anthrax is in most cases fatal, so vaccination is a necessary measure in close contact with livestock and wild animals.

Prevention measures

How can you protect yourself from anthrax infection?

Prevention methods are as follows:

  1. Mandatory vaccination of animals.
  2. Livestock supervision.
  3. Routinely conducting a series of tests for animals.
  4. Vaccination of people who are at risk (farmers).
  5. Proper storage of meat products.
  6. Burning of infected animal carcasses.

Anthrax is a disease that is not so common in developed countries. But still, isolated cases, alas, occur. That is why it is very important to know the ways of infection and the symptoms of the disease.

If you observe signs of anthrax in yourself, consult a doctor without fail. 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 tolerated and transmitted. We decided to dedicate a whole article to this.

Usually this disease is infected by airborne dust and food. Transmission of anthrax bacilli to humans can occur through the excretions of sick animals, their skin, corpses, and meat products. Water, soil, 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 infection and the main cause of anthrax transmission. There are professional-agricultural, professional-industrial and household types of the disease. Anthrax is more common in meat-packing factories, spinning mills and other workers who care for sick animals, bury and skin the corpses of dead animals. occur when processing raw and eating poorly cooked meat of animals with anthrax. There have been cases of human infection through various products and materials of infected animals, these can be shaving brushes, clothing, fur mittens, collars, hats, etc. The highest incidence in rural areas is observed in summer. Immunity in anthrax survivors is stable, but not absolute.

Forms of anthrax

There are three forms of anthrax - skin, 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 one, which is infected by pathogenic spores. Once in the blood or on the mucous membrane of the respiratory tract, spores produce anthrax bacterium. can last from several hours to a week. In the pulmonary form, the symptoms are similar to those of acute respiratory infections, then pneumonia joins, the temperature rises sharply, and hemoptysis begins. If you delay the treatment with the right antibiotics, a quick death can occur. Anthrax vaccinations are associated with serious complications.

Anthrax Prevention

Prevention consists in the identification and elimination of foci of infection by workers of the veterinary service. People who are at risk of anthrax infection (at the enterprises of enterprises for the processing of leather, wool, meat, veterinarians, laboratory workers examining with anthrax pathogens) are given prophylactic vaccinations with a live dry vaccine (STI). Before inoculation, the dry vaccine ampoule 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, the skin is treated with alcohol or ether of the shoulder and two drops of the vaccine are applied, making notches through each drop.

The sick are placed in a separate ward and current disinfection is carried out. The extract of the recovered occurs after the epithelialization of ulcers.

For people who have been in contact with sick animals, and there is a risk of infection, medical supervision is established for a half month.

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