Anthrax

Anthrax is an acute disease caused by Bacillus anthracis. It is usually remain in soil.But, affects man and animal both.In man it produces disease in skin,GIT,lungs. It was shown to cause disease by Robert Koch in Number of total strain 89.Sterne strain is used for vaccine production. Introduction

High Risk population Cattle-sheep,goats,camels,wild or domestic buffalo, antelopes,zebra,rhinos,elephants,lions. Human-Mainly associated with animal farm/who remain in contact with affected animal.

Virulent factors of B.anthracis 1)Endospore, 2)When endospore reaches blood then it releases 3 factors- a)lethal factor, b)edema factor, c)protective antigen.

Modes of transmission a)Ingestion of meat of affected animals b)Cutaneous c)Inhalation

Pathogenesis Endospore In blood Uptaken by macrophage Multiply with in it Bursting of affected macrophage and affects new one Endospore in blood causes release of : Lethal factor Edema factor Protective antigen

Pathogenesis Lethal factor Stimulate macrophage Release of TNF -, IL – 1, IL – 1B Septic shock Death Edema factor Inactivate neutrophil No phagocytosis

Pathogenesis Endospore transported through lymphnode Goes to mediastinum (central chest cavity) Damage caused by endospore Chest pain & difficulty in breathing

Diagnosis How is anthrax diagnosed? Anthrax is diagnosed by isolating B. anthracis from the blood, skin lesions, or respiratory secretions or by measuring specific antibodies in the blood of persons with suspected cases. In patients with symptoms compatible with anthrax, providers should confirm the diagnosis by obtaining the appropriate laboratory specimens based on the clinical form of anthrax that is suspected (i.e., cutaneous, inhalation, or gastrointestinal). Cutaneous - vesicular fluid and blood Inhalation - blood, cerebrospinal fluid (if meningeal signs are present) or chest X-ray Gastrointestinal - blood

Continue Diagnosis What are the standard diagnostic tests used by the laboratories? Presumptive identification to identify to genus level (Bacillus family of organisms) requires Gram stain and colony identification. Presumptive identification to identify to species level (B. anthracis) requires tests for motility, lysis by gamma phage, capsule production and visualization, hemolysis, wet mount and malachite green staining for spores. Confirmatory identification of B. anthracis carried out by CDC may include phage lysis, capsular staining, and direct fluorescent antibody (DFA) testing on capsule antigen and cell wall polysaccharide.

Continue Diagnosis When is a nasal swab indicated? Nasal swabs and screening may assist in epidemiologic investigations, but should not be relied upon as a guide for prophylaxis or treatment. Epidemiologic investigation in response to threats of exposure to B. anthracis may employ nasal swabs of potentially exposed persons as an adjunct to environmental sampling to determine the extent of exposure. Is there an X-ray for detecting anthrax? A chest X-ray can be used to help diagnose inhalation anthrax in people who have symptoms. It is not useful as a test for determining anthrax exposure or for people with no symptoms.

Signs & Symptoms: a)Cold/ flu like symptoms for several days b)Vomiting of blood, severe diarrhea c)Acute inflammation of GIT d)Loss of appetite e)Boil like skin lesion leads to ulcer with a black center formed with in 2 to 5 days after exposure f)Severe respiratory collapse

Prevention Vaccines: An anthrax vaccine licensed by the U.S. Food and Drug Administration (FDA) and produced from one non-virulent strain of the anthrax bacterium, is manufactured by BioPort Corporation, subsidiary of Emergent BioSolutions. The trade name is BioThrax, although it is commonly called Anthrax Vaccine Adsorbed (AVA). It is administered in a six-dose primary series at 0, 2, 4 weeks and 6, 12, 18 months; annual booster injections are required thereafter to maintain immunity.U.S. Food and Drug Administration Emergent BioSolutions Unlike NATO countries, the Soviets developed and used a live spore anthrax vaccine, known as the STI vaccine, produced in Tbilisi, Georgia. Its serious side effects restrict use to healthy adults.NATOTbilisi, Georgia

Treatment Treatment for anthrax infection and other bacterial infections includes large doses of intravenous and oral antibiotics, such as fluoroquinolones, like ciprofloxacin (cipro), doxycycline, erythromycin, vancomycin or penicillin.antibioticsquinolonesciprofloxacindoxycycline erythromycinvancomycinpenicillin Note: Dont use these medicine without consulting with your physician or doctor.

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Prepared by- Munzur-E-Murshid