google7fe7e6420122196f.html Preventive Medicine: Watch out for ANTHRAX....

Wednesday, December 3, 2008

Watch out for ANTHRAX....

Last week, I read an article on newspaper about anthrax disease in Boyolali, Central Java. A-4 years old child got various clinical symptoms that appeared to be similar with anthrax disease. For you know, boyolali is one of area in Indonesia that often report anthrax outbreak (last report was on 1990). Most of the people there work as cattle farmer, and Boyolali is famous for its milk producing cows. That article reported that the child had nose and fecal bleeding, high fever, and massive diarrhea. It's like intestinal-anthrax symptoms.In addition, the child had an animal-contact history, since he loves to play along with cows near his house.

Since, next Monday is Idul Adha (one of holidays in Islam),  and lots of people here want to celebrate and consume tons of meat.  I think I’d love to write some facts about this Anthrax disease from the CDC, .

Hope this useful..


Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in wild and domestic lower vertebrates (cattle, sheep, goats, camels, antelopes, and other herbivores), but it can also occur in humans when they are exposed to infected animals or tissue from infected animal

Anthrax infection can occur in three forms: cutaneous (skin), inhalation, and gastrointestinal. B. anthracis spores can live in the soil for many years, and humans can become infected with anthrax by handling products from infected animals or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. It is rare to find infected animals in the United States

Symptoms of disease vary depending on how the disease was contracted, but symptoms usually occur within 7 days.

Cutaneous: Most (about 95%) anthrax infections occur when the bacterial spore enters a cut or abrasion on the skin, such as when handling contaminated wool, hides, leather or hair products (especially goat hair) of infected animals. Skin infection begins as a raised itchy bump that resembles an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm in diameter, with a characteristic black necrotic (dying) area in the center. Edema or swelling of the surrounding tissues may develop and lymph glands in the adjacent area may swell. About 20% of untreated cases of cutaneous anthrax will result in death. Deaths are rare with appropriate antimicrobial therapy.

Inhalation: Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal, and even with aggressive antibiotic and supportive therapy ,45% of inhalation anthrax cases were fatal .

Intestinal: The intestinal disease form of anthrax may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial signs include nausea, loss of appetite, vomiting, fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Symptoms may also include lesions and soreness in the throat, difficulty swallowing, marked swelling of the neck and regional lymph glands. Intestinal anthrax results in death in 25% to 60% of cases.

 Person-to-person transmission is extremely unlikely and has only reported with cutaneous anthrax, where discharges from skin lesions are potentially infectious.  Communicability is not a concern in managing or visiting with patients with inhalation anthrax.

 In countries where anthrax is common and vaccination levels of animal herds are low, humans should avoid contact with livestock and animal products and avoid eating meat that has not been properly slaughtered and cooked. Also, an anthrax vaccine has been licensed for use in humans. The vaccine is reported to be 93% effective in protecting against anthrax.

A common feature of anthrax in animal is that animals in apparently good condition die suddenly without showing overt signs of ill health. Acute cases in cattle, sheep and wild herbivores are characterized by fever, depression, difficulty in breathing and convulsions. Animals may die within two or three days if not treated. It is common to see bloody discharges from natural openings. In few instances, anthrax can manifest itself as a mild disease characterized by general malaise. In pigs, the disease is characterised by swelling of the throat, which may cause difficulties in breathing. In dogs, cats and wild carnivores, the disease resembles that seen in pigs.

Although the chance of getting anthrax through your mail is remote, a simple precaution you can take is to be sure to wash your hands thoroughly with soap and water after handling your mail.

The anthrax vaccine is manufactured and distributed by BioPort, Corporation, Lansing, Michigan. The vaccine is a cell-free filtrate vaccine, which means it contains no dead or live bacteria in the preparation. The final product contains no more than 2.4 mg of aluminum hydroxide as adjuvant. Anthrax vaccines intended for animals should not be used in humans

The Advisory Committee on Immunization Practices has recommended anthrax vaccination for the following groups:

  • Persons who work directly with the organism in the laboratory 
  • Persons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax spores.
  • Persons who handle potentially infected animal products in high-incidence areas. (Incidence is low in the United States, but veterinarians who travel to work in other countries where incidence is higher should consider being vaccinated.) 
  • Military personnel deployed to areas with high risk for exposure to the organism (as when it is used as a biological warfare weapon). 
  • Pregnant women should be vaccinated only if absolutely necessary.

The immunization consists of three subcutaneous injections given 2 weeks apart followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are recommended thereafter.

 Anthrax is diagnosed by culture and isolation of the causative bacterium, B. anthracis; by detecting the bacterial DNA or antigens; or by measuring specific antibodies in the blood of persons with suspected cases.  The bacteria can be cultured from the blood, skin lesions, fluid from the lungs or respiratory secretions, spinal fluid, or other affected tissues prior to the start of antibiotic treatment.   Detection of the DNA or antigens of the bacteria, and detection of antibodies in the blood of suspected cases, are important tools for diagnosis because positive culture is unlikely after antibiotic treatment has been started. 

Doctors can prescribe effective antibiotics. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal. Some of antibiotics that can be used to treat this disease are .Some of the different medications in the prevention of Anthrax include:

DisperMoxMoxilinGen-AmoxicillinLin-AmoxPMS- AmoxicillinAcroxil-Amobay-Amoxifur-AmoxilAmoxinovagAmoxisolAmoxivetAmpliron-ArdineFlemoxonGimalxinaGrunicinaHidramoxMoxlinPenamoxPolymoxServamoxSolciclinaXalyn-OrBioThrax




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