ANTHRAX
ANTHRAX
Anthrax is a serious disease usually caused by Bacillus anthracis bacteria. It's found naturally in soil
around the world and commonly affects livestock and wild animals. The bacteria exist in spore form,
which allows them to survive in harsh environmental conditions for decades. These spores are the
primary means of transmission.
Ethiology/Cause
People usually get sick with anthrax if they come in contact with infected animals or contaminated
animal products. People can breathe in anthrax spores, eat food or drink water contaminated with
spores, or get spores in a cut or scrape in the skin.
Mode of Transmission
Anthrax manifests in humans in four main forms, depending on the route of infection:
1. Cutaneous Anthrax: Occurs when spores enter through cuts or abrasions on the skin.
Symptoms: Small blisters or sores that develop into a painless ulcer with a black center (eschar).
4. Injection Anthrax: Injection anthrax is a rare and serious form of anthrax infection that occurs when
Bacillus anthracis spores enter the body through an injection site, typically from contaminated drugs or
needles. It progresses rapidly to cause tissue death (necrosis), large blisters, and systemic symptoms
such as fever, shock, or organ failure.
Diagnosis
2. Test of Infected Skin/Skin Sores: For cutaneous anthrax, samples from skin lesions (such as fluid or
tissue) are examined for the presence of B. anthracis.
3. Blood Testing: Used to detect anthrax bacteria or antibodies in the bloodstream, particularly in
systemic or inhalation anthrax cases.
4. CT Scans and Chest X-Ray: Imaging tests are crucial for diagnosing inhalational anthrax.
They help identify mediastinal widening (enlarged lymph nodes in the chest) or pleural effusion, which
are hallmark signs of inhalational anthrax.
5. Lumbar Puncture (Spinal Tap): Performed to analyze cerebrospinal fluid in cases of anthrax meningitis,
a rare but severe complication.
6. Endoscopy of the Intestine and Throat: Used to assess lesions or damage caused by gastrointestinal
anthrax, often due to ingestion of contaminated food.
Treatment/Medication
Treatment of anthrax depends on the form of the disease (cutaneous, inhalational, gastrointestinal, or
injection) and its severity.
1. Antibiotic Therapy:
First-line antibiotics:
Ciprofloxacin or Doxycycline: These are the most commonly used antibiotics for anthrax treatment and
prophylaxis.
These antibiotics are effective against the Bacillus anthracis bacteria and help stop their spread in the
body.
Duration:
2. Antitoxins:
Anthrax immune globulin (AIG): A plasma-derived product that targets anthrax toxins.
3. Supportive Care:
Ventilation: For respiratory failure in inhalational anthrax.
Fluids and electrolytes: To manage dehydration and shock, especially in gastrointestinal anthrax.
Pain management and wound care: For patients with injection anthrax or severe cutaneous forms.
Surgical intervention: Sometimes necessary to remove necrotic tissue in injection or cutaneous anthrax.
Geographic Distribution
Anthrax is endemic in several regions, particularly in areas with suitable environmental conditions for
the persistence of Bacillus anthracis spores. It occurs naturally in certain wild and domestic animals (e.g.,
cattle, sheep, goats, camels, etc.), most commonly in South and Central America, sub-Saharan Africa,
central and southwestern Asia, southern and eastern Europe, and the Caribbean.
Outbreaks
Zambia
In 2023, an anthrax outbreak in Zambia began with the first human cases reported in May. As of
November 2023, 684 suspected human cases were reported, with four deaths. The outbreak was
centered in the Sinazongwe District, where 287 cases were reported.
Nigeria
In 2023, the first case of anthrax in Nigeria was reported in July. The outbreak started on a farm in
Suleja, Niger State, where mass mortality was observed in a variety of animals.
Croatia
In 2022, an anthrax outbreak occurred in Croatia, with 17 patients reporting cutaneous anthrax. All
patients recovered after being treated with antibiotics.
Ethiopia
Between 2016 and 2019, 1,188 suspected human cases of anthrax were reported in Ethiopia. The
highest number of cases were reported in Amhara, followed by Tigray, SNNPR, and Oromia.
Spain
In 2021, an anthrax outbreak occurred in Spain, with five cases reported. The cases were linked to
several farms in one region of Spain.
Philippines
2017 in Cayapa Village, Abra province, a case-control study identified 29 suspected cases of anthrax. The
study found that all of the suspected cases ate the meat of a dead water buffalo, and that the most
common symptoms were abdominal pain, fever, and diarrhea. The study concluded that the outbreak
was likely caused by eating the carcass of the dead animal.
Prevention
1. Vaccinating livestock
6. Controlling dust
7. Providing good air circulation when working with animal hides, fur, hair, or wool
10. Refraining from drinking unpasteurized milk or eating potentially contaminated meats
11. Wearing nitrile or vinyl gloves to prevent skin contact with BA-contaminated materials.