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Home Disease Index Anthrax

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Overview

Causes
Symptoms
Risk Factor

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What is anthrax?

 


Anthrax is a bacterial disease caused by an organism called Bacillus anthracis. This organism is capable of producing spores - essentially a protective casing - which allows it to survive for decades in soil and other similar environments.

Anthrax is primarily a disease of grass-eating animals such as sheep, goats, cattle and horses. Human infection requires direct contact with either infected animals or animal products such as hides containing spores of the bacteria. There is considerable present anxiety that distribution of anthrax spores could be used as a method of biological warfare or terrorist attack.

Generally anthrax is confined to parts of Asia, Africa and the Middle East where exposure to infected animals or animal products is more likely. Within the UK, anthrax is a rare condition and when it occurs it is usually linked to contaminated imported hides, wool, goat hair, bristles, bone meal in fertilizers, etc.

The spread of anthrax depends on exposure to the bacteria. It is not a contagious disease, ie it is very unusual for it to spread from person to person..



Causes

 


Anthrax isn't new. Some historians believe anthrax was one of the Egyptian plagues at the time of Moses.

Anthrax disease is caused by a rod-shaped bacterium, Bacillus anthracis, which normally resides as a spore in the soil. These spores remain dormant until they find their way into a host to infect — an animal or a human. Anthrax spores are extremely hardy. They're resistant to sunlight and have been known to survive in soil for decades.

Anthrax spores are odorless, tasteless and invisible to the naked eye. The spores measure about 1 micron in size, the equivalent of one-thousandth of a millimeter.

Anthrax primarily affects farm animals — sheep, cattle, horses, goats and camels — that typically contract intestinal anthrax by eating spores from the soil. Anthrax once was common in most areas where livestock are raised. But in modern times, animal vaccination programs have greatly reduced the natural occurrence of the disease among both animals and humans in much of the world.

Outbreaks of animal anthrax still occur in places that don't have widespread livestock immunization programs, such as Central and South America, eastern and southern Europe, Asia, Africa, the Caribbean and the Middle East. Naturally occurring anthrax is rare in the United States. However, epidemics have been reported in Louisiana, Mississippi, Illinois, Pennsylvania and Delaware.

Historically, most human cases of anthrax occurred as a result of exposure to infected animals or their meat or hides. In fact, anthrax used to be known as woolsorters' disease because people who worked with wool in the 18th century often contracted inhalation anthrax from handling spore-contaminated wool in enclosed factory spaces.



What are the features of anthrax?

 


Anthrax bacteria can enter the body by the skin, by the soft lining of the mouth and digestive tract (mucous membranes) or by the lungs. The incubation period, ie the time between exposure to the organism and the development of the illness, is between 12 hours to five days, but is usually three to five days.

Skin
The skin (cutaneous) route is by far the most common. At the site of entry, which may be a cut or abrasion for example, the bacteria multiply and produce toxic chemicals which then lead to the typical tissue changes. At first there is an itchy, red-brown lump that enlarges and becomes surrounded by tissues swollen with fluid. This lump then ulcerates, leaving a central black scab, which gives rise to the infection's name - anthrax is the Greek word for coal.

The local lymph nodes are usually swollen and the affected person may have other symptoms such as tiredness, muscle aches, fever, nausea and headaches.

Digestive system
Rarely, anthrax can be caught by eating contaminated meat, particularly if there is also a break in the lining of the mouth or gut. Spread of the infection to the lymph nodes within the abdomen can then lead to a severe or possibly fatal illness.

Lungs
The inhalation of anthrax spores is potentially the most serious route of infection. This is called pulmonary anthrax. Generally there is also another condition present, such as a cold perhaps, which has weakened the defences of the lung and airways and upon which the invading anthrax bacteria can settle. Within the lymph nodes of the central chest (the mediastinum) the bacteria multiply and cause tissue destruction which spreads rapidly to other parts of the body. The initial symptoms of pulmonary anthrax are very similar to those of the 'flu', but within a few days the picture changes and the infected person develops trouble breathing and then can develop shock, with usually a fatal outcome.



What is the risk of deliberate anthrax exposure?

 


This is difficult to quantify but anthrax has many disadvantages as a biological warfare agent. It is very difficult to manufacture a form that could be distributed to a large number of people with the intention to cause widespread infection. The recent suspicion of terrorist distribution of anthrax in the US reinforces the need for the public to be wary of suspicious packages arriving through the post, yet it is unlikely that even a deliberately contaminated package would have much chance of causing the illness in someone who opened it. The present advice to the UK public who receive any suspicious package is not to open it, but to contact the police for further advice.

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