What is Anthrax? Symptoms, Causes and Contagion, How It Is Contracted and Treatment

Where Is It?

Bacillus Anthracis: Where Is Anthrax Found?

In nature, anthrax is found in soil and usually affects grazing, farmed animals (such as goats, cattle, sheep and horses) and wild animals (e.g. elephants and buffaloes) throughout the world, often proving lethal. .

Fortunately, natural infection is quite rare in industrialized areas, but the potential use of anthrax as a biological weapon has increased fear of this disease. In the United States, in 2001, the spores of the microorganism were used as bioterrorism weapons and spread, in the form of a very fine powder, through the postal service.

Who Is Most At Risk?

Human infection is very rare, but certain activities can increase a person’s chances of becoming infected. The groups at risk include: farmers, veterinarians, butchers, tanners, carders and anyone else who finds themselves working with:

• Infected animals ;
•  Contaminated products from infected animals .

Causes And Contagion

What Causes Anthrax?

Anthrax is caused by gram-positive bacteria known as Bacillus anthracis , which can cause severe disease in both humans and animals.

Bacillus anthracis is a rod- shaped , aerobic or facultative anaerobic, capsulated , toxin -producing microorganism .

Under aerobic conditions, Bacillus anthracis is capable of producing extremely resistant spores , which can remain viable in soil, wool and animal fur for decades. Spores germinate and multiply rapidly when they enter an environment rich in amino acids and glucose (such as tissues and blood ).

When anthrax spores enter the body , they can become activated, so the bacteria can multiply, spread throughout the body, produce toxins, and cause serious illness.

How Is Anthrax Contracted?

People become infected with anthrax when the spores enter the body. This can happen when people:

• They inhale the spores ;
• They eat food or drink water contaminated by the spores ;
• The spores enter a cut or scrape in the skin .

Anthrax: How People Get Infected

Most people who get anthrax are exposed while working with infected animals or contaminated animal products such as wool, hides or hair.

As regards CUTANEOUS ANTHRAX , open wounds or abrasions increase the vulnerability to contracting the infection, but this can occur even when the skin is intact .

INHALATION ANTHRACUS can occur when spores present in the air are inhaled (vaporized) during the industrial processing of contaminated materials such as wool, leather or hair.

However, consuming raw or undercooked meat from infected animals can cause GASTROINTESTINAL ANTHRACUS . This occurs in countries where livestock are not periodically vaccinated against anthrax and animals intended for food are not checked before slaughter.

Recently, another type of anthrax infection has been identified among heroin users in northern Europe: INJECTION ANTHRACUS .

How Do Animals Get Infected?

Farmed and wild animals, such as cattle, sheep, goats, antelope and deer, can become infected when they breathe in or ingest spores found in contaminated soil, plants or water.

In areas where the infection has been found, livestock are usually vaccinated periodically against anthrax to prevent epidemics. Furthermore, animals intended for food are checked before slaughter.

Epidemiology

Anthrax: Where Is The Infection Spread?

Anthrax is more common in developing countries and those that do not have public health veterinary programs to routinely vaccinate animals against anthrax.

Anthrax is most prevalent in agricultural regions of South America, sub-Saharan Africa, central and southwestern Asia, southern and eastern Europe, and the Caribbean. In other areas of the world, sporadic epidemics occur.

Types Of Anthrax

The disease a person develops depends on how anthrax enters the body: Typically, Bacillus anthracis enters through the skin, lungs , or gastrointestinal system.

All types of anthrax can eventually spread throughout the body and cause death if they are not treated with antibiotics .

Cutaneous Anthrax

• Characteristics : Cutaneous anthrax involves the skin and tissues around the site of infection, most commonly on the head, neck, forearms, and hands. This is the most common form of Bacillus anthracis infection , as well as the least dangerous.
• Incubation period : Infection usually develops 1 to 7 days after exposure.
• Prognosis: If left untreated, the mortality rate of cutaneous anthrax is up to 20%, but, with adequate treatment, virtually all patients with cutaneous anthrax survive.

Inhalation Anthrax

• Characteristics : Inhalation anthrax initially develops in the lymph nodes of the chest, then spreads to the rest of the body, eventually causing severe breathing problems and shock. Inhalation anthrax is considered the most lethal form of anthrax.
• Incubation period: the infection usually begins within a week of exposure, but incubation can last up to 2 months.
• Prognosis: Without treatment, only 10-15% of patients affected by inhalation anthrax survive. However, with aggressive therapy, approximately 55% of patients survive.

Gastrointestinal Anthrax

• Characteristics : Once Bacillus anthracis spores are ingested , gastrointestinal anthrax can affect the throat, esophagus , stomach , and intestines .
• Incubation period: Infection usually develops 1 to 7 days after exposure.
• Prognosis: Without treatment, more than half of patients with gastrointestinal anthrax die. However, with adequate therapy, 60% of patients survive.

Injection Anthrax

Symptoms of injection anthrax may be similar to those of cutaneous anthrax, but a deeper infection may occur under the skin or in the muscle where the drug was injected. Injection anthrax can spread through the body more quickly and can be more difficult to recognize and treat.

Anthrax Symptoms

Anthrax Symptoms: How Does It Occur?

The symptoms of anthrax depend on the type of infection.

Symptoms Of Cutaneous Anthrax

• Groups of small blisters or bumps that may cause itching
• Swelling may develop around the wound
• After the blisters or bumps, a painless sore ( ulcer ) with a black center appears
• Most often, cutaneous anthrax lesion occurs on the face, neck, arms, or hands

Symptoms Of Inhalation Anthrax

• Fever and chills
• Chest discomfort
• Shortness of breath
• Confusion and dizziness
• Cough
• Nausea, vomiting or stomach pain
• Heachache
• Profuse sweating
• Extreme tiredness
• Pains all over the body

Symptoms Of Gastrointestinal Anthrax:

• Fever and chills
• Swelling of the neck or neck glands
• Sore throat
• Painful swallowing
• Hoarseness
• Nausea and vomiting , especially blood in vomit
• Diarrhea or diarrhea with bleeding
• Heachache
• Redness of the face and eyes
• Stomach ache
• Fainting
• Abdominal swelling

Symptoms Of Injection Anthrax

• Fever and chills
• Where the drug was injected: group of small blisters or bumps that may cause itching
• Painless wound with a black center appearing after the blisters or bumps
• Swelling around the wound
• Abscesses deep under the skin or in the muscle where the drug was injected

See also: Anthrax symptoms

Diagnosis And Treatment

Anthrax: How Is The Diagnosis Made?

The diagnosis of anthrax involves analyzing the patient’s medical history to understand how the exposure could have occurred and prescribing the diagnostic tests necessary to confirm the diagnosis.

These exams consist of:

• Measure antibodies or toxins in the blood
• Directly test for the presence of Bacillus anthracis in a blood sample, skin lesion swab, spinal fluid or respiratory secretions

Clearly, samples must be taken before the patient starts taking antibiotics for treatment.

Performing a chest x-ray or CT scan can confirm whether the patient has mediastinal widening or pleural effusion , signs typically seen in patients with inhalational anthrax.

Treatment Of Bacillus Anthracis Infection

Doctors have several options for treating anthrax patients, including antibiotics and antitoxin in combination with other supportive care . These drugs are usually selected on the basis of the clinical picture and medical history of the patient, taking into consideration that, compared to monotherapy, it is more likely that a combined antimicrobial pharmacological treatment (antibiotics with specific activity against  B. anthracis  and at least one inhibitor of protein ).

Ciprofloxacin (belonging to the fluoroquinolone class ) and doxycycline (belonging to the tetracycline class ) are first-line treatments, but other antibiotics ( levofloxacin and moxifloxacin ) may also be administered.

For post-exposure prophylaxis , monoclonal antibodies (raxibacumab and obiltoxaximab), developed after the 2001 terrorist attacks in the United States, can also be used in exceptional circumstances .

In symptomatic cases, it is important to get medical attention as quickly as possible to have the best chance of a complete recovery.

To know more: Drugs to Treat Anthrax

Anthrax Vaccine – Adsorbed Anthrax Vaccine

For the prevention of disease caused by Bacillus anthracis in individuals aged 18 to 65 years at high risk of exposure, an active anthrax vaccine manufactured under the trade name BioThrax is available . It is a subunit vaccine ( purified acellular filtrate ) that is cell-free and does not contain whole or live anthrax bacteria. Vaccination prepares the body to fight the infection by blocking the toxin produced by Bacillus anthracis .

Bibliography And Useful Sources

• Anthrax in humans and animals – guidelines. World Health Organization publications
• Centers for Disease Control and Prevention (CDC). What is Anthrax?