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What is anthrax? Is anthrax contagious?

Antrax is an infectious disease of bacteria which is called “Bacillus anthracis”. This bacteria is usually transmitted from infected animals or their products (Goat, Sheep, Horse, Cattle).

Antrax can cause some very dangerous dieseases like skin, lung, bowel dieseases. And these dieases can be very deadly, such as pulmunary antrax.


How do we diagnose this disease?

We use cultures from infected tissues in order to diagnose.


What causes Anthrax?

The agent of anthrax is a bacterium called Bacillus anthracis. While other investigators discovered the anthrax bacillus, it was a German physician and scientist, Dr. Robert Koch, who proved that the anthrax bacterium was the cause of a disease that affected farm animals in his community. Under the microscope, the bacteria look like large rods. However, in the soil, where they live, anthrax organisms exist in a dormant form called spores. These spores are very hardy and difficult to destroy. The spores have been known to survive in the soil for as long as 48 years. The bacteria secrete toxins composed of three proteins termed protective antigen, lethal factor, and edema factor. 


How does anthrax infect  humans?

Anthrax can infect humans in three ways. The most common one is infection through the skin which causes ugly , dark sores . Humans and animals can ingest anthrax from carcasses of dead animals that have been contaminated with anthrax. Ingestion of anthrax can cause serious, sometimes fatal disease. The most deadly form is inhalation anthrax. If the spores of anthrax are inhaled, they migrate to lymph glands in the chest where they proliferate, spread, and produce toxins that often cause death.


Which professions has high risk to have Anthrax?


Livestock and farmers

Travelers to areas where anthrax is endemic

Labarotory personel that study anthrax

Mail handlers , military personel and bioterrorists or biological warfare


How long is incubation period with anthrax?

The incubation period (period between contact with arthrax and start of symptoms) may be relatively short, from one to five days, the incubation period is quite variable like other infection dieseases and it may take weeks before patient feels sick.


What kind of dieseases does anthrax cause? What are the signs and symptoms of the anthrax infections?

There are four forms of dieases caused by anthrax: cutaneous (skin) anthrax, inhalation anthrax, gastrointestinal and injection anthrax.


Cutaneous(skin) anthrax: This form of anthrax is most common one (80% of all anthrax infections). It starts as a red-brown raised spot that enlarges with considereble redness around infected tissue, blistering and hardening. The center of the spot then showns ulcer crater with bloodthinged drainage and formation of black crust called an eschar. There are swollend glands (lymph nodes) in the area. Symptoms include muscle aches and pain, headache, fever, nausea, and vomiting. The illness resolves in about 6 weeks, but deaths may occur if patients do not receive appropriate antibiotics.


Injection anthrax : This new form of anthrax has been identified in heroin injection drug users in northern europe and has not yet been reported in United states. Symptoms may take days to months before they appear. The signs and symptoms of injection anthrax can include small blisters that may itch at injection site, fever and chills,  swelling around sores and deep abscesses may develop under the skin or muscle. Painless skin sores with black centers may apper after the blisters or bumps develop.


Inhalation anthrax : The first symptoms of inhalation anthrax are similar with influnza symptoms, sore throat and headache. In a few days when illness get worsens there may be severe respiratory distress with shortness of breath and pain in the chest or in muscles. Some patients may cough up blood. Shock, coma and death follow. Inhalation anthrax does not cause true pneumonia, in fact spore get picked in lungs up by scavenger cells called macrophages. Most of the spores are killed by macrophages but unfortunately, some survive and are transported to the glands in chest called lymp nodes. Lymp nodes may swell. In lymp nodes, spores that survive multiply, produce deadly toxins and spread throughout the body. Severe hemorrhage and tissue death (necrosis) occur in lymp nodes in the chest. From there, the diesease spreads to adjacent lungs and the rest of the body. Inhalation anthrax is very serious disease and unfortunately, most affected individuals will die even they get appropriate antibiotics. Because the antibiotics are effective in killing bacteria, but they do not destroy the deadly toxins that have been already realesed by anthrax bacteria.


Gastrointestinal anthrax: This is a rare form of anthrax. It is the result of eating undercooked, contaminated meat. The symptoms of this anthrax include nausea, loss of appetite, bloody diarhea and fever followed by abdominal pain. The bacteria invade through the bowel wall then infection spreads throughout the body through the bloodstream (septicemia) with deadly toxicity.


Treatment of Anthrax

In most cases, early treatment can cure anthrax. The cutaneous (skin) form of anthrax can be treated with common antibiotics such as penicillin, tetracycline, erythromycin, and ciprofloxacin. The pulmonary form of anthrax is a medical emergency. Early and continuous intravenous therapy with antibiotics may be lifesaving. In a bioterrorism attack, individuals exposed to anthrax will be given antibiotics before they become sick. A vaccine exists but is not yet available to the general public. Of note, anthrax is a reportable disease. That means that local or state health agencies must be notified if a case of anthrax is diagnosed. These agencies can better characterize the anthrax so that the affected individual can receive the most effective treatment for that particular organism.

Individuals exposed to aerosolized spores (bioterrorism scares or attacks, for example) can participate in postexposure prevention of anthrax. Four antibiotics are recommended by the FDA: doxycycline, ciprofloxacin, levofloxacin, and parenteral procaine penicillin G. In addition to these antibiotics, a three-dose series of anthrax vaccine should be started as soon as possible after exposure.



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Kadir Timuçin Güneren
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