Anthrax

Anthrax: definition

In the medical field, the term anthrax refers to a severe acute infection, fortunately rare, sustained by the beating Bacillus anthracis, involving the skin, the gastrointestinal tract and the lungs: the danger of anthrax is very high, since many of its variants are lethal. Anthrax develops above all in herbivorous mammals, both wild and domestic (eg sheep, goats, cattle, pigs, etc.) but, following contact with these infected animals, the bacterium can also infect humans, either by ingesting infected meat or by inhaling the spores. Inter-human contagion does not seem to be possible The areas where the risk of contracting anthrax is real are the poor countries of Asia, Africa and Europe.

Causes

Otherwise called anthrax-anthrax (not to be confused with staphylococcal carbuncle), anthrax is triggered by a "bacterial infection sustained by the Bacillus anthrax; more precisely, the disease is an expression of the spores of the Bacillus, which occur naturally in the soil of many areas of the world.
The spores of the Bacillus anthrax they are extremely resistant, just think that they can remain dormant and unaltered in the soil for decades; only when they find an ideal host, the spores are activated and create damage. Anthrax is mostly transmitted by ingesting the meat of infected animals, although the airway is also an important and extremely dangerous means of spreading the bacterium.
The mode of contagion of anthrax in some African peoples is curious and particular: these tribes have the custom of building drums with animal skins; considering the poor respect of hygiene standards in these countries, it is not uncommon for the drums to be lined with the skins of infected animals. In this way, anthrax has claimed many lives.
Equally curious, as rare, is the contamination of the anthrax bacillus through the post: a decade ago, 22 cases of anthrax were diagnosed following exposure to the bacillus spores through the post. Five of the unfortunates died.

In-depth study: anthrax and drug addiction
There is no evidence of a close correlation between drug addiction and the risk of contracting anthrax; however, a few years ago, in Scotland, the number of drug addicts infected with Bacillus anthrax it increased exaggeratedly. This correlation, at first glance inexplicable, was soon clarified: it seems that the spores of the anthrax bacteria have contaminated the heroin (or the cutting substance), so the toxins, inhaling, smoking or injecting the heroin, were involved in the infection.

Classification

There is no "single form of anthrax; we see, below, the most frequent:

1. Cutaneous anthrax: occurs in the skin, following direct contact with skins or animals previously infected with the anthrax bacillus. The subjects most at risk are workers in tanneries, especially in contact with skins from abroad. or of dubious origin.
2. Respiratory anthrax (pulmonary variant): Inhalation of the spores of the anthrax bacillus can promote infection. It is a typical disease of those in contact with animal skins, wool and foreign bones.
3. Intestinal Anthrax: Probably the rarest form of all, anthrax causes severe intestinal disturbances when contracted from ingestion of infected animal meat.

Symptoms

For further information: Anthrax Symptoms

The characteristic symptoms of anthrax usually begin 1-7 days after contact with the bacillus (incubation time) for the cutaneous variant, and after 2 days if the anthrax bacterium is inhaled.
The characteristic symptoms for each form of anthrax are described below:

1. 

   Cutaneous anthrax (95% of diagnosed cases): the etiopathological agent comes into contact with the organism through small wounds or cuts in the skin, creating considerable damage which, in the most extreme forms, can lead to death. After a few days (incubation time: 2-5 days), cutaneous anthrax manifests itself with the formation of skin rash, including blisters and furuncles similar to those of mosquitoes, with a black core, associated with swelling and pain of the lymphatic glands neighbors.
2. Pulmonary anthrax: the spores of the bacillus, coming into contact with the mucous membranes of the respiratory tract (first), and with the other parts of the body (after), they create exaggerated damage, the prognosis of which is often poor.

   

   Pulmonary anthrax is the most dangerous form of the disease, starting with flu-like symptoms, such as fever, sore throat, muscle aches, fatigue and chest pain. As the disease continues, the subject complains of high fever, serious difficulties respiratory, shock and hemorrhagic meningitis, up to death.
3. Gastrointestinal anthrax: following the ingestion of raw or undercooked meat of animals infected with bacillus of anthrax, the man may manifest typically gastrointestinal symptoms, such as diarrhea (with possible blood loss), nausea, vomiting (also bloody). In addition to these prodrome, the affected patient complains of difficulty swallowing, chest pain, fever, swelling in the neck, loss of appetite, sore throat and general fatigue.

For further information: Anthrax Symptoms

Diagnosis

The differential diagnosis is fundamental to distinguish anthrax from other infectious forms: in fact, the pulmonary form of the disease can be confused, at least in the very early stages, with common flu diseases, since it begins with very similar symptoms. differential must be made above all with pneumonia and flu. The most popular diagnostic tests are:

1. Blood test: indicated for detecting white blood cell counts
2. Liver function test: to detect any increase in transaminases
3. Skin analysis: removal of a flap of skin, to ascertain whether or not the diagnosis of cutaneous anthrax. The sample taken will be analyzed in the laboratory.
4. Endoscopy of the throat or intestine: to ascertain intestinal anthrax
5. Serological diagnosis (ELISA test)
6. Chest X-ray or Chest CT: Inhalation anthrax is often associated with particular chest pain
7. Sputum Analysis
8. Stool collection: for the assessment of intestinal anthrax
9. Spinal specimen collection: for the diagnosis of anthrax hemorrhagic meningitis

Care

See also: Drugs for the treatment of anthrax

Given the danger of the disease, it is strongly recommended to start pharmacological treatment for anthrax within the shortest time from the onset of symptoms. The cure is based on an antibiotic course of 60 days: the most used drugs are ciprofloxacin, penicillin and doxycycline, often also taken in combination. Pharmacological therapy is quite long (60 days): prolonging the therapy for such a long time is important, since the spores of the Bacillus anthrax they germinate for long periods.
The cutaneous form of anthrax can be cured by administering antibiotics (especially ciprofloxacin and doxycycline) for a shorter period, normally ranging from 7 to 10 days; sometimes, as a prophylactic, treatment for 60 days is also indicated.
For the advanced form of inhaled anthrax, not even a combination of antibiotics can reverse the disease.

Prevention

A vaccine for anthrax is commercially available; however, it is not mandatory and is generally reserved for patients at risk and for soldiers (classic method of administration: booster of 5 doses over a period of 18 months).
For subjects exposed to the anthrax bacillus but without symptoms, post-exposure prevention is recommended, to be carried out by administering specific antibiotics. It is not necessary to undertake any antibiotic treatment following skin contact with a patient infected with the Bacillusantraci, unless both have been exposed to the same source of contagion: human-to-human transmission of anthrax has not been detected so far.