Anthrax

1. Anthrax The World’s Most Famous Bacteria

2. History • Anthrax has afflicted humans throughout recorded history. The fifth and sixth plagues of Egypt described in Exodus are widely believed to have been anthrax. The disease was featured in the writings of Virgil in 25 BC and was familiar in medieval times as the Black Bane. It was from studies on anthrax that Koch established his famous postulates in 1876, and vaccines against anthrax the best known being that of Pasteur (1881)were among the first bacterial vaccines developed.

3. What is it? • Anthrax is caused by Bacillus anthracis. • Bacillus species are rod-shaped, endospore-forming aerobic or facultatively anaerobic • The spores are resistant to heat, cold, radiation, desiccation, and disinfectants. Bacillus anthracis needs oxygen to sporulate; this constraint has important consequences for epidemiology and control. In vivo, B anthracis produces a polypeptide (polyglutamic acid) capsule that protects it from phagocytosis.

4. How Can You Get It? • Humans acquire the disease directly from contact with infected herbivores or indirectly via their products. The clinical forms include ( 1 ) cutaneous anthrax ,from handling infected material (this accounts for more than 95 percent of cases); (2) intestinal anthrax, from eating infected meat; and (3) pulmonary anthrax, from inhaling spore-laden dust.

5. Cutaneous Anthrax • Cutaneous anthrax usually occurs through contamination of a cut or abrasion, although in some countries biting flies may also transmit the disease. After a 2- to 3-day incubation period, a small pimple or papule appears at the inoculation site. A surrounding ring of vesicles develops.

6. Cutaneous Anthrax • Over the next few days, the central papule ulcerates, dries, and blackens to form the characteristic eschar .The lesion is painless and is surrounded by marked edema that may extend for some distance. Pus and pain appear only if the lesion becomes infected by a pyogenic organism.

7. Cutaneous Anthrax • In most cases the disease remains limited to the initial lesion and resolves spontaneously. The main dangers are that a lesion on the face or neck may swell to occlude the airway or may give rise to secondary meningitis. Approximately 20 percent of untreated cases of cutaneous anthrax progress to fatal septicemia.

8. Cutaneous Anthrax

9. Cutaneous Anthrax

10. Cutaneous Anthrax

11. Gastrointestinal Anthrax • Gastrointestinal and pulmonary anthrax are both more dangerous than the cutaneous form because they are usually identified too late for treatment to be effective. • If the spores enter a lesion in the gastrointestinal mucosa, they germinate and are taken into the bloodstream and lymphatics, finally producing systemic anthrax, which is usually fatal.

12. Symptoms • Intestinal: The intestinal disease form of anthrax may follow the consumption of contaminated meat and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, fever are followed by abdominal pain, vomiting of blood, and severe diarrhea. Intestinal anthrax results in death in 25% to 60% of cases.

13. Pulmonary Anthrax • inhaling anthrax spores from contaminated animal products. In pulmonary anthrax, inhaled spores are transported by alveolar macrophages to the mediastinal lymph nodes, where they germinate and multiply to initiate systemic disease. • Pulmonary Anthrax is usually fatal.

14. PulmonaryAnthrax • Initial symptoms may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is usually fatal.

15. Treatment • Doctors can prescribe effective antibiotics, Anthrax is readily treated with penicillin, tetracycline, chloramphenicol, gentamicin, or erythromycin. To be effective, treatment should be initiated early. If left untreated, the disease can be fatal.

16. Anthrax as a Biological Warfare Agent • Anthrax is the preferred biological warfare agent because: • It is highly lethal. • 100 million lethal doses per gram of anthrax material (100,000 times deadlier than the deadliest chemical warfare agent). • Silent, invisible killer. • Inhalational anthrax is virtually always fatal.

17. Anthrax as a Biological Warfare Agent • There are low barriers to production. • Low cost of producing the anthrax material. • Not high-technology. Knowledge is widely available. • Easy to produce in large quantities. • It is easy to weaponize. • It is extremely stable. It can be stored almost indefinitely as a dry powder. • It can be loaded, in a freeze-dried condition, in munitions or disseminated as an aerosol with crude sprayers.