Acute Infectious Anthrax

Acute Anthrax is a very well known, zoonotic diseases (transmits from animals to human) that ages back to ancient history. Amerthrax according to FBI name occurred in 2001 where anthrax was raised to a top concern when letters containing the Anthrax bacteria were mailed to several individuals, killing 5 persons and was of great concern to the national security.

Bioterrorism

Acute Anthrax is an infectious disease that occurs in Africa, Asia, China, Eastern Europe and Haiti. The organism exists in animals and transmission to humans can occur. The potentially fatal disease spreads by handling infected animal carcasses, handling or eating infected animals or laboratory or bioterrorism.

• Found in the soil, Anthrax spores are able to survive for decades. It is most common for an animal to contract the disease while grazing in a field. Although you can become sick from eating the meat of an infected animal, it is most common that infected individuals have come in direct contact with an infected animal. This characteristic of Anthrax makes it almost completely restricted to certain occupations that handle animals first hand, such as veterinarians, and farmers.

Types of Acute Anthrax infection

Anthrax disease can present in one of four clinical patterns depending on the route of infection (cutaneous, gastrointestinal, pneumonic, or injectional).

• Cutanous Anthrax accounts for the vast majority of cases up to 90%. However, if  un-treated, the disease can work it’s way through the blood vessels causing poisoning of the blood and death. Another type of Anthrax is, Gastrointestinal anthrax, which is much more fatal. Typically Gastrointestinal anthrax will begin with symptoms such as nausea, vomiting, and fever, and can then be followed by abdominal bleeding, tissue death, and septicemia.

Pulmonary anthrax arises after the inhalation of small, ~2–5 μm, aerosolized spores. The incubation time can be up to 100 days in the mediastinal lymph nodes. Inhalational symptoms include fevers, chills, sore throat, malaise, non-productive cough, and respiratory distress. Meningitis can complicate any type of anthrax.

Treatment:

Penicillin has long been considered the drug of choice and only rarely has penicillin resistance been found in naturally occurring strains. In vitro B anthracis is also susceptible to fluoroquinolone (levofloxacin), member of the fluoroquinolone family, is a synthetic broad-spectrum antibiotic for oral and intravenous administration.

Levofloxacin inhibit bacterial DNA replication, transcription, repair, and recombination.  Additionally; In-vitro susceptibility occurs also to tetracycline, chloramphenicol, aminoglycosides, macrolides, imipenem/meropenem, rifampicin, and vancomycin. Take care;The organism is resistant to cephalosporins, trimethoprim, and sulfomanides.

Prevention

Anthrasil

• Anthrasil (Anthrax Immuno-Globulin) is an intravenous preparation of purified polyclonal human IgG specific to the anthrax toxin. These antibodies are present in the plasma of individuals vaccinated against anthrax. The recommendation is to give Anthracil for the treatment of inhalational anthrax in combination with antibacterial drugs.

• Raxibacumab: Raxibacumab (ABthrax) is an anthrax-specific antitoxin.  Human IgG1λ monoclonal antibody directed against the B. anthracis Protective Antigen. Therapy with Raxibacumab prevents the progression of the disease by binding the Bacillus Anthrax protective antigen and preventing the lethal toxins from invading and destroying the human body. Another indication for Raxibacumab in high-risk groups even before exposure events.

• BioThrax Anthrax Vaccine Adsorbed. For use in post-exposure prevention of infection in suspected or confirmed Bacillus anthrax exposure. Administration of Anthrax Vaccine Adsorbed occurs together with the recommended course of antimicrobial therapy. Ciprofloxacin hydrochloride Cipro (Quinolones family of antibiotics) can decrease the chance of developing anthrax infection following exposure to the anthrax spores.