Infectious disease Anthrax is known since antiquity. Nowadays, it does not carry, as before, an epidemiological character and occurs only in isolated cases. For example, in Russia, from 15 to 50 cases of the disease are fixed each year, which is 350 times less compared to the beginning of the 19th century.
What is anthrax?
Disease Anthrax in humans is an infectious disease caused by bacteria (Bacillus anthracis) and proceeds mainly in the form of a dermal form, when carbuncles form on the skin. Less often you can meet this ailment in the form of a pulmonary or intestinal infection with sepsis. The high lethality of this disease is higher in pulmonary and intestinal forms and can reach 90%. The cutaneous appearance is amenable to successful treatment, but in its absence, the death rate is 5-10%
Causative agent of anthrax
The causative agents of the Anthrax are bacteria - Sibiriazvennye bacilli, which are resistant to changes in the environment and can be in the form of spores in animal skins or soil for decades. If we consider in more detail, the Siberian anthrax is caused by B. Anthracis - large sticks, up to 10 μm in length and up to 1.5 μm in diameter. When detected in smears, they are more often found in the form of chains or pairs.
Anthrax - ways of infection
The main source of infection are infected herbivores (cattle, goats, horses, camels, sheep) and pigs. Infected animals secrete bacilli through wounds, urine and stool. There is some classification of the ways of transmission of pathogens.
- Nutritional. Occurs after eating contaminated meat, dairy and sour-milk products.
- Contact. Risk group - workers who are in close contact with animals. Still infected with anthrax is possible and through contact with the skins of dead animals (it is known that an anthrax bacillus can live in skins or soil for a decade).
- Airborne dust. Infection with anthrax occurs through the mucous membranes of the respiratory tract. In the risk group - leatherwork workers.
Anthrax - symptoms in humans
Symptomatic of this dangerous disease depends largely on the form of anthrax. Modern classification distinguishes two clinical forms, which we will consider in more detail below:
- skin;
- generalized.
However, the generalized form is of three kinds and the symptomatology of each of the forms has cardinal differences:
- pulmonary;
- intestinal;
- septic.
Cutaneous form of anthrax
With this form of the disease, the first symptoms may appear the day after the onset of the anthrax spore, but there are cases when no manifestations of spore activity were observed for two weeks. The skin anthrax at the initial stage resembles a sensation after a mosquito bite, but in the future there are such symptoms:
- pain and itching;
- the appearance of vesicles, which later turn into black sores and are accompanied by swelling;
- temperature increase;
- lack of appetite;
- feverish conditions;
- headache;
- inflamed lymph nodes .
After the formation of the ulcer after 5-6 days, its bottom sinks, and at the edges vesicles with colorless contents become visible. When the ulcer reaches a size of 8 to 15 millimeters, it becomes an anthrax carbuncle. With timely and proper treatment, a scab forms in the place of the ulcer, which falls off after a few weeks, but the recovery period may be longer.
Pulmonary form of anthrax
Disease Anthrax in the pulmonary form is painful and carries a serious threat to health and even human life. Infectology distinguishes two stages of the course of this disease in the pulmonary form:
- The first can last up to two weeks.
- The second arises suddenly.
Anthrax, the symptoms of which at the initial stage of the pulmonary form can be accompanied only by uncomfortable sensations in the chest. In the future, the patient's condition deteriorates noticeably and appears:
- severe shortness of breath ;
- increased body temperature (often to critical levels);
- cyanosis of the skin;
- intoxication syndrome;
- chills;
- tachypnea.
Over time, the pain in the chest becomes stronger and resemble the infarction pain syndrome. Inflammation of lymph nodes, cough increases to bloody sputum. If you do not start timely treatment of this form of the disease, then this can lead to death. The percentage of mortality in advanced pulmonary form or in the absence of treatment is up to 90%.
Intestinal form of anthrax
Symptomatology, which is observed in the intestinal form of the disease, can be very different and this is its danger. The asymptomatic course of the disease leads to a neglected form, which often ends pitifully. In this form is often affected by the mucosa of not only the intestines, lesions can be observed in the esophagus and in the small intestine. The main symptoms of the intestinal form are:
- intensifying pain in the abdomen;
- vomiting and diarrhea with blood;
- nausea and fever;
- complete lack of appetite;
- in 3-4 days (after the spores of the Siberian ulcer hit the mucosa), ascites may develop;
- shock state;
- death can occur 2-5 days after the onset of symptoms.
Septic form of anthrax
Disease Anthrax has another form - septic. This form is secondary (the bacterium of anthrax is the cause of the disease in other forms) and is transformed from intestinal and pulmonary, more rarely - cutaneous. The main symptoms of septic form:
- severe chills;
- bloody loose stools;
- significant increase in body temperature;
- tachypnea and chest pain;
- dyspnea;
- nausea with vomiting;
- spotting during a strong cough.
Diagnosis of anthrax
Disease Anthrax all the more is amenable to therapy, the earlier it was revealed. Laboratory diagnosis of anthrax includes several methods, each of which complements information obtained with the help of other studies.
- Bacteriological method. Select special media for sowing and after a few days identify the newly discovered colony of bacteria.
- Skin and allergic test. In this method of research, anthracin (antigen) is introduced into the skin. A positive test indicates the presence in the human body of antibodies to the pathogen.
- Biological method. They infect laboratory animals and, after their death, isolate and identify the pathogen that caused the disease and death.
- Microscopy of native material. From vesicles and cutaneous ulcers take and observe the material under a microscope. If the anthrax is there, its rod-shaped bacteria will be clearly visible.
Anthrax in man - treatment
If an "Anthrax" is diagnosed, treatment should begin without delay, which in the literal sense, can be death alike. Treatment is carried out exclusively in the hospital with the help of complex therapy.
- etiotropic (penicillins);
- Immunological (introduction of serum);
- pathogenetic (the goal is to reduce intoxication, inflammation and improvement in the coagulability of blood).
Along with this it is recommended:
- The introduction of anti-STI immunoglobulin (depending on the severity of the state from 20 to 80 ml).
- With the dermal form, aseptic dressings have proved to be very good, because surgical interventions in this form are not carried out because of the possibility of provoking the skin to become generalized.
- Specialists also talk about the need for active detoxification with the introduction of intravenous infusions of crystalloid and colloidal solutions into which Prednisolone is added. At the same time, forced diuresis is carried out (a method in which accelerated removal of urine from the body contributes to the removal of toxins and other unsafe products of life, pathogens, including).
Anthrax - antibiotics
Etiotropic therapy of the disease is penicillin antibiotics in anthrax, which effectively affect the pathogen B. Anthracis. As a rule, among the most prescribed drugs:
- Penicillin (intramuscularly for 7-8 days at a daily dose of 12-24 million units);
- Doxycycline (in usual doses);
- Levofloxacin (500 mg once daily);
- Ciprofloxacin in especially severe cases (twice a day for 400 mg).
In the most severe cases, antibiotic therapy is administered intravenously for several weeks. For people who have been in contact with those who are sick with anthrax, they are required to prescribe a two-month course of oral antibiotic treatment. Among the antibiotics to which Bacillus anthracis is particularly sensitive, the following (besides those already mentioned) can be noted:
- Gatifloxacin;
- Chloramphenicol;
- Amoxicillin ;
- Ampicillin.
Serum against anthrax
Antisibiotic immunoglobulin is necessarily included in the complex of therapeutic measures in the Siberian anthrax. It contains antibodies necessary for the control of bacilli, has a pronounced antibacterial action and well neutralizes the action of anthrax toxin. To date, Antisiberian immunoglobulin is the most effective serum.
Before the introduction of serum, special samples are performed to determine the degree of human sensitivity to serum proteins (by intradermal administration and subsequent reaction). Serum is injected not immediately, but within an hour - with an interval of about 15 minutes (2-3 times) intramuscularly. After that, the patient should be under the supervision of a specialist for as much time.
Prevention of Anthrax
As is known, the Siberian ulcer is an infection that has got into the human body in the form of an anthrax bacillus, therefore it is necessary to take seriously preventive measures, in particular, to the risk group. Preventive measures are composed of veterinary and health measures aimed at:
- account of the areas in which cases of such diseases were observed;
- control over cattle grazing and their condition;
- immunization of animals that are potential carriers of infection;
- control over pastures and various livestock facilities.
If we talk about preventive measures, conducted directly in the outbreak, they are as follows:
- Hospitalization of a patient with suspected anthrax. Observation of such a patient and his treatment is made by a special team of doctors.
- The patients are discharged only after full recovery.
- The corpses of people who died of Anthrax do not open people. In exceptional cases, the procedure is performed by the head doctor, followed by complete disinfection of the room.
Inoculation from anthrax
The vaccine against Anthrax is applicable in cases where a person has close contact with animals for a long time due to professional activity, works on a slaughterhouse, comes into contact with raw materials of animal origin. To the group of people who are shown the vaccine against anthrax, they include those who have contact with contaminated materials. Vaccination is carried out on schedule.
Contraindications to vaccination include:
- radiation therapy;
- infectious and non-communicable diseases in acute form;
- malignant blood diseases;
- endocrine diseases;
- reception of glucocorticosteroids;
- recurrent diseases of the skin and connective tissue;
- pregnancy and lactation period;
- age to 14 years.