Anthrax

Description

This is a highly infectious disease of animals caused by Bacillus anthracis, transmitted to man by contact with the animal or animal products (carcasses) or faeces. It is a notifiable disease. It is classified as cutaneous, pulmonary or inhalational or gastrointestinal. Farmers, animal product industry, laboratory personnel are at high risk of infection

Signs and Symptoms

• The incubation period varies from 12 hours to 5 days
• The cutaneous form:
o painless (but may be pruritic) red-brown papule that enlarges with considerable peripheral erythema,
vesiculation, and induration. Central ulceration follows, with serosanguineous exudation and formation
of a black eschar.
o Local lymphadenopathy
o Fever
o Malaise
o Nausea and vomiting
o Myalgia
o Headache
• Pulmonary (Inhalation) Anthrax:
o Progresses rapidly after non-productive cough and low-grade fever
o Pulmonary oedema
o Pleural effusion
o Severe shortness of breath
o Cyanosis
o Chest pain
o Septic shock

Investigations

• Microscopy and culture of swabs from cutaneous lesions or sputum
• Blood culture
• Lumbar puncture if anthrax meningitis is suspected
• Serological tests (ELISA)
• PCR
• Chest x-ray/CT scan of chest may show diffuse patchy infiltration; the mediastinum is widened because of enlarged haemorrhagic lymph nodes.

Treatment

Table 140: Treatment of Anthrax

• Prevention
o Vaccination for those at high risk (veterinarians, laboratory technicians, butchers and employees of
textile mills processing goat hair)
o Use of personal protective equipment, gloves, overalls, and boots.
• Post exposure prophylaxis
o Given to those with risk of inhalation of anthrax spores during the burning of infected carcasses.
o The evaluation of these cases should be in consultant with the Public health specialist and infectious
disease physicians.
o The Regimens for the prophylaxis should be:

Table 141: Anthrax Post-Exposure Prophylaxis

For cutaneous exposure, the prophylaxis can be administered for a period of 7 days

Referral Criteria

Disseminated or meningitis anthrax should be referred for specialist treatment