ANTHRAX: Primarily a disease of herbivores; humans and carnivores are incidental hosts. It is generally an occupational hazard primarily of workers who process hides and hair, and of veterinarians, agriculture, and wildlife workers who handle infected animals. Human anthrax is much more common in those agricultural regions of the world where anthrax in animals is common; these include countries in South and Central America, southern and eastern Europe, Asia and Africa.
My soldiers who did missions in these areas where required to take the vaccine. Anthrax is considered a leading potential agent in bioterrorism or biowarfare.
IDENTIFICATION: Anthrax is an acute BACTERIAL disease that usually affects the skin, but which may very rarely involve the throat or intestinal tract. In cutaneous “skin” anthrax, like most of the cases we have heard about, itching of an exposed skin surface occurs first, followed by a lesion that develops a depressed black wound. The wound is usually surrounded by moderate to severe and very extensive edema. Pain is unusual. Also, the head, forearms, and hands are common sites of infection. Untreated infections may spread to regional lymph nodes and to the bloodstream. Untreated skin anthrax has a fatality rate between 5
nd 20Awhich is actually very LOW. With effective antibiotics, few deaths occur.
Initial symptoms of inhalation anthrax are mild and nonspecific and may include fever, malaise, and mild cough or chest pain. Acute symptoms of respiratory distress, x-ray evidence of intestinal widening, fever, and shock follow in 3-5 days, with death shortly thereafter. Intestinal anthrax is rare and more difficult to recognize, except that it tends to occur in explosive food poisoning outbreaks. Abdominal distress is followed by fever, signs of septicemia, and death in the typical case. A throat form of primary disease has been described.
On exposure to the air, the “vegetative” forms produce spores, which are very resistant to adverse environmental conditions and disinfection, and may remain viable in contaminated soil for many years. This is the scary part. Spore density on the ground is enhanced by flooding or other environmental conditions. Dried skins and hides of infected animals may harbor the spores for years, and they were the primary causes of the disease spreading worldwide.
MODE OF TRANSMISSION: Skin infection spreads by contact with contaminated products such as mail. Inhalation anthrax results from inhalation of spores in densely populated areas where the spores have come into contact with an airborne mechanism. Accidental infections may occur among workers where the spores have settled into the clothes of another person, but cannot be transmitted after infection through touch or breath. Again, transmission from person to person is very rare, but may be more common than we think now due to the mail system being compromised.
Also, a positive finding of does not mean that the person has the disease. About 8,000 spores must be inhaled for a person to develop inhalation anthrax. This is about the size of the tip of a pin needle.
VACCINE: I have been vaccinated, as well as most of the men and women who worked for me in the Middle East.
