SERIES 1: Directory of Diseases That Affect Nigerians (Background, Transmission, Symptoms, Treatment)
Mosope Kehinde
The A-Z of diseases is a directory of diseases that affect Nigerians.
In different series, we have arranged them by alphabets, however for this edition we are looking at the background, transmission, symptoms, treatment of Anthrax
ANTHRAX
Background
Anthrax is a serious infectious disease caused by a gram-positive, rod-shaped bacteria known as Bacillus anthracis. The bacteria which exist as spores are resistant to extreme environmental conditions and can survive for decades making the control or eradication of the disease very difficult.
It occurs naturally in soil and commonly affects domestic and wild animals around the world. Domestic and wild animals such as cows, pigs, camels, sheep, goats, antelope, deer etc., can become infected when they breathe in or ingest spores in contaminated soil, plants, or water. Routine vaccination of domestic animals helps in the prevention of outbreaks.
Humans can get infected with anthrax if they come in contact with infected animals or contaminated animal products. The type of illness a person develops depends on how anthrax enters the body. Typically, anthrax gets into the body through the skin, lungs, or gastrointestinal system. All types of anthrax can eventually spread throughout the body and cause death if not treated. The different types of anthrax infection include:
Cutaneous anthrax (Skin infection)
Cutaneous anthrax is the most common form of anthrax infection, and it is also considered to be the least dangerous. Symptoms usually develop within 1 to 7 days after exposure. When anthrax spores get into the skin, usually through a cut or scrape, a person can develop cutaneous anthrax. This can happen when a person handles infected animals or contaminated animal products like wool, hides, or hair. Cutaneous anthrax is most common on the head, neck, forearms, and hands. It affects the skin and tissue around the site of infection.
Inhalation anthrax
Inhalation anthrax is considered to be the deadliest form of anthrax. Symptoms usually develop within a week after exposure, but it can also take up to 2 months. When a person breathes in anthrax spores, they can develop inhalation anthrax. Inhalation anthrax starts primarily in the lymph nodes in the chest before spreading throughout the rest of the body, ultimately causing severe breathing problems and shock.
Gastrointestinal anthrax
Gastrointestinal anthrax has an incubation period of 1 to 7 days An individual can develop gastrointestinal anthrax after eating raw or undercooked meat from an animal infected with anthrax. Once ingested, anthrax spores can affect the upper gastrointestinal tract (throat and oesophagus), stomach, and intestines, causing a wide variety of symptoms.
Injection anthrax
This type of infection has been identified in heroin-injecting drug users. Symptoms may be similar to those of cutaneous anthrax, but there may be infection deep under the skin or in the muscle where the drug was injected. Injection anthrax can spread throughout the body faster and be harder to recognise and treat.
Transmission
People get infected with anthrax when spores get into the body. The anthrax spores become activated in the body and develop into anthrax-toxin-producing bacteria. The bacteria can then grow, disperse throughout the body, release toxins (poisons), and result in serious sickness. Anthrax spores can get into the body by
– Breathing in spores
– Eating food or drinking water that is contaminated with spores, or
– Getting spores in a cut or scrape in the skin.
– People can get anthrax after getting in contact with infected animals or their products, such as wool, hides, or hair. People most at risk are
– People who handle animals or animal products, i.e., veterinarians, veterinary laboratory workers, farmers, abattoir workers, butchers, cattle rearers, livestock producers and traders, wildlife handlers, hunters, park rangers, processors, importers, and exporters of hide and skin, animal health workers etc.
– People who consume animals (cattle, sheep, and goats) that are found dead.
– People who consume meat or products from sick animals
– People who consume raw or undercooked meat from sick animals
– Healthcare workers, diagnostic laboratory workers and caregivers who are exposed to the sores of an infected patient.
– Law enforcement officers (Police, Military, Immigration, Customs, Point of Entry Personnel etc.).
Imported animal hides can also be associated with anthrax infection through human contact or handling of the drums or in the environment where they were made. Some imported hides may contain anthrax spores, and although this is rare, there is no way to test for the presence of spores on hides.
Human-to-human transmission is rare. Humans do not get infected with the disease from an infected human like the cold or flu.
Symptoms
In animals, anthrax can cause symptoms such as high fever, weakness, loss of appetite, bleeding from all body openings (nose, mouth, ears, anus etc.), swelling and difficulty in breathing and bloody diarrhoea. It can lead to sudden death in most cases. The blood of an animal that has been infected with anthrax DOES NOT CLOT on slaughter. Also, at slaughter, there is marked bloating and quick decay is observed.
In humans, the symptoms of anthrax depend on the type of infection and can develop between 1 day to 2 months.
Cutaneous anthrax symptoms can include:
– A group of small blisters or bumps that may itch
– A painless skin sore (ulcer) with a black centre that appears after the small blisters or bumps
– Swelling can occur around the sore
Most often the sore will be on the face, neck, arms, or hand
Inhalation anthrax symptoms can include:
– Fever and chills
– Chest discomfort
– Shortness of breath
– Confusion or dizziness
– Cough
– Nausea, vomiting, or stomach pains
– Headache
– Profuse sweats (often drenching)
– Extreme tiredness
– Body aches
Gastrointestinal anthrax symptoms can include:
– Fever and chills
– Swelling of neck or neck glands
– Sore throat
– Painful swallowing
– Hoarseness
– Nausea and vomiting, especially bloody vomiting
– Diarrhoea or bloody diarrhoea
– Headache
– Stomach pain
– Fainting
– Swelling of the abdomen (stomach)
Injection anthrax symptoms can include:
– Fever and chills
– A group of small blisters or bumps that may itch, appearing where the drug was injected.
– A painless skin sore with a black centre that appears after the blisters or bumps.
– Swelling around the sore
– Abscesses deep under the skin or in the muscle where the drug was injected.
Injection anthrax symptoms are similar to those of cutaneous anthrax, but injection anthrax can spread throughout the body faster and be harder to recognise and treat than cutaneous anthrax. Skin and injection site infections associated with injection drug use are common and do not necessarily mean the person has anthrax.
Diagnosis/Testing
Laboratory testing plays the largest role in diagnosing patients with anthrax. Confirmatory diagnosis of anthrax can be done via
– Measure of antibodies or toxins in the blood
– Direct testing for Bacillus anthracis in blood, skin lesion swab, spinal fluid, and respiratory secretions samples.
If inhalation anthrax is suspected, chest X-rays or CT scans can confirm if the patient has mediastinal widening or pleural effusion, which are X-ray findings typically seen in patients with inhalation anthrax.
Treatment
PREVENTION
– Exercise caution when buying animals – cows, camels, sheep, goats, and other livestock. Observe for any symptoms of illness
– Carefully observe rams or cattle to be slaughtered for signs of sickness before slaughtering.
– Do NOT SLAUGHTER sick animals. Slaughtering the sick animal can expose the anthrax spores which can be inhaled by humans if the animal is infected with anthrax.
– Do NOT EAT products from sick or dead animals.
– Hunters SHOULD NOT pick sick or dead animals from the bush or forest to be sold for human consumption.
– Report any incidence of sudden death of animals to the nearest veterinary authorities or the State Ministry of Agriculture
– Anthrax is treatable in humans when reported early. Visit the nearest health facility if you notice any of the signs and symptoms associated with anthrax for prompt treatment.
Preventive measures for livestock owners:
– Vaccination is the most effective preventive measure against anthrax in livestock. Consult with a veterinarian to develop a vaccination schedule suitable for your specific livestock.
– Antibiotics medication and anthrax vaccination cannot work together. Animals cannot receive antibiotics treatment 2 weeks before or after vaccination.
– Use personal protective equipment (gloves, facemasks, goggles, boots) when handling sick animals.
– Regularly monitor livestock for any sign of sickness or unusual behaviour.
– Immediately report cases of animals bleeding from body openings to veterinary authorities, or agriculture extension workers. Note: The blood of an anthrax-infected animal DOES NOT CLOT.
– DO NOT PROCESS or MOVE THE DEAD or SICK ANIMAL, QUICKLY REPORT to your VETERINARY DOCTOR or VETERINARY AUTHORITIES at the Ministry of Agriculture in your state.
– Maintain good hygiene practices on the farm through regular cleaning and disinfection of animal housing, feeding equipment, and water troughs.
– Practice biosecurity measures, such as controlling access to the farm, restricting the movement of animals, and disinfecting vehicles and equipment entering and leaving the premises.
– Ensure a clean and safe water supply for livestock and avoid using water from stagnant sources.
– Sick animals should be isolated and strict quarantine measures implemented to prevent the spread of anthrax to other animals or humans.
NCDC
