Anthrax and its Effects on Public Health

Anthrax which is a communicable disease that affects both animals and humans is caused by the Bacillus anthracis and its effects are lethal to the infected organism.  The Bacillus is usually found dormant in some soils in form of spores and may be inhaled by some organisms then they become reactive with their bodies multiplying in at a high rate where after infection it results in skin lesions (Miller, 2002).  From the herbivorous animals, humans may get the disease through feeding or coming into contact with the affected flesh whether cooked or uncooked.  The mode of transmission is through the spores which can be transferred from one organism to another through clothing, skin, inhalation or ingestion.

As mentioned earlier, anthrax enters the human body through the skin (cutaneous), lungs (inhalation) and intestines (ingestion).  When humans are affected they are usually separated from the rest or quarantined as a precautious way of avoiding chances of infection of the unaffected humans (Zubay, 2005).  Within the public health arsenal isolation and quarantine are two basic procedures in the case of an outbreak of anthrax. Quarantine and isolation form the most basic yet significant potent tools and procedures of control and prevent of anthrax in todays public health armory. Quarantine and isolation as procedures are not synonymous.

 Isolation is most probably applied on patients who have been confirmed as having the illness while by extension quarantine and its procedures are usually administered to persons who have to yet been infected with the disease but they are presumed to have been exposed to the threats of infection (Miller, 2002). These two procedures, that is quarantine and isolation, are carried on concurrently, and the major focuses is geared towards restricting movements from infected areas to uninfected regions in order to slow down the rate of infection or stop it completely.

Commonly affected animals are the wild animals, such as zebras, gazelles, and domesticated herbivores because those bacilli spores are found dormant in the soils.  The disease doesnt spread directly from one animal to another or form one infected person to another to another unless by the conduct of infected products like fur, skin, or blood.

For centuries anthrax has been found to kill numerous animals and people especially those who were in the concentration camps in the US, Europe, south Vietnam, Africa and Australia during the first and second world wars (Zubay, 2005).  It was not until the discovery of vaccines and immunization programmes for animals and people that the disease effects have been tamed.  

The disease has a variety of strains that are curable while some are found to be resistant.  The inhalation strains are found to be more virulent.  Once inhaled or ingested the bacilli is transferred to the intestine or lungs from where it may further move to the blood stream and the lymph nodes.

While the spores are in the lymph nodes they breakdown the immune system within few hours and propagate so first that in two days death may even occur (Miller, 2002).  The organism affected, otherwise called the host, is may have blood oozing from any body opening before it dies.  When the antibiotic are administered to the organism before severe attacks then it may survive when the bacilli is eradicated but if it is administered late the host may still die, depending on the severity of the effect caused by the bacilli before administration.

For the lethal factors and the edema to penetrate the body cells, they use a special protein that is generated by the bacilli to inactivate the neutrophils hence weakening the cells in large numbers. The body swells and cells rupture hence bleeding and death of the organism.

There are known cases of death of people who contracted the disease from their work stations. For example a drum maker who worked with untreated leather died in the United Kingdom in 2008 November and it was reported to have died from anthrax infection. Also in December 2009 an adult female was confirmed to have the infection while she worked in New Hampshire health and human service department (Zubay, 2005). To prevent such occurrence there is regular vaccination programmes for those working in anthrax prone areas.  Anthrax outbreak was also recorded in Glasgow Scotland in the midst of heroin fanatics majority of whom died in the same year.  Upon thorough research it was realized that in Afghanistan, the heroin was usually blended with bone meal which would have been contaminated with the bacilli spores.

Unless one knows the symptoms of the disease it is difficult to suspect it. For example if one is infected they may think they were suffering form the common flu or common colds which many people dont think of treating because it clears by itself (Miller, 2002). The disease is characterized by instances of flu that starts in a mild form and later develop in to severe thorax infection, pain in the chest, and a fatal respiratory collapse which may be followed by blood spots in the mucus and tonsillitis that may eventually to general illness and death. Inhaled bacilli are found to cause more than 90 of the anthrax deaths.   Most of the inhaled infections are from exposure to the infected hides and skin or breaking of animal horns and bones.

The gastrointestinal anthrax results from ingested material that is affected like flesh, blood, and can be noticed by symptoms like vomiting blood, acute inflammation of the gastro intestinal tract relentless diarrhea and low appetite. Once this spreads to the blood stream it is fatal (Zubay, 2005).  Gastrointestinal anthrax is treatable but usually causes more that 60 of deaths if it attacks humans.
The skin related anthrax is spread through the spores that are as a result of skin contact. This one exhibits symptoms like, lesion on the skin that appear like boils then after sometime they develop into ulcers that has a dark scar at the center yet it is rarely painful. This type of infection is curable and rarely causes death.

Large dosages of oral antibiotics as well as the intravenous antibiotics are a good treatment of the infection. Some of the antibiotics that are commonly used include, fluoroquinolones, such as cipro, erythromicyne, penicillin, doxiphylaxis and vancomycin. Inhalation anthrax can be treated by the use of drugs like the ABthrax (raxibacumab) that is a recent drug towards treating emergency cases.
It is medically proven that anthrax does not spread from one person to another by just using a common environment but quarantine has to be done the reduce chances of spread of the bacilli spores through the air which could be a potential hazard (Miller, 2002). The contaminated persons clothes are washed thoroughly by the use of antimicraibial soap and plenty of water then the effluent further treated by a bleaching agent that can destroy the spores completely.  The washed clothes or utensils are then boiled in water for more than half an hour.

Clothes of the infected person can also be burnt to kill the spore completely. Dead bodies are to be handled with care if they arte suspected to have died form anthrax.  Even the simple burial practices can not kill the disease.  It should be noted that these dead bodies should first be fully inspected of any traces of the disease then upon full realization of the cause of the death if anthrax the body should be sealed in special non perforated rubber bags that are airtight then disposed by burying deep in the ground to prevent any further contamination (Miller, 2002).  The dead persons clothes should be burnt.  Those handling the patients should be very careful and use protective masks to avoid possible contamination.  The preferred protection is the use of disposable masks.

It is also important to understand that once the disease attacks a patient they should be treated at once because any delay makes the cases untreatable and more communicable. Therapy of this infection should only be attempted in a biohazard laboratory that is fully equipped and with well trained and qualified personnel.

Anthrax affected animals may die without significant signs but with people, mild cases of headache, bouts of common cold, mild fever, experiences of sore throat, and painful muscles may be noticed initially.  Most humans die from two days of infection, while the majority may die in 8 day and others taking even a month.

More so in order to contain anthrax infections and its spread, there are measures that should be taken for public safety (Zubay, 2005).  A number of notifications need to be done.  The procedure for solution to anthrax exposures includes investigation, to find out if the there is possibility of the exposure of suspected patients to the disease.  Investigations are done in the clinical laboratories that are specially designed to carry out these investigations.

The investigation process may include going to the field to collect samples from patients in the suspected area then testing the samples.  If traces of the bacteria are noted then treatment should start at once to avoid the spread.  Different departments at this level must then be informed that of the findings so that alert messages to warn the different officials concerned with the public safety health are informed.

These departments include the epidemiology department, the local department of health, FBI and the CDC.  When all these notifications are made, the affected patients whose diagnosis is complete should be transferred to the isolation chambers for treatment and further tests.
The next procedure up on the notification of different medical departments and the public health department, the public health officer then issued a notification to the government warning that there is an outbreak of the disease (Miller, 2002).  When this information is validated the government through the ministry may issue a warning towards isolation and quarantine of the infected persons from the health ones.  Quarantine may be regional that restricts the movement of people from one place to another until the quarantine exercise if terminated up on the assurance of safety once the disease has been controlled. Quarantine may also involve short term or long term termination of movement of animals from infected zones to others and the vice versa. Once the disease has been managed, the quarantine warning may be withdrawn.  

The responsibility of the public health sector in the control of the disease is to ensure that appropriate investigations are on any suspected cases of any such infection then ensure that the appropriate medical investigation forms are filled out and submitted to the necessary  authority (Zubay, 2005).  Also the department is charged with the responsibility of providing education regarding the disease outbreak its effects and control measures to the all citizens, clinical officers, and possible emergency controllers.  The public health department also should commence active surveillance at once when suspected cases are notified.  They should also carry 0out active research sessions to identify the cluster zones with the infected cases, and ensure fast stoppage to more exposure and transmission.
Vaccinations can be used as preventive measures especially to people working in leather, hides and skins as well as fur handling areas (Miller, 2002). Those who work in military force in areas prone to the disease and those working in the organism laboratory should also be vaccinated. Immunizations are also available for prevention of the spread of the disease although infected persons should not be immunized, they should only be separated and treated separately.

Contaminated site from which the dead body was found should be cleaned thoroughly because the spores of the bacilli can survive under adverse environments even if the infected body has been buried.   The best clean agents to the site contaminated with anthrax include oxidizing agents for example the peroxides, bleaching agents, chlorine dioxide, and sandia foam and ethylene oxide among others. EPA is the most recommended bleaching agent for cleaning sites (Zubay, 2005).  Chlorine dioxide is now a well known biocide to use while cleaning anthrax contaminated surfaces. It is more hectic to clean animal ranches or domestic animal areas because it requires one to keenly collect the carcass plus any remnants of the dead animal and burn them completely to be consumed by fire.

This process is difficult in forested areas in wild animal ranges because it may result in the destruction of the environment if fires are not carefully managed. Formaldehyde solution is used to soak the carcass to kill the spores although this has been discovered to be an environmental hazard. In most cases the site clearance involves block burning of anthrax infested vast lands which deters any scavengers and hyenas from feasting on the carcass and possibly spreading the disease to other areas in he field.  This is the only effective way of clearing a forested site that is contaminated by anthrax.
 Anthrax is not only a health hazard in normal environments but it has also been used in wars (Miller, 2002). For example, the Japanese were the first people to carry out tests on anthrax in 1930s in which some of the tests were carried by intentionally subjecting the infection to war prisoners, majority of whom died. In the 1940s anthrax was used as a biological warfare when the US used weaponized anthrax in wars which were later destroyed in the 1972.

Anthrax has been used many times in weapons during warts to attack enemies for example, the British attacked Scotland with such weapons in the 1942 and the contamination lasted until the 1990 when decontamination was effected. The Germanys are also known to have used this biological warfare in the 1944 while Rhodesia used it in the 1978-1979 when it fought with the black nationalists (Miller, 2002).  Following these attempts to use the biological warfare, the American military are vaccinated against it frequently to, protect them against severe attacks in case of wars.  This also applies to the British armies.  It therefore true that these spores can be cultivated for terrorism events.
 
In conclusion anthrax is a communicable disease and while handling the patients or contaminated surfaces one need to be carefully protected and handling of dead bodies should be carefully done.  It should also be noted that anthrax can survive in harsh conditions for long and surfaces and contaminated sites need to be decontaminated with care.

0 comments:

Post a Comment