What is Anthrax?

The scare spreads internationally!

My phone rang at 2:25 in the morning, my mother at the other end said she will never send mail to me anymore and advised that I should not open any either. I realized that she has also been a victim of the scare that has been generated by the recent flood of information and misinformation on anthrax due to the rather unusual infections and exposures to the disease in the United States and a few countries in the world.

I became aware that fiction and facts has been blurred by the blitz of print and broadcast media on the subject of anthrax infection or exposure. The scare took a stronger hold in part because of the mode and rate people are exposed to or infected by spores of anthrax recently and a world already reeling from the September 11 terrorist attacks on the United States. I hope many people would know the facts so they can be a resource for their family, friends, acquaintances, co-workers, and the community at large.

Unfortunately, heightened emotions have led to overreaction, and exposure is being confused with diagnosis. For instance, just because someone tests positive for exposure to anthrax doesn't mean he or she has the disease. Clinical diagnosis requires physical symptoms combined with laboratory confirmation. Exposure to anthrax is defined as contact with an item or environment known or suspected to be contaminated with bacillus anthracis. Evidence of exposure, even without laboratory confirmation, is an indication for considering antibiotic therapy, but it does not equate with disease.

The Florida man, who contracted the inhalation form of anthrax and eventually died, cannot be labeled as 100 % positive for diagnosis. The bacterium has to be isolated in his blood, lung tissue or spinal fluid to justify 100 % certainty of death from anthrax. Think about it, ten people and counting out of millions in the US and the many people who has been exposed to the disease actually contracted it. Certainly, there is good reason to be concerned, and prompt assessment and treatment are essential; but we all need to remember that person-to-person transmission of the disease, according to the Center for Disease Control (CDC), is "extremely unlikely". Here's what you should know about the different forms of this disease and how to deal with suspicious mail.

Anthrax is a disease caused by a type of bacteria called Bacillus anthracis. The germ produces infectious spores that, when buried in the ground, can live for years. Anthrax is most often seen in wild and domesticated cattle, but it also can sicken humans who touch or inhale any spores from a live or dead infected animal, or eat undercooked meat from an infected animal. According to the Center for Disease Control (CDC), anthrax is a likely candidate for use as a weapon of biological terrorism, or bioterror. The antibiotic Cipro is the only drug currently FDA-approved for preventing the development of anthrax after exposure, or the worsening of symptoms after the disease has taken hold. Anthrax is curable if it is recognized and treated early enough in the development of the infection. The disease takes three distinct forms depending on how the germ enters the body: cutaneous (through a cut or scrape on the skin), inhalation (breathed in), and gastrointestinal (eaten). All forms of anthrax are quite rare in the U.S. But when one does occur, symptoms usually show up a day to a week after exposure. Here is a list of what these symptoms look like:

Cutaneous>

Starts out with a bump like a mosquito bite, usually on the hand, but within a few days, it turns into a painless, open sore with a tell-tale black center of dead tissue. This form of anthrax is highly treatable and about 20% of untreated victims die.

Inhalation:

At first, it feels like the common cold, but it can rapidly progress to severe pneumonia with difficulty breathing and shock. This form is usually fatal without treatment, but it is not contagious.

Gastrointestinal:

Begins with loss of appetite, nausea, vomiting, and fever, and it progresses to vomiting of blood and severe diarrhea. This form is deadly in 25% to 60% of cases but is extremely rare in humans and almost unknown in the U.S. Farm animals are regularly vaccinated against anthrax, but formulas prepared for livestock should never be used in people. A human anthrax vaccine does exist, which is used to boost the immune system. The vaccine for people is about 93% effective, but for now, it's available only to military personnel deployed to areas with a high threat of biological warfare and to people who work closely with the bacteria, potentially-infectious animals, or animal by-products. The only other way to develop immunity to the disease is to have survived a previous anthrax infection.

The body then recognizes the dangerous type of bacteria again and knows how to fight it. Immunization isn't a quick fix, anyway. It requires three shots given two weeks apart, three more shots given six, 12, and 18 months later, then annual booster shots after that. There are no live or dead anthrax bacteria in the vaccine, and the serious adverse reactions are rare (about 0.2%).

You can reach the Anthrax Vaccine Immunization Program in the U.S. Army Surgeon General's Office at 1-877-GETVAC. We are living in a very different and difficult time; however, accurate information will lead to less fear and unnecessary panic in our community, country and the world. We have to be vigilant- it's a new reality, but people cannot be paralyzed. If you receive any suspicious mail, don't open it. If you did and find any suspicious contents, isolate and cover the mail immediately, wash your hands with soap and water and call 911 immediately. Do not call family members to see the suspicious contents. The disease is most fatal in children and the elderly. Lest I forget, I requested my mother, to mail anchovies to me the next day, and she did!


Source: Reuben Hadzide, Former President, Ghana Nurses Students Association ( all Nurses Institutions in Ghana),Former Secretary, Ghana Nurses Association, Former President og the Ghana National Council
Copyright © 2001 GHANA NURSES ASSOCIATION OF THE MIDWEST