A to Z of Anthrax

A. Anthrax: 

Anthrax is an acute disease caused by Bacteria Bacillus Anthracis, characterized by blackish ulcerative lesions on skin surface. It can be fatal especially inhalational form if remain untreated.


B. Bacillus Anthracis:

Bacillus Anthracis is the main culprit for causing anthrax. The bacterium lives in soil. It forms spores and may come to life from being dormant when necessary.

C. Cutaneous anthrax: 

Cutaneous or skin anthrax infection shows up a boil like lesion that eventually forms a blackish ulcer. It generally forms if any bruises or other lesions occur on skin surface. This type of anthrax can be fatal if remain untreated.






D. Discovery: 

A German physician/scientist named Robert Koch first identified the bacteria causing anthrax. He was rewarded Nobel prize in Physiology or Medicine for his pioneering work to understand that diseases could be caused by microbes.




E. Exposure: 

Occupational exposure to infected animals or their products (e.g. meat, skin, wool) is the usual pathway of exposure for humans. Workers who are exposed to dead animals or animal products are at the highest risks.


F. Fatal disease: 

If proper cure, prevention or treatments are not given then the disease can be fatal.




G. Gastrointestinal anthrax: 

Gastrointestinal infection often happens by eating anthrax infected cows meat. It’s characterized by serious gastrointestinal difficulty, vomiting of blood, severe diarrhoea and loss of appetite. Lesions can be found in the intestines.


H. Herbivores: 

Herbivores (e.g. cow) are often get affected whilst grazing, browsing and eating rough, irritant spiky vegetation. Humans get affected from them. But it’s not contagious from men to men.




I. Inhalational anthrax: 

Inhalational anthrax is the most lethal form. It initially presents flu-like symptoms for several days followed by respiratory collapse.


J. Junks: 

Humans get affected by inhaling smell or come in touch with the junk products (e.g. intestines) of the anthrax affected herbivores.

K. Killing of spores: 

Bacillus Anthracis bacteria spores are soil-borne and because of their long lifetime, they may still persist after burial of affected herbivores. So, burning the junks is much effective way of killing spores.


L. Lesions: 

Intestinal lesions can be found in gastrointestinal anthrax while black, blister like lesions can be found in the cutaneous anthrax. Cutaneous anthrax do not cause pain.


M. Mode of infection: 

1. Gastrointestinal anthrax by eating affected herbivore’s meat. 
2. Inhalational anthrax by inhaling smell of the junk products of the affected herbivores. 
3. Cutaneous anthrax can be caused when come in touch to affected animals or their products.


N. Necrotic ulcer: 

The blackish, boil-like skin lesions caused in cutaneous anthrax often turn to large necrotic painless ulcers. It generally forms after 3 or 4 days of getting affected.


O. Open cut: 

An open cut of the skin is a vulnerable route for getting affected. After entering through the cut, the bacterium begins multiplying inside human body and typically kills the host within a few days or weeks.


P. Prognosis: 

Anthrax prognosis may be unfavourable when it becomes difficult to control. A doctor cannot be absolutely certain about the outcome for a particular patient.




Q. Quinolones: 

Quinolones (Antibiotics), precisely fluroquinolones like ciprofloxacin, doxycycline, erythromycin, vancomycine or penicillin are the main medicines for treating anthrax.


R. Risk factors: 

For: 
1. People deployed in anthrax threatened are, 
2. People working with anthrax in a laboratory setting, 
3. Handling of animal skins, furs or wool, 
4. People working in veterinary medicine.




S. Symptoms: 

1. Cutaneous anthrax: A raised, itchy bump resembling an insect bite that quickly develops a painless sore with a black centre. Swelling is present nearby the sore. 
2. Gastrointestinal anthrax: Nausea, vomiting, loss of appetite, fever, swollen neck. 
3. Inhalational anthrax: Flu-like symptoms, chest discomfort and meningitis.


T. Treatment: 

Antibiotics, mentioned above (Quinolones) are for treating an anthrax patient. Early antibiotic prophylaxis treatment is crucial to prevent possible death.

U. Understanding: 

Understanding of anthrax is important. The disease is caused by bacteria. It’s contagious from animal to animal through spores but not from man to man.


V. Vaccine: 

An anthrax vaccine (Trade name: Biothrax) for human is available only in some developed countries. Bangladesh has yet to get it. The vaccine has many side effects (like allergic reaction), limitations and is expensive too.


W. Weapon: 

Anthrax spores can and have been used as a biological warfare weapon. Its first modern incidence occurred between Scandinavian freedom fighters and Imperial Russian Army in 1916. Concentrated anthrax spores were used for bioterrorism in The USA in 2001, delivered by posting spore containing letters.


X. X-factor: 

An anthrax screening test can be done by nasal swab collection to identify spores. But most laboratories cannot fully identify anthrax spores from nasal swab. So screening test remains as an x-factor for identifying anthrax.

Y. Yolk agar: 

Bacillus Anthracis is susceptible to penicillin and produces a wide zone of lecithinase (enzyme) on egg yolk agar. It’s done for identifying bacteria.


Z. Zone of testing:

1. Skin biopsy can detect cutaneous anthrax, 
2. Blood testing for detecting bacteria, 
3. Chest X-ray or CT Scan for inhalational anthrax, 
4. Endoscopy and stool sample for detection of gastrointestinal anthrax, 
5. Lumbar puncture for anthrax meningitis.