anthrax

definition

Of the anthrax (Anthrax) is one through spore forming bacteria transmitted infectious disease. Cloven-hoofed animals (horses, goats, sheep, cattle, but also camels or reindeer) are particularly endangered and cannot be transmitted from humans to other humans.

Since the spleen if the disease progresses untreated discolored brown-black, one speaks of "anthrax". The Latin name Anthrax is derived from the black pus vesicles that appear in one Skin anthrax (the most common form of anthrax).

causes

The is triggered anthrax by the responsible bacterium (Bacillus anthracis). The bacterium belongs to the class of gram positive, aerobic, spore-forming bacteria. Since it is capable of spore formation, it can also outside the host at favorable temperatures (12-43 ° C) and sufficient oxygen several decades to survive. This mainly consists in warmer areasthat have access to water (transport of the bacterium over river areas) the risk of spreading.

When the bacterium gets into its host, it produces it Anthrax toxin (Anthratoxin) which destroys cells.

The transmission is through direct skin contact possible (Skin anthrax) that can spores inhaled become (Pulmonary anthrax) or through infected dairy products or meat to be eaten (Intestinal anthrax). However, because the spores are so resistant and also survive outside the host for a long time, anthrax can also be caused by the Wearing infected clothing (e.g. sheep's wool, leather) are triggered. Even the transmission through contaminated heroin is possible.

diagnosis

In the Diagnosis of anthrax is above all that Patient talk (anamnese) crucial. The doctor should focus on the possible Danger at work respect, think highly of. Is the patient using a lot Ungulates or their recovery products in contact, for example in a tannery, this can be an indication of anthrax disease.

To make a final diagnosis, the cough or pus bladder becomes one sample taken, which then on a Culture medium is grown. If an anthrax colony grows, the patient is infected.

Also a genetic proof with the help of Polymerase chain reaction (PCR) is possible, but more expensive.

A Blood test The following quick test can also provide information.

The diagnosis of anthrax is in Germany notifiable!

Frequency distribution

The anthrax is one right rare disease, however, infections keep coming back. The most common form is Skin anthrax. Annually are around the world 2000 people affected by skin anthrax.

The bacterium of anthrax was also called Combat weapon used. In an accident in what was then the Soviet Union, numerous residents died of anthrax. On the island "Gruinard Island“In Great Britain they experimented with the bacteria, so the island is probably contaminated to this day. The island in the Aral Sea in Central Asia was also contaminated for a long time with the bacteria that caused the anthrax, as the Soviet military carried out experiments here.

Kick in Germany for years no diseases through infection more on. The reported anthrax cases appealed contaminated heroin syringesthat led to the onset of the disease.

Symptoms

The Symptoms of anthrax can be very diverse. As a result, it is often difficult to distinguish anthrax from a harmless disease.

Of the Skin anthrax shows first symptoms after 1-12 days. He fails for the first time itchy, black ulcers on the body, which is surrounded by puffy skin (Edema). These ulcers become blacker and blacker in the middle, as cell death (necrosis) is coming. Since the necrosis is not a programmed cell death, but through a poison (here the Anthratoxin) is triggered, the formation of pus-filled vesicles. It is important to consult a doctor immediately to avoid connecting the purulent vesicles to blood vessels, otherwise it could lead to a life-threatening blood poisoning (sepsis) can come. This form of anthrax is just through direct skin contact possible, whereby the skin must already show minimal injuries. Skin anthrax is the most harmless form. If left untreated, only 5-20% of all cases are fatal. With timely treatment with one antibiotic the death rate drops to around 1%.

Another form is that Pulmonary anthraxwhich, however, is rarer since about 5,000 spores inhaled must be in order to develop their harmful effects. With this form of anthrax, the symptoms are difficult to see. First of all it comes to light coughthen the disease progresses flu-like. It comes to high fever, Shortness of breath (Dyspnea) and to chills. However, since these symptoms only appear when the bacterium has already multiplied strongly, therapy is more difficult and the death rate is therefore very high. In addition, the coughed up liquid extremely infectious. Since there are surrounding body structures like that Mediastinum ignite, there is a drainage disorder in the Lymphatic system. This is how it comes to Swelling (Edema formations) in the neck and neck area. After a few days it usually comes to one septic shock, the one with total organ failure goes hand in hand. If left untreated, almost 100% of cases are fatal. But even when the disease is discovered, is one full recovery unlikely.

Eating infected dairy products or meat can cause it to Intestinal anthrax come. The first symptoms appear within a few hours or days. These are initially characterized by slimy diarrhea out. Also Pain in the abdomen, fever and lack of hunger are among the primary symptoms. After that it comes to mostly bloody vomiting (Hematemesis) and bloody diarrhea (Diarrhea). The blood comes from the injured and infected sections of the intestine. Since the bacterium is absorbed through the intestines and released into the blood, it quickly develops Blood poisoning (sepsis), which then too Heart and kidney failure leads. This form of anthrax is the rarest form. Around half of those affected die from it.

Of the Injection anthrax arises through ingestion of bacteria contaminated syringes (especially common among drug users). This occurs all over the body after a few days Water retention (Edema) as well as to Collections of pus (Abscesses). Here, too, it is important to remove them as quickly as possible. If the bacteria get into the blood, sepsis can also be life-threatening Meningitis (meningitis) come.

therapy

In the Therapy of anthrax, it is crucial to identify the disease as early as possible. Since the anthrax by a bacterium is a therapy with antibiotic most effective.

At the Skin anthrax took the antibiotic penicillin Proven to be particularly effective. Also like other oral antibiotics Erythromycin or Ciprofloxacin can help prevent the fatal consequences of anthrax.

There Colon and lung anthrax only become noticeable in the late stage, the antibiotic is injected here intravenous in order to achieve the direct effect in the blood as quickly as possible. The antibiotic must be administered over a period of approx 2 months because it takes a long time for the pus vesicles to regress, for example, and for the bacteria to have all been rendered harmless.

Also one Antibody administration is possible. These antibodies are directed against the so-called Lethal factor (LF) of anthrax toxin. This lethal factor is a subunit of the toxin and ensures that our body cells are converted into cell death. If you inhibit the effect of this lethal factor, you can keep your own body cells alive. Thus, the body's own Immune response supported. Antibodies against another subunit, namely the so-called protective antigen (PA) direct, prevent the pathogenic effects of the toxin. Thus, for example, the formation of edema is suppressed.

The Pus vesicles, which occur with skin anthrax, must also cut out become.

prophylaxis

A Anthrax prophylaxis is through one vaccine possible. This was first tested on animals and later found importance, especially in the military, since the fight with anthrax spores as a biological weapon is forbidden, but was used again and again. This vaccination is still in Germany today not allowedbecause it has very high side effects. In addition, it is associated with an enormous amount of time and effort. 6 vaccinations are necessary within the first 18 months, after which you have to have a new vaccination every year. Since the treatment with Antibiotics If more successful, the vaccination is not used as a prophylaxis in Germany.

The vaccination of animals as prophylaxis is also prohibited in Germany!

If you come into contact with the toxin, you should definitely take appropriate hygiene measures (washing hands, disinfecting) and consult a doctor.

forecast

The forecast depends a lot on early detection the disease.

Of the Skin anthrax shows itself very clearly in its early stages through the strong formation of edema and the pus vesicles. If you see a doctor before the pus can get into the blood vessels, treatment is with antibiotic very efficient and only 1% of all sick people die.

Of the Pulmonary anthrax has a very bad prognosis. Since the first signs are only noticeable at a stage in which the toxin has already spread throughout the body, antibiotics are rarely helpful. This form of anthrax ends mostly fatal. Without antibiotics, 100% of all sick people die after a few days. With timely help, the death rate will drop to over 50%.

Of the Intestinal anthrax has a similarly poor prognosis. Since the toxin also has access to the bloodstream here and can therefore quickly be distributed throughout the body, the fastest possible detection is of great importance here too. Yet die about 50% of all sick patients despite administration of antibiotics.

Of the Injection anthrax also has a bad prognosis because the toxin is released directly into the blood. Despite treatment every third patient dies.

Despite treatment you can Long-term consequences occur, for example increased fatigue or Powerlessness.

history

In September 2001 several senators and various news channels in the USA received letters containing the dangerous anthrax toxin. While the skin anthrax toxin was being sent to the news channels, the senators received the dangerous pulmonary anthrax spores. A total of 5 people were killed in the attack. The exact circumstances are not clear to this day, but Bruce Edwards Ivins was accused of committing suicide in 2008.