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ANTHRAX
DENOMINATION DEFINITION SYMPTOMS CASES DIAGNOSTIC TREATMENT PROPHYLAXIS TO SEE TO CONSULT

OTHER NAMES

Carbunco, bacteriological weapon.

DEFINITION

The anthrax is a sharp infectious illness caused by the Bacillus anthracis, which is a bacterium that can be transmitted in the shape of spores by the air.
Normally fond of herbivorous, wild and domestic, such animals as calves, goats, sheep, camels, antelopes and others, but also it can affect the man for contact with infected animals or textiles originated from infected animals.

The spores of the Bacillus anthrasis can be produced in big quantities with basic biology knowledge. They can be stored for decades without losing his potential. They can be easily interspersed in the air by means of missiles, rockets, bombs, artillery and up to aerosols, for it one considers inside the possible bacteriological weapon.

SYMPTOMS

There can be variables depending to the contagion route. If the spores bring in the guest for the skin across a wound the infection begins like an insect sting, transforming then in a vesicle and finally in a painless ulcer of approximately 3 cm in diameter with textile died in his interior. It is possible to treat with antibiotics and rarely it is mortal.

If the contagion route is across spore inhaled or breathed the symptoms begin like a common cold, and then it transforms in respiratory symptoms with the rapid appearance of hipoxia, shortness of breath and high temperature. This form of illness is generally it is mortal.

In the contagion route for contaminated meat there takes place a sharp inflammation of the intestinal tract, morning sickness, vomiting with blood, fever and diarrhea; between 25 and 60 % of the cases are mortal.

More rarely it can appear with the sharp appearance of high fever, possibly with convulsions and loss of the conscience, signs and symptoms meníngeos.

EVALUATION OF THE CASES

  • Supposed case: Case that is compatible with the clinical description and has an epidemiologic linkage with confirmed or supposed cases in animals or with contaminated animal products.
  • Probable case: Supposed case that has a positive reaction to the cutaneous allergic test (in persons without vaccinating).
  • Confirmed case: Supposed case that is confirmed by laboratory tests.

LABORATORY DIAGNOSIS

It is possible to isolate the Bacillus anthracis in the blood, injuries ó exudados of a supposed case. There is realized a cross-check of the presence of Bacillus anthracis in a sample by means of the microscopic examination of dyed smears of liquid vesicular, blood, spinal liquid, liquid pleural, dregs, etc.
Also the antibodies detection is realized anti-Bacillus anthracis by means of the positive seerología (ELISA, Western Blot, detection of toxins, essay cromatográfico, tries fluorescent antibodies, RCP (chain reaction of polimerasa).

TREATMENT

The election antibiotic is the Ciprofloxacino to dose of 400 mg route endovenosa, or the Levofloxacino.
The alternative is the penicillin G, that more possible precozmente must administer, in dose of 2-3 million units, every 4-6 hours, at least for 7 days. If the picture is serious or talks each other of not cutaneous locations, the doses must come to 20-24 million units, for intravenous route, for 10-15 days, according to the evolution.

PROPHYLAXIS

The best measurements for the prevention of the illness in the exposed individuals are the protection of skin and mucous membranes and the vaccination. There is important the use of gloves and masks, for which a health education is needed.

In exposed persons and without symptoms there is used the oral ciprofloxacino or the oral doxiciclina. The vaccine realized with the purified protective antigen, needs three 0,5 ml subcutaneous injections with 2 weeks of interval, and a dose of annual memory.

REFERENCES

  1. JAMA 281: 1735, 1999
  2. NEJM 341: 815, 1999
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Writing: Medical equipment   Update: June, 2009


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