Anthrax

There is no way to write about anthrax and make it sound like a friendly disease. Anything that is used in germ warfare is dead serious. Still, we must roll out of bed each morning and do the good we can for that day, with ALL the troubles of the world shoved into the white noise of everyday life. Otherwise, courage would be hard to come by. It is a goal of mine to join all the other folks in the world doing good and add a little to all that goodness. I have an image in my head of each act and attitude of joy, kindness and understanding is as a candle in the night. With all the candles lit, it is not so hard to find one’s way in the dark. With all of your lit candles, I feel very found.

In a rural setting, anthrax, as one of my clients put it, is a "barnyard disease." Sheep get it cows get it, goats get it. Anthrax is a germ that lives in the soil when conditions are right. Grazing animals pull anthrax into their bodies on the food they eat, or inhale anthrax as they graze. Most of the time, there are not enough anthrax spores in the soil to do any harm to the animals. Once in the body, anthrax multiplies and exudes toxins that destroy the body tissue in its neighborhood. This tissue could be skin, lung, stomach or brain. Each of these invasions has its own way of presenting itself. Because of these special features, it seems there are four anthrax diseases and not just one.

In the soil Bacillus Anthracis, ( the name of the germ), lives as a spore, just another piece of dust. Often, that is all there is. But in a soil too alkaline, PH greater than 6, ol’ B. Anthracis will multiply and become dense enough to cause disease. This is made worse if there is a wet early spring followed by a long enough dry time to allow the germ to be spread about by the winds and then another wet spell for more germination. Given this cycle, acid rain seems like a good thing. Areas prone to this cycle in the United States include Louisiana, Oklahoma, and Colorado. Turkey, Iran, Pakistan and Sudan are the overseas areas troubled with this disease. The kind of anthrax that we are really worried about today is manufactured and genetically engineered anthrax that is high dose and lethal right from point of first contact.

In what now seems the "way old days," people who got anthrax were those who worked with animals, farmers and veterinarians, or who worked with animal products such as wool, bone meal and fertilizers. There were even cases of human anthrax infections traced to shaving brushes, saddle blankets and bongo drums.

Ninety-five percent of these infections were skin anthrax. In fact the name anthrax comes from the skin lesions looking and feeling like anthracite coal, the hard black coal we used to use for fuel. Once the skin lymph system is infected by anthrax, it takes a few days to notice a raised bump with pus in it. This gets other little raised bumps around it, like a ring. The area becomes swollen and tender from the toxins put out by the bacteria, and the wound grows larger. If left untreated, the wound grows larger and larger, the area more tender and a black scab forms, that is like the coal. With no treatment at all, eighty percent of those infected with skin anthrax recover. With antibiotic treatment death from skin anthrax is rare. Skin or cutaneous anthrax can be treated with penicillin or doxycycline, for those allergic to penicillin. If the bacteria is resistant to penicillin, then doxycycline will work or other antibiotics such as Cipro or Clindamycin, erythromycin, and Vancomycin can be used with good effect.

Inhaled anthrax, anthrax involving lung tissue lymph system is much more serious. Because the anthrax bacteria invades and multiplies in the lymph system of the lung, as do viruses, it feels just like a very bad virus. This is why some may think it is the flu. Influenza A and B are viral infections of the lung lymph system. All the aches and pains we feel with "the flu" are a result of

all the swelling lymph tissue putting out alarm signals to the rest of our body, recruiting aid from other cells and tissues, raising the temperature to create a hostile environment to bacteria that might want to take advantage of our compromised state, and getting us to rest, so the processes of healing can be begun. Inhaled anthrax infection is scarey because of the toxin produced by the bacteria creates so much swelling and accumulation of fluid in the lung, that the lungs main function of supplying oxygen to our body tissues becomes very difficult. About half of those with inhaled anthrax get meningitis from the anthrax. Early antibiotics are important and may not be enough. Those with known exposures to anthrax are given prolonged courses of antibiotics to keep the number of bacteria down, This, in turn, keeps the amount of toxin in the body to a minimum. As we have already seen and heard in the news. It is very difficult to recover from anthrax when the toxin titer is high..

The kind of anthrax that is ingested by eating food products contaminated with anthrax has been reported in developing countries. Abdominal pain, bleeding and fluid in the abdomen result from the toxin produced by the anthrax reproducing it self in the abdominal lymph system. Unless we were very aware of contaminated food sources, this form of anthrax would not be suspected until the disease was advanced in the body.

For all forms of anthrax the antibiotics are the same. Treating the area of the body affected requires supportive care. Again, it is very hard to protect the body from a high dose of destructive toxin.

There are some clues that help diagnose anthrax, including the pattern on the chest x-ray. Nasal swabs can look for the boxcar shaped bacteria that stains blue. But these are suggestive, but not definitive. This is why it takes longer to be sure it is anthrax and not some other bacteria. Cultures and chemical ID’s are needed. Mayo Clinic has developed a DNA anthrax screening test that will give a much quicker definitive answer regarding anthrax infections. This test is not yet widely available, but will be soon.

Getting a "flu shot" does not protect anyone from getting inhaled anthrax. However, if one is immunized, protected from the "flu" virus, then the chance of experiencing those symptoms that would create a concern for anthrax would be greatly reduced. The usual head cold symptoms are not related to anthrax.

Preventive measures include frequent hand washing, using antibacterial gels when soap and water are not available. Handiwipes or babywipes can be kept in the car for those who travel. Used towels can be sealed in zip lock bags. Follow all the rules in your workplace and use the gloves and masks provided if you are in a location that is at risk for anthrax contamination. What if there is a white powder that you feel could be anthrax? Do not touch or inhale the product. Get away from the product. Report the product. Call 911 or, if you are in Frederick county, call 1-301-694-2165.