Anthrax prevention: Difference between revisions
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==Overview== | ==Overview== | ||
===Prophylaxis=== | |||
If a person is suspected as having died from anthrax, every precaution should be taken to avoid skin contact with the potentially contaminated body and fluids exuded through natural body openings. The body should be put in strict quarantine and then burned. A blood sample taken in a sealed container and analyzed in an approved laboratory should be used to ascertain if anthrax is the cause of death. Microscopic visualization of the encapsulated bacilli, usually in very large numbers, in a blood smear stained with polychrome methylene blue (McFadyean stain) is fully diagnostic, though culture of the organism is still the gold standard for diagnosis. Full isolation of the body is important to prevent possible contamination of others. Protective, impermeable clothing and equipment such as [[rubber glove]]s, rubber apron, and rubber boots with no perforations should be used when handling the body. No skin, especially if it has any wounds or scratches, should be exposed. Disposable personal protective equipment is preferable, but if not available, decontamination can be achieved by autoclaving. Disposable personal protective equipment and filters should be autoclaved, and/or burned and buried. ''B. anthracis'' bacillii range from 0.5–5.0 μm in size. Anyone working with anthrax in a suspected or confirmed victim should wear respiratory equipment capable of filtering this size of particle or smaller. The US [[National Institute for Occupational Safety and Health]]- and [[Mine Safety and Health Administration]]-approved high-efficiency respirator, such as a half-face disposable respirator with a high-efficiency particulate air filter, is recommended.<ref>National Personal Protective Technology Laboratory [http://www.cdc.gov/niosh/npptl/default.html Respirators]. National Institute for Occupational Safety and Health. 30 April 2009.</ref> All possibly contaminated bedding or clothing should be isolated in double plastic bags and treated as possible biohazard waste. The victim should be sealed in an airtight body bag. Dead victims who are opened and not burned provide an ideal source of anthrax spores. Cremating victims is the preferred way of handling body disposal. No embalming or autopsy should be attempted without a fully equipped biohazard laboratory and trained, knowledgeable personnel. | |||
Delays of only a few days may make the disease untreatable, so treatment should be started even without symptoms if possible contamination or exposure is suspected. Animals with anthrax often just die without any apparent symptoms. Initial symptoms may resemble a common cold—sore throat, mild fever, muscle aches, and malaise. After a few days, the symptoms may progress to severe breathing problems and shock, and ultimately death. Death can occur from about two days to a month after exposure, with deaths apparently peaking at about eight days after exposure.<ref>{{harvnb|Guillemin|1999|p=27 chart of Russian deaths at Sverdlovsk, 1979}}</ref> Antibiotic-resistant strains of anthrax are known. | |||
Early detection of sources of anthrax infection can allow preventive measures to be taken. In response to the anthrax attacks of October 2001, the [[United States Postal Service]] (USPS) installed biodetection systems (BDSs) in their large-scale mail cancellation facilities. BDS response plans were formulated by the USPS in conjunction with local responders including fire, police, hospitals and public health. Employees of these facilities have been educated about anthrax, response actions, and [[prophylaxis|prophylactic]] medication. Because of the time delay inherent in getting final verification that anthrax has been used, prophylactic antibiotic treatment of possibly exposed personnel must be started as soon as possible. | |||
== Primary Prevention== | == Primary Prevention== | ||
In recent years there have been many attempts to develop new drugs against anthrax; but the existing supply still works fine if treatment is started soon enough. | In recent years there have been many attempts to develop new drugs against anthrax; but the existing supply still works fine if treatment is started soon enough. | ||
Revision as of 05:29, 1 July 2014
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Anthrax Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Anthrax prevention On the Web |
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American Roentgen Ray Society Images of Anthrax prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Prophylaxis
If a person is suspected as having died from anthrax, every precaution should be taken to avoid skin contact with the potentially contaminated body and fluids exuded through natural body openings. The body should be put in strict quarantine and then burned. A blood sample taken in a sealed container and analyzed in an approved laboratory should be used to ascertain if anthrax is the cause of death. Microscopic visualization of the encapsulated bacilli, usually in very large numbers, in a blood smear stained with polychrome methylene blue (McFadyean stain) is fully diagnostic, though culture of the organism is still the gold standard for diagnosis. Full isolation of the body is important to prevent possible contamination of others. Protective, impermeable clothing and equipment such as rubber gloves, rubber apron, and rubber boots with no perforations should be used when handling the body. No skin, especially if it has any wounds or scratches, should be exposed. Disposable personal protective equipment is preferable, but if not available, decontamination can be achieved by autoclaving. Disposable personal protective equipment and filters should be autoclaved, and/or burned and buried. B. anthracis bacillii range from 0.5–5.0 μm in size. Anyone working with anthrax in a suspected or confirmed victim should wear respiratory equipment capable of filtering this size of particle or smaller. The US National Institute for Occupational Safety and Health- and Mine Safety and Health Administration-approved high-efficiency respirator, such as a half-face disposable respirator with a high-efficiency particulate air filter, is recommended.[1] All possibly contaminated bedding or clothing should be isolated in double plastic bags and treated as possible biohazard waste. The victim should be sealed in an airtight body bag. Dead victims who are opened and not burned provide an ideal source of anthrax spores. Cremating victims is the preferred way of handling body disposal. No embalming or autopsy should be attempted without a fully equipped biohazard laboratory and trained, knowledgeable personnel.
Delays of only a few days may make the disease untreatable, so treatment should be started even without symptoms if possible contamination or exposure is suspected. Animals with anthrax often just die without any apparent symptoms. Initial symptoms may resemble a common cold—sore throat, mild fever, muscle aches, and malaise. After a few days, the symptoms may progress to severe breathing problems and shock, and ultimately death. Death can occur from about two days to a month after exposure, with deaths apparently peaking at about eight days after exposure.[2] Antibiotic-resistant strains of anthrax are known.
Early detection of sources of anthrax infection can allow preventive measures to be taken. In response to the anthrax attacks of October 2001, the United States Postal Service (USPS) installed biodetection systems (BDSs) in their large-scale mail cancellation facilities. BDS response plans were formulated by the USPS in conjunction with local responders including fire, police, hospitals and public health. Employees of these facilities have been educated about anthrax, response actions, and prophylactic medication. Because of the time delay inherent in getting final verification that anthrax has been used, prophylactic antibiotic treatment of possibly exposed personnel must be started as soon as possible.
Primary Prevention
In recent years there have been many attempts to develop new drugs against anthrax; but the existing supply still works fine if treatment is started soon enough.
Prevention can also be accomplished through early detection. In response to the anthrax attacks of October, 2001 utilizing the United States Postal Service (USPS), the USPS has installed BioDetection Systems (BDS) in their large scale mail cancellation facilities. BDS response plans have been formulated by the USPS in conjunction with local responders including fire, police, hospitals and public health. Employees of these facilities have been educated about anthrax, response actions and prophylactic medication. Because of the time delay inherent in getting final verification that anthrax has been used, prophylactic antibiotics use for possibly exposed personnel should commence as soon as possible.
The ultimate in prevention is vaccination against infection but this has to be done well in advance of exposure.
Anthrax vaccines
An FDA-licensed vaccine, produced from one non-virulent strain of the anthrax bacterium, is manufactured by BioPort Corporation, subsidiary of Emergent BioSolutions. The trade name is BioThrax, although it is commonly called Anthrax Vaccine Adsorbed (AVA). It is administered in a six-dose primary series at 0,2,4 weeks and 6,12,18 months; annual booster injections are required thereafter to maintain immunity. The injections are typically very painful, and may leave the area of injection with swelling; this area may be painful for several days.
Unlike the West, the Soviets developed and used live spore anthrax vaccines produced in Tbilisi, Georgia. This is known as the STI vaccine and its serious side effects restrict its use to healthy adults. [3]
References
- ↑ National Personal Protective Technology Laboratory Respirators. National Institute for Occupational Safety and Health. 30 April 2009.
- ↑ Guillemin 1999, p. 27 chart of Russian deaths at Sverdlovsk, 1979
- ↑ ANTHRAX, the investigation of a Deadly Outbreak, Jeanne Guillemin, University of California Press, 1999, ISBN 0=520-22917-7, pg 34