|
|
| (58 intermediate revisions by 12 users not shown) |
| Line 1: |
Line 1: |
| {{Infobox_Disease | | {{Infobox Disease | |
| | Name = Anthrax
| | Name = Anthrax | |
| | Image = Bacillus anthracis Gram.jpg
| | Image = Anthrax-6.jpg | |
| | Caption = Microphotograph of a [[Gram stain]] the bacterium ''Bacillus anthracis'' which causes anthrax.
| | Caption = Anthrax skin lesion<SMALL><SMALL>''[http://phil.cdc.gov/phil/ Adapted from Public Health Image Library (PHIL), Centers for Disease Control and Prevention.]''<ref name="PHIL">{{Cite web | title = Public Health Image Library (PHIL), Centers for Disease Control and Prevention | url = http://phil.cdc.gov/phil/}}</ref></SMALL></SMALL>| |
| | DiseasesDB = 1203
| | }} |
| | ICD10 = {{ICD10|A|22|minor|LinkGroup|LinkMajor}}
| | __NOTOC__ |
| | ICD9 = {{ICD9|022}}
| | {{About1|Bacillus anthracis}} |
| | ICDO =
| | |
| | OMIM =
| |
| | OMIM_mult = {{OMIM2|606410}} {{OMIM2|608041}}
| |
| | MedlinePlus = 001325
| |
| | eMedicineSubj =
| |
| | eMedicineTopic =
| |
| | MeshID = 68000881
| |
| }} {{Anthrax}}
| |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| | {{Anthrax}} |
| | {{CMG}}; {{AE}} {{JS}} |
|
| |
|
| {{CMG}} | | {{SK}} Woolsorters' disease; ragpicker's disease, malignant pustule, Siberian ulcer, malignant edema, malignant oedema, black bane, Bradford disease, pulmonary anthrax, cutaneous anthrax, gastrointestinal anthrax, inhalation anthrax, Bacillus anthracis, B. anthracis |
| ==Overview==
| |
| | |
| ==Introduction==
| |
| | |
| | |
| | |
| ==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.<ref> ANTHRAX, the investigation of a Deadly Outbreak, Jeanne Guillemin, University of California Press, 1999, ISBN 0=520-22917-7, pg 34</ref>
| |
| | |
| == Site cleanup ==
| |
| Anthrax spores can survive for long periods of time in the environment after release. Methods for cleaning anthrax contaminated sites commonly use oxidizing agents such as [[peroxides]], ethylene
| |
| Oxide, Sandia Foam [http://www.eurekalert.org/pub_releases/2007-04/dnl-sdf042607.php], (available as Mold Control 500, distributed by Scott’s Liquid Gold) chlorine dioxide (used in Hart Senate office building), liquid bleach products contain sodium hypochlorite. These agents slowly destroy bacterial spores.
| |
| A bleach solution for treating hard surfaces has been approved by the EPA [http://ehso.com/bleach.htm] can be prepared by mixing one part bleach (5.25%-6.00%) to one part white vinegar to eight parts water. Bleach and vinegar must not be combined together directly, rather some water must first be added to the bleach (e.g., two cups water to one cup of bleach), then vinegar (e.g., one cup), and then the rest of the water (e.g., six cups). The pH of the solution should be tested with a paper test strip; and treated surfaces must remain in contact with the bleach solution for 60 minutes (repeated applications will be necessary to keep the surfaces wet).
| |
| | |
| [[Chlorine dioxide]] has emerged as the preferred biocide against anthrax-contaminated sites, having been employed in the treatment of numerous government buildings over the past decade. Its chief drawback is the need for ''[[in situ]]'' processes to have the reactant on demand.
| |
| | |
| To speed the process, trace amounts of a non-toxic [[catalyst]] composed of [[iron]] and tetro-amido macrocyclic [[ligand]]s are combined with [[sodium carbonate]] and [[bicarbonate]] and converted into a spray. The spray formula is applied to an infested area and is followed by another spray containing tertiary-butyl hydroperoxide.
| |
| | |
| Using the catalyst method, a complete destruction of all anthrax spores takes 30 minutes. A standard catalyst-free spray destroys fewer than half the spores in the same amount of time.
| |
| They can be heated, exposed to the harshest chemicals, and they do not easily die.
| |
|
| |
|
| Cleanups at a Senate office building, several contaminated postal facilities and other U.S. government and private office buildings showed that decontamination is possible, but it is time-consuming and costly. Clearing the Senate office building of anthrax spores cost $27 million, according to the Government Accountability Office. Cleaning the Brentwood postal facility outside Washington cost $130 million and took 26 months. Since then newer and less costly methods have been developed. [http://www.defensenews.com/story.php?F=2712190&C=america], {{PDFlink|[http://www.bnl.gov/bnlweb/pubaf/bulletin/2003/bb101703.pdf]|332 [[Kibibyte|KiB]]<!-- application/pdf, 340763 bytes -->}}
| | ==[[Anthrax overview|Overview]]== |
|
| |
|
| == History == | | ==[[Anthrax historical perspective|Historical Perspective]]== |
| ===Discovery===
| |
| [[Robert Koch]], a German physician and scientist, first identified the bacteria which caused the anthrax disease in 1877.<ref name=Brock>{{cite book | author = Madigan M; Martinko J (editors). | title = Brock Biology of Microorganisms | edition = 11th ed. | publisher = Prentice Hall | year = 2005 | id = ISBN 0-13-144329-1 }}</ref> His pioneering work in the late nineteenth century was one of the first demonstrations that diseases could be caused by microbes. In a groundbreaking series of experiments he uncovered the life cycle and means of transmission of anthrax. His experiments not only helped create an understanding of anthrax, but also helped elucidate the role of microbes in causing illness at a time when debates were still held over spontaneous generation versus [[cell theory]]. Koch went on to study the mechanisms of other diseases and was awarded the 1905 Nobel Prize in Physiology or Medicine for his discovery of the bacteria causing tuberculosis. Koch is today recognized as one of history's most important biologists and a founder of modern bacteriology. | |
|
| |
|
| === First vaccination=== | | ==[[Anthrax pathophysiology|Pathophysiology]]== |
| In May 1881, [[Louis Pasteur]] performed a public experiment to demonstrate his concept of vaccination. He prepared two groups of 25 sheep, one goat and several cows. The animals of one group were all injected with a self-prepared anti-anthrax [[vaccine]] twice, with an interval of 15 days. The animals of the other group were left unvaccinated. Thirty days after the first injection, both groups were injected with a culture of live anthrax [[bacterium|bacteria]]. All the animals in the non-vaccinated group died, whilst all of the animals in the vaccinated group survived.<ref>Decker, Janet. ''Deadly Diseases and Epidemics, Anthrax.'' Chelesa House Publishers, 2003. ISBN 0-7910-7302-5 p 27–28.</ref>
| |
|
| |
|
| After mastering his method of vaccination, Pasteur applied this concept to [[rabies]]. He went on to develop vaccines against [[small pox]], [[cholera]], and [[swine erysipelas]].
| | ==[[Anthrax causes|Causes]]== |
|
| |
|
| == Biological warfare == | | ==[[Anthrax differential diagnosis|Differentiating Anthrax from other Diseases]]== |
| [[Image:Powell-anthrax-vial.jpg|thumb|300px|Colin Powell holding a model vial of anthrax while giving a presentation to the United Nations Security Council.]] | |
| Anthrax spores can and have been used as a [[biological warfare]] weapon. There is a long history of [[bioweapons]] research in this area. For example, in 1942 [[United Kingdom|British]] bioweapons trials severely contaminated Gruinard Island in Scotland with anthrax spores of the Vollum-14578 strain, thereby rendering it uninhabitable for the following 48 years.<ref>The Times Newspaper:[http://www.timesonline.co.uk/article/0,,2-1726745,00.html Saddam's germ war plot is traced back to one Oxford cow]</ref> The Gruinard trials involved testing the effectiveness of a submunition of an "N-bomb"—a biological weapon. Additionally, five million "cattle cakes" impregnated with anthrax were prepared and stored in Porton Down for attacks on Germany by the Royal Air Force as an anti-livestock weapon. However neither the cakes nor the bomb were ever used . | |
|
| |
|
| More recently, the Rhodesian government used anthrax against cattle and humans in the period 1978–1979 during its war with black nationalists.<ref>Southern African News Feature : [http://www.sardc.net/editorial/sanf/2001/iss21/specialreport.html the plague wars]</ref>
| | ==[[Anthrax epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| American military and British Army personnel are routinely vaccinated against anthrax prior to active service in places where biological attacks are considered a threat. The [[anthrax vaccine]], produced by BioPort Corporation, contains non-living bacteria, and is approximately 93% effective in preventing infection.
| | ==[[Anthrax risk factors|Risk Factors]]== |
|
| |
|
| Weaponized stocks of anthrax in the US were destroyed in 1971–72 after President Nixon ordered the dismantling of US biowarfare programs in 1969 and the destruction of all existing stockpiles of bioweapons[http://www.bordeninstitute.army.mil/cwbw/default_index.htm]. Research continues to this day in the United States on ways to counter act possible bioweapons attacks.
| | ==[[Anthrax natural history|Natural History, Complications and Prognosis]]== |
|
| |
|
| === Soviet accident: 2 April 1979 === | | ==Diagnosis== |
| | [[Anthrax history and symptoms|History and Symptoms]] | [[Anthrax physical examination|Physical Examination]] | [[Anthrax laboratory findings|Laboratory Findings]] | [[Anthrax chest x ray|Chest X Ray]] | [[Anthrax CT|CT]] | [[Anthrax other diagnostic studies|Other Diagnostic Studies]] |
|
| |
|
| Despite signing the 1972 agreement to end bioweapon production the government of the Soviet Union had an active bioweapons program that included the production of hundreds of tons of weapons-grade anthrax after this period. On 2 April 1979 part of the over one million people living in Sverdlovsk (now called Ekaterinburg, Russia), roughly 850 miles east of Moscow were exposed to a accidental release of anthrax from a biological weapons complex located near there. The first victim died after four days; ten victims died in eight days at the peak of the deaths and the last victim died six weeks later. In all at least 94 people were infected, of which at least 68 died. Extensive cleanup, vaccinations and extensive medical interventions managed to save about 30 of the victims. <ref> ANTHRAX, the investigation of a Deadly Outbreak, Jeanne Guillemin, University of California Press, 1999, ISBN 0=520-22917-7, names of victims, pg 275-277</ref> Extensive cover-ups and destruction of records by the KGB continued from 1979 till 1992 when Russian President Boris Yeltsin finally admitted this anthrax accident. A combined Russian and United States team investigated this accident in 1992 as reported by Jeanne Guillemin in 1999 <ref> Guillmin, op. cit. </ref> [http://www.pbs.org/wgbh/pages/frontline/shows/plague/sverdlovsk/], [http://www.medicinenet.com/script/main/art.asp?articlekey=18982]
| | ==Treatment== |
| | [[Anthrax medical therapy|Medical Therapy]] | [[Anthrax surgery|Surgery]] | [[Anthrax prevention|Prevention]] | [[Anthrax cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Anthrax future or investigational therapies|Future or Investigational Therapies]] |
|
| |
|
| There was a ceramics plant directly across the street from the biological facility (compound 19), where nearly all of the night shift workers became infected and most died. Since most of these people were men, there were suspicions by Western governments that the Soviet Union had developed a gender-specific weapon (Alibek, 1999). The government blamed the outbreak on the consumption of anthrax-tainted meat and ordered the confiscation of all uninspected meat that entered the city. They also ordered that all stray dogs be shot and that people not have contact with sick animals. There was also a voluntary evacuation and anthrax vaccination program established for people from 18–55 (Meselson et al., 1994).
| | ==Related Chapters== |
| | |
| To support the story, Soviet medical and legal journals published articles about an outbreak in livestock that caused GI anthrax in people who consumed the meat and cutaneous anthrax in people who came into contact with the animals. All medical and public health records were confiscated by the KGB (Meselson et al., 1994). In addition to the medical problems that the outbreak caused, it also prompted Western countries to be more suspicious of a covert Soviet Bioweapons program and to increase their surveillance of suspected sites. In 1986, the American government was allowed to investigate the matter and concluded that the exposure was from aerosol anthrax from a military weapons facility (Sternbach, 2002). In 1992, President Yeltsin admitted that he was "absolutely certain" that "rumors" about the Soviet Union violating the 1972 Bioweapons Treaty were true. The Russians, like the US and UK, agreed to submit information to the UN about their bioweapons programs but the Russian report omitted known facilities and never acknowledged their weapons program (Alibek, 1999).
| |
| | |
| === Preparation of biowarfare-grade anthrax === | |
| | |
| Theoretically, cultivating anthrax spores can be done with minimal special equipment and a first-year collegiate [[microbiology|microbiological]] education. Fortunately, there are many obstacles to overcome to do this and doing this can be quite dangerous. To make large amounts of an aerosol form of anthrax suitable for biological warfare, requires extensive practical knowledge, training and highly advanced equipment.
| |
| | |
| Concentrated anthrax spores were used for bioterrorism in the 2001 anthrax attacks in the United States, delivered by mailing postal letters containing the spores. Only a few grams of material were used in these attacks and it is unknown if this material was produced by a single individual or by a state sponsored bioweapons program. These events also spawned innumerable anthrax hoaxes. In response, the US Postal Service sterilized some of the mail using a process of gamma [[irradiation]] combined with the use of a unique and proprietary [[enzyme]] treatment formula supplied by Sipco Industries Ltd.<ref>USPS - DEPARTMENT OF PUBLIC AFFAIRS AND COMMUNICATIONS [http://www.usps.com/news/facts/lfu_021202.htm]</ref>
| |
| | |
| === Theoretical "at home" Countermeasure ===
| |
| | |
| A scientific experiment performed by a high school student (later published in The Journal of Medical Toxicology) suggested that a common electric iron adjusted to the hottest setting (at least 400 degrees Fahrenheit) and used for at least 5 minutes should destroy all anthrax spores in a common envelope contaminated with anthrax.<ref>Pittsburgh Tribune-Review, February 2006 HAHA:[http://www.pittsburghlive.com/x/tribune-review/trib/pittsburgh/s_425621.html high school research findings]</ref>
| |
| | |
| == See also ==
| |
| * 2001 anthrax attacks
| |
| * Anthrax hoaxes
| |
| * [[Ames strain]] | | * [[Ames strain]] |
| * Sverdlovsk Anthrax leak
| |
| * [[Anthrax toxin]] | | * [[Anthrax toxin]] |
| * [[Anthrax Detection Device]] | | * [[Anthrax Detection Device]] |
| * [[Anthrax Vaccine]] | | * [[Anthrax Vaccine]] |
| * [[Anthrax Vaccine Immunization Program]], or AVIP: the program for vaccinating all members of the armed services in the United States.
| |
| * [[Black death]] | | * [[Black death]] |
|
| |
|
| ==References== | | ==References== |
| | {{reflist|2}} |
|
| |
|
| <!-- ----------------------------------------------------------
| | [[Category:Disease]] |
| See http://en.wikipedia.org/wiki/Wikipedia:Footnotes for a
| |
| discussion of different citation methods and how to generate
| |
| footnotes using the <ref>, </ref> and <reference /> tags
| |
| ----------------------------------------------------------- -->
| |
| <div class="references-small">
| |
| <references />
| |
| * Alibek, K. Biohazard. New York, New York: Dell Publishing, 1999.
| |
| * {{cite web | title=''Bacillus anthracis'' and anthrax | work=Todar's Online Textbook of Bacteriology (University of Wisconsin-Madison Department of Bacteriology) | url=http://textbookofbacteriology.net/Anthrax.html | accessdate=June 17 | accessyear=2005}}
| |
| * {{cite web | title=Anthrax | work=CDC Division of Bacterial and Mycotic Diseases | url=http://www.cdc.gov/ncidod/dbmd/diseaseinfo/anthrax_g.htm | accessdate=June 17 | accessyear=2005}}
| |
| * {{cite web | title=Focus on anthrax | work=Nature.com | url=http://www.nature.com/nature/anthrax/index.html | accessdate=June 17 | accessyear=2005}}
| |
| * Chanda, A., S. Ketan, and C.P. Horwitz. 2004. Fe-TAML catalysts: A safe way to decontaminate an anthrax simulant. Society of Environmental Journalists annual meeting. October 20–24. Pittsburgh.
| |
| * Meselson, M. et al. (1994). "The Sverdlovsk Outbreak of 1979". Science 266(5188) 1202–1208
| |
| * Sternbach, G. (2002). "The History of Anthrax". The Journal of Emergency Medicine 24(4) 463–467.
| |
| </div>
| |
| | |
| ==External links==
| |
| *[http://www.bt.cdc.gov/agent/anthrax/index.asp Anthrax] - Comprehensive information from the [[Centers for Disease Control and Prevention]] (CDC)
| |
| *[http://www.logicalimages.com/resourcesBTAgents.htm Bioterrorism Category A Agents - Information Resources]
| |
| *[http://www.logicalimages.com/resourcesBTAgentsAnthraxCut.htm Cutaneous Anthrax Images and Diagnosis Synopsis]
| |
| *[http://www.udetection.com/product-bsm-2000.asp Anthrax Detection Device]
| |
| *[http://www.frankolsonproject.org/Articles/VictimsBlood.html Article re. Fort Detrick and Vollum strain of Anthrax]
| |
| *{{PDFlink|[http://deepblade.net/journal/Holland_JUNE2005.pdf Exports of biological materials to Iraq: mentions Vollum strain and Gruinard Island]|463 [[Kibibyte|KiB]]<!-- application/pdf, 474210 bytes -->}}
| |
| *[http://www.bt.cdc.gov/agent/anthrax/]
| |
| *[http://www.bt.cdc.gov/agent/anthrax/anthrax-images/cutaneous.asp]
| |
| | |
| {{Bacterial diseases}}
| |
| | |
| {{Link FA|he}}
| |
| [[cs:Anthrax]]
| |
| [[da:Miltbrand]]
| |
| [[de:Milzbrand]]
| |
| [[es:Carbunco]]
| |
| [[eo:Antrakso]]
| |
| [[fr:Charbon (maladie)]]
| |
| [[ko:탄저병]]
| |
| [[hr:Antraks (bolest)]]
| |
| [[id:Antraks]]
| |
| [[is:Miltisbrandur]]
| |
| [[it:Antrace]]
| |
| [[he:גחלת]]
| |
| [[ms:Penyakit Antraks]]
| |
| [[nl:Miltvuur]]
| |
| [[ja:炭疽症]]
| |
| [[no:Miltbrann]]
| |
| [[pt:Carbúnculo]]
| |
| [[ru:Сибирская язва]]
| |
| [[simple:Anthrax]]
| |
| [[sk:Slezinová sneť]]
| |
| [[sl:Vranični prisad]]
| |
| [[fi:Pernarutto]]
| |
| [[sv:Mjältbrand]]
| |
| [[ta:ஆந்த்ராக்ஸ்]]
| |
| [[uk:Сибірка]]
| |
| [[zh:炭疽病]]
| |
| | |
| {{SIB}}
| |
| | |
| [[Category:Bacterial diseases]] | | [[Category:Bacterial diseases]] |
| [[Category:Biological weapons]] | | [[Category:Biological weapons]] |
| [[Category:Livestock]] | | [[Category:Livestock]] |
| [[Category:2001 anthrax attacks]]
| |
| [[Category:Zoonoses]] | | [[Category:Zoonoses]] |
| [[Category:Medical disasters]] | | [[Category:Medical disasters]] |
| | [[Category:Emergency mdicine]] |
| | [[Category:Up-To-Date]] |
| [[Category:Infectious disease]] | | [[Category:Infectious disease]] |
| [[Category:Mature chapter]] | | [[Category:Dermatology]] |
| | | [[Category:Pulmonology]] |
| [[pl:Wąglik]] | | [[Category:Gastroenterology]] |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |
