Question

1. List an outbreak report on Bacilus Anthricis. (Make sure to provide a clear statement of the outbreak, risk assessment and advice).

2. Describe the current risk for future infection based on the mode of transmission and steps taken to mitigate the outbreak.

3. Provide relevant advice to the public relating to the outbreak. Include information to reduce public risk of infection and identify signs and symptoms.

Answer 1

1. Anthrax is a life-threatening infectious disease caused by Bacillus anthracis that usually affects livestock, particularly ruminants (e.g. goats, cattle, sheep, and horses). By contact with infected animals or their goods, anthrax can be transmitted to humans.

The outbreak caused by Bacillus anthracis happened in 2016, in Siberia, Russia. This was a major outbreak of anthrax that sickened at least 13 Siberian people and killed over 2,000 reindeer. Authorities believe that a reindeer who died of anthrax 75 years ago was unburied by the melting permafrost, allowing anthrax spores to be released.

Risk factors include individuals working with animals or products for animals, travelers, postal workers, and military personnel.

If anyone exposed to spores, antibiotics are prescribed to prevent infection. The Food and Drug Administration allows ciprofloxacin (Cipro), doxycycline (Monodox, Vibramycin, others) and levofloxacin (Levaquin) for post-exposure anthrax protection for adults and children.

2 Anthrax can enter the human body through the intestines (ingestion), lungs (inhalation), or skin (cutaneous), resulting in distinct clinical symptoms based on the entry location.

Individuals at higher risk of anthrax infection include

• veterinarians,
• livestock producers and farmers,
• travelers to areas where anthrax is endemic,
• handlers of animal products (for example, animal hides),
• laboratory personnel that study anthrax, and
• mail handlers, military personnel, and individuals trained to respond to bioterrorists and/or biological warfare.

3. Diseases caused by anthrax: cutaneous (skin) anthrax, inhalation anthrax, gastrointestinal (bowel) anthrax, and the newly designated injection anthrax.

1. The cutaneous (skin) form of anthrax (80% of all anthrax infections) begins as an elevated red-brown spot that enlarges, blistering and hardening with considerable redness around it. symptoms include pain and muscle aches, headache, fever, nausea, and vomiting. The disease usually resolves in about six weeks, but if patients do not receive adequate antibiotics, death may occur.

2. Injection anthrax.

It may take days to months before symptoms appear. Signs and symptoms of anthrax injection may include small blisters or bumps that may come in at the injection site, fever, and chills, swelling around the sores, and may grow deep abscesses under the skin or muscle. Painless skin sores with black centers (dark scabs) may appear after the blisters or bumps develop.

3. Inhalation anthrax. With a sore throat and nausea, the first symptoms are vague, incremental and flu-like (influenza). Nevertheless, in a few days, the disease worsens and severe respiratory failure besides shortness of breath and pain in the lungs and/or muscles can occur.

4. Gastrointestinal anthrax. Nausea, loss of appetite, bloody diarrhea and fever followed by abdominal pain are the symptoms of this form of anthrax. The bacteria penetrate the surface of the intestine. The disease then spreads throughout the body with deadly toxicity through the bloodstream (septicemia).