|
|
 |
What You Should Know About Anthrax
The recent incidents of anthrax exposure have raised concern about this disease and its possible use as a terrorist weapon. This bulletin is intended to provide information about anthrax in order for companies and individuals to detect, respond to, and prevent the possibility of contracting this disease.
What is anthrax?
Anthrax is an acute infectious disease caused by a spore-forming bacteria. It was usually found in agricultural regions where it was transmitted through infected animals (cattle, sheep, goats, camels, antelopes, and other herbivores) or through soil contaminated by diseased animal skins and carcasses. Although rare, occupational risk groups had included laboratorians, those in contact with livestock or livestock products, e.g. veterinarians, tannery and wool workers or animal handlers. Due to recent developments, mail handlers and high profile individuals have also been put on alert. Until recently, anthrax was rarely found in North America outside of laboratories. If diagnosed early, most forms of anthrax can be treated successfully with antibiotics.
Where is anthrax found?
Although the bacterium, bacillus anthracis, is found naturally in the environment, it's most commonly found in developing countries or countries without veterinary health programs. Certain regions of the world (South and Central America, Southern and Eastern Asia, Africa, the Caribbean, and the Middle East) reported more anthrax in animals than other regions. Anthrax spores from infected animal hides or carcasses can live in the soil, water or other materials for many years. However, the spores are vulnerable to the sun's ultraviolet rays and other weather conditions. In the United States, many laboratories have had anthrax for various experimental purposes.
What does anthrax look like?
Anthrax spores themselves are too small to see. If the spores are mass-produced, then dried, they may resemble a fine powder when concentrated. If anthrax were converted to an aerosol form or pumped into a building ventilation system and dispersed, it would be undetectable to the eye.
How is anthrax transmitted?
Anthrax is a single bacterium which can infect people in three ways: through the skin (cutaneous), by inhalation (pulmonary) or by ingestion (gastrointestinal). Human to human transmission is extremely rare and only reported with cutaneous anthrax.
- Cutaneous anthrax occurs when the bacterium enters a cut on the skin, such as when handling contaminated wool, hides, leather, or hair products of infected animals (which accounted for about 95% of reported cases) and more recently, mail handlers. A cutaneous exposure responds well to antibiotics if treatment is started soon after symptoms appear.
- Pulmonary anthrax is contracted from inhaling tiny airborne spores. The spores must be a precise size and shape (3-5 microns) to enter the lungs and must be airborne for enough time to be inhaled by the thousands before it can cause harm. Once in the lungs, bacteria begins to germinate and spread to chest tissue producing toxins that can then enter the bloodstream. Without quick treatment, this form of the disease is usually fatal.
- Gastrointestinal anthrax is very rare but can be contracted from eating the undercooked meat of infected animals. Antibiotic treatment started soon after symptoms appear has been effective.
What are the symptoms of this disease?
Symptoms of the disease vary depending on how it was contracted. Symptoms usually appear between 12 hours and five days after exposure to the bacteria, but can take up to six weeks to appear.
- Skin infection from anthrax begins as a raised, itchy bump resembling an insect bite but in one or two days the infection becomes a painless ulcer with a black center. There may also be swelling of the lymph glands in the adjacent area.
- The first symptoms of anthrax inhalation may resemble a common cold or the flu. After several days, the victim may experience difficulty breathing, heavy sweating, blue-colored skin, and shock.
- Intestinal anthrax is characterized by an acute inflammation of the intestinal tract. Initial signs are nausea, loss of appetite, fever, abdominal pain, vomiting blood, and severe diarrhea.
Can an anthrax infection be treated?
Because anthrax is not a virus, it can usually be treated with antibiotics. A wide variety of antibiotics including penicillin and doxycycline as well as ciprofloxacin and other antibiotics in its class (the fluoroquinolones) can kill the anthrax bacteria, but only if they are given before or shortly after symptoms start. Asymptomatic individuals who may have been exposed to anthrax may be advised to take antibiotics for a limited time.
Federal health officials say they can fly ample supplies of ciprofloxacin to anywhere in the U.S. within 12 hours of an outbreak. In addition, the Center for Disease Control is in continuous contact with various national security agencies for updates and analyses of biothreat agents to ensure that the National Pharmaceutical Stockpile program reflects current needs.
Should I take antibiotics to prevent getting the disease?
It is dangerous for people to take antibiotics merely because they fear being infected with anthrax. The antibiotics used to treat anthrax are powerful and potentially toxic. Ciprofloxacin (Cipro) does not make people immune to the disease and taking it may lower the body's ability to fight other illnesses and could even hamper doctors from diagnosing an anthrax infection. Ciprofloxacin in children has serious side effects such as bone and joint disorders. Precautionary use of antibiotics when there is no actual exposure not only weakens resistance against other diseases and but can deplete the supply of drugs that might be needed in a real emergency.
Is there an anthrax vaccine and who should take it?
An anthrax vaccine was licensed by the FDA in 1970 for at-risk veterinary and laboratory workers and livestock handlers. The Department of Defense also reserves a stockpile of the vaccine for military use. Anthrax vaccines intended for animals should not be used in humans.
The advisory Committee on Immunization Practices has recommended anthrax vaccination for persons who work with imported animal hides or furs, those who handle potentially infected animal products in high-incidence areas, and military personnel deployed to areas with high risk for exposure to the organisms.
Is there a way to prevent anthrax infection?
There is no evidence that anthrax is "contagious" from human to human, but using common protection and sanitation techniques are essential in preventing exposure. Individuals should also avoid eating meat that has not been properly slaughtered or sufficiently cooked.
Should you get tested?
Individual testing for anthrax is not recommended unless an individual shows signs of infection or has been in an outbreak area. There is currently no home test available.
Would a gas mask provide protection?
Only custom-fitted gas masks with special filters worn during exposure are effective against inhaled anthrax. And experts say it's unlikely people would know they are being exposed until it's too late to put on the mask.
How can anthrax be used as a terrorist weapon?
Although anthrax is fairly easy to acquire, a terrorist would need detailed knowledge and sophisticated facilities to mass-produce anthrax spores or even find the most potent strains of the bacteria. Distributing it is difficult. Only extremely fine, dry anthrax powders can make it to the lungs. To be effective as a weapon, the anthrax spores must remain airborne in sufficient concentrations to allow victims to inhale large numbers. However, there are several countries have already "weaponized" this disease into a highly lethal inhaled form. In its most destructive form-an aerosol sprayed into the air-it is invisible and odorless. In a dry, powder form, it can remain potent for decades.
How can companies prepare and protect their employees?
A strong and flexible infrastructure is the best defense against any disease outbreak. It would be prudent for companies to have a coordinated response plan in place. This response should include, at minimum, training of all personnel in the following:
- how anthrax is transmitted, how to recognize it, and how to respond to an anthrax detection
- how to deal with items suspected of containing chemical or biological contaminants
- what appropriate protective measures will help safeguard employee exposure e.g. gloves, hand washing, etc.
- immediate procedures to minimize anthrax contamination e.g. secure area, turn off ventilation units, list all individuals who may have been in the affected area or handled the contaminant, etc.
- medical first responder and public health official notification procedures law enforcement notification procedures
- In the event of a public health emergency, local and state health departments will inform the public about the actions individuals need to take.
Where can I find more information about anthrax?
For further information regarding anthrax, you can access the Center for Disease Control and Prevention's internet site at www.cdc.gov/ncidod/dbmd/diseaseinfo/anthrax_g.htm. They will continue to post information regarding the most common questions about this subject as well as the latest information on their preparedness efforts.
For information about how to handle suspicious mail, see the attached CDC Health Advisory, “How to Handle Anthrax and Other Biological Agent Threats,” or visit the U.S. Postal Service website at: www.usps.com/news/2001/press/pr01_1010tips.htm.
Additional Article:
Official CDC Advisory -How To Handle Anthrax And Other Biological Agent Threats
"Information or recommendations contained in these articles were obtained from sources believed to be reliable at the date of publication. Information is only advisory and does not presume to be exhaustive or inclusive of all workplace hazards or situations."
The above evaluations and/or recommendations are for general guidance only and should not be relied
upon for legal compliance purposes. They are based solely on the information provided to us and relate
only to those conditions specifically discussed. We do not make any warranty, expressed or implied, that your workplace is safe or healthful or that it complies with all laws, regulations or standards.
|
|
