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Epidemiology of ANTHRAX.pptx.......................
- 1. Epidemiology of Anthrax Prepared By KrupaMathew.M, Associate professor
- 2. INTRODUCTION • Anthrax isa severe infectious disease caused by Gram positive, rod shaped bacteria Bacillus anthracis. • Anthrax is found naturally in soil and generally affects domestic and wild animals around the world. • Humans usually catch the disease from infected animals and as a result of exposure to contaminated animal products due to the nature of their occupation.
- 3. Other names • Woolsortersdisease • Cumcumberland disease • Maladi charbon • Malignant pustule • Malignant carbuncle • Milzbrand splenic fever
- 4. DEFINITION OF ANTHRAX DEFINITION Itis primarily a disease of domestic and wild animals such as sheep, cows, horses, goats. It is derived from the Greek Word anthrakos or coal.
- 5. PROBLEM STATEMENT • Commonin Africa, South East Asia, China, South America, Turkey, Pakistan and India. • Grazing animal become infected through ingestion of spores in the soil. • Incidence in India-National centre of disease control (NCDC),Delhi, reported 6 outbreaks during 2014. • Reported mainly in Andhra Pradesh, Jammu and Kashmir, Tamil Nadu, Orissa.
- 6. EPIDEMIOLOGICAL DETERMINANTS Agent: • Anthraxis caused by the bacterium Bacillus anthracis. Cycle of infection: • The infected host sheds the vegetative bacilli onto the ground and these sporulate on exposure to the air. • The spores, which can persist in soil for decades, wait to be taken up by another host, when germination and multiplication can again take place upon infection. • Flies appear to play an important role in large outbreaks in endemic areas.
- 7. Host: • Infected animalshave haemorrhagic exudates in the mouth, nose and anus and these are filled with large numbers of bacteria. • Humans usually develop the cutaneous form of anthrax after skin contact with infected animal tissues such as hides, wool, bone, meal and blood
- 8. Environment • Anthrax epidemicsmostly found in areas which have alkaline and calcerous soil, warmer environment with periodic flooding. • Human anthrax occurrence is infrequent and sporadic mainly due to an occupational hazard. • This has been used by bioterrorist as a weapon E.g. In 2001, weaponized anthrax was delivered in letters through the united states mail, resulting in 11 cases of inhalational anthrax and 11 cases of cutaneous anthrax. Five people died with inhalational anthrax
- 9. Types • Cutaneous anthraxis the most common form of anthrax infection, and it is also considered to be the least dangerous. Infection usually develops from 1 to 7 days after exposure. • When anthrax spores get into the skin, usually through a cut or scrape, a person can develop cutaneous anthrax. • This can happen when a person handles infected animals or contaminated animal products like wool, hides, or hair. • Cutaneous anthrax is most common on the head, neck, forearms, and hands. It affects the skin and tissue around the site of infection. • Without treatment, up to 20% of people with cutaneous anthrax die. However, with proper treatment, almost all patients with cutaneous anthrax survive.
- 10. • Gastrointestinal anthraxhas rarely been reported in the United States. • Infection usually develops from 1 to 7 days after exposure. • When a person eats raw or undercooked meat from an animal infected with anthrax, they can develop gastrointestinal anthrax. • Once ingested, anthrax spores can affect the upper gastrointestinal tract (throat and esophagus), stomach, and intestines, causing a wide variety of symptoms. • Without treatment, more than half of patients with gastrointestinal anthrax die. However, with proper treatment, 60% of patients survive.
- 11. • Inhalation anthraxis considered to be the most deadly form of anthrax. • Infection usually develops within a week after exposure, but it can take up to 2 months. • When a person breathes in anthrax spores, they can develop inhalation anthrax. • People who work in places such as wool mills, slaughterhouses, and tanneries may breathe in the spores when working with infected animals or contaminated animal products from infected animals. • Inhalation anthrax starts primarily in the lymph nodes in the chest before spreading throughout the rest of the body, ultimately causing severe breathing problems and shock. • Without treatment, inhalation anthrax is almost always fatal. However, with aggressive treatment, about 55% of patients survive.
- 12. MODE OF TRANSMISSION Cutaneousinfection occurs through contact with products from infected animals (cattle, goat, sheep) such as leather or woolen goods or through contact with soil containing anthrax spores.
- 14. INCUBATION PERIOD • Generally1 to 7 days but varies with the form of disease. Symptoms of cutaneous anthrax appear after 2 to 3 days. • The incubation period for the gastrointestinal form is usually 2 to 5 days but may be as short as 15 hours
- 15. SIGNS AND SYMPTOMS Inhalational(Pulmonary) anthrax • Flu like symptoms lasts for few hours or days include sore throat, fever, fatigue and myalgia. • Chest discomfort • Shortness of breath • Nausea • Coughing up blood • Painful swallowing • shortness of breath and chest pain • Shock • Meningitis
- 16. Gastrointestinal Anthrax This iscaused by eating under cooked meat from an infected animal • Nausea • Vomiting • Abdominal pain • Headache • Loss of apetite • Fever • Severe bloody diarrhea in the later stages of the disease • Sorethroat and difficulty swallowing • Swollen neck
- 17. Cutaneous anthrax A cutaneousanthrax infection enters body through a cut or other sore on your skin. • A macula papular skin lesions • Painless sore with a black eschar • Swelling over the sore • Scab forms and dries and falls off within 2 weeks • Lymphadenopathy
- 18. DIAGNOSIS • Blood culture •Chest CT scan or chest x ray • Spinal tap to check infection around the spinal column • Sputum culture.
- 19. PREVENTION Animal handling: • Washthe hands with soap and running water after contact with animals or their faeces. • This includes playing with pets, touching animals in pet stores and petting zoos, and cleaning litter boxes or cages. • Disinfect all surfaces touched by animals, especially reptiles • Keep immunocompromised people, infants, and young children away from areas inhabited by animals, reptiles, and fowl.
- 20. TREATMENT • Penicillin isthe drug of choice • Antibiotics are typically used to treat anthrax. Antibiotics prescribed may include pencillin, doxycycline and ciprofloxacin.
- 21. Vaccination Anthrax vaccine Adsorbed(AVA) • Anthrax vaccine is approved by the Food and Drug Administration (FDA) and recommended for adults 18 to 65 years of age who are at risk of exposure to anthrax bacteria • These people should get 3 doses of anthrax vaccine, followed by booster doses for ongoing protection.
- 22. Prevention • Immunize highrisk persons • Educate employees • Control dust • Wash hands • Disinfect and sterilize all domestic animals at risk • Control of patient, contacts and the immediate environment
- 23. Control program The modelcountry program was designed by WHO. Activities: • Surveillance • Screening • Reporting • Vaccination • Health education
- 24. Reference • K.PARK,Text bookof preventive and social medicine,25th edition.,M/S Banarsidas Bhanot publisher,India. • e-book of Anthrax in humans and animals, WHO cataloguing-in-publication data, WHO Press.( https://who.int/csr/resources/publications/anthra x.pdf ) • Other websites: • https://www.ncbi.nlm.nih.gov/books