Anthrax

Anthrax is an acute disease, caused by a bacterium known as Bacillus anthracis. Anthrax is most likely to occur in mammals and herd animals such as sheep and cattle, and other herbivores such as camels and antelopes. Human beings can be naturally exposed to the agent through such animals, by either consuming them or working with the animal parts.

Unfortunately, today it is most known for its role in biological warfare and, most recently, for its use as a bioterrorist weapon after 9-11. In reality, anthrax may have been among us since biblical times. It is believed that reports of great plagues sweeping the human race could well have been anthrax outbreaks but this is only speculation. To use anthrax as a biological warfare is inhumane, ethically and morally wrong. We now live in a global world where our neighbors are only a few hours away by plane and therefore, considering this type of bio-warfare is dangerous to the whole globe!

Death by anthrax is recognized by its suddenness, and by the non-clotting, dark-colored blood that leaks from the body’s orifices. Anthrax that remains in the body after death is usually destroyed by the body’s anaerobic bacteria within a very short time after death (minutes to several hours). However, anthrax can “escape” the dead body via the oozing blood, and form into a spore that can become dormant, essentially “laying in wait” for later reactivation and infection.

History of Anthrax

Anthrax used to be known as Woolsorters’ or Ragpickers’ disease, because those professions exposed the workers to animal products that were possible carriers of the spores. Other professions involving the handling of potentially exposed animals include those that carve animal horns and tusks (for use in manufacturing buttons), those who handle hair and fur (for use in making bristle brushes), or those that involve working with animal skins. The animal may not have been infected by the spores, but may have merely acted as a transporter of the spore that could have been picked up from simply resting on the ground or digging in the soil where the spores existed. I believe that as we improved sanitation in developing countries, the threat was diminished greatly.

Today, cases of natural exposure to anthrax in the United States are exceedingly rare. The Centers for Disease Control (CDC) show only two official cases of wild anthrax by ingestion (gastrointestinal infection) in the history of the United States. In 1942, the case resulted in death, and in 2010, the person survived. It was believed that the woman who survived contracted the infectious agent through a drum she had played that was made in Africa. (speculation) The last known case of death by natural anthrax inhalation—versus by intentional inhalation such as with bioterrorism—in the United States was from a weaver who was exposed to the deadly agent in wool from Pakistan.

The use of anthrax as biowarfare was used against the US after the 911 attack. A post office was closed down on Oct. 18, 20021 after anthrax-laced letters were discovered. (See death from Anthrax) Four people may have died from that exposure.

When was Anthrax Discovered

In 1876, Robert Koch showed that the bacterium caused disease. Koch, a German physician and scientist, revealed to the world the life cycle and modes of disease transmission via demonstrations and experiments. Koch worked with not only anthrax, but also tuberculosis, and his groundbreaking studies lead to great discoveries for treatment and improved understanding of infectious agents. In 1905, Koch was awarded the Nobel Prize for his work.

Louis Pasteur used anthrax to demonstrate his theory of vaccination. In 1881, he injected one group of sheep with his anthrax vaccine, and thirty days later, injected the vaccinated group and a non-vaccinated group of sheep with the live anthrax bacteria. The non-vaccinated group did not survive, while the vaccinated sheep did. A vaccine for humans was released in 1954, and was improved to a cell-free vaccine in 1970.

Anthrax was first used as a biological weapon by the Scandinavian against the Imperial Russian Army in 1916. The results are unknown, but in the 1930s, the Japanese in Manchuria tested anthrax as a biological agent on prisoners of war, injecting and killing thousands.

Anthrax Strains

Anthrax is caused by the bacterium Bacillus anthracis. Infection can occur through:

• Inhalation: Through breathing in spores. Ten to twenty thousand inhaled spores lead to a potentially lethal infection.
• Gastrointestinal: Through ingestion of spores or infected animal products.
• Cutaneous: Through open wounds or cuts in the skin.

It is believed that low amounts of exposure to the bacteria occur more often than we may realize, and are resisted by the body’s natural immune system.

Method of Exposure

Dormancy and reactivation: Anthrax, as a member of the genus Bacillus, can become dormant in the form of an endospore. (Endospore is commonly referred to as a “spore,” but should not be confused with a fungal spore.) The dormant anthrax spore can survive in very harsh environments for centuries. Spores have even been identified in Antarctica. When the spore is reactivated through inhalation or ingestion, or through the body’s tissues, it can quickly multiply.

Ingestion and inhalation: Cattle, sheep, and other grazing mammals can ingest or inhale the spores. In turn, carnivores that consume the infected herbivore then become infected, and in turn, other carnivores (humans included) that ingest the infected carnivore can become infected with the disease. Humans may also become infected by direct contact, if the infected blood of the diseased animal comes in contact with the broken skin of a human.

Bioterrorism: Anthrax is produced for use as a biological weapon. The spores, which are the infectious agent, can be easily transmitted on a person’s body, exposing others in proximity to potentially inhale the spores.

Mechanism of the Disease Within the Body

The spores, once reactivated, produce powerful exo-toxins within the host (the body of the animal that ingested or otherwise consumed the spore). The toxins enter the cells, and death of the cell is rapid. It is not known precisely how the toxin results in the death of the cell, except that it binds with protein components that create: i) what is known as a “resistant complex;” and, ii) a toxic and acidic environment.

Parts of the Body Infected

• Pulmonary: Inhaled spores result in respiratory infection. Humans may exhibit cold or flu symptoms, which ultimately result in respiratory collapse. Death by anthrax due to respiratory infection was thought to be inevitable (92% mortality), until the World Trade Center-related anthrax attacks showed that early treatment can reduce mortality to 45%, greatly increasing the likelihood of survival. When not treated early, the death rate remains extremely high at 97%.
• Gastrointestinal: Infection by ingestion (obtained by either eating anthrax-infected animal meat or by ingesting dormant spores) results in inflammation of the intestinal tract, causing major gastrointestinal upset in the form of severe diarrhea, vomiting of blood, and loss of appetite. Death by gastrointestinal infection is 25% – 60%, depending on how quickly the infection can be treated.
• Cutaneous (On the Skin): Anthrax can enter the body through sores or cuts on the skin, and occurs most commonly in humans when handling infected animals or animal products. With treatment, cutaneous anthrax infections are rarely fatal. Without treatment, 20% of cutaneous anthrax infections result in death. Curiously, though the infection creates major lesions that can be quite large and cause extreme discoloration, there is usually no pain associated with it.

How Does it Spread and Multiply in the Body

The bacterium in spore form becomes reactivated under the right conditions. Once reactivated, the spores germinate, and spread into the tissues of the host. The spores spread very quickly via the body’s natural circulation to the lymph nodes. The resulting bacilli enter the bloodstream, and release three proteins. The proteins by themselves are not toxic, but together form a resistant and toxic complex that can be – and, when left untreated, often is lethal.

• Ingestion: One hypothesis is that the eating of rough vegetation can create open wounds within the intestinal tract, which allows the ingested spores to enter the tissues of the animal, where through the body’s natural processes; the infectious agent quickly enters the bloodstream. This is the rarest form of infection by anthrax in the United States.
• Inhalation: The spores are breathed in, and travel through the air passages to the alveoli in the lungs, which are the tiny, sac-like structures in the lungs. The body’s natural processes pick up the spores via scavenger cells (macrophages) and transport them to the lymph nodes, where the spores germinate and multiply, causing the scavenger cells to burst. The germinated spores (now bacilli) are released into the blood stream. Inhalation is the most common mode of transportation (and infection) in humans.

Illness duration

Cutaneous (on the skin): Usually, an infection forms within 2 to 5 days of exposure to the infectious agent. An itchy, raised bump occurs, much like an insect bite that rapidly changes into what is known medically as an “ulcer” – a skin lesion, about 1-3 cm in diameter. The ulcer occurs within 1-2 days of the first sign of the infection, and then turns black, indicating “necrosis” – death of the cell. Lymph nodes may also become swollen as the immune system gets engaged in fighting the illness.

Gastrointestinal: Gastrointestinal discomfort quickly progresses from nausea, fever, abdominal distress and pain, and loss of appetite to vomiting of blood and severe diarrhea. Inhalation: The first symptoms occurring include low-grade fever, sore throat, and general aches and pains. Within 2-3 days, severe breathing difficulty occurs, and often the victim goes into shock, followed quickly by death.

We will never know when we could be exposed to this terrible disease and let us hope it is not an accidental leak from a laboratory where they are working on a bio-warfare agent! That seems to be the most likely way that this disease could be introduced into this country.