ANTHRAX

By : Suryanie Sarudji, MKes.,

DVM

ANTHRAX PERACUTE –ACUTE DISEASE CHARACTERIZED BY

SEPTICAEMIA, SUBCUTAN SEROHAEMORRAGIC CONTAGIOUS & ZOONOSIS FEVER WITH TEMP OF 42OC SUDDENLY DIE WITH THE EXUDATION OF TARRY

BLOOD FROM THE BODY ORIFICES, FAILURE OF THE BLOOD TO CLOT

ABSENCE OF RIGOR MORTIS PRESENCE OF SPLENOMEGALY WHEN NECROPSY

ARE DONE CALLED BY RADANG LIMPA DISEASE (INA)

ETIOLOGY : BACILLUS ANTHRACIS

Encapsulated Large gram-positive rods on Gram stain, Nonmotile, Nonhemolytic

Vegetative and spores form Sporulation requires : = Poor nutrient conditions = Presence of oxygen Spores :• = Very resistant to extremes environment• = Survive for decades• = Taken up by host and germinate Lethal dose 2,500 to 55,000 spores Capsule found from specimen. From the culture, bacteria formed chain

EPIZOOTIOLOGY

OCCUR AT MAJOR CLIMATE CHANGE IN LACK OF NUTRIENT : HEAVY RAIN AFTER PROLONGED DROUGHT

OUTBREAKS ORIGINATING FROM SOIL-BORNE INFECTION

GROUND DISEASE: WHEN SOIL ARE WET, HUMID, FLOOD, SWAMP AND ALKALINE

SUSCEPTIBLE ANIMALS : RUMINANT, MARMOT, RABBIT

TRANSMISSION :

Animal Transmission

DIRECTLY : NO! INDIRECLY : ORAL, CUTAN, INHALATION AS TRANSMITTEN : CARNIVORES, WILD

BIRD (BURUNG PEMAKAN BANGKAI), MILK, FLIES, INSECTS, SOIL AND WIND

INCUBATION PERIOD 1-3 DAYS---->14 DAYS SUDDENLY DEATH IN 36 HOURS

Most commonly infected by ingestion from contaminated soil or contaminated feed or bone meal

Human Transmission

Industry• Tanneries• Textile mills• Wool sorters• Bone processors• Slaughterhouses

Cutaneous• Contact with infected

tissues, wool, hide, soil• Biting flies

Inhalational• Tanning hides,

processing wool or bone Gastrointestinal

• Undercooked meat

PATHOGENESIS

B. ANTHRACIS : ANTIGENT DAN TOXIN ANTIGENT : SOMATIC Ag ---> RESISTANT TO PHAGOCYTES

CAPSULAR Ag --> POLYGLUTAMIC ACID : TOXIC AND ANTIPHAGOSITOSIC

TOXIN : PROTEIN COMPLEK TOXINS : EDEMA FACTORS : DEMAGE ENDOTHEL PROTEKTIF ANTIGEN : DEPRESS CORTEX CEREBRI

ELECTRIC

LETHAL FACTORS : INCREASE PERMEABILITY OF

BLOOD VESSELS = CAPILIER (LUNGS) ---> EDEMA INTERSTISIALIS ---> SFACE OF INTER ALVEOLARIS & BRONCHIAL FULL OF EXUDAT, LYSES OF ERYTHROCYTES -- BLOOD BECOME BLACK COLOUR

ORAL Spore Veg cell capsule Ag&Toxin Veg cell

Septicemia penetrate blood EH endothelia damaged vessels lyses E, Phagocytes

spleen splenomegali

O2 & CO2, Plasma excrete udema, blood viscous

Resp alkalosis Tachycardia Shock Met Acidosis dead

INHALATION

inhibit Nicotinamide O2 aren’t able to Ag& toxin dinucleatide bound by Hb depress Cortex Cerebri CO2 aren’t able to released

by Hb Vasoconstriction of Bronchi Hypoxia O2 titanic paralysis dyspnea of intercostalis

Tachycardia blood presser

Shock blood presser dead

SKIN

Ag & Toxin damage phagocytes & capillary

Septicemia Regional Lgl Bleeding

As like as transmission by oral

TO INDENTIFY DISEASE

CLINICALS : Suddenly death Sopor, collapse, oedem Fever high temp Frequency in breath

(respiration rapid and deep)

Blood excrete from body orifices and fail to clot

Tremor, kaki dihentak-hentakan

Difficult to defecate and pain

Shock

POST MORTEM: (“Forbidden to necropsy”) Bleeding in wide area Blood aren’t able to clot Absence of Rigor Mortis Spleen appear like Tar Gastrointestinal contain

blood Peritoneum filled by

exudates

Clinical Signs in Animals

Signs differ by species• Ruminants at greatest risk

Three forms of illness• Peracute

• Ruminants (cattle, sheep, goats, antelope)

• Acute• Ruminants and equine

• Subacute-chronic• Swine, dogs, cats

Copyright WHO

Ruminants Peracute infection

• Rapid onset• Sudden death• Bloody discharge from

body orifices• Incomplete rigor mortis• Rapidly bloat

Ruminants Acute infection: 1-3 days

• Fever, anorexia• Decreased rumination• Muscle tremors• Dyspnea• Abortions• Disorientation• Bleeding from orifices• Hemorrhages on internal organs

Ruminants

Chronic infection• Pharyngeal and lingual edema• Ventral edema • Death from asphyxiation

Treatment successful if started early

Equine Ingestion

• Enteritis, severe colic, high fever, weakness, death within 48-96 hours

Insect bite/vector• Hot, painful swelling• Spreads to throat, sternum,

abdomen, external genitalia• Death

Copyright WHO

Swine

Sudden death without symptoms Localized swelling of throat Death by asphyxiation Ingestion of spores

• Anorexia, vomiting, enteritis

Dogs & Cats Relatively resistant

• Ingestion of contaminated raw meat

Clinical signs• Fever, anorexia, weakness• Necrosis and edema of upper GI tract• Lymphadenopathy and edema of head and neck• Death

• Due to asphyxiation, toxemia, septicemia

Diagnosis and Treatment

Necropsy not advised! Do not open carcass! Samples of peripheral blood needed

• Cover collection site with disinfectant soaked bandage to prevent leakage

DIAGNOSIS

BASED ON :

Clinic Signs Necropsy finding (if we’d done too far )

Bacteriologic examination Biologic test Serologic test

Differential Diagnosis

Blackleg Botulism Poisoning

• Plants, heavy metal, snake bite

Lightening strike Peracute babesiosis

TREATMENTS

Administrative Prevention, Control and Elimination Therapy

1. ADMINISTRATIVE

Report to authorities (livestock service & head of district)

Report from livestock service to Directorate General of livestock & head of districts

Send specimen to authority lab Announce/statement about an area was found or

free from anthrax. The announcement be carried out by head of a district

2. Prevention

Quarantine the area Do not open carcass Minimize contact Wear protective clothing

• Latex gloves, face mask

Vaccination of susceptible animals

Animal Anthrax Vaccine :

Recommended for livestock in endemic areas Sterne strain

• Live encapsulated spore vaccine

Immunity in 7-10 days Other countries use in pets and exotics

• No safety or efficacy data

• Adjuvant may cause reactions

Working dogs may be at risk

3. Control and Elimination

Burn or bury carcasses,bedding, other materials

Decontaminate soil Remove organic

material and disinfect structures

Free district: closely control come in and come out of animals

Prevent healthy animals from disease by vaccine each year especially in area of enzootic

Suspected animals: • Inject with antiserum with prevention dose• Inject with antibiotic of therapy dose• Inject simultaneously with Antiserum and

antibiotic• Considered to treat with chemotherapy or

combine chemotherapy with antiserum

Isolate the disease animals in place where they got ill. Near at the place make hole in deep of 2 – 2.5 M to fill with waste of food and feces.

After animals dead/recovery/the hole was load by 60 % of wastes, the hole be covered by fresh ground

Not advised to slaughter the disease animals Suspected animals not be moved from their place

and the other animals not come to the place When the suspected animals appear the sign of the

disease, the animals is treated as like as point 1. When the suspected animals in 14 day aren’t appear

illness, the animals are stated as health animals

= At the entry of suffered animals place be announced about “Contagious Disease” acompanied by the name of local termination

= Cadavers be burned and buried in hole of the depth of minimal 2 meters

= After animals death/recovery, stable be decontaminated. Materials that easy to burn are burned

= The area are supposed to no more disease after 14 days from the last of animals disease are dead or recovery

To ovoid transmitted by insect, use insecticide

Ovoid the cadaver are eaten by carnivore or animals that eat cadaver

General sanitation for the people who contacted with sufferer

Disinfection :

Effective disinfection may be difficult Prevention of sporulation best Soil

• 5% lye or quicklime• Hydrogen peroxide, peracetic acid or

gluteraldehyde Bleach 1:10 dilution

• May be corrosive

Preliminary disinfection• 10% formaldehyde• 4% glutaraldehyde (pH 8.0-8.5)

Cleaning• Hot water, scrubbing, protective clothing

Final disinfection: one of the following• 10% formaldehyde • 4% glutaraldehyde (pH 8.0-8.5)• 3% hydrogen peroxide,• 1% peracetic acid

4. THERAPY

Antibiotic : Penicillin and Tetracycline Therapy with antiserum. Dose for big

animals is 100 – 150 ml, small animal is 50 – 100 ml. Antiserum homolog subcutaneous or intra vena, antiserum heterolog subcutaneous.

Suspected animals inject with antiserum with preventive dose.

Antiserum can be combined with antibiotic or chemotherapy. Antibiotic alone are given with high dose