AN ANCIENT DISEASE IN A DIFFERENT AVATAR..Introduction
A "Gram positive" bacterium means it has the type of cell walls which are harmless, unlike the cell walls of "Gramnegative" bacteia, which attack tissue. Therefore, anthrax canonly attack tissue by producing a special toxin that it excretes.A few cells or spores do not produce enough toxin to start aninfection. Studies have apparently determined that, typically,ten thousand anthrax spores must be inhaled to start aninfection. Anthrax normally attacks the lungs, becauseit must lodge in vulnerable tissue.
Naturally occurring anthrax is a disease acquired following contact withanthrax-infected animals or anthrax-contaminated animal products. Infectiongains entrance in the body by ingestion, inhalation or through the skin. Thedisease most commonly occurs in herbivores, which are infected by ingestingspores from the soil. Biting flies and other insects have often been found toharbour anthrax organisms but the transmission is mechanical only.
Anthrax in Humans
Anthrax infection can occur in three forms: cutaneous (skin), inhalationand gastrointestinal. The clinical picture varies depending on how the diseasewas contracted, but symptoms usually occur within seven days.
The bacterium enters a cut or abrasion onthe skin, the infection begins as a papule resembling an insect bite but within 1-2 days develops into a vesicle and then a painless ulcer, usually 1-3 cm indiameter, with a characteristic blank necrotic area in the centre. Lymph glandsin the adjacent area may swell. Deaths are rare with appropriate antimicrobialtherapy.
After initial respiratory trouble, thesymptoms may progress to severe breathing problems and shock. Inhalationanthrax usually results in death in 1-2 days after onset of the acute symptoms.On entry of the spores, macrophages try to engulf many of them. Survivingspores are transported via lymphatica to mediastinal lymph nodes, wheregermination may occur up to 60 days later. The process responsible for thedelayed transformation of spores to vegetative cells is poorly understood butwell documented. The toxins are released by the colonizing bacteria leading tohaemorrhage, oedema, and necrosis.Production of the anthrax toxin is mediated by a temperature-sensitive plasmid. The toxin consists of three distinct antigenic components. They are-theoedema factor, which is necessary for the oedema producing activity of thetoxin: Factor-II is the protective antigen (PA), because it induces protectiveantitoxic antibodies in guinea pigs: Factor-III is known as the lethal factor because it is essential for the lethal effects of the anthrax toxin. Once toxin production has reached critical threshold, death occurs even if sterility of the
Dr kedar karki.(M.V.St. Preventive Medicine)