Anthrax

1
Anthrax

• Malignant Pustule, Malignant Edema, Woolsorters
  Disease, Ragpickers Disease, Maladi Charbon,
  Splenic Fever

2
Overview

• Organism
• History
• Epidemiology
• Transmission
• Disease in Humans
• Disease in Animals
• Prevention and Control

3
The Organism
4
The Organism

• Bacillus anthracis
• Large, gram positive non-motile rod
• Vegetative form and spores
• Nearly worldwide distribution
• Over 1,200 strains

5
The Spore

• Sporulation requires
• Poor nutrient conditions
• Presence of oxygen
• Spores
• Very resistant to extremes
• Survive for decades
• Taken up by host and germinate
• Lethal dose 2,500 to 55,000 spores

6
History
7
Sverdlovsk, Russia, 1979

• 94 people sick 64 died
• Soviets blamed contaminated meat
• Denied link to biological weapons
• 1992
• Soviet President Yeltsin admits outbreak related
  to military facility
• Western scientists find victim clusters downwind
  from facility
• Caused by faulty exhaust filter

8
South Africa, 1978-1980

• Anthrax used by Rhodesian and South African
  apartheid forces
• Thousands of cattle died
• 10,738 human cases
• 182 known deaths
• Black Tribal lands only
• White populations untouched

9
Aum Shinrikyo

• Japanese religious cult
• Supreme truth
• 1993
• Unsuccessful attempts
  at biological terrorism
• Released anthrax from office building
• Vaccine strain used not toxic
• No human injuries
• Successful attempt in 1995
• Sarin gas release in Tokyo subway
• 1,000 injured 12 deaths

10
2001 Anthrax Letters
11
(No Transcript)
12
Anthrax Cases, 2001

• 22 cases
• 11 cutaneous
• 11 inhalation
• 5 deaths (all inhalation)
• Index case in Florida
• 2 postal workers in Maryland
• Hospital supply worker in NYC
• Elderly farm woman in Connecticut

13
Anthrax Cases, 2001

• 7 month old boy
• Visited ABC Newsroom
• Cutaneous lesion
• Initial diagnosis
• spider bite
• Punch biopsies confirmed anthrax

14
Anthrax Cases, 2001

• CDC survey of health officials following 9-11-01
• 7,000 reports regarding anthrax
• 4,800 phone follow-ups
• 1,050 led to lab testing
• 1996-2000
• Less than 180 anthrax inquiries

15
Anthrax Cases, 2001

• Antimicrobial prophylaxis
• Ciprofloxacin
• 5,342 prescribed
• 60 day regime
• 44 compliance
• 57 suffered side effects