Ántrax cutáneo, último brote diagnosticado en Chile / Cutaneous anthrax, the last outbreak diagnosed in Chile

Resumen El ántrax, es una zoonosis causada por una bacteria generadora de esporas, llamada Bacillus anthracis. En forma natural tiene una distribución global, con una predilección en zonas agrícolas con pocas normativas de sanidad pública veterinaria. El contagio humano ocurre por el consumo de carnes de animales enfermos, por contacto a través de una puerta de entrada en la piel o por la inhalación de esporas de productos derivados del animal afectado (lana, cuero, huesos). La infección en los seres humanos compromete con mayor frecuencia la piel, seguido por el tracto gastrointestinal y los pulmones. El control de la enfermedad se basa en la prevención, de allí la importancia de la vigilancia en la detección de casos y brotes. Presentamos el último brote de ántrax cutáneo diagnosticado en Chile con descripción de dos primeros casos clínicos del brote.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

Selected infectious disease disasters for nursing staff training at Egyptian eastern border

Infectious disease disasters are events that involve a biological agent, disease and that result in mass casualties, such as a bioterrorism attack, an emerging outbreak of infectious disease; all disasters pose a risk of infection transmission. But, infectious disease disasters pose the great-risk to illness or death from an infectious disease. This study raised the awareness and improved knowledge by educational program for Military Nursing Staff on selected infectious disease disasters acquired at Egyptian Eastern Border. The selected arthropodborne diseases were Anthrax, Tick borne relapsing, Louse borne replasing fever and liver fluke; Clonorchis sinensis. An interventional study was used, for 125 staff nurse who accepted to participate. The tools dealt with four questionnaires: [1] Some socio-demographic characteristics data [2] Educational needs assessment a structured questionnaire. [3] Knowledge test [pre/ post-test] and [4] Participants' reactions questionnaire. The results showed that educational intervention significantly improvements the nursing staff knowledge, which were achieved at the immediate post intervention phase, and retained via three months post-test phase. In the service training programs about infectious disease disasters at Egyptian Eastern Border must be established and continued on regular basis. This would improve their knowledge about the epidemiology of these infectious disease disasters

Anthrax outbreak in Iraq

An early report received from Dahuk province of Northern Iraq suggests an outbreak of Anthrax in humans. Three villages in the district of Aqra in Dahuk province reported 37 suspected cases of Cutaneous anthrax. Earlier anthrax has been laboratory confirmed in animals in same area by the state veterinary services and deaths of livestock have been reported from the same villages reporting suspected cases of cutaneous anthrax. Similar suspected cases of human Cutaneous anthrax and animal deaths have also been reported from Afghanistan and are currently being investigated

Anthrax in cattle in southern Brazil: 1978-2006

Ten outbreaks of anthrax occurred in cattle from 1978 to 2006 in southern Brazil, in 5 municipalities on the border with Uruguay, a country where the disease is frequent. The 10 outbreaks represented 0.2% of all bovine specimens received during the period by the Regional Diagnostic Laboratory of the Federal University of Pelotas, causing 267 deaths in a risk population of 6,605 head. The disease affected young and adult cattle mainly during summer. Only one farmer reported that sheep and horses were also affected. Clinically the peracute form was more frequent, but in some outbreaks the acute form with a clinical manifestation period of 6-48 hours was also observed. The source of infection was not established; but the reduced rainfall, associated with low, flat, flooded lands used for agriculture followed by animal grazing after harvest was probably related to the disease occurrence. Annual vaccination is an efficient way to prevent the disease.

Foi realizado um estudo retrospectivo da ocorrência de carbúnculo hemático em bovinos na área de influência do Laboratório Regional de Diagnóstico (LRD) da Faculdade de Veterinária da Universidade Federal de Pelotas. Entre 1978 e março de 2006, dez surtos da enfermidade ocorreram em cinco municípios da região sul do Rio Grande do Sul, todos localizados na fronteira com o Uruguai. A enfermidade representou 0,2% dos diagnósticos realizados no LRD no período. Ocorre em bovinos jovens e adultos, principalmente em verões quentes e secos, e com menor freqüência em outras épocas do ano. Freqüentemente, a doença se apresenta na forma hiperaguda, entretanto casos de carbúnculo hemático agudo podem ser observados. Não foi possível estabelecer a origem das infecções, mas precipitações pluviométricas menores que as normais, em campos planos, sujeitos a alagamentos freqüentes, utilizados para plantio e posterior uso das restevas (restolhos) para a criação dos animais podem ter favorecido a ocorrência dos surtos. A prática da vacinação anual dos animais é a forma de evitar eficientemente os surtos da doença.

Cutaneous reactions in nuclear, biological and chemical warfare.

Nuclear, biological and chemical warfare have in recent times been responsible for an increasing number of otherwise rare dermatoses. Many nations are now maintaining overt and clandestine stockpiles of such arsenal. With increasing terrorist threats, these agents of mass destruction pose a risk to the civilian population. Nuclear and chemical attacks manifest immediately while biological attacks manifest later. Chemical and biological attacks pose a significant risk to the attending medical personnel. The large scale of anticipated casualties in the event of such an occurrence would need the expertise of all physicians, including dermatologists, both military and civilian. Dermatologists are uniquely qualified in this respect. This article aims at presenting a review of the cutaneous manifestations in nuclear, chemical and biological warfare and their management.

An outbreak of cutaneous anthrax in a non-endemic district--Visakhapatnam in Andhra Pradesh.

BACKGROUND: Anthrax is a disease of herbivorous animals, and humans incidentally acquire the disease by handling infected dead animals and their products. Sporadic cases of human anthrax have been reported from Southern India. METHODS: Five tribal men presented with painless ulcers with vesiculation and edema of the surrounding skin on the extremities without any constitutional symptoms. There was a history of slaughtering and consumption of a dead goat ten days prior to the development of skin lesions. Clinically cutaneous anthrax was suspected and smears, swabs and punch biopsies were taken for culture and identification by polymerase chain reaction (PCR). All the cases were treated with intravenous followed by oral antibiotics. Appropriate health authorities were alerted and proper control measures were employed. RESULTS: Smears from the cutaneous lesions of all five patients were positive for Bacillus anthracis and this was confirmed by a positive culture and PCR of the smears in four of the five cases. All the cases responded to antibiotics. CONCLUSION: We report five cases of cutaneous anthrax in a non-endemic district, Visakhapatnam, Andhra Pradesh, for the first time.

Cutaneous anthrax in Lima, Peru: retrospective analysis of 71 cases, including four with a meningoencephalic complication

El ántrax es una zoonosis producida por el Bacillus anthracis y la infección humana es endémica en diversas partes del mundo, incluyendo el Perú. Más del 95% de las infecciones adquiridas naturalmente son cutáneas y aproximadamente 5% de ellas pueden evolucionar para meningoencefalitis. En este estudio revisamos las características clínicas y epidemiológicas de los pacientes con diagnóstico de ántrax cutáneo evaluados entre 1969 y 2002 en el Hospital Nacional Cayetano Heredia (HNCH) y en el Instituto de Medicina Tropical Alexander von Humboldt, en Lima, Perú. Se incluyeron 71 pacientes [49/71 (69%) del sexo masculino], con edad media de 37 años. Los diagnósticos fueron clasificados como definitivos (44%) o probables (56%). La ocupación más frecuente fue la agricultura (39%). La fuente de infección fue identificada en 63 (88.7%) pacientes. Todos presentaron lesiones ulcerativas con necrosis central. La mayoría de ellos (65%) tuvieron lesiones múltiples, principalmente localizadas en miembros superiores (80%). Cuatro pacientes (5.6%) desarrollaron meningoencefalitis y tres de ellos fallecieron. En conclusión, considerando sus particulares características clínicas y epidemiológicas, el ántrax cutáneo debe ser siempre incluido en el diagnóstico diferencial de las lesiones cutáneas ulcerativas. Los pacientes con sospecha clínica de la enfermedad deben recibir tratamiento precoz con el objetivo de evitar complicaciones neurológicas, las cuales presentan elevados índices de fatalidad.

Detection of spores of Bacillus anthracis from environment using polymerase chain reaction.

A sensitive PCR based detection of Bacillus anthracis spores from environnment was standardized. Specific 1247bp amplicon could be detected with template concentration as low as 13 pg. Sensitivity was enhanced to 10 fold by nesting with second set of primers, forming 208bp amplicon. Extraction of DNA from spores purified from soil samples by aqueous polymer two-phase system followed by partial germination and freeze-thaw treatment yielded best results. Soil sample spiked with spores (8x10(2)/g of sample) could be detected with this method.

Case report: intestinal anthrax in a 4-year old boy

Anthrax is a highly dangerous disease that results in death in the absence of prompt diagnosis and treatment. Intestinal form of this disease is rare but fatal. This report presents a 4-year old boy with abdominal pain, vomiting, distension and poor general condition. He was taken to the operating theatre with the diagnosis of peritonitis; right hemicolectomy was performed because of ileo-cecal invagination and perforation. Four hours later the patient died of septic shock. His laboratory studies revealed the diagnosis of anthrax. We have discussed the epidemiological aspects of the disease and emphasized the importance of immediate diagnosis and treatment

Anthrax.

Anthrax is caused by Bacillus anthracis, an encapulated and spore-forming bacillus. The disease is usually contracted through uptake of spores that remain viable in the contaminated soil for many years. Anthrax is primarily a disease of herbivorous animals and is uncommon in humans who may get the infection through contact with contaminated animals or their products. Anthrax spores germinate after entering the body through skin abrasions (cutaneous anthrax) or by inhalation (inhalation anthrax) or ingestion (gastrointestinal anthrax) and multiply to produce two exotoxins which determine the virulence along with capsule. Although most cases occur within 48 hours of exposure, germination of spores may occur upto 60 days later. While inhalation anthrax is almost always fatal, intestinal anthrax results in death in 25% to 60% of cases. Upto 20% of cases having cutaneous anthrax may die. Antibiotics are effective if the disease is recognised early and treated appropriately. Penicillin is the drug of choice when disease occurs in natural setting. Ciprofloxacin is recommended when aerosols of anthrax spores are used as bioweapon, prophylactic antibiotics should not be prescribed until risk of exposure is considered real by experts.

Carbunco cutáneo: revisión de casuística en el Hospital de Enfermedades Infecciosas de Santiago, entre 1975-1993 / Cutaneous anthrax: case review at the Hospital de Enfermedades Infecciosas at Santiago, between 1975-1993

Se revisan 10 casos de carbunco cutáneo internados en el Hospital de Enfermedades Infecciosas profesor Dr. Lucio Cordova entre los años 1975 a 1993. En todos los pacientes las manifestaciones clínicas fueron la base del diagnóstico lo que unido al antecedente epidemiológico, evolución del cuadro clínico y cultivos bacteriológicos, hicieron que el reconocimiento de esta enfermedad fuera relativamente fácil. Se describieron las características clínicas, de laboratorio y los buenos resultados del tratamiento con penicilina sin que se produjeran casos fatales