Anthrax

Prepared by
Dr. Ghalib S. Ridha
Visiting Assistant professor of
Internal medicine & Infectious
diseases.
Dept. of Internal Medicine
Faculty of Veterinary Medicine
Al-Fateh university
08/03/09 Tripoli, LIBYA
Dr. Ghalib's Lectures. 1
 Anthra
x
Synonyms: Splenic fever, Charbon, Milzbrand,
Woolsorter’s disease.

 Anthrax is an peracute, contagious, and usually rapidly fatal

septicemia affecting wide range of mammals including humans.

Most commonly affected are cattle & sheep, less commonly,

horse & goats. Although all ages are susceptible, older ages are
more commonly affected. Bulls are more at risk than cows.

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 Anthrax is characterized by sudden death and exudation of
tarry blood from natural body orifices of cadaver.

 The most important necropsy findings are

 failure of the blood to clot,

 absence of rigor mortis, and

 the presence of splenomegaly

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 Etiology
 The causative bacterium, Bacillus anthracis, is a Gram-positive,
non-motile, capsulated, spore-forming, aerobic bacilli.

 When bacilli discharged from an

infected animal or exposed to free
oxygen from an opened carcass,
they form spores that are resistant
to extreme temperature, chemical disinfectants, and
desiccation.

 Anthrax bacilli can remain viable in the soil for more than 30
years. In an unopened carcass, the vegetative organisms are
rapidly destroyed (1 to 2 hr) at ambient temperature often
during the summer. For this reason, the carcass of an
animal dead from anthrax should not be necropsied.
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 Epidemiology
 It is distributed worldwide with incidence varies with soil and
climate. The disease is enzootic and restricted in particular
areas, the so called “anthrax belt”.

 Animals can get spores directly from;

 The soil or

 Pasture grown on infected soil,

 from contaminated bone or meat meal

 from excretion, blood or other materials from infected animal

 Contaminated water

 Contaminated animal products such as hides, fertilizers, hair

& wool.
 Infection gain entrance to the body by ingestion, inhalation or
through the skin.
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 It is considered that most animals are infected by ingestion of
contaminated food or water. Injury to the mucous membrane of
digestive tract will facilitate infection.

 Inhalation is of minor importance in animals but workers in the

wool and hair industries (woolsorters disease in humans) can
get infection by inhalation.

 Biting flies and insects have been found to harbor anthrax, but
the incidence of this mode of mechanical vector transmission is
of minor importance.

 Outbreaks commonly are associated with neutral or alkaline,

calcareous soils. When environmental conditions of soil
(moisture, temperature, and nutrition) are optimal, the spores
revert to the vegetative and multiply to infectious levels.
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 Typically anthrax occurs during the warm, dry summer months,
in some African countries, when grasses are short & dusty,
although it may occur in cold climates.

 Epidemics originating from soil-borne infections tend to follow

periods of marked climatic and ecologic changes such as heavy
rainfall or flooding preceded by drought or dusty conditions and
always in seasons of warm weather when the minimal daily
environmental temperature is over 15°C.

 Even in endemic areas, anthrax occurs irregularly often with

many years between occurrence.

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 The zoonotic potential of anthrax is that man may
develop;
 localized cutaneous lesion (malignant carbuncle) from
contact of broken skin with infected blood or tissues or

 man may acquired a highly fatal hemorrhagic mediastinitis.

(woolsorters disease) from spore inhalation when handling
contaminated wool or hair.

 man may also acquire intestinal anthrax from consumption

of uncooked meat.

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 Pathogenesis
 After entry of spores by ingestion, the most common route of
infection which may be facilitated by grazing of abrasive
forages allowing penetration of the spores through the breaks in
the oral mucosa.

 The bacteria are moved to local lymph nodes, proliferate &

pass via lymphatic vessels into blood and septicemia with
massive invasion of all body tissues.

 B. anthracis possess 2 primary virulence factors which are

associated with the presence of 2 plasmids that carry the genes
coding for toxin and capsule production. B. anthracis produces
an
 edema toxin and

 a lethal toxin.

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 Both toxins and the capsule are the primary virulence factors of
the anthrax bacillus.

 The toxins cause wide spread damage to reticuloendothelial

system and vasculature.

 Death results from secondary changes, including diffuse

edema, tissue damage, acute renal failure, shock, and terminal
anoxia mediated by the CNS.

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 Clinical findings
 Anthrax can occur as a peracute, acute or chronic disease. The
incubation period is 3-7 days but can range from 1-14 days.

 Peracute form is of sudden onset and rapid fatal course.

There may be staggering, dyspnea, trembling, collapse with few
convulsive movements and death may occur in cattle, sheep or
goats without previous signs of illness.

 In acute form of anthrax in cattle and sheep, there is a high

fever (41.5°C), ruminal stasis, hematuria, bloody diarrhea,
abrupt decrease in milk production, and possibly blood-tinged
or yellow milk. A period of excitement and aggression followed
by depression, muscle tremors, cardiac and respiratory
distress, staggering, convulsions and death (1-3 days) with
bloody discharges exude from natural orifices.

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 Chronic anthrax in ruminants is characterized by localized
edematous swellings on the shoulder, ventral neck, and thorax.

 Horses with acute anthrax may show signs of fever, weakness,

depression, severe colic, enteritis with bloody diarrhea, and
swellings in the region of neck, sternum, lower abdomen, and
external genitalia.

 Death usually occurs within 2-4 days.

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 Necropsy findings
 Carcasses suspected of having
anthrax should not be opened for
necropsy to reduce environmental
contamination and health risk to
humans.

 The gross lesions of anthrax include, black tarry blood from

body orifices (mouth, nostrils, vulva, and anus), failure of blood
to clot, incomplete rigor mortis, splenomegaly ( dark red to
black, soft, semifluid spleen is common with increased size of
2-4 times), marked bloating and rapid body decomposition.

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 The liver, kidneys, and lymph nodes usually are congested
and enlarged.

 Other findings,
 Ecchymotic hemorrhages of serosal and mucosal lining

on the abdomen, thorax, epicardium, pericardium and

GIT.
 Areas of gelatinous edema in skeletal muscles, organs,

subcutis, and lymph nodes.

 Serosanguinous peritoneal and pericardial effusions

may be found

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 Diagnosis
 It can be determined without necropsy (unopened carcass).
Various laboratory tests can be performed to determine the
presence of B. anthracis:
 Bacterial staining and culture, ELISA test, FAT, and mouse and
guinea pigs
inoculation.

 Other specific diagnostic tests include PCR, chromatographic

assays, and Western blot
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 The organisms can be detected in blood collected by needle
puncture of superficial blood vessel, ear or jugular vein or
edema fluid & transported to the lab through sealed syringe,
sterile swab, or blood smear.

 If decomposition of a carcass is advance an ear or section of

spleen sealed in a leak-proof bag should be sent to lab to be
used for bacterial isolation and for preparation of an Ascoli
precipitin test.

 P.M materials should be collected from untreated animals dead

less than 12 hr because other motile, capsulated bacilli such as
Clostridium perfringens and other Bacillus spp. rapidly
contaminate the carcass.
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 A simple and quick diagnosis of anthrax is through the use of
staining techniques in combination with
 Clinical signs

 History of endemic areas, and

 Necropsy findings.

 Various stains can be used including Giemsa Loeffler’s

methylene blue or Wright’s stain.

 With a Gram stain, young bacteria will appear Gram-positive,

but older organisms may appear Gram-negative.

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 Differential diagnosis
 Anthrax must be differentiated from other causes of sudden
death in cattle and sheep including;
 Clostridial infection

 Acute boat

 Acute leptospirosis

 Lightning stroke

 Bacillary hemoglobinuria

 Anaplasmosis

 Acute lead poisoning.

08/03/09 Dr. Ghalib's Lectures. 18

 Treatment and control
 Because of the rapid death and high mortality rate (90%)
associated with anthrax, treatment should be initiated before
death and vigorous implementation of a preventive program are
essential.

 If anthrax is suspected, immediate segregation of infected

animals is advised with early antimicrobial therapy may be
useful.

 The M.O. is highly susceptible to a wide range of antimicrobials

including penicillin, streptomycin, and tetracycline with 1st dose
should be administered IV & can be continued IM for at least 5
days.

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 When soil-borne outbreak occur, antibiotics for sick animals
and immunize all apparently well animals are used in the herd
& surrounding premises.

 If outbreak is due to contaminated bone meal, antibiotic therapy

of exposed animals & removal of the source may be more
effective than vaccination in reducing losses.

 In the endemic area, control is largely depend on annual

vaccination of all grazing animals and by application of control
measures. This can be accomplished through the use of a
viable, avirulent, non-capsulated spore vaccine (Stern-strain
spore vaccine). It should be done 2-4 wk before the season
when outbreaks may be expected.

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 Two vaccine doses is recommended to produce more solid
immunity in cases of an outbreak. Antibiotics should not
administered before and during the 1st wk following vaccination.

 Immunity is established within 1 wk.

 There is 2 mo slaughter withdrawal after administration of live

spore vaccines.

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 Beside therapy and immunization, specific control
procedures to contain the disease and prevent its spread are
necessary. These include the following:
 Official notification

 Rigid quarantine measures

 Prompt disposal of dead animals and infected materials

 Isolation of sick animals & removal of well animals from

infected areas.
 Disinfection of stables, barns, pens, and equipments.

 Use of insects repellents

 Control scavengers.

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