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18/11/13

Biology

Chelsea Sutherland

Anthrax: A Killer
For as long as humanity has existed, so too has disease and death. It is common knowledge that people get sick sometimes hundreds of thousands of people get infected with a disease at the same time. This is known as an epidemic. (CLICK) The disease to be discussed today is Bacillus anthracis more commonly known as Anthrax. Anthrax is a very deadly disease that usually only affects animals such as goats, cattle, sheep and horses, however Anthrax is easily transmitted to human beings when they come into contact with infected animals or their products. It has come to light recently that Anthrax can be used as a biological weapon, but the disease does not spread from person to person, fortunately. Anthrax is a bacterium called Bacillus anthracis. There are three different forms of Anthrax; cutaneous, gastrointestinal and inhalation. All three have various symptoms that are recognised. (CLICK)Cutaneous anthrax is the most common form of anthrax infection with around 95% of cases being cutaneous. It occurs when the bacterial anthrax spores enter the body perhaps through a cut or graze. It begins with a raised, itchy lump which may resemble a bug bite. In time, the lump becomes blister-like. This blister may pop, excreting a bloody liquid. Within 36 hours, the blister will become black, now dead flesh. Along with the blister may come high fever, vomiting, profuse sweating and a loss of strength coupled with exhaustion. This is the least deadly form of anthrax and deaths are rare with appropriate medication. 20% of untreated cases will result in death. (CLICK)Next comes gastrointestinal anthrax, which can occur after the consumption of infected meat. Those ailed with the disease may begin to experience a chill or a high fever, accompanied by a headache and pain in the back and abdomen. Additional symptoms include vomiting, vomiting blood, and bloody diarrhea. It is possible the patient may also experience swelling of the neck and difficulty swallowing. Victims may then go into shock, followed by death. (CLICK)Lastly is inhalation anthrax. Patients will find themselves with cold-like symptoms such as a chill, back pain, leg pain, fever, rapid breathing and rapid pulse, shortness of breath, cough and vomiting. Normally inhalation anthrax will result in death 1-2 days after the onset of symptoms. Inhalation is normally fatal. (CLICK)There have been suspected cases of Anthrax peppered throughout history, frequently occurring amongst cattle. In the 1600s -- "Black Bane," thought to be anthrax, killed 60,000 cattle in Europe. This is one of the earliest suspected cases of Anthrax. It wasnt until hundreds of years later, in 1876, that Anthrax was discovered. Robert Koch discovered and confirmed the bacterium that caused Anthrax.

18/11/13

Biology

Chelsea Sutherland

The first successful immunization of livestock against Anthrax occurred in 1880. From 1915 onwards, Anthrax was used worldwide as a biological weapon. Germany, Japan, United Kingdom, United States all these countries experimented with or researched Anthrax. It wasnt until 1969 that President Richard Nixon ended the United States' offensive biological weapons program. Defensive work continued, however. 1970 saw the approval of a vaccine against Anthrax. 1979 onwards, there began to be a lot more cases of inhalation Anthrax, brought on by bioterrorism. An Anthrax Vaccination plan is made up for United States military personnel in 1998. And most recently, in 2001, following the terrorist attacks on the World Trade Center, letters are sent out to people containing anthrax spores. Anthrax can be contracted in two ways; either from contact with an infected animal or from an act of bioterrorism. When contracted from an animal, the victim may have been handling products from an infected animal. Alternatively, they might have just breathed in anthrax spores when handling infected animal products. Bioterrorism is a different matter. Transmission can occur when Anthrax powder is put into letters or air conditioning systems and then inhaled. (CLICK)There is various pathology associated with the different forms of anthrax. In cutaneous anthrax, the anthrax spore particles enter the body through cuts or abrasions in the skin. Once inside, the spores migrate to the bloodstream. Gastrointestinal is contracted with these spore particles are in food, which is then consumed. Inhalation anthrax occurs when spore particles are inhaled. After a brief journey to the lungs, the inhaled spores enter alveolar sacs and attach to the tissue of the alveoli within the lungs. At this point, the body initiates an immune response against the foreign bodies. Microphage cells become alerted to the bacterium and subsequently leave the bloodstream to engulf the spores. Once the spores have been engulfed, the immune cells will re-enter the bloodstream and travel for a brief time. The normal response associated with macrophage cells involves the destruction of the foreign body that was engulfed. They then travel to lymph glands to prepare the body for future attacks of the same type. However, in the case of Anthrax, the spores engulfed by the immune cells are not destroyed. Instead, they germinate within the macrophage cell until delivered to a lymph gland. Once inside the gland, the spores develop into vegetative bacteria known as Bacilli. The Bacilli is released from the macrophage cells and they begin to cause damage to the cells of the lymph gland. From here, they travel through the lymphatic system and begin to grow and multiply, infecting surrounding areas. They eventually make their way back into the bloodstream.

18/11/13

Biology

Chelsea Sutherland

The anthrax bacterium secretes exotoxins in the bloodstream. These exotoxins leave the bloodstream and begin to invade neighboring cells. This invasion makes the cells unable to regulate their environment and causes the cells to release water, and eventually die. The buildup of water in the system causes a condition known as pulmonary edema. This is a large buildup of fluid in the lungs, resulting in tissue damage and pulmonary complications. (CLICK)Anthrax, while deadly, can still be absolutely be treated. Antibiotics are the go-to infection preventer. Certain types of antibiotics are approved by the Food and Drug Administration for post-exposure prevention. Contraction of Anthrax is preventable by exercising caution. If living in or travelling to an under-developed country, its necessary that people avoid contact with livestock and animal skin as much as possible. Cooking food (particularly meat) is also of utmost importance. Even in developed countries, it's important to handle any dead animal with care and to take precautions when working with animal products. A vaccine has been developed but is unavailable to the general public, due to the infrequency of anthrax infections. People who are at high risk of infection, such as military personnel who must travel overseas or doctors and researchers who work directly with the bacterium, are vaccinated. The vaccine is not always 100% effective either. (CLICK)While there is a current vaccine for anthrax, research continues to be undertaken at various medical institutions and disease prevention centers around the world. For example, NIAID or the National Institute of Allergy and Infectious Diseases conduct research in the fight against anthrax. They aim to improve their ability to prevent, diagnose and treat anthrax. Since the bioterrorist attack on America occurred, anthrax research has really expanded. Findings have helped to improve the understanding of how this bacterium causes disease and how better to prevent it. NIAID researchers are hard at work uncovering the molecular pathway taken by the bacterium in order to form spores, survive in people and cause sickness. The scientists over there envision this currently basic research to lead to great things such as new vaccines, drugs and diagnostic tools. To gain complete control of this deadly disease, it must first be discovered exactly how and why the bacterium forms spores. If its possible to prevent this from occurring, it will greatly reduce the infected soil and livestock. A way to completely kill spores may be useful as well, as known anthrax-infected sites could be cleansed of the bacterium. (CLICK)While there isnt a whole lot of anthrax infections around the world, there is always a great risk of outbreak associated with bioterrorism. This seems the most likely cause of outbreak. (CLICK) Imagine Sally. Sally is twenty six years old, female and in great shape. She rarely ever gets sick and she makes sure to eat as healthy as possible to keep her body prepped

18/11/13

Biology

Chelsea Sutherland

to fight disease. Sally does not have time to be sick as she works a lot and wishes to maintain her stellar work performance. One day Sally heads to work in her city of residence New York City. A week later, she, along with thousands of others, (CLICK) is dead. What happened to Sally, such a fit healthy person? (CLICK) (CLICK)DAY 1: Sally begins her Monday morning like any other day; she gets dressed, eats breakfast and then begins her trek to work. After a short walk to the bus station, she waits patiently for her bus to arrive. Her bus arrives late, annoying Sally. This means the train station will be busier. As predicted, when she arrives at Grand Central Station, its packed with busy people making their way to work to start the day. Little does Sally know that being late for work is the least of her problems. As she walks through Grand Central Station, she is breathing in spores of Bacillus anthracis, or Anthrax. The spores are transported to Sallys lungs where they take root in her alveoli. Sally doesnt feel this. Neither do the hundreds of other people surrounding her, who are breathing the same infected air. Sally gets to work on time, thankfully, and she heads home via the same route she took in the morning. Once home, Sally gets a good nights rest in preparation for the next day. While she sleeps, her body is triggering an immune response the bacterium nestled in her lungs. Macrophage cells engulf the foreign bodies of anthrax spores and then proceed to re-enter the bloodstream. (CLICK) (CLICK)DAY 2: Sally still cant feel it in the morning, but overnight her immune system has been carrying around a pathogen, allowing it to germinate. The disease has not been destroyed. (CLICK)DAY 4: Sally wakes up with a cold. She hasnt had a cold since she was seventeen. She has a slight chill and her back is aching. This isnt any common cold, though. The macrophage cells, following their normal pathway, have delivered the germinated anthrax spores to a lymph gland in Sallys body. Here they have left the immune cell as bacilli and have begun to cause damage to the cells of the gland. (CLICK)DAY 5: Sally has to take the day off work. She is not feeling well enough to leave the house. She now has a fever and is coughing and vomiting persistently. Her symptoms have become more flu-like. Sally is not worried, only annoyed. She should be worried, however, as the bacilli in her body has travelled through her lymphatic system, all the while growing and multiplying. Theyve made their way back into her bloodstream. (CLICK)DAY 6: Sally is finding it hard to breathe at this point. The disease she has picked up has gone too far. The bacterium in her bloodstream has been secreting exotoxins. The exotoxins

18/11/13

Biology

Chelsea Sutherland

leave her bloodstream and invade neighboring cells. (CLICK)The cells, unable to regulate their environment, release water and eventually die. Pulmonary edema, a buildup of fluid in the lungs ensues, causing major tissue damage and pulmonary complications. (CLICK)DAY 7: Sally does not wake up from her sleep on this day. She has become a victim of anthrax. It turns out that thousands of people in New York City died of inhalation anthrax around the same time as Sally. How did this deadly disease get into Grand Central Station? (CLICK) Through bioterrorism. In the early hours of that morning, terrorists disguised as cleaners entered the Station. They were carrying enormous amounts of anthrax in powder form. In order to do the most damage, the terrorists placed the powder in the air systems. The powder was dispersed through the air in the Station and subsequently, (CLICK) (CLICK) (CLICK) (CLICK) the thousands of people who walked through that morning, and mornings after, breathed in the deadly spores.

18/11/13

Biology

Chelsea Sutherland

Bibliography
CNN. (2001). Timeline: Anthrax through the ages. Retrieved 2013, from CNN: http://edition.cnn.com/2001/HEALTH/conditions/10/16/anthrax.timeline/ Fishbein, M. (2013). Anthrax. Retrieved 2013, from MedicineNet: http://www.medicinenet.com/anthrax/article.htm Harper, T. K. (2005). Anthrax. Retrieved 2013, from tarakharper: http://www.tarakharper.com/b_anthrx.htm#sympt Mayo Clinic Staff. (2011). Prevention. Retrieved 2013, from Mayo Clinic: http://www.mayoclinic.com/health/anthrax/DS00422/DSECTION=prevention NIAID. (2010). Anthrax. Retrieved 2013, from NIH: http://www.niaid.nih.gov/topics/anthrax/pages/research.aspx Schoenstadt, A. (2013). Anthrax Transmission. Retrieved 2013, from MedTV: http://anthrax.emedtv.com/anthrax/anthrax-transmission.html Twenhafel, N. A. (2010). Pathology of Inhalational Anthrax Animal Models. Retrieved 2013, from Veterinary Pathology: http://intl-vet.sagepub.com/content/47/5/819.full