Anthrax and other bioterrorism stuff: an EMS perspective
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What is anthrax?
Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax occurs most commonly in hoofed animals and can also infect humans. The bacteria is classified as a large, gram-positive rod bacterium. Anthrax is considered one of the most likely biological warfare or terrorist threat agents.
Is anthrax contagious?
Anthrax infection occurs in humans through inhalation of the spores when handling contaminated hair, wool, hides, flesh, blood and excreta of infected animals and from manufactured products such as bone meal. Cutaneous anthrax is introduced through scratches or abrasions of the skin, direct contact with skin lesions may result in cutaneous infection. Gastrointestinal anthrax is rare in humans, but is contracted by ingestion of insufficiently cooked meat from infected animals. The most likely route of infection from a terrorist attach is inhalation of dispersed spores.
What's the incubation time?
For Inhalation anthrax, incubation is 1 to 6 days, but could be as long as 6 weeks. Cutaneous anthrax incubates in 1 to 12 days and GI anthrax in 1 to 7 days. Mortality in untreated cutaneous anthrax ranges up to 25%, in inhalation and intestinal cases, the untreated case fatality rate is almost 100%.
What are the Signs and Symptoms?
Inhalation Anthrax:
Flu-like symptoms possible 1-2 days, improvement, then rapid respiratory failure and shock. Meningitis may develop.
Cutaneous anthrax:
Intense itching followed by painless papular lesions, then vesicular lesions, developing into eschar surrounded by edema.
GI anthrax:
Abd pain, NVD, GI bleeding, fever.
What should we do to protect ourselves on the job?
You already know this: universal precautions. Isn't it nice to know that the old way works with a new threat? To protect yourself from inhaling spores of suspected dust, use the HEPA masks provided for respiratory infection precautions (TB). You won't contract inhalation anthrax from an infected patient, infection occurs only from inhaling spores. It may be possible to contract cutaneous anthrax from lesion drainage. To protect yourself from cutaneous lesion drainage, use latex gloves and other blood product isolation equipment (mask, gown).
What do we do if we have to pick up a suspect package or mail?
Guess... Universal precautions! The item should be double-bagged when you arrive, if it's not, have the person double bag it. Using universal precautions, place the item in a biohazard bag, label it and transport it to the Director's office. We will not open anything or test items for people, the item will be incinerated per the current FBI recommendations. Read that again: use universal precautions, the way we have been doing for the past ten or so years.
BCEMS employees click here now to take the test for credit
Here's a great link
It provides a chart with information about anthrax and other bioterrorist agents. HIGHLY RECOMMENDED! PRINT THE CHART and study it! [CHART]
In case the link doesn't work, the address is: http://www.unc.edu/depts/spice/NCchart.pdf
Other Links:
CDC Centers for Disease Control, Atlanta
Johns Hopkins University