Anthrax

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Anthrax

Definition of antrax
Anthrax is a disease in wild animals, or pets, namely ruminant animals (herbivores), such as cows, buffaloes, goats, sheep, pigs and horses. The disease is transmitted to humans, especially in people who his work is always associated with / adjacent to livestock such as farmers, shepherds, veterinarians, laboratory workers, factory workers, goods leather goods and bones.





Cause of antrax

Germs of anthrax (Bacillus anthracis)
Modes of Transmission
The disease is usually transmitted to humans by the entry of spores or anthrax bacilli into the body through various ways, namely through skin abrasions or injury that causes skin anthrax, through the mouth as food ingredient contaminated food, resulting in intestinal anthrax (gastrointestinal), inhalation respiratory tract causing pulmonary anthrax. Antrak inflammation of the brain (Meningitis) usually is a form of continuation of skin anthrax, intestinal or
pulmonary. Pulmonary anthrax is very rare and meningitis were reported in Indonesia.
Transmission occurs by direct contact with the animal patient, eg contact with blood coming out of the holes kumlah animals died due to anthrax or ingredients of animal origin contaminated by spores anthrax, such as meat, offal, hides, flour, wool, and so forth. Besides the that, other potential sources of transmission is ligkungan, among other lands, crops (vegetables) and water contaminated by anthrax spores.


Clinical Overview
A. Anthrax Clinical Skin
- The incubation period of 7 days (average 1-7 days)
- Itching spot lesions
- Papel
- Vesicles
- Ulcer (ulcers) in the middle there is a form of scab of necrotic tissue black (pathognomonic sign of anthrax) and is usually obtained erythema and edema around the ulcer. At the touch, edema is not soft and does not dent (non-pitting) when pressed. Here is obtained pus unless secondary infection followed.
- There can be enlarged regional lymph nodes
- A fever that is, headache, malaise rare
- Predilection for skin anthrax is usually in open places, such as face, neck, arms, hands, and feet
- Untreated skin anthrax will grow worse with spreading to the lymph nodes and continue into the bloodstream, thereby lead to septicemia and possible death of 5-20%
- Bacteriological examination of exudates in skin lesions obtained bacilli in the preparation of clear and positive culture.

2. Clinical Intestinal Anthrax
- The incubation period varies from 2-5 days
- Early symptoms of nausea, no appetite, and temperature rise
- Vomiting
- Severe abdominal pain
- Constipation
- Can also occur with acute gastro-enteritis is sometimes bloody, hematemesis, general weakness, fever and no history of exposure with animals or food products.
- Bacteriological Examination of stool specimens obtained from the bacillus removed and preparation of the positive culture.

Diagnosis
A. Skin anthrax suspect
If a case or "explosion" or a history of anthrax in animals exposure to animals / materials of animal origin and the polluted environment by spores / bacilli of anthrax and found abnormalities in the form of skin ulcers the dead tissue form a black scab in the middle (eskar),
redness around the ulcer, swollen, swollen area on the palpability is not soft and does not dent and is usually not found except pus Primary infection is followed sekunder.

2. People with skin anthrax (definite diagnosis)
If on skin anthrax suspect the diagnosis confirmed by bacteriological examination.

3. Intestinal anthrax suspect
If a case or "explosion" or a history of anthrax in animals exposure to animals or food products and found the heat accompanied by abdominal pain and vomiting.

4. Patients with intestinal anthrax (definite diagnosis)
If on skin anthrax suspect the diagnosis confirmed bybacteriological examination.

Management of anthrax
- Drug of choice (drug of choice) for patients with skin anthrax is penicillin.
Procain penicillin 1.2 million IU im dose of 2 x day for 5-7 days
or benzylpenicillin 250 000 IU dose every 6 hours. Before granting
do penicillin skin test. Patients who are hypersensitive to penicillin
tetracycline can be administered at a dose of 500 mg, 4 times daily for 5-7 days.
Should not be given to children under 6 years. Alternative medicine
is chloramphenicol.
- The intestinal anthrax may be given penicillin G 18-24 million units per day
intravenously, can be added tetracycline 1 g per day.
- Symptomatic medications and supportive if necessary
- Refer to hospital if necessary.

Prevention of Anthrax
- Public asked to report to the local health clinic if there is a suspect Animal anthrax and reported to the animals when there are sick with symptomsanthrax
- It is forbidden to slaughter sick animals anthrax
- It is forbidden to consume meat from animals that anthrax illness
- Not allowed to create items of animal origin such as craft of horn, leather, fur, bones from animals sick / dead because the disease anthrax.
- Community Health Center is required to report to the District Health Office / City if
meet the patient / suspect anthrax.