Anthrax anxiety sweeps the Western world

From San Francisco to New York, from London to Berlin to Rio, the anthrax scare has people worried. Sightings of “white dust” have scores of people panicking, stock-buying antibiotics and chemical warfare protection suits, which are useless against anthrax, a bacteria, invisible and odourless.

The virulence of bacillus anthracis, discovered by the scientist Davaine in 1863, depends upon the strain (there are around 90) and the levels of toxin in the protective capsule in which the spore is enclosed. Anthrax passed through some notable hands – Robert Koch, better known for his discovery of the Bacillus of Koch (tuberculosis) was the first scientist to cultivate bacillus anthracis in a laboratory and Louis Pasteur invented the first vaccine, for sheep, in 1881. Anthrax is nothing new.

It is endemic in goats, sheep, camels, cows. and other herbivores, such as antelopes, but there are human variants of the disease. Ninety-five percent of cases are caught by touching contaminated animals when the anthrax spores enter the host through skin lesions. To be in contact with the spore does not mean it has entered the body, rather like being HIV positive but not having AIDS. Moreover, there are to date only five cases of confirmed anthrax in the USA and only one person has died. Everywhere else in the world, the hundreds of scares have turned out to be hysteria or hoaxes.

The symptoms of skin anthrax are like an insect bite, which later develops into an ulcer some three cm. across, with necrotic tissue at the centre. Early treatment with antibiotics provides an easy cure. There is an 80% survival rate for this form of the disease, if treatment is started early.

If the spores are inhaled, pulmonary anthrax is a more serious proposition. If treatment is not begun early enough, there is a 10% survival rate but it should be understood that preventive treatment programmes with antibiotics are administered in all suspected cases of contact with the anthrax spores. Sixty-day treatment with antibiotics such as penicillin, amoxycillin, doxicicline or ciproflaxacine (for more resistant strains) started 48 hours after exposure, gives the patient an extremely high chance of survival.

Symptoms appear after two to six days and are flu-like, with a dry cough as the spores spread through the lymph glands. After six to eight days, the spores develop into bacteria and for a day or two, the patient begins to feel better. After eight days, with the massive multiplication of the bacteria, toxin levels rise. The patient experiences breathing difficulties, the skin turns blue, there is profuse sweating and finally, after nie days, a respiratory and cardiac systems collapse.

The third form of anthrax is caused by eating infected meat. In these cases, there is a 25 to 60% death rate, depending again on early treatment. Acute intestinal inflammation causes nausea, vomiting blood, high fever, and severe diarrhoea.

The toxicity depends upon levels of exotoxins (PA-EF and PA-LF) contained in the capsule in which the spore can live, protected against extreme conditions for decades. One toxin, the PA-EF, causes the oedema. PA-LF is lethal. These spores can be produced in great quantities, artificially, by anyone with notions of basic biology.

Tests by the British authorities during the Great Patriotic War (Second World War) on the island of Gruinard in Scotland, proved that anthrax spores rendered it uninhabitable for half a century. After an intense cleaning up programme, it was declared safe again in 1990.

A vaccine exists. It is made by US company BioCorp. The FDA authorises its use for skin anthrax but not the pulmonary form of the disease, because there is insufficient documentary evidence from tests. The battle between the FDA and BioCorp has been continuing for the last 40 years. It is understood that the form of vaccination for the latter form of the disease would be different from that in cases of skin anthrax.

Stories about a wave of mass hysteria are true, given the very reduced number of confirmed cases but the reaction is understandable. When symptoms of anthrax appear, the disease is already two to six days old. If effective treatment with antibiotics must begin within 48 hours of infection, the patient is dependent upon the antibiotics fighting the anthrax bacteria successfully before these multiply and expose the body to an unacceptable level of toxin.

Timothy BANCROFT-HINCHEY PRAVDA.Ru LISBON PORTUGAL