tetanus and anthrax

Question 1

Tetanus MB

Answer 1

gram + rod motile drum stick appearance on microscope , they are spore forming rods

Question 2

how to we acquire tetanus

Answer 2

The bacteria are usually found in soil, dust, and manure and enter the body through breaks in the skin — usually cuts or puncture wounds caused by contaminated objects.

through the soil
deep wound and will be able to survive as long as conditions are anaerobic
object contaminated with spores

Question 3

virulence factor of tetanus

Answer 3

tetanolysin- destroys blood cells
tetanospasmin (increases excitability of neurones leading to parlaysiis ) it is a neurotoxin . it blocks the inhibitory neurones meaning the production of ACH is uncontrolled due to less gaba produced

Question 4

symptoms of tetanus

Answer 4

first symptom is usally pain around the site

trismus ( jaw lock)
rises sardinicus due to spasm of facial muscles
opisthotonus
very severe spasms that can even cause bone fractures
spasms are painful
fever , tachy, hypertentsion

difficulty swallowing
s.o.b

Question 5

treatment tetanus

Answer 5

penicillin

Question 6

prophylaxis

Answer 6

DPT vaccine which includes toxoids of sipstheira and tetanus and killed pertussis or angins of pertussis (double check)

Question 7

who’s at risk for tetanus

Answer 7

neonates via the umbilical stump and very fatal >90%, caused by when the mother did not pass protective ab’s to baby , babies will have optihstonun

foreign body in wound

exposure to soil or manure

Question 8

types o tetanus

Answer 8

1. descending type - most common has a shorter incubation period and worser prognosis
2. ascending type - opposite

Question 9

spores of tetanus

Answer 9

remain viable soil for many years, they are heat stable to kill them you need to autoclave them at 121 for 15 mins . however the vegetative forms are heat liable

Question 10

diagnosis of tetanus

Answer 10

wound exudates

Question 11

prognosis of tetanus

Answer 11

ortality is high once the stage of lock- jaw has been reached.

Question 12

types of patients you will meet

Answer 12

Patients who were immunized as a child and re- ceived periodic boosters but the last shot was more than 10 years ago. These patients are given another booster.
2) Patients who have never been immunized. Not only do these patients need a booster, but they should also receive preformed antibodies to the tetanus toxin called human tetanus immune globulins.
3) Patients who come to the hospital having already developed tetanus. The big picture is to clear the toxin and the toxin-producing bacteria and to keep the pa- tient alive until the toxin has cleared. This is accom- plished in the following 5 steps of therapy:
a) Neutralize circulating toxin with human tetanus immune globulins.
b) Give an immunization booster to stimulate the patient’s own immune system to develop anti- tetanus toxin antibodies.
c) Clean the wound, excising any devitalized tis- sue, to remove any remaining source of Clostridium tetani.
d) Antibiotics (penicillin) may help to clear the remaining toxin-producing bacteria.
e) Provide intensive supportive therapy until the toxin is cleared. Muscle relaxants may have to be
administered, and the patient may have to be placed on a ventilator.

Question 13

what type of disease is bacillus anthrosis

Answer 13

a zoonoses affects humans and animals such as herbivores sheep and cows and horses . it mainly affects animals!

Question 14

mb anthrax

Answer 14

the same as tetanus gram + rod
has a capsule - the only bacteria with a protein capsule and has spores but is an adobe unlike clostridium

Question 15

why is anthrax so important

Answer 15

because it can be used a weapon for terrorism bio in 2001 spores sent on letter s in the US , because of its small size (enough to inhale) stability in environment and 100% fatality in pulmonary hemorrage . it was used by the japense army

Question 16

SPORES. of bacillus

Answer 16

just like tetanus they survive for years and only destroyed by autoclaving but vegetative forms are heat labile

Question 17

how do humans catch anthrax

Answer 17

direct contact with spores in soil
alimentary route - contaminated meat
respiratory route
skin - has to be a break into the skin
handling contaminated animal products like fur and wool

Question 18

forms of anthrax

Answer 18

skin- most common erythema (BLACK) without tx up to 20% can die but with tx rarely fatal
pulmonary - hemorragic pneumonia (most sever) by inhalation of spores
intestinal - eating contaminated meat
septic - complications of. above

Question 19

diagnosis anthrax

Answer 19

microscopy: bamboos stick appearance
culture from respiratory sections, cutaneous
pcr , elisa

Question 20

vaccine for anthrax

Answer 20

live vaccine but controversial
animals obligatory vaccination

its not typically available to the general public but for people at increased risk

Question 21

tx anthrax

Answer 21

penicillin its still sensitive too
doxycycline

Question 22

virulence factors of anthrax

Answer 22

The exotoxin contains 3 separate proteins, which by themselves are nontoxic but together produce the systemic effects of anthrax:
edema facto
lethal factor
protective factor

Question 23

can anthrax spread from person to person s

Answer 23

Inhalation (lung) anthrax is not spread from person to person. Even if you develop symptoms of inhalation anthrax, you are not contagious to other persons. If you develop cutaneous (skin) anthrax, the drainage from an open sore presents a low risk of infection to others. The only way cutaneous (skin) anthrax can be transmitted is by direct contact with the drainage from an open sore.rare cases reported. Anthrax is not spread from person to person by casual contact, sharing office space or by coughing and sneezing.

Question 24

spores definition

Answer 24

A spore is a dormant form that certain bacteria take when they have no food supply. Spores can grow and cause disease when better conditions are present, as in the human body

Question 25

where is bacillus naturally found

Answer 25

in the soil like tetanus

Question 26

anthrax in history

Answer 26

Robert Koch uses anthrax to develop his famous Koch Postulates - demonstrate a causal relationship between a specific microorganism and a disease.

later

1881 - Louis Pasteur creates the first vaccine for anthrax

Question 27

epi on anthraz

Answer 27

sub Saharan africa

Question 28

anthrax in Bulgaria

Answer 28

On 21 July 2015, Bulgaria reported a fatal case of Bacillus anthracis infection in a 53-year-old breeder of sheep and cows;
He died on 17 July in Varna after having slaughtered a sick cow. Further investigations revealed that a meat processing plant used contaminated meat from the sick animal to prepare sausages.
Bulgarian authorities implemented control measures, minimizing the risk of further spread of the infection.
Exposure to the infected animal or its meat occurred only at a local level, and there were no reports of international distribution of possibly contaminated meat.
The event was rated as a negligible risk for other EU/EEA countries.

Question 29

how do animals get affected with anthrax

Answer 29

by spores in the soil,

Question 30

IP period of anthrax

Answer 30

usually 5-7 days

Question 31

new form of anthrax

Answer 31

Since 2009, anthrax has emerged among heroin users in Europe, presenting a novel clinical manifestation, ‘injectional anthrax’, which has been attributed to contaminated heroin.
Before 2009, only one such case had been reported.
In 2009–2010, Scotland experienced the largest ever outbreak of injectional anthrax, with 119 cases identified. A few cases, most likely linked to the same contaminated batch of heroin, were also reported in Germany and the UK.

Question 32

vaccination of anthrax schedule

Answer 32

for those at high risk Five IM injections - at day 0, week 4, months 6, 12, and 18.
After the 6 month dose (3 doses), the vaccine recipient is considered protected and can work in areas where there is a risk of exposure to anthrax.
Annual booster - are recommended for ongoing protection.

Question 33

contact persons

Answer 33

Anthrax vaccine is also recommended for unvaccinated people who have been exposed to anthrax.
The vaccine has not been studied or used in children less than 18 years of age (informed consent from parents).
These people should get 3 doses of vaccine together with recommended antimicrobial drugs (doxycycline, ciprofloxacin, levofloxacin):
-the first vaccine dose as soon after exposure as possible,
-the remaining doses 2 and 4 weeks after the first.

Question 34

people at risk for anthrax

Answer 34

veterinarian
military personnel
livestock handlers

Question 35

what to do if you suspect a dead animal

Answer 35

Report to authorities - In animal farms, owners or workers should report any unexplained fever or new skin lesions to their health care provider and describe any recent contact with suspected sick animals.
Quarantine the area - Make sure there is minimal contact with the carcass by establishing a quarantine area, generally for 21 days after the last anthrax death.
Do not open carcass
Minimize contact
Wear protective clothing
Latex gloves, face mask
Vaccination of susceptible animals

Burn or bury carcasses, bedding, other materials
Decontaminate soil - with 5% lye or quicklime (anhydrous calcium oxide), hydrogen peroxide, peracetic acid or gluteraldehyde
Remove organic material and disinfect structures
In all these cases - Protective clothing should be worn!!!

Question 36

final disinfection in th case of anthrax

Answer 36

For final disinfection, one of the following disinfectants should be applied at a rate of 0.4 liters per square meter for an exposure time of at least 2 hours:
10% formaldehyde (approximately 30% formalin);
4% glutaraldehyde (pH );
3% hydrogen peroxide;
1% peracetic acid.
Hydrogen peroxide and peracetic acid are not appropriate if blood is present. When using glutaraldehyde, hydrogen peroxide or peracetic acid, the surface should be treated twice with an interval of at least one hour between applications. Formaldehyde and glutaraldehyde should not be used at temperatures below 10°C.
After the final disinfection, closed spaces such as rooms or animal houses should be well ventilated before use. The effectiveness of the disinfection procedure cannot be assumed and attempts should be made to confirm it has been adequate by means of swabs and culture.

Question 37

IP tetanus

Answer 37

around 8 days

Question 38

correlation to IP and nervous system

Answer 38

In general the further the injury site is from the central nervous system, the longer is the incubation period.
-Shorter incubation periods are associated with a higher chance of death.

Question 39

clinical forms of tetanus

Answer 39

cephalic (rare)- occasionally occurring with otitis media in which C. tetani is present in the flora of the middle ear, or following injuries to the head. difficulty swallowing and rigidity o abdominal muscles

local

generalised: descending type, causing truisms and commonly involves cranial nerves espaiclly fo the face

Question 40

the immunity of tetanus

Answer 40

People who recover from tetanus do not have natural immunity and can be infected again and therefore need to be immunized!!!!

Active immunization with tetanus toxoid should begin or continue as soon as the person’s condition has stabilized.

Question 41

vaccination for tetanus

Answer 41

6 doses (3 primary plus 3 booster doses) of tetanus-toxoid-containing vaccines (TTCV) through routine immunization!!!

Question 42

diagnosis of tetanus

Answer 42

C. tetani is recovered from the wound in only 30% of cases and can be isolated from patients who do not have Tetanus.

The diagnosis is entirely clinical and does not depend upon bacteriologic confirmation.

Question 43

toxid vaccine

Answer 43

There are two types of toxoid available:
- adsorbed (aluminum salt precipitated) toxoid
fluid toxoid.
Although the rates of seroconversion are about equal, the adsorbed toxoid is preferred because the antitoxin response reaches higher titers and is longer lasting than that following the fluid toxoid.

Question 44

boosters for teteanus

Answer 44

Antitoxin levels decrease with time. While some persons may be protected for life, by 10 years after the last dose, most persons have antitoxin levels that only approach the minimal protective level. As a result, routine boosters are recommended every 10 years.

Question 45

prevent neonatal tetanus

Answer 45

Neonatal tetanus can be prevented by immunizing women of reproductive age with TTCV, either during pregnancy or outside of pregnancy.

and using clean instruments on umbilicus