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Anthrax Briefing

Background
The Public Health Protection Unit has been notified of 2 confirmed cases of anthrax in injecting drug users. One of these cases sadly died. Initial investigations suggest that this is most likely due to a batch of contaminated heroin. The infected batch of heroin appears to be darker in colour than normal.

Anthrax is a very rare infectious disease that can be spread from animals to humans. It is caused by a bacterial organism called Bacillus anthracis, which exists in the soil in the form of spores.

Anthrax is most commonly found in countries such as South and Central America, Eastern Europe, Asia, Africa, the Caribbean and the Middle East.

Cause of infection

Anthrax can be caught through direct contact with the skins or tissues of infected animals or inhalation. When the spores come in contact with a human skin lesion or a skin wound the spores will germinate into thriving colonies of bacteria. The resulting toxins produced from these bacteria are potentially fatal if not treated

Symptoms

The symptoms of the disease vary depending on how it was contracted. The first symptoms usually occur within 1 - 7 days of exposure.

When anthrax spores enter a skin cut, skin infection begins as a raised itchy bump that resembles an insect bite. Within a day or two, it develops into a blister and then a painless ulcer usually 1-3 cm in diameter, with a dying area in the centre. Lymph glands in the adjacent area may swell. Fever, swelling and headache may follow.

When anthrax spores are inhaled, the initial symptoms may be like those of a common cold or flu. They may start with a cough but in a few days the symptoms may develop into nausea, severe breathing problems and total collapse of bodily functions, known as shock.

Treatment

If diagnosed early, anthrax is easily treated with antibiotics. Unfortunately, infected people often confuse early symptoms with more common infections and do not seek medical attention until severe symptoms appear.

The earlier anthrax is treated, the greater the chances of successful treatment. If left untreated anthrax can be fatal.

What to do

Please advise anyone who complains of suffering from any of the above symptoms to go immediately to the Accident & Emergency department at their nearest hospital.
If you are aware of an injecting drug user who has a severe soft tissue infection please advise them to seek medical attention immediately.
Carole Hunter, Lead Pharmacist, Glasgow Addiction Services.
John Mitchell, Associate Medical Director, Glasgow Addiction Services.

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