Anthrax alert
What is anthrax?
By Hiranthi Fernando
The anthrax scare gripping the United States and many other countries,
has now spread to Sri Lanka. Over the past ten days, foreign missions,
offices and even schools have received letters suspected of containing
anthrax spores, prompting the government to set up a national task force
to deal with the threat.
The first 'anthrax' letter, containing a white powder was received by
the US Embassy on Thursday, October 18. As the anthrax threat had been
anticipated, embassy officials immediately sealed the letter according
to the guidelines given to them. On Tuesday, October 23, another such letter
was received. Both samples have been sent to the US for testing, but the
results are not known yet. The US Sri Lanka Fulbright Commission office
on Flower Terrace has been closed since Monday following an anthrax scare.
On Friday, October 19, the Australian High Commission received a threatening
letter addressed to the High Commissioner containing some white powder.
The letter was signed by someone claiming to be from the Al Qaeda movement.
As High Commissioner Peter Rowe was out of the country at the time, the
letter was opened by his secretary in the presence of Deputy High Commissioner
Kate Logan. The Police were summoned, the substance collected and the room
sealed off. "We are taking the precaution of not opening letters at the
moment," Ms. Logan said. "Anyone who wishes to contact us would have to
do so by fax or e-mail."
The French Embassy received a suspected anthrax contaminated letter
on Monday, October 22. Deputy Head of Mission, Claudia Delmas Sherrer said
the envelope contained a blank sheet of paper and some white powder. The
sample has been collected taking due precautions and the room sealed off
for the present. The secretary who opened the letter immediately washed
her hands and changed her clothes. Those who open mail at the embassy have
been provided with gloves. "In France, more than 300 such letters have
been received daily, during the last week," Ms. Delmas Sherrer said. "All
were hoaxes and so far not a single anthrax contaminated letter has been
received. However because of the seriousness of the situation in the US,
we have to take all precautions."
The British High Commission too received a suspicious envelope on October
23. "We anticipated it and had been taking precautions when opening mail,"Alison
Kemp of the British High Commission said. The Indian High Commission, Pakistan
High Commission and the Norwegian Embassy have also received suspicious
envelopes.
The anthrax scare has not been confined to foreign missions. On Monday,
October 22, a suspicious letter was received by a girls' school in Gampaha.
The clerk who usually opens the mail did not open it as it was addressed
to the Principal, but when he took it to the Principal's office, some powdery
substance had leaked out. School authorities informed the Police and the
Medical Officer of Health (MOH) for the area who collected the still unopened
letter. The office was closed and thoroughly disinfected. The letter has
now been sent to the Medical Research Institute (MRI) for testing.
Two days later, another suspicious letter was reported to have been
received by an international school in Colombo. And so, the list goes on.
With so many suspicious letters turning up, how do we react? The public
is naturally concerned but is the threat real? "People are getting unnecessarily
scared and a fear psychosis is setting in," commented Dr. A.L.M. Beligaswatte,
Director General of Health Services. "The more people get scared, the more
hoaxes there will be."
But with increasing reports of letters containing powders, the government
moved swiftly to set up a national task force to combat bioterrorism. Dr.
Beligaswatte, who heads the Task Force, confirmed that the MRI has received
a number of telephone calls about suspicious letters or parcels and would
have its laboratory ready for testing such substances by Thursday.
Explaining the procedure people should follow when dealing with suspicious
letters, he said that if the letter or parcel is unopened, it should first
be cleared by the Police to make sure it does not contain any explosive
material. "It is a criminal act and the Police must be vigilant and respond
to such calls. If it is suspected to contain anthrax spores, it should
on no account be blasted because the spores will then be dispersed into
the air. The person handling the parcel could also be at risk by inhaling
the spores."
"So many samples are coming in and we have to be absolutely careful,"
said Dr. G.S.S.K. Colombage, Director, MRI. "I am visiting the high-risk
places and discussing how to tackle the problem. Samples have to be closed
up and collected with all precautions.
"So far it has been done under my supervision. Then we have to start
testing, which could take two to four days."
Dr. Colombage said the MRI has devised a box covered with polythene
where the letters can be opened safely. The hands could be inserted into
the box and the letter and the envelope carefully cut open with scissors
so that the powder does not spread. Gloves and masks should be worn by
the person handling the letters.
"All organisations must make their own plans and take some action to
open their letters very carefully. Anyone who wishes to, could come over
to the MRI and have a look at the box we have made," she said.
A special counter has been opened for collecting suspected samples at
the MRI. "We do not know the magnitude of the problem and we are also short
of staff, but we have advised the Police not to take suspected samples
anywhere without informing us," Dr. Colombage said.
Explaining the bioterrorism threat,Task Force Co-ordinator Dr. S.D.
Atukorala said that when a micro-organism is used in armed conflict it
has to be produced in sufficient quantity and in a form that would be stable
and easy to disseminate.
In the case of bacillus anthracis, it is relatively easy to cultivate
from environmental sources and the inhalation form of the disease has a
high mortality rate. However, since the creation of an aerosol with bacillus
anthracis is not easy, it is unlikely that mere contact with contaminated
letters and parcels constitutes a significant risk.
"The last cutaneous anthrax case in Sri Lanka was in 1976 and the last
outbreak was in Yala in the 1980s," he pointed out. A complete set of guidelines
has been prepared by the Task Force and an awareness campaign will be carried
out to inform the public of what they should do.
What is anthrax?
Anthrax is a disease caused by the spore-forming bacterium Bacillus anthracis,
and is most commonly found in wild and domestic animals (cattle, sheep,
goats, camels, antelopes and other herbivores). Humans can be infected
with it when they are exposed to infected animals or tissue from infected
animals.
How common is anthrax, and where is it found?
Anthrax can be found globally but is most common in farming regions
in developing countries in South and Central America, Southern and Eastern
Europe, Asia, Africa, the Caribbean and the Middle East.
How is anthrax transmitted?
People can contract anthrax in three ways: Through the skin (cutaneous),
by inhaling it, and by eating or drinking it. B. anthracis spores can live
in the soil for years, and humans can become infected with anthrax by handling
products from infected animals or by inhaling anthrax spores from contaminated
animal products. Anthrax can also be spread by eating undercooked meat
from infected animals.
What are the symptoms of anthrax?
The symptoms vary depending on how the disease was contracted, but all
usually occur within seven days.
Cutaneous: Most (about 95 percent) anthrax infections occur when
the bacterium enters a cut or scrape on the skin. Skin infection begins
as a raised, itchy bump that resembles an insect bite but within 1-2 days
develops into a vesicle and then a painless ulcer, usually 1-3 cm. in diameter,
with a characteristic black necrotic (dying) area in the centre. Nearby
lymph glands may swell. About 20 percent of people with untreated cases
of cutaneous anthrax will die. Deaths are rare when the disease is treated.
Inhalation: First symptoms may resemble a common cold. After
several days, the symptoms may progress to severe breathing problems and
shock. Inhalation anthrax is usually fatal.
Intestinal: The intestinal form is characterized by an acute
inflammation of the intestinal tract. Initial signs are nausea, loss of
appetite, vomiting and fever, followed by abdominal pain, vomiting of blood,
and severe diarrhoea. Intestinal anthrax results in death in 25 percent
to 60 percent of cases.
Is there a way to prevent infection?
The anthrax vaccine is about 93 percent effective in protecting against
anthrax, but supplies are limited.
Taking antibiotics as a preventative is not wise; widespread use may
mean that the drugs over time may not work against other diseases. Also,
taking antibiotics does not give you immunity. If you don't have symptoms
or reason to suspect you've been exposed, you may be doing more harm than
good by dosing yourself with antibiotics.
How is anthrax diagnosed?
By isolating B. anthracis from the blood, skin lesions, or respiratory
secretions or by measuring specific antibodies in the blood of persons
with suspected cases.
Is there a treatment for anthrax?
Doctors can prescribe antibiotics. To be effective, treatment should
be started early. If left untreated, the disease can be fatal.
How does inhaled anthrax progress?
Incubation lasts up to six days. For the next four days, there are aches
and pains, tiredness, a cough and fever. Then there may be an improvement.
After that, the second stage begins abruptly. It lasts about 24 hours;
it includes severe breathing problems, fever, and internal bleeding, among
other symptoms, and usually ends in death.
-(Health Scout News) |
