Department of
Health
HEALTH INFORMATION
Thursday, 18th October
2001
Emergency
Department Staff ~ BE ALERT FOR ANTHRAX!
Following the use of anthrax as an
aerosolised biological weapon, casualties are most likely to present with
inhalational anthrax and less commonly, with cutaneous anthrax.
| Inhalational
anthrax |
Cutaneous
anthrax |
Incubation period:
1-7 days (incubation periods of up to 60 days are theoretically
possible). |
Incubation period:
1-5 days |
Signs and symptoms:
The clinical presentation has been described as a two-stage illness.
First stage: 'Flu-like symptoms including
fever, dyspnoea, cough, headache, vomiting, chills, weakness,
abdominal pain and chest pain. This stage of the illness lasts from
hours to 5 days.
Second stage: Acute symptoms
of fever, respiratory distress, X-ray evidence of mediastinal
widening and shock. Death may occur within hours of the onset of the
second stage. |
Signs and symptoms:
Initially, an itchy lump on the skin (resembling an insect bite).
Within 1-2 days, the lump develops into a fluid-filled vesicle, which
ruptures (generally near the end of the first week) to form a painless
ulcer (called an eschar), usually 1-3cm in diameter, with a black area
in the centre. There is often associated swelling in surrounding
tissue and adjacent lymph nodes. |
Investigations:
Blood cultures
CXR may show a widened mediastinum and/or pleural effusions but
typically without infiltrates |
Investigations:
Soak two dry sterile swabs in vesicular fluid from a previously
unopened vesicle OR if eschar is present rotate two swabs beneath the
edge of the eschar without removing the eschar. Send to microbiology
department for microscopy and culture for anthrax. |
Immediately on clinical
suspicion of anthrax
- Perform microbiological investigations (as described
above) and other investigations as clinically necessary.
- Administer ciprofloxacin either: 400mg intravenously
every 12 hours OR 1000mg orally stat, followed by 750mg every 12
hours. For paediatric patients or pregnant women, seek microbiological
or infectious diseases specialist advice.
Notify all clinically suspected cases (where
antibiotic therapy is commenced) or microbiologically-confirmed cases to
the Communicable Disease Control Branch. Telephone 8226-7177
(24hrs/7days service)
Back to Health Alert -
Information on
Anthrax
Additional
advice from CDCB on handling mail
The facts about Anthrax
Attorney General's
Department
|
