3. OBJECTIVES
After this presentation the student will be able to
Define anthrax
Epidemiologic triad
Clinical manifestation
Diagnosis
Essential nursing care with diagnosis
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5. DEFINE
ANTHRAX IS AN ACUTE INFECTIOUS DISEASE COMMON TO CATTLES
OCCURRING SPORADICALLY IN MEN IN THREE FORM CUTANEOUS,
PULMONARY AND INTESTINAL BY CONTACT WITH
INFECTED ANIMALS
ANTHRACIS DERIVED FROM GREEK WORD ‘’ANTHRAKIS ‘’ MEAN
‘COAL’’ BECAUSE IT CAUSE DARK COAL LIKE SPOT ON AFFECTED
AREAS
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6. AGENT
Bacillus anthracis
Gram positive
Nonmotile large bacilli
Rectangular
Spore forming bacillus
Spores are refractile, oval and central in position
LAB FINDINGS; in cultures appearance as
‘BAMBOO STICK’
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7. HOST
This disease occur in persons who are
hide serapers
Tanners
Butchers
Wool sorters
Mill workers
Bone possessors
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12. Cutaneous anthrax
• 95% of all cases globally
• Cutaneous anthrax usually occur in
arms, face or head at the site of abrasion of skin
which admits infection.
• Incubation: 2 to 6 days
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13. • Spores enter skin through open wound or abrasion cause site to
become hot and itching
• Papule vesicle ulcer black eschar painful
lymphadenopathy
• Case fatality rate 5 to 20%
• Untreated – septicemia and death
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16. PULMONARY ANTHRAX
Incubation: 1 to 7 days
Initial phase
Nonspecific (mild fever, malaise)
Second phase
Severe respiratory distress
Dyspnea, cough, headache, vomiting, chills, abdominal pain, chest pain,
diaphoresis, moracielymphadenitis, stridor, cyanosis, mediastinal widening,
death in 24 to 36 hours
Case fatality: 75 to 90% (untreated)
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17. • Gestational anthrax is enteric form
of anthrax
• It result from eated infected meat,
drinking infected milk or from
contamination of food by contact
with external environment.
Gastrointestinal anthrax
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19. GASTROINTESTINAL ANTHRAX
• Incubation period : 2 to 5 days
• Onset is with ingestion include nausea, vomiting, abdominal pain, blood
stained membrane, acute abdominal sepsis and ascites
chill, diarrhea, moderate fever, severe back and leg pain
• Breathing become difficult & pt. looks worried and anxious
• Petechiae occur on mouth and skin
• Spleen is enlarged and blood is very dark
• Death occur in 24 hours
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22. PREVENTIVE MEASURES
• Humans protected by preventing disease in animals
− Veterinary supervision
− Trade restrictions
• Giving proper education according diseases and its causes and advice them
to take precaution
• Giving vaccine according to following rules :six initial doses of 0.2 and 4
weeks & 6, 12 and 18 months followed by a yearly booster
• Improved industry standards
• Safety practices in laboratories
• Post-exposure antibiotic prophylaxis
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23. NURSING DIAGNOSIS
• Hyperthermia related to diseased prognosis as evidenced by increase
body temperature.
• Impaired skin integrity related to disease process as evidenced by scar
formation.
• Acute pain related to lesions as evidence by patient verbalizing
• Activity intolerance related to weakness as evidence by altered activities
of daily livings
• Ineffective breathing pattern related to disease prognosis as evidence
by shortness of breath
• Imbalance nutrition less then body requirement related to nausea as
evidence by lethargic condition
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24. • Nausea related to infection as evidenced by verbalizing by pt.
• Impaired oral mucous membrane related to infection as evidenced by petechial on
mouth.
• Diarrhea related to infectious process as evidenced by pt verbalizing increased
frequency of stools.
• Fatigue related to acute infection /nutritional deficit / vomiting/ inadequate tissue
perfusion as evidenced by lethargic condition.
• Risk for Deficit fluid volume related to vomiting/ diarrhea /hyperthermia.
• Risk for impaired respiratory function related to excessive or thick secretion
secondary to infection.
CONT.……
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26. NURSING MANAGEMENT
Isolation
• Use of aseptic techniques
• Wearing rubber gloves.
• Wearing face mask when handling pulmonary anthrax.
• Identify mode of transmission based upon infecting agent
• teach the client regarding the chain of infection and patient responsibilities in
the hospital and at home.
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27. NURSING MANAGEMENT
Diet
• As patient desire
• If pt. suffering from fever nourishing liquid and giving soft diet
• Fluid should be urged
• monitor levels of electrolytes and intake out put.
• Encourage use of yogurt, rice , bananas , tomatoes and potatoes
• Avoid use of very cold and hot foods and milk products, spicy food and
caffeine.
• Encourage client to eat small and frequent food slowly and rest in semi
fowlers position after eating to prevent nausea.
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28. NURSING MANAGEMENT
CONTINU…….
• Determine daily calorie of pt.
• Weight daily & instruct pt. to maintain good oral hygiene.
• Provide pleasant and comfortable atmosphere for eating.
• Instruct patient to eat dry and salty food and avoid overly sweet, rich ,
greasy and fried food
• Assist client to take rest before meal
• Observe for at least 1 hour after meal.
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29. NURSING MANAGEMENT
Temperature
• Temperature is high in systemic form 103-105 F
• Teach the person the importance of maintaining an adequate fluid intake
• Assess whether clothing or bedcovers are too warm for environment
• Explain the need to avoid alcohol, caffeine and large heavy meals
• Teach early sign of hyperthermia flushed skin, headache, fatigue and loss of
appetite
• Take cool baths or shower several time in a day
• Given tepid sponging when lowering the fever
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30. NURSING MANAGEMENT
Elimination
• Assess for pt. bowel sounds frequently.
• Record the numbers of stools per day.
• Record the consistency of stool.
• Strictly measure the intake and output.
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31. TREATMENT
Pharmacological
therapy
• Penicillin V
• Penicillin G
• Streptomycin
• Tetracycline
• Doxycycline
• Erythromycin
Dosage for adults
• 2oo-400mg orally QID
• 8million -12million U(IV) in
4-6 hours
• 30mg/kg IM/IV per day
• 250-500mg orally &IV QIDS
• 200mg orally and IV then
50-100mg BD
• 250mg orally BD
Dosage for children
• 25-50mg/kg orally BD & OD
• 100,000-150,000 U/kg 4-6
hours
• Not approved for children
• Not approved for children <
9years
• 40mg/kg/day QIDS
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32. TREATMENT
Pharmacological
therapy
• Erythromycin
lactobionate
• Chloramphenicol
• ciprofloxacin
• Corticosteroids
• dexamethasone
Dosage for adults
• 15-25mg/kg IV per day
• 50-100mg/kg/day orally ,IV
BD
• 250-750mg orally BD, 200-
400mg IV BD
• For edema, IV/IM BD 1-
2mg/kg
• 0.75ml
Dosage for children
• 20-40mg/kg/day IV QIDS
• 50-75mg/kg/day QIDS
• 20-30mg/kg/day BD,IV not
appropriate for children
<18years
• Prednisone 0.5-2mg/kg/day
orally/day
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33. PREVENTION AND CONTROL
• Given proper education regarding disease and its causes and preventive controls
• Given vaccination properly
• Humans protected by preventing disease in animals
− Veterinary supervision
− Trade restrictions
• Improved industry standards
• Safety practices in laboratories
• Post-exposure antibiotic prophylaxis
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34. PREVENTION AND CONTROL
Vaccination
• Six initial doses of 0.2-4 weeks, 6,12 and
18months followed by a yearly boosters
• At risk groups
• Veterinarians
• Lab workers
• Livestock handlers
• Military personnel
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35. PREVENTION AND CONTROL
Convalescence
• Convalescence is usually uneventful, normal activities should be resumed
gradually after sign & symptoms.
• Clean new born infant should be admitted in nursery after removal of
infected infants.
• All equipment's ,walls, floor ,bassinets,tables,chairs and scales are washed
with soap and water.
• All bedding sheets, blankets, clothing, water bottles, medicines bottles , jars
and ointments nipple, breck feeder, cotton applicators should be
autoclaved.
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36. HOME REMEDIES
1.WHITE FIR
popular natural cures for anthrax
oxygenating as anti-septic properties
use in bacterial and viral infections.
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37. HOME REMEDIES
2. WINTERGREEN
Wintergreen essential oil has great oxygenating
properties.
It is very useful when discomfort in bones and
muscles are experienced during the course of
disease.
It can be used by diluting it in any base oil like olive
oil or coconut oil and apply to the soles of the
feet.
Few drops of wintergreen oil can also be added to
body wash and used daily
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38. HOME REMEDIES
Garlic
has natural antibiotic properties due to the presence
of number of sulfur compounds such as vitamins,
minerals, calcium, potassium, zinc, etc.
This also helps in strengthening the immune system
and improves the functions of white blood corpuscles.
It inhibits the production if toxins due to its bactericidal
and bacteriostatic properties.
It inhibits the harmful bacteria and virus entering body
from replicating further.
Consuming 3-4 cloves of raw garlic every morning on empty stomach helps in
fighting the anthrax infection from within the body.
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39. HOME REMEDIES
• Thyme and Melissa
potent herbs with high anti-bacterial properties.
People suffering from anthrax infection must use extracts
of thyme and Melissa in the form of capsules.
Take 12 drops of thyme and 1 drop of Melissa in a capsule
and consume 3 of these capsules every day.
Follow this remedy continuously for 10 days and then
take a break for 48 hours before continuing to take it.
. It can also be used as massage oil by mixing few drops
of essential oil in the base oil.
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