탄저균 알고 고민합시다........(퍼온글)

[도치]

중앙일간지, 방송사 연일 탄저병에 대한 공포를 보도하면서도 탄저병에 대
한 해설기사는 좀채로 찾아보기 힘든 현실입니다. 저도 탄저병을 그저 막연
히 알고는 있었지만, 19세기에 이미 없어졌고 그저 담뱃잎에 대한 탄저병
이 아직도 있는 것으로 알고 있었습니다. 어떤 사람은 탄저병이 바이러스
로 감염되는 것으로 이야기 하는 사람도 있었습니다.
아직 우리 대중매체가 sensationalism에만 집착하여 국민에게 알려야 할 것
은 알리지 않고 그저 선정적인 글에만 집착하는 것을 보며, 언제쯤 대중매
체도 국민을 두려워 할 시기가 올 수 있을지 막연합니다.
간단히 탄저병에 관한 글을 올리니 참고하시고 너무 겁먹지 마시기를 부탁드립니다.
탄저균을 백색가루로 만들어 우편물을 통해 전달할 수 있는 이유는 탄저균이 다른 병
원성 박테리아와는 달리 곰팡이와 같이 포자를 형성할 수 있어 건조하고 고온에서도
잘 견딜 수 있어 무기화 할 수 있는 것이라고 알고 있습니다. 특히 피부로 감염된 탄
저균은 피부에 검은색 궤양을 일으켜 피부를 괴사시켜 그 이름도 석탄 "탄"자를 써
탄저병이라고 명명된 것으로 알고 있습니다. 요즘은 좋은 항생제가 많으니 너무들 걱
정하지 마시기 바랍니다. 19세기 이전에 항생제가 발견되기 전에는 항상 폐결핵으로
소설이나 오페라의 주인공들이 인생을 마감하지 않았습니까? 요즘 어느 영화나 소설에
서 폐결핵으로 주인공의 인생을 마감시키는 경우를 보신 적이 있으신 분은 저에게 연
락 바랍니다. 그렇다고 탄저병 걸리지는 마십시요. 우리나라에는 현재 문제가 되고 있
는 탄저균 strain에 맞는 vaccine은 없는 것으로 알고 있는데, 혹시 제가 잘못 알고
있으면 reply 기다리겠습니다. 아래 vaccination schedule에도 나와 있지만 예방주사
는 피하주사로 2주 간격으로 3회 접종후 마지막 접종 다음 6개월, 12개월, 18개월 도
합 6번을 예방주사로 맞아야 된다는군요. 그리고 매년 booster shot(injection)을 해
야 된다니 매우 번거롭지요?
하여튼 이런 생화학무기를 만들어 일부러 인명을 살상하려는 인간 같지 않은 인간들
과 같은 지구를 쓰고 있으니 지구가 좁은가 봅니다.



탄저병


■ 정 의
감염된 육류를 섭취하거나 피부, 호흡기 접촉에 의해 전염되는 인수 공통
전염병이다.
■ 증 상
피부 탄저병 : 2-5일의 잠복기 후 작은 구진이 나타나 수 일 내에 수포가
되고, 주위에 홍반과 부종이 생긴다. 가려우며, 수포는 청흑색이 되어 터지
며, 궤양이 되고 가피가 생긴다.

호흡기 탄저병 : 1-5일 잠복기 후 가벼운 상기도 감염 증상이 나타나다가
2-4일 후 호전되지만, 곧 호흡 곤란, 청색증, 천명, 발한, 목과 가슴에 피
하 부종이 생기며, 발열이 있으면서 흉막강에 삼출액이 생긴다. 흉부 X선
소견상 종격동이 넓어지면서 24시간 내에 사망한다.

위장관 탄저병 : 육류를 먹은 후 2-5일 후에 구역, 구토, 발열이 생기고,
복통, 토혈, 혈변 등이 나타나 급성 복증의 양상을 나타내며, 패혈증, 쇼크
로 사망한다.

뇌막염 : 피부, 호흡기, 위장관 탄저병의 합병증으로 수막염이 동반되며,
원발 병소로는 피부 감염이 50%로 가장 많다. 뇌척수액 소견은 출혈성 소견
을 보인다.
■ 원인/병태생리
탄저균에 감염된 가축(주로 소, 말, 양, 돼지 등)과 접촉하거나 감염된 동
물의 육류 제품을 먹은 사람에게 발병한다.
■ 진 단
피부 감염의 경우 임상 증상으로 의심을 할 수 있으며, 호흡기 감염의 경
우 흉강 삼출액에서, 수막염의 경우 척수액에서 균을 배양하여 진단할 수
있다.
■ 치 료
치료는 증세가 경한 감염의 경우 페니실린-V을 7-10일간 투여(분복)하고,
심한 경우에는 프로카인 페니실린을 7일간 투여(근육 주사)한다. 페니실린
에 과민 반응이 있는 경우 테트라사이클린을 사용한다. 호흡기 감염이나 뇌
막염에는 수용성 페니실린-G를 10일 이상 정맥 내 투여한다.
(http://www.daumclinic.com/info/int/infection/quarterevil.html)


더욱 자세한 사항은 아래와 같습니다.
Anthrax - 炭疽病-
Frequently Asked Questions

What is anthrax?
Why has anthrax become a current issue?
How common is anthrax and who can get it?
How is anthrax transmitted?
What are the symptoms of anthrax?
Where is anthrax usually found?
Can anthrax be spread from person-to-person?
Is there a way to prevent infection?
What is the anthrax vaccine?
Who should get vaccinated against anthrax?
What is the protocol for anthrax vaccination?
Are there adverse reactions to the anthrax vaccine?
How is anthrax diagnosed?
Is there a treatment for anthrax?
Where can I get more information about a recent Department of Defense
decision to require men and women in the Armed Services to be
vaccinated against anthrax?

----------------------------------------------------------------------
----------

What is anthrax?

Anthrax is an acute infectious disease caused by the spore-forming
bacterium Bacillus anthracis. Anthrax most commonly occurs in wild
and domestic lower vertebrates (cattle, sheep, goats, camels,
antelopes, and other herbivores), but it can also occur in humans
when they are exposed to infected animals or tissue from infected
animals.



Why has anthrax become a current issue?

Because anthrax is considered to be a potential agent for use in
biological warfare, the Department of Defense (DoD) has begun
mandatory vaccination of all active duty military personnel who might
be involved in conflict.

How common is anthrax and who can get it?

Anthrax is most common in agricultural regions where it occurs in
animals. These include South and Central America, Southern and
Eastern Europe, Asia, Africa, the Caribbean, and the Middle East.
When anthrax affects humans, it is usually due to an occupational
exposure to infected animals or their products. Workers who are
exposed to dead animals and animal products from other countries
where anthrax is more common may become infected with B. anthracis
(industrial anthrax). Anthrax in wild livestock has occurred in the
United States.



How is anthrax transmitted?

Anthrax infection can occur in three forms: cutaneous (skin),
inhalation, and gastrointestinal. B. anthracis spores can live in the
soil for many 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. It is rare to find
infected animals in the United States.



What are the symptoms of anthrax?

Symptoms of disease vary depending on how the disease was contracted,
but symptoms usually occur within 7 days.

Cutaneous: Most (about 95%) anthrax infections occur when the
bacterium enters a cut or abrasion on the skin, such as when handling
contaminated wool, hides, leather or hair products (especially goat
hair) of infected animals. 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 center. Lymph
glands in the adjacent area may swell. About 20% of untreated cases
of cutaneous anthrax will result in death. Deaths are rare with
appropriate antimicrobial therapy.

Inhalation: Initial 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 disease form of anthrax may follow the
consumption of contaminated meat and is characterized by an acute
inflammation of the intestinal tract. Initial signs of nausea, loss
of appetite, vomiting, fever are followed by abdominal pain, vomiting
of blood, and severe diarrhea. Intestinal anthrax results in death in
25% to 60% of cases.



Where is anthrax usually found?

Anthrax can be found globally. It is more common in developing
countries or countries without veterinary public health programs.
Certain regions of the world (South and Central America, Southern and
Eastern Europe, Asia, Africa, the Caribbean, and the Middle East)
report more anthrax in animals than others.

Can anthrax be spread from person-to-person?

Direct person-to-person spread of anthrax is extremely unlikely to
occur. Communicability is not a concern in managing or visiting with
patients with inhalational anthrax.



Is there a way to prevent infection?

In countries where anthrax is common and vaccination levels of animal
herds are low, humans should avoid contact with livestock and animal
products and avoid eating meat that has not been properly slaughtered
and cooked. Also, an anthrax vaccine has been lic
ensed for use in
humans. The vaccine is reported to be 93% effective in protecting
against anthrax.

What is the anthrax vaccine?

The anthrax vaccine is manufactured and distributed by BioPort,
Corporation, Lansing, Michigan. The vaccine is a cell-free filtrate
vaccine, which means it contains no dead or live bacteria in the
preparation. The final product contains no more than 2.4 mg of
aluminum hydroxide as adjuvant. Anthrax vaccines intended for animals
should not be used in humans.



Who should get vaccinated against anthrax?

The Advisory Committee on Immunization Practices has recommend
anthrax vaccination for the following groups:

Persons who work directly with the organism in the laboratory
Persons who work with imported animal hides or furs in areas where
standards are insufficient to prevent exposure to anthrax spores.
Persons who handle potentially infected animal products in high-
incidence areas. (Incidence is low in the United States, but
veterinarians who travel to work in other countries where incidence
is higher should consider being vaccinated.)
Military personnel deployed to areas with high risk for exposure to
the organism (as when it is used as a biological warfare weapon).
The anthrax Vaccine Immunization Program in the U.S. Army Surgeon
General's Office can be reached at 1-877-GETVACC (1-877-438-8222).
http://www.anthrax.osd.mil

Pregnant women should be vaccinated only if absolutely necessary.



What is the protocol for anthrax vaccination?

The immunization consists of three subcutaneous injections given 2
weeks apart followed by three additional subcutaneous injections
given at 6, 12, and 18 months. Annual booster injections of the
vaccine are recommended thereafter.

Are there adverse reactions to the anthrax vaccine?

Mild local reactions occur in 30% of recipients and consist of slight
tenderness and redness at the injection site. Severe local reactions
are infrequent and consist of extensive swelling of the forearm in
addition to the local reaction. Systemic reactions occur in fewer
than 0.2% of recipients.



How is anthrax diagnosed?

Anthrax is 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 effective antibiotics. To be effective,
treatment should be initiated early. If left untreated, the disease
can be fatal.



Where can I get more information about the recent Department of
Defense decision to require men and women in
the Armed Services to be vaccinated against anthrax?

The Department of Defense recommends that servicemen and women
contact their chain of command on questions about the vaccine and its
distribution. The anthrax Vaccine Immunization Program in the U.S.
Army Surgeon General's Office can be reached at 1-877-GETVACC (1-877-
438-8222). http://www.anthrax.osd.mil