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anthrax

What is a Siberian ulcer -

anthrax- acute zoonotic infection flowing with severe intoxication, the formation of carbuncles on the skin (skin shape) or in the form of sepsis.

Brief historical information
The disease is known from antiquity under various names: "Holy Fire", "Persian Fire", "Carhuff", etc. In Russia, it was called "Siberian ulcers" in connection with the preferential distribution in Siberia. Currently, the disease occurs in isolated cases. Identity of infection in animals and humans and the possibility of its transfer from sick animals to people proved by S.S. Andreevsky in self-response experience (1788). The causative agent of the disease is described by F. Pollander, F. Browell and K. Daven (1849-1850); Pure culture allocated R. Koh (1876). An outstanding role in the study of Siberian ulcers belongs to the domestic scientist - I.I. Mesnikov, G.N. Minhu, N.F. Gamalee, A.A. Vladimirov, L.S. Tsackovsky and others.

What provokes / causes Siberian ulcers:

The pathogen is an optional-anaerobic fixed gram-positive spore-forming capsulated bacterium V. Anthracis of the genus Bacillus family of ViLLASEE. Morphologically looks like a large wand with chopped ends. In the smear is single, pairs or chains. In the presence of oxygen forms disputes. Good grows on meat-pepton environments. The antigenic structure of the pathogen is represented by a capsule and somatic antigen, antibodies to them do not have protective properties. The pathogenicity of the pathogen is determined by the presence of the capsule and the synthesis of exotoxin. The siberiated wand is able to allocate a strong exotoxin of protein nature, which has both inflammatory and death. It consists of three components, or factors: anterior, protective antigen (not toxic, manifests immunogenic properties) and actually flying factor. Its combined effect on the human body is manifested by the ethics of tissues, disorders of the processes of tissue respiration, the oppression of the activity of phagocytes. Siberiane exotoxin is extremely labile: it is completely destroyed after half-hour heating at 60 ° C.

Temperature optimum for growth of 35-37 ° C, the optimum pH is 7.2-7.6. Vegetative forms of unstable in the external environment, quickly die when heating and boiling, under the action of ordinary disinfectants. Disputes are very stable, can remain for a long time under the most unfavorable conditions in water for several years, in the soil - dozens of years. After a 5-minute boiling disputes retain the ability to vegetate. Under the action of fluid pair is dying only after 12-15 minutes, at 110 ° C - after 5-10 minutes. The dry heat (140 ° C) kills the dispute after 3 hours. Under the action of a 1% solution of formalin and a 10% solution of NaOH digested after 2 hours. In the soil, disputes of the pathogen of Siberian ulcers are not only experiencing a long time, but under certain conditions they can germinate and reappear Disputes, maintaining the existence of the soil focus.

Epidemiology
Reservoir and source of infection- Herbivores (large and small cattle, horses, camels, pigs, etc.). The level of contagiosity of the source is equal to the period of animal disease, during which they highlight pathogens with urine, feces, bloody discharges. Among animals, an alimentary path of transmission of the pathogen is important among animals: when eating feeds or drinking water contaminated by the disputes of Siberian ulcers. The transmissible path of transmission is implemented through the bites of flies, blinding, carrying the pathogen from sick animals, infectious corpses and external environment objects to a healthy animal. An unborn corpse of the patient animal is infected for 7 days. The raw materials obtained from the sick animal (wool, skins, etc.) and its recycling products are dangerous for many years. In the soil, the causative agent can not only be maintained, but also under certain conditions (the temperature is not lower than 12-15 ° C, the humidity is 29-85%, neutral or weakly alkaline medium, etc.) grow into a vegetative form. Soil foci of Siberian ulcers retain a potential epizootic and epidemic hazard over decades. When conducting construction, hydro-eleiological and other earthworks, as well as with storm and flood waters, disputes can be put on the surface of the soil, creating the possibility of infection of animals and people. Reliable cases of human infection from man are unknown, but a person can become a source of animal infection. The sick person does not represent a danger to healthy individuals, which can be explained by the peculiarities of the transmission mechanism of infection, implemented among animals or from an animal to a person and impossible among people.

Mechanism of transmission - diverse, most often pin. The pathogen penetrates the body through damaged skin cover, microtraums of mucous membranes. Infection is more often happening in the process of care for the sick animals, slaughter, cutting the carcasses, culinary processing of meat, working with animal raw materials and the manufacture of items from it (serve, brushes for shaving, etc.). There are extremely rare cases of food in food, as well as inhaling an infected aerosol. The transfer factors are infected animal products, raw materials, processing products, contaminated objects of the external environment and inventory for animal care. Contamination of pathogen disputes through airways In the past, repeatedly noted on paper and wool-processing enterprises. The "rag disease" was distributed in Russia from collectors of the landfill rag, contaminated by the discharge and manure of animals.

Natural susceptibility of people Relatively low (about 20% of persons who have undergone infection risk), but almost universal with air-drip (dust) infection. Durable immunity remains, repeated cases of diseases are extremely rare.

Main epidemiological signs. Siberian ulcer is common everywhere; Most cases are registered mainly in developing countries in Asia, Africa and South America. Diseases are met in regions with developed animal husbandry. Seasonality of the incidence of people to a certain extent repeats the summer-autumn nature of the morbidity of animals. Sporadic cases and group diseases register. The main causes of group diseases are non-compliance with veterinary and sanitary requirements in terms of the prevention of Siberian ulcers by private owners of livestock, managers of farms, trade and procurement organizations and enterprises of various forms of ownership engaged in the preparation, processing and sale of meat and meat products.

Diseases prevail in rural areas among active ages, more often male. There are domestic and professional incidence of Siberian ulcers. Infection in urban conditions are associated with the workpiece, storage, processing of animal raw materials, with violations of technological regime and safety regulations. Sometimes there are diseases when carrying out earthworks; There are cases of laboratory infection.

The disputes of the pathogen of Siberian ulcers can be applied as a means of bioterrorism, which visually demonstrated events in the USA in the fall of 2001.

Pathogenesis (what happens?) During the Siberian ulcers:

The causative agent penetrates the human body through damaged skin, less often through the mucous membranes of the respiratory tract or the gastrointestinal tract. At the site of the entrance gate under the action of bacterial exotoxin there is a focus of serous-hemorrhagic inflammation with microcirculatory disorders, a pronounced edema, hemorrhagic changes in surrounding tissues and coagulation necrosis. Against the background of the inflammatory hearth, a carbuncle is formed with a section of necrosis in the center, sometimes other local manifestations of the disease in the form of a sharp edema, bubbles or changes resembling an eryzipeloid. Movable macrophages enter the pathogen in the nearest lymph nodes where regional lymphadenitis develops. Bacteriamia with the development of the secondary septic process with the skin form of the Siberian ulcers is extremely rare. Sepsis occurs more often when penetrating the pathogen through the respiratory tract or the gastrointestinal tract, overcoming the protective barriers to bronchopulmonal or mesenteric lymph nodes and hematogenic generation of infection.

Characteristic pathologist changes in Siberian ulcers are developing not only in the field of the local inflammatory hearth. Also observe the serous-hemorrhagic inflammation of regional lymph nodes, changes in the internal organs with their full-rod, serous-hemorrhagic edema, the development of hemorrhagic syndrome with focal hemorrhages and multiple hemorrhages.

Sybir Symbols:

Incubation period. It continues within a few days, but can be left to 8-14 days or shrink to several hours. Severe skin (localized) and generalized forms of the disease.

Skin shape. It is most often found (more than 95% of cases). It may proceed in the form of several varieties - carbunculese, edematous and bullose. The most commonly developing a carbunculeous variety of skin shapes. In these cases, a painless reddish spot with a diameter of up to several millimeters appears on the skin at the front of the entrance gate of infection. It very quickly turns into a papula of copper-red, sometimes with a crimson, raised above the skin level. Formation of the Papula spot accompany the local itching and light burning. After a few hours, the papula turns into vesicula with a diameter of 2-4 mm, filled with serous content. The contents of vesicles quickly becomes bloody, acquires a dark, and sometimes the purple-purple color (Pustula Maligna). When combing or (less often), spontaneously burst, and a ulcer is formed with the edges raised above the skin level, the bottom-brown bottom and serous-hemorrhagic separated. In its edges, secondary vesicles appear ("Necklace"), which is considered typical for the disease. In the future, the "subsidiaries" vesiculas pass the same stages of development as the primary element. With their autopsy and fusion, the sizes of ulcers increase.

A few days later, sometimes after 1-2 weeks, due to necrosis in the center of the ulcers, black scrap is formed, which increases rapidly in size, closing all the bottom of the ulcers, and resembles a strongly burnt crust. Pain sensitivity in the region of the stamp is lost ( local anesthesia) What is an important differential diagnostic sign. An inflammatory crop of a crimped color is formed around the stamp, towering over the level of healthy skin. Externally scrap with the roller resembles a fading corner, which determined the old Russian name ("carbohyer") and modern latin name Diseases (from Greek. Anthrax - coal). In general, skin changes were called Carbuncoule. Its dimensions vary from a few millimeters to 5-10 cm.

According to the periphery of the carbuncule, a pronounced tissue edema develops, sometimes high sections, especially in places with loose subcutaneous tissue (for example, on the face). The character of the edema studdow-shaped, when hit by a percussion hammer in its area there is a trembling trembling (Symptom of Stefan). The localization of the carbuncule and the edema on the face is very dangerous, because it can spread to the upper respiratory tract, and lead to asphyxia and death. The formation of the carbuncule accompanies regional lymphadenitis (and with a serious course of the disease and lymphangitis).

From the very beginning of the disease, there is a pronounced intoxication with a high body temperature, headache, adamasy, fragile in the lower back. Fever is maintained for 5-6 days, after which the body temperature is critical. Its normalization accompanies the reverse development of general and local symptoms. By the end of the 2-3rd week, the Strick is discarded, the ulcer gradually heals with the formation of a scar.

More often formed one carbuncoon, while the disease in most cases occurs in a light or medium-stage form. In rare cases, the number of carbuncles can reach 10 or more. When developing them on the head, neck, mucous membranes of the mouth and nose The disease proceeds especially hard and can be complicated by the development of a symbolic sepsis.

Edenatous variety of skin shape. At the beginning, the disease is manifested only by a pronounced edema, the development of necrosis and the formation of a burbuncle of large sizes is observed in more late time Diseases.

Bullese variety of skin shape. It is distinguished by the formation of bubbles with hemorrhagic content at the site of the entrance gate of infection. After opening the bubbles, extensive ulcers are formed; Subsequent necrosis in the field of their bottom leads to the development of carbuncule.

The forecast for the skin form of the Siberian ulcers is usually favorable.

Generalized form. It is rare in the form of light, intestinal or septic varieties.

Light variety of generalized form. The symptoms of the defeat of the respiratory organs are typical, which is due to the fact that the lungs are the first tissue filter on the path of the outflow of lymph into the blood. The first phase of the disease is manifested by influenznous symptoms: malaise, headache, myalgias, tears, runny nose, cough. From the very beginning, pronounced tachycardia, tachipne and shortness of breath are noted. The duration of this phase is from several hours to 2 days. In the second phase, there is a rapid increase in intoxication, and the body temperature rises to 39-41 ° C, accompanied by a strong chill. Often there are pain and stencils in the chest, cough with an abundant allocation of blood wet, which is cooled in the form of a "cherry jelly". Lightly listened to a large number of wheezes; It is possible the formation of extensive dulling zones of percussion sound over light. On the radiograph, signs of pneumonia or pleurite (serous-hemorrhagic effusion in the pleura) are revealed. The third phase is characterized by a rapid increase in cardiovascular insufficiency, the development of eighty and oliguria. Consciousness of patients is saved. The duration of the third phase is not more than 12 hours.

Intestinal variety of generalized form. Differs in the most severe course and adverse outcome in most cases. For the first short-term phase of the disease (no more than 1.5 days), there are headache, dizziness, pain and burning in the throat, chills, high fever. In the second phase to the listed symptoms, strong cutting pain in the stomach, nausea, bloody vomiting, liquid stools are joined. In the cartoons, blood visually discovered. At the third phase of the disease, the decompensation of cardiac activity catastrophes. Patients are experiencing anxiety, fear. The face of pink-blue or crimson, sclera is injected. In some cases, papulese or hemorrhagic rashes can appear on the skin.

Septic variety of generalized form. It may proceed in the form of a primary sepsis or a secondary, arising as a complication of any forms of the disease. This type is distinguished by the rapid increase in intoxication, the abundance of skin and internal hemorrhages, involvement in the process brain shells. A frequent outcome of this variety is infectious toxic shock.

Complications
The development of meningoencephalitis, the edema and swelling of the brain is possible, gastrointestinal bleeding, passer of the intestine, peritonitis. The most dangerous complication with any form of the disease, especially with generalized, is infectious-toxic shock with the development of the hemorrhagic edema of the lungs. These complications dramatically worsen the disease forecast.

Diagnosis of Siberian ulcers:

The skin shape of the Siberian ulcers should be differentiated primarily from bacterial carbunculov. Siberialess carbuncoon is distinguished by the formation of secondary vesicles ("necklaces") on the edges of the ulcers, black-shaped stamp at its bottom with a characteristic loss of pain sensitivity, a pronounced studdoid edema on the periphery. The latter may precede the formation of the carbuncule (edentous form).

The generalized form is characterized by the rapid increase in signs of intoxication with the development of cardiovascular insufficiency, hemorrhagic syndrome, edema, oliguria, infectious-toxic shock. For different options Its flows state the lesions of the lungs (pneumonia, pleurisy) with abundant blood grid ("cherry jelly"), a gastrointestinal trash, a liquid chair with an admixture of blood.

In some cases, it is necessary to differentiate the disease from the plague and tularemia.

Laboratory diagnostics
Bacteriological studies, consisting of three consecutive stages - microscopy of smears from pathological material, isolating on nutrient media of a clean culture of the pathogen, biological sample on laboratory animals.
Serological studies: The thermocipation reaction on ascoli, luminescent and serological analysis and other serological methods.
Skin-allergic test with anxance.
Studies are carried out in special laboratories in compliance with the rules of working with pathogens dangerous infections.

Treatment of Siberian ulcers:

Penicillin remains an effective etiotropic agent. It is prescribed intramuscularly in daily dose 12-24 million units before the disappearance of clinical signs of intoxication, but not less than 7-8 days. It is possible to prescribe inside of doxycycline in ordinary doses and left-oxacin of 500 mg 1 time per day, in heavy cases - ciprofloxacin intravenously at 400 mg 2 times a day.

Ethiotropic therapy is combined with intramuscular administration of anti-protein-free immunoglobulin: with light form 20 ml, and with heavy and medium-sized forms of 40-80 ml; In case of severe the course of the disease, the term dose can reach 400 ml. The drug is used in heated form 30 minutes after the administration of 90-120 mg of prednisolone.

Active detoxification therapy with intravenous infusions of colloid and crystalloid solutions is needed with the addition of prednisolone and the simultaneous carrying out of the forced diurea. Treatment of heavy complications, including infectious-toxic shock, are carried out according to generally accepted methods.

Prevention of Siberian ulcers:

Epidemiological supervision aims to identify groups and time risk. As with other zonosos, great importance It has the exchange of information for medical and veterinary workers. Stationarily disadvantaged points (locality, livestock farm, pasture, a tract, in the territory of which the epizootic focus was found, regardless of the statute of limitation of its occurrence) and soil foci (cattleochilicians, biotermic pits and other places of burial of animal corpses who fell from Siberian ulcers) . Active observation of the incidence of animals and persons from risk groups.

Preventive actions Include veterinary and health events. The veterinary service detects, accounting, passporting of dysfunctional in the Siberian paragraphs, as well as planned immunization of animals, monitoring the state of cattle bins, pastures, livestock facilities, compliance with appropriate conditions for harvesting, storage, transportation and processing of animal raw materials.

A complex of medical and sanitary activities includes control over the general sanitary situation in dysfunctional points in the Siberian paragraphs, as well as when harvesting, storing, transporting and processing raw materials of animal origin. The identification of sick people, their hospitalization, conducting measures in the foci of infection is carried out by a medical service. Planned vaccine-philatics are carried out among people of certain professions exposed to an increased risk of infection with a Siberian ulcer. This is primarily faces working with alive symbolized cultures, veterinarine workers and other persons professionally engaged in the radical content of livestock, as well as the taste, cutting on the carcass and the removal of the skins, the person engaged in the collection, storage, transportation and primary processing of the raw material of animal origin. Immunoprophylaxis is carried out by two-time introduction of a live vaccine at intervals 21 days. Revaccination is carried out annually.

Preventive disinfection is carried out in stationary disadvantaged points in the Siberian ulcers, livestock farms, in slaughtering points of cattle, in factories, processing products and raw materials of animal origin, as well as in the points of its workpiece, storage and transportation by all types of transport. It is recommended to spend 2 times a year.

Events in the epidemic focus
The patient is hospitalized into an infectious hospital (or infectious compartment). To care for patients with a heavy form of Siberian ulcers, separate medical personnel. Recovered from the skin form of the Siberian ulcers are written out from the hospital after the epithelization and scarring of the ulcers on the place of the disappointing stamp. With a septic form, the discharge is carried out after clinical recovery. Dispensary observation of persecutors not regulated.

The corpses of people who died from laboratory confirmed Siberian ulcers are not exposed to opening. When of course An autopsy conducts a doctor with a mandatory disinfection of the premises, all objects, tools, bathrobes, gloves, shoes, etc. The burial of the corpses of people who died from Siberian ulcers is carried out on a regular cemetery. In cases where the corpse was not opened, it was placed in the coffin, lined with cellophane film, the corpus closely closed the same film with the same film to eliminate contact with the skin of the face and the hand of the corpse. In the burial of the corpse, subjected to autopsy, under the cellophane film on the bottom of the coffin, pour a layer of dry chlorine lime.

Disagreement of contact persons do not carry out. For contacting with a sick animal or a person, they establish medical observation to the complete elimination of the hearth. Emergency prevention shown during the first 5 days of contact; It is carried out by people in contact with the material containing the pathogen or his disputes who took part in the slaughter and cutting the carcass of the animal, which was sick of the Siberian ulcer, as well as persons who cared for sick animals and participated in the burial of their corpses who prepared or eating meat Sick animal. For this, antibiotics are used (phenoxymethylpenicillin per 1 mg 3 times a day for 5 days, tetracycline 0.5 mg 3 times a day or other antibiotics). In the focus spend disinfection.

What doctors should contact if you have a Siberian ulcer:

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Siberian ulcer - especially dangerous infectious disease agricultural and wild animals of all kinds, as well as a person.

Historical reference. For the first time about the disease, similar to the Siberian ulcer, reported about 600 years before our era. This disease was described in detail in the ancient manuscripts, hypocrates, Galen, Celsius wrote about this.

In European countries, epizooty and epidemics of Siberian ulcers were observed 826.992,1682. And later.

In Russia, the Siberian Yazve is mentioned in the annals for 978,1158 and 1284.
Frequent outbreaks of Siberian ulcers were observed in 14.18 centuries. Flashes of Siberian ulcers applied to agriculture. Greater damage is particularly large devastation, the disease caused in Siberia and the European part of Russia.

The first studies in Siberian ulcers were held in Russia in 18 months by Abram Ashke (1758) and Nikita Knieweshchikov (1762), who worked in Siberia.

In 1876 R.ko allocated the causative agent of Siberian ulcers in clean culture and studied its properties in detail. A year later, Ascoli developed a precipitation reaction for the diagnosis of Siberian ulcers. In 1881, Paster suggested a living vaccine for the specific prevention of saber siblings. In Russia for this purpose in 1882. L.S. Sotorkovsky made a live vaccine. From 1944 In practice, the Vaccine (Sanitary Institute of Technology) was widely used, proposed by N.N. Ginzburg and A.L. Tamarin. In 1956 S.G. Kolosov, N.A. Mikhailov and Yu.F. Borisovich offered a hydro-oxuminum vaccine (GNIs - State Scientific and Control Institute of Veterinary Preparations).

Today, the Siberian ulcer is registered in many countries of the world. In Russia, the Siberian ulcer is now registered as sporadic cases or small outbreaks.

Economic damage Pretty significant, since mortality in Siberian ulcers above 60%. During quarantine events, milk is destroyed, corpses and manure from patients are burned. Especially high mortality is noted among small cattle and horses (above 90%). The risk of the emergence of large outbreaks of Siberian ulcers causes the need to constantly organize preventive measures, and the threat of infection of the Siberian ulcer of people makes it very strict veterinary and sanitary activities, to establish quarantine.

Pathogen - fixed bacillus, having a look of a stick, a length of 5-8μ, a thickness of 1-1,5μ; Optional aeroba. In the smears from the blood and tissues of the dead animals, sticks are single or in the form of short chains. The ends of the sticks facing each other sharply cut down, and opposite, free - rounded. In the middle of the sticks of thinner, and to the ends - wider, because of which these chains look outwardly resemble a bamboo cane. When growing on nutrient media, it forms long chains. In the body and in the cultivation of serum and blood media, the bacillus form a capsule. The capsule protects the bacillus from the bactericidal effect of the body's fluids and determines its virulence. The loss of the ability to form a capsule leads to the loss of virulence bacillos. This property bacilli is used in the manufacture of vaccines.

Outside the body at neutral and weakly alkaline reactions of the medium and the access of air oxygen, the symbolized sticks form the disputes of oval shape. Optimal temperatures for sporing 30-35 °. The disputes are not formed at temperatures below 12 ° and above 42 °. There are wild strains.

The vegetative forms of the pathogen are little resistant to unfavorable external environment factors, and disputes are very resistant.
Straight sunlight Kills Bacillus in a few hours. When heated to 50 ° is dying after 30 minutes, up to 75 ° - 1 minute, when boiling instantly. In the water, the symbolized sticks remain viable for several months, in some corpses they persist 2-4 days (in the bone marrow to 7 days). With a negative temperature of -10 °, bacillos remain viable up to 24 days, at-24 ° - 12 days. Disputes at a negative temperature are not dying. Disputes in the external environment remain viable for several decades. Boiling kills them for 45-60 minutes, dry heat at 140 ° - 3 hours. Disputes are resistant and to disinfectants. Thinking the skins and the ball of meat do not kill them. 1% formalin solution and a 10% solution of caustic sodium kill disputes for 2 hours.

Gastric juice destroys bacillos, but does not affect disputes, and they can stand out with feces, while maintaining virulence.

Epizootological data. Animals of all kinds, more susceptibles of sheep, goats, cattle, buffaloes, horses, donkeys, deer, camels, raids are susceptible to the Siberian izres. Less susceptible pigs. Wild empty animals (moose, mountain rams, roasted, bison, wild boars, antelopes, giraffes, zebras) are sensitive to Siberian ulcers. In natural conditions, Siberian ulcers are infected with rodents. Carnivorous animals (dogs, cats), as well as wild carnivorous (foxes, sacks, coyotes) and birds (vultures, hawks, cobbi), relatively resistant to Siberian ulcers. Cats differ only at young age. Infected by the Siberian ulcer in eating the corpses of the fallen from the Siberian ulcers of animals, the disputes of the Siberian ulcers are distinguished for a long time called masses, Contulting the soil during its hunting nomads at a significant area. A person is susceptible to Siberian ulcers.
The source of the causative agent of infection in Siberian ulcers is a sick animal, in some cases, the excretion barmers from which the soil pollute. The excretion of the pathogen of the Siberian ulcers from the body occurs in the last hours of life and in the first hours after his death from natural holes with bloodflenged liquid. Patients of the Siberian ulcers are distinguished by the causative agent with urine, kalis Assam, saliva, and with milk for 10-16 hours before their death. Bacillus of Siberian ulcers with dust, wastewater can be transferred to previously prosperous areas and under favorable conditions to create new foci of infection in the soil. For animals in this respect, swampy, flooded meadows and fields are especially dangerous.

As the transmission factor of the pathogen of the Siberian ulcers is particularly dangerous by the body of the fallen animal from the Siberian ulcers, which is flooded with bacyllams contained in blood, organs, tissues, lymph nodes and in infiltrates available in subcutaneous tissue. As a result of the contact of blood and other discharge from the fallen air, at a temperature of 12-42 ° C, disputes of the pathogen of the Siberian ulcers, infecting the environment and mainly the soil.
Soil infection contributes to the assassination of parts of the corpses of the siberiated animals by carnivorous animals and predatory birds, export to the fields of rals from infected reservoirs, etc. The high stability of the pathogens of the Siberian ulcers in the external environment leads to the fact that the infected areas of the soil decades are potentially dangerous for herbivores. The removal of the siberiated argument from the deep layers of the soil, the infection of its surface layers on the pasture can contribute to the spills of rivers and stormwater, erosion of the soil, the disintegration of the boron sites of animals, various earthworks.
Factors of transmission of the pathogen of the Siberian ulcers are the sources of water supply contaminated with the infected wastewater of leather factories, wrestomies and other industrial enterprises, processing the animal raw materials, animal feed, as well as animal care objects infected by the disputes of the pathogen of the Siberian ulcers.

The main way of infection of animals in natural conditions is -alimentary. Animal infection with an aerogenic way is observed extremely rarely. Animals are infected mainly when contacting the soil during eating feed contaminated with the pathogen or with water through the mucous membranes of the oral cavity and the digestive tract, much less often through damaged skin, nasal mucosa, conjunctiva. Cases of intrauterine infection is very rare. Siberian ulcer can be transmitted by transmissive. IN summer time Blood-suicide arthropods (blind, flies), peeling the blood of patients with animals, can distribute infection for tens of kilometers. Infection of animals by Siberian ulcers with staining insects is more common in wooded places. Among the reindeer outbreaks of the Siberian ulcers are celebrated on hot summertime, when there are extremely many bloodsowing insects in the tundra. The maximum incidence of animals by the Siberian ulcer is observed in the summer months, which is due to the abundance of dust during drought: animals along with dust particles swallow disputes of Siberian ulcers. Dry stalks of plants, rhizomes, damaging mucous membranes of the oral cavity and esophagus, contribute to the emergence of infection.

Pathogenesis. The causative agent of Siberian ulcers penetrates the body only when damaged natural barriers (wounds, scratches of the skin and mucous membranes). Once in the body of the animal, penetrates lymph and blood, multiplies there, causing common septicemia. The nature of the flow and form of the disease depends on the place of penetration of the pathogen, its virulence and resistance of the body. In the pathogenesis, it matters the method of intake animals. Rubbly animals due to the features of the digestion taken feed immediately swallow it, practically non-chewing. As a result, coarse stems fall in the bargain, foreign objectswhich hurts his mucous membrane. All this creates the possibility of penetration of the pathogen of Siberian ulcers directly in blood system, causing a septicemia from an infected animal. Pigs, in contrast to ruminant animals, carefully chew feed and therefore more often wound the mucous membrane of the oral cavity. The pathogen of the Siberian ulcers in the oral cavity falls into a well-developed lymphatic system, as a result they most often register a localized process in the submandibular space.

In the development of the disease, the possibility of bacillic is important to produce certain components of exotoxin. Some types of bacillos, especially if they are weakened, allocate more factor of swelling and less and death. They cause a protracted course of the disease, accompanied by the formation of massive swelling at the place of penetration of the pathogen. Other bacillus form more of the factors of mortality, which leads to a rapid flow of the disease; Edema in this case is minor or missing at all.

The siberiane process in animals is developing in two stages. Initially, the causative agent penetrating the body of the body meets on its path only local protectors that are in mucus and in cells. Neutralization of protective equipment occurs with the help of aggressins and exotoxins allocated by bacillos. In the case when the animal is local protective funds Depressed, the penetrating pathogen of the Siberian ulcers begins to multiply quickly and is entered with the lymph current into lymph nodes. In the fight against the pathogen, the cells of lymphoid type are introduced, which neutralize the toxins of bacilli and causes them lysis. Especially rapidly this process is when the antibiotic animal is introduced, which violate the metabolism in bacilloms. When the bacilli is destroyed, the endotoxins and a capsule substance are released, which sometimes accumulates in places of development of the causative agent in large quantities, causing an edema in animal. Toxic products Bacill damage endothelium vessels. As a result of damage to the endothelium of blood vessels, the normal flow of blood is disturbed, which leads to hemorrhages and fluid infiltration into the surrounding tissue.

After some time, antibodies begin to form an animal, which in large quantities begin to come to the place of development of the Bacillis in the body. In this case, the inductive phase of the formation of antibodies continues 2-4 hours, which depends on the rate of origin of the tremendant, its virulence and other factors. So begins the second stage of the development of infection in the animal body. If the organism is highly essential, the formed antibodies neutralize toxic substances. During this period, an allergic mechanism is additionally operating in the body. As a result, there is a gradual resorption of the inflammatory hearth, the existing clinical signs of the local form of Siberian ulcers disappear, and the animal comes recovery.

With high pendant virulence and as a result of rapid reproduction of it, in the absence sufficient number Antibodies for the neutralization of the pathogen, the disease in an animal will end with the development of sepsis and death.

The pathogen of the Siberian ulcers can flow into the blood or from the inflammatory focus as a result of its large accumulation, or directly when infected. In the event of the penetration of the pathogen in the blood, it is distributed to all organs and tissues with its current. Most of the pathogen who fell into the body is delayed in the spleen, a significant amount of it is settled in the bone marrow. Bacillus who fell into the body begin to multiply quickly and if the organ is not able to hold them more, they enter the blood. This is usually happening 2-3 hours after the primary hit Bacill in the organ. Due to the fact that the blood antibodies have not appeared in the blood, the bacillos begin to multiply in it. In the course of the life of microbes in the blood, the oxygen content is sharply reduced, the acid-alkaline equilibrium is disturbed, the amount of amino acids decreases, the blood loses the ability to coat and acquires a black lacquer. Exotocins violate the permeability of blood endothelium, affect the central nervous system.

In the affected vessels, blood circulation deteriorates, the stool occurs, there is an exudation of the liquid part of blood in various cavities and fabrics, hemorrhages appear. All this leads to shopful deterioration The state of the animal and comes his death.

The flow and symptoms of the disease. The incubation period in Siberian ulcers usually lasts 1-2 days, rarely - more. The Siberian ulcer in animals flows lightning, sharply, incense, atypically and manifests septic and locally. Depending on the location of localization pathological process It is customary to distinguish between the carbuncular and local forms of Siberian ulcers.

In ruminants and horses, the Siberian ulcer flows lightning and sharply with sepsis phenomena and intestinal lesions.

In pigs, the disease occurs more often to the subacuit, sometimes sharply chronically; It is manifested locally, rarely septic.

Lightning flow. For this flow Diseases Animal may die suddenly, without any clinical signs. In the event that the disease is somewhat delayed, some clinical signs are manifested in a sick animal.

In sheep and goats Arrives arises, they grind up their teeth, when walking, they make sharp jumps and fall or make manetable movements. Animal has sharply rising body temperature. Blooding foam is distinguished from the oral and nasal cavities. Typically, animals are dying a few minutes after the appearance of the first symptoms of the disease during a strong convulsive seizure.

Cattle and horses Also, initiation appears, the look becomes frightened, the body temperature rises to 40-42 °, the pulse becomes rapid, breathing heavy, intermittent, visible mucous membranes cyanotic. The starting excitation in individual animals is intensified, but is often replaced by rapidly developing oppression. In cases where an excitation increase occurs in an animal, there is a reduction in individual muscles in different parts Bodies and then muscle groups. Following this, the animal falls, makes a deaf soap, throws the head on the back, sometimes puts it on a torso or presses to the chest and dying. A bloodflenged liquid is distinguished from the mouth and nose, from anus - blood. The death of the animal comes suddenly or within a few hours.

Acute current Diseases accompanied by a high body temperature (41-42 °). In the fever, in the animal, we mark the muscular trembling. Pulse 80-100 per minute, with auscultation, cardiac abbreviations knocking, breathing accelerates and becomes intermittent. The sick animal refuses the feed, the gum stops, thirst increases. Visible mucous membranes cyanotic. Lactation is reduced by lactating cows or completely stops; Waste animals abortion. Disorders of digestion appear, which are accompanied by the intestinal meteorism, constipation or diarrhea. In horses, the sharp flow is accompanied by colic and release of liquid blood masses. Often, blood flow is celebrated in the urine. The sick animal lags behind the herd or octara, periodically stops, breathing heavily and pulls her neck. Due to weakness rear limbs, animal swings. With acute flow in sheep and goats, clinical signs are less pronounced, the body temperature rises. Sheep and goats are excited, sometimes sit down, tipped into the ground and lie in different poses. Their skin in the area of \u200b\u200bthe tip of the nose, temporal bones And on the ears it becomes red. Urine of red, profuse diarrhea alternates with constipation. Sick animals are convulsions, paralysis of the limbs, the curvature of the neck and death comes. In the agonal state of the nose and the mouth there is a breakdown of a bloodflenny liquid. The disease lasts 2-3 days and ends with the death of the animal.

Subighteous current Patients with animals are manifested by the same clinical signs as the acute course. The difference is that with a subacute clinical symptoms Diseases may disappear after a while. During this period, it seems healthy: they are usually eaten food, chew a chew. However, after a few hours, their condition deteriorates sharply. Such attacks of disease in animals can be repeated 2-3 times. Separate sheep and goats may appear edema in the field of udder, belly and genital organs with skin hyperemia on the inside of the hind limbs.

Evenkers are there various shapes And the values, during palpation they are test, cold and painless. In individual animals, sometimes I celebrate Carbuncules. If the owners of the animal will not have a timely animal medical assistanceThe disease will end with fatal. The subacute course of the disease lasts more than 8 days.

Chronic flow Right animals and horses are usually accompanied by progressive exhaustion. Pigs in chronic form are affected by lymph nodes in the neck area. The chronic course of the disease lasts 2-3 months and is usually found when carrying out the post-delivery vestum, especially in pigs. The chronic flow of sheep and goats is rare. It continues up to 2 months and is accompanied by an increase in body temperature, progressive, and diarrhea.

Atypical form Observed very rarely. With her, a patient animal has a weak rise in temperature. Such animals are usually recovered.

Carbunculus form It can be independent or accompany the septic acute and subacute to the flow of the disease. Carbuncules with this form may occur in different parts of the body of the patient. Initially, diseases appear dense, hot and painful swelling. However, very soon swelling becomes cold and painless. In the future, in the center of the Carbuncule, there is a leaning of fabrics, which then disappear, and an ulcer is formed. Sometimes in the language or on the mucous membrane of the sky, the cheeks, lips or in the rectum, bubbles are appear with egg. With the loop of bubbles, the dark liquid is distinguished from them, fabrics on the edges of ulcers are necrotized. The body temperature during the carbuncular form in the animal is increasing slightly.

Local form. This form of Siberian ulcers is usually characterized by a long flow. The body temperature in this form rises slightly. The submandibular, caps and cervical lymph nodes are often affected. The disease is clinically manifested in animals in the form of angina. In the patient of the animal in the neck area there is swelling. At the same time, some animals swelling is small, other animals swelling starts from the larynx, stretches along the trachea and often moves to the chest and forearm. The skin in the neck area at the point of swelling acquires a bluish-reddish tint. Due to the strong swelling of the pharynx, the animal holds his head intensely, the snippet, it cannot be swallowed normally, when taking feed is given. In such animals, we note the cough, hoarse in some cases of vomiting. Visible mucous membranes when examining cyanotic. When examining the pharynx detects swelling of the tongue and solid sky. It is noted only an depressed state, the sore animal seeks to break into the litter and lies for a long time. It rarely happens that the symbolic process can be localized in the lungs. When strong enemy Potta and larynx The death of the animal comes from suffocation.

Pathoanatomic changes. The corpse is strongly swapped, the stuffing is missing or expressed very weakly. Only in sheep, the stuffing occurs around an hour after the death of the animal and is held about 10-12 hours. Very quickly, especially in the summer, an exposition of the corpse comes. From the natural holes, a foam bleeding liquid is distinguished, and sometimes blood. The subcutaneous tissue is permeated with point hemorrhrargia and impregnated by serous-hemorrhagic exudate yellowish color. The subcutaneous tissue vessels are filled with blood. Therefore, the skin, removed from the symbolized corpse, has a dark red color from the inside, the blood of a dark cherry blossom, thick, not curled (tar-shaped). Musculature of brick-red body, flabbulating consistency. In the abdominal and thoracic cavities and in the window-shaped bag - a large number of serous-hemorrhagic exudate. Lymphatic nodes are increased, juicy, sometimes on the surface there are dark cherry-colored hemorrhages. On the cut of the lymph nodes of brick-red. The spleen is greatly increased, full-blooded; On the cut, the softened pulp flows in the form of a coffee ground. In very rare cases, the spleen may be not enlarged. The liver and kidneys are increased slightly. They are brick-red or cherry blossoms, are filled with blood. Lightweight female, hyperemic and permeated with point hemorrhages. Fuchery and bronchi are filled with serous-hemorrhagic fluid. The heart is hyperemed, filled with blood, dark color, on endocardium spot hemorrhages of dark cherry blossom. The intestine is hyperemic, is filled with moderately, the contents are usually bleeding, liquid consistency. The mucous membrane of the thin division of the intestines and especially the 12-sighted intestine is hyperemic, edema and dotted with point and heavy hemorrhages of dark cherry blossoms. Sometimes in the intestines, the thickening of their walls or overlap on the mucous membrane is found in the form of a yellowish-shape. On peer plaques and solitary follicles there may be scape and ulcers. The thick division of the intestine is amazed rarely. Sometimes the mucosa of the rectum find swelling in the form of rollers (carbuncules).

In pigs in Siberian ulcers, hemorrhagic lymphadenitis is often installed with the lesion of submandibular, cap and cervical lymph nodes, and sometimes almonds. In the neck area, a serous-hemorrhagic exudate in the form of a jelly greenish color is found. The affected lymph nodes are usually increased, sometimes to the size of the chicken egg.

In the initial stage of the disease in lymph nodes, minor, the magnitude with the pea pin head, lesions are noted. In the future, lymph nodes are faded, and their color on the cut can vary from brick-red to purple-red. Against this background, dark red or dark cherry dotted hemorrhages are distinguished. In the future, lymph nodes are necrotized, lose their structure, become friable, brittle, crumbling. Sometimes they look like a lattice bone or porous limestone. In individual animals in lymph nodes, various abscesses are found, surrounded by a connective tissue capsule.

Very rarely in the lungs, you can detect the swelling of the magnitude from pigeon to the chicken egg.

In the intestinal form of Siberian ulcers, there is a damage to a limited sector, it is usually hemorrhagically inflamed. Under the damage to the large portion, the gut has the form of a thick tube of dark red. On the mucous membrane, a limited swollen dark-red round inflammatory foci with a diameter of several millimeters to 3 cm is detected. They are noted mainly on Peyer plaques, they are easily subject to necrosis, and then it is formed a crumb-shaped mass of greenish yellow or yellow-gray. At the site of necrotic masses, ulcers with uneven edges are found. Brocereshy brick or brick-red brick lymph nodes. In the affected place mesentery of the female, blood vessels Injected. In the case of a sluggish treatment of the disease according to the periphery of lymph nodes, we note productive inflammation, as a result of which the integrated tissue is growing, while the hinges of the intestines will grow together and arranged in the neighboring authorities. Inflammatory areas are encapsulated with the formation of a pus inside the capsules, sometimes these sites are subject to necrosis. Often the intestinal shape of Siberian ulcers is limited by the development of hemorrhagic inflammation in one of the mesenteric nodes and edema mezhek. In individual animals, at the opening, we show heart attacks in the spleen, liver, kidneys.

With a carbuncular shape on the skin we find the nodules of red.

Diagnosis to Siberian ulce clinical signs It will establish difficult, due to the lightning flow, they are expressed, and in acute and other currents are similar to the symptoms of other diseases. The most reasonable suspicion of the Siberian ulcer occurs from a veterecyalist only with a carbuncular form or in the presence of edema in the submandibular region (especially in pigs).

Open the corpses in suspected Siberian ulcers are categorically prohibited, so the main method of diagnosing Siberian ulcers is bacteriological. To this end, the patient's animal or corpse take blood from the surface vessels of the ear, tail, limbs and make thick strokes on several slot glasses or other small clean pieces of glass. The smears are dried in the air in the shade and are cleaned into clean, better parchment paper. After that, they are thoroughly wrapped with polyethylene film and tie. As an exception instead of blood smears, an animal corpse can be taken to study the ear. For this, the lower ear in the corpse is tied up above and below the place of the intended line of the cut and after the clipping the ends of the chip is migrated. The ear is wrapped in parchment paper and polyethylene film. Instead of parchment paper, you can use a material impregnated with a 3% solution of carbolic acid or other disinfectants. Wrapped ear placed in a jar, which is tightly closed.

Since in blood pigs in the blood, the pathogen of Siberian ulcers is rarely discovered, they are not suitable for bacteriological research. If there is edema in the submandibular region, then in this place, we carefully make a cut and get the struck submandibular, plug or cervical lymphone. In the event that changes in the corpse are not detected, as an exception, they produce an autopsy and take the affected areas of organs. Taking pathological material produced at the site of the destruction of the corpse.

Pathological material is placed in a jar with a fit and carefully wrapped into parchment paper, and then into a polyethylene film. Material for research should be fresh (without signs of decomposition). It is sent to the windbathorry urgently and necessarily with a drug. If the material is receded, the reaction of precipitation uses.

Especially carefully veterinary specialists should conduct a study with a forced kiss of the animal. Branches must bear in mind that the degree of expression of pathological changes in this case may be different - from barely notable lesions in lymph nodes and swelling in subcutaneous tissue to pronounced changes in organs and tissues. The industrialists of farms, the gloomy in all cases of the forced slaughter of animals are obliged to send material from these animals into a windbathorry to exclude primarily Siberian ulcers and food toxicoinfections.

Differential diagnosis. When diagnosing a diagnosis to Siberian ulcers, the branch must be excluded from cattle: and; In sheep:, Pastellosis, Emcar, malignant swelling, sheep piroplasmosis; Pigs:, malignant OTD and.
When Emkar and the gas swelling at palpation of swelling, attitudes are heard (crackling), and at percussion - clear tympanic sound.

With Pastellosis, the rapid increase in inflammatory edema of subcutaneous tissue, lung damage.

Bradzot and Enterothemia Sheep on clinical signs is difficult to distinguish from Siberian ulcers. In all cases, the diagnosis must be confirmed by bacteriological research.

Treatment with a patient with an animal branch must be rendered immediately, since the disease often lasts only a few hours. Patients need to be isolated from other animals. The best results in the treatment are obtained by simultaneously use of specific hyperimmune serum and antibiotics (penicillin, biomycin, streptomycin, etc.). Serum is injected intravenously in doses: large cattle and horses 100-200ml; Small cattle, calves and pigs 50-100ml. In order to prevent anaphylactic shock, the animal first injected 0.1-1 ml of serum, and after 15-30 minutes, the rest of the dose. Serum before administration is heated in a water bath to 37-38 °. Simultaneously with the introduction of serum, antibiotics are injected with a sick animal. Antibiotics are injected intramuscularly 3 times a day every 4 hours, and when the state is improved by 6 hours. In the event that the temperature in the patient's animal is not reduced after 6-12 hours, the serum is administered again. The course of treatment usually lasts 3-4 days.

Antibiotic therapy is desirable to spend in maximum doses (500 thousand e d penicillin of the animal weight). Serum and antibiotics can be applied and separately, but the effect of treatment is reduced. Upon local manifestation of Siberian ulcers (carbuncules, swelling in the submandibular region) drugs can be injected and around the pathological focus.

Immunity and specific prophylaxis.

To create passive immunity, a hyperimmune serum or globulin is used, which is administered animals in a half-time dose. After the introduction of the above drugs, the immunity in animals occurs immediately and lasts up to 10-14 days.

The first vaccine against Siberian ulcers was proposed by L. Pasteur in 1881.

In Russia, such a vaccine was made by L.S. Scenkovsky in 1882.

In 1940 N.N. Ginsburg in the USSR created highly immunogenic and practically aactogenic for animals and people a spore vaccine against Siberian ulcers.

Now for the prevention of Siberian ulcers, a vaccine against Siberian ulcers from strain 55-VNIIIVV and M.

Vaccine is released in 4 forms: lyophilized. Liquid, concentrated, superconcentricated.

The vaccine is used once for preventive and forced vaccinations of all types of animals. It is not allowed to use a vaccine of young people who have not reached 3 months of age, sick, weak and depleted animals having increased body temperature, animals in the last month of pregnancy and for 7-10 days after delivery, for 7-10 days after Surgical operations, in the hot and cold season, as well as with the disadvantaged farms in acute infectious diseases. Adult animals are immunized once a year. Young people of all types of animals, except foals, are vaccinated for the first time in 3 monthly ageFoal - in nine-month, re-in six months.

The dry vaccine concentrated (with intradermal and subcutaneous administration) is divorced by sterile saline or water in compliance with the aseptic rules.

The vaccine at subcutaneous administration is used in the following doses:
Sheep and goats in the area of \u200b\u200bthe rear third neck or into the inner surface of the hip in the volume of 0.5 ml; horses, cattle, deer, camels and donors in the area of \u200b\u200bthe rear third neck in the amount of 1ml; Pigs in the field of the inner surface of the thigh or behind the ear in a dose of 1ml.
The concentrated and diluted superconnecated vaccine is administered intraderially with the help of a non-bihed injection of the Bi-7 "Wood"; Cattle, deer, camels - in a razless section of the crotch or dairy mirror, horses and dose-in the area of \u200b\u200bthe rear third of the neck, pigs - behind the ear in the volume of 0.2 ml, sheep and fur beasts - in the sheath mirror in the dose of 0.1ml.

Prohibited subcutaneous use of a vaccine divorced for intradermal application.

For vaccination, syringes, needles, as well as an idle intersect, are used, which before starting and after the end of operation are sterilized with boiling in distilled water for two hours. Do not use chemical disinfectants for sterilization.

In the process of immunization, the bottle with vaccine periodically shake.
During vaccination, the rules of asepsis and antiseptics are followed. The vaccine place is disinfected by a 70% ethyl alcohol solution.
Immunity at graft animals occurs after 10 days and last at least 12 months. Waterstecialists within 10 days after vaccination are monitored by vaccinated animals.

Milk from graft animals is allowed to use without restrictions. The slaughter of vaccinated animals is allowed 10 days after vaccination. In the case of forced slaughter of vaccinated animals before this period, the carcass and boa waste are sent to industrial processing or burned.

On the vaccination on vaccinated animals, an act indicating the number of vaccinated animals (by type), the name of the vaccine used, the manufacturer, the number of the series and the state control, the dates of its manufacture, the amount of vaccine spent, as well as the name of the Wetspecialist vaccinated cattle and observed for its condition and the content of vaccinated animals. The act of animals belonging to agricultural enterprises, LPH and KFH are attached to the act, indicating the name of the owner, the species, quantities and ages belonging to him animals.

If for any reason (acute disease, low fatness, deep pregnancy, etc.) Animal cannot be instilled, it is included in a separate inventory indicating the reason, due to which it has not been vaccinated, and the possible vaccination period about They are informed by the owner of the animal.

Documents (acts and inventories) are subject to storage at the branch and in the institution of a state-owner for 2 years.

Veterinary specialists within 14 days after vaccination are required to monitor all vaccinated animals.

Measures of struggle. Plots of the territory on which there were cases of animal diseases by Siberian ulcers, are taken by the vehicle on strict accounting, regardless of the time of the disease. In agricultural enterprises, LPH and KFH, located in these territories, all animals must be regularly subject to anti-protectic vaccinations.

In the case of the detection of an animal, sick of the Siberian ulcer, it is necessary to urgently isolate it and organize treatment. In the case of a case of an animal, the cause of death is established, and the corpse is burned along with the skin.
On the farm, LPH, kfch and locality in which the Siberian ulcer is established in accordance with Order No. 476 of December 19, 2011 of the Ministry agriculture RF "On approval of a list of contagious, including specially dangerous animal diseases, which can establish restrictive activities (quarantine) by the decision of the regional governor, quarantine is superimposed and activities are held in accordance with the instructions on measures against Siberian ulcers (approved by the main management of veterinary department of the USSR Ministry of Agriculture June 5, 1981).

Quarantine is removed after 15 days from the date of the last case of the case or recovery of the animal, sick of the Siberian ulcer and in the absence of reactions in animals to vaccine vaccinations.

When removing quarantine, an act is drawn up with an indication of the course of the disease to vaccinations, the date and number of fallen animals by type, the number of graft animals, the names of the used vaccine, doses, numbers, series and the government control, the date of manufacture, the name of the bofabrika, which had complications after vaccinations conducted by veterinary -Sanitarian events, places of storage of infected manure, etc.

Malignant carbuncoon or anthrax is the most famous in medical circles the names of Siberian ulcers. What else do we know about this disease? She is found online today in certain areas. But these statisticians do not interfere with the disease to enter the list of the most dangerous infections around the world. Another feature of Siberian ulcers is rapid development and a large number of deaths, despite the early detection and practically lightning care.

What is this infection? How does the Siberian ulcer manifest? Where does this disease come from and how dangerous is she for others? What to do at the first signs and how to treat an infection? What preventive measures will help avoid infection? Let's deal with these issues.

Historical information about Siberian ulcers

The first mention of the disease reached us since ancient times. Then the infection was known under the mythical names: "Holy Fire", in some sources - "Persian fire".

Why is the Siberian ulcer now so called? In pre-revolutionary times in Russia, cases of the disease in Siberia became increasing, which was the reason to call the disease at its occurrence. At the end of the XVIII century, Russian scientist S.S. Andreevsky as a result of experiments on himself proved that the disease is transmitted from the animal to a person.

In history, there are a number of assumptions that it was the bacteria of Siberian ulcers used as a biological weapon during the war.

In the entire history of studying the Siberian ulcers, the causative agent was fully described by several scientists almost simultaneously, but only R. Koh first allocated him. Now this infection occurs occasionally, and the number of cases per year does not exceed a dozen. Then why is it still interested in doctors? There are weighty reasons for it.

Siberian causative agent

Siberian ulcer is bacterial infection. The causative agent has a number of features, so that it easily multiplies and leads to the affix of the internal organs.

The pathogen of the Siberian ulcers (Bacillus Anthracis) refers to the genus Bacill. This is a major gram-positive wand. These bacteria can be in two forms - vegetative and disputes.

What is the difference between the causative agent of Siberian ulcers?

1. In the usual form of bacteria, they quickly die during boiling and action on them disinfectants.
2. Disputes are saved in the soil for decades without changing their properties.
3. Those types of bacteria that can cause a disease in the animal body produce specific substances that impede the work of immunity against the pathogen.
4. Disputes of the Siberian ulcers are resistant in the external environment, but die only during autoclaving after 40 minutes.
5. Bacteria can highlight exotoxin, leading to edema and fatal outcome.

The pathogen of Siberian ulcers can be found in the environment, while working with animals. It is much easier to proact with him, but it is almost impossible to get rid of it. It is important that bacteria are deep in the soil, from where with precipitation or thanks to the wild animals they spread over the ground.

Ways transfer

The source of Siberian infection is sick animals, including home:

Cats and dogs are practically immune to bacteria. Siberian ulcers in domestic animals often flows in generalized form. The person's susceptibility depends on the number of causative agents in the body, from the path of infection and immunity.

Ways of transmission of Siberian ulcers, following.

IN surrounding man The setting is three sources of Siberian ulcers:

• agricultural;
• industrial;
• domestic.

For the first option, seasonality is characterized - it manifests itself more often in the summer-autumn period, but you can meet with others throughout the year. Flashes or epidemics of Siberian ulcers in Russia are registered and in our time. The last surge in infection was recorded in November 2016.

How do bacteria behave inside the human body

What is a Siberian ulcer? - This is a sharp, particularly dangerous bacterial infectious disease, characterized by strong intoxication, the formation of foci of inflammation on the skin, an increase in lymph nodes and damage to the internal organs.

Why do the pathogen refer to one of the most dangerous all over the world? The bacteria of the Siberian ulcers fall inside the person through damaged areas of the skin, and can also penetrate the mucous membranes of the respiratory tract, possibly through gastrointestinalWhat happens much less frequently.

In the place where the introduction of the primary complex of lesions - carbuncoon develops. This is a focus of inflammation with elements of necrosis or tissue homing with the involvement of adjacent lymph nodes (lymphadenitis).

The inflammation of lymph nodes occurs due to the fact that blood cells are trying to cope with the causative agent of Siberian ulcers and deliver them here, but the result turns out to be opposite. All primary effects leading to fabric damage occur due to exotoxin allocation. So, the skin form of Siberian ulcers is developing more often.

Septic Siberian ulcer occurs in the introduction of the pathogen through the digestive system or through the respiratory tract. Blood infection is the most unfavorable sign regarding human life.

From the moment of the yield of infection in the blood, it takes place on all internal organs, while amazed:

• all heart shells;
• digestive organs and lymphatic system, its surrounding;
• lungs;
• brain.

Mass penetration of bacteria in all organism systems and isolating toxin leads to inflammation and kneading cells.

Symptoms of Siberian ulcers

This is one of the fastest growing infections. The incubation period of the Siberian ulcers is from several hours to three days.

Two main forms of the disease are known:

• localized or skin;
• septic.

In almost 98-99% of cases, the shape of Siberian ulcers is developing. What is different?

Besides general signs Carbunculeous forms of Siberian ulcers, there are some more features of its flow.

1. This form in developing it on the face and mucous membranes is often striking the upper respiratory tracts, which, maybe end up with a suffocation and lightning death.
2. One of the distinguishing prognostic symptoms of Carbuncoule is trembling, resembling jelly fluctuations when tapping a special percussion hammer. This symptom is called Stefan.

Symptoms of other forms of localized Siberian ulcers

In addition to the carbunculent form of Siberian ulcers, there are some more options for the course of this type of disease.

What other types of Siberian ulcers exist? This is a generalized or septic form of the disease.

The signs of the generalized form of Siberian ulcers include:

The eighth eighth, inflammation of the brain, peritonitis and the defeat of the heart muscle leads to an instant fatal outcome.

Classification of Siberian ulcers by severity

Septic form is always characterized by severe flow. Localized has its own classification. In 80% of cases, it is light and medium-sized forms.

The forecast for the skin form of the Siberian ulcers in most cases is favorable and can end in full recovery. With the development of sepsis and involve other organs and systems, the disease ends with a fatal outcome.

Diagnosis of infection

In the correct diagnosis, clinical and epidemiological and laboratory data play the role. At the time of the development of the epidemic of the Siberian ulcers, the diagnosis is easy to put. In other cases, relying falls on clinical data and laboratory diagnostics.

In the formulation of the diagnosis, bacteriological and bacterioscopic methods of detection of the pathogen plays.

1. The material for studying during the skin form of the disease is the boruncular separated; with light - sputum; generalized - blood. Anyone biological fluid Explore in a special room to avoid possible infection of health workers. Press up strokes painted in grams, then the culture of cells are seeded on special environments. A few hours later, the growth of bacteria is evaluated.
2. The diagnosis of Siberian ulcers using a bacteriological method occurs by infection guinea pigs or laboratory mice.
3. Apply immunofluorescent methods.
4. Nowadays, also use allergological diagnosis of Siberian ulcers. For this, the person is introduced from the "Anxance", with a positive result, changes on the skin appear on the fifth day.

Treatment of Siberian ulcers in humans

Due to a pronounced action on toxin tissue, even timely, the initiated treatment does not guarantee full recovery. Therefore, this infection belongs to the category of particularly dangerous.

The care plan for sick Siberian ulcers includes:

• its complete isolation into specialized boxes of an infectious hospital;
• lack of contacts with loved ones;
• gentling diet for the entire treatment period;
• regular observation of the patient of the medical staff;
• maintaining the work of all systems and organs.

The treatment of Siberian ulcers in people is carried out on the following points.

The treatment of Siberian ulcers is carried out only in the hospital under the supervision of doctors. Even light form Infections are not a reason for destination of the home mode.

Prevention

The prevention of Siberian ulcers in humans are engaged in state -plain services and veterinary doctors. The first stage is not specific prophylaxis Diseases.

Vaccination of people against Siberian ulcers

Specific prevention and the main way to reduce morbidity among people is an advent of Siberian ulcers. Due to the large number of deaths after the development and serious flow of infection, there was a need to search for modern methods of preventing the disease. A vaccine against Siberian ulcers was created.

Currently, three vaccine options are used:

• siberian vaccine vaccine, which is applied from and intraderially;
• inactivated vaccine;
• combined anti-vaccine vaccine is available in the form of injections and dry matter.

Alive I. combined drug Used in Russia.

Vaccine against Siberian ulcers is introduced once. There are other options for administering the drug, which depends on the type of vaccine. For example, for the first time they make a vaccination with an interval of 20 or 30 days. 2 weeks after that, human immunity is produced against the disease. But we protect vaccines only for a short period of time - just a year.

Indications for vaccination

Vaccination of people against Siberian ulcers is carried out in the foci of infection. But the prevention is carried out not to everyone, but only certain categories of individuals.

Who is in the risk group for the development of infection?

1. Employees of laboratories involved in the development of a vaccine or in the study of people and animals in the places of frequent occurrence of Siberian ulcers.
2. All employed in the field of animal husbandry: workers scotch, doctors-veterinarians.
3. People often contact with animals - scaffolding.
4. Working on enterprises for skin processing and wool.

Of course, it is not in every region they instill all persons from the above categories. Prevention is carried out only in areas where cases or outbreaks of infection have been recorded. That is, the vaccine is introduced to people from dangerous areas on the emergence of Siberian ulcers. And can also instill people commoded to these areas, provided that their work is also associated with animals.

Perform vaccination starting from 14 years. Vaccination make either the season of development of infection or in emergency cases At the moment of infection.

Body reaction

How is vaccine transferred? Mostly well. Local or general reactions of the body are possible after its introduction:

• local is inflammation or redness there, where the drug was injected;
• of the generals it is necessary to note weakness, malaise, perhaps a slight increase in body temperature and even a small increase in local lymph nodes.

Contraindications

Contraindications for vaccination against Siberian ulcers, the following:

• do not conduct vaccination if the previous introduction was the reaction;
• people with diseases of the connecting tissues, the vaccination is contraindicated;
• with the problem of skin diseases;
• age up to 14 years old and over 60.

Bacteria of Siberian ulcers are able to easily straighten into the human body and cause the disease. If immunity is weakened and the number of bacteria turned out to be critical - human disease develops quickly. Until the actual manifestation of Siberian ulcers, all the surrounding people are in the risk group. Despite great amount antibacterial drugs Nowadays, it is not always possible to cope with the infection, because most of them will not have time to act on bacteria. Therefore, the main treatment is prevention.

Siberian ulcers (malignant carbuncoon; anrhrax; rag disease; a disease of the sorters of wool) is a particularly harsh, saprosological, bacterial infection with a contact transmission mechanism and characterized by serous-hemorrhagic skin inflammation and other organs against intoxication.

The disease is known since ancient times called "Holy Fire", "Persian Fire" and others. In pre-revolutionary Russia, due to the predominant distribution in Siberia, it received the name of Siberian ulcers. A significant role in this title was played by the Russian scientist S.S. Andreevsky, self-use proven identity of the Siberian ulcers of a person and an animal, as well as indicating the possibility of transferring it from animals to a person. Do not worry, Andreevsky cured.

The pathogen - Bacillus Antracis, it is gram-positive (in the smears of blue color) fixed wand. TO nourishing media Not demanding and forms colonies, in the form of threads of departing from the center, as a result, this growth is often compared with "curls" or "lionen mane". Features of the structure are factors of pathogenicity, i.e what explains the clinical current:

If you get into the body forms a capsule - it protects the pathogen from phagocytosis (cell destruction immune system);
Outside the body, with the action of adverse factors of the external environment, the pathogen forms a dispute, which makes it extremely stable.
The presence of a somatic and capsule antigen that has a diagnostic value in the formulation of the Askol reaction;
The presence of a complex toxin, which consists of the 3rd components: of the defective factor, the action of which is based on the accumulation of CAMF in cells - the activation of this cascade reaction explains the output of Na and Cl from the cell, and after them and the water in the intercellular space, there are edema . The population antigen, the population of which causes the formation of immunity, the LF-lethal factor causes a fatal outcome, having a cytotoxic effect and summing up the ethiotic factor, by the formation of the edema of the lungs.

Vegetative forms of Siberian ulcers have the same degree of sustainability, as well as other non-rooting bacteria - at temperatures above 75 ° C are dying after 5-10 minutes, in animal corpses under the influence of livelihood products. pinged bacteria and enzymatic factors - death occurs within 7 days. Also, the causative agent quickly dies under the action of boiling and disinfecting solutions within a few minutes.

There is a different deal with the spore-forming form, which has time to form from the part of the pathogens who have fallen under the conditions of adverse factors: in the soil they are kept decades (about 60 years) after the death of the owner and, when re-hitting in another organism, begin to germinate in vegetative forms and Again become active. Resistant to boiling - die for 30-60 minutes. When autoclaving (steam action 100 ° C) - 40 minutes. Dry heat with a temperature of 140 ° C kills disputes for forms within 3 hours. Direct Ufa is destroyed for 20 or more days. Disinfecting solutions (chlorine, hot formaldehyde, hydrogen peroxide) kill disputes for 2 hours.

The susceptibility is universal and is associated with the paths of infection, the value of the infecting dose and the factors of the resistance of the macroorganism. Geographic prevalence has no restrictions, but the most often recorded episodic outbreaks in countries with temperate climates, and mainly in livestock regions in spring-autumn period. As a result of the repetition of biological cycles (the burial of infected animals → The pathogen falling into the soil → Education dispute → eating other animals of infected grass → Infection), the pathogen of the Siberian ulcers contributes to the creation of long-term active soil foci, that is, potentially dangerous territories are "damned fields". As such, there are no geographical foci, there is a conditional foci of foci: professional-agricultural, vocational and industrial and household.

Causes of Siberian ulcers

Symptoms of Siberian ulcers

The incubation period is from the moment of the introduction of the pathogen in macroorganism and to the first clinical manifestations, it can last during Siberian ulcers from several hours to 8 days, but more often 2-3 days. The duration of this period will depend on the paths of penetration and infecting dose of the pathogen. So, for example, with a transmission mechanism, a skin arises, and incubation period 2-14 days, and with an aerogenic or alimentary infection, a generalized form arises, in which the incubation period lasts only a few hours, and death comes 2-3 days. But the contact path does not exclude generalization, the chances of the occurrence of such a lightning course of the disease are simply reduced, as in generalization.

At the place of deployment of the pathogen, there is an action of toxin and this indicates the beginning of the next period, because in this place there is a modification of tissues. The period of clinical manifestations is characterized by acute principle and, depending on the entrance gate, either the skin or generalized form arises. But in any case, where the pathogen does not have, everywhere there will be the same mechanism - damage to the endothelium of blood vessels occurs, with the result that their permeability is disturbed, serous-hemorrhagic edema, inflammation, hemorrhagic infiltrates and loss of sensitivity in the infection gates occurs:

Under the skin form - a reddish or bluish spot is developing, similar to the insect bite → After a few hours, it is rebuling this spot in a pimple (a vulnerable bubble - papula) copper-red → then this pimple turns into a bubble with serous-hemorrhagic content, And nearby - child little bubbles. In fact, all this skin formation is accompanied by burning and itching, and when calculated, this bubbles are opened with the formation of ulcers covered with dark brown lap (reminds of the angle, from here and the name of antrax-coal disease) - this indicates the formation of a carbuncule (skin inflammation and subcutaneous fatty fiber around the group hair follicles). Around this formation - hyperemia (redness), edema and loss of pain sensitivity. Regional lymphhadenitis registered near Carbunkula (the increase in the closest lymph nodes is dense, movable, slightly sensitive) and lymphangitis (an increase in lymphatic vessels located near Carbunkula). The presence of lymphadenitis is a sign of drift by macrophages of the causative agent into these lymph nodes. Skin changes are underway against the background of the general conciliation state and fever (38-40 ° C), in the form of chills, weaknesses, headaches and reduced blood pressure. On the 8-10 day of the disease, with proper and timely treatment, the processes of scarring and epithelials of ulcers occur, with sharp decline Temperatures and improvement of the general background state. Even in 10-30 days, the Strick turns away and the ulcer heals.

The generalized form can be as primary, i.e, when infected with an alimentary or aerogenic way and secondary as a result of the occurrence of septicemia due to the distribution of the pathogen with lymphogenic and hematogenic way. This form is characterized by a rapid beginning, stunning chills, revealed symptoms of intoxication, headache, vomiting, tachycardia, progressive hypotension (reduction of systemic pressure), deafness of cardiac tones.
When infected with an aerogenic way, the pulmonary form of generalized the flow occurs and, to all of the time, characteristic of the generalized form are joined the following symptoms: Child, pain in chest With breathing, shortness of breath, coughing with bloody wet, which almost immediately acquires a jelly-like consistency, the breathing and shortening of the percussion sound speaks of the developing pleurite (inflammation of the pleural / pulmonary leaflets), solid-caliber wet raids are listened. With this form, death occurs in 90% of cases and within 2-3 days even during treatment.
When infected with an alimentary way, an intestinal form of a generalized flow is developing, for which, in addition to the generally combat symptoms, the following are inherent in the first day: from the first day of the disease - cutting pains in the lower abdomen, bloody vomiting and a frequent liquid stool with an admixture of blood, the intestinal paresis and peritonitis.

Diagnosis of Siberian ulcers

1. According to epidemic data - study of the place of work (care of the cattle, cutting carcasses, working with leather and skins), conditions and place of residence (countryside), consumption of infectious products (consumption of meat of not past veterinary and sanitary control, forced to slaughter sick animals ) etc

2. For clinical sources - the presence of a black stamp with a hyperemia whisk ("black corner on a red background"). This skin formation is powered by a needle and, if the sensitivity is reduced or absent, it gives a chance to confirm the preliminary diagnosis.

3. Laboratory data:
- bacteriological research by microscopy of smears from the patient's biological material: blood, urine, vomit mass, feces, wet
- genetic method (determination of the pathogen DNA using a PCR method, i.e. polymerase chain reaction)
- Serological method: Reef (immunofluorescence reaction) and rland (reaction of indirect hemagglutination) - these two expensive methods are aimed at determining the antigen. ELISA (enzyme immunoassay analysis) - determines the intensity of immunity.
- Immunohistochemical method
- Skin-allergic test with anxissine

4. Additional methods Studies in suspected generalized form: Ultrasound, Lumbal puncture, OAK, OAM - they are applicable only to determine the degree of compensation from the underlying bodies and the system, to address the further preparation of the treatment plan.

Treatment of Siberian ulcers

Treatment complex, consisting of etiotropic, pathogenetic and symptomatic therapy. It is also necessary to comply with the beddown for the period of the disease and compliance medical nutrition - Table №13, and in difficult cases pass on enteral-parenteral nutrition (that is, partially ordinary feeding, and partly - intravenous-drip).

1. Etiotropic therapy is aimed at the destruction of the pathogen, using such drugs as: ampicillin, doxycycline, rifampicin, peffloxacin, ciprofloxacin, gentamicin, amikacin - combine them and used in the appropriate age dosages for 7 days, and with severe currents - For 14 days.
2. Pathogenetic therapy is to join the anti-protein immunoglobulin.
3. Local treatment is only in the processing of the affected areas of the skin with solutions of antiseptics. The dressings do not impose, surgical treatment does not apply, because it can provoke the generation of infection.
4. In the development of life inheritant complications (ITH - infectious-oxide shock), prednisone (the strongest GKS) is used, disinfecting therapy is carried out, aimed at combating hemodynamic disorders - polyionic solutions are used with the addition of polyglyukin, refooliglucin or hemodesa.

The statement of recovering patients under skin shape is carried out after rejection of the stamp and the formation of the scar. In generalized forms, they discharge after complete clinical recovery and a two-time negative result of bacteriological studies with 5 day intervals. Maintaining such patients at home hospital is unacceptable.

Complications of Siberian ulcers

ITS, sepsis, meningitis, one (acute respiratory failure)

Prevention of Siberian ulcers

Veterinary: Identification and timely diagnosis with subsequent treatment or caution of sick animals, epizootological examination of the hearth, disinfection of the corpses, the destruction of meat / skins / wool of fallen animals, the current and final disinfection in the focus, rehabilitation of cattle bisos / pastures / unfavorable territories on the causative agent, as well as planned Immunization of lively siberiane vaccine of farm animals in adverse items. Medicosanic events:

Monitoring the observance of commonitarian norms in the workpiece, storage, transportation and processing of raw materials of animal origin;

Vaccinoprophilaxis of a lively controversial dry-free vaccine - double-planned (in potentially dangerous areas) or unscheduled (by epidemic testimony, followed by revaccination annually);

Timely diagnosis, hospitalization and treatment of patients;

Epidemic survey of the focus, followed by the current and final disinfection;

Ban on the opening of patients due to the high risk of contamination by disputes;

Persons in contact with patients with people or animals are administered anti-member immunoglobulin and etiotropic drugs for 5 days, and in contact with the same is observed within 14 days.

Consultation of the doctor in Siberian ulcers:

Question: Is the sick person dangerous?
Answer: Sick people do not pose a danger to others, but in contact with them, for the purpose of prevention, they still conduct passive immunization.

Question: Is immunity formed after the suffering disease?
Answer: It is formed, but not long and not resistant, there are cases of repeated diseases.

Question: What gives the vaccine-philantic?
Answer: Vaccine is considered highly efficient and sharply reduces the risk of morbidity.

Doctor Therapist Shabanova I.E.