Don’t panic about Anthrax

Easy for me to say: I don’t have anthrax.

But as the Mail and Guardian dives in with this headline:

…I think it’s important to understand that anthrax – at least the bit of anthrax they’re talking about here – isn’t going to be the next Coronavirus, just like Monkeypox isn’t either. This is an unfortunate outbreak in the far North West corner of Sierra Leone.

Obviously, that’s bad news for the far North West corner of Sierra Leone, but it’s unlikely to adversely affect anyone outside that area.

This headline does highlight a couple of things regarding reporting of infectious diseases in the press though. Firstly, the tendency to sensationalise things a little. Anthrax can be a deadly pathogen, but a short course of really basic antibiotics will see it happily on its way. A vaccine for your herd of cattle will stop it before it’s even begun.

And “fray”:

a usually disorderly or protracted fight, struggle, or dispute

…does rather suggest that we are engaged in a constant fight against microbes, which yes, again, is kind of true, but then that always has been the case: that’s biology. There’s nothing exceptional about this particular outbreak. Anthrax has been around for millennia and so have we. It’s inevitable that our paths will cross every now and again. These things haven happened all the time and we never heard about them before. But we’re much more sensitive about bacteria and viruses now, because of what’s happened over the last couple of years.

Indeed, if the South African M&G (and yes, I recognise that this is an article originally from their pan-African partner) had taken just a moment to scoot around some high-quality local blogs, they’d find that we’ve had anthrax outbreaks right on our national doorstep very recently: In Zim in 2008 and in Lesotho in 2019. And we survived them.

With all the difficulties of obtaining decent data in deepest, darkest Africa – the continent upon which most of the global anthrax cases occur – it’s difficult to say how much anthrax there is around. But the generally accepted numbers are somewhere between 20,000 and 100,000 cases each year worldwide.

And yes, mostly in Africa, and yes, mostly in poorer, rural areas.

Just like the Port Loko District in the far North West corner of Sierra Leone.

All of which does rather make one wonder why the M&G is using that sort of language in a headline over a couple of hundred cows and sheep.

First Horseman Sighted, Detained.

Breaking News here on your favourite neighbourhood blog: the much-anticipated first official sighting of a Horseman Of The Apocalypse has officially taken place somewhere around the border between Lesotho and the Free State. And while everyone thought they knew exactly which of the quartet was going to have a go at finishing us all off first, it’s a shock victory for Plague over the odds-on favourite, War.

In fact, the bug in question – Bacillus anthracis – is arguably much worse than Yersinia pestis (which causes bubonic plague). This one causes Anthrax: it’s all over landlocked Lesotho like a heavily infected blanket, and now it’s knocking at the door of SA.

The Veterinary Authority of Lesotho has reported three anthrax outbreaks to the World Organisation for Animal Health.

The department of agriculture, forestry and fisheries (DAFF) has banned livestock imports and their products from Lesotho into South Africa, following a report of a susceptible anthrax outbreak.

According to a report, the first outbreak started on May 12, and a total of 24 cattle were reported to have died of anthrax.

The good news for SA is that this first Horseman of the Apocalypse won’t be allowed to enter the country on his noble steed, due to the implementation of those livestock imports. And any of the other Horsemen of the Apocalypse – War, Famine and Conquest – hoping to cross the border into SA to kill us all, would likely also be stopped by these draconian, yet necessary, restrictions.

It’s actually a bit of an own goal for Plague, who has been under constant pressure since Fleming’s discovery of penicillin in 1928 and the vaccine work of Edward Jenner and Jonas Salk, both of which have really limited the options available when it comes to ending the world through disease.
Even though his policy of over-prescription of antibiotics and his recruitment of Andrew Wakefield in the late 90s has had some detrimental effect on the general health of the human race, we’re actually still some way from losing the war with microbes. And this new development of trapping each of his companions on the wrong side of a border point near Maseru is certainly not going to win him any fans amongst those anxious to see all life ending in South Africa – and indeed, the world.

I know. Few would have thought that the planet’s impending doom would have been altogether less impending because of some underpaid Home Affairs officials in the middle of the Free State countryside, but it does seem that, with the scary blokes and their equine companions banged up in Lesotho, the world is safe – at least for the time being.

We’ll be keeping you updated on this story as Donald Trump sends in American helicopters and a Navy Seals extraction team to grab War and Conquest ahead of his planned nuclear obliteration of Iran.

Happy Days.

Oopsie! My bad!

Incoming from Atlanta:

As many as 75 scientists working in US government laboratories in Atlanta may have been exposed to live anthrax bacteria and are being offered treatment to prevent infection from the deadly organism, the US Centers for Disease Control and Prevention (CDC) says.

That’s not good.

Potentially dangerous bugs are categorised on a 1-4 scale so that when we’re working with them, we can handle them appropriately and protect ourselves (both laboratory workers and the general public) accordingly:

  • Hazard Group 1 – A biological agent that is unlikely to cause human disease.
  • Hazard Group 2 – A biological agent that can cause human disease and may be a hazard to employees; it is unlikely to spread to the communityand there is usually an effective prophylaxis or effective treatment is usually available.
  • Hazard Group 3 – A biological agent that can cause severe human disease and presents a serious hazard to employees; it may present a risk of spreading to the community but there is usually effective prophylaxis or treatment available.
  • Hazard Group 4 – A biological agent that causes severe human disease and is a serious hazard to employees; it is likely to spread to the community and there is usually no effective prophylaxis or treatment available.

Bacillus anthracis – the bacteria that causes Anthrax – is a Hazard Group 3 organism. For reference, Ebola virus is a 4 (you have to wear a big yellow suit), E.coli is a 2 (you can play with it on your desk), and Tobacco Mosaic Virus is a 1 (you can lick it and still not get ill).
Obviously, this is a scale set up for humans. If you’re a tobacco plant, Tobacco Mosaic Virus would be right up there in the 4’s. TMV is the tobacco plant version of Ebola. Tobacco plants should not lick TMV. Hell, tobacco plants shouldn’t even have tongues.

So, while you’d probably rather not work with stuff at the top end, sometimes you just have to (I do this with TB – also group 3 – every day), so you take precautions, for example “inactivating” (read: “killing”) the bug before you work with it. That’s what should have happened with this B.anthracis, but someone made an oopsie and forgot to do it.
Or at least forgot to do it right. Awkies.
Or maybe deliberately chose to forget to do it. (In which case, click here.)

Thus, what should have been a perfectly harmless bug turned out to be anything but, and now loads of people have potentially been exposed to a rather nasty disease:

With anthrax, the biggest threat is inhalation anthrax, in which bacterial spores enter the lungs where they germinate before actually causing disease, a process that can take one to six days. Once they germinate, they release toxins that can cause internal bleeding, swelling and tissue death.
About 90 percent of people with second-stage inhalation anthrax die, even after antibiotic treatment.

Fortunately, you have to mess around quite a lot with B.anthracis to get those spores aerosolised (as in Dustin Hoffman’s famous line in Outbreak: “OMG… it’s gone airborne!”) in order that they can be inhaled, so that’s probably not… sorry… they did what?

Two of the three labs conducted research that may have aerosolised the spores, the CDC said on Thursday.

“…may have”. Lolz. I love it. As if it’s something that could have happened accidentally.
That’s like saying:

“Steve, did you write a detailed 2500 word essay on the formation of the popular 1980s rock band Def Leppard, with specific reference to their roots in city of Sheffield and the declining mining and manufacturing sectors in South Yorkshire around the time of their inception, this morning?”

“Umm. I may have.”

Presumably, these US Government labs were merely working on Anthrax in order to protect the general public should any more “white powder” letters be sent through the US Postal Service.
As the two crisply dressed, concerningly efficient American gentlemen who are suddenly standing behind me (how did you guys get into my house, by the way?) have just pointed out, I can’t for the life of me think what other reason they would have for producing aerosolised Anthrax spores, inactivated or otherwise.

Anthrax – the bug that keeps on giving

So, in addition to all the other problems that Zimbabwe faces, which are too many, too varied and far too well-documented to even think about listing here, and following hot on the heels of the recent cholera outbreaks, anthrax has now reared its ugly head.

Anthrax can kill when infected meat is touched, or eaten or when infected spores are inhaled. A quarantine zone has been declared in the affected areas of Matebeleland North, but because of the desperate hunger in the region some families are still eating infected meat. Traders have also been seen taking potentially infected carcasses out of the restricted zones to trade in Victoria Falls, which risks the disease spreading across Zimbabwe and even over the border into neighbouring Zambia. 

An emergency assessment by the Save the Children and the Ministry of Health found 32 cases of human anthrax in Binga district. Anthrax infections have also killed 160 livestock, as well as two elephants, 70 hippo and 50 buffalo. But with symptoms lying dormant for up to 21 days or more and no communications in the region, the death toll could already be higher.

In all likelihood, this outbreak is due to the breakdown in veterinary services and the routine vaccination of livestock – a similar effect was seen with diphtheria in the independent states formed when the Soviet Union fell apart in the early 1990’s. And while the lack of vaccination is probably the main reason behind this new threat to Zim and its people, it is ably assisted by a general lack of medical resources including antibiotics, a shortage of food and no decent communication network throughout the country.

This isn’t Zimbabwe’s first anthrax outbreak. In fact, the country holds the dubious record of the largest ever human anthrax outbreak, which occurred during the civil war in 1979/80, with close on 11,000 human cases and 182 deaths. The spores of Bacillus anthracis from that episode almost 30 years ago are the little buggers responsible for this new outbreak. What I didn’t know until recently was that there is evidence, albeit nothing concrete, that the 79/80 outbreak was probably caused by deliberate release (i.e. biowarfare) as part of the bitter conflict which was taking place at that time.
Much like landmines once the war is over, the spores don’t just disappear once the epidemic has passed. Vaccination of livestock has kept the disease at bay since independence, but the spores have just been hanging around, waiting for their moment in the spotlight.
Thanks to Mr Mugabe, it’s now turned into a talent contest for bugs. Pop Die-dol. Strictly Come Dying. Whatever. I’m not sure Zimbabwe can take any more. Microbiologically, it’s pretty interesting though.

UPDATE: Nice piece by Rowan Philp in the Sunday Times on what life is actually like in Zim right now.