CONTROL OF THE DISEASES

CAUSED BY GRAM POSITIVE:

BACILLUS ANTHRACIS, CLOSTRIDIUM
TETANI, STREPTOCOCCUS PYOGENES,
MYCOBACTERIUM TUBERCULOSIS

By: prof. Taksh d vala

BACILLUS ANTHRACIS
 Anthrax is a rare but serious illness caused by a spore-
forming bacterium, Bacillus anthracis. Anthrax mainly
affects livestock and wild game. Humans can become
infected through direct or indirect contact with sick
animals.
 There's no evidence that anthrax is transmitted from
person to person, but it's possible that anthrax skin
lesions may be contagious through direct contact or
through contact with a contaminated object (fomite).
 Usually, anthrax bacteria enter the body through a wound
in the skin. You can also become infected by eating
contaminated meat or inhaling the spores.
 Symptoms
 There are four common routes of anthrax infection, each
with different signs and symptoms. In most cases,
symptoms develop within six days of exposure to the
bacteria. However, it's possible for inhalation anthrax
symptoms to take more than six weeks to appear.
 Cutaneous anthrax
 A skin-related (cutaneous) anthrax infection enters your
body through your skin, usually through a cut or other sore.
It's by far the most common route of the disease. It's also the
mildest. With appropriate treatment, cutaneous anthrax is
seldom fatal. Signs and symptoms include:
 A raised, itchy bump resembling an insect bite that quickly
develops into a painless sore with a black center
 Swelling in the sore and nearby lymph glands
 Sometimes, flu-like symptoms including fever and headache
You can contract anthrax when spores penetrate your skin, usually through an
open wound. The infection begins as a raised, sometimes itchy, bump resembling
an insect bite. But within a day or two, the bump develops into an open, usually
painless sore with a black center.
 Gastrointestinal anthrax
 A gastrointestinal anthrax infection results from eating
undercooked meat from an infected animal. It can affect your
gastrointestinal tract from your throat to your colon. Signs and
symptoms include:
 Nausea

 Vomiting

 Abdominal pain

 Headache

 Loss of appetite

 Fever

 Severe, bloody diarrhea in the later stages of the disease

 Sore throat and difficulty swallowing

 Swollen neck
 Inhalation anthrax
 Inhalation anthrax develops when you breathe in anthrax
spores. It's the most deadly form of the disease, and is often
fatal, even with treatment. Initial signs and symptoms include:
 Flu-like symptoms for a few hours or days, such as sore throat,
mild fever, fatigue and muscle aches
 Mild chest discomfort
 Shortness of breath
 Nausea
 Coughing up blood
 Painful swallowing
 High fever
 Trouble breathing
 Shock — an acute medical condition involving collapse of the
circulatory system
 Meningitis
This illustration shows how the spores that cause inhalation
anthrax — the most deadly form of anthrax infection — enter and
affect the body.
PREVENTION
 To prevent infection after being exposed to anthrax spores, the
Centers for Disease Control and Prevention recommends:
 A 60-day treatment with antibiotics — ciprofloxacin,
doxycycline and levofloxacin are approved for adults and
children
 A three-dose series of anthrax vaccine
 In some cases, treatment with monoclonal antibodies —
raxibacumab and obiltoxaximab
 Anthrax vaccine
 An anthrax vaccine is available for certain groups of people.
The vaccine doesn't contain live bacteria and can't lead to
infection. However, the vaccine can cause side effects, ranging
from soreness at the injection site to more-serious allergic
reactions.
 The vaccine isn't intended for the general public. Instead, it's
reserved for military personnel, scientists working with anthrax
 Avoiding infected animals
 If you live or travel in a country where anthrax is
common and herd animals aren't routinely vaccinated,
avoid contact with livestock and animal skins as much as
possible. Also avoid eating meat that hasn't been
properly cooked.
 Even in developed countries, it's important to handle any
dead animal with care and to take precautions when
working with or processing imported hides, fur or wool.
CLOSTRIDIUM TETANI
 Tetanus is a serious disease of the nervous system
caused by a toxin-producing bacterium. The disease
causes muscle contractions, particularly of your jaw and
neck muscles. Tetanus is commonly known as lockjaw.
 Severe complications of tetanus can be life-threatening.
There's no cure for tetanus. Treatment focuses on
managing symptoms and complications until the effects
of the tetanus toxin resolve.
 Because of the widespread use of vaccines, cases of
tetanus are rare in the United States and other parts of
the developed world. The disease remains a threat to
people who aren't up to date on their vaccinations. It's
more common in developing countries.
SYMPTOMS
 The average time from infection to appearance of signs and
symptoms (incubation period) is 10 days. The incubation
period can range from 3 to 21 days.
 The most common type of tetanus is called generalized
tetanus. Signs and symptoms begin gradually and then
progressively worsen over two weeks. They usually start at
the jaw and progress downward on the body.
 Signs and symptoms of generalized tetanus include:
 Painful muscle spasms and stiff, immovable muscles (muscle
rigidity) in your jaw
 Tension of muscles around your lips, sometimes producing a
persistent grin
 Painful spasms and rigidity in your neck muscles
 Difficulty swallowing
 As the disease progresses, other signs and symptoms
may include:
 High blood pressure

 Low blood pressure

 Rapid heart rate

 Fever

 Extreme sweating
 Localized tetanus
 This uncommon form of tetanus results in muscles
spasms near the site of a wound. While it's usually a less
severe form of disease, it can progress to generalized
tetanus.
 Cephalic tetanus

 This rare form of tetanus results from a head wound. It

results in weakened muscles in the face and spasms of
the jaw muscles. It also can progress to generalized
tetanus.
COMPLICATIONS
 Complications of tetanus infection may include:
 Breathing problems. Life-threatening breathing problems can
occur from tightening of the vocal cords and muscle rigidity in
the neck and abdomen, especially during a generalized spasm.
 Blockage of a lung artery (pulmonary embolism). A blood
clot that has traveled from elsewhere in your body can block
the main artery of the lung or one of its branches.
 Pneumonia. A lung infection caused by accidentally inhaling
something into the lungs (aspiration pneumonia) may be a
complication of generalized spasms.
 Broken bones. Generalized spasms may cause fractures of the
spine or other bones.
 Death. Death from tetanus is often caused by a blocked airway
during spasms or damage to the nerves that regulate breathing,
heart rate or other organ functions.
PREVENTION
 Vaccination for children
 The tetanus vaccine is given to children as part of the
diphtheria and tetanus toxoids and acellular pertussis vaccine
(DTaP). Diphtheria is a serious bacterial infection of the nose
and throat. Acellular pertussis, also called whooping cough, is
a highly contagious respiratory infection.
 Children who do not tolerate the pertussis vaccine may receive
the alternative vaccine called DT.
 The DTaP is a series of five shots typically given in the arm or
thigh to children at ages:
 2 months
 4 months
 6 months
 15 to 18 months
 4 to 6 years
 Vaccination for children ages 7 to 18
 A booster shot is recommended for children at age 11 or 12. This
booster is called the Tdap vaccine. If your child didn't get a
booster shot as this age, talk to your doctor about appropriate
options.
 Vaccination for adults age 19 and older
 A booster shot is recommended for adults once every 10 years.
This may be one of two vaccines, Tdap or Td. If you weren't
vaccinated against tetanus as a child or are unsure about your
vaccination status, see your doctor about getting the Tdap vaccine.
 Vaccination during pregnancy
 A booster is recommended during the third trimester of a
pregnancy, regardless of the mother's vaccination schedule.
 Other recommendations
 Ask your doctor to review your vaccination status regularly.
 Check whether you are current on your vaccination schedule if
you are planning international travel.
STREPTOCOCCUS PYOGENES
 Strep throat is caused by infection with a bacterium
known as Streptococcus pyogenes, also called group A
streptococcus.
 Streptococcal bacteria are contagious. They can spread
through droplets when someone with the infection
coughs or sneezes, or through shared food or drinks. You
can also pick up the bacteria from a doorknob or other
surface and transfer them to your nose, mouth or eyes.
SYMPTOMS
 Signs and symptoms of strep throat can include:
 Throat pain that usually comes on quickly
 Painful swallowing
 Red and swollen tonsils, sometimes with white patches or
streaks of pus
 Tiny red spots on the area at the back of the roof of the
mouth (soft or hard palate)
 Swollen, tender lymph nodes in your neck
 Fever
 Headache
 Rash
 Nausea or vomiting, especially in younger children
 Body aches
Strep throat usually causes throat pain and difficulty swallowing.
This photo of strep throat shows inflammation and red spots,
caused by the infection.
COMPLICATIONS
 Strep throat can lead to serious complications. Antibiotic
treatment reduces the risk.
 Spread of infection

 Strep bacteria may spread, causing infection in:

 Tonsils

 Sinuses

 Skin

 Blood

 Middle ear
 Inflammatory reactions
 Strep infection may lead to inflammatory illnesses, including:
 Scarlet fever, a streptococcal infection characterized by a
prominent rash
 Inflammation of the kidney (poststreptococcal
glomerulonephritis)
 Rheumatic fever, a serious inflammatory condition that can
affect the heart, joints, nervous system and skin
 Poststreptococcal reactive arthritis, a condition that causes
inflammation of the joints
 A possible relationship has been suggested between strep
infection and a rare condition called pediatric autoimmune
neuropsychiatric disorder associated with group A streptococci
(PANDAS). Children with this condition experience worsened
symptoms of neuropsychiatric conditions, such as obsessive-
compulsive disorder or tic disorders, with strep. This relationship
currently remains unproved and controversial.
PREVENTION
 To prevent strep infection:
 Wash your hands. Proper hand-washing is the best way
to prevent all kinds of infections. That's why it's
important to wash your own hands regularly with soap
and water for at least 20 seconds. Teach your children
how to wash their hands properly using soap and water
or to use an alcohol-based hand sanitizer if there is no
soap and water available.
 Cover your mouth. Teach your children to cover their
mouths with an elbow or tissue when they cough or
sneeze.
 Don't share personal items. Don't share drinking
glasses or eating utensils. Wash dishes in hot, soapy
water or in a dishwasher.
MYCOBACTERIUM TUBERCULOSIS
 Tuberculosis is caused by a bacterium called Mycobacterium
tuberculosis.
 People with active TB disease in the lungs or voice box can
spread the disease. They release tiny droplets that carry the
bacteria through the air. This can happen when they're
speaking, singing, laughing, coughing or sneezing. A person
can get an infection after inhaling the droplets.
 The disease is more likely to spread when people spend a lot
of time together in an indoor space. So the disease spreads
easily in places where people live or work together for long
periods. Also, the disease spreads more easily in crowded
gatherings.
 A person with a latent TB infection cannot pass the disease to
other people. A person taking drugs to treat active TB disease
usually can't pass the disease after 2 to 3 weeks of treatment.
SYMPTOMS
 When tuberculosis (TB) germs survive and multiply in
the lungs, it is called a TB infection. A TB infection may
be in one of three stages. Symptoms are different in each
stage.
 Primary TB infection. The first stage is called the
primary infection. Immune system cells find and capture
the germs. The immune system may completely destroy
the germs. But some captured germs may still survive
and multiply.
 Most people don't have symptoms during a primary
infection. Some people may get flu-like symptoms, such
as:
 Low fever.

 Tiredness.

 Cough.
 Latent TB infection. Primary infection is usually
followed by the stage called latent TB infection. Immune
system cells build a wall around lung tissue
with TB germs. The germs can't do any more harm if the
immune system keeps them under control. But the germs
survive. There are no symptoms during
latent TB infection.
 Active TB disease. Active TB disease happens when the
immune system can't control an infection. Germs cause
disease throughout the lungs or other parts of the body.
Active TB disease may happen right after primary
infection. But it usually happens after months or years of
latent TB infection.
 Symptoms of active TB disease in the lungs usually
begin gradually and worsen over a few weeks. They
may include:
 Cough.

 Coughing up blood or mucus.

 Chest pain.

 Pain with breathing or coughing.

 Fever.

 Chills.

 Night sweats.

 Weight loss.

 Not wanting to eat.

 Tiredness.

 Not feeling well in genera

PREVENTION
 If you test positive for latent TB infection, you may need
to take drugs to prevent active TB disease.
 Preventing the spread of disease

 If you have active TB disease, you'll need to take steps to

prevent other people from getting an infection. You will
take drugs for four, six or nine months. Take all of the
drugs as directed during the entire time.
 During the first 2 to 3 weeks, you will be able to
pass TB bacteria to others. Protect others with these steps:
 Stay home. Don't go to work or school.

 Isolate at home. Spend as little time as possible among

members of your household. Sleep in a separate room.
 Ventilate the room. Tuberculosis germs spread more
easily in small, closed spaces. If it's not too cold
outdoors, open the windows. Use a fan to blow air out. If
you have more than one window, use one fan to blow air
out and another to blow air in.
 Wear face masks. Wear a mask when you have to be
around other people. Ask other members of the
household to wear masks to protect themselves.
 Cover your mouth. Use a tissue to cover your mouth
anytime you sneeze or cough. Put the dirty tissue in a
bag, seal it and throw it away.
 Vaccinations
 In countries where tuberculosis is common, infants often
are vaccinated with the bacille Calmette-Guerin (BCG)
vaccine. This protects infants and toddlers who are more
likely to have active TB disease in the fluid surrounding
the brain and spinal cord.
 The vaccine may not protect against disease in the lungs,
which is more likely in the United States. Dozens of
new TB vaccines are in various stages of development
and testing.