The air was slightly chilly that afternoon in the Soviet town. The sky was hazy blue, the sun hanging lazily at an oblique angle of 39 degrees above the horizon. There was a prevailing northerly wind to be had, but otherwise, nothing of consequence seemed to be happening. Just another day in Soviet Russia.
The date: April 2nd, 1979. Unbeknownst to the town’s 1.2 million Slavic inhabitants, something of great, deadly significance was afoot that day. It might be more accurate to say “aloft,” actually. For death was in the air that day, though the citizens had no way of knowing it [1].
Gently wafting through the air that day was a multitude of minute, but deadly spores. Carried by the prevailing wind from the site of a nearby military facility, like hell’s snowflakes, some descended upon the city. By pure chance, some spores found and entered human hosts, 96 in number. Some spores entered through cuts in the skin of their new hosts, the result of a slipped knife while preparing dinner, perhaps. The others were inhaled, sucked in along with the frigid Russian air. There was no telltale flash of pain in the moment of exposure and infection, not even a festering sense of unease. Nothing at all. Just another day in Soviet Russia. On the macroscopic scale at least.
For some, it began with what looked like a small insect bite, around four days after exposure. These were the people who had been infected through cuts or scrapes. Itchy, but painless, these initial lesions probably wouldn’t have been given much thought. These bumps, however, would grow in diameter to as large as three centimeters, developing a blackened, necrotic center. Additionally, the tissue surrounding this center would have been marked by severe edema (abnormal fluid retention). Overall, these visually alarming developments would thankfully not be accompanied by proportional amounts of pain. The majority of this group would at worst suffer the symptoms of fever, malaise, and headache.
These people would be the lucky ones, all would survive, though left with a permanent scar at the site of the blackened lesion. [2,3]
Those who inhaled the deadly spores were less lucky. First came the general symptoms of malaise, fatigue, and fever. Then difficulty breathing, caused by the compression of the trachea by swollen lymph nodes. Finally, an onset of septic shock. Once this occurred, there would only be two days at most before the immunological battle would be over, with a final victory most probably belonging to the invader, and not the invaded. Of the 79 individuals infected by inhalation, 64 would ultimately expire from their afflictions, a staggering fatality rate of 81%. [1,3]
The identity of this deadly, efficient killer? The bacterium Bacillus anthracis. More colloquially, just anthrax.
The 1979 outbreak of anthrax in the Soviet town of Sverdlovsk is the event that I described above. It was not a natural outbreak of anthrax.
In an incident that probably cost someone his job at the least, or perhaps an obligatory decade-long vacation to the tropical locale of the Siberian wastes, weaponized anthrax spores (designed to be aerosolized) were accidentally released from the military facility located on the edge of the town. The prevailing wind served to carry the airborne spores over and into the town. The military origin of the outbreak was confirmed in late 1992, when Russian president Boris Yeltsin was quoted as vaguely acknowledging that “the KGB admitted that our military developments were the cause.” [1]
This just goes to show: the idea of weaponizing anthrax is not a new one, despite the fact that the most relevant incident in (American) minds would be the relatively recent 2001 anthrax attacks [Wikipedia]. In fact, as early as WWI, anthrax was by Germany used as a biological weapon, although in that instance, the target were horses being raised for usage in Allied cavalry units and not humans [4].
Bacillus anthracis itself is not a newcomer to the microscopic party. A 1981 paper speculates that the Egyptian 5th and 6th plagues ca 1250 BC (illness and boils affecting livestock and people) described in the Bible is the earliest recorded incident of an outbreak of anthrax. There is also evidence that the ancient Greeks and Chinese were familiar with the ravaging effects of anthrax on both beast and man, based on descriptions in the writings of Hippocrates (400 BC) and a couple of medical texts, respectively (500-600 BC). Later, it was Koch’s work with anthrax in the 1870s that allowed him to formulate his famous Four Postulates (4 conditions that must be fulfilled before one can connect a disease to a pathogen, still used today)[5]. As a side note, anthrax arrived in the US in the early 1700s, and had reached both east and west coasts by the second half of the 1800s [4].
Anthrax may not be new, but neither does it seem like it’s going away any time soon. Today, it has a global distribution, although the frequency of animal and human cases is highest in developing countries who don’t regularly practice animal vaccination for anthrax but primarily rely on animal husbandry for a source of income. With the current largest livestock population, animal anthrax is a common occurrence in India, although human cases occur only intermittently. As recently as 2010, 600 people died as the result of eating meat contaminated with anthrax in Bangladesh [2]. Anthrax is still out there, “in the wild,” and not just in the freezers of some military research facility.
About Anthrax
What exactly does anthrax do, out in the wild? Exposed to the elements, anthrax exists in the form of dormant, environmentally resistant spores. Much like giardia, although with the slight difference that giardia forms cysts, and not spores. You’ll notice that the general modus operandi of these two pathogenic organisms is the same though: revert to a dormant state until introduced to the nutrient-rich and exploitable environment of a host.
Gruinard island: here be was anthrax
Anthrax spores can last a very long time though. Case in point: anthrax spores were intentionally released on the Scottish Gruinard island during World War II for biological warfare trials. Over 40 years later, when people finally got around to decontaminating the island, some of those spores were still viable [6].
Yeah, so anthrax spores can last a long time in the environment, but in this inert state, they aren’t doing or harming anything (or anyone).
What happens when a spore enters a host?
Once a spore enters a host either through the cutaneous (skin), inhalational, or gastrointestinal routes, it germinates into its active “vegatative bacteria” form. This is when the interesting (and deadly) stuff starts to happen. The bacterial cells shortly produce a capsule that protects them from the activity of phagocytic (engulfing) immune cells [5]. In addition, the capsule blocks antibodies from attaching to the bacterial cell [7].
On the offensive side, anthrax releases two toxins, called lethal and edema toxin. As a whole, these two toxins serve to disable early immune responses to infection, which gives the bacteria time to multiply [3,5]. As the amount of bacteria present in the host’s circulatory system increases, the toxins also disrupt the functions of the heart, blood vessels, and the liver inducing fatal vascular shock [5].
Upon the death of host, anthrax bacilli are released into the environment. In the case of infected animals, this might happen when scavengers rip open the infected corpse. When the anthrax cells come into contact with oxygen, they convert into their spore form, completing one turn of anthrax’s life cycle [2]. It’s a messy one.
So, can you do anything besides sit and wait once you get infected by anthrax?
Thankfully yes! Once anthrax has been identified as the particular pathogen that ails you, a number of antibiotics (including penicillin) are viable treatments, although depending on the route you were infected, the dosage and means of application (e.g IV, oral) may vary [3,5].
It’s important to note though, that just because you’ve killed all of the anthrax, doesn’t mean you’re in the clear. You also need to deal with all the toxin that was produced. Antibodies introduced as a therapeutic accomplish this, but only to a limited degree, as they can only neutralize toxins that haven’t been absorbed by cells. For an optimal outcome, it seems treatment must be early as possible [5]. In the case of the 2001 anthrax attacks, early identification and treatment resulted in a 42% mortality rate, which is still kind of high, but far better than the normal 92% [2].
What about vaccines?
Yes, there are vaccines too, several of them. Some use a component of the anthrax toxin, while others use capsule-less anthrax bacilli. [5]
So while anthrax isn’t anything to scoff at, you ought to be encouraged that there are at least vaccines and methods of treatment in the event you do get infected. Anyhow, if there’s anything you’ve taken away from this, it’s that if you manage to acquire a time machine, you definitely don’t want to travel to Sverdlovsk, Russia in early April, 1979.
~ BJW
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