Wednesday, April 01, 2020
     

KANSAS GOVERNOR LAURA KELLY'S EXECUTVE ORDER 20-16  Statewide "stay home" order unless performing an essential activity (read the order for details)

Information regarding the Coronavirus (COVID-19) from the Marion County Health Department.

 
THE MARION COUNTY COURTHOUSE IS TEMPORARILY CLOSED  to public walk-in traffic

PUBLIC ATTENDANCE OF COUNTY COMMISSION MEETINGS BY TELECOMMUNICATION ONLY.  Pursuant to KS Governor Order 20-16, in-person attendance at the County Commission meetings will not be allowed at this time.  We encourage attendance by telecommunication which also allows public interaction.
To join the County Commission meetings from your computer, tablet or smartphone, go to https://global.gotomeeting.com/join/639484901 or by phone dial 1-866-899-4679.  The access code is 639-484-901#.

Please contact individual County offices directly for any questions or assistance.

Anthrax

Epidemiology:

  • Anthrax can be transmitted by inhalation, ingestion, or inoculation (inhalation) is the most likely during a bioterrorist attack)
  • The spore form of ANTHRAX is highly resistant to physical and chemical agents: spores can persist in the environment for years.
  • Anthrax is not transmitted from person to person

Clinical:

  • Incubation period is 1-5 days (ranges up to 43 days)
  • Inhalation anthrax presents as acute hemorrhagic mediastinitis
  • Biphasic illness, with initial phase characterized by nonspecific flu-like illness followed by acute phase characterized by acute respiratory distress and toxemia (sepsis)
  • Chest x-ray findings: Mediastinal widening in previously healthy patient in the absence of trauma is pathognomonic for anthrax
  • Mortality rate for inhalation anthrax approaches 90%, even with treatment. Shock and death within 24-36 hours

Laboratory Diagnosis:

  • Laboratory specimens should be handled in a Bio-safety Level 2 facility (e.g. California state Microbial Diseases Laboratory)
  • Gram stain shows gram positive bacilli, occurring singly or in short chains, often with squared off ends (safety pin appearance). In advanced disease, a gram stain of unspun blood may be positive
  • Distinguishing characteristics on culture included: non-hemolytic, non-motile, capsulated bacteria that are susceptible to gamma phage lysis
  • ELISA and PCR test are available at national reference laboratories

Patient Isolation:

  • Standard barrier isolation precautions. Patients do not require isolation rooms
  • Anthrax is not transmitted person to person

Treatment:

  • Prompt initiation of antibiotic therapy is essential
  • Antibiotic susceptibility testing is KEY to guiding treatment * Ciprofloxician (400 mg IV q 12 hr) is the antibiotic of choice for penicillin-resistant anthrax or for empiric therapy while awaiting susceptibility results
  • All patients should be treated with anthrax vaccine if available; antibiotic treatment should be continued until 3 doses of vaccine have been administered (day 0, 14 and 28). If vaccine is unavailable, antibiotic treatment should be continued for 60 days.

Prophylaxis:

  • If vaccine is available, all exposed persons (as determined by local and state health deparmemt) should be vaccinated with 3 doses of anthrax vaccine (days 0, 14 and 28)
  • Start antibiotic prophylaxis immediately after exposure with ciprofloxicin (500 mg po q 12 hrs) or doxycycline (100 mg po q 12 hrs). (If strain is penicillin -susceptible, therapy can be modified to penicillin or amoxicillin.)
  • Antibiotic prophylaxis should be continued until 3 doses of vaccine have been administered; if vaccine is unavailable, antibiotics should be continue for 60 days.