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PLoS Neglected Tropical Diseases Dec 2022Anthrax is a serious zoonosis caused by Bacillus anthracis, which primarily affects wild herbivorous animals with spillover into humans. The disease occurs nearly...
Anthrax is a serious zoonosis caused by Bacillus anthracis, which primarily affects wild herbivorous animals with spillover into humans. The disease occurs nearly worldwide but is poorly reported in Southeast Asian countries. In Vietnam, anthrax is underreported, and little is known about its temporal and spatial distributions. This paper examines the spatio-temporal distribution and epidemiological characteristics of human and livestock anthrax from Dien Bien province, Vietnam from 2010 to 2019. We also aim to define the role of livestock vaccination in reducing human cases. Historical anthrax data were collected by local human and animal health sectors in the province. Spatial rate smoothing and spatial clustering analysis, using Local Moran's I in GeoDa and space-time scan statistic in SaTScan, were employed to address these objectives. We found temporal and spatial overlap of anthrax incidence in humans and livestock with hotspots of human anthrax in the east. We identified three significant space-time clusters of human anthrax persisting from 2010 to 2014 in the east and southeast, each with high relative risk. Most of the human cases were male (69%), aged 15-59 years (80%), involved in processing, slaughtering, or eating meat of sick or dead livestock (96.9%) but environmental and unknown exposure were reported. Animal reports were limited compared to humans and at coarser spatial scale, but in areas with human case clusters. In years when livestock vaccination was high (>~25%), human incidence was reduced, with the opposite effect when vaccine rates dropped. This indicates livestock vaccination campaigns reduce anthrax burden in both humans and livestock in Vietnam, though livestock surveillance needs immediate improvement. These findings suggest further investigation and measures to strengthen the surveillance of human and animal anthrax for other provinces of Vietnam, as well as in other countries with similar disease context.
Topics: Animals; Humans; Male; Female; Anthrax; Livestock; Vietnam; Bacillus anthracis; Animals, Wild; Spatial Analysis; Vaccination; Disease Outbreaks
PubMed: 36538536
DOI: 10.1371/journal.pntd.0010942 -
American Family Physician May 2003Recent events have demonstrated that bioterrorists have the ability to disseminate biologic agents in the United States and cause widespread social panic. Family... (Review)
Review
Recent events have demonstrated that bioterrorists have the ability to disseminate biologic agents in the United States and cause widespread social panic. Family physicians would play a key role in the initial recognition of a potential bioterrorism attack. Familiarity with the infectious agents of highest priority can expedite diagnosis and initial management, and lead to a successful public health response to such an attack. High-priority infectious agents include anthrax, smallpox, plague, tularemia, botulism, and viral hemorrhagic fever. Anthrax and smallpox must be distinguished from such common infections as influenza and varicella. Anthrax treatment is stratified into postexposure prophylaxis and treatment of confirmed cutaneous, intestinal, or inhalation anthrax. Disease prevention by vaccination and isolation of affected persons is key in preventing widespread smallpox infection. Many resources are available to physicians when a bioterrorism attack is suspected, including local public health agencies and the Centers for Disease Control and Prevention.
Topics: Anthrax; Bacterial Infections; Bioterrorism; Botulism; Hemorrhagic Fevers, Viral; Humans; Plague; Smallpox; Tularemia; Vaccines; Virus Diseases
PubMed: 12751654
DOI: No ID Found -
Clinical Microbiology and Infection :... Jun 2014Microbiological war and terrorist attacks are made to weaken populations by transmitting pathogenic and epidemic microorganisms. These bacteria or viruses are often... (Review)
Review
Microbiological war and terrorist attacks are made to weaken populations by transmitting pathogenic and epidemic microorganisms. These bacteria or viruses are often difficult to diagnose. Anthrax alerts following September 2001 showed that most clinical microbiology laboratories were not adequately prepared, using obsolete diagnostic methods or being too slow to use accurate tools when facing a major threat. Following this period, most microbiology laboratories were prepared for bioterrorism alerts, in order to provide accurate and rapid results, although such events are rare and unexpected. In this review, we describe the organization and preparedness of our clinical microbiology laboratory regarding bioterrorism risk, although its main task is to perform routine diagnostic microbiology tests. To illustrate the difficulties, we briefly describe an anthrax alert.
Topics: Anthrax; Bacteriological Techniques; Bioterrorism; Civil Defense; Humans
PubMed: 24845109
DOI: 10.1111/1469-0691.12682 -
Veterinary Medicine and Science Sep 2021Bacillus anthracis is a zoonotic bacterium that affects wide numbers of vertebrate animals and man and has life threating potential both in animal s as well as humans.
BACKGROUND
Bacillus anthracis is a zoonotic bacterium that affects wide numbers of vertebrate animals and man and has life threating potential both in animal s as well as humans.
METHODS
A cross sectional study was conducted to assess the knowledge about, attitudes towards, and practices addressing (KAPs) anthrax among community members in selected upazillas' of Meherpur and Sirajgonj districts for the prevention and control of anthrax using a structured questionnaire.
RESULTS
A total of 424 community members were considered in this study irrespective of their age and sex. Most of the respondents were female (57.54%) and about half were illiterate (47.40%). Most of the respondents (86.32%) were self-employed with crop and livestock farming. Among the self-employed farmers, cattle (63.73%) were the highest reared animals. Among the respondents, 37.26% had no knowledge about anthrax. On the other hand, among the existing knowledge level, 46.69% received information of anthrax from neighbour, 74.05% and 56.82% were concerned about the mode of transmission of anthrax from animal to human through eating, handling and soil. Respondents usually collected vaccine from quack (58.25%) and vaccination status was highest in Kamarkhand (52.03%) and lowest in Gangni upazilla (10.82%). Overall 62.74% community members considered that anthrax is a fatal disease for livestock and 82.54% people disposed carcass in buried method.
CONCLUSION
The study findings indicated that the community members had average knowledge on cause, symptoms, transmission and prevention of anthrax. The supplied vaccine was found negligible with the number of livestock in the studied upazilas. Veterinary and Medical health planners should design and implement interventions for awareness building on anthrax under One Health (OH) approach for educating the community people on anthrax control and prevention.
Topics: Animals; Anthrax; Bangladesh; Cattle; Cattle Diseases; Cross-Sectional Studies; Farmers; Female; Health Knowledge, Attitudes, Practice; Humans; Livestock; Zoonoses
PubMed: 34232568
DOI: 10.1002/vms3.561 -
BMC Public Health Aug 2022Anthrax is a zoonotic disease that causes frequent outbreaks in livestock and fatal human cases in Burkina Faso. Effective surveillance of this disease calls for the... (Review)
Review
BACKGROUND
Anthrax is a zoonotic disease that causes frequent outbreaks in livestock and fatal human cases in Burkina Faso. Effective surveillance of this disease calls for the establishment of an integrated surveillance system, in line with the One Health concept. However, despite a strong technical and financial support from international partners, surveillance is still poorly conducted within an integrated approach. Based on stakeholder perspectives, the study has for objective to deepen our understanding of the anthrax surveillance system and to identify the obstacles and levers towards a more integrated approach to anthrax surveillance in Burkina Faso.
METHODS
The data was collected from a literature review and interviews with surveillance stakeholders. We first conducted a qualitative descriptive analysis of the data to characterize the surveillance system (programmes, actors, collaboration). In a second step, we conducted a thematic analysis of the informants' discourse in order to identify what represents an obstacle or, conversely, a lever for a more integrated approach to anthrax surveillance.
RESULTS
The surveillance system of anthrax in Burkina Faso includes three programmes (in the livestock, wildlife and human sectors), which involves 30 actors. These sectoral programmes operate almost independently from one another, although some collaborations are existing for the governance and implementation of surveillance activities. Analysis of the discourse of key stakeholders led to the identification of four categories of factors that may influence the implementation of an integrated surveillance system in the country: knowledge; technical, organizational and social capacities; motivation; intersectoral governance.
CONCLUSIONS
This study highlights the difficulty of translating One Health governance to the national level and the need to better articulate the visions of all categories of stakeholders. This study also reveals the need to develop specific evaluation systems for integrated policies in order to provide credible evidence of their added value for a better management of zoonotic diseases. Finally, our study underlines the need to act upstream the emergence of zoonoses and allocate more resources to the prevention of zoonoses than to their control.
Topics: Animals; Anthrax; Burkina Faso; Humans; Livestock; One Health; Zoonoses
PubMed: 35962327
DOI: 10.1186/s12889-022-13878-3 -
International Journal of Environmental... Oct 2020Although anthrax occurs globally, the burden of the disease remains particularly high in Africa. Furthermore, the disease anthrax has significant public health and...
BACKGROUND
Although anthrax occurs globally, the burden of the disease remains particularly high in Africa. Furthermore, the disease anthrax has significant public health and economic implications. However, sufficient attention has not been given to the geographic distribution of anthrax outbreaks and cases in Lesotho. Therefore, this study investigates the spatial patterns of anthrax outbreaks and cases among livestock in Lesotho from 2005 to 2016.
METHODS
A cross-sectional study design was adopted to realise the objectives of this study using retrospective data of anthrax outbreaks and cases recorded by the Department of Livestock Services (DLS) between 2005 and 2016. Anthrax outbreaks were geo-coded at village level and aggregated at district level. Proportions and 95% CI of anthrax outbreaks and cases by village and district were calculated. Cartographic maps displaying the distribution of anthrax outbreaks and cases at village and district level were constructed.
RESULTS
A total of 38 outbreaks were reported over the study period, and they were clustered in the Lowlands districts of Lesotho. Most outbreaks (52.6%, 20/38) in livestock were reported in the Maseru district. The Leribe district reported the lowest proportions of outbreaks (5.3%, 2/38) and cases (0.6%, 3/526). At the village level, 18% (7/38) of outbreaks were in Maseru Urban, followed by Ratau (16%, 6/38) and Mofoka (13%, 5/38). The Maseru district reported the highest (1.3%, 369/29,070) proportion of cases followed by Mafeteng (0.9%, 73/8530). The village with the most cases was Kolo (10.5%, 21/200), followed by Thaba-Chitja (7.7%, 33/430).
CONCLUSION
Anthrax outbreaks and cases exclusively occur in the Lowlands districts of Lesotho, with villages such as Mahobong, Pitseng, Kolo, and Thaba-Chitja having a higher risk of anthrax disease. Findings of the present study have serious public health implications in light of the fact that between 2003 and 2008 Lesotho's main abattoir was closed; hence, most of the meat in Lesotho was imported and/or sourced from the informal slaughter facilities. Much larger studies are needed to further investigate factors contributing to spatial disparities in anthrax outbreaks and cases observed in this study. Findings of the present study can be used to guide the formulation of a policy on prevention and control of anthrax in Lesotho.
Topics: Africa; Animals; Anthrax; Cross-Sectional Studies; Disease Outbreaks; Lesotho; Livestock; Retrospective Studies
PubMed: 33086488
DOI: 10.3390/ijerph17207584 -
Clinical Infectious Diseases : An... Oct 2022The deliberate use of Bacillus anthracis spores is believed by the US government to be a high bioweapons threat. The first line of defense following potential exposure...
BACKGROUND
The deliberate use of Bacillus anthracis spores is believed by the US government to be a high bioweapons threat. The first line of defense following potential exposure to B. anthracis spores would be postexposure prophylaxis with antimicrobials that have activity against B. anthracis. Additional therapies to address the effects of toxins may be needed in systemically ill individuals. Over the last 2 decades, the United States government (USG) collaborated with the private sector to develop, test, and stockpile 3 antitoxins: anthrax immunoglobulin intravenous (AIGIV), raxibacumab, and obiltoxaximab. All 3 products target protective antigen, a protein factor common to the 2 exotoxins released by B. anthracis, and hamper or block the toxins' effects and prevent or reduce pathogenesis. These antitoxins were approved for licensure by the United States Food and Drug Administration based on animal efficacy studies compared to placebo.
METHODS
We describe USG-sponsored pre- and postlicensure studies that compared efficacy of 3 antitoxins in a New Zealand White rabbit model of inhalation anthrax; survival following a lethal aerosolized dose of B. anthracis spores was the key measure of effectiveness. To model therapeutic intervention, intravenous treatments were started following onset of antigenemia.
RESULTS
In pre- and postlicensure studies, all 3 antitoxins were superior to placebo; in the postlicensure study, raxibacumab and obiltoxaximab were superior to AIGIV, but neither was superior to the other.
CONCLUSIONS
These data illustrate the relative therapeutic benefit of the 3 antitoxins and provide a rationale to prioritize their deployment.
Topics: Animals; Anthrax; Antigens, Bacterial; Antitoxins; Bacillus anthracis; Exotoxins; Rabbits
PubMed: 36251555
DOI: 10.1093/cid/ciac593 -
Veterinary Medicine and Science Aug 2019In Zambia, anthrax has emerged as a serious disease decimating humans, livestock and wildlife with devastating effects on eco-tourism resulting in the destabilization of...
In Zambia, anthrax has emerged as a serious disease decimating humans, livestock and wildlife with devastating effects on eco-tourism resulting in the destabilization of major pristine wildlife sanctuaries. Consequently, the thrust of this study was to establish the spatial distribution of anthrax and determine ecological drivers of its recurrence, maintenance and epidemiological linkage to anthropogenic activities. Environmental and biological samples were collected within the livestock production and conservation areas (n = 80). Each sample was serially tested for Bacillus anthracis positivity through blood agar culture and Gram stain technique, and then confirmation by multiplex polymerase chain reaction (MPCR). Questionnaires (n = 113) were conducted at independently distinct villages in terms of space and time. Most respondents showed that animals that died from anthrax were not properly disposed off. More likely than not, poverty being the main driver for anthrax carcass dressing and meat distribution contributed to environmental contamination with anthrax spores in areas where the animals subsequently died resulting in further environmental contamination, which is the major source of primary infection for livestock and wildlife. From the samples, 15 pure isolates of anthrax were obtained which were spatially distributed across four districts. Twelve, biologically plausible variables were found to be highly significant on multivariable logistic regression analysis model for questionnaires which included herd size (odds = 10.46; P = 0.005; CI 8.8-16), carcass disposal method (odds = 6.9; P = 0.001; CI = 3.4-9.8), access to veterinary services (odds = 10.87; P = 0.004; CI = 4.8-15.9) and management system (odds = 2.57; P = 0.001; CI = 1.3-7.5). In summary, the majority (78.7%) of anthrax outbreaks were observed in areas with low veterinary services (χ = 8.6162, P = 0.013) within the newly created districts of Nalolo, Mwandi and Luampa.
Topics: Animals; Anthrax; Bacillus anthracis; Cattle; Cattle Diseases; Geographic Mapping; Risk Assessment; Spatial Analysis; Zambia
PubMed: 30920176
DOI: 10.1002/vms3.168 -
Clinical Microbiology and Infection :... Aug 2002Anthrax is one of the oldest threats to humankind, and remains endemic in animals in many parts of the world. Human cases are infrequent, and some result from biological... (Review)
Review
Anthrax is one of the oldest threats to humankind, and remains endemic in animals in many parts of the world. Human cases are infrequent, and some result from biological warfare. This review summarizes the current knowledge on the antibacterial activity of available antibiotics. For potential use in the most severe cases of anthrax, antibacterials need to exhibit potent in vitro activity, intracellular bioactivity, and suitable locations in lymph nodes. In animal models, it has been shown that doxycycline and fluoroquinolones are the most active compounds. There is a lack of data for animal models for macrolides and ketolides, some of them exhibiting good in vitro activity. However, systemic anthrax (inhalation or gastrointestinal) is mainly due to anthrax toxin, and therapy directed against intoxication is needed as basic treatment.
Topics: Animals; Anthrax; Anti-Bacterial Agents; Bacillus anthracis; Biological Warfare; Disease Models, Animal; Disease Outbreaks; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests
PubMed: 12197869
DOI: 10.1046/j.1469-0691.2002.00527.x -
Clinical Infectious Diseases : An... Oct 2022US Centers for Disease Control and Prevention guidelines currently recommend triple-therapy antimicrobial treatment for anthrax meningitis. In the Kyrgyz Republic, a...
Risk Factors for Severe Cutaneous Anthrax in a Retrospective Case Series and Use of a Clinical Algorithm to Identify Likely Meningitis and Evaluate Treatment Outcomes, Kyrgyz Republic, 2005-2012.
BACKGROUND
US Centers for Disease Control and Prevention guidelines currently recommend triple-therapy antimicrobial treatment for anthrax meningitis. In the Kyrgyz Republic, a country with endemic anthrax, cutaneous anthrax patients are routinely hospitalized and treated successfully with only monotherapy or dual therapy. Clinical algorithms have been developed to identify patients with likely anthrax meningitis based on signs and symptoms alone. We sought to retrospectively identify likely meningitis patients in the Kyrgyz Republic using a clinical algorithm and evaluate risk factors and their outcomes by type of treatment.
METHODS
We conducted a retrospective chart review of cutaneous anthrax patients in the Kyrgyz Republic from 2005 through 2012. Using previous methods, we developed a highly specific algorithm to categorize patients by meningitis status. We then evaluated patient risk factors, treatments, and outcomes by disease severity and meningitis status.
RESULTS
We categorized 37 of 230 cutaneous anthrax patients as likely having meningitis. All 37 likely meningitis patients survived, receiving only mono- or dual-therapy antimicrobials. We identified underlying medical conditions, such as obesity, hypertension, and chronic obstructive pulmonary disease, and tobacco and alcohol use, as potential risk factors for severe anthrax and anthrax meningitis.
CONCLUSIONS
Based on our analyses, treatment of anthrax meningitis may not require 3 antimicrobials, which could impact future anthrax treatment recommendations. In addition, chronic comorbidities may increase risk for severe anthrax and anthrax meningitis. Future research should further investigate potential risk factors for severe anthrax and their impact on laboratory-confirmed meningitis and evaluate mono- and dual-therapy antimicrobial regimens for anthrax meningitis.
Topics: Algorithms; Anthrax; Anti-Bacterial Agents; Anti-Infective Agents; Humans; Kyrgyzstan; Meningitis, Bacterial; Retrospective Studies; Risk Factors; Skin Diseases, Bacterial; Treatment Outcome
PubMed: 36251556
DOI: 10.1093/cid/ciac537