Global & Disaster Medicine

Archive for the ‘Anthrax’ Category

Safety of inadvertent anthrax vaccination during pregnancy: An analysis of birth defects in the U.S. military population, 2003–2010

 

Vaccine

Highlights

Anthrax vaccination is compulsory for certain United States military personnel.

Assurance of anthrax vaccine safety in pregnancy is important for military members.

Infants inadvertently exposed to anthrax vaccine in the 1st trimester are not at higher risk for birth defects.

Infants inadvertently exposed to anthrax vaccine are not at increased risk for any specific individual birth defects.

Study findings are not only relevant to military populations but also to civilian populations for bioterrorism preparedness.

 


Anthrax research: Estimating the post-exposure period for effective treatment of human inhalational anthrax.

Rubinson L, Corey A, Hanfling D. Estimation of Time Period for Effective Human Inhalational Anthrax Treatment Including Antitoxin Therapy. PLOS Currents Outbreaks. 2017 Jul 28 . Edition 1.

doi: 10.1371/currents.outbreaks.7896c43f69838f17ce1c2c372e79d55d.

“…..Results: For antibiotic sensitive infections, treatment with antibiotics alone ≤4 days after spore exposure prevents toxemia. Administration of raxibacumab together with antibiotics protects ≥ 80% of subjects for 3 additional days (7 days post exposure). In the setting of antibiotic resistance, raxibacumab would be protective for at least 6 days post exposure.
Conclusions: Although the animal model of disease does not reflect the potential impact of supportive care (e.g. fluid resuscitation received by critically ill patients) on PA kinetics and raxibacumab PK, the simulations suggest that administration of antitoxin in combination with antibiotics should provide a longer postexposure window for effective treatment than for antibiotics alone. In addition, raxibacumab administration soon after exposure to an antibiotic resistant strain should provide effective treatment…..”

 

  • Raxibacumab, an IgG monoclonal antibody against protective antigen (PA);
  • For inhalational anthrax, protective antigen (PA) drives much of the mortality
  • Raxibacumab is an anti-PA monoclonal antibody
  • The anthrax toxin is a tripartite toxin: lethal factor (LF) and edema factor (EF) have enzymatic activities, while PA binds to cell receptors. PA binds and translocates LF and EF into the cell. Inhibition of PA binding to cell receptors blocks binding and internalization of LF and EF.

4/2/1979: The world’s first anthrax epidemic begins in Sverdlosk, Russia. By the time it ended 6 weeks later, 62 were dead and another 32 survived serious illness.

History Channel


Epidemiology of Human Anthrax in China, 1955−2014

EID

Using national surveillance data for 120,111 human anthrax cases recorded during 1955−2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China. After 1978, incidence decreased until 2013, when it reached a low of 0.014 cases/100,000 population. The case-fatality rate, cumulatively 3.6% during the study period, has also decreased since 1990. Cases occurred throughout the year, peaking in August. Geographic distribution decreased overall from west to east, but the cumulative number of affected counties increased during 2005−2014. The disease has shifted from industrial to agricultural workers; 86.7% of cases occurred in farmers and herdsmen. Most (97.7%) reported cases were the cutaneous form. Although progress has been made in reducing incidence, this study highlights areas that need improvement. Adequate laboratory diagnosis is lacking; only 7.6% of cases received laboratory confirmation. Geographic expansion of the disease indicates that livestock control programs will be essential in eradicating anthrax.

Li Y, Yin W, Hugh-Jones M, Wang L, Mu D, Ren X, et al. Epidemiology of Human Anthrax in China, 1955−2014. Emerg Infect Dis. 2017;23(1):14-21. https://dx.doi.org/10.3201/eid2301.150947

Anthrax postexposure prophylaxis (PEP) was recommended to 42 people after a laboratory incident & 3/4 didn’t finish taking it. How come?

Health Security

Postexposure Prophylaxis After Possible Anthrax Exposure: Adherence and Adverse Events.  Nolen Leisha D., Traxler Rita M., Kharod Grishma A., Kache Pallavi A., Katharios-Lanwermeyer Stefan, Hendricks Katherine A., Shadomy Sean V., Bower William A., Meaney-Delman Dana, and Walke Henry T.. Health Security. December 2016, 14(6): 419-423. doi:10.1089/hs.2016.0060.

“…..At least 31 (74%) individuals who initiated PEP did not complete either the recommended 60 days of antimicrobial therapy or the 3-dose vaccine regimen. Among the 29 that discontinued the antimicrobial component of PEP, most (38%) individuals discontinued PEP because of their low perceived risk of infection; 9 (31%) individuals discontinued prophylaxis due to PEP-related minor adverse events, and 10% cited both low risk and adverse events as their reason for discontinuation. Most minor adverse events reported were gastrointestinal complaints, and none required medical attention……”

 


40 now hospitalized after anthrax outbreak in Yamal, more than half are children

The Siberian Times

 


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