Anthrax: an update

Abstract

Anthrax is a zoonotic disease caused by Bacillus anthracis. It is potentially fatal and highly contagious disease. Herbivores are the natural host. Human acquire the disease incidentally by contact with infected animal or animal products. In the 18th century an epidemic destroyed approximately half of the sheep in Europe. In 1900 human inhalational anthrax occured sporadically in the United States. In 1979 an outbreak of human anthrax occured in Sverdlovsk of Soviet Union. Anthrax continued to represent a world wide presence. The incidence of the disease has decreased in developed countries as a result of vaccination and improved industrial hygiene. Human anthrax clinically presents in three forms, i.e. cutaneous, gastrointestinal and inhalational. About 95% of human anthrax is cutaneous and 5% is inhalational. Gastrointestinal anthrax is very rare (less than 1%). Inhalational form is used as a biological warefare agent. Penicillin, ciprofloxacin (and other quinolones), doxicyclin, ampicillin, imipenem, clindamycin, clarithromycin, vancomycin, chloramphenicol, rifampicin are effective antimicrobials. Antimicrobial therapy for 60 days is recommended. Human anthrax vaccine is available. Administration of anti-protective antigen (PA) antibody in combination with ciprofloxacin produced 90%-100% survival. The combination of CPG-adjuvanted anthrax vaccine adsorbed (AVA) plus dalbavancin significantly improved survival.

Clinical evaluation of CpG oligonucleotides as adjuvants for vaccines targeting infectious diseases and cancer

“…The spores of this pathogen are highly resistant to environmental degradation (desiccation, heat, UV light) and many disinfectant solutions [49]. Protection against anthrax is provided by Abs targeting the ‘protective antigen’ (PA) component of the toxin.…”

Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response

“…If combinatorial vaccines that protect against two or more infectious diseases or combinatorial interventions that provide both a preventive and therapeutic intervention in one are used (Kamal et al 2011), or if multiple doses of vaccine are expected to be necessary, then additional safety studies will be required to determine tolerance to additives (such as preservatives) and to repeated doses of the antigen. Definitive assays that can predict unfavorable outcomes in individuals may be an important part of a safety strategy.…”

Injectional anthrax in human: A new face of the old disease

“…Resolution is slow (2-6 weeks), regardless of treatment. [10][11][12][13][14][15] Cutaneous anthrax is the most common form of B. anthracis infection. The mortality rate of this form without medical treatment is estimated to be 20%.…”

“…Less specific findings include pleural effusions and parenchymal infiltrates. 10,[12][13][14][15] Gastrointestinal form of anthrax is a result of consumption of contaminated food (usually meat) or drinking contaminated water. It can present clinically as either oropharyngeal or intestinal infection.…”