Systematic Review: A Century of Inhalational Anthrax Cases from 1900 to 2005

Holty, Jon Erik C.; Bravata, Dena M; Liu, Hau; Olshen, Richard A.; McDonald, Kathryn M; Owens, Douglas K

doi:10.7326/0003-4819-144-4-200602210-00009

Cited by 233 publications

(235 citation statements)

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“…Hence, the dose to which the victims were exposed is largely indeterminate. The prodromal and fulminant phases of inhalation anthrax can be illuminated with these data, although in most cases prophylactic treatment occurred, which complicates ones ability to determine the natural course of the disease in the absence of medical treatment (24).…”

Section: Temporal Progression Of Inhalation Anthraxmentioning

confidence: 99%

“…The medical intervention posited here consists of antibiotic distribution to 95% of the exposed population, estimated for the 1-kg release in Washington, DC, discussed above to be Ϸ300,000 people for model A anthrax and Ϸ30,000 people for model D anthrax, over a period of two days (possibly followed by vaccina- tion), that antibiotic treatment before the onset of symptoms is 98% effective, and that postsymptomatic antibiotic treatment is relatively effective if delivered within Ϸ4 days of becoming symptomatic, assuming intensive medical care is available of the sort provided to the victims of the fall 2001 U.S. anthrax letter attacks (i.e., multidrug regimens and pleural fluid drainage) (24). Fig.…”

Section: Policy Implicationsmentioning

confidence: 99%

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Sverdlovsk revisited: Modeling human inhalation anthrax

Wilkening

2006

Proc. Natl. Acad. Sci. U.S.A.

103

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Several models have been proposed for the dose-response function and the incubation period distribution for human inhalation anthrax. These models give very different predictions for the severity of a hypothetical bioterror attack, when an attack might be detected from clinical cases, the efficacy of medical intervention and the requirements for decontamination. Using data from the 1979 accidental atmospheric release of anthrax in Sverdlovsk, Russia, and limited nonhuman primate data, this paper eliminates two of the contending models and derives parameters for the other two, thereby narrowing the range of models that accurately predict the effects of human inhalation anthrax. Dose-response functions that exhibit a threshold for infectivity are contraindicated by the Sverdlovsk data. Dose-dependent incubation period distributions explain the 10-day median incubation period observed at Sverdlovsk and the 1-to 5-day incubation period observed in nonhuman primate experiments.bioterrorism ͉ dose-response function ͉ incubation period

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Section: Temporal Progression Of Inhalation Anthraxmentioning

confidence: 99%

Section: Policy Implicationsmentioning

confidence: 99%

Sverdlovsk revisited: Modeling human inhalation anthrax

Wilkening

2006

Proc. Natl. Acad. Sci. U.S.A.

103

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“…Alternatives include the times of hospital admission or death providing there was some a priori information regarding the distribution describing the time from exposure to hospital admission or death, respectively. For example, the timeto-death distribution for inhalational anthrax has previously been estimated directly [26] or can be estimated via the convolution of the incubation period distribution with the symptom onset to death distribution [81,100] (cf. equation (3.2); note that the latter process allowed for the additional forecasts in figure 2).…”

Section: Discussionmentioning

confidence: 99%

A review of back-calculation techniques and their potential to inform mitigation strategies with application to non-transmissible acute infectious diseases

Egan

Hall

2015

J. R. Soc. Interface.

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Back-calculation is a process whereby generally unobservable features of an event leading to a disease outbreak can be inferred either in real-time or shortly after the end of the outbreak. These features might include the time when persons were exposed and the source of the outbreak. Such inferences are important as they can help to guide the targeting of mitigation strategies and to evaluate the potential effectiveness of such strategies. This article reviews the process of back-calculation with a particular emphasis on more recent applications concerning deliberate and naturally occurring aerosolized releases. The techniques can be broadly split into two themes: the simpler temporal models and the more sophisticated spatio-temporal models. The former require input data in the form of cases' symptom onset times, whereas the latter require additional spatial information such as the cases' home and work locations. A key aspect in the back-calculation process is the incubation period distribution, which forms the initial topic for consideration. Links between atmospheric dispersion modelling, within-host dynamics and backcalculation are outlined in detail. An example of how back-calculation can inform mitigation strategies completes the review by providing improved estimates of the duration of antibiotic prophylaxis that would be required in the response to an inhalational anthrax outbreak.

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“…Instead, they rely heavily on detection via aerosol sensors. Such an approach has its merits; early detection, followed by heavy prophylaxis, has the potential to prevent an outbreak [1]. However, if the aerosolized pathogen is not detected (for example, if the attacked site is not instrumented with sensors), an outbreak may be expected, leading to a rapid and large increase in demand for medical resources.…”

Section: Chapter 1 Introductionmentioning

confidence: 99%

Risk-based decision making for staggered bioterrorist attacks : resource allocation and risk reduction in "reload" scenarios.

Lemaster¹,

Ehlen

Boggs³

et al. 2009

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Staggered bioterrorist attacks with aerosolized pathogens on population centers present a formidable challenge to resource allocation and response planning. The response and planning will commence immediately after the detection of the f rst attack and with no or little information of the second attack. In this report, we outline a method by which resource allocation may be performed. It involves probabilistic reconstruction of the bioterrorist attack from partial observations of the outbreak, followed by an optimization-under-uncertainty approach to perform resource allocations. We consider both single-site and time-staggered multi-site attacks (i.e., a reload scenario) under conditions when resources (personnel and equipment which are diff cult to gather and transport) are insuff cient. Both communicable (plague) and non-communicable diseases (anthrax) are addressed, and we also consider cases when the data, the time-series of people reporting with symptoms, are confounded with a reporting delay. We demonstrate how our approach develops allocations prof les that have the potential to reduce the probability of an extremely adverse outcome in exchange for a more certain, but less adverse outcome. We explore the effect of placing limits on daily allocations. Further, since our method is data-driven, the resource allocation progressively improves as more data becomes available.

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Systematic Review: A Century of Inhalational Anthrax Cases from 1900 to 2005

Cited by 233 publications

References 100 publications

Sverdlovsk revisited: Modeling human inhalation anthrax

Sverdlovsk revisited: Modeling human inhalation anthrax

A review of back-calculation techniques and their potential to inform mitigation strategies with application to non-transmissible acute infectious diseases

Risk-based decision making for staggered bioterrorist attacks : resource allocation and risk reduction in "reload" scenarios.

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