The Anthrax

Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(2):104-127

​ Lobzin Yu.V., Volzhanin V.M., Zakharenko S.M.
anthrax Bacillus anthracis bioweapon bioterrorism fluoroquinolones anthrax vaccine
Section
Diseases and Pathogens
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2002; 4(2):104-127

Abstract

Anthrax, along with smallpox and plague, is considered one of the most potential biological warfare agents. It has been proved during the recent bioterroristic events in the USA in the fall last year. This article presents the questions of etiology, epidemiology and pathogenesis of Bacillus anthracis infection. Clinical features of the different forms and major criteria for diagnosis of anthrax are described in details. Different microbiological diagnostics for confirmation of anthrax infection are analyzed. Management of the naturally occurring anthrax as well as patients with anthrax in mass casualty setting is emphasized. Routine preexposure and postexposure vaccination are also discussed. Recommendations for postexposure prophylaxis following an aerosol exposure to B.anthracis spores are presented.

  • 1. Harrison L.H., Ezzell J.W. Evaluation of serologic tests for diagnosis of anthrax after an outbreak of cutaneous anthrax in Paraguay. J Infect Dis 1989; 160:706-10.
  • 2. Danies J.C. A major epidemic of anthrax in Zimbabve. Centr Afr J Med 1982; 28:291-8.
  • 3. Smego R.A. Jr, Gebrian B., Desmangels G. Cutaneous Manifestation of Anthrax in Rural Haiti. Clin Infect Dis 1998; 26:97-102.
  • 4. Kumar A., Kanungo R., Bhattacharya S., Badrinath S., Dutta T.K., Swaminathan R.P. Human anthrax in India: urgent need for effective prevention. J Commun Dis 2000; 32:240-6.
  • 5. Caksen H., Arabaci F., Abuhandan M., Tuncer O., Cesur Y. Cutaneous anthrax in eastern Turkey. Cutis 2001; 67:488-92.
  • 6. Inglesby T.V., Henderson D.A., Bartlett J.G., et al. Anthrax as a biological weapon: medical and public health management. JAMA 1999; 281:1735-45.
  • 7. Centers for Disease Control and Prevention. Update: Investigation of Bioterrorism-Related Inhalational Anthrax – Connecticut. 2001 MMWR 2001; 50:1077-9.
  • 8. Enserink M. ANTHRAX: A Second Anthrax Genome Project. Science 2001; 294:1812.
  • 9. Turnbull P.C.B., Kramer J.M. Bacillus. In: Balows A., Hausler W.J.Jr., Herrmann K.L., et al. Manual of Clinical Microbiology, 5th ed. Washington, DC, American Society for Microbiology; 1991. p. 296-303.
  • 10. UK gives guidance on anthrax [editorial]. Scrip 2001; 2689:5.
  • 11. Friedlander A.M. Anthrax. In: Sidell F.R., Takafuji E.T., Franz D.R., editors. Textbook of Military Medicine: Medical Aspects of Chemical and Biological Warfare. Washington, DC: Office of the Surgeon General, US Dept of the Army; 1997:467-78.
  • 12. Dhawan B., Desikan-Trivedi P., Chaudhry R., Narang P. Bioterrorism: a threat for which we are ill prepared. Natl Med J India 2001; 14:225-30.
  • 13. Cieslak T.J., Eitzen E.M. Jr. Clinical and Epidemiologic Principles of Anthrax. Emerg Infect Dis 1999; 5:552-5.
  • 14. Meselson M., Guillemin J., Hugh-Jones M., Langmuir A., Popova I., Shelokov A., Yampolskaya O., et al. The Sverdlovsk anthrax outbreak of 1979. Science 1994; 266:1202-7.
  • 15. Grinberg L.M., Abramova F.A., Yampolskaya O.V., Walker D.H., Smith J.H. Quantitative pathology of inhalational anthrax I: quantitative microscopic findings. Mod Pathol 2001 May; 14:482-95.
  • 16. Lew D.P. Bacillus anthracis (Anthrax). In: Mandell G.L., Bennett J.E., Dolin R. Principles and practice of infectious diseases. 5th ed. V. 2. p. 2215-20.
  • 17. Green B.D., Battisti L., Koehler T.M., Thorne C.B., Ivins B.E. Demonstration of capsule plasmid in Bacillus anthracis. Infect Immun 1985; 49:291-7.
  • 18. Mikesell P., Ivins B.E., Ristroph J.D., Dreier T.M. Evidense for plasmid-mediated toxin production in Bacillus anthracis. Infect Immun 1983; 39:371-6.
  • 19. Sirard J.C., Mock M., Fouet A. The three Bacillus anthracis toxin genes are coordinately regulated by bicarbonate and temperature. J Bacteriol 1994; 176:5188.
  • 20. Bhatnagar R., Batra S. Anthrax toxin. Crit Rev Microbiol 2001; 27:167-200.
  • 21. Bradley K.A., Mogridge J., Mourez M., Collier R.J., Young J.A. Identification of the cellular receptor for anthrax toxin. Nature 2001; 414:225-9.
  • 22. Ahuja N., Kumar P., Bhatnagar R. Hydrophobic residues Phe552, Phe554, Ile562, Leu566, and Ile574 are required for oligomerization of anthrax protective antigen. Biochem Biophys Res Commun 2001; 287:542-9.
  • 23. Singh Y., Khanna H., Chopra A.P., Mehra V. A dominant negative mutant of Bacillus anthracis protective antigen inhibits anthrax toxin action in vivo. J Biol Chem 2001; 276:22090-4.
  • 24. Duesbery N.S., Webb C.P., Leppla S.H., et al. Proteolitic inactivation of MAP-kinase-kinase by anthrax lethal factor. Scienсe 1998; 280:734-7.
  • 25. Lin C.G., Kao Y.T., Liu W.T., et al. Cytotoxic effects of anthrax lethal toxin on macrophage-like cell line j774a.1. Curr Microbiol. 1996; 33:224-7.
  • 26. Pannifer A.D., Wong T.Y., Schwarzenbacher R., Renatus M., Petosa C., Bienkowska J., Lacy D.B., Collier R.J., Park S., Leppla S.H., Hanna P., Liddington R.C. Crystal structure of the anthrax lethal factor. Nature 2001; 414:229-33.
  • 27. Farrar W.E. Anthrax: virulence and vaccines. Ann Intern Med 1994; 121:379.
  • 28. Fox J. Bioterrorism: microbiology key to dealing with threats [letter]. ASM News 1998; 64:225-7.
  • 29. Mourez M., Kane R.S., Mogridge J., Metallo S., Deschatelets P., Sellman B.R., Whitesides G.M., Collier R.J. Designing a polyvalent inhibitor of anthrax toxin. Nat Biotechnol 2001; 19:958-61.
  • 30. Liu X.H., Collier R.J., Youle R.J. Inhibition of Axotomyinduced Neuronal Apoptosis by Extracellular Delivery of a Bcl-XL Fusion Protein. J Biol Chem 2001; 276:4632632.
  • 31. Watters J.W., Dewar K., Lehoczky J., Boyartchuk V., Dietrich W.F. Kif1C, a kinesin-like motor protein, mediates mouse macrophage resistance to anthrax lethal factor. Curr Biol 2001; 11:1503-11.
  • 32. Hanna P. How anthrax kills. Science 1998; 280:1671-3.
  • 33. Abramova F.A., Grinberg L.M., Yampolskaya O.V., Walker D.H. Pathology of inhalational anthrax in 42 cases from the Sverdlovsk outbreak in 1979. Proc Natl Acad Sci USA 1993; 90:2291-4.
  • 34. Celebi S., Aykan U., Alagoz G., Esmerligil S. Palbebral anthrax. Eur J Ophthalmol 2001; 11:171-4.
  • 35. Soysal H.G., Kiratli H., Recep O.F. Anthrax as the cause of preseptal cellulitis and cicatricial ectropion. Acta Ophthalmol Scand 2001; 79:208-9.
  • 36. Hanter P. In response to Recent Events: Update on Bacillus anthracis. ESCMID News 2001; 3:23-6.
  • 37. Khajehdehi P. Toxemic shock, hematuria, hypokalemia, and hypoproteinemia in a case of cutaneous anthrax. Mt Sinai J Med 2001;68:213-5.
  • 38. Brachman P.S., Friedlander A.M. Anthrax. In: Plotkin & Mortimer, ed. Vaccines. Philadelphia (PA): W.B. Saunders; 1994. p. 730.
  • 39. Dodanay M., Almac A., Hanagasi R., Primary throat anthrax. A report of six cases. Scand J Infect Dis. 1986; 18:415-9.
  • 40. Ndyabahinduka D.G.K., Chu I.H., Abdou A.H., Gaifuba J.K. An outbreak of human gastrointestinal anthrax. Ann Ist Super Sanita 1984; 20:205-8.
  • 41. Brachman P.S., Kaufmann A.F. Anthrax. In: Evans A.S., Brachman P.S., et al. Bacterial infections of humans. New York: Plenum Medical Book Company; 1998. p. 95-111.
  • 42. Buchanan T.M., Feeley J.C., Hayes P.S., et al. Anthrax indirect microhemagglutination test. J Immunol. 1971; 107:1631.
  • 43. Clinical Issues in the Prophylaxis, Diagnosis and Treatment of Anthrax [editorial]. Emerg Infect Dis 2002; 8:222-5.
  • 44. Turnbull P.C.B., Doganay M., Lindeque P.M., et al. Serology and anthrax in humans, livestock and Etosha National Park wildlife. Epidemiol Infect. 1992; 108:299-313.
  • 45. Patra G., Vaissaire J., Weber-Levy M., le Doujet C., Mock M. Molecular Characterization of Bacillus Strains Involved in Outbreak of Anthrax in France in 1997. J Clin Microbiol 1998; 36:3412-4.
  • 46. Smith K.L., DeVos V., Bryden H., Price L.B., HughJones M.E., Keim P. Bacillus anthracis Diversity in Kruger National Park. J Clin Microbiol 2000; 38:3780-4.
  • 47. Pitt M.L., Little S.F., Ivins B.E., Fellows P., Barth J., Hewetson J., Gibbs P., Dertzbaugh M., Friedlander A.M. In vitro correlate of immunity in a rabbit model of inhalational anthrax. Vaccine 2001; 19:4768-73.
  • 48. Halperin G., Marcus H. Application of recovery tests in the validation of immunoassays for assessing the immunogenicity of B. anthracis PA vaccine. PDA J Pharm Sci Technol 2001; 55:150-61.
  • 49. Shlyakhov E., Rubinstein E. Evaluation of the anthraxin skin teat for diagnosis of acute and past human anthrax. Eur J Clin Microbiol Infect Dis. 1996; 15:242-5.
  • 50. Munoz F.M., Galasso G.J., Gwaltney J.M., et al. Current research on influenza and other respiratory viruses: II International Symposium. Antiviral Res 2000; 46:91-124.
  • 51. Brook I., Elliott T.B., Pryor H.I., Sautter T.E., Gnade B.T., Thakar J.H., Knudson G.B. In vitro resistance of Bacillus anthracis Sterne to doxycycline, macrolides and quinolones. Int J Antimicrob Agents 2001; 18:559-62.
  • 52. Odendaal M.W., Peterson P.M., de Vos V., Botha A.D. The antibiotic sensitivity patterns of Bacillus anthracis isolated from the Kruger National Park. Onderstepoort J Vet Res 1991; 58:17-9.
  • 53. Doganay M., Aydin N. Antimicrobial susceptibility of Bacillus anthracis. Scand J Infect Dis 1991; 23:333-5.
  • 54. Lightfoot N.F., Scott R.J., Turnbill P.C. Antimicrobial susceptibility of Bacillus anthracis. Salisbury Med Bull 1990; 68: S 95-8.
  • 55. Dixon T.C., Meselson M., Guillemin J., Hanna P.C. Anthrax. N Engl J Med 1999; 341:815-26.
  • 56. Centers for Disease Control and Prevention. Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Exposure Management and Antimicrobial Therapy. MMWR Morb Mortal Wkly Rep 2001 October 24; 50:909-19.
  • 57. Roche K.J., Chang M.W., Lazarus H. Cutaneous anthrax infection: images in clinical medicine. N Engl J Med 2001. Available from: URL: http://www.nejm.org.
  • 58. Centers for Disease Control and Prevention. Update: interim recommendations for antimicrobial prophylaxis for children and breastfeeding mothers and treatment of children with anthrax. MMWR Morb Mortal Wkly Rep 2001; 50:1014-6.
  • 59. Lalitha M.K., Thomas M.K. Penicillin resistance in Bacillus anthracis. The Lancet 1997; 349:1522.
  • 60. Centers for Disease Control and Prevention. Use of Anthrax Vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2000; 49(No. RR-15):5-7.
  • 61. Pasteur L., Chamberlain C-E, Roux E. Compte rendu sommaire des experiences faites a Pouilly-le-Fort, pres Melun, sur la vaccination chrabonneuse [French]. Comptes Rendus des seances De LAcademie des Sciences 1881; 92:1378-83.
  • 62. Price B.M., Liner A.L., Park S., Leppla S.H., Mateczun A., Galloway D.R. Protection against anthrax lethal toxin challenge by genetic immunization with a plasmid encoding the lethal factor protein. Infect Immun 2001; 69:4509-15.
  • 63. Turnbull P.S.B., Broster M.G., Carman J.A., Manchee R.J., Melling J. Development of antibodies to protective antigen and lethal factor components of anthrax toxin in humans and guinea pigs and their relevance to protective immunity. Infect Immun 1986; 52:356-63.
  • 64. Anthrax vaccines. Med Lett Drugs Thera 1998; 40:52-3.
  • 65. Friedlander M., Pittman R., Parker G.W. Anthrax Vaccine. Evidence for Safety and Efficacy Against Inhalational Anthrax. JAMA 1999; 282:2104-6.
  • 66. Turnbull P.C.B. Anthrax vaccine: Past, present and future. Vaccine. 1991; 9:533-9.
  • 67. Ivins B.E., Pitt M.L.M., Fellows P.F., et al. Comparative efficacy of experimental anthrax vaccine candidates against inhalation anthrax in rhesus macaques. Vaccine 1998; 16:1141-8.
  • 68. Pittman P.R., Gibbs P.H., Cannon T.L., Friedlander A.M. Anthrax vaccine: short-term safety experience in humans. Vaccine 2001; 20:972-8.
  • 69. National Communicable Disease Center. Investigational new drug application for anthrax protective antigen, aluminum hydroxide absorbed. FDA № DBS-IND 180, 1970.
  • 70. Swanson-Biearman B., Krenzelok E.P. Delayed lifethreatening reaction to anthrax vaccine. J Clin Toxicol 2001; 39:81-4.
  • 71. Centers for Disease Control and Prevention. Bioterrorism alleging use of anthrax and interim guidelines for management – United States, 1998. MMWR Morb Mortal Wkly Rep 1999; 48:69-74.
  • 72. Friedlander A.M., Welkos S.L., Pitt M.L.M., Ezzell J.W., Worsham P.L., et al. Postexposure prophylaxis against experimental anthrax. J Infect Dis 1993; 167:1239-43.
  • 73. Reuveny S., White M.D., Adar Y.Y., Kafri Y., Altboum Z., Gozes Y., Kobiler D., Shafferman A., Velan B. Search for correlates of protective immunity conferred by anthrax vaccine. Infect Immun 2001; 69:2888-93.
  • 74. Welkos S., Little S., Friedlander A., Fritz D., Fellows P. The role of antibodies to Bacillus anthracis and anthrax toxin components in inhibiting the early stages of infection by anthrax spores. Microbiology 2001; 147(Pt 6):1677-85.
  • 75. Prophylactic treatment of anthrax with antibiotics [editorial]. BMJ 2001; 323:1017-8.
  • 76. Centers for Disease Control and Prevention. Updated recommendations for antimicrobial prophylaxis among asymptomatic pregnant women after exposure to Bacillus anthracis. MMWR Morb Mortal Wkly Rep 2001; 50:960.
  • 77. Food and Drug Administration. Prescription drug products: doxycycline and penicillin G procaine administration for inhalational anthrax (post-exposure). Fed Reg 2001; 66-55679-82.
  • 78. Centers for Disease Control and Prevention. Interim guidelines for investigation of and response to Bacillus anthracis exposures. MMWR Morb Mortal Wkly Rep 2001; 50:987-90.
  • 79. Centers for Disease Control and Prevention. Additional options for preventive treatment for persons exposed to inhalational anthrax. MMWR Morb Mortal Wkly Rep 2001; 50:1142, 1151.
  • 80. Henry L. Inhalational Anthrax: Threat, Clinical Presentation, and Treatment. J Am Acad Nurse Pract. 2001; 13:164-8.
  • 81. Centers for Disease Control and Prevention. Update: Adverse events associated with anthrax prophylaxis among postal employees – New Jersey, New York City, and District of Columbia Metropolitan area, 2001. MMWR Morb Mortal Wkly Rep 2001; 50:1051-4.
  • 82. Hooper DC. Emerging mechanisms of fluoroquinolone resistance. Emerg Infect Dis 2001; 7:337-41.
  • 83. Ferrandiz M.J., Fenoll A., Linares J., De La Campa A. Horizontal transfer of parC and gyrA fluoroquinoloneresistant clinical isolates of Streptococcus pneumoniae. Antimicrob Agent Chemother 2000; 44:840-7.
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