Difference between revisions of "Bacillus anthracis"

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==''Bacillus anthracis'' - Anthrax==
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=Hosts=
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===Hosts===
 
 
This bacterium infects multiple types of hosts including herbivorous mammals such as livestock and is considered zoonotic however humans are a dead end host and do not become infectious.
 
This bacterium infects multiple types of hosts including herbivorous mammals such as livestock and is considered zoonotic however humans are a dead end host and do not become infectious.
  
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===Transmission/Exposure Routes===
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=Transmission/Exposure Routes=
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Cutaneous: skin contact with spores from infected animals.<br />  
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Cutaneous: skin contact with spores from infected animals (95% of Cases; Most in Africa, Asia, and eastern Europe).<br />  
 
Gastrointestinal: eating poorly cooked meat/dairy from infected animal. <br />
 
Gastrointestinal: eating poorly cooked meat/dairy from infected animal. <br />
 
Inhalation: Inhalation of spores<br />
 
Inhalation: Inhalation of spores<br />
 +
Injectional: soft tissue infection associated with injection drug use <br/> <ref name=IntCareMed>[http://www.springerlink.com.proxy2.cl.msu.edu/content/136q4u1j54743815/fulltext.pdf Int Care Med]</ref> <br/>
 +
Anthrax is not contagious and cannot be transmitted from person-to-person. <ref name=Brookmeyer></ref>
  
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===Case fatality ratio ===
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=Case fatality ratio =
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{|                                                  
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{| class="wikitable" style="text-align:left;"                                                  
−
{| border = "1"
 
 
|+ '''Case fatality ratios'''                                   
 
|+ '''Case fatality ratios'''                                   
 
|-
 
|-
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| Cutaneous with treatment
 
| Cutaneous with treatment
 
| General US Population
 
| General US Population
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| ([http://www.bt.cdc.gov/agent/anthrax/ CDC])
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| <ref name=CDC>[http://www.bt.cdc.gov/agent/anthrax/ CDC]</ref>
 
|-
 
|-
 
| 20%
 
| 20%
 
| Cutaneous without treatment
 
| Cutaneous without treatment
 
| General US population
 
| General US population
−
| ([http://www.bt.cdc.gov/agent/anthrax/ CDC])
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| <ref name=CDC></ref>
 
|-
 
|-
 
| 75%
 
| 75%
 
| Inhalation despite treatment
 
| Inhalation despite treatment
−
|  
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| Not Reported
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| ([http://www.bt.cdc.gov/agent/anthrax/ CDC])
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| <ref name=CDC></ref>
 +
|-
 +
| 89%
 +
| Inhalation
 +
| Occupationally Acquired: 20th century untreated
 +
| <ref name=IntCareMed></ref>
 
|-
 
|-
 
| 45%
 
| 45%
 
| 2001 US Attack
 
| 2001 US Attack
 
| Adult US
 
| Adult US
−
| ([http://www.annals.org/content/144/4/270 Holty et al, 2006])
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| <ref name=Holty>Holty J, Bravata D, Liu H, Olshen R, Mcdonald K, and Owens D. (2006) Systematic Review: A Century of Inhalational Anthrax Cases from 1900 to 2005. Annals of Internal Medicine. 144, 4. 270-280. [http://www.annals.org/content/144/4/270 Full Text]</ref>
 
|-
 
|-
 
| 14% (5 of 37)
 
| 14% (5 of 37)
 
| Cutaneous
 
| Cutaneous
 
| Children 1900-2005
 
| Children 1900-2005
−
| ([http://archpedi.ama-assn.org/cgi/reprint/161/9/896.pdf Bravata et al, 2007])
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| <ref name=Bravata>Bravata D, Holty J, Wang E, Lewis R, Wise P, McDonald K, and Owen D. (2007) Inhalational, Gastrointestinal, and Cutaneous Anthrax in Children. Arch Pediatr Adolesc Med. 161 (9): 896-905.  [http://archpedi.ama-assn.org/cgi/reprint/161/9/896.pdf Full Text]</ref>
 
|-
 
|-
 
| 60%
 
| 60%
 
| Inhalation
 
| Inhalation
 
| Children 1900-2005
 
| Children 1900-2005
−
| ([http://archpedi.ama-assn.org/cgi/reprint/161/9/896.pdf Bravata et al, 2007])
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| <ref name=Bravata></ref>
 
|-
 
|-
 
| 65% (13 of 20)
 
| 65% (13 of 20)
 
| Gastrointestinal
 
| Gastrointestinal
 
| Children 1900-2005
 
| Children 1900-2005
−
| ([http://archpedi.ama-assn.org/cgi/reprint/161/9/896.pdf Bravata et al, 2007])
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| <ref name=Bravata></ref>
 +
|-
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| 100%
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| Gastrointestinal
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| Unreported
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| <ref name=IntCareMed></ref>
 +
|-
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| 100% (6 of 6)
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| primary meningoencephalitis
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| Children 1900-2005
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| <ref name=Bravata></ref>
 
|-
 
|-
 
| 100% (6 of 6)
 
| 100% (6 of 6)
 
| primary meningoencephalitis
 
| primary meningoencephalitis
 
| Children 1900-2005
 
| Children 1900-2005
−
| ([http://archpedi.ama-assn.org/cgi/reprint/161/9/896.pdf Bravata et al, 2007])
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| <ref name=Bravata></ref>
 
|-
 
|-
 
| 1.5% (of 132)
 
| 1.5% (of 132)
 
| Not reported
 
| Not reported
 
| Hospitalized adults and children, Turkey 1986 to 2000
 
| Hospitalized adults and children, Turkey 1986 to 2000
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| ([http://www.springerlink.com/content/v8ctc3ajmnwxhryn/fulltext.pdf Kaya et al, 2002])
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| <ref name=Kaya>Kaya A, Tasyaran M, Erol S, Ozkurt Z, and Ozkan B. (2002) Anthrax in Adults and Children: A Review of 132 Cases in Turkey. Eur J Clin Microbiol Infect Dis. 21: 258-261. [http://www.springerlink.com/content/v8ctc3ajmnwxhryn/fulltext.pdf Full Text]</ref>
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|-
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| 30% (3 of 10)
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| Injectional
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| Adults aged 23-53, UK
 +
| <ref name=IntCareMed></ref>
 
|-
 
|-
 +
 
|}
 
|}
 
|}
 
|}
  
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===Incubation Times===
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=Incubation Times=
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{|                                                  
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{| class="wikitable" style="text-align:left;"
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{| border = "1"
 
 
|+ '''Incubation Times'''
 
|+ '''Incubation Times'''
 
|-
 
|-
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| Days
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| '''Days'''
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| Pathway
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| '''Pathway'''
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| Population
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| '''Population'''
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| Reference
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| '''Reference'''
 
|-
 
|-
 
| 0-1
 
| 0-1
 
| Cutaneous
 
| Cutaneous
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|  
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| Not Reported
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| ([http://www.bt.cdc.gov/agent/anthrax/ CDC])
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| <ref name=CDC></ref>
 
|-
 
|-
 
| 1-7 days
 
| 1-7 days
 
| Inhalation  
 
| Inhalation  
 
Ingestion
 
Ingestion
−
|  
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| Not Reported
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| ([http://www.bt.cdc.gov/agent/anthrax/ CDC])
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| <ref name=CDC></ref>
 
|-  
 
|-  
 
| 60 (max)
 
| 60 (max)
 
| Inhalation
 
| Inhalation
 
Ingestion
 
Ingestion
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|
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| Not Reported
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| ([http://www.bt.cdc.gov/agent/anthrax/ CDC])
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| <ref name=CDC></ref>
 +
|-
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| 10 Days (SD: 8.67)
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| Inhalation
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| Sverdlovsk 1979 outbreak (70 cases)
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| <ref name=Brookmeyer>Brookmeyer, R., Johnson, E., & Barry, S. (2005). Modelling the incubation period of anthrax. Statistics in Medicine, 24(4), 531–542. doi:10.1002/sim. [http://www.ncbi.nlm.nih.gov/pubmed/15678407 Full Text]</ref>
 
|-
 
|-
 
|}
 
|}
  
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===Burden of Disease===
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=Burden of Disease=
  
  
 
====Duration of infectiousness and disease====
 
====Duration of infectiousness and disease====
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Anthrax is not contagious and cannot be transmitted from person-to-person.  
+
Gastrointestinal: 10-14 days<ref name=IntCareMed></ref>
 +
====Symptomology====
 +
Cutaneous: <br/>
 +
*Primary skin lesion 3-5 days after infection is painless puriritic papule.
 +
*Lesion forms a necrotic vesicle leaving a black eschar surrounded by edma.
 +
*Eschar dries and sloughs in next 1-2 weeks.
 +
<br/>
 +
Gastrointestinal: <br/>
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*Oral-pharyngeal form: oral or esophageal ulcer with regional lymphadenopathy edema and sepsis
 +
*Lower GI form: primary intestinal lesions predominantly in terminal ileum or cecum. Nausea, vomiting, malaise, bloody diarrhea, acute abdomen, and sepsis are common symptoms of the Lower GI form.
 +
<br/>
 +
Inhalational: <br/> Two-stages
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*1: Flu-like symptoms including cough fever, fatigue that last from hours to a few days
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*2: Rising fever, dyspnea, diaphoresis, shock. In advanced form, cyanosis and hypotension progress rapidly and death can occur within hours
 +
<br/>
 +
Injectional: <br/>
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*Tissue swelling around the injection site
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*Abdominal symptoms<ref name=IntCareMed></ref>
 +
 
  
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====Symptomology====
 
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Flu-like symptoms including:
 
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Fever (temperature greater than 100 degrees F). The fever may be accompanied by chills or night sweats.
 
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Cough, usually a non-productive cough, chest discomfort, shortness of breath, fatigue, muscle aches
 
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Sore throat, followed by difficulty swallowing, enlarged lymph nodes, headache, nausea, loss of appetite, abdominal distress, vomiting, or diarrhea
 
−
   
 
 
====Excretion Rates  (see Exposure)====
 
====Excretion Rates  (see Exposure)====
 +
Spores are cleared from the lung at a rate between 8-14% per day. <ref name=Brookmeyer></ref>
  
 +
====Immunity====
 +
Anthrax vaccination consists of 5 total intramuscular injections, followed by recommended annual boosters to maintain immunity. <ref name=CDC></ref>
  
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====Immunity====
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=Microbiology=
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Anthrax vaccination consists of 5 total intramuscular injections, followed by recommended annual boosters to maintain immunity.  
+
Gram +, aerobic, encapsulated, nonmotile. Exists in a dormant spore or an actively replicating vegetative rod form Extremely hardy spores can persist for years, even decades.<ref name=IntCareMed></ref>
  
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===Microbiology===
 
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Gram +, aerobic, encapsulated, nonmotile, spore-forming, rod-shaped bacterium. Extremely hardy spores can persist for years, even decades.
 
  
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===Envrionmental Survival===
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=Envrionmental Survival=
  
  
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===Recommended Dose Response model===
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=Recommended Dose Response model=
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[[has DR model::Dose response models for Bacillus anthracis]]
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[[Bacillus anthracis: Dose Response Models]]
 
<br />
 
<br />
 
Exponential model: optimal value of k is 1.65E-05 [[File:Exponential_model.png|thumb|left|200px]]
 
Exponential model: optimal value of k is 1.65E-05 [[File:Exponential_model.png|thumb|left|200px]]
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 +
 +
<headertabs />
  
 
===References===
 
===References===
−
[http://www.bt.cdc.gov/agent/anthrax/ CDC Anthrax Page] <br />
+
<references/>
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http://en.wikipedia.org/wiki/Anthrax <br />
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[[Category:Bacterium]][[Category:BT category A]][[Category:Agent Overview]]
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Holty J, Bravata D, Liu H, Olshen R, Mcdonald K, and Owens D. (2006) Systematic Review: A Century of Inhalational Anthrax Cases from 1900 to 2005. Annals of Internal Medicine. 144, 4. 270-280. [http://www.annals.org/content/144/4/270 Full Text] <br />
 
−
Bravata D, Holty J, Wang E, Lewis R, Wise P, McDonald K, and Owen D. (2007) Inhalational, Gastrointestinal, and Cutaneous Anthrax in Children. Arch Pediatr Adolesc Med. 161 (9): 896-905.  [http://archpedi.ama-assn.org/cgi/reprint/161/9/896.pdf Full Text] <br />
 
−
Kaya A, Tasyaran M, Erol S, Ozkurt Z, and Ozkan B. (2002) Anthrax in Adults and Children: A Review of 132 Cases in Turkey. Eur J Clin Microbiol Infect Dis. 21: 258-261. [http://www.springerlink.com/content/v8ctc3ajmnwxhryn/fulltext.pdf Full Text] <br />
 
−
[[Category:PSDS]]
 
−
[[Category:Bacterium]][[Category:BT category A]]
 

Latest revision as of 16:57, 3 July 2013

[edit]

This bacterium infects multiple types of hosts including herbivorous mammals such as livestock and is considered zoonotic however humans are a dead end host and do not become infectious.

Cutaneous: skin contact with spores from infected animals (95% of Cases; Most in Africa, Asia, and eastern Europe).
Gastrointestinal: eating poorly cooked meat/dairy from infected animal.
Inhalation: Inhalation of spores
Injectional: soft tissue infection associated with injection drug use
[1]
Anthrax is not contagious and cannot be transmitted from person-to-person. [2]

Case fatality ratios
Case Fatality Ratio Pathway/conditions Population References
1% Cutaneous with treatment General US Population [3]
20% Cutaneous without treatment General US population [3]
75% Inhalation despite treatment Not Reported [3]
89% Inhalation Occupationally Acquired: 20th century untreated [1]
45% 2001 US Attack Adult US [4]
14% (5 of 37) Cutaneous Children 1900-2005 [5]
60% Inhalation Children 1900-2005 [5]
65% (13 of 20) Gastrointestinal Children 1900-2005 [5]
100% Gastrointestinal Unreported [1]
100% (6 of 6) primary meningoencephalitis Children 1900-2005 [5]
100% (6 of 6) primary meningoencephalitis Children 1900-2005 [5]
1.5% (of 132) Not reported Hospitalized adults and children, Turkey 1986 to 2000 [6]
30% (3 of 10) Injectional Adults aged 23-53, UK [1]

|}

Incubation Times
Days Pathway Population Reference
0-1 Cutaneous Not Reported [3]
1-7 days Inhalation

Ingestion

Not Reported [3]
60 (max) Inhalation

Ingestion

Not Reported [3]
10 Days (SD: 8.67) Inhalation Sverdlovsk 1979 outbreak (70 cases) [2]

Duration of infectiousness and disease

Gastrointestinal: 10-14 days[1]

Symptomology

Cutaneous:

  • Primary skin lesion 3-5 days after infection is painless puriritic papule.
  • Lesion forms a necrotic vesicle leaving a black eschar surrounded by edma.
  • Eschar dries and sloughs in next 1-2 weeks.


Gastrointestinal:

  • Oral-pharyngeal form: oral or esophageal ulcer with regional lymphadenopathy edema and sepsis
  • Lower GI form: primary intestinal lesions predominantly in terminal ileum or cecum. Nausea, vomiting, malaise, bloody diarrhea, acute abdomen, and sepsis are common symptoms of the Lower GI form.


Inhalational:
Two-stages

  • 1: Flu-like symptoms including cough fever, fatigue that last from hours to a few days
  • 2: Rising fever, dyspnea, diaphoresis, shock. In advanced form, cyanosis and hypotension progress rapidly and death can occur within hours


Injectional:

  • Tissue swelling around the injection site
  • Abdominal symptoms[1]


Excretion Rates (see Exposure)

Spores are cleared from the lung at a rate between 8-14% per day. [2]

Immunity

Anthrax vaccination consists of 5 total intramuscular injections, followed by recommended annual boosters to maintain immunity. [3]

Gram +, aerobic, encapsulated, nonmotile. Exists in a dormant spore or an actively replicating vegetative rod form Extremely hardy spores can persist for years, even decades.[1]


References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Int Care Med
  2. ↑ 2.0 2.1 2.2 Brookmeyer, R., Johnson, E., & Barry, S. (2005). Modelling the incubation period of anthrax. Statistics in Medicine, 24(4), 531–542. doi:10.1002/sim. Full Text
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 CDC
  4. ↑ Holty J, Bravata D, Liu H, Olshen R, Mcdonald K, and Owens D. (2006) Systematic Review: A Century of Inhalational Anthrax Cases from 1900 to 2005. Annals of Internal Medicine. 144, 4. 270-280. Full Text
  5. ↑ 5.0 5.1 5.2 5.3 5.4 Bravata D, Holty J, Wang E, Lewis R, Wise P, McDonald K, and Owen D. (2007) Inhalational, Gastrointestinal, and Cutaneous Anthrax in Children. Arch Pediatr Adolesc Med. 161 (9): 896-905. Full Text
  6. ↑ Kaya A, Tasyaran M, Erol S, Ozkurt Z, and Ozkan B. (2002) Anthrax in Adults and Children: A Review of 132 Cases in Turkey. Eur J Clin Microbiol Infect Dis. 21: 258-261. Full Text
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