2005-2011年甘肃省炭疽流行病学分析

目的 分析甘肃省近年炭疽流行病学特征,为制定防制策略提供科学依据.方法 对甘肃2005-2011年炭疽疫情报告情况及相关资料进行回顾性分析.结果 7年来甘肃省每年均有炭疽病例发生,累计报告发病306例,发病率在0.07/10万～0.25/10万之间波动,年平均发病率为0.17/10万;具有一定的地域性特征,主要发病在牧区,甘南州发病率最高(4.88/10万);发病季节多见于夏秋季的6-9月,占总发病数的54.58％;男性(67.65％)多于女性(32.35％),年龄以青壮年为主;以皮肤型炭疽最为多见,占98.37％.结论 甘肃省仍然是我国炭疽高发省份之一;认真做好炭疽防治知识的宣传教育工作,加强相关部门间合作,及时发现并处理疫情是防治本病的重要措施.     

MCNP程序模拟中子杀灭炭疽菌的研究

目的 研究中子辐照杀灭炭疽菌的可行性以及制定一套高效率的采用中子照射杀灭炭疽菌的方案。方法 利用MCNP程序建立模型,通过模拟得到单个中子在炭疽孢子中的能量沉积,以此估算出在该种情况下使全部炭疽孢子达到致死剂量的时间。通过研究反射层厚度、材料种类、炭疽层的面积以及中子源种类等因素对单个中子能量沉积的影响,制定出一套高效率的杀灭炭疽菌的方案。结果 以14.0MeV中子管为中子源,炭疽层样本的面积为10cm×10cm,中子源距离炭疽层上表面5cm时的值为5×10^-4 MeV/g,只需要约20min就可以将炭疽孢子全部杀灭,而如果使用10¹⁴n/s产额的中子管只需十多秒即可使炭疽孢子达到致死剂量。结论 中子辐照杀灭炭疽菌具有很高的效率和研究价值。     

Anthrax: memorandum from a WHO meeting.

The risk of anthrax can be reduced through international collaboration in health education and training, promotion of research, and provision of scientific and technical advice. These issues were discussed by a WHO Working Group on Anthrax in September 1995, and this Memorandum presents their priority concerns and recommendations in several areas: surveillance, epidemiology, diagnosis in humans and in animals, prevention and control, and international cooperation.     

Endemic gastrointestinal anthrax in 1960s Lebanon: clinical manifestations and surgical findings

Anthrax is an ancient disease caused by the gram-positive Bacillus anthracis; recently, it has gained much attention because of its potential use in biologic warfare. Anthrax infection occurs in three forms: cutaneous, inhalational, and gastrointestinal. The last type results from ingestion of poorly cooked contaminated meat. Intestinal anthrax was widely known in Lebanon in the 1960s, when a series of >100 cases were observed in the Bekaa Valley. We describe some of these cases, introduce the concept of the surgical management of advanced intestinal anthrax, and describe some of the approaches for treatment.     

1960-2004年四川省甘孜州炭疽疫情分析

目的分析甘孜州45年炭疽疫情动态及流行因素,为制定防制策略提供科学依据。方法根据疫情资料及暴发疫情现场流调报告,对疫情资料进行病学统计分析。结果45年间,甘孜州共报告炭疽病例1005例,死亡84例。流行表现形式以常年散发伴局部地区暴发为主,具有一定的地域性特征,主要发病在牧区和半农半牧地区,发病季节多见于夏秋季,发病年龄以农牧民中的青壮年为主,男性多于女性,病例以农业型为主。资料显示,疫情发生与暴发的主要因素是农牧民缺乏科学的自我防范意识,就地宰杀病死畜。畜间检疫和监管力度不严,菌苗接种率低。结论应加大健康教育力度,加强对畜间的免疫和监管,卫生、畜牧部门相互配合,及时发现和处理疫情。     

2009-2013年内蒙古炭疽流行病学特征分析

摘要:目的　分析2009-2013年内蒙古自治区炭疽流行病学特征,为预防和控制该病提供参考依据。方法　收集2009-2013年炭疽疫情资料,采用描述性流行病学方法,对其进行分析。结果　炭疽发病呈现老疫区反复不断,多以散发为主,偶有暴发。东部地区发病高于西部地区,有向西部地区蔓延趋势。男性多于女性,分别占80.73%和19.24%。农、牧民为主要发病群体。发病主要集中在30～59岁人群。结论　2009-2013年内蒙古炭疽发病呈现老疫区反复不断,主要集中在夏秋季节;年龄、性别、职业存在差异,主要分布在东部农牧区。畜牧部门和卫生部门应建立协作机制,加强防治工作,使危害降到最低水平,防止疫区的扩大。     

Be-Am中子源杀灭炭疽的可行性分析

目的 研究Be-Am中子源用于杀灭炭疽的可能性。方法 通过MCNP模拟计算方法,建立其所使用的模型,计算了Be-Am中子源杀灭炭疽杆菌芽孢的辐照剂量,比较了单个中子沉积能量与Cf-252放射性同位素源和中子管源的不同。结果 建立MCNP模拟Be-Am中子源产生中子辐照消毒的模型,得出所用中子辐照强度与炭疽层面积成正比,并且与中子管和Cf-252的辐照剂量在同一个数量级上,但是Be-Am中子源具有价格低廉、中子产额稳定及使用期限长等优点。结论 利用Be-Am中子源杀灭炭疽杆菌芽孢更具有现实意义。     

A serological survey of anthrax in domestic dogs in Zimbabwe: a potential tool for anthrax surveillance

Anthrax is an important disease caused by the bacterium Bacillus anthracis affecting both domestic and wild animals at the wildlife/livestock interface, defined here as a physical space in which wild and domestic species overlap in range and potentially interact. In endemic regions, sporadic anthrax outbreaks occur, causing significant deaths of both wildlife and livestock and sporadically, humans. However, it may also occur as isolated outbreaks with a few animals affected. Such isolated anthrax outbreaks maybe missed. High seroprevalence among carnivores suggests either regular non-fatal exposure to the pathogen circulating in a given environment, or contact with missed cases through consumption of anthrax carcases. To investigate the relevance of this potential indicator, a cross-sectional study was conducted to determine anthrax seroprevalence in domestic dogs (Canis lupus familiaris) from selected interface and non-interface areas of Zimbabwe with known history of anthrax outbreaks. Based on past anthrax outbreaks in the respective areas, the sites were further classified as high or low risk areas for anthrax outbreaks. Sera were collected from domestic dogs (n = 186) and tested for antibodies against B. anthracis protective antigens (PA) using an ELISA test. The overall seroprevalence was 51.6% (96/186; 95% CI 44.2–59.0). Sites from the non-interface areas recorded a significantly (P < 0.001) higher (72.1%) anthrax seroprevalence compared with those from the wildlife –livestock interface (41.5%). The results demonstrated a strong association (χ² = 14.3; OR = 3.2, 1.6 < OR < 6.2, P < 0.001) between anthrax seropositivity and interface type. Low-risk sites (42.5%) had a significantly (P = 0.044) lower seroprevalence compared with high-risk sites (58.5%) but still demonstrated high seroprevalence for areas where anthrax was last reported more than 20 years back. Dogs from Tsholotsho South were more than 90-times (OR = 96.5, 13.5 < OR < 690.8) more likely to be seropositive compared with those from Hwange. The study demonstrated the potential to use domestic dogs as indicators of anthrax in the study areas to survey anthrax circulation in supposed low-risk areas and calls for a redefinition of both low and high risk areas for anthrax in Zimbabwe based on an improved surveillance.Key words: Anthrax, domestic dogs, seroprevalence, wildlife/livestock interface, Zimbabwe     

2012 - 2016年青海省炭疽流行病学分析

目的 分析2012 - 2016年青海省炭疽流行病学特征,为下一步工作提供预防和控制依据。方法 采用描述性流行病学方法,对2012 - 2016年全省炭疽病例疫情数据和个案调查表数据进行分析。结果 青海省炭疽2016年发病数较2012年上升238.0%,男性多于女性,高发季节为7 - 11月,藏族发病最高,地市级医院报告最多,为41.7%;所有患者症状均有炭疽痈处瘙痒疼痛,主要在手指,发病到就诊时间平均为5.5 d,使用抗生素时间早于采样时间1.9 d,检出率较低（6.8%）,感染方式主要为剥皮（46.1%）,病死畜组织和炭疽痈渗出液检出率较高,分别为25.0%和5.8%。结论 加大对地市级医院的监测力度,在使用抗生素前采样是提高检测率的关键,屠宰时应加强手部的防护。     

1958-2010年阿坝州炭疽流行状况分析

目的分析阿坝州1958-2010年炭疽发病情况,找出发病规律和特点,探讨有效降低炭疽病发病的措施和方法。方法对53年来的炭疽疫情数据进行流行病学分析。结果 53年来累计报告炭疽病例1 349例,死亡21例,年均发病率3.47/10万、死亡率0.06/10万。全年均有病例报告,但集中在4～10月,3个牧区县的发病占报告总数的89.03%;职业以牧民为主,发病年龄集中在20～44岁。1958-2001年发病率在0.8/10万～2.52/10万之间,2002-2010年发病率在6.33/10万～12.66/10万之间。结论阿坝州1958-2001年炭疽发病较平稳,2002年起发病呈逐年上升趋势,且发病主要在牧区,应加强健康教育和畜牧业管理,做好疫点、外环境消毒和预防接种,有效控制牧区炭疽流行。     

Anthrax in eastern Turkey, 1992-2004

We investigated animal and human anthrax cases during a 13-year period in eastern Turkey. From 1992 to 2004, a total of 464 animal and 503 human anthrax cases were detected. Most cases occurred in summer. Anthrax remains a health problem in eastern Turkey, and preventive measures should be taken.     

Efficacy of the AV7909 anthrax vaccine candidate in guinea pigs and nonhuman primates following two immunizations two weeks apart

The anthrax vaccine candidate AV7909 is being developed as a next-generation vaccine for post-exposure prophylaxis (PEP) against inhalational anthrax. In clinical studies, two vaccinations with AV7909 administered either two or four weeks apart induced an enhanced immune response compared to BioThrax® (Anthrax Vaccine Adsorbed) (AVA). Anthrax toxin-neutralizing antibody (TNA) levels on Day 70 following initial vaccination that were associated with protection of animals exposed to inhalational anthrax were previously reported for the 0, 4-week AV7909 vaccination regimen. The current study shows that a 0, 2-week AV7909 vaccination regimen protected guinea pigs (GPs) and nonhuman primates (NHPs) against a lethal inhalational anthrax challenge on Days 28 and 70 after the first immunization. An earlier induction of protective TNA levels using a 0, 2-week AV7909 vaccination regimen may provide benefit over the currently approved AVA PEP 0, 2, and 4-week vaccination regimen.     

B. anthracis in a wool-processing factory: seroprevalence and occupational risk

In a Belgian wool-processing factory, living anthrax spores were found in raw goat hair and air dust, but confirmed anthrax cases had never been reported. Anthrax vaccines are not licensed nor recommended in Belgium. We conducted a B. anthracis seroprevalence study to investigate risk factors associated with positive serology and advise on protective measures. Overall 12·1% (8/66) employees were seropositive; 30% of persons processing raw goat hair and 20% of persons sorting raw goat hair were seropositive compared to 3% in less exposed jobs [adjusted prevalence ratio (aPR) 44·4, P=0·001; aPR 14·5, P=0·016, respectively). The number of masks used per day was protective (aPR 0·3, P=0·015). Results suggest a dose-response association for those processing raw goat hair. Host-related factors probably played a role as antibody response varied from person to person within an exposure group. Workers exposed to raw goat hair should be offered higher protection against anthrax and have access to anthrax vaccines.     

A single-dose combination therapy that both prevents and treats anthrax infection

Exposure to anthrax leaves susceptible hosts at prolonged risk of infection since spores can persist in vivo for months before germinating to cause life-threatening disease. Anthrax vaccine adsorbed (AVA, the licensed US vaccine) induces immunity too slowly to protect susceptible individuals post-exposure. Antibiotics prevent the proliferation of vegetative bacilli but do not block latent spores from germinating. Thus, anthrax-exposed individuals must remain on antibiotic therapy for months to eliminate the threat posed by delayed spore germination. Unfortunately, long-term antibiotic treatment is poorly tolerated and frequently discontinued. This work explores whether administering a single dose of a long-acting antibiotic (Dalbavancin) combined with a rapidly immunogenic vaccine/adjuvant combination can provide seamless protection from anthrax with minimal patient compliance. Results show that significant protection is achieved by delivering a single dose of this therapeutic combination any time before through 3 days after anthrax exposure.     

Surveillance for adverse events associated with anthrax vaccination--U.S. Department of Defense, 1998-2000

Concerns about the potential use of anthrax as a biologic weapon prompted the U.S. Department of Defense (DoD) to announce on December 15, 1997, anthrax vaccination of all U.S. military personnel. This effort is coordinated by the Anthrax Vaccine Immunization Program (AVIP). AVIP plans a phased vaccination process to achieve total force protection against anthrax by 2004. The current phase of implementation includes vaccination of all service members and mission-essential DoD civilian employees assigned or deployed to high-threat areas. On the basis of program monitoring, as of April 12, 2000, 425,976 service members had received 1,620,793 doses of anthrax vaccine adsorbed (AVA) (Bioport, Inc., Lansing, Michigan). Some service members have cited concerns about vaccine safety and efficacy in their decision to refuse vaccination, despite the possibility of administrative or disciplinary actions. To assess anthrax vaccination safety, DoD has conducted surveys of vaccinated personnel. This report describes three completed or ongoing surveys. The findings indicate that rates of local reactions were higher in women than men and that no patterns of unexpected local or systemic adverse events have been identified.     

Anthrax due to deliberate infection]

Anthrax is a zoonosis which is particularly prevalent in cattle, goats and sheep and is caused by Bacillus anthracis, a Gram-positive spore forming aerobic microorganism. The endospores can survive outside of the body for many decades. The natural form of anthrax has a cutaneous, pulmonary and intestinal form. The pulmonary form can be rapidly fatal but is difficult to recognise due to an initially non-specific, flu-like clinical picture. As a result of spores being inhaled, a mediastinal lymphadenitis arises from which a systemic disease develops with a violent toxaemia, damage to the vascular endothelium, oedema, internal haemorrhages and circulatory collapse. Anthrax is diagnosed by demonstrating the presence of the bacteria in the cutaneous abnormality, in blood or another sterile body component such as cerebrospinal fluid, by means of a direct preparation, immunofluorescence or surface antigens, molecular diagnostics with PCR, or by means of culturing. B. anthracis is sensitive to quinolones, clindamycin and tetracyclines, and often to penicillin. Although naturally acquired cutaneous anthrax can be effectively treated with a short antibiotic cure, it is nevertheless advised in the USA to complete the full 60-day cure and to regard the cutaneous manifestation as a telltale sign of possible respiratory exposure. Anthrax is not transmitted from one person to another.     

Assessing the safety of anthrax immunization in US Army aircrew members via physical examination

OBJECTIVE: Anthrax in weaponized form is the bioterrorism agent of most concern. Questions raised about the safety of the anthrax vaccine can be addressed by comparing immunized and unimmunized people in population-based studies. METHODS: A retrospective evaluation of data from periodic physical examinations collected on anthrax-immunized and -unimmunized US Army aircrew members between 1998 and 2005 was performed to evaluate the safety of anthrax immunization. Mean changes in variables found on physical examination and laboratory analysis were compared by use of t tests. Multiple linear regression predicted change in outcome from baseline characteristics. RESULTS: We compared 6,820 immunized subjects and 4,145 unimmunized controls based on US Army aircrew physical examination and screening laboratory tests. No association between anthrax immunization and a clinically relevant change in a tested physiologic parameter was detected. CONCLUSIONS: No attributable risk of anthrax immunization was observed in this group of Army aircrew members.     

Effect of nasal immunization with protective antigen of Bacillus anthracis on protective immune response against anthrax toxin

Anthrax toxin consists of three proteins: protective antigen (PA), lethal factor (LF) and edema factor (EF). PA in combination with LF (lethal toxin) is lethal to mammalian cells and is the major component of human anthrax vaccine. Immunization with PA elicits the production of neutralizing antibodies that form a major component of the protective immunity against anthrax. Recent reports have shown that neutralizing antibody titres can serve as a reliable surrogate marker for protection against anthrax. In the present study, the use of non-invasive routes such as bare skin and nose for immunization with PA on its protective immune response was investigated. Mice were inoculated intranasally (i.n.), subcutaneously (s.c.) or through the skin on days 0, 15 and 28 with purified PA. Intranasal and subcutaneous immunization with PA resulted in high IgG ELISA titers. The predominant subclass in each group was IgG1. High titres of IgA were observed only in i.n. immunized mice. In a cytotoxicity assay these sera protected J774A.1 cells from lethal toxin challenge. The results suggest that non-invasive nasal immunization may be useful in improving vaccination strategies against anthrax.     

2008-2018年四川省炭疽流行病学特征分析

目的 掌握四川省炭疽发病现况、流行特征及机构报告特点,为今后防控工作提供依据。方法 对2008-2018年炭疽报卡、突发公共卫生事件和畜牧养殖进行分析。结果 2008-2017年炭疽发病率呈波动下降趋势,2018较2017上升108.31%。2008-2018年仅甘阿凉三州报告发病,甘孜发病数占比逐年增加。仅牧区和半农半牧区发病。所有牧区均发病,病例数占78.57%。发病数前三县均为牧区(若尔盖、红原、石渠)。发病率随牛饲养量增加而增大(r=0.951,P=0.004)。发病到诊断平均时间8天。县级及以下机构上报病例数占91.47%,且疑似病例占比高于州级及以上机构。累计共报告5起突发事件,接触感染病例占92.86%。结论 发病有地域性,阿坝向甘孜有扩散趋势,散发为主,偶见暴发。牧区为防控重点,提高当地实验室水平,减少疑似病例上报。加强联防联控,特别是疫情发生后要彻底消毒处理。     

Anthrax--continuous threat to humans and animals

Gram-positive, spore-forming, aerobic bacterium Bacillus anthracis is an etiological agent of anthrax a disease very dangerous to humans and all warm-blooded animals. The spore forms are markedly resistant to unfavourable environmental extremes of heat, cold, desiccation, chemicals, irradiation etc. The vegetative forms characterised virulence factors: the antiphagocytic poly-gamma-D-polipeptide capsule and three proteins, edema factor (EF), lethal factor (LF) and protective antigen (PA). Anthrax is mainly transmitted from animals to man through food of animal origin, animal products and contamination of the environment with B. anthracis and its spores. There are three types of this disease: cutaneous, intestinal and inhalation anthrax. Research on anthrax as a biological weapon began more then 80 years ago. Depending on the target chosen and the scale of the attack the anthrax spores may by used to contaminate of foodstuffs or liquids and water. The aerosolised release of anthrax spore can cause illness with a high fatality rate.