The global distribution of Bacillus anthracis and associated anthrax risk to humans, livestock and wildlife

FapR regulates HssRS-mediated heme homeostasis in Bacillus anthracis

Bacillus anthracis, a Gram-positive facultative anaerobe and the causative agent of anthrax, multiplies to extraordinarily high numbers in vertebrate blood, resulting in considerable heme exposure. Heme is an essential nutrient and the preferred iron source for bacteria during vertebrate colonization, but its high redox potential makes it toxic in excess. To regulate heme homeostasis, many Gram-positive bacteria, including B. anthracis, rely on the two-component signaling system HssRS. HssRS comprises the heme sensing histidine kinase HssS, which modulates the activity of the HssR transcription factor to enable bacteria to circumvent heme toxicity. However, the regulation of the HssRS system remains unclear. Here, we identify FapR, the transcriptional regulator of fatty acid biosynthesis, as a key factor in HssRS function. FapR plays an important role in maintaining membrane integrity and the localization of the histidine kinase HssS. Specifically, disruption of fapR leads to increased membrane rigidity, which hinders the penetration of HssRS inducers, resulting in the inactivation of HssRS. Furthermore, deletion of fapR affects the loading of HssS onto the cell membrane, compromising its heme sensing function and subsequently reducing endogenous heme biosynthesis. These findings shed light on the molecular mechanisms governing bacterial adaptation to heme stress and provide potential targets for antimicrobial intervention strategies.

IMPORTANCE

Understanding the mechanisms by which B. anthracis regulates heme homeostasis is crucial for developing new strategies to combat anthrax, a serious disease affecting both humans and animals. This study uncovers the role of the transcriptional regulator FapR in maintaining membrane integrity and facilitating the proper function of the HssRS two-component signaling system, which is essential for managing heme toxicity in B. anthracis, as well as other Gram-positive pathogens. By elucidating the connection between FapR and HssRS, our findings provide new insights into the molecular adaptation of bacteria to heme stress and expand our knowledge of bacterial physiology and pathogenicity. More importantly, targeting the regulatory pathways involved in heme sensing and homeostasis presents a promising approach for developing novel therapeutics against anthrax and potentially other bacterial infections that rely on similar mechanisms.

A novel one-tube RPA/CRISPR melting curve detection sensing system based on unique 3'-toehold nucleic acid aptamer for Bacillus anthracis detection

Developing effective detection methods for Bacillus anthracis is essential for our public health system to accurately detect hidden anthrax outbreaks. Herein, we introduce a unique 3'-toehold nucleic acid aptamer (probes) into Cas12a biosensor, combined with RPA, to establish a rapid (1h), specific, and sensitive (1copy/μL) detection method for B. anthracis. The design behind this approach is that the target sequence is amplified via RPA, and the amplification product triggers the crRNA/Cas12a complex to degrade the 3' toehold probes, which are analyzed using melting curve analysis on a specific instrument, naming a one-tube RPA/CRISPR melting curve detection (ORCMD) sensing system. Furthermore, ORCMD is used to detect the B. anthracis spores-positive or negative soil samples from the location of world War-II site (Harbin, China), B. anthracis was precisely identified as other methods, suggesting its significant practical application potential. This system enriches the CRISPR detection technology toolbox, compared to other CRISPR-based sensing strategies, the concept of the 3' toehold probes offers distinct advantages in the development of CRISPR-based multi-target detection methods.

Serological correlates of protection and long-term efficacy of a novel recombinant protective antigen-based anthrax vaccine in a rabbit model

The novel anthrax vaccine candidate GC1109, composed of recombinant protective antigen, has shown robust antibody responses and safety in preclinical and clinical studies. However, the assessment of GC1109 vaccine efficacy was limited in a rodent model and could not be applied in clinical studies due to ethical issues. In this study, we aim to provide predictive insights for human applications of GC1109 by examining the correlation between anthrax toxin-neutralizing antibodies (TNAs) and protection against Bacillus anthracis infection in rabbit. The threshold level of TNAs necessary for protection was assessed following subcutaneous (s.c) challenge with lethal B. anthracis spores. In addition, the longevity of immunity in GC1109-vaccinated rabbits was investigated. A positive correlation between TNA levels and survival was observed, indicating their potential as a predictor of protection in humans. The 50 % neutralization factor (NF50) value of 0.5 was associated with a 70 % probability of survival, establishing this value as a surrogate marker for protective efficacy. Long-term protection was confirmed, with the GC1109-vaccinated group exhibiting significantly higher survival rates (91.7 %) than the control group (8.3 %) at 12 months post-vaccination. These findings highlight the protective efficacy and durability of GC1109-induced immunity against lethal B. anthracis challenge. The study supports the continued development of GC1109 as a viable anthrax vaccine candidate and underscores its potential for emergency preparedness in Korea.

Exploring community knowledge, perceptions, and the impacts of anthrax among farming communities living in game management areas in Zambia: A qualitative study using a hybrid approach

Anthrax remains a neglected zoonotic disease of critical public and animal health significance in Zambia, particularly in regions with active human-wildlife-livestock interfaces such as the Western, Southern and Eastern provinces of Zambia. This study explores the socio-ecological drivers of anthrax transmission and examines the role of legal and illegal wildlife trade value chains in sustaining outbreaks. Secondly, the study explores the methodology used to investigate community knowledge, perceptions, and the impacts of anthrax through focus group discussions (FGDs) and a hybrid approach combining traditional thematic analysis with artificial intelligence (AI) tools. The research was framed within the interpretivist paradigm, aiming to understand shared experiences and socio-cultural contexts. The study utilized focus groups to encourage interaction and generate rich, collective insights. The hybrid approach allowed for data analysis that combined researcher-led reflexivity with AI-driven thematic analysis. Findings reveal diverse levels of awareness about anthrax, widespread misconceptions, and the influence of cultural beliefs on health behaviours. Communities linked anthrax outbreaks to interactions with wildlife and the illegal game meat trade, highlighting the complex interplay of ecological, economic, and behavioural factors in disease dynamics. Additionally, the study underscores the socioeconomic toll of anthrax, including livestock losses, disrupted livelihoods, and food insecurity, compounded by inadequate public health and veterinary responses. The insights gained from this research emphasize the need for multi-sectoral interventions tailored to the specific needs of these communities.

Cutaneous anthrax rapidly progressed into septic anthrax resulting in death - A case report

Anthrax is a fatal zoonotic disease and the acute risk associated with it cannot be underestimated. Cutaneous anthrax accounts for more than 95 % of anthrax and usually does not lead to death. We present a case of severe cutaneous anthrax treated with a three-day course of combination antibiotics therapy, which culminated into death due to multiple organ failure. The patient did not exhibit symptoms suspected of meningitis anthrax and pulmonary anthrax. Computed Tomography revealed subcutaneous exudates in the chest, back, left supraclavicular fossa, and bilateral axillary regions. Some newly factors, like hypotension, elevated creatinine, acidosis, and a urinary tract infection, provide valuable insights into the clinical intervention in early. In rural areas, educating residents about anthrax symptoms and risks is crucial.

Microbial diversity and interactions: Synergistic effects and potential applications of Pseudomonas and Bacillus consortia

Microbial diversity and interactions in the rhizosphere play a crucial role in plant health and ecosystem functioning. Among the myriads of rhizosphere microbes, Pseudomonas and Bacillus are prominent players known for their multifaceted functionalities and beneficial effects on plant growth. The molecular mechanism of interspecies interactions between natural isolates of Bacillus and Pseudomonas in medium conditions is well understood, but the interaction between the two in vivo remains unclear. This paper focuses on the possible synergies between Pseudomonas and Bacillus associated in practical applications (such as recruiting beneficial microbes, cross-feeding and niche complementarity), and looks forward to the application prospects of the consortium in agriculture, human health and bioremediation. Through in-depth understanding of the interactions between Pseudomonas and Bacillus as well as their application prospects in various fields, this study is expected to provide a new theoretical basis and practical guidance for promoting the research and application of rhizosphere microbes.

Navigating the Interconnected Web of Health: A Comprehensive Review of the One Health Paradigm and Its Implications for Disease Management

Disease outbreaks pose serious threats to humans, as highlighted by the recent pandemic, underscoring the need for an institutionalized multi-sectoral approach like One Health, encompassing human, animal, and environmental health. One Health has demonstrated efficacy in addressing emerging issues such as antimicrobial resistance and zoonotic disease spillover. While integrating the human-animal sector has yielded positive outcomes, the majority of zoonotic spillovers originate from wildlife, emphasizing the crucial role of environmental surveillance within global One Health systems. Additionally, climate change intensifies the frequency and emergence of infectious diseases and spillover events. Tackling the complexity and interconnectedness of health challenges necessitates integrated solutions that incorporate broader structural factors, aiding in the prevention, detection, and mitigation of disease outbreaks. Embracing One Health through multi-sectoral preparedness can effectively confront the escalating threats of pandemics and other emerging diseases.

Case report: Clinical characteristics of anthrax meningoencephalitis: two cases diagnosed using metagenomic next-generation sequencing and literature review

Purpose

To explore the clinical features, diagnosis, treatment, and prognosis of anthrax meningoencephalitis.

Methods

The clinical data of two cases of anthrax meningoencephalitis were summarized and the relevant literature was reviewed.

Results

Both patients, who were farmers, had cutaneous lesions prior to the onset of meningoencephalitis. The clinical manifestations included fever (2/2), headache (2/2), stupor (2/2), meningeal signs (2/2), and lymph node enlargement (2/2). The CSF analysis showed erythrocytes, increased neutrophils, low glucose levels and high protein levels. CSF cytology revealed rod-shaped bacilli. Metagenomic next-generation sequencing of the CSF from both patients detected Bacillus anthracis. Additionally, cultures confirmed the presence of endogenous spores of macrobacteria. Brain imaging revealed subarachnoid hemorrhages and minimal cerebral edema. Despite aggressive antibiotic treatment, both patients died. Fifty-seven articles of the past 70 years were reviewed. There were 59 patients of anthrax meningoencephalitis in total, including 46 patients died. Stupor (42/46, 91.3% vs. 3/13, 46.2%, p = 0.001), agitation (15/46, 32.6% vs. 0/13, 0.0%, p = 0.043) and intracranial hemorrhage (37/46, 80.4% vs. 4/13, 30.8%, p = 0.002) were more common in the deceased group. Two types of bactericidal drugs or intrathecal injection drugs presented more often in the surviving group (10/13, 76.9% vs. 13/46, 28.3%, p = 0.001), whereas penicillin monotherapy presented more often in the deceased group (23/46, 50.0% vs. 2/13, 15.4%, p = 0.026).

Conclusion

Anthrax meningoencephalitis typically presents as a rapidly progressive bacterial meningoencephalitis. The occurrence of stupor, agitation and intracranial hemorrhage is possibly correlated with poor outcome. Two types of bactericidal drugs or intrathecal injection drugs are associated with better prognosis. Metagenomic next-generation sequencing can quickly and accurately detect B. anthracis in CSF.

Identification of Bacillus anthracis Strains from Animal Cases in Ethiopia and Genetic Characterization by Whole-Genome Sequencing

Anthrax is a zoonotic disease characterized by rapid onset with usual fatal outcomes in livestock and wildlife. In Ethiopia, anthrax is a persistent disease; however, there are limited data on the isolation and molecular characterization of Bacillus anthracis strains. This study aimed to characterize B. anthracis isolated from animal anthrax outbreaks between 2019 and 2024, from different localities in Ethiopia. B. anthracis was identified using standard microbiology techniques and confirmed by real-time PCR. For the first time in Ethiopia, the genetic diversity of five Bacillus anthracis strains, isolated from dead cattle and goats, was investigated by Whole Genome Sequencing (WGS) and bioinformatics analyses. The five sequenced strains were compared to one Ethiopian B. anthracis genome and the other 29 B. anthracis genomes available in the global genetic databases to determine their phylogeny. The genomes of the strains were also analyzed to detect the presence of antimicrobial resistance and virulence genes. The whole genome SNP analysis showed that the Ethiopian B. anthracis strains were grouped in the A clade. Three strains (BA2, BA5, and BA6) belonged to the A.Br.034 subgroup (A.Br.005/006), and two strains (BA1 and BA4) belonged to the A.Br.161 (Heroin) clade of the Trans-Eurasian (TEA) group. The findings of this study will contribute to expanding the current understanding of the anthrax hotspots in Ethiopia, and the phylogenetic correlation and/or diversity of the circulating strains.

Diversity of Endolysin Domain Architectures in Bacteriophages Infecting Bacilli

The increasing number of antibiotic-resistant bacterial pathogens is a serious problem in medicine. Endolysins are bacteriolytic enzymes of bacteriophages, and a promising group of enzymes with antibacterial properties. Endolysins of bacteriophages infecting Gram-positive bacteria have a modular domain organization. This feature can be used to design enzymes with new or improved properties by modifying or shuffling individual domains. This work is a detailed analysis 1of the diversity of endolysin domains found in bacteriophages infecting bacilli. During the course of the work, a database of endolysins of such bacteriophages was created, and their domain structures were analyzed using the NCBI database, RASTtk, BLASTp, HHpred, and InterPro programs. A phylogenetic analysis of endolysins was performed using MEGA X. In 438 phage genomes, 454 genes of endolysins were found. In the endolysin sequences found, eight different types of catalytic domains and seven types of cell wall binding domains were identified. The analysis showed that many types of endolysin domains have not yet been characterized experimentally. Studies of the properties of such domains will help to reveal the potential of endolysins for the creation of new antibacterial agents.

Toxin and capsule production by Bacillus cereus biovar anthracis influence pathogenicity in macrophages and animal models

Bacillus cereus biovar anthracis (Bcbva) causes anthrax-like disease in animals, particularly in the non-human primates and great apes of West and Central Africa. Genomic analyses revealed Bcbva as a member of the B. cereus species that carries two plasmids, pBCXO1 and pBCXO2, which have high sequence homology to the B. anthracis toxin and polyglutamate capsule encoding plasmids pXO1 and pXO2, respectively. To date, only a few studies have investigated the effect of variations in Bcbva sporulation, toxin, and capsule synthesis on animal and macrophage pathogenicity compared to B. anthracis, therefore more research is needed to gain a better understanding of the pathogenesis of this emerging infection. Here, we report that Bcbva can multiply and vegetatively survive on nutrient-rich media for a minimum of six days while generating spores. Sporulation of Bcbva occurred faster and more extensively than B. anthracis Ames. Bcbva tended to secrete less protective antigen (PA) than B. anthracis Ames when cultured in growth medium. We found Bcbva produced a substantially higher amount of attached poly-ƴ-D-glutamic acid (PDGA) capsule than B. anthracis Ames when grown in medium supplemented with human serum and CO2. In a phagocytosis assay, Bcbva spores showed reduced internalization by mouse macrophages compared to B. anthracis Ames. Our research demonstrated that Bcbva is more virulent than B. anthracis Ames using two in vivo models, Galleria mellonella larvae and guinea pigs. Following that, the efficacy of the veterinary vaccine Sterne strain 34F2 against anthrax-like disease was assessed in guinea pigs. Sterne vaccinated guinea pigs had significantly increased anti-PA titers compared to the unvaccinated control group. Toxin neutralizing antibody titers in vaccinated guinea pigs correlated with anti-PA titers. This indicates the Sterne vaccine provides adequate protection against Bcbva infection in laboratory animals.

Anthrax: A narrative review

Bacillus anthracis is a zoonotic bacterium, majorly responsible for causing human anthrax and the possibility of the outbreak spreading globally. Herbivorous animals serve as the inherent reservoir for the disease, whereas all endothermic species are vulnerable. Humans contract the disease inadvertently by contact with diseased animals or animal products or through the consumption or handling of infected flesh. There is no such reported data indicating the transmission of anthrax from human to human, which further does not guarantee the bacterium's mutations and new transmission route. Nevertheless, it can lead to various infections, including endophthalmitis, bacteremia, cutaneous infection, central nervous system infection, and pneumonia. Therefore, it is crucial to examine the present epidemiological situation of human anthrax in densely populated nations, including the altered symptoms, indications in people, and the method of transmission. This article highlights the current diagnostic methods for human anthrax, further examines the available therapy options and future perspectives in treatment protocol. This narrative review resulted from a simple search strategy on "PubMed", "ScienceDirect", "ClinicalTrials.gov" and web reports using "AND" as Boolean operator with search keywords, i.e., "Anthrax" AND "Infection", "Anthrax" AND "Pandemic", "Anthrax" AND "Infectious disease", "Anthrax" AND "Vaccine", "Anthrax" AND "Diagnosis" shows minimal narrative literature in between 2024 and 2005. Furthermore, this narrative review highlights the potential approaches for detecting anthrax infection, establishing suitable protocols for prevention, and focusing on the current epidemiology and available therapeutics, vaccine and its future developmental strategies for the prevention of infectious disorder.

Suitability of anthrax (Bacillus anthracis) in the Black Sea basin through the scope of distribution modelling

The Black Sea basin has a strategic geographic location bridging Asia and Europe and depends on traditional livestock practices for their local economies. Anthrax, a zoonotic bacterial disease caused by Bacillus anthracis, poses a significant global threat impacting public health, food security, pastoralist communities, and national economies. The disease is endemic or sporadic in the Black Sea basin, however, the study of its distribution has seldom been addressed, despite its burden and the presence of historical B. anthracis burial sites in the region. The viability of B. anthracis in a particular region is going to be influenced by multiple environmental factors, such as soil composition, climate, vegetation, and host abundance. For characterizing the potential distribution of B. anthracis in the Black Sea basin and assessing the potential for anthrax outbreaks, we applied an ecological niche modelling framework using the Maxent algorithm. This machine-learning algorithm models species distributions based on presence data and background information from a specified calibration region. We analyzed multiple variable combinations and proposed a novel approach for interpreting in-risk anthrax areas. Our findings underscored the importance of host abundance to the anthrax dynamics in the region. We identified anthrax-suitable areas spanning central and eastern Türkiye, Armenia, southern Georgia, southern Russia, Bulgaria, southern and eastern Romania, Hungary, Moldova, and southern Ukraine, which align with findings from previous global and regional studies on the potential suitability of anthrax. The insights gained from our research may help to develop targeted interventions, such as awareness and educational campaigns about anthrax, supervision of anthrax-infected carcasses disposal, and the promotion of livestock vaccination in high-risk areas. Additionally, these results can inform policies to mitigate the spread of anthrax in pastoralist communities in the Black Sea basin and foster collaboration between veterinary and public health entities on anthrax control.

Isolation and identification of aerobic and anaerobic bacteria from the feces of wild Korean water deer (Hydropotes inermis argyropus)

IMPORTANCE

Understanding the microbial diversity within the gastrointestinal tract of wild Korean water deer (KWD; Hydropotes inermis argyropus) is essential for gaining insights into their health and ecological interactions.

OBJECTIVE

This study aims to isolate and identify aerobic and anaerobic bacterial species in the feces of wild KWD.

METHODS

Fecal samples were collected from 55 wild KWD of varying age and sex. Aerobic bacteria were cultured at 37°C for 24-48 h under standard conditions, whereas anaerobic bacteria were cultured at 37°C for 48-72 h in an anaerobic environment. Bacterial identification was conducted using DNA extraction and polymerase chain reaction amplification targeting the 16S rRNA gene.

RESULTS

The predominant aerobic bacteria identified belonged to the Firmicutes (58.18%) and Proteobacteria (41.82%) phyla, with Escherichia coli (31.82%) and Bacillus cereus (31.82%) being the most common species. Among anaerobic bacteria, most belonged to the Firmicutes (71.03%), Proteobacteria (27.10%), and Fusobacteriota (1.87%) phyla, with Paraclostridium bifermentans (28.97%) and E. coli (22.43%) being the most prevalent species. Other frequently identified anaerobic species were Fusobacterium varium, Lactococcus garvieae, Terrisporobacter glycolicus, Enterococcus faecalis, and Clostridium sporogenes.

CONCLUSIONS AND RELEVANCE

Our findings indicate a diverse microbial community in the feces of water deer, offering valuable insights into their gut microbiota and its potential implications for health and ecology.

Risk perceptions and preventive preparedness toward anthrax re-emergence within the lens of one health in Northcentral Nigeria

Anthrax has re-emerged in domestic ruminants in Nigeria with public health concerns. This study assessed stakeholders' perceptions and preventive preparedness toward further resurgence and spread at the human-animal-environment interface. A questionnaire-based cross-sectional study was conducted in Nigeria. Descriptive and analytical statistical analyses were performed at 95% confidence levels. All the 384 recruited stakeholders responded. The majority (96.2%) of animal health practitioners (AHPs) and 56.7% of pastoralists were aware of the recent anthrax re-emergence in Nigeria (p < 0.001). Noteworthy, 88.5% of the AHPs and 32.2% of pastoralists mentioned that anthrax has an environmental component in its transmission to humans and animals. From the environmental perspective, 87.7% of AHPs and 24.0% of pastoralists significantly perceived that soil and aerosol contamination with anthrax spores are highly plausible explanation routes for its re-emergence. Extreme weather events (high rainfall, flooding, winds, and drought) (p = 0.001); grazing of livestock on pastures grown on contaminated soil (p < 0.001), transboundary movement and trade of animals (p = 0.001); introduction of new animals into the herds without quarantine (p = 0.001); and bioterrorism (p < 0.001) were more likely to influence the re-emergence and spread of anthrax. To tackle gaps in knowledge and risk perceptions, and address the socio-economic and anthropogenic drivers, cooperation and collaborations through the lens of the One Health approach are needed. The partnership will promote an integrated disease surveillance system from planning to implementation for the realization of elimination or reduction of the burden of anthrax and other zoonoses in Nigeria and contribute to achieving food safety, food security, and public and ecosystem health.

Comprehensive Spatial-Temporal and Risk Factor Insights for Optimizing Livestock Anthrax Vaccination Strategies in Karnataka, India

Anthrax, a zoonotic disease affecting both livestock and humans globally, is caused by Bacillus anthracis. The objectives of this study were the following: (1) to identify environmental risk factors for anthrax and use this information to develop an improved predictive risk map, and (2) to estimate spatial variation in basic reproduction number (Ro) and herd immunity threshold at the village level, which can be used to optimize vaccination policies within high-risk regions. Based on the anthrax incidences from 2000-2023 and vaccine administration figures between 2008 and 2022 in Karnataka, this study depicted spatiotemporal pattern analysis to derive a risk map employing machine learning algorithms and estimate Ro and herd immunity threshold for better vaccination coverage. Risk factors considered were key meteorological, remote sensing, soil, and geographical parameters. Spatial autocorrelation and SaTScan analysis revealed the presence of hotspots and clusters predominantly in the southern, central, and uppermost northern districts of Karnataka and temporal cluster distribution between June and September. Factors significantly associated with anthrax were air temperature, surface pressure, land surface temperature (LST), enhanced vegetation index (EVI), potential evapotranspiration (PET), soil temperature, soil moisture, pH, available potassium, sulphur, and boron, elevation, and proximity to waterbodies and waterways. Ensemble technique with random forest and classification tree models were used to improve the prediction accuracy of anthrax. High-risk areas are expected in villages in the southern, central, and extreme northern districts of Karnataka. The estimated Ro revealed 11 high-risk districts with Ro > 1.50 and respective herd immunity thresholds ranging from 11.24% to 55.47%, and the assessment of vaccination coverage at the 70%, 80%, and 90% vaccine efficacy levels, all serving for need-based strategic vaccine allocation. A comparison analysis of vaccinations administered and vaccination coverage estimated in this study is used to illustrate difference in the supply and vaccine force. The findings from the present study may support in planning preventive interventions, resource allocation, especially of vaccines, and other control strategies against anthrax across Karnataka, specifically focusing on predicted high-risk regions.

Microbial richness and air chemistry in aerosols above the PBL confirm 2,000-km long-distance transport of potential human pathogens

The existence of viable human pathogens in bioaerosols which can cause infection or affect human health has been the subject of little research. In this study, data provided by 10 tropospheric aircraft surveys over Japan in 2014 confirm the existence of a vast diversity of microbial species up to 3,000 m height, which can be dispersed above the planetary boundary layer over distances of up to 2,000 km, thanks to strong winds from an area covered with massive cereal croplands in Northeast (NE) Asia. Microbes attached to aerosols reveal the presence of diverse bacterial and fungal taxa, including potential human pathogens, originating from sewage, pesticides, or fertilizers. Over 266 different fungal and 305 bacterial genera appeared in the 10 aircraft transects. Actinobacteria, Bacillota, Proteobacteria, and Bacteroidetes phyla dominated the bacteria composition and, for fungi, Ascomycota prevailed over Basidiomycota. Among the pathogenic species identified, human pathogens include bacteria such as Escherichia coli, Serratia marcescens, Prevotella melaninogenica, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus saprophyticus, Cutibacterium acnes, Clostridium difficile, Clostridium botulinum, Stenotrophomonas maltophilia, Shigella sonnei, Haemophillus parainfluenzae and Acinetobacter baumannii and health-relevant fungi such as Malassezia restricta, Malassezia globosa, Candida parapsilosis and Candida zeylanoides, Sarocladium kiliense, Cladosporium halotolerans, and Cladosporium herbarum. Diversity estimates were similar at heights and surface when entrainment of air from high altitudes occurred. Natural antimicrobial-resistant bacteria (ARB) cultured from air samples were found indicating long-distance spread of ARB and microbial viability. This would represent a novel way to disperse both viable human pathogens and resistance genes among distant geographical regions.

Development and application of a WebGIS-based prediction system for multi-criteria decision analysis of porcine pasteurellosis

Porcine pasteurellosis is an infectious disease caused by Pasteurella multocida (P. multocida), which seriously endangers the healthy development of pig breeding industry. Early detection of disease transmission in animals is a crucial early warning for humans. Therefore, predicting risk areas for disease is essential for public health authorities to adopt preventive measures and control strategies against diseases. In this study, we developed a predictive model based on multi-criteria decision analysis (MCDA) and assessed risk areas for porcine pasteurellosis in the Chinese mainland. By using principal component analysis, the weights of seven spatial risk factors were determined. Fuzzy membership function was used to standardize all risk factors, and weight linear combination was used to create a risk map. The sensitivity of the risk map was analyzed by calculating the mean of absolute change rates of risk factors, as well as calculating an uncertainty map. The results showed that risk areas for porcine pasteurellosis were predicted to be locate in the south-central of the Chinese mainland, including Sichuan, Chongqing, Guangdong, and Guangxi. The maximum standard deviation of the uncertain map was less than 0.01and the ROC results showed that the prediction model has moderate predictive performance with the area under the curve (AUC) value of 0.80 (95% CI 0.75-0.84). Based on the above process, MCDA was combined with WebGIS technology to construct a system for predicting risk areas of porcine pasteurellosis. Risk factor data was directly linked to the developed model, providing decision support for disease prevention and control through monthly updates.

Pan-genome analysis reveals novel chromosomal markers for multiplex PCR-based specific detection of Bacillus anthracis

BACKGROUND

Bacillus anthracis is a highly pathogenic bacterium that can cause lethal infection in animals and humans, making it a significant concern as a pathogen and biological agent. Consequently, accurate diagnosis of B. anthracis is critically important for public health. However, the identification of specific marker genes encoded in the B. anthracis chromosome is challenging due to the genetic similarity it shares with B. cereus and B. thuringiensis.

METHODS

The complete genomes of B. anthracis, B. cereus, B. thuringiensis, and B. weihenstephanensis were de novo annotated with Prokka, and these annotations were used by Roary to produce the pan-genome. B. anthracis exclusive genes were identified by Perl script, and their specificity was examined by nucleotide BLAST search. A local BLAST alignment was performed to confirm the presence of the identified genes across various B. anthracis strains. Multiplex polymerase chain reactions (PCR) were established based on the identified genes.

RESULT

The distribution of genes among 151 whole-genome sequences exhibited three distinct major patterns, depending on the bacterial species and strains. Further comparative analysis between the three groups uncovered thirty chromosome-encoded genes exclusively present in B. anthracis strains. Of these, twenty were found in known lambda prophage regions, and ten were in previously undefined region of the chromosome. We established three distinct multiplex PCRs for the specific detection of B. anthracis by utilizing three of the identified genes, BA1698, BA5354, and BA5361.

CONCLUSION

The study identified thirty chromosome-encoded genes specific to B. anthracis, encompassing previously described genes in known lambda prophage regions and nine newly discovered genes from an undefined gene region to the best of our knowledge. Three multiplex PCR assays offer an accurate and reliable alternative method for detecting B. anthracis. Furthermore, these genetic markers have value in anthrax vaccine development, and understanding the pathogenicity of B. anthracis.

Anthrax in Humans, Animals, and the Environment and the One Health Strategies for Anthrax Control

Anthrax is a notorious disease of public health importance caused by Bacillus anthracis. The causative agent can also be used as a biological weapon. Spores of these bacteria can sustain extreme environmental conditions and remain viable in soil for decades. Domestic and wild ruminants are highly susceptible to this pathogen, which usually presents as a peracute to acute disease. In humans, cutaneous anthrax is frequent but pulmonary and enteric anthrax are more serious. Humans, animals, and the environment are all involved, making anthrax a perfect target for a One Health approach. The environment plays a key role in disease transmission. At a time when the One Health concept is not mere slogans, collaborative efforts of medical professionals, veterinarians, and environmental scientists will be valuable for the prevention and control of this disease. In this review, we discussed the transmission dynamics of anthrax in the environment, animals, and humans, as well as One Health strategies to control and prevent anthrax.

Water and mosquitoes as key components of the infective cycle of Francisella tularensis in Europe: a review

Francisella tularensis is the pathogen of tularemia, a zoonotic disease that have a broad range of hosts. Its epidemiology is related to aquatic environments, particularly in the subspecies holarctica. In this review, we explore the role of water and mosquitoes in the epidemiology of Francisella in Europe. F. tularensis epidemiology has been linked to natural waters, where its persistence has been associated with biofilm and amebas. In Sweden and Finland, the European countries where most human cases have been reported, mosquito bites are a main route of transmission. F. tularensis is present in other European countries, but to date positive mosquitoes have not been found. Biofilm and amebas are potential sources of Francisella for mosquito larvae, however, mosquito vector capacity has not been demonstrated experimentally, with the need to be studied using local species to uncover a potential transmission adaptation. Transstadial, for persistence through life stages, and mechanical transmission, suggesting contaminated media as a source for infection, have been studied experimentally for mosquitoes, but their natural occurrence needs to be evaluated. It is important to clear up the role of different local mosquito species in the epidemiology of F. tularensis and their importance in all areas where tularemia is present.

Knowledge, attitude and practice related to anthrax among livestock farmers in West Kazakhstan

BACKGROUND

Anthrax is the most prioritized zoonotic disease in Kazakhstan due to its threatening potential to the public health and agricultural sector. Sporadic anthrax outbreaks are being reported annually among human and livestock populations throughout the country, with the highest frequency occurring in West Kazakhstan.

METHODS

A cross-sectional study was conducted using a survey-based face-to-face interview. From January to May 2022, 489 randomly selected participants were surveyed in 6 districts of the Baiterek province in West Kazakhstan oblast to evaluate the knowledge, attitude and practice (KAP) regarding anthrax among community members. This is the first KAP study conducted relating to outbreaks of anthrax in Kazakhstan.

RESULTS

In this study, most participants (74%) surveyed were males, and 40% of respondents had a secondary level education. Overall, 91% of the community respondents were engaged in agriculture and livestock rearing. Among these community members, cattle rearing was the most common (67%) occupation compared to other livestock species. Additionally, over a 50% of the population studied had no knowledge about the zoonotic nature of the disease, and about 82% and 87% of respondents were unaware of any animal and human anthrax symptoms, respectively. About 70% of the respondents were interested in vaccinating their livestock against anthrax. Individuals aged 45-54 displayed notably higher animal vaccination rates (45%; 95% CI: 38.4-52.0; p < 0.025) compared to those aged 25-34 and 65-74. Respondents residing in the Beles district (20%; 95% CI: 17.1-24.7; p < 0.005) exhibited a significantly higher level of awareness concerning the fatality of anthrax in contrast to participants from Bolashak. Roughly 61% of respondents held the belief that anthrax is a lethal disease. An overwhelming majority of the survey participants (99%) affirmed their non-participation in the slaughter of infected animals.

CONCLUSION

The findings of this study indicate that KAP among community members relating to anthrax is low and requires swift implementation of education programmes in building awareness of anthrax under the One Health approach, especially in anthrax prone regions.

FapR regulates HssRS-mediated heme homeostasis in Bacillus anthracis

Bacillus anthracis, a Gram-positive facultative anaerobe and the causative agent of anthrax, multiplies to extraordinarily high numbers in vertebrate blood, resulting in considerable heme exposure. Heme is an essential nutrient and the preferred iron source for bacteria during vertebrate colonization, but its high redox potential makes it toxic in excess. To regulate heme homeostasis, many Gram-positive bacteria, including B. anthracis, rely on the two-component signaling system HssRS. HssRS comprises the heme sensing histidine kinase HssS, which modulates the activity of the HssR transcription factor to enable bacteria to circumvent heme toxicity. However, the regulation of the HssRS system remains unclear. Here we identify FapR, the transcriptional regulator of fatty acid biosynthesis, as a key factor in HssRS function. FapR plays an important role in maintaining membrane integrity and the localization of the histidine kinase HssS. Specifically, disruption of fapR leads to increased membrane rigidity, which hinders the penetration of HssRS inducers, resulting in the inactivation of HssRS. Furthermore, deletion of fapR affects the loading of HssS onto the cell membrane, compromising its heme sensing function and subsequently reducing endogenous heme biosynthesis. These findings shed light on the molecular mechanisms governing bacterial adaptation to heme stress and provide potential targets for antimicrobial intervention strategies.

Upper Limb Compartment Syndrome-An Extremely Rare Life-Threatening Complication of Cutaneous Anthrax

(1) Background: Cutaneous anthrax is a disease caused by a Gram-positive bacillus, spore-forming Bacillus anthracis (BA). Cutaneous anthrax accounts for 95% of all anthrax cases, with mortality between 10-40% in untreated forms. The most feared complication, which can be life-threatening and is rarely encountered and described in the literature, is compartment syndrome. (2) Methods: We report a series of six cases of cutaneous anthrax from the same endemic area. In two of the cases, the disease was complicated by compartment syndrome. The systematic review was conducted according to systematic review guidelines, and the PubMed, Google Scholar, and Web of Science databases were searched for publications from 1 January 2008 to 31 December 2023. The keywords used were: "cutaneous anthrax" and "compartment syndrome by cutaneous anthrax". (3) Results: For compartment syndrome, emergency surgical intervention for decompression was required, along with another three surgeries, with hospitalization between 21 and 23 days. In the systematic review, among the 37 articles, 29 did not contain cases focusing on compartment syndrome of the thoracic limb in cutaneous anthrax. The results were included in a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram. (4) Conclusions: Early recognition of the characteristic cutaneous lesions and compartment syndrome with early initiation of antibiotics and urgent surgical treatment is the lifesaving solution.

Mapping high probability area for the Bacillus anthracis occurrence in wildlife protected area, South Omo, Ethiopia

Anthrax is a zoonotic disease caused by a spore-forming gram-positive bacterium, Bacillus anthracis. Increased anthropogenic factors inside wildlife-protected areas may worsen the spillover of the disease at the interface. Consequently, environmental suitability prediction for B. anthracis spore survival to locate a high-risk area is urgent. Here, we identified a potentially suitable habitat and a high-risk area for appropriate control measures. Our result revealed that a relatively largest segment of Omo National Park, about 23.7% (1,218 square kilometers) of the total area; 36.6% (711 square kilometers) of Mago National Park, and 29.4% (489 square kilometers) of Tama wildlife Reserve predicted as a high-risk area for the anthrax occurrence in the current situation. Therefore, the findings of this study provide the priority area to focus on and allocate resources for effective surveillance, prevention, and control of anthrax before it causes devastating effects on wildlife.

Spatial clusters of human and livestock anthrax define high-risk areas requiring intervention in Lao Cai Province, Vietnam 1991-2022

Anthrax, a widespread zoonosis in low and middle-income countries with low disease awareness and insufficient livestock vaccination coverage, has been known in Lao Cai Province in northern Vietnam for years before its apparent absence in 2009, which requires investigation as this infection is frequently reported from neighbouring provinces and countries. We aimed to describe the seasonal patterns of anthrax (1991-2008), compare livestock anthrax vaccine coverage to disease occurrence (1991- 2022), and delineate the high-risk areas to inform local disease surveillance in the province. We illustrated the seasonal pattern of anthrax and provided a comparison between livestock vaccine coverage and disease occurrence by purely spatial SaTScan (Poisson model, 25% population at risk) to detect spatial clusters of human and livestock anthrax using population derived from zonal statistics routines. The number of cases, crude cumulative incidence, and spatial clusters of human and livestock anthrax were mapped in QGIS. Results indicate peak anthrax incidence from May to October. Buffalo, domestic cattle, and horses accounted for 75% of total animal cases. Horse anthrax was more common in Lao Cai than in its neighbours and often occurred in years with human mortality. Vaccination covered less than 30% of the livestock population. We found an apparent pattern where anthrax was controlled from 1998-2003 with higher vaccine coverage (>20%) and identified spatial clusters of human and livestock anthrax in Muong Khuong, Bao Thang, and Bac Ha districts of Lao Cai. The local public health and veterinary agencies are recommended to revisit the high-risk areas and communicate with neighbouring provinces for a regional approach to anthrax surveillance and control.

LETHAL TOXIN NEUTRALIZING ANTIBODY RESPONSE INDUCED FOLLOWING ORAL VACCINATION WITH A MICROENCAPSULATED BACILLUS ANTHRACIS STERNE STRAIN 34F2 VACCINE PROOF-OF-CONCEPT STUDY IN WHITE-TAILED DEER (ODOCOILEUS VIRGINIANUS)

Improved methods are needed to prevent wildlife deaths from anthrax. Caused by Bacillus anthracis, naturally occurring outbreaks of anthrax are frequent but unpredictable. The commercially available veterinary vaccine is labeled for subcutaneous injection and is impractical for large-scale wildlife vaccination programs; therefore, oral vaccination is the most realistic method to control and prevent these outbreaks. We reported the induction of an anthrax-specific lethal toxin (LeTx) neutralizing antibody response in mice following oral vaccination with alginate microcapsules containing B. anthracis Sterne strain 34F2 spores, coated with poly-L-lysine (PLL) and vitelline protein B (VpB). We continued evaluating our novel vaccine formulation through this proof-of-concept study in white-tailed deer (WTD; Odocoileus virginianus; n = 9). We orally vaccinated WTD via needle-free syringe with three formulations of the encapsulated vaccine: 1) PLL-VpB-coated microcapsules with 107-8 spores/ml (n = 5), 2) PLL-VpB-coated microcapsules with 109-10 spores/ml (n = 2), and 3) PLL-coated microcapsules with 109-10 spores/ml (n = 2). Although the limited sample sizes require continued experimentation, we observed an anthrax-specific antibody response in WTD serum following oral vaccination with PLL-coated microcapsules containing 109 spores/ ml. Furthermore, this antibody response neutralized anthrax LeTx in vitro, suggesting that continued development of this vaccine may allow for realistic wildlife anthrax vaccination programs.

Impact of traditional cutaneous scarification on anthrax lesions: A series of cases from Cubal, Angola

OBJECTIVES

Bacillus anthracis infection is a worldwide zoonosis that affects the most vulnerable population and has a high mortality rate without treatment, especially in non-cutaneous presentations. Cutaneous scarification is still common in some regions of the world for the treatment of certain diseases as part of traditional medicine. We describe a series of cutaneus anthrax from a rural setting in Angola where cutaneus scarification is common.

CASE PRESENTATION

This is a retrospective observational study describing a series of cutaneous anthrax cases from Cubal (Angola), many of whom were treated with skin scarification before admission. A total of 26 cases were diagnosed from January 2010 to December 2018. None of the cases were confirmed and eight (30.8%) were probable cases according to the Centers for the Disease Control and Prevention anthrax case definition. The median age was 11 (4.7-30.5) years, 17 (65.4%) had lesions on the head, face, or neck and 15 (57.7%) were treated with cutaneous scarification. Nine (34.6%) patients died. Traditional cutaneous scarification was significantly associated with cutaneous superinfection, respiratory, systemic involvement, and death.

CONCLUSION

Our case series points to increased complications and worse outcome of cutaneous anthrax disease if treated with skin scarification.

Suspected cutaneous anthrax in a yak herder in a highland community in Bhutan, 2023: A case report

This case presents cutaneous anthrax in yak herder from a central highland community in Bhutan. We highlight the clinical presentation, diagnosis and management of the case in a resource-limited setting, and the public health response through the One Health approach.

Modelling climate change impacts on the spatial distribution of anthrax in Zimbabwe

BACKGROUND

In Zimbabwe, anthrax is endemic with outbreaks being reported almost annually in livestock, wildlife, and humans over the past 40 years. Accurate modelling of its spatial distribution is key in formulating effective control strategies. In this study, an Ensemble Species Distribution Model was used to model the current and future distribution of anthrax occurrence in Zimbabwe.

METHODS

Bioclimatic variables derived from the Beijing Climate Centre Climate System Model were used to model the disease. Collinearity testing was conducted on the 19 bioclimatic variables and elevation to remove redundancy. Variables that had no collinearity were used for anthrax habitat suitability modelling. Two future climate change scenarios for different Representative Concentration Pathways (RCP), RCP4.5 and RCP8.5 were used. Model evaluation was done using true skill, Kappa statistics and receiver operating characteristics.

RESULTS

The results showed that under current bioclimatic conditions, eastern and western districts of Zimbabwe were modelled as highly suitable, central districts moderately suitable and southern parts marginally suitable for anthrax occurrence. Future predictions demonstrated that the suitable (8%) and highly suitable (7%) areas for anthrax occurrence would increase under RCP4.5 scenario. In contrast, a respective decrease (11%) and marginal increase (0.6%) of suitable and highly suitable areas for anthrax occurrence were predicted under the RCP8.5 scenario. The percentage contribution of the predictors varied for the different scenarios; Bio6 and Bio18 for the current scenario, Bio2, Bio4 and Bio9 for the RCP4.5 and Bio3 and Bio15 for the RCP8.5 scenarios.

CONCLUSIONS

The study revealed that areas currently suitable for anthrax should be targeted for surveillance and prevention. The predicted future anthrax distribution can be used to guide and prioritise surveillance and control activities and optimise allocation of limited resources. In the marginally to moderately suitable areas, effective disease surveillance systems and awareness need to be put in place for early detection of outbreaks. Targeted vaccinations and other control measures including collaborative 'One Health' strategies need to be implemented in the predicted highly suitable areas. In the southern part where a high decrease in suitability was predicted, continued monitoring would be necessary to detect incursions early.

Combatting anthrax outbreaks across Nigeria's national land borders: need to optimize surveillance with epidemiological surveys

BACKGROUND

Anthrax is a non-contagious zoonotic disease caused by the Gram-positive, spore-forming bacterium Bacillus anthracis. Infection is common in livestock and wild animals such as cattle, goats, sheep, camels, and antelopes. In humans, anthrax may occur after contact with contaminated carcasses or animal products like milk and meat. The best method to prevent anthrax in people is to ensure livestock are vaccinated, which significantly limits the risk of zoonotic spread to humans. However, the rate of vaccination of domesticated animals kept by nomadic pastoralists in West Africa is low. These groups regularly cross over national boundaries with their grazing herds. Nigeria is a country that historically has done comparatively well to contain this public health threat. However, in 2023 several outbreaks of human disease appear linked to the consumption of anthrax-contaminated animal products brought into Nigeria by pastoralists from neighboring countries. Clinical manifestations include skin sores or ulcers, nausea, vomiting, and fever. This article aims to raise awareness of recent outbreaks of anthrax in West Africa and to call for a renewed focus on measures to combat this neglected public health concern to the region.

MAIN BODY

The imperative to pinpoint pivotal issues relating to the ongoing emergence of anthrax cases in Nigeria cannot be overstated. By delving into the prevalence of anthrax in both livestock and human populations residing along Nigeria's borders, unraveling the genetic diversity and potential sources of B. anthracis strains, and identifying the primary animal host(s) responsible for transmission, we stand to enhance our understanding of this critical issue. Furthermore, investigating the multifaceted factors contributing to anthrax transmission, assessing community knowledge and practices, mapping common migratory routes of pastoralists, and formulating targeted intervention strategies tailored to the challenges of border communities, are each crucial steps towards effective control and prevention.

CONCLUSION

Closing these knowledge gaps on anthrax is not only essential for safeguarding both animal and human health but also for fostering sustainable and resilient communities. Addressing research questions on these interdisciplinary concerns will undoubtedly pave the way for informed decision-making, proactive measures, and a more secure future for Nigeria and its border regions.

Molecular characterization of an outbreak-involved Bacillus anthracis strain confirms the spillover of anthrax from West Africa

BACKGROUND

Anthrax, a zoonotic disease caused by the spore-forming bacterium Bacillus anthracis, remains a major global public health concern, especially in countries with limited resources. Sierra Leone, a West African country historically plagued by anthrax, has almost been out of report on this disease in recent decades. In this study, we described a large-scale anthrax outbreak affecting both animals and humans and attempted to characterize the pathogen using molecular techniques.

METHODS

The causative agent of the animal outbreak in Port Loko District, Sierra Leone, between March and May 2022 was identified using the nanopore sequencing technique. A nationwide active surveillance was implemented from May 2022 to June 2023 to monitor the occurrence of anthrax-specific symptoms in humans. Suspected cases were subsequently verified using quantitative polymerase chain reaction. Full-genome sequencing was accomplished by combining long-read and short-read sequencing methods. Subsequent phylogenetic analysis was performed based on the full-chromosome single nucleotide polymorphisms.

RESULTS

The outbreak in Port Loko District, Sierra Leone, led to the death of 233 animals between March 26th and May 16th, 2022. We ruled out the initial suspicion of Anaplasma species and successfully identified B. anthracis as the causative agent of the outbreak. As a result of the government's prompt response, out of the 49 suspected human cases identified during the one-year active surveillance, only 6 human cases tested positive, all within the first month after the official declaration of the outbreak. The phylogenetic analysis indicated that the BaSL2022 isolate responsible for the outbreak was positioned in the A.Br.153 clade within the TransEuroAsian group of B. anthracis.

CONCLUSIONS

We successfully identified a large-scale anthrax outbreak in Sierra Leone. The causative isolate of B. anthracis, BaSL2022, phylogenetically bridged other lineages in A.Br.153 clade and neighboring genetic groups, A.Br.144 and A.Br.148, eventually confirming the spillover of anthrax from West Africa. Given the wide dissemination of B. anthracis spores, it is highly advisable to effectively monitor the potential reoccurrence of anthrax outbreaks and to launch campaigns to improve public awareness regarding anthrax in Sierra Leone.

In Vitro Protection and Titer Duration of Anthrax-Specific Antibodies Following Subcutaneous Vaccination of White-tailed Deer (Odocoileus virginianus) with Bacillus anthracis Sterne 34F2 Strain Spores

Outbreaks of anthrax, caused by the soilborne bacterium Bacillus anthracis, are a continuous threat to free-ranging livestock and wildlife in enzootic regions of the United States, sometimes causing mass mortalities. Injectable anthrax vaccines are commercially available for use in livestock, and although hand injection is not a cost- or time-effective long-term management plan for prevention in wildlife, it may provide a tool for managers to target selectively animals of high conservation or economic value. Vaccine-induced anthrax-specific antibody responses have been reported previously in white-tailed deer (Odocoileus virginianus), but the protective nature was not determined. In this study, five white-tailed deer were subcutaneously vaccinated with one dose (1 mL) of the Anthrax Spore Vaccine. Eight blood collections by jugular venipuncture were conducted over 146 d to measure the anthrax-specific antibody response in each deer's serum over time. Antibodies were first detected by ELISA and later with toxin neutralization assays to estimate in vitro protection. Average peak absorbance by ELISA occurred at 14 d postvaccination, whereas average peak in vitro protection occurred at 28 d postvaccination. Observed in vitro protection on average for white-tailed deer after this single-dose vaccination protocol lasted 42-56 d postvaccination, although three individuals still maintained lethal toxin-neutralizing serum antibody titers out to 112 d postvaccination. Vaccination responses were variable but effective to some degree in all white-tailed deer.

One health approach to mitigate anthrax in Ghana

Anthrax outbreaks in Ghana have become a pressing public health concern, posing threats to human health, the agricultural sector, and social well-being. This letter to the editor highlights the gravity of the anthrax situation in Ghana and advocates for comprehensive interventions using a One Health approach. The epidemiology of anthrax, including its historical roots and modes of transmission, is discussed. The consequences of anthrax outbreaks, such as severe illness, economic losses, and social distress, are outlined. To combat this complex issue, the letter emphasizes the importance of enhanced awareness, prevention, accurate diagnosis, and timely treatment. Recommendations include vaccination of animals and humans, education campaigns, proper disposal of infected carcasses, strengthening healthcare systems, surveillance, and early detection. Collaboration and coordination among professionals in the human, animal, and environmental sectors are crucial. By adopting a One Health approach and implementing these measures, Ghana can effectively mitigate the impact of anthrax outbreaks and safeguard the health and well-being of its population and livestock.

Spatial analysis of human and livestock anthrax in Lai Chau province, Vietnam (2004-2021)

Anthrax is reported globally with varying disease intensity and seasonality among countries. In Vietnam, anthrax epidemiology and ecology remain understudied. We used historical data of human and livestock anthrax from 2004 to 2021 in Lai Chau province, to identify spatial clusters of human and livestock anthrax, describe epidemiological characteristics, and compare livestock anthrax vaccine coverage to human and livestock disease incidence. Local Moran's I (LISA) using spatial Bayes smoothed commune-level cumulative incidence (per 10,000) for the study period, epidemiological descriptive statistics, livestock vaccine coverage data, and annual incidence rates (per 10,000) at provincial level were used. LISA identified a human anthrax hotspot (high-high) in the southeast which did not overlap spatially with livestock anthrax hotspots in southeastern and northeastern communes. Most human cases were male, aged 15-59 years, handled sick animals, and/or consumed contaminated meat. Almost all cases were reported by grassroot health facilities with a delay of 6.3 days between exposure and case notification to the national surveillance system. 80 % of human cases were reported from June-October. The increase in disease incidence occurred shortly after livestock anthrax vaccine coverage decreased. This study informs vaccination strategy and targeted surveillance and control measures in newly identified high-risk areas and seasons of anthrax.

An integrated model for anthrax-free zone development in developing countries

Anthrax is more prevalent in impoverished nations and those without veterinarian public health initiatives. A comprehensive strategy was pursued to build an anthrax-free model in which there would be no anthrax. The strategy included routine vaccination, increased public awareness, rapid confirmation, and prompt disposal, as well as the establishment of an effective surveillance system, the development of an emergency prevention system, the enforcement of regulations, and the improvement of collaboration between human health and veterinary services. From 2017 through 2020, several initiatives including both social and laboratory activities were performed. After strictly applying the study's procedures, it was determined that the vast majority of community people (97.5%) were knowledgeable of the disease's nature, prevalence, significance to public health, and treatment in the study area. The farmers' risky practices and attitudes about the killing of sick livestock decreased dramatically (85%). The vaccination rate climbed from 40% to 85%, and the proportion of farmers who can presumptively identify anthrax based on its prominent clinical symptoms rose from 30% to 85%. A confirmation methodology based on PCR was implemented. A geographical map depicting the green and dangerous pastureland was created. The formation of a steering group to assess the progress of scientific activity. Locals established a slaughterhouse in that location, where individuals slaughtered their animals following veterinary examination and strictly followed drug withdrawal period. The contaminated area has been free of anthrax infection for four years as a consequence of these efforts. There also reduction of antibiotic used due to mass awareness. The study indicated that the model is an efficient, effective, and appropriate technique for establishing an anthrax-free zone where no anthrax outbreaks would occur. It could be replicated in any part of the world where socioeconomic and geographical conditions are similar.

Get to Know Your Neighbors: Characterization of Close Bacillus anthracis Isolates and Toxin Profile Diversity in the Bacillus cereus Group

Unexpected atypical isolates of Bacillus cereus s.l. occasionally challenge conventional microbiology and even the most advanced techniques for anthrax detection. For anticipating and gaining trust, 65 isolates of Bacillus cereus s.l. of diverse origin were sequenced and characterized. The BTyper3 tool was used for assignation to genomospecies B. mosaicus (34), B. cereus s.s (29) and B. toyonensis (2), as well as virulence factors and toxin profiling. None of them carried any capsule or anthrax-toxin genes. All harbored the non-hemolytic toxin nheABC and sphygomyelinase spH genes, whereas 41 (63%), 30 (46%), 11 (17%) and 6 (9%) isolates harbored cytK-2, hblABCD, cesABCD and at least one insecticidal toxin gene, respectively. Matrix-assisted laser desorption ionization-time of flight mass spectrometry confirmed the production of cereulide (ces genes). Phylogeny inferred from single-nucleotide polymorphisms positioned isolates relative to the B. anthracis lineage. One isolate (BC38B) was of particular interest as it appeared to be the closest B. anthracis neighbor described so far. It harbored a large plasmid similar to other previously described B. cereus s.l. megaplasmids and at a lower extent to pXO1. Whereas bacterial collection is enriched, these high-quality public genetic data offer additional knowledge for better risk assessment using future NGS-based technologies of detection.

Structure and function of the EA1 surface layer of Bacillus anthracis

The Gram-positive spore-forming bacterium Bacillus anthracis is the causative agent of anthrax, a deadly disease mostly affecting wildlife and livestock, as well as representing a bioterrorism threat. Its cell surface is covered by the mutually exclusive S-layers Sap and EA1, found in early and late growth phases, respectively. Here we report the nanobody-based structural characterization of EA1 and its native lattice contacts. The EA1 assembly domain consists of 6 immunoglobulin-like domains, where three calcium-binding sites structure interdomain contacts that allow monomers to adopt their assembly-competent conformation. Nanobody-induced depolymerization of EA1 S-layers results in surface defects, membrane blebbing and cell lysis under hypotonic conditions, indicating that S-layers provide additional mechanical stability to the cell wall. Taken together, we report a complete model of the EA1 S-layer and present a set of nanobodies that may have therapeutic potential against Bacillus anthracis.

Investigation of human anthrax outbreak in Koraput district of Odisha, India

BACKGROUND

Anthrax is a zoonotic infection resulting from the bacteria Bacillus anthracis. Humans contract cutaneous anthrax by coming into contact, and gastrointestinal (GI) anthrax by consumption of infected animals or animal products. An outbreak investigation was conducted to confirm the occurrence of the anthrax outbreak, comprehend its extent, understand the epidemiological characteristics, identify the outbreak's cause, and propose control measures.

METHODS

A descriptive epidemiology was carried out for this outbreak investigation. We defined a suspected human cutaneous anthrax case as appearance of skin lesions and symptoms (itching/redness/swelling) and a suspected case of GI anthrax as appearance of diarrhoea/abdominal pain/vomiting in a resident of Koraput district after being associated with slaughtering and/or consumption of carcass during 5th April to 15th May 2023. The etiological hypothesis was formulated using descriptive epidemiological methods. Laboratory confirmation was performed by real-time polymerase chain reaction (RT-PCR). Statistical analyses were conducted using SPSS 25.

RESULTS

A total of 47 clinically suspected anthrax cases were identified during the outbreak in five villages of Koraput district in Odisha. The epidemic curve indicated multiple point-source exposures starting from 13th April 2023. About 10 cases were identified by RT-PCR testing as confirmed cases of anthrax. No death was recorded in this outbreak investigation.

CONCLUSIONS

Based on a thorough examination of epidemiological survey results and laboratory findings, we conclude that the outbreak was of human cutaneous and GI anthrax. Exposures from handling dead animals were associated with cutaneous anthrax, whereas eating uncooked meat of dead sheep was associated with gastrointestinal anthrax.

Spatial and phylogenetic patterns reveal hidden infection sources of Bacillus anthracis in an anthrax outbreak in Son La province, Vietnam

Bacillus anthracis, the bacterial cause of anthrax, is a zoonosis affecting livestock and wildlife often spilling over into humans. In Vietnam, anthrax has been nationally reportable since 2015 with cases occurring annually, mostly in the northern provinces. In April 2022, an outbreak was reported in Son La province following the butchering of a water buffalo, Bubalus bubalis. A total of 137 humans from three villages were likely exposed to contaminated meat from the animal. Early epidemiological investigations suggested a single animal was involved in all exposures. Five B. anthracis isolates were recovered from human clinical cases along with one from the buffalo hide, another from associated maggots, and one from soil at the carcass site. The isolates were whole genome sequenced, allowing global, regional, and local molecular epidemiological analyses of the outbreak strains. All recovered B. anthracis belong to the A.Br.001/002 lineage based on canonical single nucleotide polymorphism analysis (canSNP). Although not previously identified in Vietnam, this lineage has been identified in the nearby countries of China, India, Indonesia, Thailand, as well as Australia. A twenty-five marker multi-locus variable number tandem repeat analysis (MLVA-25) was used to investigate the relationship between human, soil, and buffalo strains. Locally, four MLVA-25 genotypes were identified from the eight isolates. This level of genetic diversity is unusual for the limited geography and timing of cases and differs from past literature using MLVA-25. The coupled spatial and phylogenetic data suggest this outbreak originated from multiple, likely undetected, animal sources. These findings were further supported by local news reports that identified at least two additional buffalo deaths beyond the initial animal sampled in response to the human cases. Future outbreak response should include intensive surveillance for additional animal cases and additional molecular epidemiological traceback to identify pathogen sources.

Emerging infectious diseases of the skin: a review of clinical and histologic findings

Emerging infectious diseases are of great importance to public health and clinical practice. This review aims to characterize the clinical and histopathologic features of emerging infectious diseases with cutaneous manifestations in order to increase awareness of these entities among dermatologists, pathologists, and dermatopathologists.

One Health Assessment of Bacillus anthracis Incidence and Detection in Anthrax-Endemic Areas of Pakistan

Anthrax, a severe zoonotic disease, is infrequently reported in anthrax-endemic regions of Pakistan. Despite clinical reports indicating its presence, particularly cutaneous anthrax, there is insufficient laboratory evidence regarding disease occurrence and environmental persistence. The present study aimed to confirm Bacillus anthracis presence, accountable for animal mortality and human infection, while exploring environmental transmission factors. Between March 2019 and July 2021, a total of 19 outbreaks were documented. Of these, 11 affected sheep/goats in Zhob district and 8 affected cattle/sheep in Bajour Agency. Clinical signs suggestive of Bacillus anthracis outbreak were observed in 11 animals. Blood and swab samples were collected for confirmation. The study followed a One Health approach, analyzing animal, environmental (soil/plant), and human samples. Of the 19 outbreaks, 11 were confirmed positive for anthrax based on growth characteristics, colony morphology, and PCR. Soil and plant root samples from the outbreak areas were collected and analyzed microscopically and molecularly. Cutaneous anthrax was observed in six humans, and swab samples were taken from the lesions. Human serum samples (n = 156) were tested for IgG antibodies against PA toxin and quantitative analysis of anthrax toxin receptor 1 (ANTXR1). Bacillus anthracis was detected in 65 out of 570 (11.40%) soil samples and 19 out of 190 (10%) plant root samples from the outbreak areas. Four out of six human samples from cutaneous anthrax lesions tested positive for Bacillus anthracis. Human anthrax seroprevalence was found to be 11% and 9% in two districts, with the highest rates among butchers and meat consumers. The highest ANTXR1 levels were observed in butchers, followed by meat consumers, farm employees, meat vendors, veterinarians, and farm owners. These findings highlight the persistence of anthrax in the region and emphasize the potential public health risks.

Anthrax revisited: how assessing the unpredictable can improve biosecurity

B. anthracis is one of the most often weaponized pathogens. States had it in their bioweapons programs and criminals and terrorists have used or attempted to use it. This study is motivated by the narrative that emerging and developing technologies today contribute to the amplification of danger through greater easiness, accessibility and affordability of steps in the making of an anthrax weapon. As states would have way better preconditions if they would decide for an offensive bioweapons program, we focus on bioterrorism. This paper analyzes and assesses the possible bioterrorism threat arising from advances in synthetic biology, genome editing, information availability, and other emerging, and converging sciences and enabling technologies. Methodologically we apply foresight methods to encourage the analysis of contemporary technological advances. We have developed a conceptual six-step foresight science framework approach. It represents a synthesis of various foresight methodologies including literature review, elements of horizon scanning, trend impact analysis, red team exercise, and free flow open-ended discussions. Our results show a significant shift in the threat landscape. Increasing affordability, widespread distribution, efficiency, as well as ease of use of DNA synthesis, and rapid advances in genome-editing and synthetic genomic technologies lead to an ever-growing number and types of actors who could potentially weaponize B. anthracis. Understanding the current and future capabilities of these technologies and their potential for misuse critically shapes the current and future threat landscape and underlines the necessary adaptation of biosecurity measures in the spheres of multi-level political decision making and in the science community.

Whole genome sequencing of Bacillus anthracis isolated from animal in the 1960s, Brazil, belonging to the South America subclade

Bacillus anthracis causes anthrax disease and can affect humans and other animals. This zoonotic disease has an impact on the economic and health aspects. B. anthracis population is divided into three major clades: A (with worldwide distribution), B, and C (restricted to specific regions). Anthrax is most common in agricultural regions of central and southwestern Asia, sub-Saharan Africa, Southern and Eastern Europe, the Caribbean, and Central and South America. Here, we sequenced by short and long reads technologies to generate a hybrid assembly of a lineage of B. anthracis recovered from animal source in the 1960s in Brazil. Isolate identification was confirmed by phenotypic/biochemical tests and MALDI-TOF MS. Antimicrobial susceptibility was performed by in-house broth microdilution. B. anthracis IAL52 was susceptible to penicillin, amoxicillin, doxycycline, levofloxacin, and tetracycline but non-susceptible to ciprofloxacin. IAL52 was classified as sequence type ST2, clade A.Br.069 (V770 group). Sequencing lineages of B. anthracis, especially from underrepresented regions, can help determine the evolution of this critical zoonotic and virulent pathogen.

Diversity of the bacteriocins, their classification and potential applications in combat of antibiotic resistant and clinically relevant pathogens

There is almost a century since discovery of penicillin by Alexander Fleming, a century of enthusiasm, abuse, facing development of antibiotic-resistance and clear conclusion that the modern medicine needs a new type of antimicrobials. Bacteriocins produced by Gram-positive and Gram-negative bacteria, Archaea and Eukaryotes were widely explored as potential antimicrobials with several applications in food industry. In last two decades bacteriocins showed their potential as promising alternative therapeutic for the treatment of antibiotic-resistant pathogens. Bacteriocins can be characterised as highly selective antimicrobials and therapeutics with low cytotoxicity. Most probably in order to solve the problems associated with the increasing number of antibiotic-resistant bacteria, the application of natural or bioengineered bacteriocins in addition to synergistically acting preparations of bacteriocins and conventional antibiotics, can be the next step in combat versus drug-resistant pathogens. In this overview we focussed on diversity of specific lactic acid bacteria and their bacteriocins. Moreover, some additional examples of bacteriocins from non-lactic acid, Gram-positive and Gram-negative bacteria, Archaea and eukaryotic organisms are presented and discussed. Therapeutic properties of bacteriocins, their bioengineering and combined applications, together with conventional antibiotics, were evaluated with the scope of application in human and veterinary medicine for combating (multi-)drug-resistant pathogens.

Comparative evaluation of in-house developed latex agglutination test (LAT) with World Organisation for Animal Health (WOAH) -recommended methods for the detection of Bacillus anthracis spores from the soil

In-house developed Bacillus anthracis-specific synthetic peptide-based latex agglutination test (LAT) assay was comparatively evaluated with World Organisation for Animal Health (WOAH)-recommended polymerase chain reaction (PCR)/real-time PCR (qPCR) methods for the screening of B. anthracis spores from the soil to provide a simple, rapid, and economical immunodiagnostic test for field application.

Microbial Risks Caused by Livestock Excrement: Current Research Status and Prospects

Livestock excrement is a major pollutant yielded from husbandry and it has been constantly imported into various related environments. Livestock excrement comprises a variety of microorganisms including certain units with health risks and these microorganisms are transferred synchronically during the management and utilization processes of livestock excrement. The livestock excrement microbiome is extensively affecting the microbiome of humans and the relevant environments and it could be altered by related environmental factors as well. The zoonotic microorganisms, extremely zoonotic pathogens, and antibiotic-resistant microorganisms are posing threats to human health and environmental safety. In this review, we highlight the main feature of the microbiome of livestock excrement and elucidate the composition and structure of the repertoire of microbes, how these microbes transfer from different spots, and they then affect the microbiomes of related habitants as a whole. Overall, the environmental problems caused by the microbiome of livestock excrement and the potential risks it may cause are summarized from the microbial perspective and the strategies for prediction, prevention, and management are discussed so as to provide a reference for further studies regarding potential microbial risks of livestock excrement microbes.

Modeling gastrointestinal anthrax disease

Bacillus anthracis is a spore-forming microbe that persists in soil and causes anthrax disease. The most natural route of infection is ingestion by grazing animals. Gastrointestinal (GI) anthrax also occurs in their monogastric predators, including humans. Exposure of carcasses to oxygen triggers sporulation and contamination of the surrounding soil completing the unusual life cycle of this microbe. The pathogenesis of GI anthrax is poorly characterized. Here, we use B. anthracis carrying the virulence plasmids pXO1 and pXO2, to model gastrointestinal disease in Guinea pigs and mice. We find that spores germinate in the GI tract and precipitate disease in a dose-dependent manner. Inoculation of vegetative bacilli also results in GI anthrax. Virulence is impacted severely by the loss of capsule (pXO2-encoded) but only moderately in absence of toxins (pXO1-encoded). Nonetheless, the lack of toxins leads to reduced bacterial replication in infected hosts. B. cereus Elc4, a strain isolated from a fatal case of inhalational anthrax-like disease, was also found to cause GI anthrax. Because transmission to new hosts depends on the release of large numbers of spores in the environment, we propose that the acquisition of pXO1- and pXO2-like plasmids may promote the successful expansion of members of the Bacillus cereus sensu lato group able to cause anthrax-like disease.

Research on Detection of Ultra-Low Concentration Anthrax Protective Antigen Using Graphene Field-Effect Transistor Biosensor

BACKGROUND

Protective antigen (PA) is an important biomarker for the early diagnosis of anthrax, and the accurate detection of protective antigen under extremely low concentration conditions has always been a hot topic in the biomedical field. To complete the diagnosis of anthrax in a timely manner, it is necessary to detect PA at extremely low concentrations, as the amount of PA produced in the early stage of anthrax invasion is relatively small. Graphene field-effect transistor (Gr-FET) biosensors are a new type of material for preparing biosensors, with the advantages of a short detection time and ultra-low detection limit.

METHODS

The effect of different concentrations of diluents on the affinity of PA monoclonal antibodies was determined via an ELISA experiment. Combined with the Debye equation, 0.01 × PBS solution was finally selected as the diluent for the experiment. Then, a PA monoclonal antibody was selected as the bio-recognition element to construct a Gr-FET device based on CVD-grown graphene, which was used to detect the concentration of PA while recording the response time, linear range, detection limit, and other parameters.

RESULTS

The experimental results showed that the biosensor could quickly detect PA, with a linear range of 10 fg/mL to 100 pg/mL and a detection limit of 10 fg/mL. In addition, the biosensor showed excellent specificity and repeatability.

CONCLUSIONS

By constructing a Gr-FET device based on CVD-grown graphene and selecting a PA monoclonal antibody as the bio-recognition element, a highly sensitive, specific, and repeatable Gr-FET biosensor was successfully prepared for detecting extremely low concentrations of anthrax protective antigen (PA). This biosensor is expected to have a wide range of applications in clinical medicine and biological safety monitoring.

A Case Report of Cutaneous Anthrax Diagnosed by Using a Metagenomic Next-Generation Sequencing (mNGS) Approach

Anthrax is caused by Bacillus anthracis. Humans are mainly infected through contact with the fur and meat of livestock. The cutaneous form is the most common form. The skin lesions of typical cutaneous anthrax are characterized by shallow ulcers with black crusts, surrounded by small blisters and nonpitting edema of nearby tissues. Metagenomic next-generation sequencing (mNGS) is a new pathogenic detection method which is rapid and unbiased. We reported the first case of cutaneous anthrax diagnosed by mNGS. Ultimately, the man received prompt antibiotic therapy and had a good prognosis. In conclusion, mNGS is proved to be a good method for etiological diagnosis, especially for rare infectious diseases.