Epidemiological Investigation and Etiological Analysis of a Cutaneous Anthrax Epidemic Caused by Butchering Sick Cattle in Guizhou, China

Anthrax meningoencephalitis: A case report

The present study describes the case of a patient with anthrax meningoencephalitis with the aim of providing a scientific basis for the control of this disease. The cerebrospinal fluid and blood of the patient were tested for genes and Bacillus anthracis was detected. The patient's meningitis was cured following treatment. Tracing the route of infection, anthrax was detected on the chopping board of the rural cattle and sheep butcher shop where the patient had purchased meat. In 2018, the patient complained of intermittent nasal discharge for 11 days after brain injury and came to the Second People's Hospital of Liaocheng (Linqing, China). Considering the existence of cerebrospinal fluid rhinorrhea, the patient's cerebrospinal fluid biochemistry was assessed and showed low sugar and high protein levels, resulting in a diagnosis of bacterial encephalitis. This encephalitis was considered to be related to bacterial retrograde infection after cerebrospinal fluid rhinorrhea. It is required to strengthen the training of medical personnel according to guidelines and laws and improve the level of early detection, reporting and diagnosis, as well as timely treatment at medical institutions. There is an urgent need to intensify the education of the population regarding the awareness and prevention of the disease. For individuals involved in the breeding, slaughtering and processing of livestock, multiple measures need to be taken to comprehensively intervene and to enhance occupational protection awareness and disease prevention capabilities.

Rational corticosteroids administration and antibiotic treatment is key to managing cutaneous anthrax

BACKGROUND

Anthrax is a global health concern, with cutaneous anthrax accounting for over 95% of cases and generally promising outcomes. Nonetheless, the absence of timely intervention can result in mortality rates of 10-40%. This research aims to explore the clinical presentations and phenotypic characteristics of cutaneous anthrax patients and evaluate the efficacy of various therapeutic approaches.

METHODS

A retrospective study was performed on 76 cutaneous anthrax patients identified at three hospitals from 2017 to 2022. Patients were categorized based on their hospital stay into two groups: those hospitalized for at least seven days and those for shorter durations. We assessed their clinical and phenotypic profiles, including symptoms, general health status, and laboratory findings, alongside treatment outcomes, focusing on corticosteroids therapy and antibiotic regimens.

RESULTS

The study encompassed 76 diagnosed individuals, predominantly young adult males (78.9%). A significant gender disparity was noted. Hormonal treatment markedly improved edema regression in patients (P < 0.002), highlighting its therapeutic value. The impact of various antibiotic treatments on disease progression differed significantly based on corticosteroids treatment status, with specific combinations showing more effectiveness in non-corticosteroids-treated patients.

CONCLUSIONS

The predominance of young male adults among cutaneous anthrax cases was observed, with corticosteroids treatment significantly reducing edema duration. In cases where corticosteroids therapy is not utilized, employing piperacillin-tazobactam alone or in combination with quinolones effectively shortens the illness duration, suggesting a tailored approach to treatment can enhance patient outcomes.

Epizootological and epidemiological situation of anthrax in Ukraine in the context of mandatory specific prevention in susceptible animals

The problem of zoonoses remains relevant in the context of reliable prevention of human disease and effective ways to achieve this result, in particular through the impact on susceptible animals by the efforts of veterinary medicine. Anthrax is an acute, particularly dangerous infectious disease of all species of farm, domestic and wild animals, as well as humans, which is caused by Bacillus anthracis microbes. The causative agent of anthrax belongs to the group of aerobic spore-forming bacteria and exists in two main forms: vegetative and spore. The vegetative form in the body of an infected animal can form a "capsule". In Ukraine, according to the provisions of the current "Instruction for the prevention and control of animal anthrax" (2000), the main method of preventing anthrax among animals is regular vaccination of animals susceptible to this disease. The authors conducted a retrospective analysis of the epizootic and epidemiological situation of anthrax in Ukraine for the period 1994–2021 and made a critical assessment of the performance of mandatory measures for specific prevention of susceptible animals. In order to find out the ecological and geographical features of the spread of anthrax, data on outbreaks of the disease in cattle, swine, small ruminants and humans on the territory of Ukraine were analyzed by regions for the time period under investigation. Over the past 28 years in Ukraine, animal anthrax was registered in in all areas except Zhytomyr region. In total, during the analyzed period, 177 affected points and 637 infected animals (cattle, small ruminants, pigs, horses, wild and fur-bearing animals, dogs) were registered (estimated at 3.59 animals per outbreak). Cattle were most often involved in the epizootic process, followed by pigs and small ruminants, while horses and other animal species were least infected. Ecological and geographical analysis showed that the largest number of affected points among animals during the analyzed period was found in Kyiv, Volyn, Kharkiv, Luhansk, Khmelnytskyi, Cherkasy, Odesa, and Vinnytsia regions. A small number of affected points during the analyzed period were found in Zakarpattia, Ternopil, Kherson, Autonomous Republic of Crimea, Poltava, Dnipropetrovsk and Ivano-Frankivsk regions. During the analyzed period, 68 people in 11 regions of Ukraine were infected with anthrax, 15 outbreaks were registered (4.46 people per outbreak). Most cases were reported in Donetsk, Kyiv and Odesa regions. The association between outbreaks of anthrax in animals and cases of anthrax among humans has been established, this dependency was 86.6% (the index of contiguity, which takes into account the number of years with simultaneous registration of animal and human cases, was 0.5). The authors thoroughly proved that it is vaccination among susceptible animals that will finally prevent the incidence of anthrax among people.

Identification of the molecular characteristics of Bacillus anthracis (1982-2020) isolates in East Indonesia using multilocus variable-number tandem repeat analysis

Background and Aim:

Anthrax is one of the endemic strategic diseases in East Indonesia, particularly in the provinces of South Sulawesi, West Sulawesi, Gorontalo, East Nusa Tenggara, and West Nusa Tenggara. Anthrax is an important disease due to its zoonotic and economic impact on the livestock industry. This study aimed to identify the molecular characteristics of Bacillus anthracis in East Indonesia using multilocus variable-number tandem repeat (VNTR) analysis (MLVA).

Materials and Methods:

Isolates were obtained from an investigation of anthrax outbreaks in five provinces of East Indonesia from 1982 to 2020. Conventional polymerase chain reaction for B. anthracis was used to identify MLVA-8. Deoxyribonucleic acid sequencing analysis was based on MLVA-8 primers for VNTR identification of the phylogenetic relationship among 24 isolates of B. anthracis obtained from 17 distinct districts/cities in East Indonesia. Tandem Repeats Finder was used for VNTR identification, and Molecular Evolutionary Genetics Analysis X was used to construct phylogenetic analysis.

Results:

In this study, 24 isolates were classified as genotype or lineage A. There were four subgroups of B. anthracis circulating in East Indonesia based on eight molecular marker loci sequence results.

Conclusion:

The findings of this study show that MLVA-8 typing might be useful as a subtyping tool for the epidemiological investigation of identical genotypes and low genetic diversity of B. anthracis. No other lineage of B. anthracis was circulating in East Indonesia. Other molecular methods are needed, such as extended MLVA, whole-genome sequencing, and canonical single-nucleotide polymorphism, for a more precise study of B. anthracis genetic diversity.

Changed epidemiology of anthrax and molecular characteristics of Bacillus anthracis in Inner Mongolia Autonomous Region, China

Anthrax is a natural foci disease in Inner Mongolia, which poses a severe threat to public health. In this study, the incidence number, rate and constituent ratio were used to describe the epidemiological characteristics of anthrax in the region from 1956-2018. The molecular correlation and genetic characteristics of the strains were investigated using canonical single nucleotide polymorphisms (CanSNP), multiple-locus variable-number tandem repeat analysis (MLVA-15) and whole genome sequencing (WGS). The epidemiological characteristics of anthrax in Inner Mongolia have altered significantly. The incidence of anthrax has decreased annually without vaccination, and the regional distribution of anthrax gradually transferred from central and western regions to the eastern. Moreover, the occupation distribution evolved from multiple early occupations to predominated by farmers and herdsmen. This change is closely related to policy factors and to changes in the means of production and the living habits of the local population. This indicates that reformulating the control and prevention strategies is essential. Both A. Br. Ames and A. Br. 001/002 subgroups were the predominant CanSNP genotypes of Bacillus anthracis in Inner Mongolia. A total of 36 strains constituted six shared MLVA-15 genotypes, suggesting an epidemiological link between the strains of each shared genotype. The six shared genotypes ([GT1, 9, 11 and 15] and [GT8 and 12]) consisting of 2-7 strains confirmed the occurrence of multiple point outbreaks and cross-regional transmission caused by multiple common sources of infection. Phylogenetic analysis based on the WGS core genome showed that strains from this study formed an independent clade (C.V.), and they were positioned close to each other, suggesting a common origin. Further comparison analysis should be performed to ascertain the geographic origin of these strains.