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.

Sporadic human cutaneous anthrax outbreak in Shaanxi Province, China: report of two cases from 2018

ABSTRACT China's compulsory annual livestock anthrax vaccination policy has remarkably reduced but not completely eradicated human anthrax infections. Herein we describe a sporadic human cutaneous anthrax outbreak involving two cases in 2018 in Shaanxi Province, both involving herdsman who dealt with unvaccinated and potentially sick cattle. Both patients showed Bacillus anthracis-positive blister smear and blood culture. Treatment with penicillin was followed by uneventful recovery for both. The prompt performance of the prophylactic measures successfully interrupted the further transmission of this sporadic human cutaneous anthrax outbreak.

Sporadic human cutaneous anthrax outbreak in Shaanxi Province, China: report of two cases from 2018.

China's compulsory annual livestock anthrax vaccination policy has remarkably reduced but not completely eradicated human anthrax infections. Herein we describe a sporadic human cutaneous anthrax outbreak involving two cases in 2018 in Shaanxi Province, both involving herdsman who dealt with unvaccinated and potentially sick cattle. Both patients showed Bacillus anthracis-positive blister smear and blood culture. Treatment with penicillin was followed by uneventful recovery for both. The prompt performance of the prophylactic measures successfully interrupted the further transmission of this sporadic human cutaneous anthrax outbreak.

[Cutaneous anthrax, the last outbreak diagnosed in Chile]. / Ántrax cutáneo, último brote diagnosticado en Chile.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

Ántrax cutáneo, último brote diagnosticado en Chile / Cutaneous anthrax, the last outbreak diagnosed in Chile

Resumen El ántrax, es una zoonosis causada por una bacteria generadora de esporas, llamada Bacillus anthracis. En forma natural tiene una distribución global, con una predilección en zonas agrícolas con pocas normativas de sanidad pública veterinaria. El contagio humano ocurre por el consumo de carnes de animales enfermos, por contacto a través de una puerta de entrada en la piel o por la inhalación de esporas de productos derivados del animal afectado (lana, cuero, huesos). La infección en los seres humanos compromete con mayor frecuencia la piel, seguido por el tracto gastrointestinal y los pulmones. El control de la enfermedad se basa en la prevención, de allí la importancia de la vigilancia en la detección de casos y brotes. Presentamos el último brote de ántrax cutáneo diagnosticado en Chile con descripción de dos primeros casos clínicos del brote.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

[Update of knowledge on Neglected Diseases in Haiti: Mansonelliasis, Tungiasis, Leprosy, and Anthrax]. / Mise à jour des connaissances concernant quatre maladies délaissées en Haïti : mansonellose, tungose, lèpre, charbon.

Haiti, like most limited-resources countries in the world, faces numerous neglected infectious diseases. They represent a real public health issue with lethal consequences especially in children. We are reviewing here the available literature on four neglected infectious diseases, mansonelliasis, tungiasis, leprosy and anthrax. Filariasis, due to Mansonella ozzardi, has been totally neglected since its discovery in 1920 in Haiti; it persists in coastal homes with a high prevalence in adults when an effective treatment is available. The skin lesions caused by Tunga penetrans have existed since the pre-Columbian period in Haiti. They persist in the most retreated and hard-to-reach areas where the population lives in precarious conditions and in extreme poverty. New available research data show the importance of the problem with very high prevalence rates in some rural communities far away from any healthcare center. Cases of leprosy are recently reemerging as no monitoring program has been in place since 2004. Finally, anthrax is still endemic; small epidemics resurfacing periodically in families in rural areas. Screening of people for these diseases and managing the cases are necessary to improve health and reduce morbidity and mortality in Haiti.

Comme dans la plupart des pays pauvres de la planète, les maladies infectieuses négligées sont nombreuses en Haïti où elles représentent un réel problème de santé publique avec des conséquences létales, surtout pour les enfants. Nous faisons le point des données accessibles pour quatre d'entre elles. Totalement délaissée depuis la découverte de sa présence en Haïti en 1920, la filariose due à Mansonella ozzardi persiste en foyers côtiers avec une prévalence élevée chez les adultes alors qu'un traitement efficace est disponible. Connues depuis la période précolombienne dans l'île d'Hispaniola, les lésions cutanées dues à Tunga penetrans persistent dans les régions les plus reculées et difficiles d'accès où la population vit dans des conditions précaires et dans une très grande pauvreté. Nous rapportons les données d'enquêtes récentes qui montrent l'importance de cette ectoparasitose en Haïti où les taux de prévalence sont très élevés dans certaines communautés rurales isolées. Des cas de lèpre resurgissent en Haïti alors qu'aucun programme de surveillance n'est effectif depuis 2004. Enfin, la maladie du charbon est endémique dans les régions d'élevage où des épidémies familiales resurgissent périodiquement en milieu rural. Le dépistage des personnes atteintes de ces maladies et leur prise en charge sont nécessaires pour une amélioration de la santé et une baisse de la mortalité en Haïti.

Bacillus anthracis: una mirada molecular a un patógeno célebre / Bacillus anthracis: a molecular look at a famous pathogen

Bacillus anthracis es un bacilo gram positivo del grupo Bacillus cereus, que posee un genoma extremadamente monomórfco y comparte gran similitud fsiológica y de estructura genética con B. cereus y Bacillus thuringiensis. En este artículo se describen nuevos métodos moleculares para la identifcación y tipifcación de B. anthracis, basados en repeticiones en tándem de número variable o en diferencias genéticas detectadas por secuenciación, desarrollados en los últimos años. Los aspectos moleculares de los factores de virulencia tradicionales, cápsula, antígeno protector, factor letal y factor edema se describen en profundidad, junto con factores de virulencia recientemente propuestos, como los sideróforos, petrobactina y bacilibactina, la adhesina de la capa S y la lipoproteína MntA. También se detalla la organización molecular de los megaplásmidos pXO1 y pXO2, incluyendo la isla de patogenicidad de pXO1. El esqueleto genético de estos plásmidos se ha encontrado en otras especies relacionadas, probablemente debido a eventos de transferencia lateral. Finalmente, se presentan los dos receptores celulares del antígeno protector, ANTXR1/TEM8 y ANTXR2/CMG2, esenciales en la interacción del patógeno con el hospedador. Los estudios moleculares realizados en los últimos años han permitido aumentar enormemente el conocimiento de los diferentes aspectos de este microorganismo y su relación con el hospedador, pero a la vez han abierto nuevos interrogantes sobre este notorio patógeno.

Bacillus anthracis, a gram-positive rod belonging to the Bacillus cereus group, has an extremely monomorphic genome, and presents high structural and physiological similarity with B. cereus and Bacillus thuringiensis. In this work, the new molecular methods for the identifcation and typing of B. anthracis developed in the last years, based on variable number tandem repeats or on genetic differences detected through sequencing, are described. The molecular aspects of traditional virulence factors: capsule, protective antigen, lethal factor and edema factor are described in depth, together with virulence factors recently proposed, such as the siderophores petrobactin and bacillibactin, the S-layer adhesin and the MntA lipoprotein. It is detailed the molecular organization of megaplasmids pXO1 and pXO2, including the pathogenicity island of pXO1. The genetic skeleton of these plasmids has been observed in related species, and this could be attributed to lateral gene transfer. Finally, the two anthrax toxin protective antigen receptors, ANTXR1/TEM8 and ANTXR2/CMG2, essential for the interaction of the pathogen with the host, are presented. The molecular studies performed in recent years have greatly increased knowledge in different aspects of this microorganism and its relationship with the host, but at the same time they have raised new questions about this noted pathogen.

[Bacillus anthracis: a molecular look at a famous pathogen]. / Bacillus anthracis: una mirada molecular a un patógeno célebre.

Bacillus anthracis, a gram-positive rod belonging to the Bacillus cereus group, has an extremely monomorphic genome, and presents high structural and physiological similarity with B. cereus and Bacillus thuringiensis. In this work, the new molecular methods for the identification and typing of B. anthracis developed in the last years, based on variable number tandem repeats or on genetic differences detected through sequencing, are described. The molecular aspects of traditional virulence factors: capsule, protective antigen, lethal factor and edema factor are described in depth, together with virulence factors recently proposed, such as the siderophores petrobactin and bacillibactin, the S-layer adhesin and the MntA lipoprotein. It is detailed the molecular organization of megaplasmids pXO1 and pXO2, including the pathogenicity island of pXO1. The genetic skeleton of these plasmids has been observed in related species, and this could be attributed to lateral gene transfer. Finally, the two anthrax toxin protective antigen receptors, ANTXR1/TEM8 and ANTXR2/CMG2, essential for the interaction of the pathogen with the host, are presented. The molecular studies performed in recent years have greatly increased knowledge in different aspects of this microorganism and its relationship with the host, but at the same time they have raised new questions about this noted pathogen.

[Landscape components favouring the occurrence of anthrax in the Flooding Pampa grasslands (Buenos Aires province, Argentina)]. / Componentes del paisaje que favorecen la aparición de carbunco en la Pampa Deprimida (provincia de Buenos Aires, Argentina).

The authors studied the landscape components that favour the occurrence of anthrax in the Flooding Pampa grasslands (Buenos Aires province, Argentina). They made spatial locations of anthrax outbreaks diagnosed by registered veterinary laboratories in the study area's zone of influence. As variables for study, they differentiated areas that are flooded for 20% of the time or more from primary and secondary runoff channels. They also identified areas with low-productivity pasture. Logistic regression analysis of farm populations revealed that landscape components favouring the occurrence of anthrax outbreaks are shared runoff channels (odds ratio (OR) = 2.3; confidence interval (CI) = 1.2; 4.7) and > or = 40% low-productivity pasture (OR = 5.4; CI = 3.5; 8.3). Contrary to initial assumptions, susceptibility to flooding was not a significant variable (OR = 1.1; CI = 0.5; 2.1). The authors concluded that the first step in decision-making and ensuring more efficient implementation of future anthrax control and eradication plans was to identify risk variables.

Cutaneous anthrax in the Artibonite Valley of Haiti: 1992-2002.

More cutaneous anthrax cases were noted at Hospital Albert Schweitzer (HAS) in the Artibonite Valley of Haiti. We examine the incidence of anthrax in the Artibonite between 1992 and 2002, describe the clinical presentation of cutaneous anthrax, and determine risk factors for anthrax. In 1992 HAS reported 1 case of anthrax for an incidence of 4 cases per million persons/year. In 2002, there were 20 cases of anthrax for an incidence of 72 cases per million persons/year. This is a 17-fold increase (P = 0.0002). Causes of death from anthrax included asphyxiation from edema of the neck with tracheal compression and concurrent gastrointestinal anthrax. Butchering cattle that had died of illness was identified as a risk factor. The incidence of human anthrax has increased in the Artibonite Valley and is a cause of significant mortality. Control of anthrax in humans depends on improved animal vaccination programs.

[Molecular study of Argentine strains of Bacillus anthracis]. / Estudio molecular de cepas argentinas de Bacillus anthracis.

Bacillus anthracis is one of the most monomorphic bacteria known and epidemiological studies of this microorganism have been hampered by the lack of molecular markers. For the genotyping of fourteen Argentine field strains and the vaccine strain Steme 34F2 the presence or absence of the virulence plasmids as well as vrrA locus containing a variable-number tandem repeat (VNTR) and presenting a polymorphism involving five variants, were analyzed. Strains were isolated from cows, sheep and pigs during outbreaks occurred in Buenos Aires, Entre Ríos, Santa Fe and La Pampa in the past fifty years. All of the field strains presented plasmids pXO1 and pXO2, except for a strain isolated from pig that only presented plasmid pXO2. All the strains and the vaccine strain belonged to the same VNTR variant that was defined by sequencing the vrrA locus from three of the isolates and the strain 34F2. These sequences were completely identical and corresponded to the variant VNTR4. Thus, the fourteen Argentine B. anthracis strains studied showed great uniformity at molecular level even though they had been isolated from different mammal species within a wide time period and covering an extensive geographical area.

First detection of Bacillus anthracis in feces of free-ranging raptors from central Argentina.

Prevalence of anthrax spores in feces of raptors was determined from samples collected in November-December 2000 and April-May 2001 in an agricultural region of Santa Fé province, Argentina. Feces were tested from 48 birds of six raptor species. One of 14 chimango caracaras (Milvago chimango) and one of eight road-side hawks (Buteo magnirostris) tested positive. The prevalence of Bacillus anthracis spores in feces for the six species was 4% (n=48). The prevalence was 7% (n=14) for chimango caracaras, 13% for road-side hawks (n=8), and 0% for the remaining species (Burrowing owl [Speotyto cunicularia] [n=17], Swainson's hawk [Buteo swainsoni] [n=3], Aplomado falcon [Falco femoralis] [n=2], and American kestrel [Falco sparverius] [n=4]). Grouped by their feeding habits, prevalence for scavenger species was not significantly different than for predators (7% vs. 3%, P>0.999). This study provides evidence that in central Argentina scavenger and non-scavenger raptors may have a role in the epidemiology of anthrax. Long-term studies to determine the extent of this potential involvement in the epidemiology of anthrax in central Argentina are required.

Anthrax in cattle in southern Brazil: 1978-2006

Ten outbreaks of anthrax occurred in cattle from 1978 to 2006 in southern Brazil, in 5 municipalities on the border with Uruguay, a country where the disease is frequent. The 10 outbreaks represented 0.2% of all bovine specimens received during the period by the Regional Diagnostic Laboratory of the Federal University of Pelotas, causing 267 deaths in a risk population of 6,605 head. The disease affected young and adult cattle mainly during summer. Only one farmer reported that sheep and horses were also affected. Clinically the peracute form was more frequent, but in some outbreaks the acute form with a clinical manifestation period of 6-48 hours was also observed. The source of infection was not established; but the reduced rainfall, associated with low, flat, flooded lands used for agriculture followed by animal grazing after harvest was probably related to the disease occurrence. Annual vaccination is an efficient way to prevent the disease.

Foi realizado um estudo retrospectivo da ocorrência de carbúnculo hemático em bovinos na área de influência do Laboratório Regional de Diagnóstico (LRD) da Faculdade de Veterinária da Universidade Federal de Pelotas. Entre 1978 e março de 2006, dez surtos da enfermidade ocorreram em cinco municípios da região sul do Rio Grande do Sul, todos localizados na fronteira com o Uruguai. A enfermidade representou 0,2% dos diagnósticos realizados no LRD no período. Ocorre em bovinos jovens e adultos, principalmente em verões quentes e secos, e com menor freqüência em outras épocas do ano. Freqüentemente, a doença se apresenta na forma hiperaguda, entretanto casos de carbúnculo hemático agudo podem ser observados. Não foi possível estabelecer a origem das infecções, mas precipitações pluviométricas menores que as normais, em campos planos, sujeitos a alagamentos freqüentes, utilizados para plantio e posterior uso das restevas (restolhos) para a criação dos animais podem ter favorecido a ocorrência dos surtos. A prática da vacinação anual dos animais é a forma de evitar eficientemente os surtos da doença.

Anthrax in cattle in southern Brazil: 1978-2006 / Carbúnculo hemático em bovinos no sul do Brasil: 1978-2006

Ten outbreaks of anthrax occurred in cattle from 1978 to 2006 in southern Brazil, in 5 municipalities on the border with Uruguay, a country where the disease is frequent. The 10 outbreaks represented 0.2% of all bovine specimens received during the period by the Regional Diagnostic Laboratory of the Federal University of Pelotas, causing 267 deaths in a risk population of 6,605 head. The disease affected young and adult cattle mainly during summer. Only one farmer reported that sheep and horses were also affected. Clinically the peracute form was more frequent, but in some outbreaks the acute form with a clinical manifestation period of 6-48 hours was also observed. The source of infection was not established; but the reduced rainfall, associated with low, flat, flooded lands used for agriculture followed by animal grazing after harvest was probably related to the disease occurrence. Annual vaccination is an efficient way to prevent the disease.(AU)

Foi realizado um estudo retrospectivo da ocorrência de carbúnculo hemático em bovinos na área de influência do Laboratório Regional de Diagnóstico (LRD) da Faculdade de Veterinária da Universidade Federal de Pelotas. Entre 1978 e março de 2006, dez surtos da enfermidade ocorreram em cinco municípios da região sul do Rio Grande do Sul, todos localizados na fronteira com o Uruguai. A enfermidade representou 0,2% dos diagnósticos realizados no LRD no período. Ocorre em bovinos jovens e adultos, principalmente em verões quentes e secos, e com menor freqüência em outras épocas do ano. Freqüentemente, a doença se apresenta na forma hiperaguda, entretanto casos de carbúnculo hemático agudo podem ser observados. Não foi possível estabelecer a origem das infecções, mas precipitações pluviométricas menores que as normais, em campos planos, sujeitos a alagamentos freqüentes, utilizados para plantio e posterior uso das restevas (restolhos) para a criação dos animais podem ter favorecido a ocorrência dos surtos. A prática da vacinação anual dos animais é a forma de evitar eficientemente os surtos da doença. (AU)

A workflow spatial scan statistic.

We propose a modification of the spatial scan statistic that takes account of workflow, which is the movement of individuals between home and work. The objective is to detect clusters of disease in situations where exposure occurs in the workplace, but only home address is available for analysis. In these situations, application of the usual spatial scan statistic does not account for possible differences between home and work address, thereby reducing the power of detection. We describe an extension to the usual spatial scan statistic that uses workflow data to search for disease clusters resulting from workplace exposure. We also present results from simulations that demonstrate the increased power of the workflow scan statistic over the usual scan statistic for detecting clusters arising from exposures in the workplace.