'A remedy for this dread disease': Achille Sclavo, anthrax and serum therapy in early twentieth-century Britain.

In the years around 1900 one of the most significant practical consequences of new styles of bacteriological thought and practice was the development of preventive vaccines and therapeutic sera. Historical scholarship has highlighted how approaches rooted in the laboratory methods of Robert Koch, Louis Pasteur and their collaborators were transformed in local contexts and applied in diverse ways to enable more effective disease identification, prevention and treatment. Amongst these, the anti-anthrax serum developed by the Italian physician Achille Sclavo (1861-1930) has received little to no attention from historians. This article positions Sclavo's serum as a neglected but significant presence in British microbiology, which achieved widespread uptake amidst a wave of optimism, despite prolonged uncertainty about its mechanism of action and dosage. After being introduced to Britain in 1904 by the enterprising first medical inspector of factories Thomas Morison Legge, within a matter of months the serum became regarded by medical practitioners as an effective treatment of cutaneous anthrax, though access to 'fresh' serum and the necessary speedy diagnosis remained problematic. Like the disease anthrax itself, discussion of 'Sclavo's serum' was out of all proportion to the relatively low number of cases, reflecting a deep-seated fascination with the wider possibilities afforded by effective serum therapy.

Comparison of spatiotemporal patterns of historic natural Anthrax outbreaks in Minnesota and Kazakhstan.

Disease spread in populations is a consequence of the interaction between host, pathogen, and environment, i.e. the epidemiological triad. Yet the influences of each triad component may vary dramatically for different settings. Comparison of environmental, demographic, socio-economic, and historical backgrounds may support tailoring site-specific control measures. Because of the long-term survival of Bacillus anthracis, Anthrax is a suitable example for studying the influence of triad components in different endemic settings. We compared the spatiotemporal patterns of historic animal Anthrax records in two endemic areas, located at northern latitudes in the western and eastern hemispheres. Our goal was to compare the spatiotemporal patterns in Anthrax progression, intensity, direction, and recurrence (disease hot spots), in relation to epidemiological factors and potential trigger events. Reported animal cases in Minnesota, USA (n = 289 cases between 1912 and 2014) and Kazakhstan (n = 3,997 cases between 1933 and 2014) were analyzed using the spatiotemporal directionality test and the spatial scan statistic. Over the last century Anthrax occurrence in Minnesota was sporadic whereas Kazakhstan experienced a long-term epidemic. Nevertheless, the seasonality was comparable between sites, with a peak in August. Declining number of cases at both sites was attributed to vaccination and control measures. The spatiotemporal directionality test detected a relative northeastern directionality in disease spread for long-term trends in Minnesota, whereas a southwestern directionality was observed in Kazakhstan. In terms of recurrence, the maximum timespans between cases at the same location were 55 and 60 years for Minnesota and Kazakhstan, respectively. Disease hotspots were recognized in both settings, with spatially overlapping clusters years apart. Distribution of the spatiotemporal cluster radii between study sites supported suggestion of site-specific control zones. Spatiotemporal patterns of Anthrax occurrence in both endemic regions were attributed to multiple potential trigger events including major river floods, changes in land use, agriculture, and susceptible livestock populations. Results here help to understand the long-term epidemiological dynamics of Anthrax while providing suggestions to the design and implementation of prevention and control programs, in endemic settings.

Anthrax Epizootic in Wildlife, Bwabwata National Park, Namibia, 2017.

In late September 2017, Bwabwata National Park in Namibia experienced a sudden die-off of hippopotamuses and Cape buffalo. A multiorganizational response was initiated, involving several ministries within Namibia and the US Centers for Disease Control and Prevention. Rapid interventions resulted in zero human or livestock cases associated with this epizootic.

[An historical, sociocultural view and in the fiction literature of Bacillus anthracis cases by shaving brushes]. / Una visión histórica, socio-cultural y literaria de casos de Bacillus anthracis por brochas de afeitar.

In the period from 1915 to 1924 anthrax outbreaks were described by Bacillus anthracis due to the contamination of razor brushes that reached Europe and the United States from areas such as Japan, China or Russia. The brushes were made with badger hair, and then, to reduce the cost with horse hair and other animals. World War I supoosed that the traffics of these brushes, that passed through Europe, changed and the processes of sterilization of the same were deficient giving rise to these outbreaks, that in a percentage of 20% produced the death of the users. The impact of the fashion of wearing a beard, the presence of these cases in the press, in the society of that period, and literature are studied through the work of Agatha Christie who wrote, in 1936, the Hercules Poirot´s novel Cards on the table, and where she describes the murder of one of the characters with the shaving brush contaminated with Bacillus anthracis spores.

Anthrax Cases Associated with Animal-Hair Shaving Brushes.

During the First World War, anthrax cases in the United States and England increased greatly and seemed to be associated with use of new shaving brushes. Further investigation revealed that the source material and origin of shaving brushes had changed during the war. Cheap brushes of imported horsehair were being made to look like the preferred badger-hair brushes. Unfortunately, some of these brushes were not effectively disinfected and brought with them a nasty stowaway: Bacillus anthracis. A review of outbreak summaries, surveillance data, and case reports indicated that these cases originated from the use of ineffectively disinfected animal-hair shaving brushes. This historical information is relevant to current public health practice because renewed interest in vintage and animal-hair shaving brushes has been seen in popular culture. This information should help healthcare providers and public health officials answer questions on this topic.

Historical cases of anthrax in Sweden 1916-1961.

As in most European countries, anthrax was common in Swedish livestock during the centuries leading up to the mid-twentieth century. After 1957, the disease was regarded as practically extinct. However, in the past 7 years, three outbreaks have caused public alarm because of the risk of environmental contamination. Properly buried carcasses should present little risk of spore contamination, and instructions were in place to ensure this since the 1890s. However, as has been demonstrated in recent outbreaks, carcasses were not always adequately buried and viable spores may remain in some sites. This study was prompted by the lack of historical information to assess the geographical risk of old anthrax spores. The aim was to obtain sufficient information to map old anthrax outbreaks, to study clusters and variation between years. Historical data were retrieved from Official National and Regional Veterinary Archives. In the years 1916 to 1961, anthrax was reported from more than 3000 farms and all 24 counties in Sweden were affected. Most cases were single animals, but there were also some larger outbreaks mainly involving cattle. Anthrax in horses was mostly reported before the mid-twentieth century, and the same was seen for pigs and wildlife. A ban in 1957, on the import of bone meal for animal feed led to a drastic reduction of outbreaks. The majority of cases were reported during the summer months in animals on pasture. Historical records proved useful for the investigation of current outbreaks. If handled properly, old carcasses pose no substantial risk, but if not, they may present a risk to grazing animals in some areas. Historical information is useful for all planning of work that involves digging or relocation of soil masses. Anthrax can be regarded as one of the diseases where history is a key to present knowledge.

Redefining the Australian Anthrax Belt: Modeling the Ecological Niche and Predicting the Geographic Distribution of Bacillus anthracis.

The ecology and distribution of B. anthracis in Australia is not well understood, despite the continued occurrence of anthrax outbreaks in the eastern states of the country. Efforts to estimate the spatial extent of the risk of disease have been limited to a qualitative definition of an anthrax belt extending from southeast Queensland through the centre of New South Wales and into northern Victoria. This definition of the anthrax belt does not consider the role of environmental conditions in the distribution of B. anthracis. Here, we used the genetic algorithm for rule-set prediction model system (GARP), historical anthrax outbreaks and environmental data to model the ecological niche of B. anthracis and predict its potential geographic distribution in Australia. Our models reveal the niche of B. anthracis in Australia is characterized by a narrow range of ecological conditions concentrated in two disjunct corridors. The most dominant corridor, used to redefine a new anthrax belt, parallels the Eastern Highlands and runs from north Victoria to central east Queensland through the centre of New South Wales. This study has redefined the anthrax belt in eastern Australia and provides insights about the ecological factors that limit the distribution of B. anthracis at the continental scale for Australia. The geographic distributions identified can help inform anthrax surveillance strategies by public and veterinary health agencies.

Anthrax of domestic animals in Vrbas Banate: from traditional beliefs to the first scientific views on the ancient disease.

From 1929 to 1941, the Vrbas Banate was one of nine provinces of the Kingdom Yugoslavia, and according to historical data, the poorest one, without well-organized and sustainable agriculture production. Naturalistic production and poor animal health control in the Vrbas Banate were the most important risk factors for infectious disease spreading. Anthrax was very prevalent infectious disease in domestic animals and humans in that period, but some data on this disease remain scarce. In this paper epidemiology and clinical investigation of anthrax in the Vrbas Banate are reviewed. Apart from many aggravating factors that influenced the control of anthrax, the veterinary service of Banate contributed to the development of animal husbandry, animal health and public health in that period.

Spatiotemporal Clustering Analysis and Risk Assessments of Human Cutaneous Anthrax in China, 2005-2012.

OBJECTIVE: To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters. METHODS: CA cases reported during 2005-2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ2 test or Kruskal-Wallis test. RESULTS: The group of 30-39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis. CONCLUSION: CA was geographically and persistently clustered in the Southwestern China during 2005-2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.

Human anthrax as a re-emerging disease.

Anthrax is primarily a disease of herbivores and the etiological agent is B. anthracis which is a gram-positive, aerobic, spore-forming, and rod shaped bacterium. Bacillus anthracis spores are highly resistant to heat, pressure, ultraviolet and ionizing radiation, chemical agents and disinfectants. For these reasons, B. anthracis spores are an attractive choice as biological agents for the use of bioweapon and/or bioterrorism. Soil is the main reservoir for the infectious agent. The disease most commonly affects wild and domestic mammals. Human are secondarily infected by contact with infected animals and contaminated animal products or directly expose to B. anthracis spores. Anthrax occurs worldwide. This infection is still endemic or hyperendemic in both animals and humans in some part of areas of the world; particularly in Middle East, West Africa, Central Asia, some part of India, South America. However, some countries are claiming free of anthrax, and anthrax has become a re-emerging disease in western countries with the intentional outbreak. Currently, anthrax is classified according to its setting as (1) naturally occurring anthrax, (2) bioterrorism-related anthrax. Vast majority of human anthrax are occurring as naturally occurring anthrax in the world. It is also a threaten disease for western countries. The aim of this paper is to review the relevant patents, short historical perspective, microbiological and epidemiological features, clinical presentations and treatment.

Confirmed Bacillus anthracis infection among persons who inject drugs, Scotland, 2009-2010.

In Scotland, the 2009 outbreak of Bacillus anthracis infection among persons who inject drugs resulted in a 28% death rate. To compare nonsurvivors and survivors, we obtained data on 11 nonsurvivors and 16 survivors. Time from B. anthracis exposure to symptoms or hospitalization and skin and limb findings at presentation did not differ between nonsurvivors and survivors. Proportionately more nonsurvivors had histories of excessive alcohol use (p = 0.05) and required vasopressors and/or mechanical ventilation (p≤0.01 for each individually). Nonsurvivors also had higher sequential organ failure assessment scores (mean ± SEM) (7.3 ± 0.9 vs. 1.2 ± 0.4, p<0.0001). Antibacterial drug administration, surgery, and anthrax polyclonal immune globulin treatments did not differ between nonsurvivors and survivors. Of the 14 patients who required vasopressors during hospitalization, 11 died. Sequential organ failure assessment score or vasopressor requirement during hospitalization might identify patients with injectional anthrax for whom limited adjunctive therapies might be beneficial.

Robert Koch (1843-1910) and dermatology on his 171st birthday.

Robert Koch (1843-1910) received the Nobel Prize in Medicine in 1905 for his studies of tuberculosis. He contributed significantly to microbiology, isolating also cholera and anthrax pathogens, and introducing several postulates in this field. In addition, he developed staining methods, as well as culturing and microscopic techniques. Many of his achievements have also influenced dermatology. This contribution reviews his life and major achievements on the occasion of the 171st anniversary of his birth.

The Mountain Meadows Massacre and "poisoned springs": scientific testing of the more recent, anthrax theory.

It has been recorded that one of the possible causes that eventually escalated into the 1857 manslaughter at Mountain Meadows in Southern Utah was the poisoning of an open spring by the Fancher-Baker party as they crossed the Utah territory on their way from Arkansas to California. Historical accounts report that a number of cattle died, followed by human casualties from those that came in contact with the dead animals. Even after the Arkansas party departed, animals continued to perish and people were still afflicted by some unknown plague. Proctor Hancock Robison, a local 14-year-old boy, died shortly after skinning one of the "poisoned" cows. A careful review of the historical records, along with the more recent scientific literature, seems to exclude the likelihood of actual poisoning in favor of a more recent theory that would point to the bacterium Bacillus anthracis as the possible cause of human and animal deaths. In order to test this hypothesis, Proctor's remains were exhumed, identified through mitochondrial DNA analysis, and tested for the presence of anthrax spores. Although preliminary testing of remains and soil was negative, description of the clinical conditions that affected Proctor and other individuals does not completely rule out the hypothesis of death by anthrax.

Influencia de Louis Pasteur en el control de las enfermedades infecciosas / No disponible

Se revisan los distintos periodos de la vida de Pasteur, así como los aspectos más relevantes de su obra. Algunos de sus trabajos, entre los que cabe destacar los relativos a las fermentaciones, las enfermedades de los gusanos de seda, el carbunco o la rabia, han tenido una gran influencia en la medicina contemporánea y en el control de las enfermedades infecciosas, contribuyendo, entre otros aspectos, a modificar la estructura de los futuros hospitales, con nuevos conceptos del aislamiento de los pacientes o a reducir eficazmente las infecciones quirúrgicas, mediante el método antiséptico de Lister, basado en estudios de Pasteur. Sin embargo, sus investigaciones más relevantes son probablemente las relacionadas con la profilaxis de la rabia. Su obra contribuyó asimismo al desarrollo de algunas especialidades como la Microbiología médica o la Higiene

Different periods of Pasteur's life as well the most relevant aspects of his work are revised in the article presented. His work related to fermentation, silkworm's disease, carbuncle or rabies have had great influence in contemporary medicine as well as in controlling infectious diseases. Lister's antiseptic method, largely based on Pasteur's studies, has helped to modify the structure of modern hospitals and in the construction of new concepts of patient's isolation. It has also helped to reduce surgical infections more efficiently. However, his most prominent research is those related to the prophylaxis of rabies. His works have contributed to the development of some more specialized fields such as Microbiology and Hygiene

[S. S. Andreyevsky a scientist and reformer of medical work in Russia].

The article deals with the activities of S. S. Andreyevsky--a heroic researcher of anthrax, known public health organizer and public figure. He played an important role in the development of Russian medical education.