Seguridad ocupacional contra Bacillus anthracis en la industria de curtiembre peruana / Occupational safety against Bacillus anthracis in the Peruvian tannery industry

El carbunco es una zoonosis que afecta a animales herbívoros, causada por el microorganismo Bacillus anthracis; que se encuentra en su forma vegetativa en el organismo infectado, y una vez en contacto con el aire forma esporas que infectan al huésped, liberando toxinas que inducen edema, septicemia y necrosis tisular. En humanos, la transmisión se produce por cortes, pinchazos o contacto directo de piel lesionada con esporas o tejidos de animales infectados. En Perú, para la década de 1980, se reportaron 400 casos anuales en áreas rurales agrícolas, adquiridos por manipulación del ganado vacuno, muerto por ántrax. Es por ello, que la piel y el cuero procedente de animales infectados representa un riesgo de infección para los trabajadores de industrias curtiembres. Se realizó un estudio transversal para evaluar el riesgo biológico ocupacional y las medidas de bioseguridad relacionadas con el Bacillus anthracis en pequeñas, medianas y grandes empresas curtiembres peruanas. Se aplicó un instrumento a los trabajadores para cuantificar las variables, componentes de riesgo biológico y conocer las medidas higiénicas adoptadas. Posteriormente se calculó e interpretó el nivel de riesgo biológico. Se encontró que el nivel de riesgo supera el límite de exposición biológica para el Bacillus anthracis en todas las empresas evaluadas y los trabajadores de las pequeñas empresas tienen poco conocimiento acerca del riesgo biológico al que están expuestos, siendo necesaria la capacitación de los trabajadores acerca del Bacillus anthracis y adopción de medidas de bioseguridad en empresas curtiembres, que garanticen la salud de los trabajadores(AU)

Anthrax is a zoonosis that affects herbivorous animals, caused by the microorganism Bacillus anthracis; which is found in its vegetative form in the infected organism, and once in contact with the air it forms spores that infect the host, releasing toxins that induce edema, septicemia and tissue necrosis. In humans, transmission occurs through cuts, punctures, or direct contact of broken skin with spores or tissues of infected animals. In Peru, for the 1980s, 400 annual cases were reported in rural agricultural areas, acquired by handling cattle, which died of anthrax. For this reason, the skin and leather from infected animals represent a risk of infection for workers in tanneries. A cross-sectional study was carried out to evaluate the occupational biological risk and biosafety measures related to Bacillus anthracis in small, medium and large Peruvian tanneries. An instrument was applied to the workers to quantify the variables, components of biological risk and to know the hygienic measures adopted. Subsequently, the level of biological risk was calculated and interpreted. It was found that the level of risk exceeds the biological exposure limit for Bacillus anthracis in all the companies evaluated and the workers of the small companies have little knowledge about the biological risk to which they are exposed, being necessary the training of the workers about the Bacillus anthracis and adoption of biosafety measures in tanneries, which guarantee the health of workers(AU)

Analysis of epidemic characteristics of anthrax in China from 2017 to 2019 and molecular typing of Bacillus anthracis / 中华预防医学杂志

Objective: To analyze the epidemiological characteristics of anthrax in China from 2017 to 2019 and molecular typing of Bacillus anthracis isolated from some provinces (autonomous regions). Methods: Surveillance data of anthrax cases reported from 2017 to 2019 in the Infectious Disease Surveillance information System of China Disease Prevention and Control and the Public Health Emergency Reporting and Management Information System were collected, and descriptive epidemiological methods were used to analyze the epidemic characteristics, including the temporal, geographic and demographic distribution of this disease. A total of 47 strains of Bacillus anthracis isolated from 2017 to 2019 were analyzed by canSNP and MLVA15. Results: A total of 951 cases of anthrax were reported from 2017 to 2019, of which 938 were cutaneous anthrax, representing 98.63% of the total number reported. It was mainly distributed in the west and northeast of China, and the three provinces with the highest number of cases were Gansu (215), Sichuan (202) and Qinghai (191). Cases had been reported throughout the year, more cases occurred in the summer and autumn, and August was the month with the most cases,66.35% (211/318), 72.32% (243/336) and 68.01% (202/297) of cases were reported during June to September. The age distribution was mainly between 20 and 59 years old, accounting for more than 80% of all cases. The number of male cases was significantly higher than that of female cases, the ratio of male to female was about 3∶1. The occupations were mainly herdsmen and farmers, accounting for 49.70% to 58.18% and 31.45% to 36.70%, respectively. Public health events occurred every year, and 29 events had been reported from 2017 to 2019. canSNP analysis showed that 37 of the 47 strains belonged to the A.Br.001/002 subgroup and 10 belonged to the A.Br.Ames subgroup. MLVA15 analysis showed that there were 17 genotypes, of which 10 genotypes contained only one strain. Conclusion: Cutaneous anthrax was the predominant clinical type in China from 2017 to 2019.The seasonal, geographic and demographic distribution characteristics were evident.Molecular typing methods such as canSNP and MLVA15 can be used to trace the source of infectious diseases and provide technical support for anthrax prevention and control.

After-action review of rabies and anthrax outbreaks multisectoral response in Tanzania, challenges and lessons

After-action review uses experiences gained from past events to adopt best practices, thereby improving future interventions. In December 2016 and late 2018, the government of Tanzania with support from partners responded to anthrax and rabies outbreaks in Arusha and Morogoro regions respectively. The One Health Coordination Desk (OHCD) of the Prime Minister's Office (PMO) later coordinated after-action reviews to review the multi-sectoral preparedness and response to the outbreaks. To establish and describe actions undertaken by the multi-sectoral investigation and response teams during planning and deployment, execution of field activities, and outbreak investigation and response, system best practices and deficiencies. These were cross-sectional surveys. Semi-structured, open and closed-ended questionnaire and focus group discussions were administered to collect information from responders at the national and subnational levels. It was found that the surveillance and response systems were weak at community level, lack of enforcement of public health laws including vaccination of livestock and domestic animals and joint preparedness efforts were generally undermined by differential disease surveillance capacities among sectors. Lack of resources in particular funds for supplies, transport and deployment of response teams contributed to many shortfalls. The findings underpin the importance of after-action reviews in identifying critical areas for improvement in multi-sectoral prevention and control of disease outbreaks. Main sectors under the coordination of the OHCD should include after action reviews in their plans and budget it as a tool to continuously assess and improve multi-sectoral preparedness and response to public health emergencies.

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.

Early Detection of Bacillus anthracis From Saliva in Anticipation of a Bioterrorism Attack

Objective: To assess potential for early detection of oral infection by B. anthracis spores for preparedness of a bioterrorism attack. Material and Methods: The laboratory study used saliva with a range of initial anthrax concentrations, to compare detection by direct observation from conventional blood agar culture and by anthrax-specific PCR after a shorter culture in BHI broth. Three types of saliva were collected: stimulated saliva, unstimulated/whole saliva, and unstimulated/whole saliva with antibiotic treatment (for negative control). Using bivariate Kruskal-Wallis and Mann-Whitney tests for statistical analysis for factors that could affecting anthrax detection, significant differences between the test groups was assumed at p<0.05. Results: From unstimulated whole saliva heat shock treated at 62.50C, B. anthracis growth was detected with both methods. PCR detection from a BHI broth culture could shorten the time to diagnosis in comparison to conventional culture in blood agar. Conclusion: Saliva can provide useful samples for diagnosis of oropharyngeal anthrax. In comparison to conventional culture on blood agar, shorter-term culture in BHI broth provides potential for earlier detection and diagnosis.

Effect of simultaneous administration of foot-and-mouth disease (FMD) and anthrax vaccines on antibody response to FMD in sheep

PURPOSE: Foot-and-mouth disease (FMD) and anthrax are important diseases in sheep. Vaccination is a favorable strategy against both infections. Simultaneous administration of vaccines does generally not impede the immune responses of each other, although there are some exceptions, and it may help reduce the labor and costs of vaccination as well as distress on animals. Although oil adjuvant FMD vaccine has been tried with live anthrax vaccine in cattle, there are no reports on the simultaneous use of both vaccines in sheep. MATERIALS AND METHODS: In this study, FMD seronegative sheep were used to investigate the impact of the simultaneous vaccination of FMD and anthrax on FMD antibody titers of sheep. Virus neutralization test and liquid phase blocking enzyme-linked immunosorbent assay were used to determine the antibody response to the FMD vaccine. RESULTS: The results demonstrated that both vaccines can be used simultaneously without any interference with the FMD response. Moreover, the simultaneous administration with anthrax vaccine had a stimulating effect on the early (day 7 post-vaccination) virus neutralization antibody response to the FMD vaccine. CONCLUSION: The simultaneous use of the FMD and anthrax vaccines did not hinder the response to the FMD vaccine in sheep.

Evaluation of in vitro antimicrobial susceptibility of Bacillus anthracis strains isolated during anthrax outbreaks in Italy from 1984 to 2017

Anthrax, caused by Bacillus anthracis, is a non-contagious infectious disease that affects a wide range of animal species (primarily ruminants) including humans. Due to the often-fatal outcome in humans, quick administration of definitely effective antimicrobials is crucial either as prophylaxis or as a clinical case therapy. In this study, 110 B. anthracis strains, temporally, geographically, and genetically different, isolated during anthrax outbreaks in Italy from 1984 to 2017, were screened using a broth microdilution method to determine their susceptibility to 16 clinically relevant antimicrobial agents. The strains were isolated from various matrices (human, animal, and environmental samples) and were representative of thirty distinct genotypes previously identified by 15-loci multiple-locus variable-number of tandem repeats analysis. The antimicrobials tested were gentamicin, ceftriaxone, streptomycin, penicillin G, clindamycin, chloramphenicol, vancomycin, linezolid, cefotaxime, tetracycline, erythromycin, rifampin, amoxicillin, ciprofloxacin, doxycycline, and trimethoprim. All isolates were susceptible to most of the tested antimicrobials, with the exception of trimethoprim for which all of them showed high minimal inhibitory concentration values. An intermediate level of susceptibility was recorded for ceftriaxone and cefotaxime. Although the Centers for Disease Control and Prevention recommend the use of doxycycline, ciprofloxacin, penicillin G, and amoxicillin for treatment of human cases and for post-exposure prophylaxis to anthrax spores, this study shows a high degree of in vitro susceptibility of B. anthracis to many other antimicrobials, suggesting the possibility of an alternative choice for prophylaxis and therapy.

Prévalence de l'hypertension artérielle et facteurs de risque des troubles hémodynamiques chez les charbonniers de Kinshasa

Introduction : Les charbonniers de Kinshasa constituent un groupe d'ouvriers exposé aux stress et aux polluants professionnels potentiellement dangereux sur la santé. L'objectif de cette étude était de déterminer la prévalence de l'hypertension artérielle (HTA) ainsi que les facteurs de risque des troubles hémodynamiques chez les professionnels de charbon de bois. Méthodes : Etude transversale et prospective, conduite à Kinshasa entre juin 2017 et juin 2018 auprès des 170 charbonniers ayant au moins 2 ans d'ancienneté. Les variables d'intérêts étaient l'ancienneté dans l'activité, les paramètres anthropométriques et hémodynamiques. L'analyse statistique a été faite à l'aide du logiciel SPSS 20.0 for IBM. Résultats : Nous avons trouvés 91 hommes (tous convoyeurs) et 79 femmes (toutes vendeuses), avec une moyenne d'âge de 38.3 ± 13.65 ans. Ces charbonniers avaient une ancienneté moyenne de 8.1 ± 7.5 ans. La moyenne de l'indice de masse corporelle était de 23.5 ± 6.5 kg/m2 dont 16.5% étaient en surpoids et 11.2% obèses. Les femmes étaient plus âgées, en surpoids, avec fréquence cardiaque plus élevée que les hommes (p < 0.001). Sur le plan hémodynamique : la prévalence de l'HTA était de 22.4% pour la systolique, 11.8% pour la diastolique, 21.8% pour la tachycardie de repos. Les facteurs de risque de l'hypertension artérielle et de la tachycardie de repos étaient l'ancienneté dans l'activité, être vendeuse, l'âge ≥ 40 ans et la taille ≤ 170 cm. Conclusion : La fréquence de l'hypertension artérielle et les facteurs de risque hémodynamique observés chez les charbonniers démontrent la nécessité d'implémenter des mesures de surveillance dans l'exercice de cette activité professionnelle

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.

Cutaneous Manifestations of Potential Chemical, Biological, and Radiological Agents and Their Clinical Management / 대한피부과학회지

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.

Cutaneous Manifestations of Potential Chemical, Biological, and Radiological Agents and Their Clinical Management / 대한피부과학회지

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.

Eficacia del parche hemático transvaginal endocervical autólogo en ruptura prematura de membranas pretérmino / Effectiveness of transvaginal blood patch endocervical Autologous in Preterm premature rupture of membranes

OBJETIVO: comparar la efectividad terapéutica del parche hemático transvaginal endocervical autólogo en casos de ruptura prematura de membranas pretérmino frente al llamado tratamiento expectante. MÉTODOS: Ensayo controlado, aleatorio y prospectivo teniendo como variables determinantes el tiempo de latencia de la ruptura y la sobrevida de los recién nacidos. En un período de 12 semanas, solo 35 pacientes con edades comprendidas entre 16 y 37 y promedio de 26,5 años, cumplieron los criterios de inclusión. La edad de gestación tuvo una media de 23,5 ± 3,92 semanas. Con distribución aleatoria, se formaron dos grupos independientes y estadísticamente comparables donde el primero con 9 casos (25,7.%) fue tratado con el parche hemático y el segundo considerado grupo control, con 26 casos (74,2.%) recibió el tratamiento expectante. RESULTADOS: Con un nivel de significancia de 0,05 hubo una diferencia significativa tanto en el período de latencia (P=0,002) como en la sobrevida de los recién nacidos (P=0,006) demostrando la efectividad terapéutica del parche frente al tratamiento expectante. No hubo diferencia referente a la edad materna y la edad gestacional. Con el tratamiento con el parche hemático la reducción del riesgo absoluto fue de 54,70 %, el riesgo relativo de muerte de 0,289, la reducción del riesgo relativo de muerte del 71,11 % , el número necesario de pacientes a tratar fue de 1,83 pacientes y "Odds Ratio"= 0,09 (0,086). El parche hemático no evidenció efectos adversos, complicaciones y fue de bajo costo. CONCLUSIONES: Los resultados obtenidos demuestran de manera significativa la efectividad terapéutica del parche hemático frente al tratamiento expectante, mejorando tanto el período de latencia del embarazo como la sobrevida de los recién nacidos con ruptura de membranas ovulares pretermino.

OBJECTIVE: to compare the therapeutic effectiveness of the autologous endocervical transvaginal blood patch, in cases of preterm premature rupture of membranes, versus the so called expectant treatment. METHODS: Controlled, randomized and prospective trial having latency time of the break and survival of newborns as determining variables. In a 12-week period, only 35 patients aged between 16 and 37 and averaging 26,5 years, met the inclusion criteria. Gestational age had an average of 23.5 ± 3.92 weeks. With a random distribution, two independent and statistically comparable groups where formed; where the first one, with nine cases (25.7 %), was treated with the blood patch; and the second one, with 26 (74.2%), and considered the control group, received expectant treatment. RESULTS: With a significance level of 0.05, there was a significant difference in both the latency period (P = 0.002) and the survival of newborns (P = 0.006), demonstrating the therapeutic effectiveness of the patch as compared with the expectant treatment. There was no difference regarding maternal age and gestational age. With the blood patch treatment, Absolute Risk Reduction (ARR) was 54.70 %; the relative risk of death (RR), of 0.289; the reduction of the relative risk of death (RRR), of 71.11 %; the number needed to treat (NNT) was 1.83 patients; and the "Odds ratio" (OR) = 0.09 (0.086). The blood patch did not report adverse effects, complications and was inexpensive. CONCLUSIONS: The results show a significant therapeutic effectiveness of the blood patch versus the expectant treatment, improving both the latency period of pregnancy and the survival of infants in cases of preterm rupture of ovular membranes.

Selected infectious disease disasters for nursing staff training at Egyptian eastern border

Infectious disease disasters are events that involve a biological agent, disease and that result in mass casualties, such as a bioterrorism attack, an emerging outbreak of infectious disease; all disasters pose a risk of infection transmission. But, infectious disease disasters pose the great-risk to illness or death from an infectious disease. This study raised the awareness and improved knowledge by educational program for Military Nursing Staff on selected infectious disease disasters acquired at Egyptian Eastern Border. The selected arthropodborne diseases were Anthrax, Tick borne relapsing, Louse borne replasing fever and liver fluke; Clonorchis sinensis. An interventional study was used, for 125 staff nurse who accepted to participate. The tools dealt with four questionnaires: [1] Some socio-demographic characteristics data [2] Educational needs assessment a structured questionnaire. [3] Knowledge test [pre/ post-test] and [4] Participants' reactions questionnaire. The results showed that educational intervention significantly improvements the nursing staff knowledge, which were achieved at the immediate post intervention phase, and retained via three months post-test phase. In the service training programs about infectious disease disasters at Egyptian Eastern Border must be established and continued on regular basis. This would improve their knowledge about the epidemiology of these infectious disease disasters

Una clave diagnóstica en la histopatología del carbunco cutáneo: necrosis de coagulación con costra hemorrágica / A diagnostic key in the pathophysiology of cutaneous anthrax: coagulation necrosis with hemorrhagic crust

El carbunco cutáneo es una zoonosis cuyo diagnóstico clínico es fácil de conseguir, aunque en muchas ciudades, en donde su incidencia es baja, 0 en lugares apartados donde el medico está aislado, el diagnostico puede tener dificultades. Se presentan dos casos sospechosos de carbunco cutáneo en estadío avanzado, procedentes de una zona enzootia de carbunco; en ambos pacientes, se realizó estudio histopatológico de las lesiones cutáneas, en ambos casos se detectó necrosis de coagulación asociado a costra hemorrágica. En el resto de la epidermis se observaron signos de hiperplasia epitelial, papilomatosis, acantosis, hiperqueratosis, paraqueratosis. La ausencia de complicaciones en la biopsia de piel, similar a la observada en la reciente epidemia norteamericana por bioterrorismo, demuestra que puede ser usada como un método seguro cuando se dificulte el diagnóstico clínico El patrón histopatológico de necrosis de coagulación asociado a costra hernorrágica puede ser considerado uno de los signos hepatológicos más característicos de carbunco cutáneo en lesiones avanzadas y un cuarto criterio diagnóstico, alternativo al clínico, epidemiológico y de laboratorio, en la definición de los casos sospechosos de carbunco.

Cutaneous anthrax is a zoonosis which clinical diagnostic is easy to get it although in many cities where it's incidence is low, or in remote areas where the doctor is isolated, it's diagnostic can be difficult. It shows two patients suspects cutaneous anthrax in advanced stage, they from anthrax enzootic area; in both patients histopathological study of cutaneous lesions was conducted, this histopathological study show clotting necrosis associated to hemorrhagic scabs Signs of epithelial hyperplasia, papilomatosis, acantosis, hiperqueratosis, and paraqueratosis were seen surrounding the necrotized epidermis. The absence of complications in skin biopsy is similar at that observed in northeamerican bioterrorism outbreak and demonstrates that may be used as a safe method in some situations when clinical diagnosis difficult. The histophathological pattern of clotting necrosis associated to haemorrhagic scabs can be considered one of the more characteristics histopathological signs of cutaneous anthrax in advanced stage and fourth diagnostic criterion, alternative to clinical, epidemiological and laboratory, in the definition of suspected cases of anthrax.

Systemic use of fluoroquinolone in children / 소아과

Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However, fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.

Genetic populations of Bacillus anthracis isolates from Korea

Bacillus (B.) anthracis is the pathogen that causes fatal anthrax. Strain-specific detection of this bacterium using molecular approaches has enhanced our knowledge of microbial population genetics. In the present study, we employed molecular approaches including multiple-locus variable-number tandem repeat analysis (MLVA) and canonical single-nucleotide polymorphism (canSNP) analysis to perform molecular typing of B. anthracis strains isolated in Korea. According to the MLVA, 17 B. anthracis isolates were classified into A3a, A3b, and B1 clusters. The canSNP analyses subdivided the B. anthracis isolates into two of the three previously recognized major lineages (A and B). B. anthracis isolates from Korea were found to belong to four canSNP sub-groups (B.Br.001/2, A.Br.005/006, A.Br.001/002, and A.Br.Ames). The A.Br.001/002 and A.Br.Ames sub-lineages are closely related genotypes frequently found in central Asia and most isolates were. On the other hand, B. anthracis CH isolates were analyzed that belonged to the B.Br.001/002 sub-group which found in southern Africa, Europe and California (USA). B.Br.001/002 genotype is new lineage of B. anthracis in Korea that was not found before. This discovery will be helpful for the creation of marker systems and might be the result of human activity through the development of agriculture and increased international trade in Korea.

The effect of seasonal variation on anthrax epidemiology in the upper Zambezi floodplain of western Zambia

Anthrax has become endemic throughout the upper Zambezi floodplain located in the Western Province of Zambia over the recent years. To date, no comprehensive study has been carried out to determine whether recurrence of anthrax outbreaks may be linked to differences in precipitation and human activities. Retrospective data for the period 1999 to 2007 showed that a total of 1,216 bovine cases of anthrax were reported. During the same period, 1,790 human anthrax cases and a corresponding case fatality rate of 4.63% (83/1,790) was documented in the upper Zambezi floodplain. Occurrence of human cases was highly correlated with cattle outbreaks (r = 0.94, p < 0.001). Differences in precipitation were significantly associated with the occurrence of anthrax outbreaks (chi2 = 4.75, p < 0.03), indicating that the likelihood of outbreaks occurring was higher during the dry months when human occupancy of the floodplain was greater compared to the flooding months when people and livestock moved out of this region. Human dependency on the floodplain was shown to significantly influence the epidemiology of anthrax in the upper Zambezi floodplain of western Zambia. Methods for mitigating anthrax outbreaks by disrupting the cycle of transmission are herein highlighted.

Vigilancia epidemiológica de zoonosis y enfermedades transmisibles por vectores: Chile 2009-2010 / Epidemiologic surveillance of zoonosis and vector-borne diseases: Chile 2009-2010

Se presenta la situación epidemiológica de las zoonosis de mayor importancia en salud pública en Chile y que están incluidas en el Decreto 158/04 como enfermedades de notificación obligatoria. Se hace el análisis de las zoonosis y enfermedades transmitidas por vectores de los años 2009 y 2010, utilizando las bases de datos ENO del Departamento de Estadísticas e Información en Salud (DEIS), MINSAL, y los informes periódicos generados en el Departamento de Epidemiología. Los resultados indican que las zoonosis muestran una tendencia decreciente. Brucelosis es una enfermedad de baja presentación, desatendida y posiblemente subnotificada. En triquinosis se observan fundamentalmente brotes en la zona centro-sur del país especialmente en la población masculina. Carbunco se manifiesta como una enfermedad de muy baja endemia y en el único caso de estos dos últimos años se manifestó la forma cutánea de la enfermedad. Leptospirosis: destaca la presentación de casos en hombres en un 100%. Hidatidosis destaca por mantener su incidencia relativamente alta y un importante número en menores de 10 años. Dengue: persiste la circulación viral en Isla de Pascua y a nivel continental se presentan casos importados que provienen especialmente de Centro y Sudamérica. Malaria: sólo existen casos importados y tendencia decreciente, posiblemente por subnotificación.

Due to the success in the elimination of measles, rubella and CRS reached in the Americas, PAHO requested the verification of the elimination of these diseases in the countries of the region. Chile ratified by means of a resolution a National Committee of Experts, which revised the information provided by the technical teams in the following components: Epidemiology of measles, rubella and CRS; quality of the surveillance; molecular epidemiology; sustainability of the Immunization Program and cohorts of vaccinated population. The information gathered from different sources allowed to integrate the evidence provided and to determine if the data were valid, complete, representatives and consistent. In this paper we describe thecertification steps and the information evaluated by the ad-hoc national committee. Their conclusions will be ratified by the International Committee, which will certify if Chile fulfills the criteria for elimination, a process that is expected to end during December 2011.