Lethal Factor Toxemia and Anti-Protective Antigen Antibody Activity in Naturally Acquired Cutaneous Anthrax

Cutaneous anthrax outbreaks occurred in Bangladesh from August to October 2009. As part of the epidemiological response and to confirm anthrax diagnoses, serum samples were collected from suspected case patients with observed cutaneous lesions. Anthrax lethal factor (LF), anti-protective antigen (an...

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Bibliographic Details
Published in:The Journal of infectious diseases 2011-11, Vol.204 (9), p.1321-1327
Main Authors: Boyer, Anne E., Quinn, Conrad P., Beesley, Cari A., Gallegos-Candela, Maribel, Marston, Chung K., Cronin, Li X., Lins, Renato C., Stoddard, Robyn A., Li, Han, Schiffer, Jarad, Hossain, M. Jahangir, Chakraborty, Apurba, Rahman, Mahmudur, Luby, Stephen P., Shieh, Wun-Ju, Zaki, Sherif, Barr, John R., Hoffmaster, Alex R.
Format: Article
Language:English
Subjects:
Animals
Anthrax
Anthrax - epidemiology
Anthrax - immunology
Antibodies
Antibodies, Bacterial - blood
Antibodies, Neutralizing - blood
Antigens
Antigens, Bacterial - immunology
Antimicrobials
Antitoxins - blood
Bacteremia
BACTERIA
Bacterial Toxins - immunology
Bacteriology
Bangladesh - epidemiology
Biological and medical sciences
Disease Outbreaks
Epidemiology
Fundamental and applied biological sciences. Psychology
Humans
Immunoglobulin G - blood
Infectious diseases
Inhalation
Lesions
Major and Brief Reports
Medical sciences
Microbiology
Miscellaneous
Skin Diseases, Bacterial
Toxins
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Summary:Cutaneous anthrax outbreaks occurred in Bangladesh from August to October 2009. As part of the epidemiological response and to confirm anthrax diagnoses, serum samples were collected from suspected case patients with observed cutaneous lesions. Anthrax lethal factor (LF), anti-protective antigen (anti-PA) immunoglobulin G (IgG), and anthrax lethal toxin neutralization activity (TNA) levels were determined in acute and convalescent serum of 26 case patients with suspected cutaneous anthrax from the first and largest of these outbreaks. LF (0.005–1.264 ng/mL) was detected in acute serum from 18 of 26 individuals. Anti-PA IgG and TNA were detected in sera from the same 18 individuals and ranged from 10.0 to 679.5 µg/mL and 27 to 593 units, respectively. Seroconversion to serum anti-PA and TNA was found only in case patients with measurable toxemia. This is the first report of quantitative analysis of serum LF in cutaneous anthrax and the first to associate acute stage toxemia with subsequent antitoxin antibody responses.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jir543