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Title: Bacillus Anthracis

I. Introduction.
a. Bacillus anthracis is a gram-positive spore forming bacterium that causes anthrax, an acute, often fatal infection. Infection are initiated by entry of spores into the host through the respiratory systems, the gastrointestinal tract, or cuts and wounds in the skin. Among the three forms of anthrax infection are inhalational, gastrointestinal, and injection anthrax.

b. Reference:

i. Wang, Y., Jenkins, S. A., Gu, C., Shree, A., Martinez-Moczygemba, M., Herold, J., & ... Xu, Y. (2016). Bacillus anthracis Spore Surface Protein BclA Mediates Complement Factor H Binding to Spores and Promotes Spore Persistence. Plos Pathogens, 14(6), 1-25. doi:10.1371/journal.ppat.1005678

II. Laboratory procedures/Pathogen characteristics
a. Test Require liquid suspension, preparing smears, testing for capsul production in blood and suspens of the organism for polymerase chain reaction (PCR). Work for further tests, such as bacterial counts, sterility tests, etc. involving liquid cultures should be done in biological safety cabinets in laboratories meeting as nearly as is possible the criteria for basic BSL3, or at least BSL2, laboratories. Bacillus anthracis is an obligate bacillus pathogen that infects many vertebrates. Based on its physical characteristics, Bacillus anthracis can be categorized with other microorganisms such as Bacillus cereus, Bacillus thuringiensis and Bacillus mycoid

b. Reference:

i. (2015). Laboratory procedures for diagnoses of anthrax and isolation and identification of Bacillus anthracis. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK310485/

III. Detection (air, methods of detection)
a. Routine culture and biochemical testing methods are useful for the identification of Bacillus anthracis, but a definitive identification may take 24 to 48 hours or longer and may require that specimens be referred to another laboratory. A number of methods, ranging from basic to complex in their application, have been employed for detecting B. anthracis. Most simply, the bacilli may be cultured and identified on blood agar.

b. Kušar, D., Pate, M., Hubad, B., Avberšek, J., Logar, K., Lapanje, A., & ... Ocepek, M. (2012). DETECTION OF BACILLUS ANTHRACIS IN THE AIR, SOIL AND ANIMAL TISSUE. Acta Veterinaria, 62(1), 77-89. doi:10.2298/AVB1201077K

IV. Infection ( incubation period and symptoms)
a. Inhalation anthrax usually develops within a week after exposure, but the incubation period may be prolonged (up to 2 months). Estimates for the case-fatality ratio are >85%; even with aggressive treatment, this ratio can be as high as 45%. Initial symptoms are nonspecific and may mimic those of influenza, including myalgia, fever, nonproductive cough, malaise, nausea, and vomiting; upper respiratory tract symptoms are rare. The patient's condition dramatically worsens 2-3 days after symptom onset, with the development of severe respiratory distress, diaphoresis, cyanosis, and shock.

b. Reference:

i. Sean, V., Rita, M., Chung, K. (2015). Infectious Diseases Related to Travel. Retrieved from https://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/anthrax

V. Diagnosis and Treatment
a. Effective antibiotic treatment of inhalational anthrax requires early diagnosis; the further the disease has progressed, the less the likelihood for cure. Current means for diagnosis such as blood culture require several days to a result and require advanced laboratory infrastructure. An alternative approach to diagnosis is detection of a Bacillus anthracis antigen that is shed into blood and can be detected by rapid immunoassay.

b. Reference:

i. Gates-Hollingsworth, M. A., Perry, M. R., Chen, H., Needham, J., Houghton, R. L., Raychaudhuri, S., & ... Kozel, T. R. (2015). Immunoassay for Capsular Antigen of Bacillus anthracis Enables Rapid Diagnosis in a Rabbit Model of Inhalational Anthrax. Plos ONE, 10(5), 1-9. doi:10.1371/journal.pone.0126304

VI. Prevention (vaccination and prevention of exposure)
a. Protective antigen (PA) of Bacillus anthracis is the main immunogen of all anthrax vaccines. It is a highly thermolabile molecule and loses its activity rapidly when exposed to higher temperatures. Earlier some cosolvents had been used to stabilize PA with variable success but no study has been done to find out the primary cause of PA thermal inactivation.

b. Reference:

i. Singh, S., Singh, A., Aziz, M. A., Waheed, S. M., Bhat, R., & Bhatnagar, R. (2004). Thermal inactivation of protective antigen of Bacillus anthracis and its prevention by polyol osmolytes. Biochemical & Biophysical Research Communications, 322(3), 1029-1037. doi:10.1016/j.bbrc.2004.08.020

VII. Summary/Conclusion- TBD

VIII. Literature Cited: see previous reference above