Mil Med 2002 Jan;167(1):74-5

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Delayed-type hypersensitivity reaction to anthrax vaccine.

Greidanus TG, Honl BA.

Evans Army Community Hospital, Fort Carson, CO, USA.

The Anthrax Vaccine Immunization Program is a Department of Defense initiative to protect military personnel against the threat of anthrax. Surveillance for adverse events associated with anthrax vaccination has shown that mild local reactions are not uncommon while systemic reactions are extremely rare. We present a case of 26-year-old male with delayed-type hypersensitivity after two doses of anthrax vaccine.

PMID: 11799819 [PubMed - in process]

 

Ophthalmology 2002 Jan;109(1):99-104

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Optic neuritis after anthrax vaccination.

Kerrison JB, Lounsbury D, Thirkill CE, Lane RG, Schatz MP, Engler RM.

Department of Ophthalmology, Wilford Hall Medical Center, 2200 Bergquist Drive, Lackland AFB, Texas 78236, USA.

OBJECTIVE: To report the occurrence of optic neuritis after anthrax vaccination in two patients. DESIGN: Observational case reports, review of literature. METHODS: Description of clinical history, examination, neuroimaging, and further studies in two patients experiencing optic neuritis in temporal association with anthrax vaccination. MAIN OUTCOME MEASURES: Visual acuity, visual fields. RESULTS: Two patients, 39 and 23 years of age, were seen with acute optic neuritis 1 month and 2 weeks, respectively, after anthrax booster vaccination and successfully treated with intravenous methylprednisolone. The first patient had a typical presentation and course of unilateral retrobulbar optic neuritis with excellent visual recovery. The second patient had a bilateral anterior optic neuritis and has required chronic immunosuppression to maintain his vision. Retinal and optic nerve autoantibodies were present in the second patient. No cross-reactive epitopes between anthrax vaccine and retina/optic nerve were identified. CONCLUSION: Optic neuritis is a potential adverse reaction of anthrax vaccination.

Publication Types:

·         Review

·         Review of Reported Cases


PMID: 11772587 [PubMed - indexed for MEDLINE]

 

Biochem Biophys Res Commun 2001 Aug 10;286(1):6-11

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Rapid purification of recombinant anthrax-protective antigen under nondenaturing conditions.

Ahuja N, Kumar P, Bhatnagar R.

Centre for Biotechnology, Jawaharlal Nehru University, New Delhi-110067, India.

Anthrax-protective antigen is the central moiety of the anthrax toxin complex that mediates the entry of the other two toxin components, lethal factor and edema factor into the cells. It is also the main immunogen of the cell-free vaccine against anthrax. However, in addition to PA, the vaccine contains trace amounts of other culture-derived proteins that contribute to the side effects of the vaccine like pain, edema, erythrema, etc. Thus there is a need to develop high-resolution purification methods to purify PA to homogeneity. In this study we have presented a purification strategy for rapid purification of recombinant protective antigen under nondenaturing conditions, which ensures that not only biological activity but also the conformational integrity of immunological epitopes is well-preserved. The protein was purified to homogeneity in a two-step purification procedure that takes just 6 h for completion. Three milligrams of recombinant protective antigen obtained from 1-liter culture was comparable to B. anthracis protective antigen in terms of functional and biological activity. Moreover, the immunogenicity elicited by the purified protein in mice was also studied. The studies reported here are part of continuing research that aims to provide a safe and efficacious alternative to the current vaccine against anthrax. Copyright 2001 Academic Press.

PMID: 11485300 [PubMed - indexed for MEDLINE]

 

J Toxicol Clin Toxicol 2001;39(1):81-4

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Delayed life-threatening reaction to anthrax vaccine.

Swanson-Biearman B, Krenzelok EP.

Pittsburgh Poison Center, Children's Hospital of Pittsburgh, Pennsylvania 15213, USA.

BACKGROUND: Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Due to the current world threat of unpredictable biological terrorism, the Department of Defense has mandated the systematic vaccination of all US military personnel against this warfare agent. Many may experience al mild flu-like illness and soreness at the injection site, but systemic reactions are rare. CASE REPORT: We report a delayed and potentially serious life-threatening adverse reaction to anthrax vaccine. A previously healthy 34-year-old male was transported to the emergency department with dyspnea, diaphoresis, pallor, and urticarial wheals on his face, arms, and torso after the administration of the third dose of anthrax vaccine. All symptoms resolved after pharmacological intervention and the patient was discharged. Pharmaco-epidemiological data indicate that 30% of anthrax vaccine recipients experience mild local reactions. With large numbers of military personnel being vaccinated, emergency physicians may encounter more vaccine-related adverse reactions.

PMID: 11327232 [PubMed - indexed for MEDLINE]

 

: J R Army Med Corps 2000 Oct;146(3):191-5

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Adverse reactions to anthrax immunisation in a military field hospital.

Hayes SC, World MJ.

33 Field Hospital Fort Blockhouse, Gosport, Hants, PO12 2AB.

OBJECTIVE: To determine the outcome of anthrax immunisation. METHODS: Adverse reactions (occurrence, nature, severity and incapacity) and immune responses to a voluntary programme of anthrax immunisation at 0, 3, 6, and 24 weeks were monitored by questionnaire and voluntary blood sampling in 129 members, including 24 immunised 7 years previously (immunes), of a military field hospital alerted for possible deployment. RESULTS: Follow-up was complete in 85%. Ninety-eight (76%) received the first anthrax immunisation. Uptake was greater (p = 0.015) in immunes. Initial prevalence of adverse reaction was 63%. Subsequent uptake and adverse reaction dwindled significantly (p < 0.001). Only 28 (22%) were immunised at 24 weeks. Proportions reporting adverse reactions following the initial immunisation were greater in immunes (p = 0.046) and officers (p = 0.02). There was no significant (p = 0.36) correlation between uptake of immunisation and prevalence of adverse reaction. Antecedent adverse reaction did not reduce the proportion of participants accepting immunisation subsequently. The nature of adverse reactions (47% local, 24% systemic and 27% both) and severity were the same throughout. Forty-five percent of adverse reactions caused incapacity. Seventy-four percent of these had pain in the injected arm (+/- systemic symptoms) which prevented lifting or driving for 48 hours in 63%. Immune responses were greater in immunes. CONCLUSIONS: It was concluded that anthrax immunisation results in a higher than expected prevalence of adverse reaction with initial incapacity of military significance affecting 18%. Greater immune responses may increase adverse reaction but this does not affect acceptance of anthrax immunisation. Poor completion rates necessitate development of a new anthrax immunisation strategy.

PMID: 11143687 [PubMed - indexed for MEDLINE]

 

Vaccine 1998 May-Jun;16(9-10):880-4

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The effectiveness and safety of vaccines against human anthrax: a systematic review.

Demicheli V, Rivetti D, Deeks JJ, Jefferson T, Pratt M.

Agenzia Regionale per la Protezione Ambientale del Piemonte, Area di Epidemiologia Ambientale, Allesandria, Italy.

We report on the results of a systematic review of existing controlled clinical trials undertaken to assess the effectiveness and safety of vaccines against human anthrax in relation to disease incidence and side-effects. Two articles retrieved by electronic and hand search fulfilling some of the inclusion criteria underwent a quality assessment by a group of reviewers. Data synthesized from the two trials showed that estimates of overall effectiveness and safety favour treatment (overall odds ratio 0.16; 95% confidence interval 0.07-0.34). The route of inoculation appears to make little difference to the effectiveness of the vaccines; however, one study shows that the incidence and severity of side-effects are significantly higher with the killed vaccine than with the alum-based placebo (overall odds ratio 0.16; 95% confidence interval 2.38-27.17).

Publication Types:

·         Review

·         Review, Tutorial


PMID: 9682332 [PubMed - indexed for MEDLINE]

 

Med Trop (Mars) 1994;54(1):33-7

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Erratum in:

·         Med Trop (Mars) 1994;54(2):136


[Delayed hypersensitivity after anthrax vaccination. I--Study of guinea pigs vaccinated against anthrax]

[Article in French]

Shlyakhov E, Rubinstein E.

Unite des Maladies Infectieuses, Centre medical Sheba, Universite de Tel Aviv, Israel.

To evaluate delayed hypersensitivity after anthrax vaccination, an Anthraxin skin test was performed in 682 guinea pigs at various times after immunization with veterinary unencapsulated active anthrax vaccine. Results were compared with those obtained in unimmunized control guinea pigs (n = 216), in guinea pigs that received a non-immunizing dose of live vaccine (n = 183) and in guinea pigs inoculated with inactivated vaccine (n = 120). Anthraxin skin tests were positive in the first postvaccination days. The incidence and intensity of positive tests peaked between two weeks and one month after vaccination and then gradually decreased during the first year. Study of resistance of guinea pigs to an inoculum at a lethal dose of a virulent strain of Bacillus anthracis showed a close correlation between positive tests and resistance. These findings demonstrate development of cell-mediated immunity after anthrax vaccination. The Anthraxin skin test should have practical applications for the production of vaccines and for evaluation of the immune status of vaccinated livestock [corrected].

PMID: 8196523 [PubMed - indexed for MEDLINE]

 

Zh Mikrobiol Epidemiol Immunobiol 1978 Jun;(6):81-4

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[An index of blood neutrophil injury in man and animals immunized with live anthrax vaccine]

[Article in Russian]

Shentsev IV, Shumilov GP, Tarumov VS, Derbin MI.

The authors present the results of study of the blood neutrophil injury in guinea pigs, rabbits, monkeys, and also humans inoculated subcutaneously with live anthrax vaccine. Along with intradermal test with anthraxin, the mentioned test is suggested to assess the immunological status of persons immunized with anthrax vaccine.

PMID: 97884 [PubMed - indexed for MEDLINE]

 

Zh Mikrobiol Epidemiol Immunobiol 1975 Sep;0(9):97-9

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[Toxic properties of the exotoxin from anthrax vaccinal strain CTI-1 in an experiment on animals]

[Article in Russian]

Lesniak OT.

A study of sensitivity of various laboratory animals (guinea pigs, albino mice, Cricetus auratus W., albino rats and chick embryos) demonstrated that they all, excluding the latter, reacted by specific edema in response to the administration of the exotoxin produced by the vaccine strain CTI-1. A quantitative characteristics of the activity of the preparation for albino mice was presented and a method permitting to determine the activity of the anthrax exotoxin in intradermal test on guinea pigs with a greater precision than the accepted one was elaborated.

PMID: 812312 [PubMed - indexed for MEDLINE]