title: Lethal factor toxemia and anti-protective antigen antibody activity in naturally acquired cutaneous anthrax.
abstract: 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.
authors: Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. aboyer@cdc.gov
authors: Anne E
authors: AE
authors: Boyer
authors: Conrad P
authors: CP
authors: Quinn
authors: Cari A
authors: CA
authors: Beesley
authors: Maribel
authors: M
authors: Gallegos-Candela
authors: Chung K
authors: CK
authors: Marston
authors: Li X
authors: LX
authors: Cronin
authors: Renato C
authors: RC
authors: Lins
authors: Robyn A
authors: RA
authors: Stoddard
authors: Han
authors: H
authors: Li
authors: Jarad
authors: J
authors: Schiffer
authors: M Jahangir
authors: MJ
authors: Hossain
authors: Apurba
authors: A
authors: Chakraborty
authors: Mahmudur
authors: M
authors: Rahman
authors: Stephen P
authors: SP
authors: Luby
authors: Wun-Ju
authors: WJ
authors: Shieh
authors: Sherif
authors: S
authors: Zaki
authors: John R
authors: JR
authors: Barr
authors: Alex R
authors: AR
authors: Hoffmaster
mesh_terms: D000818:Animals; D000881:Anthrax / Q000453:epidemiology* / Q000276:immunology*; D000907:Antibodies, Bacterial / Q000097:blood; D057134:Antibodies, Neutralizing / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology*; D000992:Antitoxins / Q000097:blood*; D001427:Bacterial Toxins / Q000276:immunology*; D001459:Bangladesh / Q000453:epidemiology; D004196:Disease Outbreaks; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D017192:Skin Diseases, Bacterial
chemical_list: D000907:Antibodies, Bacterial; D057134:Antibodies, Neutralizing; D000942:Antigens, Bacterial; D000992:Antitoxins; D001427:Bacterial Toxins; D007074:Immunoglobulin G; C030325:anthrax toxin