{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:44:33Z","timestamp":1792827873050,"version":"4.5.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Anthrax is a toxin-mediated zoonotic disease caused by Bacillus anthracis, with a worldwide distribution recognized for millennia. Bacillus anthracis is considered a potential biowarfare agent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We completed a systematic review for clinical and demographic characteristics of adults and children hospitalized with anthrax (cutaneous, inhalation, ingestion, injection [from contaminated heroin], primary meningitis) abstracted from published case reports, case series, and line lists in English from 1880 through 2018, assessing treatment impact by type and severity of disease. We analyzed geographic distribution, route of infection, exposure to anthrax, and incubation period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data on 764 adults and 167 children were reviewed. Most cases reported for 1880 through 1915 were from Europe; those for 1916 through 1950 were from North America; and from 1951 on, cases were from Asia. Cutaneous was the most common form of anthrax for all populations. Since 1960, adult anthrax mortality has ranged from 31% for cutaneous to 90% for primary meningitis. Median incubation periods ranged from 1 day (interquartile range [IQR], 0\u20134) for injection to 7 days (IQR, 4\u20139) for inhalation anthrax. Most patients with inhalation anthrax developed pleural effusions and more than half with ingestion anthrax developed ascites. Treatment and critical care advances have improved survival for those with systemic symptoms, from approximately 30% in those untreated to approximately 70% in those receiving antimicrobials or antiserum\/antitoxin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This review provides an improved evidence base for both clinical care of individual anthrax patients and public health planning for wide-area aerosol releases of B. anthracis spores.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac534","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T18:48:21Z","timestamp":1666032501000},"page":"S341-S353","source":"Crossref","is-referenced-by-count":35,"title":["Clinical Features of Patients Hospitalized for All Routes of Anthrax, 1880\u20132018: A Systematic Review"],"prefix":"10.1093","volume":"75","author":[{"given":"Katherine","family":"Hendricks","sequence":"first","affiliation":[{"name":"Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa K","family":"Person","sequence":"additional","affiliation":[{"name":"Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S","family":"Bradley","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Rady Children\u2019s Hospital San Diego and the University of California San Diego School of Medicine , San Diego, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thitipong","family":"Mongkolrattanothai","sequence":"additional","affiliation":[{"name":"Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"},{"name":"Oak Ridge Institute for Science and Education, CDC Fellowship Program , Oak Ridge, Tennessee , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Hupert","sequence":"additional","affiliation":[{"name":"Departments of Population Health Sciences and of Medicine, Weill Cornell Medicine, Cornell University, and New York-Presbyterian Hospital , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Eichacker","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Clinical Center, National Institutes of Health , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur M","family":"Friedlander","sequence":"additional","affiliation":[{"name":"US Army Medical Research Institute of Infectious Diseases , Frederick, Maryland , USA"},{"name":"Department of Medicine, Uniformed Services University of Health Sciences , Bethesda, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6538-8665","authenticated-orcid":false,"given":"William A","family":"Bower","sequence":"additional","affiliation":[{"name":"Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"2022113009301991900_ciac534-B1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.7326\/0003-4819-144-4-200602210-00009","article-title":"Systematic review: a century of inhalational anthrax cases from 1900 to 2005","volume":"144","author":"Holty","year":"2006","journal-title":"Ann Intern 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