{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:42:45Z","timestamp":1755225765825,"version":"3.43.0"},"reference-count":8,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2000,10]]},"abstract":"\n Objective<\/jats:title>\n To determine the outcome of anthrax immunisation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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 (\u00b1 systemic symptoms) which prevented lifting or driving for 48 hours in 63%. Immune responses were greater in immunes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/jramc-146-03-07","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T19:44:55Z","timestamp":1363722295000},"page":"191-195","source":"Crossref","is-referenced-by-count":13,"title":["Adverse Reactions to Anthrax Immunisation in a Military Field Hospital"],"prefix":"10.1136","volume":"146","author":[{"given":"SC","family":"Hayes","sequence":"first","affiliation":[{"name":"33 Field Hospital Fort Blockhouse, Gosport, Hants, PO12 2AB"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MJ","family":"World","sequence":"additional","affiliation":[{"name":"Royal Defence Medical College, Fort Blockhouse, Gosport, Hants, PO12 2AB 106201.1307@compuserve.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2000,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1001\/archinte.158.5.429","article-title":"Anthrax as a potential biological warfare agent","volume":"158","author":"Pile, J.C.; Malone, J.D.; Eitzen, E.M.; Friedlander, A.M.","year":"1998","unstructured":"Pile JC, Malone JD, Eitzen EM, Friedlander AM. Anthrax as a potential biological warfare agent. Arch Int Med 1998; 158: 429-434","journal-title":"Arch Int Med"},{"key":"ref_2","first-page":"28","article-title":"Anthrax pneumonia","volume":"12","author":"Penn CC, Klotz SA","year":"1997","unstructured":"Penn CC, Klotz SA. Anthrax pneumonia. Semin Respir Infect 1997; 12: 28-30","journal-title":"Semin Respir Infect"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1093\/infdis\/167.5.1239","article-title":"Postexposure prophylaxis against experimental inhalation anthrax","volume":"167","author":"Freidlander, A.M.; Welkos, S.L.; Pitt, M.L.M.; Ezzell, J.W.; Worsham, P.L.; Rose, K.J.","year":"1993","unstructured":"Freidlander AM, Welkos SL, Pitt MLM, Ezzell JW, Worsham PL, Rose KJ et al. Postexposure prophylaxis against experimental inhalation anthrax. J Infect Dis 1993; 167: 1239-1242","journal-title":"J Infect Dis"},{"issue":"56-60","key":"ref_4","first-page":"5","article-title":"Production and purification of recombinant protective antigen and protective efficacy against Bacillus anthracis","volume":"26","author":"Miller, J.; McBride, B.W.; Manchee, R.J.; Moore, P.; Baillie, L.W.J.","year":"1998","unstructured":"Miller J, McBride BW, Manchee RJ, Moore P, Baillie LWJ. Production and purification of recombinant protective antigen and protective efficacy against Bacillus anthracis. Lett Appl Microbiol 1998; 26: 56-60 5. Brachman PS, Gold H, Plotkin S, Fekety FR, Werrin M, Ingraham NR Field evaluation of a human anthrax vaccine. Am J Public Health 1962; 52: 632-645 6.","journal-title":"Lett Appl Microbiol; Ingraham NR Field evaluation of a human anthrax vaccine"},{"issue":"478","key":"ref_5","first-page":"7","article-title":"The use of anthrax antigen to immunise man and monkey","volume":"476","author":"Darlow, H.M.; Belton, F.C.; Henderson, D.W.","year":"1956","unstructured":"Darlow HM, Belton FC, Henderson DW. The use of anthrax antigen to immunise man and monkey. Lancet 1956; II: 476-478 7.","journal-title":"Lancet"},{"issue":"169178 8","key":"ref_6","article-title":"Health of UK servicemen who served in Persian Gulf War","volume":"353","author":"Unwin, C.; Blatchley, N.; Coker, W.; Ferry, S.; Hotopf, M.; Hull, L.","year":"1999","unstructured":"Unwin C, Blatchley N, Coker W, Ferry S, Hotopf M, Hull L et al. Health of UK servicemen who served in Persian Gulf War. Lancet 1999; 353: 169178 8.","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1001\/jama.280.11.981","article-title":"Chronic multisymptom illness affecting air force veterans of the gulf war","volume":"280","author":"Fukuda, K.; Nisenbaum, R.; Stewart, G.; Thompson, W.W.; Robin, L.; Washko, R.M.","year":"1998","unstructured":"Fukuda K, Nisenbaum R, Stewart G, Thompson WW, Robin L, Washko RM et al. Chronic multisymptom illness affecting air force veterans of the gulf war. JAMA 1998; 280: 981-988 9.","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0140-6736(98)11339-9","article-title":"Is there a Gulf War syndrome?","volume":"353","author":"Ismail, K.; Everitt, B.; Blatchley, N.; Hull, L.; Unwin, C.; David, A.","year":"1999","unstructured":"Ismail K, Everitt B, Blatchley N, Hull L, Unwin C, David A et al. Is there a Gulf War syndrome? Lancet 1999; 353: 179-182","journal-title":"Lancet"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-146-03-07","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:41:32Z","timestamp":1755106892000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-146-03-07"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,10]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2000,10,1]]},"published-print":{"date-parts":[[2000,10]]}},"alternative-id":["10.1136\/jramc-146-03-07"],"URL":"https:\/\/doi.org\/10.1136\/jramc-146-03-07","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"type":"print","value":"0035-8665"},{"type":"electronic","value":"2052-0468"}],"subject":[],"published":{"date-parts":[[2000,10]]}}}