{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:08:04Z","timestamp":1776920884157,"version":"3.51.2"},"reference-count":32,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>In this report, three cases of human cutaneous anthrax are described, one complicated by meningitis, and all were linked to a single infected bullock. A 41-year-old male truck driver, along with two male slaughterhouse workers, 45 and 42, were hospitalized for necrotic lesions of the arm associated with edema of the limb and high fever. All three patients were involved in transporting a bullock to the slaughterhouse. Microbiological examination on the prescapular lymph node and a piece of muscle from the bullock carcass showed the presence of Bacillus anthracis. The three patients underwent a biopsy of the affected tissues, and all samples tested positive for B. anthracis DNA using PCR. Furthermore, the truck driver also complained of an intense headache, and a CSF sampling was performed, showing him positive for B. anthracis by PCR, confirming the presumptive diagnosis of meningitis. Fast diagnosis and appropriate treatment are crucial for the management of human anthrax. Cooperation between human and veterinary medicine proved successful in diagnosing and resolving three human anthrax cases, confirming the reliability of the One Health approach for the surveillance of zoonoses.<\/jats:p>","DOI":"10.3390\/life12060909","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T05:25:11Z","timestamp":1655443511000},"page":"909","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["An Outbreak of Human Systemic Anthrax, including One Case of Anthrax Meningitis, Occurred in Calabria Region (Italy): A Description of a Successful One Health Approach"],"prefix":"10.3390","volume":"12","author":[{"given":"Maurizio","family":"Guastalegname","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Jazzolino Hospital, 89900 Vibo Valentia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Rondinone","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lucifora","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale del Mezzogiorno, 80055 Portici, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Vallone","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Jazzolino Hospital, 89900 Vibo Valentia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"D\u2019Argenio","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Jazzolino Hospital, 89900 Vibo Valentia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Petracca","sequence":"additional","affiliation":[{"name":"Surgery Unit, Jazzolino Hospital, 89900 Vibo Valentia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Prevention, Azienda Sanitaria Provinciale Vibo Valentia, 89900 Vibo Valentia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigina","family":"Serrecchia","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8342-5375","authenticated-orcid":false,"given":"Viviana","family":"Manzulli","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0742-5119","authenticated-orcid":false,"given":"Lorenzo","family":"Pace","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Fasanella","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-9809","authenticated-orcid":false,"given":"Domenico","family":"Simone","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora","family":"Cipolletta","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1159-2801","authenticated-orcid":false,"given":"Domenico","family":"Galante","sequence":"additional","affiliation":[{"name":"Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"20877","DOI":"10.2807\/1560-7917.ES2014.19.32.20877","article-title":"Injectional anthrax\u2014New presentation of an old disease","volume":"19","author":"Berger","year":"2014","journal-title":"Eurosurveillance"},{"key":"ref_2","unstructured":"Gupta, R.C. (2015). Handbook of Toxicology of Chemical Warfare Agents, Academic Press. [2nd ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1089\/vbz.2013.1302","article-title":"Suspect Vector Transmission of Human Cutaneous Anthrax During an Animal Outbreak in Southern Italy","volume":"13","author":"Fasanella","year":"2013","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1800685","DOI":"10.2807\/1560-7917.ES.2019.24.24.1800685","article-title":"Unexpected human cases of cutaneous anthrax in Latium region, Italy, August 2017: Integrated human-animal investigation of epidemiological, clinical, microbiological, and ecological factors","volume":"24","author":"Nicastri","year":"2019","journal-title":"Eurosurveillance"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1093\/cid\/ciw184","article-title":"Identifying Meningitis During an Anthrax Mass Casualty Incident: Systematic Review of Systemic Anthrax Since 1880","volume":"62","author":"Holty","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1046\/j.1469-0691.2002.00500.x","article-title":"Anthrax in Europe: Its epidemiology, clinical characteristics, and role in bioterrorism","volume":"8","author":"Schmid","year":"2002","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_7","first-page":"83","article-title":"Severe anthrax outbreaks in Italy in 2004: Considerations on factors involved in the spread of infection","volume":"33","author":"Fasanella","year":"2010","journal-title":"New Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S166","DOI":"10.1089\/bsp.2013.0003","article-title":"Genetic diversity of Bacillus anthracis in Europe: Genotyping methods in forensic and epidemiologic investigations","volume":"11","author":"Derzelle","year":"2013","journal-title":"Biosecur Bioterror."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Rondinone, V., Serrecchia, L., Parisi, A., Fasanella, A., Manzulli, V., Cipolletta, D., and Galante, D. (2020). Genetic characterization of Bacillus anthracis strains circulating in Italy from 1972 to 2018. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227875"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"9269","DOI":"10.1038\/s41598-018-27604-w","article-title":"Climatic influence on anthrax suitability in warming northern latitudes","volume":"8","author":"Walsh","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/S0140-6736(96)90901-0","article-title":"Fulminant meningitis due to Bacillus anthracis in 11-year-old girl during Ramadan","volume":"347","author":"Berthier","year":"1996","journal-title":"Lancet"},{"key":"ref_12","first-page":"51","article-title":"A cluster of anthrax cases including meningitis","volume":"36","author":"Leblebicioglu","year":"2006","journal-title":"Trop. Dr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"19076","DOI":"10.2807\/ese.13.51.19076-en","article-title":"Investigations and control measures following a case of inhalation anthrax in East London in a drum maker and drummer, October 2008","volume":"13","author":"Anaraki","year":"2008","journal-title":"Eurosurveillance"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1097\/MD.0b013e3181c202fa","article-title":"Three related cases of cutaneous anthrax in France: Clinical and laboratory as-pects","volume":"88","author":"Cinquetti","year":"2009","journal-title":"Medicine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"20008","DOI":"10.2807\/ese.16.45.20008-en","article-title":"Two cases of infection with Bacillus anthracis, Romania, October 2011","volume":"16","author":"Popescu","year":"2011","journal-title":"Eurosurveillance"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"20245","DOI":"10.2807\/ese.17.32.20245-en","article-title":"Cutaneous infection caused by Bacillus anthracis in Larissa, Thessaly, Central Greece, July 2012","volume":"17","author":"Stefos","year":"2012","journal-title":"Eurosurveillance"},{"key":"ref_17","first-page":"20050","article-title":"Three probable cases of cutaneous anthrax in autonomous province of Vojvodina, Serbia, June 2011","volume":"17","author":"Petrovic","year":"2012","journal-title":"Eurosurveillance"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S137","DOI":"10.1016\/j.ijfoodmicro.2010.07.039","article-title":"A multiplex real-time PCR for identifying and differentiating B. anthracis virulent types","volume":"145","author":"Wielinga","year":"2011","journal-title":"Int. J. Food Microbiol."},{"key":"ref_19","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2016). Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria, CLSI. [3rd ed.]. CLSI Guideline M45."},{"key":"ref_20","unstructured":"Clinical and Laboratory Standards Institute (CLSI) (2017). Performance Standards for Antimicrobial Susceptibility Testing, CLSI. [27th ed.]. CLSI Supplement M100."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Marston, C.K., Allen, C.A., Beaudry, J., Price, E.P., Wolken, S.R., Pearson, T., Keim, P., and Hoffmaster, A.R. (2011). Molecular Epidemiology of Anthrax Cases Associated with Recreational Use of Animal Hides and Yarn in the United States. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0028274"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"669","DOI":"10.4236\/abb.2014.57079","article-title":"Application of High-Throughput Sequencing: Discovery of Informative SNPs to Subtype Bacillus anthracis","volume":"5","author":"Girault","year":"2014","journal-title":"Adv. Biosci. Biotechnol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e0288920","DOI":"10.1128\/JCM.02889-20","article-title":"A Whole-Genome-Based Gene-by-Gene Typing System for Standardized High-Resolution Strain Typing of Bacillus anthracis","volume":"59","author":"Chiaverini","year":"2021","journal-title":"J. Clin. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1002\/cpbi.102","article-title":"Using SPAdes De Novo Assembler","volume":"70","author":"Prjibelski","year":"2020","journal-title":"Curr Protoc Bioinformatics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1093\/bioinformatics\/btu153","article-title":"Prokka: Rapid prokaryotic genome annotation","volume":"15","author":"Seemann","year":"2014","journal-title":"Bioinformatics"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3691","DOI":"10.1093\/bioinformatics\/btv421","article-title":"Roary: Rapid large-scale prokaryote pan genome analysis","volume":"15","author":"Page","year":"2015","journal-title":"Bioinformatics"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Price, M.N., Dehal, P.S., and Arkin, A.P. (2010). FastTree 2-approximately maximum-likelihood trees for large alignments. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0009490"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"W293","DOI":"10.1093\/nar\/gkab301","article-title":"Interactive Tree Of Life (iTOL) v5: An online tool for phylogenetic tree display and annotation","volume":"49","author":"Letunic","year":"2021","journal-title":"Nucleic Acids Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.mib.2003.12.001","article-title":"The roles of anthrax toxin in pathogenesis","volume":"7","author":"Moayeri","year":"2004","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1212\/WNL.59.3.327","article-title":"Anthrax meningoencephalitis","volume":"59","author":"Lanska","year":"2002","journal-title":"Neurology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ijid.2021.05.013","article-title":"Anthrax meningoencephalitis complicated with brain abscess\u2014A case report","volume":"108","author":"Popescu","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gainer, R.S., Vergnaud, G., and Hugh-Jones, M.E. (2020). Review of Arguments for the Existence of Latent Infections of Bacillus anthracis, and Research Needed to Understand their Role in the Outbreaks of Anthrax. Microorganisms, 8.","DOI":"10.3390\/microorganisms8060800"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/6\/909\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:33:46Z","timestamp":1760139226000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/6\/909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,17]]},"references-count":32,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["life12060909"],"URL":"https:\/\/doi.org\/10.3390\/life12060909","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,17]]}}}