Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States.
Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States.
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DOI：
10.3201/eid0706.010604
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发表时间：
2001-11
影响因子：
11.8
通讯作者：
Anthrax Bioterrorism Investigation Team
中科院分区：
文献类型：
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作者：
Jernigan JA;Stephens DS;Ashford DA;Omenaca C;Topiel MS;Galbraith M;Tapper M;Fisk TL;Zaki S;Popovic T;Meyer RF;Quinn CP;Harper SA;Fridkin SK;Sejvar JJ;Shepard CW;McConnell M;Guarner J;Shieh WJ;Malecki JM;Gerberding JL;Hughes JM;Perkins BA;Anthrax Bioterrorism Investigation Team
2001年10月4日至11月2日，美国首次发现了10例由故意释放炭疽杆菌引起的吸入性炭疽确诊病例。流行病学调查显示，在哥伦比亚特区、佛罗里达、新泽西和纽约爆发的疫情，是由故意通过邮寄信件或包裹传递炭疽芽孢杆菌引起的。我们描述的临床表现和过程这些病例的生物恐怖主义相关的吸入性炭疽。患者的中位年龄为56岁（范围43至73岁），70%为男性，除一人外，所有患者均已知或相信曾处理、处理或收到含有炭疽芽孢杆菌孢子的信件。已知时（n=6），从接触时间到出现症状的中位潜伏期为4天（范围4至6天）。最初出现的症状包括发热或发冷（n=10）、出汗（n=7）、疲劳或不适（n=10）、轻微或无效果的咳嗽（n=9）、呼吸困难（n=8）和恶心或呕吐（n=9）。白细胞计数中位数为9.8 × 10(3)/mm(3)（范围7.5 ~ 13.3），常伴有中性粒细胞增多和带状。9例患者血清转氨酶升高，6例患者缺氧。10例患者均有胸部x线异常；异常包括浸润（n=7）、胸腔积液（n=8）和纵隔增宽（7例）。对8例患者进行了胸部计算机断层扫描，其中7例出现纵隔淋巴结病变。采用多药抗生素方案和支持性护理，患者的生存率（60%）明显高于先前报道（<15%）。
From October 4 to November 2, 2001, the first 10 confirmed cases of inhalational anthrax caused by intentional release of Bacillus anthracis were identified in the United States. Epidemiologic investigation indicated that the outbreak, in the District of Columbia, Florida, New Jersey, and New York, resulted from intentional delivery of B. anthracis spores through mailed letters or packages. We describe the clinical presentation and course of these cases of bioterrorism-related inhalational anthrax. The median age of patients was 56 years (range 43 to 73 years), 70% were male, and except for one, all were known or believed to have processed, handled, or received letters containing B. anthracis spores. The median incubation period from the time of exposure to onset of symptoms, when known (n=6), was 4 days (range 4 to 6 days). Symptoms at initial presentation included fever or chills (n=10), sweats (n=7), fatigue or malaise (n=10), minimal or nonproductive cough (n=9), dyspnea (n=8), and nausea or vomiting (n=9). The median white blood cell count was 9.8 X 10(3)/mm(3) (range 7.5 to 13.3), often with increased neutrophils and band forms. Nine patients had elevated serum transaminase levels, and six were hypoxic. All 10 patients had abnormal chest X-rays; abnormalities included infiltrates (n=7), pleural effusion (n=8), and mediastinal widening (seven patients). Computed tomography of the chest was performed on eight patients, and mediastinal lymphadenopathy was present in seven. With multidrug antibiotic regimens and supportive care, survival of patients (60%) was markedly higher (<15%) than previously reported.
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影响因子：
--
作者：
BRACHMAN, PS;PLOTKIN, SA;ATCHISON, MM
通讯作者：
ATCHISON, MM
影响因子：
158.5
作者：
BRACHMAN, PS;ALBRINK, WS;PAGANO, JS
通讯作者：
PAGANO, JS
DOI：
10.1080/00039896.1969.10665490
发表时间：
1969-01-01
期刊：
ARCHIVES OF ENVIRONMENTAL HEALTH
影响因子：
--
作者：
LAFORCE, FM;BUMFORD, FH;SNOW, DB
通讯作者：
SNOW, DB
影响因子：
56.9
作者：
MESELSON, M;GUILLEMIN, J;YAMPOLSKAYA, O
通讯作者：
YAMPOLSKAYA, O
影响因子：
--
作者：
GOLD, H
通讯作者：
GOLD, H