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Quantitative models of the dose-response and time course of inhalational anthrax in humans.

ABSTRACT: Anthrax poses a community health risk due to accidental or intentional aerosol release. Reliable quantitative dose-response analyses are required to estimate the magnitude and timeline of potential consequences and the effect of public health intervention strategies under specific scenarios. Analyses of available data from exposures and infections of humans and non-human primates are often contradictory. We review existing quantitative inhalational anthrax dose-response models in light of criteria we propose for a model to be useful and defensible. To satisfy these criteria, we extend an existing mechanistic competing-risks model to create a novel Exposure-Infection-Symptomatic illness-Death (EISD) model and use experimental non-human primate data and human epidemiological data to optimize parameter values. The best fit to these data leads to estimates of a dose leading to infection in 50% of susceptible humans (ID50) of 11,000 spores (95% confidence interval 7,200-17,000), ID10 of 1,700 (1,100-2,600), and ID1 of 160 (100-250). These estimates suggest that use of a threshold to human infection of 600 spores (as suggested in the literature) underestimates the infectivity of low doses, while an existing estimate of a 1% infection rate for a single spore overestimates low dose infectivity. We estimate the median time from exposure to onset of symptoms (incubation period) among untreated cases to be 9.9 days (7.7-13.1) for exposure to ID50, 11.8 days (9.5-15.0) for ID10, and 12.1 days (9.9-15.3) for ID1. Our model is the first to provide incubation period estimates that are independently consistent with data from the largest known human outbreak. This model refines previous estimates of the distribution of early onset cases after a release and provides support for the recommended 60-day course of prophylactic antibiotic treatment for individuals exposed to low doses.

SUBMITTER: Toth DJ

PROVIDER: S-EPMC3744436 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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Quantitative models of the dose-response and time course of inhalational anthrax in humans.

Toth Damon J A DJ Gundlapalli Adi V AV Schell Wiley A WA Bulmahn Kenneth K Walton Thomas E TE Woods Christopher W CW Coghill Catherine C Gallegos Frank F Samore Matthew H MH Adler Frederick R FR

PLoS pathogens 20130815 8

Anthrax poses a community health risk due to accidental or intentional aerosol release. Reliable quantitative dose-response analyses are required to estimate the magnitude and timeline of potential consequences and the effect of public health intervention strategies under specific scenarios. Analyses of available data from exposures and infections of humans and non-human primates are often contradictory. We review existing quantitative inhalational anthrax dose-response models in light of criter ...[more]

PMID: 24058320

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Project description:The number and type of synthetic chemicals that are being produced worldwide continues to increase significantly. While these industrial chemicals provide numerous benefits, there is no doubt that some have potential to damage the environment and health. Toxicity must be evaluated and use must be carefully controlled and monitored in order to minimize potential damage. DNA microarray technology has become an important new technique in toxicology. We are using the yeast Saccharomyces cerevisiae as a model organism for toxicological study because it is a simple, fast-growing eukaryote that has been thoroughly characterized. In order to evaluate toxicity by newly synthesized or mixture chemicals, toxicity-induced gene expression alteration profiles by known chemicals should be collected. In our study, cells need to be exposed with same experimental cellular condition, semi lethal (IC50), respectively. In the case of iodine (CAS; 7553-56-2), the IC50 was 1 mM by growth curve with continuously diluted exposure. // Effects of Iodine on Global Gene Expression in Saccharomyces cerevisiae : It is well documented that iodine kills microorganisms with broad spectrum. However, a systematic study of its mechanism of action has not yet been reported. Here we have demonstrated the action of iodine on gene expression level, using the yeast Saccharomyces cerevisiae with a DNA microarray. It was found that like antimicrobial activity, iodine causes an immediate and dose-dependent (0.5 mM, 0.75 mM and 1 mM) transcriptional alteration on yeast cells. The effects of iodine continued after the first immediate response. Genes for C-compound and carbohydrate metabolism, for energy, and for cell rescue were continuously up-regulated. On the other hand, genes related to protein fate were induced especially at 0.5 h. The gene expression profile at 0.5 h was significantly different from other longer iodine exposed condition. The main reaction at 0.5 h after iodine addition may be due to the oxidative toxicity, and the profile at 0.5 h was similar to agricultural bactericide. Keywords: stress response

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Quantitative models of the dose-response and time course of inhalational anthrax in humans.

Publications

Quantitative models of the dose-response and time course of inhalational anthrax in humans.

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