Notes From the Field: Fatal Anthrax Pneumonia in Welders and Other Metalworkers Caused by Bacillus Cereus Group Bacteria Containing Anthrax Toxin Genes — U.S. Gulf Coast States, 1994–2020

Details

• Journal Article:
  Morbidity and Mortality Weekly Report
• Personal Author:
  Antonini, James M. ; Balsamo, Gary A. ; Bower, William A. ; Byers, Paul ; Dawson, Patrick ; de Perio, Marie A. ; Feldmann, Karl D. ; Gee, Jay E. ; Gulvik, Christopher A. ; Hendricks, Katherine ; Hoffmaster, Alex R. ; Kolton, Cari B. ; Long, Stephen ; Marston, Chung K. ; McQuiston, John R. ; Negrón, María E. ; O’Sullivan, Briana ; Salzer, Johanna S. ; Schrodt, Caroline A. ; Sokol, Theresa ; Taylor, Kathryn ; Traxler, Rita M. ; Weiner, Zachary ; Zaheer, Saad
• Description:
  In 2020, CDC confirmed two cases of pneumonia (one fatal) in welders caused by rare Bacillus cereus group bacteria containing anthrax toxin genes typically associated with Bacillus anthracis. B. cereus group bacteria are gram-positive facultative anaerobes, often toxin-producing, that are ubiquitous in the environment and reside naturally in soil and dust. B. cereus can also be found in food, and although infection typically causes illnesses characterized by diarrhea or vomiting, B. cereus can have other clinical manifestations (e.g., pulmonary, ocular, or cutaneous). Among seven persons in the United States reported to be infected with B. cereus group bacteria containing anthrax toxin genes resulting in pneumonia since 1994, five patients died and two had critical illness with prolonged hospitalization and recovery. All persons with pneumonia were welders or other metalworkers who had worked in Louisiana or Texas. In addition to the seven pneumonia cases, a cutaneous infection with B. cereus group bacteria containing anthrax toxin genes has been reported in a patient with an anthrax eschar in Florida. ... Clinicians should consider B. cereus group bacteria in the differential diagnosis when treating welders and other metalworkers with severe, rapidly progressive pneumonia or other anthrax-like disease. B. cereus group bacteria identified on culture are not always contaminants; when B. cereus with anthrax toxin is suspected, laboratorians and clinicians should pursue additional testing through their state Laboratory Response Network laboratory. Regional health departments and the Laboratory Response Network serve pivotal roles in pathogen detection and procuring anthrax antitoxin for confirmed cases. [Description provided by NIOSH]
• Subjects:
  Anthrax Antigens, Bacterial Bacillus Cereus Bacterial Toxins Genetics Metal Workers Occupational Diseases Occupational Exposure Occupational Health Pneumonia, Bacterial Respiratory Tract Diseases Safety Welding

  More +
• Keywords:
  Anaerobic bacteria; Bacterial infections; Anthrax; Genes; Pneumonia; Analytical processes; Welders; Metal workers; Metalworking; Case reports
• Source:
  MMWR 2021 Oct; 70(41):1453-1454
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  http://dx.doi.org/10.15585/MMWRmm7041a4
• ISSN:
  0149-2195
• Pubmed ID:
  34648482
• Pubmed Central ID:
  PMC8631286
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; Louisiana ; Mississippi ; Ohio ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 6 ; Texas ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; HELD - Health Effects Laboratory Division ; OD - Office of the Director
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  2 pdf pages
• Volume:
  70
• Issue:
  41
• NIOSHTIC Number:
  nn:20063732
• Contact Point Address:
  William A. Bower, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA
• Email:
  wab4@cdc.gov
• Federal Fiscal Year:
  2022
• NORA Priority Area:
  Manufacturing ; Services
• Peer Reviewed:
  False
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR) National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:79670e0a83610db89e4599f46d32da105f590d20bf4b56780f4387b94127ab609fdb6b3e7e9688aa07f69814f9b7bde37acaab24bfe273008605b8647d74a746
• Download URL:
  https://stacks.cdc.gov/view/cdc/112520/cdc_112520_DS1.pdf
• File Type:
  [PDF - 85.75 KB ]