Evidence map›Paper›PMID 24058320›Full record

ArticlePLoS pathogens2013

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

Damon J A Toth, Adi V Gundlapalli, Wiley A Schell, Kenneth Bulmahn, Thomas E Walton, Christopher W Woods, Catherine Coghill, Frank Gallegos, Matthew H Samore, Frederick R Adler

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLoS pathogens, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.

  1. Clinical Features of Patients Hospitalized for All Routes of Anthrax, 1880-2018: A Systematic Review.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Physiological Responses to a Single Low-Dose ofPathogens (Basel, Switzerland) · 2020
    Article
  8. Dose-response and transmission: the nexus between reservoir hosts, environment and recipient hosts.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2019
    Review
  9. Breaking beta: deconstructing the parasite transmission function.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2017
    Article
  10. Modeling Rabbit Responses to Single and Multiple Aerosol Exposures of Bacillus anthracis Spores.Risk analysis : an official publication of the Society for Risk Analysis · 2017
    Article
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  13. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Damon J A TothDepartment of Internal Medicine, University of Utah, Salt Lake City, Utah, USA. Damon.Toth@hsc.utah.edu
Adi V Gundlapalli
Wiley A Schell
Kenneth Bulmahn
Thomas E Walton
Christopher W Woods
Catherine Coghill
Frank Gallegos
Matthew H Samore
Frederick R Adler
Independent Sector · USDuke University · USUniversity of Utah · USVA Salt Lake City Healthcare System · USUnited States Department of Agriculture · US

Funding

PHS HHS 1 U54 A1065357
6 · The paper itself

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.

Indexed as

Administration, InhalationModels, BiologicalModels, StatisticalAnthraxAnti-Bacterial AgentsBacillus anthracisHumansTime FactorsUnited StatesAnti-Bacterial Agents

Identifiers

PMID24058320
PMCPMC3744436
OpenAlexW2118379118

What OpenQuestion holds

Textmetadata
LicenceCC0
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.