Abstract
The zoonotic disease anthrax is endemic to most continents. It is a disease of herbivores that incidentally infects humans through contact with animals that are ill or have died from anthrax or through contact with Bacillus anthracis–contaminated byproducts. In the United States, human risk is primarily associated with handling carcasses of hoofstock that have died of anthrax; the primary risk for herbivores is ingestion of B. anthracis spores, which can persist in suitable alkaline soils in a corridor from Texas through Montana. The last known naturally occurring human case of cutaneous anthrax associated with livestock exposure in the United States was reported from South Dakota in 2002. Texas experienced an increase of animal cases in 2019 and consequently higher than usual human risk. We describe the animal outbreak that occurred in southwest Texas beginning in June 2019 and an associated human case. Primary prevention in humans is achieved through control of animal anthrax.
Highlights
The zoonotic disease anthrax is endemic to most continents
During 2000–2018, a total of 63 animal anthrax cases were confirmed by culture of B. anthracis in a reference laboratory
Public Health Implications and Conclusion Anthrax is endemic to parts of the United States
Summary
Control Measures for Animal Outbreaks Because naturally occurring human anthrax cases in endemic countries are almost always related to exposure to infected animals or their byproducts, control of animal anthrax essentially eliminates human risk. The least desirable disposal method is leaving the carcass in place, because scavenging can further disseminate the spores and increase future exposure risks for susceptible animals. Alternative carcass disposal methods are needed in areas where the standard recommendations to burn or bury carcasses are impractical This need is pronounced where there is an abundance of susceptible wildlife species that are not vaccinated or where there is poor vaccination coverage of domestic hoofstock. Proper and safe carcass disposal is critical for controlling anthrax outbreaks in enzootic areas because inappropriate carcass disposal seeds the soil with spores and increases the risk for future epizootics. Aerosol exposure is unlikely in cases of natural cutaneous exposures, if potential aerosol exposure occurred, antibiotic PEP should be administered for up to 60 days and anthrax vaccine may be considered. Health departments in endemic areas that have existing vaccination programs can acquire AVA from the manufacturer
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