Abstract
BackgroundOn 18 January 2018 a 40 year old man presented with skin lesions at Rhino Camp Health Centre. A skin lesion swab was collected on 20 January 2018 and was confirmed by PCR at Uganda Virus Research Institute on 21 January 2018. Subsequently, about 9 persons were reported to have fallen ill after reporting contact with livestock that died suddenly. On 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. We investigated to determine the scope and mode of transmission and exposures associated with identified anthrax to guide control and prevention measures.MethodsWe defined a suspected cutaneous anthrax case as onset of skin lesions (e.g., papule, vesicle, or eschar) in a person residing in Rhino Camp sub-county, Arua District from 25 December 2017 to 31 May 2018. A confirmed case was a suspected case with PCR-positivity for Bacillus anthracis from a clinical sample. We identified cases by reviewing medical records at Rhino Camp Health Centre. We also conducted additional case searches in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all members of households in which at least one person had contact with the carcasses of or meat from animals suspected to have died of anthrax. We collected and tested hides of implicated animals using an anthrax rapid diagnostic test.ResultsWe identified 14 case-patients (1 confirmed, 13 suspected); none died. Only males were affected (affected proportion: 12/10,000). Mean age of case-persons was 33 years (SD: 22). The outbreak lasted for 5 months, from January 2018–May 2018, peaking in February. Skinning (risk ratio = 2.7, 95% CI = 1.1–6.7), dissecting (RR = 3.0, 95% CI = 1.2–7.6), and carrying dead animals (RR = 2.7, 95% CI = 1.1–6.7) were associated with increased risk of illness, as were carrying dissected parts of animals (RR = 2.9, 95% CI 1.3–6.5) and preparing and cooking the meat (RR = 2.3, 95% CI 0.9–5.9). We found evidence of animal remains on pastureland.ConclusionMultiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of livestock that die suddenly.
Highlights
Multiple exposures to the hides and meat of animals that died suddenly were associated with this cutaneous anthrax outbreak in Arua District
Anthrax is an acute infection caused by Bacillus anthracis (B. anthracis), an aerobic, spore-forming Gram-positive bacteria that can infect both humans and animals [1]
A skin lesion swab was collected on January 2018 and was confirmed by Polymerase Chain Reaction (PCR) at Uganda Virus Research Institute on January 2018
Summary
Anthrax is an acute infection caused by Bacillus anthracis (B. anthracis), an aerobic, spore-forming Gram-positive bacteria that can infect both humans and animals [1]. Animals become infected following ingestion of B. anthracis spores while grazing in contaminated areas or by eating contaminated feeds. Human cases occur when people are exposed to infected animals. There are three main forms of human anthrax infection, depending on the route of exposure: cutaneous, gastrointestinal, and pulmonary (inhalational) anthrax [3]. Between one and 12 days after exposure, clinical signs of cutaneous anthrax infection appear as one or more painless, itchy papules or vesicles on the skin, typically on exposed areas such as the face, neck, forearms, or hands. On 18 January 2018 a 40 year old man presented with skin lesions at Rhino Camp Health Centre. On 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak among humans in Rhino Camp sub-county. We investigated to determine the scope and mode of transmission and exposures associated with identified anthrax to guide control and prevention measures
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
