Abstract
In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases to the Andhra Pradesh state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk factors, and make recommendations for preventing similar outbreaks in the future. Suspected cutaneous anthrax was defined as a painless skin lesion (papule, vesicle, or eschar) that appeared in a resident of Musalimadugu between July and August 2011. Clinical details and smears from skin lesions from suspected cases were collected to describe the outbreak by time, place and person. A retrospective cohort study among villagers aged ≥ 15 years was conducted to identify risk factors for acquiring the infection. Sixteen livestock in the village died between 24 June and 7 August 2011. Smears from five animals showed Gram-positive, spore bearing characteristics of Bacillus anthracis. Villagers butchered and skinned the dead animals, sold the skin, and consumed the meat after boiling it for two hours. The outbreak in humans started on 30 July, and nine suspected cases of cutaneous anthrax (attack rate: 2%, no deaths) occurred until 7 August. The attack rate was higher among those aged ≥15 years. All the smears were negative on Gram staining. Individuals, who had handled, skinned, and slaughtered dead livestock were at higher risk of infection. We recommend ciprofloxacin prophylaxis to close family contacts. Vaccination of the livestock in the area and community education on the dangers of handling and slaughtering dead/ill livestock are necessary.
Highlights
In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases to the Andhra Pradesh state surveillance unit
The outbreak was preceded by death of livestock in the area. We investigated this cluster with the objectives of (1) confirming the etiology, (2) estimating the magnitude, (3) treating patients, and (4) proposing recommendations to control the present outbreak and prevent future occurrences
We identified 9 suspected cases of cutaneous anthrax from a population of 377 persons
Summary
In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases to the Andhra Pradesh state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk factors, and make recommendations for preventing similar outbreaks in the future. Anthrax is a zoonotic disease that primarily affects herbivores It is caused by spore-forming, Grampositive bacteria called Bacillus anthracis. Herbivores acquire infection while grazing and may develop septicemia After their death, the vegetative form of the bacteria is present in the meat and body fluids and the spores may be present on the hides. Heating at 100°C for 10 to 60 minutes kills spores and the vegetative form [1,2]
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