Outbreak Of Cutaneous Anthrax Research Articles

Investigation on an outbreak of cutaneous anthrax in a county of Shandong Province, China, 2021

BackgroundIn order to verify the existence of an anthrax outbreak, determine its scope, grasp the epidemiological characteristics and find out the cause of the outbreak and recommend preventive and control measures.MethodsEtiological hypothesis was developed through descriptive epidemiological methods. Hypotheses were tested by analyzing epidemiological methods by comparing the differences in the incidence of different exposure types. Nucleic acid detection and bacterial isolation and culture in the BSL-2 laboratories. SPSS 21 was used to conduct statistical analysis.ResultsA total of 126 family, workshop, shop environment samples and meat samples were collected, and 6 samples were collected from skin lesions of suspected cutaneous anthrax cases. 41 samples were positive by rPCR and 8 strains of Bacillus anthracis were cultivated. Participated in slaughtering, cutting beef of sick cattles was significantly associated with cutaneous anthrax (RR 3.75, 95% CI 1.08–13.07), this behavior is extremely dangerous.ConclusionsComprehensive analysis of laboratory results and epidemiological survey results and environmental assessments, we judge this epidemic to be an outbreak of cutaneous anthrax, associated with slaughtering and other processes from infected cattle imported from other province.

Outbreak of cutaneous anthrax associated with handling meat of dead cows in Southwestern Uganda, May 2018

BackgroundAnthrax is a zoonotic infection caused by the bacteria Bacillus anthracis. Humans acquire cutaneous infection through contact with infected animals or animal products. On May 6, 2018, three cows suddenly died on a farm in Kiruhura District. Shortly afterwards, a sub-county chief in Kiruhura District received reports of humans with suspected cutaneous anthrax in the same district. The patients had reportedly participated in the butchery and consumption of meat from the dead cows. We investigated to determine the magnitude of the outbreak, identify exposures associated with illness, and suggest evidence-based control measures.MethodsWe conducted a retrospective cohort study among persons whose households received any of the cow meat. We defined a suspected human cutaneous anthrax case as new skin lesions (e.g., papule, vesicle, or eschar) in a resident of Kiruhura District from 1 to 26 May 2018. A confirmed case was a suspected case with a lesion testing positive for B. anthracis by polymerase chain reaction (PCR). We identified cases through medical record review at Engari Health Centre and active case finding in the community.ResultsOf the 95 persons in the cohort, 22 were case-patients (2 confirmed and 20 suspected, 0 fatal cases) and 73 were non-case household members. The epidemic curve indicated multiple point-source exposures starting on May 6, when the dead cows were butchered. Among households receiving cow meat, participating in slaughtering (RR = 5.3, 95% CI 3.2–8.3), skinning (RR = 4.7, 95% CI = 3.1–7.0), cleaning waste (RR = 4.5, 95% CI = 3.1–6.6), and carrying meat (RR = 3.9, 95% CI = 2.2–7.1) increased the risk of infection.ConclusionsThis cutaneous anthrax outbreak was caused by handling infected animal carcasses. We suggested to the Ministry of Agriculture, Animal Industry and Fisheries to strengthen surveillance for possible veterinary anthrax and ensure that communities do not consume carcasses of livestock that died suddenly. We also suggested that the Ministry of Health equip health facilities with first-line antibiotics for community members during outbreaks.

Cutaneous anthrax outbreak associated with handling dead animals, Rhino Camp sub-county: Arua District, Uganda, January\u2013May 2018

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.

Outbreak of Cutaneous anthrax associated with handling meat of dead cows: Engari sub-county, Kiruhura district, south western Uganda, May 2018

Outbreak of Cutaneous anthrax associated with handling meat of dead cows: Engari sub-county, Kiruhura district, south western Uganda, May 2018

Sporadic human cutaneous anthrax outbreak in Shaanxi Province, China: report of two cases from 2018

China’s compulsory annual livestock anthrax vaccination policy has remarkably reduced but not completely eradicated human anthrax infections. Herein we describe a sporadic human cutaneous anthrax outbreak involving two cases in 2018 in Shaanxi Province, both involving herdsman who dealt with unvaccinated and potentially sick cattle. Both patients showed Bacillus anthracis-positive blister smear and blood culture. Treatment with penicillin was followed by uneventful recovery for both. The prompt performance of the prophylactic measures successfully interrupted the further transmission of this sporadic human cutaneous anthrax outbreak.

A cutaneous Anthrax outbreak in Koraput District of Odisha-India 2015

BackgroundCutaneous anthrax in humans is associated with exposure to infected animals or animal products and has a case fatality rate of up to 20% if untreated. During May to June 2015, an outbreak of cutaneous anthrax was reported in Koraput district of Odisha, India, an area endemic for anthrax. We investigated the outbreak to identify risk factors and recommend control measures.MethodWe defined a cutaneous anthrax case as skin lesions (e.g., papule, vesicle or eschar) in a person residing in Koraput district with illness onset between February 1 and July 15, 2015. We established active surveillance through a house to house survey to ascertain additional cases and conducted a 1:2 unmatched case control study to identify modifiable risk factors. In case control study, we included cases with illness onset between May 1 and July 15, 2015. We defined controls as neighbours of case without skin lesions since last 3 months. Ulcer exudates and rolled over swabs from wounds were processed in Gram stain in the Koraput district headquarter hospital laboratory.ResultWe identified 81 cases (89% male; median age 38 years [range 5–75 years]) including 3 deaths (case fatality rate = 4%). Among 37 cases and 74 controls, illness was significantly associated with eating meat of ill cattle (OR: 14.5, 95% CI: 1.4–85.7) and with close handling of carcasses of ill animals such as burying, skinning, or chopping (OR: 342, 95% CI: 40.5–1901.8). Among 20 wound specimens collected, seven showed spore-forming, gram positive bacilli, with bamboo stick appearance suggestive of Bacillus anthracis.ConclusionOur investigation revealed significant associations between eating and handling of ill animals and presence of anthrax-like organisms in lesions. We immediately initiated livestock vaccination in the area, educated the community on safe handling practices and recommended continued regular anthrax animal vaccinations to prevent future outbreaks.

Cutaneous Anthrax Outbreak in the Trakya Region of Turkey

Cutaneous Anthrax Outbreak in the Trakya Region of Turkey

Cutaneous Anthrax Outbreak in Rajshahi District

Anthrax is an acute, zoonotic infectious disease caused by gram positive, aerobic, spore forming bacterium Bacillus anthracis. Cutaneous anthrax is the commonest form of anthrax, comprising more than 95% of cases. Incidence of anthrax is declining in the developed countries; but because of inadequate livestock vaccination program, it remains a public health hazard in the developing countries. Several cutaneous anthrax outbreaks were observed in Bangladesh over the last few years and the latest one occurred in Lalitnagar village, Godagari Upazilla of Rajshahi district in September 2016. We are reporting clinico-demographic profile and treatment outcome of the affected patients with the aim of increasing awareness among the clinicians and public health experts.TAJ 2017; 30(1): 17-20

Outbreak of Cutaneous Anthrax in Kalukhali Upazilla, Rajbari District, Bangladesh 2017

Background: Anthrax is endemic and human infection has been identified in 15 of 64 districts of Bangladesh. Outbreak are associated with exposure to infected animals during droughts, floods or soil disturbances. On September 6, 2017 the civil surgeon of Rajbari District, reported six people with anthrax like lesions with exposure to one sick cow.

An outbreak of cutaneous anthrax in a tribal area of Visakhapatnam district, Andhra Pradesh

Background: Anthrax is a disease of herbivorous animals, caused by Bacillus anthracis and humans incidentally acquire the disease by handling infected animals and their products. Though the disease has become rare, endemic outbreaks occur in tropical countries, where veterinary control of livestock is marginal and environmental conditions favor an animal-soil-animal cycle. Materials and Methods: Eight tribal men from Kodipunjuvalasa village of Araku valley presented with painless ulcers associated with vesiculation and edema of surrounding skin on upper limbs without any constitutional symptoms. There was a history of slaughtering and consumption of cooked meat of sick goat 1 week to 10 days prior to the development of skin lesions. Cutaneous anthrax was suspected and smears, swabs were taken for culture and polymerase chain reaction (PCR). All the cases were treated with intravenous followed by oral antibiotics. Appropriate health authorities were alerted and proper control measures were employed. Results: Smears from the cutaneous lesions were positive for Bacillus anthracis in all our cases and this was confirmed by a positive culture and PCR of smears. All the cases responded to antibiotics. Conclusion: We report eight cases of cutaneous anthrax in tribal area of non-endemic district, Visakhapatnam, Andhra Pradesh.

Epidemiological characteristics of a cutaneous anthrax outbreak in Huairou District of Beijing

Epidemiological characteristics of a cutaneous anthrax outbreak in Huairou District of Beijing

English

English

Source and risk factors of a cutaneous anthrax outbreak, Jiangsu, Eastern China, 2012.

Anthrax is still a severe public health problem and threat to human health. A cutaneous anthrax outbreak occurred in Jiangsu Province, a non-endemic anthrax region of eastern China, from July to August 2012. Epidemiological and laboratory investigation were initiated to trace the source of infection and identify the risk factors of the outbreak. On 25 July 2012, 17 persons were exposed to a sick cow, which had been imported from northeast China a few days previously. Of the 17 exposed, eight developed symptoms between 1 and 8 days and were diagnosed as cutaneous anthrax cases. Three main genes of Bacillus anthracis were detected from both human and cow meat samples, indicating that the outbreak was associated with this infected cow. A retrospective cohort study showed that contact with blood and presence of skin damage contributed to the case infection with B. anthracis. The outbreak highlights the need to enhance quarantine for imported livestock, which should have been vaccinated prior to importation, the significance of education for high-risk individuals, and training for primary healthcare workers even in anthrax-free areas.

Familial Outbreak of Cutaneous Anthrax In Eastern Turkey

Sarbon tum dunyada gorulebilir. Bu infeksiyon gelismekte olan ulkelerde endemik bir zoonozdur. Bu yazida inek kesimine katilan hayvancilikla ugrasan ve ciftci olan ayni aileden uc hasta paylasildi. Tum olgular hafif formda deri sarbonu idi. Hastalar antibiyotik ile tedavi edildi. Sarbon Dogu Anadolu icin hala buyuk bir saglik problemidir. Erken tani ve tedavi ile olumlu sonuclar alinir. Hayvan temas hikâyesi olan hastalarda birlikte vezikuler, agrisiz, odemli lezyonlari varsa sarbon goz onunde bulundurulmalidir. Bu calismanin amaci Turkiye'nin Dogu kisminda Erzurum'da deri sarbonu salginini incelemektir.

Investigation of an outbreak of cutaneous anthrax in Banlu village, Lianyungang, China, 2012

After notification of a suspected case of anthrax following the slaughtering of a sick cow in Banlu village, an area that has not had any anthrax cases for decades, we aimed to confirm the outbreak, determine the transmission mechanism and implement control measures. The outbreak response team interviewed all people that had contact with the sick cow. Three types of cases' specimens were collected and tested by blood smear, real-time polymerase chain reaction (PCR) and the gold colloid method. Traceback of potentially contaminated meat and cattle were conducted. There were five confirmed and three probable cases verified among 17 people who had contact with the sick cow - an attack rate of 47%. The incubation period ranged from one to eightdays with a median of twodays. All eight cases had lesions. All were native residents of Banlu village aged between 21 and 48 years. Five male cases were professional butchers; two females and one male were temporary assistants. The sick cow's meat and hide, as well as all cattle processed at the same time, were recalled. Hypochlorite was used to disinfect the contaminated environments, butchering facilities and the contacts' personal effects. This outbreak was caused by anthrax bacillus transmitted to contacts from the tissues of the sick cow. Control of the outbreak was managed by recalling all potentially infected meat and disinfecting the slaughter house and the suspected cases' personal effects and environment.

Outbreak of cutaneous anthrax in Musalimadugu village, Chittoor district, Andhra Pradesh, India, July-August 2011

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.

Recent outbreak of cutaneous anthrax in Bangladesh: clinico-demographic profile and treatment outcome of cases attended at Rajshahi Medical College Hospital

BackgroundHuman cutaneous anthrax results from skin exposure to B. anthracis, primarily due to occupational exposure. Bangladesh has experienced a number of outbreaks of cutaneous anthrax in recent years. The last episode occurred from April to August, 2011 and created mass havoc due to its dreadful clinical outcome and socio-cultural consequences. We report here the clinico-demographic profile and treatment outcome of 15 cutaneous anthrax cases attended at the Dermatology Outpatient Department of Rajshahi Medical College Hospital, Bangladesh between April and August, 2011 with an aim to create awareness for early case detection and management.FindingsAnthrax was suspected primarily based on cutaneous manifestations of typical non-tender ulcer with black eschar, with or without oedema, and a history of butchering, or dressing/washing of cattle/goat or their meat. Diagnosis was established by demonstration of large gram-positive rods, typically resembling B. anthracis under light microscope where possible and also by ascertaining therapeutic success. The mean age of cases was 21.4 years (ranging from 3 to 46 years), 7 (46.7%) being males and 8 (53.3%) females. The majority of cases were from lower middle socioeconomic status. Types of exposures included butchering (20%), contact with raw meat (46.7%), and live animals (33.3%). Malignant pustule was present in upper extremity, both extremities, face, and trunk at frequencies of 11 (73.3%), 2 (13.3%), 1 (6.7%) and 1 (6.7%) respectively. Eight (53.3%) patients presented with fever, 7 (46.7%) had localized oedema and 5 (33.3%) had regional lymphadenopathy. Anthrax was confirmed in 13 (86.7%) cases by demonstration of gram-positive rods. All cases were cured with 2 months oral ciprofloxacin combined with flucoxacillin for 2 weeks.ConclusionsWe present the findings from this series of cases to reinforce the criteria for clinical diagnosis and to urge prompt therapeutic measures to treat cutaneous anthrax successfully to eliminate the unnecessary panic of anthrax.

A mini outbreak of cutaneous anthrax in Vizianagaram district, Andhra Pradesh, India

A mini outbreak of cutaneous anthrax in Vizianagaram district, Andhra Pradesh, India

An outbreak of cutaneous anthrax in a non-endemic district - Visakhapatnam in Andhra Pradesh

Anthrax is a disease of herbivorous animals, and humans incidentally acquire the disease by handling infected dead animals and their products. Sporadic cases of human anthrax have been reported from Southern India. Five tribal men presented with painless ulcers with vesiculation and edema of the surrounding skin on the extremities without any constitutional symptoms. There was a history of slaughtering and consumption of a dead goat ten days prior to the development of skin lesions. Clinically cutaneous anthrax was suspected and smears, swabs and punch biopsies were taken for culture and identification by polymerase chain reaction (PCR). All the cases were treated with intravenous followed by oral antibiotics. Appropriate health authorities were alerted and proper control measures were employed. Smears from the cutaneous lesions of all five patients were positive for Bacillus anthracis and this was confirmed by a positive culture and PCR of the smears in four of the five cases. All the cases responded to antibiotics. We report five cases of cutaneous anthrax in a non-endemic district, Visakhapatnam, Andhra Pradesh, for the first time.

Bioterrorism: guidelines for medical and public health management

This book is the most credible and up-to-date new book on the recognition, diagnosis, and management of infections caused by agents used in bloterror weapons. The focus of the book is on the history, epidemiology, microbiology, pathogenesis, diagnosis, vaccination, therapy, and management of six deadly forms of biological warfare. These include anthrax, smallpox, plague, botulinum toxin, and tularemia. In addition, all scientific information from the recent cutaneous and inhallation anthrax outbreak will be analyzed and discussed.