Current assessment of risks of anthrax outbreaks in Ukraine

Abstract

IntroductionAnthrax is an acute especially dangerous infectious disease ofanimals and humans.Bacillus anthracisis a potential bioterrorismtool. In Ukraine, there are favorable natural conditions for the spreadof anthrax. There are 13.5 thousand of constantly anthrax-troubledpoints. Anthrax epidemic situation in Ukraine could be characterizedas unstable. Because of the continuing reform of Ukrainian humanhealth entities, the State Sanitary Epidemiological Service (SSES) haslost its control functions and is remaining in an uncertain state, whichincreases possible risks.MethodsEpidemiological analysis of official data has been performedusing information from the following sources: State SanitaryEpidemiological Service of Ukraine (SSES), State Veterinary andPhytosanitary Service of Ukraine, and analytical materials fromSI UCDCM. Collected papers Distribution and EpidemiologicalCharacteristics of Major Human Infectious Diseases in Ukraine(Kyiv Research Institute of Epidemiology, Microbiology andParasitology, 1976) were also used during the study. Materials werecompiled for the period from 1945 to 2015.ResultsIn the early XX century, more than 10,000 cases of anthrax inhumans were annually registered in tsarist Russia. In 1913, 1,473cases of anthrax in animals were recorded only in Kherson province(currently, Kherson oblast of Ukraine). The morbidity among humansincreased again during the WWII. In the late 40s, massive epizooticanthrax among animals was eliminated and morbidity among peoplesignificantly reduced because of planned government measures,strengthened veterinary, sanitary, and epidemiological surveillance.Since 1950, significant reduction of incidence of human anthrax hasbeen being recorded in Ukraine.Since 1964, certification and mapping of persistent anthrax-troubled points in Ukraine have been being performed.Compulsory vaccination of people against anthrax was cancelledand compulsory vaccination of all livestock was introduced in 1990.The period from 1976 to 1993 is characterized as epidemically safe.Single cases of the disease in human were registered with intensityrates of 0.01 – 0.002 per 100,000 population (excluding 1985).No human cases were registered during the certain years: 1978, 1982,1987, 1988.The epidemic situation complicated during the period 1994-2001. The following outbreaks were registered:Table 1. Total number of disease cases/ including the numberof cases during outbreaks within regionsThe main reason for the complication of the epidemiologicalsituation was weakening of epidemiological and veterinarysurveillance during the economic crisis characterizing this period.Epizootiological outbreaks arose from incomplete anti-anthraxvaccination of agricultural animals and from violation of veterinary-sanitary rules for their keeping as well. More than 80% of humaninfection cases happened resulting compelled cattle slaughtering,while the rest 20% resulted from meat product distribution andconsumption without corresponding sanitary-veterinary expertise.Six human cases of anthrax were registered during 2002-2015.Fig. 1. Dynamics of anthrax cases in humans in Ukraine during1945 – 2015 (absolute numbers)Table 2. Chronology of anthrax epidemiological surveillancemilestones in UkraineConclusionsRelative wellbeing regarding anthrax in Ukraine persists owing tothe implementation of ruled veterinary-sanitary activities and statesanitary epidemiological surveillance in meat- and leather-processingindustries as well as because of active food control.The main risks, which could trigger complication in the currentepidemiological situation with anthrax, are the following:1) Uncertainty in the system of sanitary-epidemiological andveterinary surveillance, which resulted from the reformation of theState Sanitary-Epidemiological and State Veterinary services.2) Existence of favorable conditions for anthrax agent circulation(considerable number of persistent anthrax-troubled points in allregions).3) Economic instability in the country.4) Uncontrolled epidemic situation in the zone of the Anti-terroristoperation (Donetsk and Luhansk oblasts).