Recurrent Anthrax Outbreaks in Humans, Livestock, and Wildlife in the Same Locality, Kenya, 2014–2017

Muturi, Mathew; Gachohi, John; Mwatondo, Athman; Lekolool, Isaac; Gakuya, Francis; Bett, Alice; Osoro, Eric; Bitek, Austine; Thumbi, Samuel M.; Munyua, Peninah; Oyas, Harry; Njagi, Obadiah; Bett, Bernard K.; Njenga, M. Kariuki

doi:10.4269/ajtmh.18-0224

Cited by 61 publications

(71 citation statements)

References 35 publications

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“…However, it is interesting to note that we did not find records of anthrax outbreaks in wildlife conservancies in agro-alpine regions of Kenya including the Aberdare and Mount Kenya national parks. This observation is consistent with our findings that more outbreaks occur during the dry season, and it may be explained by the similar associated risk factors [12]. …”

Section: Discussionsupporting

confidence: 93%

“…Furthermore, the world-famous annual wildebeest ( Connochaetes taurinus ) migration occurs between the Masai Mara and Serengeti national parks [11]. A recent study in Kenya reported three anthrax outbreaks over a period of 4 years in the same locality of Rift valley in Kenya that resulted in the death of 10.5% of all wildlife herbivores in a local national park, including 17% of the buffalos and 16% endangered black rhinos and white rhinos [12]. …”

Section: Introductionmentioning

confidence: 99%

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Temporal and spatial distribution of anthrax outbreaks among Kenyan wildlife, 1999–2017

et al. 2019

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The burden of anthrax in wildlife is demonstrated through high numbers of sudden mortalities among herbivore species, including endangered animal species. East Africa is home of multiple species of faunal wildlife numbering in the millions but there are limited disease surveillance programmes, resulting in a paucity of information on the role of anthrax and other infectious diseases on declining wildlife populations in the region. We reviewed historical data on anthrax outbreaks from Kenya Wildlife Service (KWS) spanning from 1999 to 2017 in Kenya to determine the burden, characteristics and spatial distribution of anthrax outbreaks. A total of 51 anthrax outbreaks associated with 1014 animal deaths were reported across 20 of 60 wildlife conservation areas located in six of the seven agro-ecological zones. Overall, 67% of the outbreaks were reported during the dry seasons, affecting 24 different wildlife species. Over 90% (22 of 24) of the affected species were herbivore, including 12 grazers, five browsers and five mixed grazers and browsers. Buffaloes (23.5%), black rhinos (21.6%) and elephants (17.6%) were the most frequently affected species. Our findings demonstrate the extensive geographic distribution of wildlife anthrax in the country, making it one of the important infectious diseases that threaten wildlife conservation.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Temporal and spatial distribution of anthrax outbreaks among Kenyan wildlife, 1999–2017

et al. 2019

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“…Handling carcasses of animals with suspected and con rmed anthrax has previously been established as a risk factor for cutaneous [19]. The location of the black eschars for most case-patients -on the hands and back -has also been observed in other studies demonstrating livestock-human transmission of anthrax [14], and is likely related to animal carcasses being carried over the shoulder.…”

Section: Discussionmentioning

confidence: 80%

Cutaneous anthrax associated with handling carcasses of animals that died suddenly of unknown cause: Arua District, Uganda, January 2015–August 2017

Aceng

Ario²,

Alitubeera³

et al. 2020

Preprint

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Background : Anthrax is a zoonotic vaccine-preventable disease that can be transmitted to humans from infected animals. During May–June 2017, three persons with probable cutaneous anthrax were reported in Arua District, Uganda; one died. All had recently handled carcasses of livestock that died suddenly. During July, a bull in the same community died suddenly. A skin lesion from the deceased person and a blood sample from the bull tested positive by PCR for Bacillus anthracis. The aim of this investigation was to establish the scope of the problem, identify exposures associated with illness, and recommend evidence-based control measures. Methods: We defined a probable case as acute onset of a papulo-vesicular skin lesion subsequently forming an eschar in a resident of Arua District during January 2015–August 2017. A confirmed case was a probable case with a skin sample testing positive by polymerase chain reaction (PCR) for B. anthracis . We identified cases by medical record review and active community search. In a case-control study, we compared exposures between case-patients and frequency- and village-matched asymptomatic controls. We interviewed key animal health staff to learn about livestock deaths. Results: We identified 68 case-patients (67 probable, 1 confirmed), and 2 deaths. Cases occurred throughout the three-year period, peaking during dry seasons. All cases occurred following sudden livestock deaths in the villages. Case-patients came from two neighboring sub-counties: Rigbo (attack rate (AR)=20.1/10,000 population) and Rhino Camp (AR=2.1/10,000). Males (AR=17/100,000) were more affected than females (AR=0.52/100,000). Persons aged 30-39 years (AR=26/100,000 population) were most affected. Among all cases and 136 controls, skinning (OR M-H =5.0, 95%CI: 2.3–11), butchering (OR M-H =22, 95%CI: 5.5–89), and carrying the carcass of livestock that died suddenly (OR M-H =6.9, 95%CI: 3.0–16) were associated with illness. Conclusions: Exposure to carcasses of animals that died suddenly was a likely risk factor for cutaneous anthrax in Arua District during 2015-2017. We recommend public education about signs and symptoms of anthrax, prompt treatment of illness following exposure to animals that died suddenly, and safe disposal of the carcasses. In addition, the anthrax burden in livestock should be investigated to inform the cost-effectiveness of livestock vaccination.

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“…One of the wards also bordered a game reserve. The sharing of grazing land with the game often results in the transmission of anthrax to livestock [26].…”

Section: Discussionmentioning

confidence: 99%

An investigation of an anthrax outbreak in Makoni District, Zimbabwe

Makurumidze

Tafara

Magure

et al. 2020

Preprint

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Background: In Zimbabwe, anthrax continues to be a disease of public health importance with sporadic outbreaks reported in many parts of the country annually. A human anthrax outbreak occurred in Makoni District Ward 22 and 23 between June 2013 and February 2014. The human anthrax outbreak followed cattle deaths in the wards, which were laboratory confirmed to be due to anthrax. We report the clinical characteristics, distribution of anthrax cases (places, person and time), risk factors for contracting the disease, environmental assessment, district preparedness and response and outbreak prevention and control measures. Methods: We conducted an outbreak investigation with the design of a 1:1 case-control study. Cases and controls were frequency matched against sex. Data were collected using a structured interviewer-administered questionnaire. Environmental assessment, district preparedness and response and outbreak prevention and control measures were assessed using a checklist, observations and key informant interviews. Multivariable unconditional logic regression analysis was performed to identify independent risk factors associated with contracting anthrax. Results: Of the 64 cases, 37 cases and 37 controls were interviewed. All the cases had cutaneous anthrax with the commonest site of eschar being the hand (43%). Most of the cases (89%) were managed according to the national guidelines. On multivariable analysis, source of meat from other villagers [vs butchery, OR = 15.21, 95% CI (2.32-99.81)], skinning [OR = 4.32, 95% CI (1.25-14.94)] and belonging to a religion which permits eating meat from cattle slaughtered due to unknown illness or butchered after an unobserved death [OR = 6.12, 95% CI (1.28-29.37)] were associated with contracting anthrax. The district was poorly resourced and delayed to respond to the outbreak. Conclusion: The described anthrax outbreak resulted from contact and consumption of infected cattle meat. The district office response was delayed and was not prepared to control the outbreak. However, the outbreak was eventually controlled through cattle vaccination; health education and awareness campaigns. The district should strengthen its emergency preparedness and response capacity, revive zoonotic committees, conduct awareness campaign during the high-risk period and improve the surveillance of anthrax during high-risk periods.

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Recurrent Anthrax Outbreaks in Humans, Livestock, and Wildlife in the Same Locality, Kenya, 2014–2017

Cited by 61 publications

References 35 publications

Temporal and spatial distribution of anthrax outbreaks among Kenyan wildlife, 1999–2017

Temporal and spatial distribution of anthrax outbreaks among Kenyan wildlife, 1999–2017

Cutaneous anthrax associated with handling carcasses of animals that died suddenly of unknown cause: Arua District, Uganda, January 2015–August 2017

An investigation of an anthrax outbreak in Makoni District, Zimbabwe

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