First PCR Confirmed anthrax outbreaks in Ethiopia-Amhara region, 2018-2019

Anthrax is a disease that affects humans and animals. In Ethiopia, anthrax is a reportable disease and assumed to be endemic, although laboratory confirmation has not been routinely performed until recently. We describe the findings from the investigation of two outbreaks in Amhara region. Following...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2022-02, Vol.16 (2), p.e0010181-e0010181
Main Authors: Ashenefe Wassie, Baye, Fantaw, Surafel, Mekonene, Yonas, Teshale, Amete Mihret, Yitagesu, Yohannis, Tsige, Estifanos, Getahun, Desalegn, Tasew, Geremew, Abichu, Getachew, Moges, Beyene, Abate, Ebba, Abayneh, Takele, Zeru, Taye, Belay, Zewdu, Mor, Siobhan M
Format: Article
Language:English
Subjects:
Active control
Adolescent
Adult
Aged
Animal health
Animals
Anthrax
Anthrax - diagnosis
Anthrax - epidemiology
Anthrax - microbiology
Anthrax - veterinary
Bacillus anthracis - classification
Bacillus anthracis - genetics
Bacillus anthracis - isolation & purification
Biology and Life Sciences
Carcasses
Case reports
Cats - microbiology
Cattle
Cattle - microbiology
Child
Control programs
Criminal investigations
Diagnosis
Disease
Disease control
Disease Outbreaks
Distribution
Dogs - microbiology
Epidemics
Ethiopia
Ethiopia - epidemiology
Female
Goats - microbiology
Health surveillance
Households
Humans
Ingestion
Inhalation
Laboratories
Livestock
Livestock - microbiology
Male
Meat
Meat - microbiology
Medical personnel
Medicine and Health Sciences
Middle Aged
Nucleotide sequence
Orifices
Outbreaks
PCR
People and Places
Polymerase Chain Reaction
Public health
Questionnaires
Rain
Respiration
Samples
Signs and symptoms
Symptoms
Training
Tropical diseases
Vaccination
Vaccines
Young Adult
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Description
Summary:Anthrax is a disease that affects humans and animals. In Ethiopia, anthrax is a reportable disease and assumed to be endemic, although laboratory confirmation has not been routinely performed until recently. We describe the findings from the investigation of two outbreaks in Amhara region. Following reports of suspected outbreaks in Wag Hamra zone (Outbreak 1) and South Gondar zone (Outbreak 2), multi-sectoral teams involving both animal and public health officials were deployed to investigate and establish control programs. A suspect case was defined as: sudden death with rapid bloating or bleeding from orifice(s) with unclotted blood (animals); and signs compatible with cutaneous, ingestion, or inhalation anthrax ≤7 days after exposure to a suspect animal (humans). Suspect human cases were interviewed using a standard questionnaire. Samples were collected from humans with suspected anthrax (Outbreak 1 and Outbreak 2) as well as dried meat of suspect animal cases (Outbreak 2). A case was confirmed if a positive test was returned using real-time polymerase chain reaction (qPCR). In Outbreak 1, a total of 49 cows died due to suspected anthrax and 22 humans developed symptoms consistent with cutaneous anthrax (40% attack rate), two of whom died due to suspected ingestion anthrax. Three people were confirmed to have anthrax by qPCR. In Outbreak 2, anthrax was suspected to have caused the deaths of two livestock animals and one human. Subsequent investigation revealed 18 suspected cases of cutaneous anthrax in humans (27% attack rate). None of the 12 human samples collected tested positive, however, a swab taken from the dried meat of one animal case (goat) was positive by qPCR. We report the first qPCR-confirmed outbreaks of anthrax in Ethiopia. Both outbreaks were controlled through active case finding, carcass management, ring vaccination of livestock, training of health professionals and outreach with livestock owners. Human and animal health authorities should work together using a One Health approach to improve case reporting and vaccine coverage.
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0010181