Cutaneous Anthrax Outbreak Associated with Handling Dead Animals, Rhino Camp Sub-county, Arua District, Uganda, January-May 2018

  • Zoonotic
  • Animal health
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Background:
On the 9 February 2018, Arua District notified Uganda Ministry of Health of a confirmed anthrax outbreak in Rhino- camp sub-county. We investigated to determine scope, mode of transmission and exposures for transmission of anthrax to guide control and prevention measures.
Methods:
We 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 search in the affected community with support from Community Health Workers. In a retrospective cohort study, we interviewed all households in Ombeniva village. We collected and tested 3 samples of hides of implicated animals using an anthrax rapid diag- nostic test.
Results:
We identified 14 suspected case-patients (1 confirmed, 13 suspected); no deaths. Only males were affected (AR: 12/10,000). Mean age of case-persons was 33yrs (SD: 22). Epidemic curve showed one animal death a month which peaked in February, stagnated in March and April and sharply declined in May. The outbreak lasted 5 months, from Jan-2018 to May-2018.Two parishes were affected with Awuvu parish (AR=31/10,000) being more affected compared to Eranva parish (AR: 2/10,000). 10 (56%) of 18 people that participated in skinning a dead animal compared to 4 (12 %) of 33 people that did not participate in skinning developed cutaneous anthrax (RR=4.5, 95% CI=1.7-12.6). We found evidence of animal slaughter on pastureland.
Conclusion
Handling dead animals was associated with this cutaneous anthrax outbreak in Arua District. We recommended public education about safe disposal of carcasses of animals that die suddenly.

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