Wüstenschiff

ANTHRAX, HUMAN - KYRGYZSTAN: (BATKEN)
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Date: Tue 19 Feb 2013
Source: Kabar, Kyrgyz National News Agency [edited]
http://kabar.kg/eng/health/full/6379


A case of anthrax [has been reported] in Kara-Dobo village of Batken, the press service of the Kyrgyz Ministry of Emergency Situations reports.

According to data of the Ministry, UY, born in 1959, was hospitalized on 15 Feb 2013 in the infectious department of Uch-Korgon medical center. "At the moment the patient's condition is satisfactory. She continues to receive treatment, "the report says.

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Castleview Pedigree English Longhorns
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[One does not expect to see anthrax cases in the winter months unless they result from contaminated animal feed or hay. The nature of this case, whether cutaneous or gastroenteric, is not defined. But the medical authorities are not inexperienced with this disease so I think we can presume that UY is under proper medical care.

Batken forms the southern boundary of the Fergana valley of Uzbekistan, which is an area of chronic livestock outbreaks of anthrax. While Uzbekistan fails to report either human or livestock cases, they are routinely diagnosed in the surrounding Kyrgyz provinces. Unfortunately, these provinces are a long way from Bishkek and, therefore, do not get the oversight they need to have annual vaccination of their livestock. This would cost-effectively and cheaply prevent both livestock outbreaks and human cases.

The HealthMap/ProMED-mail interactive map of Kyrgyzstan can be seen at http://healthmap.org/r/5u09. For a map showing the proximity of Batken, Osh, and Uzbekistan bordering areas, see http://www.lib.utexas.edu/maps/commonwe ... _rel96.jpg. - Mod.MHJ]

ANTHRAX - ARMENIA: ex GEORGIA, HUMAN, BOVINE
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Date: 20 Mar 2013
Source: Pan Armenian Net [edited]
http://www.panarmenian.net/eng/news/150648


Two cases of skin anthrax were discovered in Armenia on Tue 19 Mar 2013, with one of the patients identified as a citizen of Georgia. Before travelling to Yerevan on 15 Mar 2013, both patients had been slaughtering cattle in a Georgian village.

Laboratory tests confirmed the anthrax diagnosis. The patients' state is assessed as satisfactory with recovery reported.

--
Communicated by:
Sabine Zentis
Castleview English Longhorns
Gut Laach
D-52385 Nideggen, Germany
<cvlonghorns@aol.com>

[Up until 2012, Armenia had reported few cases of anthrax, whether in cattle or humans, since 2007. But 2012 was different, as can be seen by the ProMED postings for that year below. Georgia, on the other hand, has had a severe, ongoing problem for many years, thus this shared pair of human cutaneous cases. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1HT_.]

ANTHRAX - GHANA (02): (UPPER EAST) BOVINE, HUMAN, CONFIRMED
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Date: Fri 5 Apr 2013
Source: GhanaWeb [edited]
http://www.ghanaweb.com/GhanaHomePage/N ... ?ID=270417


A total of 4 people have been killed by anthrax in Sapelga in the Bawku West District [Upper East region of Ghana]. 30 cattle have also been killed by the disease.

The outbreak was recently confirmed by the Pong-Tamale Veterinary College which tested samples of cattle carcasses.

The District Security Council has issued an edict restricting the movement of cattle and other animals to and from the District.

Anthrax recurrently breaks out in the Northern part of the country virtually every year. XYZ News learnt the outbreak has lingered in the region since January 2013 but went undetected until 2 days ago when lab tests confirmed the outbreak.

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[Since this was first tentatively reported there have been human cases involved, probably not unexpected considering the high number of cattle affected. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/6esD.]

ANTHRAX - BENIN (02): (ATACORA) HUMAN, BOVINE, OIE
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Date: Wed 10 Apr 2013
Source: OIE, WAHID (World Animal Health Information Database), weekly disease information 2013; 26(15) [edited]
http://www.oie.int/wahis_2/public/wahid ... rtid=13250


Anthrax, Benin
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Information received on (and dated) 10 Apr 2013 from Dr Richard Hounga Lokossou, [Director of Livestock, Ministry of Agriculture, Livestock and Fisheries], Cotonou, Benin

Summary
Report type: follow-up report No. 1
Date of start of the event: 20 Mar 2013
Date of pre-confirmation of the event: 20 Mar 2013
Report date: 10 Apr 2013
Date submitted to OIE: 10 Apr 2013
Reason for notification: reoccurrence of a listed disease
Date of previous occurrence: June 2012
Manifestation of disease: clinical disease
Causal agent: _Bacillus anthracis_
Nature of diagnosis: clinical
This event pertains to a defined zone within the country
Related reports:
Immediate notification (22 Mar 2013)
Follow-up report no. 1 (10 Apr 2013)

New outbreaks (1):
Outbreak 1: Koudogou, Natta, Boukoumbe, Boukoumbe [Atacora]
Date of start of the outbreak: 9 Apr 2013
Outbreak status: continuing (or date resolved not provided)
Epidemiological unit: village
Affected animals:
Species / Susceptible / Cases / Deaths / Destroyed / Slaughtered
Cattle / 4 / 1 / 1 / 0 / 0
Affected population: herd including a bull, a cow, a heifer and a calf

Summary of outbreaks
Total outbreaks: 1
Total animals affected:
Species / Susceptible / Cases / Deaths / Destroyed / Slaughtered
Cattle / 4 / 1 / 1 / 0 / 0
Outbreak statistics:
Species / Apparent morbidity rate / Apparent mortality rate / Apparent case fatality rate / Proportion susceptible animals lost*
Cattle / 25 percent / 25 percent / 100 percent / 25 percent
*Removed from the susceptible population through death, destruction, and/or slaughter

Epidemiology
Source of the outbreak(s) or origin of infection: unknown or inconclusive; animals in an area of anthrax-infected fields
Epidemiological comments: there was a human case in the previous outbreak, in Tabota, who has been treated and has recovered.

Control measures
Measures applied: movement control inside the country; no vaccination; no treatment of affected animals
Measures to be applied: vaccination in response to the outbreak(s)

Future reporting
The event is continuing. Weekly follow-up reports will be submitted.

Map of outbreak locations [available at the source URL above. The outbreak is close to the border with Togo. - Mod.MHJ]

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[The is the 1st report of a prior human case, fortunately recovering. The area vaccination programme is clearly progressing at its own pace.

For maps of Benin, see http://www.lib.utexas.edu/maps/africa/b ... n_2007.jpg and http://healthmap.org/r/22M3.
For Togo, see http://www.lib.utexas.edu/maps/africa/togo_pol_2007.jpg.
For Boukoumbe, see http://www.fallingrain.com/world/BN/08/Boukoumbe.html.
It is a stone's throw from the Togo border. - Mod.MHJ]

ANTHRAX - GHANA (03): (UPPER EAST), BOVINE, HUMAN, CONTAINED
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Date: Mon 15 Apr 2013
Source: Citifm Online [edited]
http://www.citifmonline.com/index.php?id=1.1338471


The anthrax outbreak in the Bawku West District of the Upper East Region has now been contained. According to the presiding member of the area, Moses Adogpam, the health directorate has undertaken a series of [livestock] vaccination exercises as a measure of containing the disease.

Reports of the sale of anthrax infected animals to persons outside the Sapelga town of Bawku have been on the increase despite a ban placed on such activities. Moses Adogpam, in an interview with Citi News, stressed that any persons caught transporting animals out of the town will be punished.

"We are saying no transportation of 4-legged animals in and out of the district, and no carcass will be sent outside the district, so all the butchers' houses have been closed. All butchers are advised against slaughtering any animal," he stated.

Mr. Adogpam added: "The public is advised to consume only birds. The animals have been given antibiotics so they can incubate, and within a period of one week, they will be vaccinated within the Zongo areas."

"All the cattle in other areas are, however, being vaccinated, so as of now, we don't have any cases of infection," he added.

Four people have so far died after eating the carcass of an anthrax infected cow in Sapelga in the Bawku West District. 30 cattle have also been killed by the disease.

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[I think that what the worthy gentleman is trying to say is that the antibiotics will stop any incubating infection in apparently healthy but infected livestock. They are giving antibiotics, but one has to wait for the antibiotic level in the blood to fall to low levels before vaccinating with live Sterne vaccine so that the follow-up vaccination will be unaffected and fully effective. With any reasonable luck, Mr. Adogpam is correct, but it is always wise to wait a minimum of 21 days following vaccination before declaring success.

To find the North-East Region go to: http://www.lib.utexas.edu/maps/africa/g ... n_2007.jpg. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1jUt.]

ANTHRAX - ROMANIA: (IASI) SUSPECTED
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Date: Mon 22 Apr 2013
Source: Gandul, Agence France-Presse (AFP) report
[in Romanian, machine transl., edited]
http://www.gandul.info/stiri/barbat-sus ... i-10781442


An 82-year-old man is hospitalized in critical condition in the intensive care unit at the Hospital of Infectious Diseases in Iasi, suspected of being infected with anthrax, He is being kept alive by machines, as reported by the AFP correspondent.

Dr Carmen Dorobat, Iasi hospital manager, told the media on Monday [22 Apr 2013] that the patient has a necrotic lesion on his upper lip and massive facial edema. These symptoms are specific to anthrax infection.

"There is suspicion of anthrax that will be confirmed after completion of investigations. We are waiting for test results," said Dr Dorobat.

"Besides the suspicion of anthrax the patient has a possible mixed infection with _Staphylococcus aureus_. He is in serious condition, being connected [presumably to a respirator. - Mod.MHJ]. He is under treatment covering both anthrax infection and a possible infection with _Staphylococcus aureus_," the doctor said.

Anthrax is an infectious and contagious disease in animals and in humans it is manifested by lung, gastrointestinal, and skin abscesses. In humans it is called "black boil, coal, or carbuncle".

--
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Sabine Zentis
Castleview Pedigree English Longhorns
Gut Laach
52385 Nideggen
Germany
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[To find Iasi, in north eastern Romania, go to http://www.fallingrain.com/world/RO/23/Iasi.html.
It is less than 16 km [about 9 mi] from the Moldova border.

Anthrax is very sporadic in Romania and as a result many livestock cases, whether in cattle or sheep, are associated with human cases. Disease awareness is re-learnt the hard way. - Mod.MHJ]

[Photo of anthrax lip lesions:
http://www.consultantlive.com/image/ima ... 2570126694
- Mod.JW

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1XhZ.]

ANTHRAX - INDIA: (ODISHA) HUMAN, BOVINE
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Date: April 22, 2013
Source: New Indian Express/Express News Service [edited]
http://newindianexpress.com/states/odis ... 556153.ece


Anthrax claims one, affects 20 in Koraput village
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One person died of anthrax and 20 others were affected in Jadidhara village of Chipakur gram panchayat under Boipariguda block in Koraput district [Odisha] during the last 3 days.

According to reports, villagers were taken ill after consuming half-boiled meat of an anthrax affected buffalo a few days back. Due to lack of medical facilities, they were treated by quacks. However, after he died and 20 others were affected, the local panchayat [district] officials reported the matter to Boipariguda Primary Health Centre (PHC). On Thursday [18 Apr 2013], some of the affected villagers were admitted to the PHC.

Jeypore SDMO [Senior District Medical Officer] Dadhibaban Tripathy, who visited the village on Sunday [21 Apr 2013], confirmed that Dhanu had died of anthrax. He said the [samples from the dead] animal will be sent to Cuttack for tests. [Cuttack is the administrative headquarters of Odisha. - Mod.MHJ] The doctor added that a special medical team from the district headquarters hospital with sufficient medicines is camping in the affected village and treating the patients. All precautionary measures are being taken, he added.

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[To find Koraput, SW Orissa, go to:
http://www.mapsofindia.com/maps/orissa/ ... oraput.htm
http://en.wikipedia.org/wiki/Koraput

Orissa is a constant in the Indian anthrax statistics with human cases in 2001, 2003 through 2008, and 2011; the data for 2012 has yet to be released. There have been significant numbers of bovine outbreaks & cases on an essentially annual basis. The disease is enzootic in some 18 of the 30 districts in the state. Reading between the lines of this local news report one can readily see why.-Mod MHJ]

ANTHRAX - GHANA (04): (UPPER EAST, NORTHERN) PLAN
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Date: 27 Apr 2013
Source: Ghana Business News [edited]
http://www.ghanabusinessnews.com/2013/0 ... l-anthrax/


The Ministry of Food and Agriculture (MOFA) is to draw up a 5 year programme to help curb the perennial outbreak of anthrax. The Northern and Upper East Regions are noted as endemic areas. The sector minister, Clement Kofi Humado [minister for food and agriculture], made this known when he visited the Upper East Region to assess the trend of the recent outbreak of the disease.

He said the ministry would issue a white paper to cabinet for consideration to kick start the programme. The programme will be concentrated on the endemic areas before it spread to other areas. Mr Humado said anthrax does not only lead to the deaths of animals but human beings as well when the infection is not tackled with urgency.

At a round table held at Bolgatanga, Bongo and Bongo-Soe with MOFA directors, veterinary officers, and animal production personnel, it came to light that one of the factors that militate against the control of the disease is the lukewarm attitude of livestock farmers to avail their animals for vaccination. The unwillingness of the farmers to pay between GH 1.00 and 50 pesewas [USD 0.25-0.50] per an animal was identified as one of the major challenges.

Other challenges include inadequate [numbers of] veterinary officers and lack of logistics.

The sector minister appealed to the Metropolitan, Municipal and District Assemblies (MMDAs) and Ghana Health Service to help MOFA deal with the problem. He also entreated the MMDAs to enact bylaws and strictly enforce them to ensure that livestock farmers allow their animals to be vaccinated.

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[To add numbers to this worthy intention, in 2005, there were 11 bovine outbreaks in the Northern Province (NO) and one in Upper East (UE); 2006, 4 (NO), 2 (UE); 2007, 2 (UE); 2008, 2 (NO), 2 (UE); 2009, one (UE); 2010, 2 (NO); 2011, 6 (NO). Not infrequently, these all involved sheep and the occasional pig, as well as humans with deaths.

The constraints on a cost effective control programme are, unfortunately, worldwide; not enough veterinary feet on the ground and farmer reluctance to cover the costs of their stocks' vaccination. What we have found to better this situation is 1st to construct an ecological niche model using GPS locations of past outbreaks. This can be done to a one sq. km precision. These models say where the disease might occur, not where they will occur. This provides an easily understood basis for surveillance -- that is, a map, and everyone thinks that they can read a map, and the map locates where each farm is in regard to this risk (in or out) -- for farmer awareness, and specifically to report any and all unexpected livestock deaths. Depending on the confidence in the locations of known outbreaks, annual vaccination is targeted on all farms within a 10-15 km radius of known outbreaks. In our experience it is not unusual to have a neighbour with dead cattle watching silently while the index outbreak is being cleaned up. So for at least the next 3 years, do this wide annual vaccination "centred" on known cases. Depending on what then happens, one can continue for another 2 or more years, or contract down to the index farm +/- his immediate neighbours. While spores can survive in the soil for a number of years, the reality is that they do die off, and one wants the livestock to be protected while at risk of getting infected.

Obviously where the soil contamination is severe, outbreaks will reoccur when vaccination is stopped -- that is, they are self-declaring -- and in these few places, a longer programme is needed. But they are few.

Anyone needing details on the niche modeling should get in touch with me, and I can then pass them on to the modeling experts. We have done it in many parts of the world with success. An additional benefit is when an outbreak occurs outside the risk area, either the model needs to be rerun, but equally importantly, it is an epidemiologic indicator that the risk was imported -- for example, in purchased contaminated hay or forage, or in a commercial feed or bone meals. A farm visit will sort that out, and the control programme can be adjusted accordingly.

To find the Northern and North-East Regions go to http://www.lib.utexas.edu/maps/africa/g ... n_2007.jpg. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1jUt, http://healthmap.org/r/1jUt.]

ANTHRAX - MOROCCO: (MARRAKECH), HUMAN ex BOVINE
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Date: 6 May 2013
Source: Alittihad Press [in Arabic, trans. Corr.SB, edited]
http://www.alittihad.press.ma/def.asp?c ... 09io000101


An anthrax-infected man has died in University Hospital in Marrakech, Morocco. A medical source has stated that the person with anthrax, who was undergoing treatment at the Ibn Tufail Marrakech hospital campus, died on Saturday evening [4 May 2013; The initial report of this case was on 29 Apr 2013 in Al Ahdath Al Maghribia, but we were unable to access the original report. - Mod.MHJ].

The deceased had been transferred to Ibn Tufail [hospital] isolation facility days before because he was in serious condition, having been diagnosed with the disease (anthrax), which is transmitted from animals to humans, and to prevent him from receiving any visits due to fear of transmission to other people [This is unnecessary, because though anthrax is infectious, it is very rarely contagious. - Mod.MHJ].

The deceased manifested symptoms of the disease following the death of a cow in a stable on the farm [in the Qalaat Sraghna region. - Mod.MHJ]. At the request of the deceased, the cow's liver was extracted to make sure of the cause of death before the burial. Shortly after this, he (the deceased) started to show symptoms of the disease, which advanced progressively and necessitated his transfer to hospital.

The doctor at the University Hospital in Marrakech [Ibn Tufail] said that the patient, aged 34 years, was relocated from outside Marrakech to the hospital too late to save him from the effects of the bacteria, as he had suffered significant damage to internal organs, and it was too difficult to treat them.

A medical source said, on condition of anonymity, that this case is not the 1st of its kind recorded in the territory outside Marrakech and that anthrax had already caused the deaths of 12 people in the same region within the past year.

The current medical information about the disease, known by other names such as Altfhamih fever, malignant edema, and navy wool disease, is an occupational disease transmitted to workers in the leather and wool industries, and veterinarians and farm workers who come into contact with animals carrying the bacteria that cause the disease.

The skin becomes infected through contact with tissues of infected animals (cattle, sheep, goats, horses, pigs) which have died because of the disease, or through touching contaminated hair, wool or leather. The bacteria can infect the lungs when spores or contaminated dust are inhaled, or the gastrointestinal system by the eating of contaminated meat. The disease spreads between herbivores through contaminated soil and food.

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Gut Laach
D-52385 Nideggen, Germany
<cvlonghorns@aol.com>

[There is a very important leather and wool preparation and dyeing industry in Marrakech. Moroccan leather is world famous. But anthrax is considered an occupational disease by people working in the Moroccan wool and hide industries.

From the official OIE statistics, this is nominally a sporadic disease of low frequency in cattle and sheep/goats in Morocco: from 2006 to 2012, there were just 0 to 5 cattle outbreaks with 3 to 16 cases, and in 2008 and 2009, just 3 outbreaks, with 16 goats affected in Centre Sud in 2009 and 17 sheep in Est in that same year. Human cases were only reported in 2007 (27, with 7 deaths) and 2009 (8 cases). The comment of 12 deaths in "the past year" makes one suspect that the official statistics may be deficient. The OIE statistics had no human cases during 2010 through 2012. Maybe it should be considered enzootic in Morocco.

The earlier report stated: "The patient had symptoms including fever, pustules and skin ulcerations in different body areas. He was transferred to a number of hospitals and finally to the Ibn Towfeil's University Hospital Intensive Care Unit. It was reported that the patient contracted the disease from an unvaccinated [cow]. The problem for the worker started when cows started dying on the farm and were culled. The cow's body was burned. The cattle and other animals on the farm were moved to an unknown destination. Cattle were also reported to have died in other parts of the region" (Al Ahdath Al Maghribia, 29 Apr 2013). Extracting the liver from an anthrax carcass would present an extreme exposure. Usually, a cotton swab dipped in the animal's blood is perfectly adequate for any diagnostic laboratory.

To find Marrakech, go to:
http://www.fallingrain.com/world/MO/47/Marrakech.html.
To find Sraghna/Srarhna (spelling varies) go to:
http://www.fallingrain.com/world/MO/47/Srarhna.html. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1lNZ.]

.................................................sb/mhj/msp

ANTHRAX - INDIA (04): (ODISHA) SUSPECTED
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Date: 12 Jun 2013
Source: The New Indian Express [edited]
http://newindianexpress.com/nation/Anth ... 630787.ece


An anthrax scare has gripped Angul district in Odisha, with more than 35 people falling ill with suspected symptoms of the disease at Suleipal village under Kaniha block.

15 people have been rushed to the SCB Medical College Hospital, while the rest are being treated at the local hospital at Kaniha. All those affected are from the same village and are displaying symptoms of cutaneous anthrax infections, like severe lesions or wounds on the skin.

"They have been admitted to the isolation ward of the hospital and are under the treatment of a special team of doctors. Though anthrax is yet to be confirmed, the symptoms are typical," the emergency medical officer of the SCBMCH, Dr B M Moharana, said.

According to sources, the people are suspected to have contracted the infection from dead animals. The villagers are reported to have consumed the meat of about 3 dead goats. While the cause of the death of the animals could not be ascertained, the people who had eaten the meat have begun to fall ill.

The suspected outbreak has become a cause of serious concern because Angul district is known to be non-endemic to the disease.

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[Odisha/Orissa is a constant in the Indian anthrax statistics, with human cases in 2001, 2003 through 2008, and 2011; the full data for 2012 have yet to be released, but in the 1st 6 months of 2012, there were 2 outbreaks involving 14 bovine cases. There have been significant numbers of bovine outbreaks and cases on an essentially annual basis. The disease is enzootic in some 18 of the 30 districts in the state.

For a map of Odisha (previously Orissa) go to: http://www.mapsofindia.com/maps/orissa/. Angul is to the west of Cuttack. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/2i2v.]

ANTHRAX - INDIA (05): (ODISHA)
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[1]
Date: Thu 13 Jun 2013
Source: The Times of India, Times News Network (TNN) [edited]
http://articles.timesofindia.indiatimes ... od-samples


The number of suspected anthrax cases at Suleipala village [Angul district], about 60 km [37 mi] from [Angul], rose to 25 on [Wed 12 Jun 2013]. At least 16 people, including 5 women, affected by the disease have been admitted to SCB Medical College and Hospital in Cuttack. A medical team had also rushed to the village.

Additional district medical [ADM] officer, Angul, Ganesh Prasad Dash said, "It is yet to be confirmed whether the disease is anthrax or not. Blood samples have been collected for testing. Report from SCB is awaited."

A relative of an affected person, said, "Most of the people had consumed meat of cattle carcasses a few days back." [An affected 45 year old] said, "My palms have swollen and I am writhing in pain."

"We have sent a special team to take stock of the situation in the village," said the ADM.

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[2]
Date: Thu 13 Jun 2013
Source: The New Indian Express [edited]
http://newindianexpress.com/nation/Odis ... 632133.ece


While the Odisha government has intensified efforts to contain the suspected outbreak of anthrax in a village of Angul district, health officials are facing stiff resistance from the affected people over hospitalising them for treatment.

Around 16 persons from Suleipal village were rushed to the SCB Medical College and Hospital [in Cuttack] on Tuesday [12 Jun 2013] and more than 10 others have been detected with signs and symptoms of the infection. However, they were not ready to be taken to the hospital, despite coaxing from the health officials.

"The officials are faced with strong resistance from the affected people, who termed the wounds minor and said did not require treatment. While the officials tried to prevail over them, many of them fled the village. We are, however, trying to explain the dangers (the disease could cause) and admit the afflicted to the hospital," ADMO [additional district medical officer] Dr Ganesh Das said.

The district administration, along with the State Health Department and Animal Husbandry and Veterinary Services (AHVS) Department, has launched a comprehensive screening of both the human and animal population in the region. A ring zone has been formed, covering all habitations along a 10-km [6 mi] radius of the affected Suleipal village.

"Ring vaccination of all livestock across the 10-km radius has commenced. The situation is being constantly monitored," sources said.

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[3]
Date: Thu 13 Jun 2013
Source: The New Indian Express [summ., edited]
http://newindianexpress.com/states/odis ... 632323.ece


[There have been problems getting people to accept treatment -- see above. But some background information on the government investigation and response follows. - Mod.MHJ]

The district administration along with State Health Department and the Animal Husbandry and Veterinary Services (AHVS) Department has launched a comprehensive screening of both human and animal population in region. A ring zone has been formed covering all habitations along a 10 km [6 mi] radius of the affected Suleipal village. While a special public health team has started screening people, the veterinary wing has rushed in scientists from Animal Disease Research Institute (ADRI) [in Cuttack] to determine if the outbreak is due to anthrax and also take emergency steps to contain the spread.

"Ring vaccination of all livestock across the 10 km radius has commenced. Teams have fanned out to the villages for collecting samples of soil as well as serum and swab from the animals. The situation is being constantly monitored", Joint Director, AHVS Department, Dr ES Patra said. The outbreak has posed questions for experts as Angul district has no history of anthrax incidence. There have, though, been animal deaths under suspicious circumstances in the recent days, mostly among goats. And the affected population is from a particular community that not only consumes meat of dead animals but also handles skin and leather for its vocation of drum-making.

Sources said not all affected people consumed meat of dead goats, which alludes to the possibility of contracting infection by handling infected skin or coming into contact with spores in soil. Anthrax spores can survive for decades and even a century. "The spores, which might have been lying dormant in soil for long, could have surfaced now and infected animals during movement. 10 teams of veterinary officials have been formed for screening of animals. An awareness campaign has been launched to educate people", chief district veterinary officer, Angul, Dr Sachidananda Patnaik said.

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[Patently the Odisha authorities are taking this outbreak very seriously and responding appropriately. We wish them success. - Mod.MHJ

The state of Odisha can be seen on the HealthMap/ProMED-mail interactive map of India at http://healthmap.org/r/7i-K. Angul district can be seen on the map at http://graphs-odisha.blogspot.ch. - Sr.Tech.Ed.MJ]

ANTHRAX - INDIA (06): (ODISHA)
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Date: 16 Jun 2013
Source: The New Indian Express [edited]
http://newindianexpress.com/states/odis ... 637483.ece


The Veterinary Services wing on Saturday [15 Jun 2013] completed its ring-vaccination measures in and around Suleipal under Kaniha block of Angul district even as one more person of the anthrax-hit village has developed symptoms of the disease.

The total number of the people affected by the disease has gone up to 26, of which 19 have been admitted to the SCB Medical College and Hospital here. Five patients have tested positive for cutaneous anthrax infection, though it is yet to be officially confirmed. Blood smears and wound swabs from all the patients have been sent to the National Institute of Communicable Diseases (NICD), New Delhi, and the official confirmation is awaited, hospital sources said.

The veterinary wing on Saturday [15 Jun 2013] said the containment measures covered the entire target region, with more than 7300 livestock including cattle and goats vaccinated. The ring vaccination was carried out in 13 villages around a 10-km radius of Suleipal village.

Ten teams comprising veterinary surgeons, livestock inspectors and health workers conducted the drive across the region and covered the entire livestock population. All the villages were also subjected to intensive sanitation and disinfection measures. "There has been no new animal casualty due to the suspected outbreak in the last 3 days. The containment and prevention measures could have been completed much earlier but for incessant monsoon rains that affected movement of the teams," Chief District Veterinary Officer, Angul, Dr Sachidananda Patnaik said.

While the expert team from the Animal Disease Research Institute (ADRI) at Phulnakhara here has collected samples from more than 150 animals and sent them for testing to the Regional Disease Diagnosis Laboratory (RDDL) at Kolkata, the situation in the region would be monitored closely.

"As Angul was a non-endemic region for anthrax, the development has necessitated intense supervision not only for the present but for years together. Vaccination of the animals, particularly livestock, would be conducted for a minimum of 10 years to ensure that the disease is eliminated.

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[It appears that the local medical clinical laboratory has confirmed the anthrax diagnosis in 5 patients, but the "formal" confirmation by the NICD in New Delhi is still awaited. As this started probably around 10-11 Jun 2013, this is acceptable. We should have heard the results of any sample taken from the suspect goats and cattle by now. Getting the 7300 head of cattle and goats vaccinated in 13 villages in 2-3 days is impressive, even with 10 teams.

The interesting component are the over 150 animal samples collected and sent for testing at the Regional Disease Diagnosis Laboratory (RDDL) at Kolkata. Were these suspect anthrax cases or just sick stock and the opportunity get some answers to chronic problems brought to the teams' notice by the villagers? If any samples turn out to be _B. anthracis_-positive, it will reflect a larger anthrax problem than previously perceived. As it is the monsoon season, I hope that they also took the opportunity to collect feed samples on farms with probable livestock anthrax cases.

The state of Odisha can be seen on the HealthMap/ProMED-mail interactive map of India at http://healthmap.org/r/7i-K. Angul district can be seen on the map at http://graphs-odisha.blogspot.ch. - Mod.MHJ]

ANTHRAX - INDIA (07): (ANDHRA PRADESH), CAPRINE SOURCE, SUSPECTED
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Date: 18 Jun 2013
Source: Deccan Chronicle [edited]
http://www.deccanchronicle.com/130617/n ... zag-agency


Two suspected cases of anthrax have been reported from Vizag Agency. The 47- and 35-year-old cases were shifted from Araku to King George Hospital (KGH) in the city for treatment.

About 2 weeks ago, 25 tribal families belonging to Kinchumanda in Dumbriguda mandal, consumed meat of a dead goat. After a couple of days, a few of them had ulcers on their fingers. As they approached the local hospitals, doctors initially prescribed antibiotics.

However, 5 of them were shifted to Araku community hospital last Thursday after their condition was found to be abnormal. Later, after deterioration of their health, they were moved to KGH in Vizag.

Sources said the tribals have been suffering from different ailments and ulcers, which are symptoms of anthrax, as they consumed a goat that died of snakebite. When contacted, DM & HO Dr R. Syamala said the laboratory reports confirmed that the cases were negative. The blood samples have been sent to Gwalior for further investigation, she added.

She said that officials have been conducting a medical camp in the village for the last 4 days. On Friday [14 Jun 2013], temporary medical officer Sobha, who has been working at Paderu community health centre, was suspended for failing to refer the cases to KGH immediately.

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[Anthrax is a constant threat in Andra Pradesh, with significant losses to cattle, small ruminants, and secondary cases in humans, the latter sometimes with deaths. Although this report has 2 named individuals being hospitalised, there are 5 others with different names also being referred to KGH in Vizag. One of the many problems of diagnosing anthrax in humans is the speed that they initiate treatment with antibiotics, sometimes before seeing any physician or nurse practitioner, and before samples are collected for laboratory examination.

Vizakhapatam is in the NE corner of the state; see the following map to find Andra Pradesh in SE India: http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg.
For a map of Andra Pradesh, see:
http://www.mapsofindia.com/maps/andhrap ... strict.htm.
To find Araku, go to:
http://www.mapsofindia.com/maps/andhrap ... patnam.htm. Araku is on the northern border of the district. - Mod.MHJ

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/2JmE.]

ANTHRAX - INDIA (08): (ANDHRA PRADESH)
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Date: Tue 18 Jun 2013
Source: The Times of India, Times News Network (TNN) [edited]
http://timesofindia.indiatimes.com/city ... 640600.cms


King George Hospital (KGH) hospital [Visakhapatnam, Andhra Pradesh] authorities reported that 2 patients from Araku Valley are undergoing treatment at the hospital, have been diagnosed with cutaneous anthrax. However, district health officials said that these are only suspected cases and samples have been sent to a government lab in Gwalior [Madhya Pradesh] for confirmation.

"The 2 patients from Araku, ages 47 and 35, were admitted a couple of days ago and are now being treated in the dermatology ward after they developed ulcers on fingers. They have been diagnosed with anthrax but their condition is stable," informed KGH resident medical officer Dr B Bangaraiah. "Anthrax caused by bacillus bacteria is curable when diagnosed and treated early, but it may affect the lungs and become fatal if timely treatment is not given," said the doctor.

However, district medical and health officer R Syamala said that the cases "haven't been confirmed" yet. "Samples have been collected and sent to the government laboratory in Gwalior for analysis and we are awaiting the reports. Medical camps have been conducted in the vulnerable Agency areas from 13 to 16 Jun 2013, but no fresh cases were reported and there's no cause for panic," said Syamala.

Agency areas, including Chintapalli, Munchingput, and Araku, are the most vulnerable and almost every year anthrax cases, including deaths, are reported from these places. "There were no dead cattle, goats, or ailing animals in Araku. Otherwise, we would have started vaccination programmes. These Agency areas are anthrax endemic regions and repeatedly anthrax cases occur here," said the joint director of animal husbandry department, V Venkateshwar Rao, who sent his team to Araku to examine the animals.

"Vaccination has been undertaken for 3 consecutive years. We have sent the soil samples for culture test for detecting the bacterial spores to the Veterinary Biological Research Institute, Hyderabad [Andhra Pradesh], and the test results are expected in a fortnight," said Rao.

"Depending on the entry of the spores, anthrax may be cutaneous (skin), intestinal, digestive, or pulmonary. In Araku, cutaneous is the most common form of anthrax," he said. "A few years ago, there were cases of skin ailments because of bacterial infections from border areas of Odisha and the symptoms were akin to anthrax. This time, again, similar symptoms could have been confused with anthrax and this needs confirmation. People might have also eaten a goat that the locals said had died of snakebite and consumption of that poisoned meat might have caused some complications," said Rao. Anthrax cases were suspected in the district as around 25 tribal families complained of ulcers on their fingers after consuming goat meat about 2 weeks ago. However, now 2 of them are under treatment at KGH.

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[This is a puzzle and will so continue until a confirmed diagnosis either way is available on these 2 human cases. While apparently livestock "vaccination has been undertaken for 3 consecutive years," these 3 named areas have "endemic" -- probably enzootic -- anthrax with repeated cases, possibly of livestock AND humans. If the vaccination programmes were effective as they should be with a competent vaccine and local participation, vaccination should have quickly reduced the incidence to sporadic. Presumably the "soil samples" were taken from the place where the suspected sick goat was butchered. The more we learn of this event the more confusing it gets.

To find Andhra Pradesh in SE India see the maps at http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg and http://healthmap.org/r/7mj2.
For a map of Andhra Pradesh, see http://www.mapsofindia.com/maps/andhrap ... strict.htm. Visakhapatnam district is in the NE corner of the state. To find Araku, on the northern border of the district, go to http://www.mapsofindia.com/maps/andhrap ... patnam.htm. - Mod.MHJ]

ANTHRAX - INDIA (09): (ANDHRA PRADESH)
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Date: Tue 18 Jun 2013
From: Panduranga Rao <raopp@ellafoundation.org> [edited]


[Re: ProMED-mail Anthrax - India (07): (AP) caprine source, susp. 20130617.1778236]
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Anthrax was endemic only in the Chithoor district earlier. Now cases of anthrax are reported from all over the sheep-rearing areas of northern coastal Andhra Pradesh [AP], Godavari districts, and Krishna districts. The disease is peracute in sheep. Most of the sheep in coastal districts of AP are nomadic and this disease is suspected to be spreading to new areas. The peracute nature of disease in sheep, the nomadic nature of sheep rearing, and the tendency of the shepherds to leave the dead carcasses in the open, precipitate these outbreaks.

Human cases are due to the habit of eating dead animals, and [this risk is compounded when] preserving the meat for [later] human consumption by sun drying after salting. [This latter action] results in disease in humans [months] after the [initial livestock] disease outbreak has been controlled.


The Veterinary Biological Research Institute (VBRI) Hyderabad has the facilities to diagnose anthrax and it is not clear why samples [from this series of cases] were sent to the defence research laboratory. This clearly stresses the need for strong collaboration between the human and animal health divisions of the state.

--
Panduranga Rao
Ella Foundation
<raopp@ellafoundation.org>

[Our thanks to Dr Rao for his insightful comments. Frankly we need more members like Dr Rao for many reasons, including special expertise and experience, and because you have your informed eyes on the ground. Thank you.

To find Andhra Pradesh in SE India see the maps at http://www.lib.utexas.edu/maps/middle_e ... _pol01.jpg and http://healthmap.org/r/2JmE.
For a map of Andhra Pradesh, see http://www.mapsofindia.com/maps/andhrap ... strict.htm. - Mod.MHJ]