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

Ashenefe Wassie, Baye, Fantaw, Surafel, Mekonene, Yonas, Teshale, Amete Mihret, Yitagesu, Yohannis, Tsige, Estifanos, Getahun, Desalegn, Tasew, Geremew, Abichu, Getachew, Moges, Beyene
et al (show 5 more authors) (2022) First PCR Confirmed anthrax outbreaks in Ethiopia-Amhara region, 2018-2019. PLoS neglected tropical diseases, 16 (2). e0010181-e0010181.

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<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: Animals, Cattle, Goats, Dogs, Cats, Humans, Bacillus anthracis, Anthrax, Polymerase Chain Reaction, Disease Outbreaks, Meat, Adolescent, Adult, Aged, Middle Aged, Child, Ethiopia, Female, Male, Young Adult, Livestock
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 11 Mar 2022 08:07
Last Modified: 18 Jan 2023 21:11
DOI: 10.1371/journal.pntd.0010181
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