Outbreak of cutaneous anthrax in Musalimadugu village, Chittoor district, Andhra Pradesh, India, July-August 2011
DOI:
https://doi.org/10.3855/jidc.2635Keywords:
cutaneous anthrax, outbreak, risk factors, IndiaAbstract
Background: In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases, to Andhra Pradesh state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk-factors and make recommendations for preventing similar outbreaks in future.
Methods: We searched for suspected cutaneous anthrax cases defined as a painless skin lesion (papule, vesicle or eschar) that appeared between July-August 2011 in resident of Musalimadugu. We collected information about clinical details as well as smears from skin lesions from suspected case-patients and described the outbreak by time, place and person.We conducted a retrospective cohort study among villagers aged ≥ 15 years to identify risk factors for acquiring the infection.
Results: During 24 June-7August 2011, 16 livestock in the village died. Smears from 5 animals showed gram positive, spore bearing, bacillus characteristic of Bacillus anthracis. Villagers butchered and skinned the dead animals, sold the skin and consumed the meat after boiling it for 2 hours. The outbreak in humans started on 30 July, and 9 suspected cases of cutaneous anthrax (attack rate: 2%, no deaths) occurred till 7 August. The attack rate was higher among those aged 15 years or more. All the smears were negative on gram staining. Persons who had handled [Relative risk (RR): 56, 95% confidence interval (CI): 8.4 -571.8, population attributable fraction (PAF): 87%)], skinned (RR: 28, 95% CI: 8.4-93, PAF=54%) and slaughtered (RR: 21, 95% CI: 6.5-68.4, PAF: 42%) dead animals were at higher risk.
Conclusions: We recommended ciprofloxacin prophylaxis to close family contacts, community education to avoid slaughtering of dead/ ill livestock and vaccination of the livestock in the area.
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