Cutaneous anthrax associated with handling carcasses of animals that died suddenly of unknown cause: Arua District, Uganda, January 2015–August 2017

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dc.contributor.authorLoy Aceng, Freda
dc.contributor.authorRiolexus Ario, Alex
dc.contributor.authorAlitubeera, Phoebe Hilda
dc.contributor.authorMatinda Neckyon, Mukasa
dc.contributor.authorKadobera, Daniel
dc.contributor.authorSekamatte, Musa
dc.contributor.authorOkethwangu, Denis
dc.contributor.authorBulage, Lilian
dc.contributor.authorHarris, Julie R.
dc.contributor.authorNguma, Willy
dc.contributor.authorBirungi Ndumu, Deo
dc.contributor.authorBuule, Joshua
dc.contributor.authorNyakarahuka, Luke
dc.contributor.authorZhu, Bao-Ping
dc.date.accessioned2022-03-18T21:05:19Z
dc.date.available2022-03-18T21:05:19Z
dc.date.issued2021
dc.description.abstractAnthrax is a zoonotic disease that can be transmitted to humans from infected animals. During May–June 2017, three persons with probable cutaneous anthrax were reported in Arua District, Uganda; one died. All had recently handled carcasses of livestock that died suddenly and a skin lesion from a deceased person tested positive by PCR for Bacillus anthracis. During July, a bull in the same community died suddenly and the blood sample tested positive by PCR for Bacillus anthracis. The aim of this investigation was to establish the scope of the problem, identify exposures associated with illness, and recommend evidencebased control measures. Methods A probable case was defined as acute onset of a papulo-vesicular skin lesion subsequently forming an eschar in a resident of Arua District during January 2015–August 2017. A confirmed case was a probable case with a skin sample testing positive by polymerase chain reaction (PCR) for B. anthracis. Cases were identified by medical record review and active community search. In a case-control study, exposures between case-patients and frequency- and village-matched asymptomatic controls were compared. Key animal health staff were interviewed to learn about livestock deaths. Results There were 68 case-patients (67 probable, 1 confirmed), and 2 deaths identified. Cases occurred throughout the three-year period, peaking during dry seasons. All cases occurred following sudden livestock deaths in the villages. Case-patients came from two neighboring sub-counties: Rigbo (attack rate (AR) = 21.9/10,000 population) and Rhino Camp (AR = 1.9/ 10,000). Males (AR = 24.9/10,000) were more affected than females (AR = 0.7/10,000). Persons aged 30–39 years (AR = 40.1/10,000 population) were most affected. Among all cases and 136 controls, skinning (ORM-H = 5.0, 95%CI: 2.3–11), butchering (ORM-H = 22, 95%CI: 5.5–89), and carrying the carcass of livestock that died suddenly (ORM-H = 6.9, 95% CI: 3.0–16) were associated with illness. Conclusions Exposure to carcasses of animals that died suddenly was a likely risk factor for cutaneous anthrax in Arua District during 2015–2017. The recommendations are investigation of anthrax burden in livestock, prevention of animal infections through vaccinations, safe disposal of the carcasses, public education on risk factors for infection and prompt treatment of illness following exposure to animals that died suddenly.en_US
dc.identifier.citationAceng FL, Ario AR, Alitubeera PH, Neckyon MM, Kadobera D, Sekamatte M, et al. (2021) Cutaneous anthrax associated with handling carcasses of animals that died suddenly of unknown cause: Arua District, Uganda, January 2015–August 2017. PLoS Negl Trop Dis 15(8): e0009645. https://doi.org/10.1371/journal. pntd.0009645en_US
dc.identifier.urihttps://doi.org/10.1371/journal. pntd.0009645
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2830
dc.language.isoenen_US
dc.publisherPLoS Neglected Tropical Diseasesen_US
dc.subjectCutaneous anthraxen_US
dc.subjectCarcasses of animalsen_US
dc.subjectArua Districten_US
dc.subjectUgandaen_US
dc.titleCutaneous anthrax associated with handling carcasses of animals that died suddenly of unknown cause: Arua District, Uganda, January 2015–August 2017en_US
dc.typeArticleen_US
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