1. Recurrent Anthrax Outbreaks in Humans, Livestock, and Wildlife in the Same Locality, Kenya, 2014-2017.
- Author
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Muturi M, Gachohi J, Mwatondo A, Lekolool I, Gakuya F, Bett A, Osoro E, Bitek A, Thumbi SM, Munyua P, Oyas H, Njagi ON, Bett B, and Njenga MK
- Subjects
- Animals, Animals, Wild microbiology, Anthrax epidemiology, Anthrax microbiology, Anthrax mortality, Bacillus anthracis pathogenicity, Buffaloes microbiology, Cattle, Cattle Diseases microbiology, Cattle Diseases mortality, Gastrointestinal Diseases epidemiology, Gastrointestinal Diseases microbiology, Gastrointestinal Diseases mortality, Humans, Kenya epidemiology, Livestock microbiology, Risk Factors, Skin Diseases, Bacterial epidemiology, Skin Diseases, Bacterial microbiology, Skin Diseases, Bacterial mortality, Spores, Bacterial pathogenicity, Survival Analysis, Anthrax veterinary, Bacillus anthracis physiology, Cattle Diseases epidemiology, Disease Outbreaks, Gastrointestinal Diseases veterinary, Skin Diseases, Bacterial veterinary, Spores, Bacterial physiology
- Abstract
Epidemiologic data indicate a global distribution of anthrax outbreaks associated with certain ecosystems that promote survival and viability of Bacillus anthracis spores. Here, we characterized three anthrax outbreaks involving humans, livestock, and wildlife that occurred in the same locality in Kenya between 2014 and 2017. Clinical and epidemiologic data on the outbreaks were collected using active case finding and review of human, livestock, and wildlife health records. Information on temporal and spatial distribution of prior outbreaks in the area was collected using participatory epidemiology. The 2014-2017 outbreaks in Nakuru West subcounty affected 15 of 71 people who had contact with infected cattle (attack rate = 21.1%), including seven with gastrointestinal, six with cutaneous, and two with oropharyngeal forms of the disease. Two (13.3%) gastrointestinal human anthrax cases died. No human cases were associated with infected wildlife. Of the 54 cattle owned in 11 households affected, 20 died (attack rate = 37%). The 2015 outbreak resulted in death of 10.5% of the affected herbivorous wildlife at Lake Nakuru National Park, including 745 of 4,500 African buffaloes (species-specific mortality rate = 17%) and three of 18 endangered white rhinos (species-specific mortality rate = 16%). The species mortality rate ranged from 1% to 5% for the other affected wildlife species. Participatory epidemiology identified prior outbreaks between 1973 and 2011 in the same area. The frequency and severity of outbreaks in this area suggests that it is an anthrax hotspot ideal for investigating risk factors associated with long-term survival of anthrax spores and outbreak occurrence.
- Published
- 2018
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