Sierra Leone - The Ministry of Health and Sanitation has declared an outbreak of human anthrax

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Immediate notification
Anthrax , Sierra Leone
...

General Information

COUNTRY OR ZONE
ZONE

DISEASE
Anthrax

STARTED ON
26-02-2022

ANIMAL TYPE
TERRESTRIAL

CONFIRMED ON
11-05-2022

REASON
Recurrence of an eradicated disease

CAUSAL AGENT
Bacillus anthracis

ENDED ON
-

DISEASE CATEGORY
OIE-listed

REPORTED ON
17-05-2022

LAST OCCURRENCE
31-08-2013

Epidemiology

SOURCE OF EVENT OR ORIGIN OF INFECTION
- Contact with infected animal(s) at grazing/watering points


EPIDEMIOLOGICAL COMMENTS
The Ministry of Agriculture is responding to the outbreak using the following actions. 1. To urgently conduct a detailed epidemiological investigation to ascertain the burden and extent of spread of the outbreak; to determine the source of exposure to animals and to undertake a joint risk assessment of risk of exposure of anthrax from animals to humans. 2. To strengthen Central Veterinary Laboratory Diagnostic capacity for laboratory confirmation. 3. To raise awareness among the livestock value chain actors and the public about the dangers of anthrax. 4. To institute appropriate prevention and control measures using a One Health Approach.
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Outbreaks

ob_103187 - Port Loko

OUTBREAK REFERENCE
-

STARTED ON
26-02-2022

EPIDEMIOLOGICAL UNIT
Farm

NUMBER OF OUTBREAKS
30

ENDED ON
-

AFFECTED POPULATION DESCRIPTION
The disease is affecting cattle, sheep, and goats in semi-intensive system of management. For the cattle, only the mature animals are dying whilst for the goats and sheep, all age and sex groups are dying. The ranches are close to forest reserves, only animals in the six ranches which share common grazing and watering facilities are affected. Most of the animals appear healthy but die suddenly.

APPROXIMATE LOCATION
Port Loko

FIRST ADMINISTRATIVE DIVISION
Northern

SECOND ADMINISTRATIVE DIVISION
Port Loko

THIRD ADMINISTRATIVE DIVISION
Maforki

GEOGRAPHIC COORDINATES
Lat : 8.6891

Long : -12.8513


SPECIES MEASURING UNIT SUSCEPTIBLE CASES DEATHS KILLED AND DISPOSED OF SLAUGHTERED/KILLED FOR COMMERCIAL USE VACCINATED
Sheep NEW Animal 430 26 26 0 0 0
TOTAL Animal 430 26 26 0 0 0
Goats NEW Animal 350 15 15 0 0 0
TOTAL Animal 350 15 15 0 0 0
Cattle NEW Animal 600 61 61 0 0 0
TOTAL Animal 600 61 61 0 0 0
- NEW Animal 1380 102 102 0 0 0
TOTAL Animal 1380 102 102 0 0 0
...

https://wahis.oie.int/#/report-info?reportId=54185

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 21: 16 – 22 May 2022
Data as reported by: 17:00; 22 May 2022
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All events currently being monitored by WHO AFRO
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Sierra Leone Anthrax Ungraded

Date notified to WCO 20-May-2022
Start of reporting period 20-May-2022
End of reporting period 20-May-2022

Total cases 7
Cases Confirmed 3
Deaths 0
CFR 0.0%

The Ministry of Health and Sanitation in Sierra Leone has declared an outbreak of human anthrax in the country after identifying 3 lab confirmed cutaneous anthrax cases in Karene district. This is subsequent to an investigation of 7 suspected anthrax cases, all residing in Buya chiefdom, of whom 4 blood samples and swabs were collected and sent to the laboratory for confirmation. The investigation was conducted as follow up to reports of sickness and death of animals in the adjacent Port Loko district between March and April, with reported consumption of meat in surrounding communities. There was also prior confirmation of anthrax from tissues collected from some of the affected animals during epi week 19. These cases are 5 males (71%) and 2 females (29%), with a median age of 8 years (range: 4 months – 60 years). Majority of them are among the age group of 15 years and above (n=3; 43%) followed by 12-59 months (n=2; 29%), 0-11 months (n=1; 14%) and 5-15 years (n=1; 14%). Five of the cases reported symptoms onset from 11th to 27th April 2022 and the other two cases had symptoms onset on 5th May 2022.

https://apps.who.int/iris/bitstream/handle/10665/354552/OEW21-1622052022.pdf

https://www.afro.who.int/countries/mozambique/publication/outbreaks-and-emergencies-bulletin-week-21-16-22-may-2022

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 22 : 23 - 29 May 2022
Data as reported by: 17:00; 29 May 2022
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Cutaneous anthrax Sierra Leone

8 cases
0 Death
0% CFR

EVENT DESCRIPTION

The Ministry of Health of Sierra Leone officially notified the World
Health Organization of a confirmed outbreak of cutaneous anthrax
in Karene District, North-West Province of the country on 16 May
2022, following laboratory confirmation.

On 14 May 2022, the Karene District health authority was alerted
of patients presenting at a local health facility with signs and
symptoms typical of anthrax. An investigation by the district
health rapid response team from 14 to 16 May 2022 identified
eight suspected human cases of anthrax in Karene District. Five
of the cases reported onset of symptoms between 11 and 27
April 2022, while three had onset of symptoms on 5 May 2022.

Swab and blood specimens were collected from four of the
suspected cases and sent to the 34 Infectious Diseases Laboratory
for testing. Culture analysis of the samples from three of the
suspected cases returned positive on 16 May 2022, confirming
Bacillus anthracis infection. The sample from the other suspected
case was not analyzed due to insufficiency. All four cases sampled
are stable and undergoing treatment on an outpatient basis at the
Karene District Hospital. The other four cases fled the area and
have not yet been located by the health team.

Of seven cases with available data, five are females and two are
males. Age group distribution of the cases showed the following:
less than one-year-old (1), 1 to 5 years old (2), 5 – 15 years old
(1), and above 15 years old (3).

The declaration of a human anthrax outbreak in Sierra Leone
followed the declaration of an outbreak of anthrax among
animals by the Ministry of Agriculture on 15 May 2022 in the
same North-West Province. The animal anthrax outbreak was
detected in Tambkebereh village, Port Loko District following
laboratory confirmation of Bacillus anthracis in one sample out
of 54 specimens from dead cattle tested at the Central Veterinary
Laboratory (CVL) on 11 May 2022. In total, 304 suspected cases
among dead cattle have been identified in two districts – Port
Loko district (204) and Karene district (100). One case has been
confirmed among dead cattle in the Port Loko district.

PUBLIC HEALTH ACTIONS

The Emergency Operation Centre (EOC) has been activated
to level two to coordinate national and district level response
to the anthrax outbreak.

The Ministry of Health and Sanitation and the Ministry of
Agriculture have officially notified WHO and the Food and
Agriculture Organization respectively, of the outbreak of
anthrax among humans and animals in Sierra Leone.

The One Health anthrax outbreak response plan is being
developed.

The process for further testing of animal sample oversees
is underway.

Anthrax fact sheet is being developed and translated into
local languages by the One Health communication team.

The human cases are receiving outpatient treatment at the
Karene District Hospital and are in a stable condition.
Identification and quantification of IPC supplies for both
human and animal health is ongoing.

The case management leads for both human and animal
health have been identified and are developing case
management protocols.

Protocol for burial of carcasses and animal vaccination is
under development.

Active case finding for additional cases is ongoing in all of the
northern districts.

Suspected case definition for human anthrax has been
developed and shared with the districts.

Plans are underway to orient the districts and community
animal and human health workers.

A ban on inter-district movement of cattle has been instituted.

SITUATION INTERPRETATION

This is the first outbreak of anthrax among humans detected and
officially notified by Sierra Leone to WHO since 1994. All human
cases identified in the current outbreak are of the cutaneous
form, a less deadly form of anthrax, and follows handling of
carcasses of infected cattle. Concerted efforts using the onehealth
approach involving the human-animal-environment interface will be
critical to containing this outbreak. Enhanced risk
communication and community engagement will be needed to
create awareness on the risk of infection among local population.
In the health care settings, samples must be collected carefully
to avoid contamination of the environment and to prevent human
exposure to the bacteria.

View/Open

OEW22-2329052022.pdf (2.568Mb)