Announcement

**Treyfish** · April 14, 2007, 07:17 PM

Re: Anthrax quarantine - 2000 persons

<TABLE summary=""><TBODY><TR><TD noWrap align=right>Published Date</TD><TD noWrap align=left>14-APR-2007</TD></TR><TR><TD noWrap align=right>Subject</TD><TD noWrap align=left>PRO/AH/EDR> Anthrax, human, livestock - Indonesia (NTT)</TD></TR></TBODY></TABLE>

ANTHRAX, HUMAN, LIVESTOCK - INDONESIA (NUSA TENGGARA TIMOR)******************************************** ***A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<http://www.isid.org>Date: Sat 14 April 2007From: Brent Barrett <salbrent@sbcglobal.net>Source: Jakarta Post<http://www.thejakartapost.com/detailnational.asp?fileid=20070414.G02&irec=1>Suspected anthrax outbreak in West Sumba results in 5 people dead.The deaths of 5 people in 2 villages in West Sumba region, East Nusa Tenggara [Nusa Tenggara Timor], have led authorities to quarantine both areas due to a suspected outbreak of anthrax. The residents, from Kapaka Madeta and Kawangohari villages, died after consuming beef at the end of last month [March 2007].Laboratory results from Makassar, South Sulawesi [Sulawesi Selatan], showed meat samples taken from buffaloes, horses and cows positively infected with the _Bacillus anthracis_ bacteria, which causes anthrax.The local administration says the outbreak in the 2 villages is an extraordinary situation and a number of relevant agencies are making efforts to vaccinate and treat thousands of hot-blooded animals, including goats, pigs, sheep and deer.Head of the Animal Health Division at the East Nusa Tenggara [Nusa Tenggara Timor] Husbandry Office, Maria Geong, said in Kupang on Friday [13 Apr 2007] that anthrax was a fatal disease."Anyone infected by the virus has little chance of surviving," she said. "Spores which protect the bacteria probably surfaced due to floods or the dry weather. Anthrax spores can live up to 60 years underground," she said.According to data at the provincial husbandry office, anthrax started appearing on Sumba, Flores, Timor and Rote islands between 1906 and 1957, attacking hot-blooded livestock. It reoccurred in Aesesa district, Ngada regency in 1954, causing the deaths of hundreds of horses, goats and sheep.The last outbreak occurred in 1987 on Sabu Island, Kupang regency, resulting in one human death as well as the death of dozens of animals. During that outbreak, hundreds of people also suffered from malignant, blister-like swellings of pus. "Data shows that 40 people in East Nusa Tenggara [Nusa Tenggara Timor] have died of anthrax so far," Maria said. Clinically, anthrax attacks only hot-blooded animals. Human infection occurs by direct physical contact with an infected animal. The disease can also be transmitted to humans by inhaling air containing the anthrax spore or (eating meat from infected carcasses)," said Maria.Animals suffering from the disease will have blood coming from their mouth, nose, ears and anus. They will have a high body temperature and difficulty breathing.--ProMED-mail<promed@promedmail.org>[Many thanks to Joe Dudley and A-lan Banks for submitting the same or similar articles. The general location of the outbreaks can be seen at: <http://www.answers.com/topic/east-nusa-tenggara>. The islands are part of a volcanic arc, the Lesser Sundra Islands, extending from Bali to Timor.The case fatality rate for gastrointestinal anthrax is high according to World Health Organization (WHO) Guidelines for the Surveillance and Control of Anthrax in Humans and Animals, which can be seen here: <http://www.who.int/csr/resources/publications/anthrax/WHO_EMC_ZDI_98_6/en/ >.Mod.MHJ who usually handles these posting but is "off duty" presently is a contributor to the document. It indicates that 95 percent or more of the cases globally are cutaneous in nature. Overt gastrointestinal and pulmonary cases of anthrax are more often fatal as treatment is often not administered in a timely fashion. Serological evidence does indicate recovery in some individuals. Gastrointestinal anthrax is of two forms, intestinal and oropharygeal. The latter can be fatal in half the cases, even with treatment.I can only guess the term "hot blooded animals" in the article means warm blooded mammals, of which herbivores are most susceptible. It is true that spores are extremely long lived in soil and that outbreaks often occurred after either rain and/or drought. The WHO surveillance guidelines indicate further research is needed to clarify the interaction of rain, temperature and drought in producing outbreaks of anthrax.Finally, it appears that outbreaks such as this are relatively common in Indonesia. Interested readers can find a discusion about surveillance and control in a previous posting referenced below - see Anthrax, human, livestock - Indonesia (West Java) 20051118.3360 - Mod.PC][For maps of Indonesia see <http://www.lib.utexas.edu/maps/middle_east_and_asia/indonesia_pol_2002.jpg> and <http://www.lib.utexas.edu/maps/middle_east_and_asia/indonesia_adm_98.jpg> (East Nusa Tenggara is also known as Nusa Tenggara Timor or NTT). For a map of East Nusa Tenggara showing the islands, including Sumba, see <http://www.indonesia-tourism.com/east-nusa-tenggara/map/ntt_map_high.png>. - Mod.MPP]http://www.promedmail.org/pls/promed/f?p=2400:1001:1879152139836165970::NO::F2400_P1001 _BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,37064</PRE>

**Treyfish** · April 15, 2007, 12:53 PM

Re: Anthrax quarantine - 2000 persons

The RSOE Alert map has the same report as promed,with the google sat/map of the area. http://hisz.rsoe.hu/alertmap/woalert...10851&lang=eng A big river in the town,farm fields and a large community center or barn.The other town is downstream.

**Treyfish** · April 17, 2007, 07:47 AM

Re: Anthrax quarantine - 2000 persons

50.
000 cartons of anthrax medicine were carried to Sumbar

The mussel, PK

The team from the NTT Service of province Livestock Breeding, on Friday (13/4/2007), departed from Kupang for Sumba West by bringing 50 thousand cartons of anthrax medicine, 30 bottles of medicine antibiotik to the village that experienced KLB anthrax, namely the Kapaka Madeta Village and the Kawangohari Village in the Subdistrict Score.
"This case in fact already through but because his spores were then we must see as far the spreading" of "animal meat that could be consumed by the resident several weeks ago that resulted in the death," said Kasubdin the Health of the NTT Animal of the Livestock Breeding Service, drh.
Maria Geong that was met in his residence in Oesapa-Kupang, on Friday (13/4/2007).
Explained, anthrax was the illness infeksius and spread to the animal that was caused by the bacteria bacillus antrhaxis that formed spores.This illness could be spread from the sufferer's animal to humankind so as to be classed as the illness zoonosa or zoonosis.
He said, anthrax not the new illness because in the Sumba Island during 1939 the plague of anthrax happened although his impact on the death of humankind at that time was not yet printed.
"This information (KLB anthrax, Red) we just knew from the newspaper as well as from the West Sumatra Livestock Breeding Service."
Because of that the first step was immediately descended to the location, said Maria Geong.
According to him, meat that has been affected by anthrax was very dangerous because that humankind might not eat him.
He said, spores could remain for 60 years in the dry land be as deep as 6 cm.
Therefore, when rain or dry long these spores emerged to the surface and caused the anthrax illness.
"So be hoped by us that livestock meat that died should be not eaten."
But, sometimes the community liked to divide animal meat that has died everywhere so as to extend the spread, he said into parts.
Asked about how identified meat and the location that have been affected by anthrax, Maria Geong said that had difficulty because in an epidemilogi manner anthrax depended on available spores in the land.
"These spores lived in the land around 6 cm and physically this anthrax illness was difficult to be combatted although using ultraviolet rays."
And, we did not know the spreading of these
spores because in the situation tetentu for example to the flood happen or dry long this illness emerged again.
Because of that that must be carried out by us was the vaccination was arranged.
Without this illness vaccination will continue to spread, he said.
He hoped so that the Regional Government/the Municipal Government in NTT strove for the operational fund for the handling of this case."All the regencies were threatened by the spreading" of "anthrax except two regencies namely Flores East and Lembata."
Because of that the regional government must prepare the operational fund to overcome this problem.
Because of this case although already dozens of years but will spread like in Australia he came back after 69 years.
Also in Sumba available since 1939 and currently again.
The return of this case, he said, also in part because of the animal traffic.
Moreover this case his spreading from the bloody animal hot like the goat, the water buffalo, cattle, the horse and the sheep as well as humankind.
And this illness zoonosis so as his handling by the livestock breeding service and the health service.Concerning the characteristics of the affected animal anthrax that is dying suddenly, the high fever, the animal carcass mengembung and rotted as well as that was most classic was to go out blood from the body hole like ears, the nose, the eyes and the anus.(iva http://www.indomedia.com/poskup/200...14/1404uta3.htm
__________________

**Treyfish** · April 17, 2007, 07:49 AM

Re: Anthrax quarantine - 2000 persons

Nasional
16/04/07 12:31

Anthrax Serang Sumba Barat

The mussel (Antara News) - the anthrax Illness it was reported attacked two villages in the Sumba Regency West, East Nusa Tenggara (NTT), so as to result in the death of dozens of tails of the cattle livestock, the water buffalo and the horse.The head of the Sub- Service (Kasubdin) the Health of the East Nusa Tenggara Animal of the Service of Province Livestock Breeding (NTT), drh.
Maria Geong, that it was confirmed on Monday, acknowledged the existence of the anthrax attack in the Sumba Regency West and at this time was leading the team to handle this case in the field.
"I was I was being in Score, Sumba West, was with the related agency in Sumba West handled this case," said Maria Geong.
He said two villages that were reported were attacked by anthrax, namely the Kapaka Madeta Village and the Kawangohari Village in the Subdistrict Score, has been isolated and the community has been asked for in order to not issue the livestock from the two villages.
The resident was also asked to bury each animal that died because of anthrax in order to be not consumed by humankind because of could endanger the safety of the spirit who consumed beef that was infected by anthrax.
This step was followed to mengisolir expanded him this anthrax illness to neighbouring villages, he said.
Anthrax was the illness ifeksius and spread to the animal that was caused by the bacteria bacillus antrhaxis that formed spores.
This illness could be spread from the sufferer's animal to humankind so as to be classed as the illness zoonosa or zoonosis.
According to him, anthrax not the new illness in the Sumba Island as one of the areas of the producer of the livestock.
During 1939 this illness had happened although his impact on the death of humankind at that time was not yet printed.
He explained meat that has been affected by anthrax was very dangerous because that might not be consumed by humankind.
"We at once descended to the field because we worried, the community divided meat that has been affected by anthrax," he said into parts.
Anthrax in the Sumba Regency West that just was known after results of the sample test of beef, the water buffalo and the horse to the laboratory to Jendral Balai Besar Veteriner Maros Directorate, Sulsel several weeks ago.
"We only read in the mass media and decided to descend to the field because of must have the step" in "early to
mengisolir the affected area the virus in order to not spread," he said.
()
http://www.antara.co.id/arc/2007/4/...ng-sumba-barat/

**Treyfish** · April 17, 2007, 07:51 AM

Re: Anthrax quarantine - 2000 persons

Caonacl 2007/04/16
Five Indonesian villagers dead from anthrax

KUPANG, Indonesia, MON.: Health officials are monitoring around 90 families in two Indonesian villages for signs of anthrax which has already killed five people, an official said Monday.

The deaths forced authorities to seal off the villages on Sumba island last Saturday and begin mass vaccination of livestock in the area, veterinary official Maria Geong said.

?At least 90 families in the two isolated villages are suspected of having been contaminated by the anthrax bacteria,? Geong said.

All members of the families had eaten parts of cows and water buffalo believed to have been infected, she said.

She said they had been asked not to leave their villages until further notice. Geong did not say how many family members in total the emergency action affected.
About 2,000 people live in the two villages, which will be sealed off for a month to stop more people from being infected.

Apart from killing five residents, the disease has forced 12 others to undergo intensive treatment after showing symptoms, Geong said.

Anthrax is an acute infection that usually only afflicts livestock but can be transmitted to humans who handle or eat affected animals.

Geong said a 60-strong team are currently vaccinating 50,000 cows, buffalo, goats and pigs in the area.

Dead and infected animals have already been burnt but any remnants of their flesh and bones were now being collected to prevent a further spread of the disease.

The bacteria can survive for more than 60 years, including buried under five centimetres of soil.

Sumba island is in East Nusa Tenggara province, where some 40 people have died from anthrax since 1994, Geong said. - AFP

http://www.nst.com.my/Article/vArt?did=20070416140742

**Treyfish** · April 17, 2007, 07:52 AM

Re: Anthrax quarantine - 2000 persons


90 families is an awful lot!If there are just 1 or 2 kids PER FAMILY means over 300 sick!12 showing symptoms so far is a low number.

**Treyfish** · April 17, 2007, 07:56 AM

Re: Anthrax quarantine - 2000 persons

Info sheet from the FAO Anthrax

Anthrax is a peracute disease of ruminants manifested with septicemia, sudden death and tarry blood from the body openings of the cadaver. It is caused by Bacillus anthracis.

Transmission
Man may contract anthrax by inhalation, ingestion and through a wound in the skin. Biting flies have been shown to be transmitters. Post-mortem findings
The peracute and acute forms in cattle and sheep are without clinical signs. Death may follow in the acute form after 1 - 2 hours of illness. The acute form lasts about 48 hours.

In pigs and horses this disease is usually localized and chronic and is often characterized by swelling around the throat and head.

Ante-mortem findings in pigs:
1. Incubation 1 - 2 weeks
2. Edematous swelling of the throat and neck
3. Swallowing and breathing difficulties
4. Death due to choking or toxaemia
5. Septicemia is not observed.

Post-mortem findings
1. Dark-tarry blood discharge from body orifices
2. Absence of rigor mortis
3. Haemorrhage of the mucous and serous membranes, lymph nodes and subcutaneous tissue
4. Enlarged spleen
5. Severe haemorrhagic enteritis
6. Degeneration of the liver and kidneys
7. Bloating and rapid decomposition of carcass
8. Localized lesions in the intestine of pigs (dysentery)

Judgment
Condemnation of the carcass and its parts by burning or burial. If disposed by burial, the carcass should be buried at least 6 feet below ground. The site should be surrounded by a foot thick layer of quicklime.

this will be a huge job to clean up and to protect others from infection. Discussion
If an animal has died from an unknown cause in an abattoir's pen or in the stockyard, a blood smear from the tip of the ear should be examined to eliminate anthrax as a cause of death. All measures should be taken to prevent further contact with the carcass. The orifices of the nose, vulva and anus should be packed with cotton swabs to eliminate further spillage of discharge. The carcass must not be opened. Due to insufficient oxygen supply in the closed carcass, spores of B. anthracis will not be formed and the organism will be killed. The spilled discharge is firstly removed by drying with sawdust and sand and is then destroyed together with the carcass. The carcass is wrapped in thick plastic sheets and destruction is performed under the supervision of an appropriate government official.
An open carcass facilitates exposure of B. anthracis to air and consequently, spores are formed within a few hours. Anthrax spores are resistant to heat and disinfectants and may survive in a suitable environment for years.

The abattoir's pen or stockyard area suspected of being in contact with an anthrax animal should be disinfected with 10 % NaOH or 5 % formaldehyde and cleaned. This cleaning should also include the cattle trucks or cars used for the transportation of infected animals.

All personnel that were in contact with anthrax or that handled contaminated material, are also subjected to decontamination. The arms and hands should be washed with liquid soap and hot water. After they have been rinsed, they should be immersed for about one minute, in an organic iodine solution or 1 p.p.m. solution of mercuric perchloride or other acceptable agents. This is followed by a potable water rinse. Clothing of the personnel involved should also be cleaned and thoroughly disinfected by boiling.

If the carcass is discovered on the killing floor, all operations must cease. The carcass and its parts including hides, hooves, viscera and blood must be condemned and destroyed. The carcasses which have been dressed by the same abattoir employees prior to or after the affected carcass must also be condemned and destroyed. Those carcasses which had been dressed before the affected carcass may have a second option of being salvaged with sterilization. They must be boiled for a minimum of 3 hours if contamination occurred with blood splashes. If impractical, these carcasses may be used for "canned meat" for which heat treatment is recommended.

Disinfection of equipment used for the dressing of a diseased carcass as well as the infected abattoir area, should be done with 5 % solution of sodium hydroxide (NaOH). This disinfectant is used because of its action on fat and grease removal. Heat in the form of a blowtorch can be used for disinfecting buildings. http://www.fao.org/ag/againfo/subje...ds/anthrax.html

**Treyfish** · April 17, 2007, 07:36 PM

Re: Anthrax quarantine - 2000 persons

From Promed...[Anthrax is sporadic through much of Indonesia now having once been
under good control, affecting cattle, small ruminants, buffalo, and
occasionally horses and pigs.[U] It is seen on West Sumatra, Jambi, DKI
Jakarta, West Java, Central Java, West Nusa Tenggara, East Nusa
Tenggara, South Sulawesi, Southeast Sulawesi, & Central Sulawesi.[/U] And
because the veterinary response is reactive, not proactive, we now
routinely see such numbers of human cases. -Mod.MHJ]
http://www.promedmail.org/pls/prome...L_ID:1000,37093

**Treyfish** · April 20, 2007, 03:40 PM

Re: Anthrax quarantine - 2000 persons

Anthrax kills 8 in Indonesia

A total of 8 people died and 6 others were hospitalized after
consuming beef meat contaminated by anthrax in the Indonesian remote
island of Sumba, the local press said Friday.

The casualties have prompted the local government to isolate the Kodi
district in the impoverished East Nusa Tenggara province from cattle
traffic to prevent the spread of the animal-borne disease, reported
major national newspaper _Kompas_.

Laboratory tests have confirmed that the casualties and the ill
persons were positive for having anthrax, Deputy East Nusa Tenggara
Governor Frans Lebu Raya was quoted as saying. He said all cattle in
the area, about 1500 km east of Jakarta, have been vaccinated.

The Indonesian language newspaper gave no details about when the
incident occurred [see previous reports, noted below, for this
information], but the anthrax patients were still in the hospital
Thursday. The province has been declared vulnerable to anthrax since
1994, with more than 1150 cows infected in several regencies.
(Source: Xinhua)

---
ProMED-mail
<promed@promedmail.org>

[This is merely an update on _The Jakarta Post_ report of 17 April
2007. At that time 5 had died and 12 others were undergoing
"intensive" treatment after showing symptoms. It would seem that 3
may have been released from hospital. - Mod.MHJ]

http://tinyurl.com/yudzvf

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Anthrax quarantine - 2000 persons

Anthrax quarantine - 2000 persons

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