Outbreak of cutaneous anthrax among residents of Meru County, Kenya 2019

Abstract

Background: Anthrax, an infectious zoonotic disease, is a global public health concern and among Kenya's top ten endemic priority zoonotic diseases. The case fatality rate (CFR) rises where no immediate action is taken.

Objective: This study estimated the magnitude and geospatial distribution of anthrax cases in Meru county

Design: A cross-sectional study

Setting: The investigation was conducted in five sub-counties of Meru county, where media reports had sighted hospitalization of community members after consumption of meat from a carcass of a cow. The majority of the people who consumed meat were traced for interview.

Interventions: Snowballing technique was applied to trace cases and electronically loaded questionnaires administered to community members and key informant interviews. Laboratory confirmation was done using the gram staining technique.

Outcome measures: A total of 40 probable cases were traced. One case tested positive for Bacillus anthracis. CFR was 5% and the median age 25 years with an interquartile range (IQR) of 54 years. Majority (90%) of the cases presented skin lesions/eschar; commonest form of exposure was the consumption of infected meat from dead livestock. Cases were distributed in 5 sub-counties. Key informants’ interview reports indicated livestock mortalities during the outbreak.

Conclusion: Consumption of livestock carcasses poses a public health threat. Epidemiological data showed wide distribution of cases within the county. Late laboratory confirmation of cases and limited resources are the main reasons for underreporting hence need to increase laboratory diagnostic capacity at the Sub-county level. There is need for public health education and regular livestock vaccination.