Article history: Received: 29-07-2017, Accepted: 03-10-2017, Published online: 04-11-2017
Corresponding author: Elibariki R. Mwakapeje
E-mail: firstname.lastname@example.orgCitation: Mwakapeje ER, Assenga JA, Kunda JS, Mjingo EE, Makondo ZE, Nonga HE, Mdegela RH, Skjerve E. Prevention, detection, and response to anthrax outbreak in Northern Tanzania using one health approach: A case study of Selela ward in Monduli district. Int J One Health 2017;3:66-76.
Background: Anthrax is an infectious fatal zoonotic disease caused by Bacillus anthracis. Anthrax outbreak was confirmed in samples of wild animals following rumors of the outbreak in wild animals, livestock, and humans in Selela ward, Monduli district of Northern Tanzania. Therefore, a multi-sectoral team was deployed for outbreak response in the affected areas.
Objectives: The aim of the response was to manage the outbreak in a One Health approach and specifically: (i) To determine the magnitude of anthrax outbreak in humans, livestock, and wild animals in Selela ward, (ii) to assess the outbreak local response capacity, (iii) to establish mechanisms for safe disposal of animal carcasses in the affected areas, and (iv) to mount effective control and preventive strategies using One Health approach in the affected areas.
Materials and Methods: This was a cross-sectional field survey using: (i) Active searching of suspected human cases at health facilities and community level, (ii) physical counting and disposal of wild animal carcasses in the affected area, (iii) collection of specimens from suspected human cases and animal carcasses for laboratory analysis, and (iv) meetings with local animal and human health staff, political, and traditional leaders at local levels. We analyzed data by STATA software, and a map was created using Quantum GIS software.
Results: A total of 21 humans were suspected, and most of them (62%) being from Selela ward. The outbreak caused deaths of 10 cattle, 26 goats, and three sheep, and 131 wild animal carcasses were discarded the majority of them being wildebeest (83%). Based on laboratory results, three blood smears tested positive for anthrax using Giemsa staining while two wildebeest samples tested positive and five human blood samples tested negative for anthrax using quantitative polymerase chain reaction techniques. Clinical forms of anthrax were also observed in humans and livestock which suggest that wild animals may contribute as reservoir of anthrax which can easily be transmitted to humans and livestock.
Conclusion: The rapid outbreak response by multi-sectoral teams using a One Health approach managed to contain the outbreak. The teams were composed of animal and human health experts from national to village levels to control the outbreak. The study testifies the importance of multi-sectoral collaboration using One Health approach in outbreak preparedness and response.
Keywords: anthrax outbreak, human-livestock and wild animal's interface, response, Tanzania.
1. World Health Organization. Anthrax in Humans and Animals. Geneva, Switzerland: World Health Organization; 2008.
2. Shandomy AE, Raizman E, Bruni M, Palamara E, Pittiglio C, Lubroth J. Anthrax outbreaks: A Warning for Improved Prevention, Control and Heightened Awareness. Page No. 37. 2016. Available from: http://email@example.com; http://www.fao.org/ag/empreshtml. Last accessed on 12-01-2017.
3. Bengis RG, Frean J. Anthrax as an example of the one health concept. Rev Sci Tech 2014;33:593-604. [Crossref]
5. Lembo T, Hampson K, Auty H, Beesley CA, Bessell P, Packer C, et al. Serologic surveillance of anthrax in the Serengeti ecosystem, Tanzania, 1996-2009. Emerg Infect Dis 2011;17:387-94. [Crossref] [PubMed] [PMC]
6. Blackburn JK, Curtis A, Hadfield TL, O'Shea B, Mitchell MA, Hugh-Jones ME. Confirmation of Bacillus anthracis from flesh-eating flies collected during a West Texas anthrax season. J Wildl Dis 2010;46:918-22. [Crossref] [PubMed]
7. Fasanella A, Scasciamacchia S, Garofolo G, Giangaspero A, Tarsitano E, Adone R. Evaluation of the house fly Musca domestica as a mechanical vector for an anthrax. PLoS One 2010;5:e12219.
9. Fasanella A, Adone R, Hugh-Jones M. Classification and management of animal anthrax outbreaks based on the source of infection. Ann Ist Super Sanita 2014;50:192-5.
10. Anthrax Outbreak in a Swedish Beef Cattle Herd - 1st Case in 27 Years: Case Report; 2010. Available from: http://www.actavetscand.com/content/52/1/7. Last accessed on 12-02-2017.
11. Chen WJ, Lai SJ, Yang Y, Liu K. Mapping the distribution of anthrax in mainland China, 2005-2013. PLoS Negl Trop Dis 2016;10:e0004637.
12. Fasanella A, Garofolo G, Galante D, Quaranta V, Palazzo L, Lista F, et al. Severe anthrax outbreaks in Italy in 2004: Considerations on factors involved in the spread of infection. New Microbiol 2010;33:83-6.
15. Mondal SP, Yamage M. A retrospective study on the epidemiology of anthrax, foot and mouth disease, haemorrhagic septicaemia, peste des petits ruminants and rabies in Bangladesh, 2010-2012. PLoS One 2014;9:e104435.
16. Chikerema SM, Pfukenyi DM, Matope G, Bhebhe E. Temporal and spatial distribution of cattle anthrax outbreaks in Zimbabwe between 1967 and 2006. Trop Anim Health Prod 2012;44:63-70. [Crossref] [PubMed]
17. Munang'andu HM, Banda F, Chikampa W, Mutoloki S, Syakalima M, Munyeme M. Risk analysis of an anthrax outbreak in cattle and humans of Sesheke district of Western Zambia. Acta Trop 2012;124:162-5. [Crossref] [PubMed]
18. Wafula MM, Patrick A, Charles T. Managing the 2004-2005 anthrax outbreak in Queen Elizabeth and Lake Mburo national park. Afr J Ecol 2008;46:24-31. [Crossref]
20. Tesha H. Anthrax Hits Rombo Killing One; 2016. Available from: http://www.the citizencotz/News/-/1840340/310016/-/indexhtml. Last accessed on 06-01-2017.
21. Zhang HL, Mnzava KW, Mitchell ST, Melubo ML. Mixed methods survey of zoonotic disease awareness and practice among animal and human healthcare providers in Moshi, Tanzania. PLoS Negl Trop Dis 2016;10:e0004476.
22. Cleaveland S, Sharp J, Abela-Ridder B, Allan KJ, Buza J, Crump JA, et al. One health contributions towards more effective and equitable approaches to health in low-and middle-income countries. Philos Trans R Soc Lond B Biol Sci 2017;372. pii: 20160168.
23. Mangesho PE, Neselle MO, Karimuribo ED. Exploring local knowledge and perceptions on zoonoses among pastoralists in northern and eastern Tanzania. PLoS Negl Trop Dis 2017;11:e0005345.
24. Swai ES, Schoonman L, Daborn CJ. Knowledge and attitude towards zoonoses among animal health workers and livestock keepers in Arusha and Tanga, Tanzania. Tanzan J Health Res 2010;12:280-6. [Crossref] [PubMed]
25. Grace D, Lindahl J, Wanyoike F, Bett B, Randolph T. Poor livestock keepers: Ecosystem-poverty-health interactions. Philos Trans R Soc Lond B Biol Sci 2017;372. pii: 20160166.
26. The United Republic of Tanzania U. Prime Minister's Office, One Health Strategic Plan 2015-2020.
27. Tanzania, Ofisi ya Taifa ya T. 2012 Population and Housing Census: Key findings. Dar es Salaam: National Bureau of Statistics; 2014.
28. The United Republic of Tanzania U. The National Integrated Diseases Surveillance and Response (IDSR) Guidelines. 2nd ed. 2011. Available from: http://wwwmohgotz. Last accessed on 15-06-2017.
29. Alcia A. Williams, Umesh D. Parashar, Adrian Stoica, Renee Ridzon, David L. Kirsche, Richard F. Mayer. . Bioterrorism related anthrax surveillance; 2012. http://wwwcdcgov/ncidod/EID/vol8no10/02-0399htm. 2010; 8(10).
30. Awoonor-Williams J, Apanga P, Anyawie M, Abachie T, Boidoitsiah S, Opare J, et al. Anthrax outbreak investigation among humans and animals in Northern Ghana: Case report. Int J Trop Dis Health 2016;12:1-11. [Crossref]
31. Turnbull PC. World Health Organization, Department of Communicable Disease Surveillance, Response. Guidelines for the Surveillance and Control of Anthrax in Humans and Animals. Geneva, Switzerland; 1998.
33. StataCorp. Stata: Release 14. Statistical Software. College Station, TX: StataCorp LP. Lakeway Drive: Stata Press Publication; 2015. p. 4905.
34. Matero P, Hemmila H, Tomaso H, Piiparinen H, Rantakokko-Jalava K, Nuotio L, et al. Rapid field detection assays for Bacillus anthracis, Brucella spp., Francisella tularensis and Yersinia pestis. CMI Clin Microbiol Infect 2011;17:34-43. [Crossref] [PubMed]
36. World Health Organization. Anthrax: Memorandum from WHO Meeting of a Working Group on Anthrax; 1995.
37. World Health Organization. Working Group Meeting on Anthrax Control and Research with Special Reference to National Develpment in Africa; 1992.
38. Hugh-Jones ME, de Vos, V. Anthrax and Wildlife. Rev Sci Tech Off Int Epiz 2002;21:359-83.
39. Bailey EM. Physiologic response of livestocks to Toxic plants. J Range Manag 1978;31:343-7. [Crossref]
40. Sitali DC, Mumba C, Skjerve E, Mweemba O, Kabonesa C, Mwinyi MO, et al. Awareness and attitudes towards anthrax and meat consumption practices among affected communities in Zambia: A mixed methods approach. PLoS Negl Trop Dis 2017;11:e0005580.
42. Turnbull. Guidelines for the Surveillance and Control of Anthrax in Humans and Animals. 3rd ed. World Health Organization; 1998.
43. Jarap. Two cases of human cutaneous anthrax in Bosnia and Herzegovina. Rapid Communications; 2014. Available from: http://www.eorosurveillance.org. Last accessed on 06-04-2017.
44. Rusch G.M, Stokke S, Roskaft E, Mwakalebe G, Wiik H, Arnemo J, Lyamuya R . Human - Wildlife interactions - Western Serengeti in Tanzania; Nina Report; 2005.
45. Coker R, Rushton J, Mounier-Jack S, Karimuribo E, Lutumba P, Kambarage D, et al. Towards a conceptual framework to support one-health research for policy on emerging zoonoses. Lancet Infect Dis 2011;11:326-31. [Crossref]
46. World Health Organization. The Control of Neglected Zoonotic Diseases. From Advocacy to Action; 2014. Available from: http://wwwwhoint. Last accessed on 14-05-2017.
47. Report. Joint Cross Border Technical Meeting between the United Republic of Tanzania and the Republic of Kenya, Kajiado County - Kenya; 2014.