For the first time in 4 years, a case of human infection with anthrax has been recorded in Ukraine. This is a very dangerous infectious disease, with a pulmonary form of which the mortality rate reaches 100%, with intestinal - 50%, and with skin - 10-20%. Although Ukrainian authorities claim that the situation is under control, it seems impossible to say that the danger has passed. Anthrax might be another challenge after botulism, leptospirosis, rabies, and African swine fever, the outbreak of which began in Ukraine
Ukraine’s Center for Public Health at the Ministry of Health confirmed a case of anthrax in humans. This person is one of the five people who participated in the slaughter of livestock in the Minyalivka village, Ukraine's southern region of Odesa. Despite the fact that the diagnosis of the remaining four has not been confirmed, it is reported that they were "hospitalized with specific symptoms of skin disease." The skin form presents with a small blister with surrounding swelling that often turns into a painless ulcer with a black center. Cutaneous anthrax presents as a boil-like skin lesion that eventually forms an ulcer with a black center. The black eschar often shows up as a large, painless, necrotic ulcer (beginning as an irritating and itchy skin lesion or blister that is dark and usually concentrated as a black dot, somewhat resembling bread mold) at the site of infection. In general, cutaneous infections form within the site of spore penetration between two and five days after exposure. Unlike bruises or most other lesions, cutaneous anthrax infections normally do not cause pain. Nearby lymph nodes may become infected, reddened, swollen, and painful. A scab forms over the lesion soon, and falls off in a few weeks. Complete recovery may take longer.
The anthrax case in Odesa region has been confirmed. The Ministry of Health claims that it is treated with antibiotics and does not pose such a danger as the pulmonary form. It is known that in the case of pulmonary anthrax the mortality rate reaches 100%. At the same time, due to any of the methods of infection, sepsis (blood infection) may develop.
The Ministry of Health claims that the current outbreak of anthrax in the Odesa region is localized and there is no threat of the spread of infection. At the same time, it is not possible to exclude that the number of cases might increase. "Doctors will monitor the health of the village residents for 15 days. Daily rounds of households are carried out to monitor the health of people who can potentially become infected with the pathogen. Persons who are at risk of infection will be prescribed urgent prophylaxis with antibiotics," as said in the message of the Center for Public Health. The average duration of the incubation period of the disease ranges from 2-3 to 8-14 days.
A person becomes infected from a sick herbivore through damaged (even by microtrauma) skin or mucous membranes during the processing of carcasses, through contact with soil contaminated with anthrax spores (during excavation work). Anthrax is transmitted by inhalation of its spores, as well as through the insects (mosquitoes, flies, gadflies). At the same time, the disease is not transmitted from person to person (by contact).
This pathogen is resilient and it can spread very quickly, it belongs to the third group of the biological hazard, and in some countries (in particular, the DPRK) it was studied as an effective biological weapon. Head of the Department of Infectious Diseases at the National Medical University Olha Holubovskaya claims that at least 5 countries have the anthrax pathogen in its service (including strains that are resistant to antibiotics). WHO experts estimate that 3 days after spraying 50 kg of a dispute over a two-kilometer zone in the direction of the wind towards the city with a population of 500 thousand people, an infection of 125 thousand (25%) residents and 95 thousand (!) deaths will occur.
In particular, in 2001-2002, there was the case of "postal terrorism fever" in the United States. Its cause was a powder containing anthrax spores. 22 people got sick because of it, and another five have died. Even earlier, in 1979, the Soviet Union has suffered the largest incident involving the massive infection of anthrax bacilli in non-combat conditions. According to official data, 64 people died in Sverdlovsk, the unofficial data indicate thousands of victims.
Officially, an infected cow became the cause of infection in Minyalivka village. The study of slaughtered meat and soil in the yard gave a positive result. As a rule, animals that become a source of human infection can get sick by eating grass in an infected pasture or drinking infected water. The anthrax spores can persist in the ground for about 70 years and become more active when its surface is disturbed, for example, as a result of flooding or displacement. The State Foodstuffs Service does not exclude that the anthrax spores revealed in the soil, remained since 1999 when an anthrax case was recorded in a village located not far from Minyalivka.
Quarantine has been established in Minyalivka and in the adjacent pasture territory (90 hectares): the sale of farm animals and animal products that are kept in the village and grazed on pasture is prohibited (disinfection is carried out directly on the pasture). Also, the collection of milk obtained from the local cows is prohibited. Six police posts were established at the entrances and exits from the village. In addition, the territories of Petropavlovsky, Faraonivsky, and Starosilsky village councils are recognized as a threat zone.
The Main Directorate of State Food Consumer Services in the Odesa region is fully provided with vaccines against anthrax animals and disinfectants to provide measures for the localization and eradication of the disease. With regard to the disease "additional vaccination of animals was carried out, 204 heads of cattle and 1 thousand sheep from Minyalivka were vaccinated."
It is unclear how it turned out that the diseased animal (if there are no other cases of the disease in the next two weeks) turned out to be unvaccinated and why no one checked this.
However, given the fact that none of the investigations into the outbreaks of such dangerous diseases as leptospirosis, rabies, botulism, has been ended, there are no hopes that this case will end with some real outcomes. For example, there is no information about the punishment of those responsible for the outbreak of African swine fever (until 2012, it was not recorded in Ukraine). The disease has caused the death of hundreds of thousands of animals, ruining farms and causing a sharp rise in prices for pork due to shortages. According to the calculations of the Pig Farming Association, only in 2016, African swine fever caused 4.81 million dollars of losses.
The African swine fever has not been defeated, from time to time; the outbreaks take place in different areas. Recently, a scandal erupted in the Kherson region, where, five and a half thousand pigs have already been burned due to rabies and African swine fever outbreak. In order to prevent the further spread of the epidemic, local authorities have decided to kill stray dogs and cats that might be potential disease carriers. After a significant public response and appeal of animal defenders, on September 28, at a meeting of the State Emergency Epizootic Commission at the Kherson City Council, it was decided to refrain from the killing the homeless animals.
The current case of human anthrax infection in Ukraine is the first since 2012 (at that time, one case of the disease was recorded in Cherkasy region). Prior to this, one case (in Mykolaiv region) was recorded in 2008, three cases (in Chernivtsi region) in 2004, and one case (in Kharkiv region) in 2003.
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