World Health Organization monitoring anthrax outbreak in Zambia

Zambia is grappling with its most significant anthrax outbreak in a decade, according to the World Health Organization (WHO).

As of late November 2023, the country has reported 684 suspected cases and four deaths, marking a substantial increase from the 2011 outbreak, which had 511 suspected cases.

Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It occurs naturally in soil and commonly affects domestic and wild animals around the world.

People can get sick with anthrax if they come in contact with infected animals or contaminated animal products

Anthrax usually does not spread from person to person. Exposure occurs through ingestion of contaminated animal products, inhalation, or entry through skin cuts.

The resulting symptoms depend on the type of exposure, ranging from skin sores to severe abdominal pain and respiratory distress.

The outbreak’s epicenter is Sinazongwe district, accounting for 287 cases (42% of the total) and two deaths (50% of the total). The most affected provinces include Southern (54%), Western (12%), Lusaka (12%), Eastern (10%), and Muchinga (7%).

The outbreak began with the first human cases reported in May, linked to the consumption of meat from three hippopotamus carcasses. Vaccines for both livestock and humans are in limited supply, with efforts focused on livestock vaccination and meat inspections in abattoirs and butcher shops.

Biological agents are germs that can sicken or kill people, livestock, or crops. If a bioterrorist attack were to happen, anthrax could be one of the biological agents most likely to be used.

Anthrax is one of the most likely agents to be used because:

• Anthrax spores are easily found in nature, can be produced in a lab, and can last for a long time in the environment.
• Anthrax makes a good weapon because it can be released quietly and without anyone knowing. The microscopic spores could be put into powders, sprays, food, and water. Because they are so small, you may not be able to see, smell, or taste them.
• Anthrax has been used as a weapon before.

Anthrax has been used as a weapon around the world for nearly a century.

In 2001, powdered anthrax spores were deliberately put into letters that were mailed through the U.S. postal system. Twenty-two people, including 12 mail handlers, got anthrax, and five of those 22 people died.

A subset of select agents and toxins have been designated as Tier 1 because these biological agents and toxins present the greatest risk of deliberate misuse with significant potential for mass casualties or devastating effects on the economy, critical infrastructure, or public confidence, and pose a severe threat to public health and safety.

Bacillus anthracis is a Tier 1 agent.