Zoonotic Diseases

Diseases discussed here have a history of use as an agent for biological warfare, either in the U.S. or abroad. Its use may have been experimental or actual, and any detrimental consequences upon humans, animals or the environment may have been intentional or not, depending on the circumstances, the point in time, and the nature of the disease.

Thursday, October 14, 2010

ANTHRAX, HUMAN, LIVESTOCK, 1999-2009 - FRANCE

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[1]

Date: 14 Sep 2010

Source: Bulletin epidemiologique hebdomadaire 2010; 14 September: 15-17

[translated, edited]







Animal anthrax in France. A 10-year report (1999-2009) with special

emphasis on the 2009 summer outbreaks

------------------------------------------

Abstract:

Between 1999 and 2009, 74 outbreaks of animal anthrax, primarily in cattle,

were confirmed by isolation of _Bacillus anthracis_ in 14 French districts

(annual mean: 7 outbreaks). All cases occurred in areas where outbreaks had

been reported previously. While the annual number of outbreaks remained low

and stable from 1999 to 2007 (0-6 outbreaks/year), 19 outbreaks were

recorded in 2008 (of which 17 clustered outbreaks in Doubs) and 22 in 2009

(of which 17 clustered outbreaks in Savoie). All cases occurred in cattle,

except for one horse case in 2001, while goat and horse cases occurred in

2009. The relatively high number of outbreaks observed in Savoie and in

Doubs is not fully explained, but certainly related in part to the local

anthrax history and to weather conditions during summer.



Outbreaks by year: 1999 (5), 2000 (5), 2001 (3), 2002 (0), 2003 (6), 2004

(3), 2005 (2), 2006 (3), 2007 (6), 2008 (19), 2009 (22).



Farms in 2009

In 2009, a total of 24 farms were suspected (of anthrax) in 8 departments.

These suspicions were confirmed in 5 departments. (A department is similar

to a state in the USA) The outbreaks occurred in areas already affected by

anthrax (fievre carboneuse) in the past. The 1st 2 outbreaks in June-July

2009 involved 2 cattle herds, respectively, in the Puy de Dome (one dead

animal) and Cote-d'Or (3 dead). The 3rd outbreak, which occurred in July

2009 in Aveyron, was in a holding of mixed cattle and goats and began with

the death of a heifer in a field with a water point. The calf was

necropsied in the pasture without special protection as it was thought to

have been killed by lightning. The body was moved using a tractor. A week

later, 4 more corpses were discovered over 3 days in this field, and 2 had

been consumed by scavengers.



A 2nd necropsy was done, this time with some caution, and anthrax

diagnosed. A total of 19 goats and 5 heifers died in this breeding

establishment. The tractor used to move the corpses had been used in

transporting feed to the goat barn and specifically their common feed

trough. This undoubtedly contributed to the extension of infection in the

goat population. During this outbreak, preventive chemotherapy was put in

place for the employees of the establishment and the family (of the) the

breeder and veterinarians who performed the autopsies. The operation to

vaccinate the cattle was also rapidly implemented.



The following farms, where a significant episode occurred, are in Savoie in

the township of La Rochette (Valee des Huiles). In less than a month (26

Jul to 15 Aug 2009), 17 outbreaks were confirmed. 15 cattle herds and 2

horses were infected, which led to the deaths of 32 head of cattle and 2

horses located in 11 nearby municipalities. Seven other herds experienced

deaths of cattle over the period but were not confirmed as anthrax. A 3rd

horse which showed clinical signs of anthrax was treated. The 3 horses had

been in contact with each other and were epidemiologically linked to at

least one cattle farm. Cases of anthrax in horses are usually rare in

France. A single outbreak was recorded in Mayenne in 2001, where a horse

had died of anthrax. Previous episodes of confirmed anthrax in Savoy had

been reported in Bauges in 2000 and in the same area of Valee des Huiles in

1997.



Two outbreaks were also confirmed in Isere in August 2009. They involved 2

herds with the same common boundary with 2 already infected communes in Savoy.



Vaccination of livestock in Savoie and Isere was very quickly established

in 16 Communes. No human cases have been reported, but preventative

treatment was administered to exposed people. Control for public health and

milk safety was put in place on the infected farms following an assessment

by the competent authorities (Direction General of Health, Direction

General of Food, National Reference Center, French Food Safety Agency).



Suspicious strains were isolated by departmental veterinary laboratories

(LVD) and/or the NRL mainly from cattle (23), but also goats (1) and horses

(2), and were confirmed as _B. anthracis_ by specific PCR and were

susceptible to penicillin, facilitating a preventive antibiotic for people

exposed. Molecular typing by MLVA [multi-locus VNTR analysis] analysis

using 10 VNTR (variable number tandem repeat) loci was performed on all

strains. The profiles of recent strains and those isolated since 1982, in

the same departments, were compared. The same VNTR genotype was found in

each department, regardless of place and date of isolation. For all

households of Savoy, the strains showed the same genotype (10 identical

loci) suggesting a common origin (for example epidemiologically linked to

outbreaks, contaminated land, same genotype). The ongoing review of other

VNTR loci is likely to test this hypothesis.



The question that remains unanswered, after successive episodes in Doubs

(French Department on Swiss border) in 2008 and Savoy in 2009, concerns the

mechanisms that led to the emergence of a significant number of affected

farms in a given location over a short period in some regions, while in

others -- fortunately in most instances -- only isolated sporadic cases

were seen. In historically contaminated areas and in favourable

hydro-geological conditions, along with delayed diagnosis, the movements of

animals, people or materials, and weather conditions all certainly

contribute each in their own way to the occurrence of multiple episodes of

disease over a short period.



--

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[I am very grateful to my colleague Susan for her translation. I only have

schoolboy French and of the mid-1950s. Interested readers are encouraged to

read the full article, which contains a table of outbreaks by year,

1999-2009, department, and species affected. This table differs here and

there from the OIE data in WAHID. - Mod.MHJ]



******

[2]

Date: 14 Sep 2010

Source: Bulletin epidemiologique hebdomadaire [edited]







Anthrax in man: review of cases and persons exposed and treated during

recent animal outbreaks in France, 2002-2008

---------------------------------------------------

Anthrax has been subject to compulsory notification since 2002. Since that

time, 4 cases of human anthrax have been identified. In 2003, a case of

cutaneous anthrax was diagnosed in a patient exposed while butchering an

infected sheep in an enzootic area. In December 2008, 3 cases of cutaneous

anthrax were identified in men who had taken part in the evisceration and

butchering of a cow with anthrax. The investigation identified 11 people in

contact with that cow who were possibly infected and consequently received

antimicrobial prophylaxis. A risk assessment was carried out concerning the

consumption of meat from cows gutted with the same knives previously used

to gut the infected cow and concerning the consumption of meals handed by

one of the cases. [1] They were diagnosed by PCR of skin biopsies from the

lesions. All responded favourably to treatment and without complications. [2]



References:

1. Mailles A, Alauzet C, Mock M, Garin-Bastuji B, Veran Y. Cas groupes de

charbon cutane humain en Moselle - Decembre 2008. Saint-Maurice: Institut

de veille sanitaire, fevrier 2010 ;4 p. Available at



2. Cinquetti G, Banal F, Dupuy AL, Girault PY, Couderc A, Guyot P, et al.

Three related cases of cutaneous anthrax in France: clinical and laboratory

aspects. Medicine (Baltimore). 2009;88(6):371-5.



--

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[see also:

2009

---

Anthrax, bovine - France (03): (AV) caprine 20090811.2863

Anthrax, bovine - France (02): (SV,IS) 20090810.2838

Anthrax, bovine - France: (SV) 20090808.2813

2008

---

Anthrax, human - Germany ex France (02) 20081213.3924

Anthrax, human - Germany ex France 20081211.3897

bovine - France (02): (Doubs) 20080821.2609

Anthrax, bovine - France: (Doubs) 20080818.2572]



......................mhj/msp/sh

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