Anthrax: Memorandum from a WHO Meeting

Article excerpt

Introduction

Anthrax is enzootic in many countries in Africa and Asia, and in a number of industrialized countries, and is sporadic in many others[1]. The main source of human infection is direct or indirect contact with infected or contaminated animal products. The occurrence of human infection correlates with the presence of disease in the animal population. Considering its public health significance, WHO has prepared guidelines on the surveillance and control of anthrax in humans and animals,(a) and contributed to the worldwide surveillance of anthrax jointly with the Food and Agriculture Organization of the United Nations (FAO) and the International Office of Epizootics (OIE)[1]. At a meeting in Mongu, Zambia, in 1992, the WHO Working Group discussed and made proposals for a comprehensive national programme on anthrax control in Africa[2].

Objectives

In view of the need to integrate anthrax control and research activities with broader human and animal health concerns, the Working Group endorsed the following statement as its mandate: "to promote human health and well-being, enhance livestock production, and preserve the wildlife populations by reducing the risk of anthrax through strengthening of education and training, promotion of research, provision of scientific and technical advice, and international collaboration."

The objectives of the Working Group included identification of priority issues and promotion of anthrax-related research in the framework of international collaboration. The following activities were identified as priority concerns:

- identifying areas, countries and regions of major

risk;

- improving the quality and expertise of national

medical and veterinary personnel for the treatment,

prevention, diagnosis and surveillance of

anthrax;

- promoting public awareness and information

through education on anthrax in infected areas;

- promoting the exchange of information on anthrax

between WHO Member States;

- promoting problem-oriented research;

- providing advice on how to prevent the introduction

of anthrax in countries or areas where it is

not present or not reported, or where the incidence

is very low;

- promoting and updating WHO's guidelines on

anthrax;(a)

- promoting training and educational activities on

anthrax through WHO Regional Offices, WHO

Collaborating Centres, and other specialized

centres or institutions; and

Memorandum

- promoting intersectoral collaboration on research,

education, control and prevention of

anthrax.

Summary of discussions

* The success of most anthrax control programmes tends to be undermined by the lack of precise case mapping and accurate single-case finding and reporting. Fully structured surveillance programmes are rare and most national anthrax programmes are given low priority. The lack of precise information on the source of infection (whether contaminated feed, "latent" infections, etc.) in individual outbreaks is seen as a major limiting factor for effective control at national and international levels. This reflects the traditional but false view that "because the ground is permanently contaminated, nothing can be done or is worth doing". In addition, livestock owners should be convinced that control programmes are useful; efficient marketing is, therefore required. A regional approach to control programmes is needed because anthrax-infected areas may cross national borders and because trade in hides, goat hair, and bone-meal may spread infection between as well as within countries. As there may be barriers to international trade, international standards for certifying a country or area as free of anthrax are necessary.

* There is a great need for training and education in the clinical aspects of anthrax in humans in areas where the disease is sporadic and often unrecognized, whether in developing or in industrialized countries. …