Review of the epidemiological situation on Anthrax around the world and the Forecast for Kyrgyzstan
Authors: Mamatkulova N.M. , Zholdoshev S.T. , Utepbergenova G.A. 
Published: June 2023

This review, prepared on the basis of WHO materials and from medical websites, and monographs by domestic and foreign researchers, provides information on cases of infection of humans and animals with anthrax in the world. The epidemiological situation for this especially dangerous infection remains quite complicated and is assessed as tense and does not tend to stabilize due to the existence of soil foci, which manifest themselves for many years as periodic outbreaks among farm animals and people. Cutaneous anthrax is an extremely preventable disease, yet still accounts for 95% of all anthrax cases, and has left many regions endemic. The objectives of this study was to review published outbreak investigations for cutaneous anthrax, while examining the current and new risk factors, as well as the present control measures and their effectiveness at preventing future outbreaks. A literature search of articles was performed using PubMed, Google Scholar, and New England Journal of Medicine, website of WHO, (HAW HamburgLibrary). Articles in English and pertaining to human subjects only, were retrieved. Seven articles included in this study examined sources of outbreak for cutaneous anthrax, investigated suspected cases using clinical diagnosis and surveys, and evaluated current control measures. Three studies reported relative risk, suggesting there is a likely association between butchering sick animals and infection. Further findings suggested a correlation between an individual's socioeconomic status and the likelihood of contracting anthrax. Additionally, the quality of livestock in the area can have a cyclical nature on cutaneous anthrax infections among humans. The cumulative evidence concludes that an improvement of surveillance and control measures is needed in endemic regions, and future investigation of new risk factors is required. Anthrax is a highly dangerous zoonotic infectious disease, the causative agent of which is the Gram-positive spore-forming bacterium Bacillus anthracis, which belongs to the pathogenicity group II. Almost all types of warm-blooded animals, including humans, are susceptible to anthrax. For herbivores, the source of infection is soil containing B. anthracis spores. The high resistance of anthrax spores to environmental factors, the ability to persist in the soil for a long time, and under certain conditions to pass into a vegetative form, makes the fight against this infection an extremely difficult task for medicine and veterinary medicine. A person becomes infected by household contact from contaminated objects of animal origin, and from 2,000 to 20,000 people fall ill every year in the world. Although anthrax is well controlled in the developed countries, anthrax remains of a global concern because B. anthracis spores can potentially be used as a biological weapon. On the other hand, some local anthrax outbreak has been recorded in western countries. For example, a case of naturallyacquired inhalation anthrax was reported in London, 2008 and another case was recorded in Scotland in 2006. Both cases were bongo drummers/drum makers who used imported animal hides. As of 14 January 2010, a total of 14 con- firmed cases of anthrax infection in Scotland were reported and 7 of these died. All cases were heroin user. Possible source of infection is said that heroin is transported in animal skin. In developed countries, there is also an infection risk after contact with a commercial product prepared from inadequately treated wool or leather. Products made from contaminated hair (e.g. shaving brush, wool coat), skins (e.g. drums, drumheads made from animal skin), and bone meal (e.g. fertilizer) may continue to be sources of infection for many years. A review of the epidemiological situation on anthrax in the world for 2021 was carried out. In Kyrgyzstan, eight cases of human infection with the cutaneous form of anthrax were registered in the Suzak district of the Jalal-Abad region and 7 cases in the Aksy district. Epizootics of anthrax among farm and wild animals have been identified mainly in the countries of Central Asia, with the largest number of confirmed human cases detected in Kyrgyzstan. Infection of people with the causative agent of anthrax is associated primarily with the ingestion of the meat of sick and dead anthrax animals, contact with animals during forced slaughter, skinning, and processing of contaminated meat. The level of incidence of anthrax in the territory of Kyrgyzstan in 2021 will be determined by a set of planned volumes of preventive measures and, subject to their proper implementation, will be limited to the detection of sporadic cases of infection that are potentially possible within certain regions of Kyrgyzstan.