An Outbreak Of Human Anthrax : A Report Of 15 Cases Of Cutaneous Anthrax

Anthrax, a zoonotic illness of herbivorous animals has caused epidemics in livestock and in man since antiquity. In India, the disease continues to be endemic, resulting in a few sporadic cases and outbreaks in human population. Such an outbreak was noted at our institute. Clinical and laboratory data of 15 cases of cutaneous anthrax recorded between July 1998 to June 2000 at the Department of Dermatology and STD. JIPMER hospital, Pondicherry was reviewed. There were 8 males and 7 females in our series of 15, with a mean age of 20.3 years (range 11 months to 56 years). The children (10) outnumbered the adults (5). In most of the cases (9) there was history of death of cattle, sheep or goat in the house or in the neighbourhood. The commonest site of cutaneous anthrax was face (7 cases). Regional lymphadenitis occurred in one case and systemic features like fever in four cases. Majority of our cases responded favourably to crystalline penicillin. Smear taken from the vesicle fluid and eschar demonstrated typical large and thick Gram positive bacilli singly or in short chains. The organism could be cultured from cutaneous lesion in six cases only and blood culture was positive for Bacillus anthracis in one case. Cutaneous anthrax is the commonest form of human anthrax. There is increasing evidence to suggest that files and mosquitoes play a role in the transmission of Bacillus anthracis to human beings. Since 20% of untreated cases of cutaneous anthrax develop bacteraemia which leads to rapid death, it is important that the disease is recognized and treated earnestly