Guidelines for the Surveillance and Control of Anthrax in Humans and Animals
WHO/EMC/ZDI/98.6
Document produced by the WHO Division of Emerging & Other Communicable Diseases
Technical Units
Order Number    19300161 Format    Package
Price    CHF    48.00 / US$    57.60 Developing countries:    CHF    33.60
English     1998        110   pages
Summary
Table of contents
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Summary
This manual provides a comprehensive guide to the surveillance and control of anthrax in humans and animals. Now in its third edition, the manual has been updated to reflect both new knowledge about the disease and recent practical experiences in national control programmes. Information is intended for use by any veterinary or public health service confronted with an epidemic, an isolated case, or questions ranging from the duration of quarantine to the safety of milk.
While noting the effectiveness of vaccines and other preventive measures, the manual gives particular attention to the complexities of controlling a disease spread by remarkably hardy spores that survive environmental extremes and many chemical disinfectants, and can travel great distances in the meat, hides, hair, wool or bones of infected animals. Information ranges from a list of measures that encourage farmers to report cases, through advice on when to vaccinate all animals in a herd, to the reasons why, in many countries, anthrax carcasses are almost always butchered and the meat consumed. Throughout, an effort is made to balance recommended best practices with the realities of resource-poor settings where anthrax poses the greatest threat to human and animal health.
The manual has two parts. Part one provides a state-of-the-art review of all knowledge about the disease relevant to its control. A brief overview of the historical importance of anthrax is followed by a summary of its etiology, cycle of infection, and the environmental behaviour of spores. Section three, on anthrax in animals, gives concise information on host range and susceptibility, geographical occurrence, sources of infection, mechanisms of transmission, pathogenesis, clinical features, and laboratory tests for diagnosis.
Anthrax in humans is covered in the next section, which includes information on incidence, geographical distribution, risks associated with industrial and non-industrial forms, characteristics of the three clinical syndromes, factors influencing the severity of infection, complications, and recommended diagnostic tests. The possible use of anthrax as a biological weapon is also briefly discussed. Other sections summarize what is known about the pathogenesis, pathology, and bacteriology of anthrax, and offer detailed advice on the most appropriate antimicrobial treatment for animals and humans.
The most extensive section, on control, deals with the many difficult problems surrounding the disposal of anthrax carcasses, infection control in the management of human cases, and procedures for the disinfection, decontamination, and safe disposal of infected or contaminated material, including laboratory equipment and facilities, the environment, animal wastes, and animal products used commercially. The place of vaccines in control programmes is also briefly discussed. Part one concludes with a series of recommendations, including standardized case definitions, intended to facilitate surveillance and reporting by national veterinary and public health systems.

Part two sets out a number of technical and practical tools for use in control programmes. These include a guide to standard laboratory procedures for isolation and identification of B. anthracis and confirmation of diagnosis, recommended media and reagents, guidelines for carcass disposal and site decontamination, and lists of manufacturers of veterinary and human vaccines. Additional information includes a contingency plan for prevention and control in response to outbreaks or isolated cases, an example of a model country programme, and advice on the safe transportation of infectious substances and diagnostic specimens.