2021 年印度科拉普特部落村庄疑似人类炭疽疫情调查

Jyoti Shandilya, D. Parai, Hariram Choudhary, J. Kshatri, Biren Kumar Padhy, Padma Mohan Pradhan, Deepika Saket, Annalisha Peter, Matrujyoti Pattnaik, A. Padhi, Sanghamitra Pati, D. Bhattacharya
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摘要

奥里萨邦是印度炭疽病流行的一个邦,经常报告疑似动物病例。在2021年10月17日发现一头牛死亡并被当地人食用后,于2021年10月24日在印度奥里萨邦Koraput县Tukum村报告了一起疑似人类炭疽疫情。从2021年10月24日至11月2日,在科拉普特县通过挨家挨户的主动监测开展了这次扩大的疫情调查。在科拉普特区公共卫生实验室收集和处理伤口上的痂皮拭子,并在印度医学研究委员会-布巴内斯瓦尔区域医学研究中心进行分析,以进行分子确认。从受污染地点采集了骨头、土壤和干肉样本,并送往克塔克动物疾病研究所进行确认。四宗怀疑人类炭疽病个案曾处理及食用死牛肉,当中一人其后死亡。计算该村高危人群的发病率为1.23%。然而,在实时聚合酶链反应中,在人拭子样本中未发现炭疽芽孢杆菌。从受污染地点收集的样本证实有炭疽杆菌。调查显示,一起疑似炭疽聚集性暴发是由于屠宰/去皮和食用感染炭疽的死亡动物所致。由于在采集样本前摄入了抗生素,因此无法确认人体样本中是否存在杆菌。这一发现突出了在适当的时间收集样本的重要性,以及可能需要采取一种保健办法,以便更好地协调不同负责部门之间的工作。
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Suspected human anthrax outbreak investigation in a tribal village of Koraput, India, 2021
Odisha is a state in India endemic to anthrax disease with frequent reports of suspected animal cases. A suspected outbreak of anthrax in humans was reported on 24 October 2021 at Tukum village in Koraput district of Odisha, India after a bullock was found dead and consumed by the locals on 17 October 2021.This extended outbreak investigation was carried out through house‐to‐house active surveillance from 24 October to 2 November 2021 in the Koraput district. Eschar skin swabs from wounds were collected and processed at District Public Health Laboratory, Koraput, and analyzed in Indian Council of Medical Research‐Regional Medical Research Centre, Bhubaneswar for molecular confirmation. Samples from bone, soil, and dried meat were collected from the contaminated sites and were transported to Animal Diseases Research Institute, Cuttack for confirmation.Four suspected cases of human anthrax were identified who had handled and consumed dead bullock meat, among which one human had died later. The attack rate of the persons at risk in the village was calculated to be 1.23%. However, no Bacillus anthracis were identified in human swab samples when tested in real‐time polymerase chain reaction. Samples collected from contaminated sites were confirmed to have anthrax bacilli.Investigation revealed that a suspected anthrax cluster outbreak was due to butchering/de‐skinning and consumption of the anthrax‐infected dead animal. The presence of bacilli in human samples could not be confirmed due to the intake of antibiotics before the collection of sample. This finding highlighted the importance of sample collection at a suitable time and a possible need for one health approach for better coordination among the different responsible departments.
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