Ministry of Health
Masaka Regional Public health Emergency operations Center.
Outbreak
Name
Date of report
Prepared by
ANTHRAX OUTBREAK SITUATION REPORT
Human B. Anthrax Disease and Animal B
Districts affected
Country- Uganda
Anthrax (Bacillus anthracis)
Kyotera
11-December 2023.
Investigation start date
Nov 23, 2023
Masaka Regional Public Health Emergency Operations Center & Kyotera District health office
Key Highlights
Today (Last 24 hours) Cumulative
Confirmed Cases
00
07
Human cases
Suspected Cases
00
25
Probable Cases
00
07
Confirmed Deaths
00
02
Human deaths
Suspected Deaths
00
08
Active Cases in Hospital
03
10
Admissions
Admissions in Home based Care
03
16
Hospital
00
07
Recoveries
Home based Care
00
16
Sudden animal deaths today
00
60
Animal Deaths
Animal Vaccinated today
77
Human Samples
37
Samples collected Animal samples
00
21
Environmental Samples
00
01
Alerts received
02
66
Alert Management
Alerts Investigated
02
66
** Affected Sub counties;
- Kabira
- Kasasa
- Kyotera T/C
Case definition: Any person with;
 Onset of skin itching, swelling and any two of the following difficulty in breathing, chest pain, abdominal pain,
headache, fever, vomiting and diarrhea in a resident of Kabira sub-county from June 2023 up to date.
1
Ministry of Health
Masaka Regional Public health Emergency operations Center.
Current Anthrax EpiCurve in Kyotera
The Epidemiological Curve depicts Suspect, Probable, and Confirmed Human Cases and Deaths Reported in Kyotera
since June
4
No of cases
3
2
1
0
9
Wk
2
15
21
Wk 3
June
27
Wk 4
3
9
Wk
1
Wk
2
15
21
Wk 3
27
Wk 4
July
2
Wk
1
8
14
Wk 2
20
Wk
3
26
Wk 4
1
7
Wk 1
13
Wk
2
August
19
Wk
3
25
Wk 4
1
7
Wk 1
Sept
13
Wk
2
19
Wk
3
25
31
Wk 4
6
Wk
1
12
Wk
2
Oct
Date of symptom onset (2023)
Al ive
Dead
PUBLIC HEALTH ACTIONS
1.1 COORDINATION

The Ministry of health is fast tracking resources mobilization

The district task force continues to meet three times a week

The rapid response teams commenced on the development of the Incident Action Plan.

The Quarantine restrictions was issued by RDC and is still effective
1.2 SURVEILLANCE AND LABORATORY

2 alerts were reported with a cumulative of 66 alerts.

4 samples (3 whole blood and 1 swab from 3 persons were collected)

Cumulatively 03/ 38 human samples tested positive for anthrax

Infectious Diseases Institute committed one Vehicle for the Laboratory Pillar for 1 month

Tracking of lab processes has started (timelines documented
2
18
Wk 3
Nov
24
Wk
4
Ministry of Health
Masaka Regional Public health Emergency operations Center.
1.3 CASE MANAGEMENT AND CARCASS DISPOSAL

There are currently 2 active cases in stable conditions at Kalisizo Hospital and 1 at Masaka Regional Referral Hospital.

Three patients are receiving home-based care associated with Kalisizo Hospital

Safe disposal of animal carcasses has been implemented, albeit with some community resistance.
•Conducted home based case visits to patients on home-based care:
- Patient 1 showed signs of improvement but still experienced chest pain.
- Patient 2, a confirmed anthrax case previously admitted at Kalisizo, had insisted on returning home to Kachanga.
He still had a painful wound in the thumb since it had dug deep, At the time of the visit he had resulted to herbs claiming
its entunuka. Unfortunately, the herbs have made the whole hand swallow at the back again. He was engaged and agreed
to resume his medication.
1.4 RISK COMMUNICATION AND SOCIAL MOBILIZATION

On Saturday, December 9th, 2023, RCCE initiatives focused on the Anthrax outbreak involved sensitizing 84
individuals at the Kyotera Seventh-day Adventist church.

On Sunday, December 10th, 2023, RCCE activities were conducted, starting with sensitization sessions held at
Calidality Ministries International (323) in Kifukamizi village, Kyotera Town council, and another born-again
church near the Roman Catholic church in Kyotera Town council, engaging 74 individuals.

Notably, within the Kyotera District Local Government (DLG), a team comprising the RDC, DPC, DPO,
along with staff from various departments including District production, health, and Town councils of Kyotera
and Kalisiizo, in addition to a Ministry of Health representative, convened to sensitize animal traders, milk
handlers, meat sellers, butcher men, and restaurant owners in Kyotera T/C (237 people) and Kalisiizo T/C
(120 people) on Anthrax prevention and management.

Extensive sensitization efforts also targeted over 1000 individuals during the market day at Kakyanga trading
center, emphasizing crucial information related to the outbreak.
3
Ministry of Health
Masaka Regional Public health Emergency operations Center.
CHALLENGES
 Lack of vaccines for animal and human
 There is no facilitation to the vaccination teams increasing the cost of Vaccination to the farmers
 Limited facilitation/fuel to run response activities by the DSFPs
 Stock out of drugs (antibiotics) at health supplies.
 Limited cooperation from the community despite intensive social mobilization
 Facilitation for trainers and field teams
 Lack of Printing training materials
 IPC and Biosafety is lacking among veterinary team
4
Ministry of Health
Masaka Regional Public health Emergency operations Center.
 Inadequate human resources by Veterinary department to collects samples
Background
In June 2023, a cow died on a farm in Kyamayembe Village, Bwamiija Parish, Kabira Sub-county. The meat of the dead
cow was sold by meat dealers at a cost between 5000 - 7000/= within the community. Following the consumption of
this meat, people started developing itching, rash, swelling and skin lesions especially on the arms/hands. The first
sudden human death occurred early July. More animals continued to die on the farm, and the veterinary team was
contacted by the farm manager. The team took off samples and informed the farm manager that East Coast Fever was
the cause of the problem on the farm. Treatment of the animals on the farm was conducted but animals continued to
die. Cumulatively about 24 animals have died since June on that farm with the last death reported on October 31, 2023.
The meat from the dead animals reportedly continued to be consumed within the community, and 3 of the affected
people were meat dealers. Two more farms were reported to have been affected but knowledge of the exact number of
dead animals is still scanty.
On October 17, 2023, a joint team of District Surveillance Focal Person (DSFP) - Masaka, District Laboratory Focal
Person-Kyotera, WHO Field Coordinator visited the affected villages in Kyotera District and conducted preliminary
field investigations. They collected samples (blood and swabs) from 2 suspected cases. Samples were sent to UVRI for
VHFs testing and returned negative.
Case definitions
Animal case definitions
1. Confirmed: Suspected case that is positive by PCR.
2. Suspected: Sudden death of a domestic ruminant with uncloated blood emerging from body orifices
Human case definitions
1. Suspected anthrax case: Any person with acute onset characterized by several clinical forms which are;
a) Cutaneous form: Any person with skin lesions evolving from over 1 to 6 days from a popular through a
vesicular stage to depressed black eschar invariably accompanied by oedema that may be mild to extensive.
b) Gastro-intestinal: Any person with abdominal distress characterized by nausea, vomiting, anorexia and
followed by fever.
5
Ministry of Health
Masaka Regional Public health Emergency operations Center.
c) Pulmonary (inhalation): any person with brief prodrome resembling acute viral respiratory illness, followed
by rapid onset of hypoxia, dysponea and high temperature, with x-ray evidence of mediastinal widening.
d) Meningeal: any person with acute onset of high fever possibly with convulsions, loss of consciousness,
meningeal signs and symptoms; commonly noted in all systemic infections, but may present without any
other clinical symptoms of anthrax.
e) AND has an epidemiological link to confirmed or suspected animal products.
2. Confirmed anthrax case
We defined a confirmed anthrax case as a suspected case with PCR-positivity for Bacillus anthracis from a clinical
sample i.e. swab from skin lesions/vesicles and blood.
Partners for Anthrax Diseases in Kyotera
1
2
Name of partner
World Health Organization
Ministry of health
3.
Infectious Diseases Institute
3
4
Public Health Fellowship Program
Masaka REOC
Pillar support
Coordination, Risk Communication and Surveillance
Surveillance, Risk Communication, Laboratory,
coordination
Coordination, Laboratory, Community engagement,
IPC, and Case Management
Case detection, Surveillance
Active case search, surveillance, coordination
Given the fast-evolving nature of this epidemic, errors and omissions are inevitable. The regional Incident Management Team
welcomes feedback and any information that could help rectify this. Send any comments and feedback to: E-mail:
mohugpheoc@gmail.com
Information Sources; District Veterinary officers and Diseases Surveillance focal persons
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