TY - JOUR AU - Vydayko, Nataliya AU - Novohatniy, Yuriy PY - 2017/05/02 Y2 - 2024/03/29 TI - Current assessment of risks of anthrax outbreaks in Ukraine JF - Online Journal of Public Health Informatics JA - OJPHI VL - 9 IS - 1 SE - One Health DO - 10.5210/ojphi.v9i1.7741 UR - https://ojphi.org/ojs/index.php/ojphi/article/view/7741 SP - AB - <div style="left: 79.8182px; top: 248.996px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1212px; top: 262.255px; font-size: 12.564px; font-family: serif; transform: scaleX(0.986136);" data-canvas-width="337.6366737373738">Anthrax is an acute especially dangerous infectious disease of</div><div style="left: 79.8182px; top: 277.036px; font-size: 12.564px; font-family: serif; transform: scaleX(0.957731);" data-canvas-width="113.2516531986532">animals and humans.</div><div style="left: 193.09px; top: 277.036px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01533);" data-canvas-width="94.10415824915823">Bacillus anthracis</div><div style="left: 287.208px; top: 277.036px; font-size: 12.564px; font-family: serif; transform: scaleX(0.942227);" data-canvas-width="142.63752979797982">is a potential bioterrorism</div><div style="left: 79.8182px; top: 291.818px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00026);" data-canvas-width="349.0070693602694">tool. In Ukraine, there are favorable natural conditions for the spread</div><div style="left: 79.8182px; top: 306.599px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03894);" data-canvas-width="350.15667289562265">of anthrax. There are 13.5 thousand of constantly anthrax-troubled</div><div style="left: 79.8182px; top: 321.38px; font-size: 12.564px; font-family: serif; transform: scaleX(0.999116);" data-canvas-width="348.97440303030305">points. Anthrax epidemic situation in Ukraine could be characterized</div><div style="left: 79.8182px; top: 336.161px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03737);" data-canvas-width="349.7307542087544">as unstable. Because of the continuing reform of Ukrainian human</div><div style="left: 79.8182px; top: 350.942px; font-size: 12.564px; font-family: serif; transform: scaleX(0.981884);" data-canvas-width="348.43792138047127">health entities, the State Sanitary Epidemiological Service (SSES) has</div><div style="left: 79.8182px; top: 365.723px; font-size: 12.564px; font-family: serif; transform: scaleX(0.989297);" data-canvas-width="348.7105595959596">lost its control functions and is remaining in an uncertain state, which</div><div style="left: 79.8182px; top: 380.504px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00087);" data-canvas-width="120.38798989898987">increases possible risks.</div><div style="left: 79.8182px; top: 407.154px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1212px; top: 420.414px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01439);" data-canvas-width="338.16436060606014">Epidemiological analysis of official data has been performed</div><div style="left: 79.8182px; top: 435.195px; font-size: 12.564px; font-family: serif; transform: scaleX(1.058);" data-canvas-width="352.77374848484845">using information from the following sources: State Sanitary</div><div style="left: 79.8182px; top: 449.976px; font-size: 12.564px; font-family: serif; transform: scaleX(0.980521);" data-canvas-width="350.4217727272728">Epidemiological Service of Ukraine (SSES), State Veterinary and</div><div style="left: 79.8182px; top: 464.757px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00901);" data-canvas-width="351.4381981481479">Phytosanitary Service of Ukraine, and analytical materials from</div><div style="left: 79.8182px; top: 479.538px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01264);" data-canvas-width="351.28617407407404">SI UCDCM. Collected papers Distribution and Epidemiological</div><div style="left: 79.8182px; top: 494.319px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01131);" data-canvas-width="351.2459693602693">Characteristics of Major Human Infectious Diseases in Ukraine</div><div style="left: 79.8182px; top: 509.1px; font-size: 12.564px; font-family: serif; transform: scaleX(1.06455);" data-canvas-width="352.84661952861927">(Kyiv Research Institute of Epidemiology, Microbiology and</div><div style="left: 79.8182px; top: 523.882px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01949);" data-canvas-width="349.51465387205377">Parasitology, 1976) were also used during the study. Materials were</div><div style="left: 79.8182px; top: 538.663px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00053);" data-canvas-width="218.44979966329964">compiled for the period from 1945 to 2015.</div><div style="left: 79.8182px; top: 563.834px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 93.1212px; top: 577.094px; font-size: 12.564px; font-family: serif; transform: scaleX(0.96161);" data-canvas-width="337.3489587542086">In the early XX century, more than 10,000 cases of anthrax in</div><div style="left: 79.8182px; top: 591.875px; font-size: 12.564px; font-family: serif; transform: scaleX(0.966888);" data-canvas-width="350.3840808080806">humans were annually registered in tsarist Russia. In 1913, 1,473</div><div style="left: 79.8182px; top: 606.656px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0135);" data-canvas-width="349.45560319865314">cases of anthrax in animals were recorded only in Kherson province</div><div style="left: 79.8182px; top: 621.437px; font-size: 12.564px; font-family: serif; transform: scaleX(0.986655);" data-canvas-width="348.33866599326603">(currently, Kherson oblast of Ukraine). The morbidity among humans</div><div style="left: 79.8182px; top: 636.218px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01804);" data-canvas-width="349.5774737373737">increased again during the WWII. In the late 40s, massive epizootic</div><div style="left: 79.8182px; top: 650.999px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00721);" data-canvas-width="349.2508104377105">anthrax among animals was eliminated and morbidity among people</div><div style="left: 79.8182px; top: 665.781px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01751);" data-canvas-width="351.51483838383785">significantly reduced because of planned government measures,</div><div style="left: 79.8182px; top: 680.562px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02653);" data-canvas-width="349.90916262626234">strengthened veterinary, sanitary, and epidemiological surveillance.</div><div style="left: 79.8182px; top: 695.343px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01334);" data-canvas-width="349.39906531986526">Since 1950, significant reduction of incidence of human anthrax has</div><div style="left: 79.8182px; top: 710.124px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00084);" data-canvas-width="161.5350016835017">been being recorded in Ukraine.</div><div style="left: 93.1212px; top: 724.905px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03217);" data-canvas-width="332.85733838383834">Since 1964, certification and mapping of persistent anthrax-</div><div style="left: 79.8182px; top: 739.686px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00086);" data-canvas-width="275.65356902356893">troubled points in Ukraine have been being performed.</div><div style="left: 93.1212px; top: 754.467px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02285);" data-canvas-width="336.5008905723907">Compulsory vaccination of people against anthrax was cancelled</div><div style="left: 79.8182px; top: 769.249px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00123);" data-canvas-width="343.37338383838375">and compulsory vaccination of all livestock was introduced in 1990.</div><div style="left: 93.1212px; top: 784.03px; font-size: 12.564px; font-family: serif; transform: scaleX(0.973348);" data-canvas-width="335.2696212121212">The period from 1976 to 1993 is characterized as epidemically safe.</div><div style="left: 79.8182px; top: 798.811px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03368);" data-canvas-width="349.9192138047136">Single cases of the disease in human were registered with intensity</div><div style="left: 79.8182px; top: 813.592px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00356);" data-canvas-width="351.4645824915823">rates of 0.01 – 0.002 per 100,000 population (excluding 1985).</div><div style="left: 79.8182px; top: 828.373px; font-size: 12.564px; font-family: serif; transform: scaleX(0.987055);" data-canvas-width="348.59497104377107">No human cases were registered during the certain years: 1978, 1982,</div><div style="left: 79.8182px; top: 843.154px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00048);" data-canvas-width="59.67887205387205">1987, 1988.</div><div style="left: 93.1212px; top: 857.935px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0283);" data-canvas-width="332.70657070707074">The epidemic situation complicated during the period 1994-</div><div style="left: 79.8182px; top: 872.717px; font-size: 12.564px; font-family: serif; transform: scaleX(1.05674);" data-canvas-width="251.94535185185183">2001. The following outbreaks were registered:</div><div style="left: 93.1212px; top: 887.498px; font-size: 12.564px; font-family: serif; transform: scaleX(1.08386);" data-canvas-width="336.24961111111094">Table 1. Total number of disease cases/ including the number</div><div style="left: 79.8182px; top: 902.279px; font-size: 12.564px; font-family: serif; transform: scaleX(1.06646);" data-canvas-width="216.74109932659934">of cases during outbreaks within regions</div><div style="left: 93.1212px; top: 917.06px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00611);" data-canvas-width="338.1706425925925">The main reason for the complication of the epidemiological</div><div style="left: 79.8182px; top: 931.841px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03132);" data-canvas-width="354.19096464646464">situation was weakening of epidemiological and veterinary</div><div style="left: 79.8182px; top: 946.622px; font-size: 12.564px; font-family: serif; transform: scaleX(0.977076);" data-canvas-width="350.50972053872067">surveillance during the economic crisis characterizing this period.</div><div style="left: 79.8182px; top: 961.403px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04683);" data-canvas-width="352.45085437710435">Epizootiological outbreaks arose from incomplete anti-anthrax</div><div style="left: 79.8182px; top: 976.185px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00862);" data-canvas-width="345.9050244107744">vaccination of agricultural animals and from violation of veterinary-</div><div style="left: 79.8182px; top: 990.966px; font-size: 12.564px; font-family: serif; transform: scaleX(0.949649);" data-canvas-width="350.1830572390574">sanitary rules for their keeping as well. More than 80% of human</div><div style="left: 79.8182px; top: 1005.75px; font-size: 12.564px; font-family: serif; transform: scaleX(0.998305);" data-canvas-width="351.0374074074072">infection cases happened resulting compelled cattle slaughtering,</div><div style="left: 79.8182px; top: 1020.53px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00394);" data-canvas-width="351.5311715488215">while the rest 20% resulted from meat product distribution and</div><div style="left: 79.8182px; top: 1035.31px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00146);" data-canvas-width="331.14863804713775">consumption without corresponding sanitary-veterinary expertise.</div><div style="left: 93.1212px; top: 1050.09px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00089);" data-canvas-width="315.0793164983164">Six human cases of anthrax were registered during 2002-2015.</div><div style="left: 93.1212px; top: 1064.87px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04314);" data-canvas-width="335.05603367003346">Fig. 1. Dynamics of anthrax cases in humans in Ukraine during</div><div style="left: 79.8182px; top: 1079.65px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04378);" data-canvas-width="169.6136363636364">1945 – 2015 (absolute numbers)</div><div style="left: 465.606px; top: 247.474px; font-size: 12.564px; font-family: serif; transform: scaleX(1.09035);" data-canvas-width="336.4280195286195">Table 2. Chronology of anthrax epidemiological surveillance</div><div style="left: 452.303px; top: 262.255px; font-size: 12.564px; font-family: serif; transform: scaleX(1.05811);" data-canvas-width="116.56854208754211">milestones in Ukraine</div><div style="left: 452.303px; top: 290.383px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 465.606px; top: 303.642px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00484);" data-canvas-width="335.8676663299662">Relative wellbeing regarding anthrax in Ukraine persists owing to</div><div style="left: 452.303px; top: 318.424px; font-size: 12.564px; font-family: serif; transform: scaleX(0.967306);" data-canvas-width="350.00339242424235">the implementation of ruled veterinary-sanitary activities and state</div><div style="left: 452.303px; top: 333.205px; font-size: 12.564px; font-family: serif; transform: scaleX(0.992625);" data-canvas-width="348.7256363636361">sanitary epidemiological surveillance in meat- and leather-processing</div><div style="left: 452.303px; top: 347.986px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00092);" data-canvas-width="258.5540016835017">industries as well as because of active food control.</div><div style="left: 465.606px; top: 362.767px; font-size: 12.564px; font-family: serif; transform: scaleX(0.955661);" data-canvas-width="336.93434764309757">The main risks, which could trigger complication in the current</div><div style="left: 452.303px; top: 377.548px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00138);" data-canvas-width="289.2980437710437">epidemiological situation with anthrax, are the following:</div><div style="left: 465.606px; top: 392.329px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01512);" data-canvas-width="338.3729225589224">1) Uncertainty in the system of sanitary-epidemiological and</div><div style="left: 452.303px; top: 407.11px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03493);" data-canvas-width="349.8915730639732">veterinary surveillance, which resulted from the reformation of the</div><div style="left: 452.303px; top: 421.892px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00596);" data-canvas-width="310.5562861952861">State Sanitary-Epidemiological and State Veterinary services.</div><div style="left: 465.606px; top: 436.673px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01692);" data-canvas-width="336.3111745791246">2) Existence of favorable conditions for anthrax agent circulation</div><div style="left: 452.303px; top: 451.454px; font-size: 12.564px; font-family: serif; transform: scaleX(0.999295);" data-canvas-width="351.1856622895621">(considerable number of persistent anthrax-troubled points in all</div><div style="left: 452.303px; top: 466.235px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0018);" data-canvas-width="44.313132996632994">regions).</div><div style="left: 465.606px; top: 481.016px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00547);" data-canvas-width="194.038">3) Economic instability in the country.</div><div style="left: 465.606px; top: 495.797px; font-size: 12.564px; font-family: serif; transform: scaleX(0.991984);" data-canvas-width="335.4392348484849">4) Uncontrolled epidemic situation in the zone of the Anti-terrorist</div><div style="left: 452.303px; top: 510.578px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00112);" data-canvas-width="209.71783838383837">operation (Donetsk and Luhansk oblasts).</div> ER -