The most common epidemiological, clinical and laboratory characteristics of patients with anthrax in Armenia

Abstract

Bacillus anthracis is an especially dangerous pathogen, which can be used in biological warfare. The bacterium causes anthrax in susceptible hosts. Anthrax is endemic to Armenia. Our goal is to describe the most common epidemiological, clinical and laboratory characteristics of anthrax in patients hospitalized in "Nork" republican hospital from 2000-2015.Methods & Materials: We used the medical charts of patients with anthrax admitted to "Nork" hospital during the period 2000-2015. The total number of patients with anthrax during that period was 20. The SPSS program was used to analyze the data.Results: All patients had the cutaneous form of anthrax. Of these, 75% were males with a mean age of 46±17 years old while 85% were residents of rural areas. Livestock exposure was recorded in 80%, agricultural activities in 50%, 65% were involved in animal slaughter. The mean duration of hospitalization was 9±7 days. Main clinical symptoms were fatigue (55%), lymphadenitis (55%), fever (50%), pallor (10%), sweating (5%), headache (5%) and hepatomegaly (5%). The vast majority of patients (95%) had ulcers and carbuncles and only one had edema of the skin; these elements were located on upper extremities in 19 patients and on the face in 1 patient. Most patients (85%) received antibiotics, mainly ciprofloxacin or penicillin. In 75% of cases (15/20), bacterial culture was used for laboratory diagnosis, although culture results were positive for just 40% (8 patients) patients. In all other cases (culture-negative and no culture) PCR was used; all these results were positive. For the CBC, leukocytosis was observed in 15% of patients while ESR was elevated in 40% of cases and one case of anemia was recorded. The urine test showed 25% of patients with elevation of leukocytes. Conclusion:Males living in rural areas who work with livestock are at higher risk for anthrax than urban dwellers. Skin lesions are primarily located on the upper extremities. Fever is not always present. Patients with anthrax symptoms but negative culture results should be tested with other diagnostic methods.

Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia

“…During the period from 2000 to 2015, 20 cutaneous anthrax cases were detected [ 51 , 52 ]. In August 2019, two outbreaks of anthrax occurred in Armenia [ 53 , 54 ]: the first happened in the Gegharkunik region, and the second one took place in the Armavir region [ 55 ].…”