Outbreak of human anthrax in Ramabhadrapuram village of Chittoor district in Andhra Pradesh.

Thirty human anthrax cases were reported from Ramabhadrapuram village of Chittoor district in Andhra Pradesh during November-December, 1989. These cases occurred following an epizootic of anthrax among cattle and sheep of the village and ingestion of contaminated meat by the villagers. The overall attack rate was 24.39 per cent with a case fatality of 16.67 per cent. All age groups and both sexes were affected. Ten cases were of cutaneous form with typical black eschar formation which were confirmed bacteriologically. Fever and headache were common systemic manifestations. They responded well to penicillins and there was no mortality. The possibility of human to human spread is suggested. The twenty cases of internal anthrax comprised intestinal, septicemic, peritonitis, meningeal and pulmonary forms. Sub-clinical forms also occurred. Fever, abdominal pain, ascites, anorexia and vomiting were notable features. Diagnosis was made clinically and also on epidemiological basis. All deaths during this outbreak occurred in women with internal anthrax, the case fatality rate for the latter being 25 per cent. Prophylactic administration of penicillin was done for individuals at risk.