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Human anthrax in India may be linked to vulture decline

BMJ 2001; 322 doi: http://dx.doi.org/10.1136/bmj.322.7282.320/c (Published 10 February 2001) Cite this as: BMJ 2001;322:320
  1. Ganapati Mudur
  1. New Delhi

    Human anthrax in India may be linked to the decline of vultures. Wildlife scientists in India suspect that a reported resurgence in anthrax among humans in some parts of the country may be linked to a sharp, unprecedented drop in India's population of vultures. Government epidemiologists say, however, that no evidence exists yet for such a link.

    Animal anthrax remains endemic in India because inadequate vaccination and lack of cooperation from farmers has kept livestock susceptible to the infection. But the incidence of human anthrax is now rising, doctors reported at the annual conference of the Association of Physicians of India in New Delhi.

    Three southern states in India have recorded at least 200 cases of human anthrax since the 1950s. But there have been three clustered outbreaks over the past two years. A hospital in the southern territory of Pondicherry treated 23 patients with anthrax during 1999, including 12 cases of fatal anthrax meningitis.

    “Village folk unwittingly handle infected carcasses or consume poorly cooked meat of infected livestock,” said Dr Tarun Dutta, professor of medicine at the Jawaharlal Nehru Institute of Postgraduate Medical Education and Research in Pondicherry.

    Over the past two years epidemiologists from India's National Institute of Communicable Diseases have investigated two outbreaks of human anthrax—one involving eight patients, including five deaths, near the southern town of Mysore and the other involving 46 patients in the eastern district of Midnapore. The researchers attributed both outbreaks to contact with carcasses or the consumption of roasted meat of infected goats, pigs, or deer.

    Last year wildlife scientists had issued an alert that an unprecedented decline in the population of vultures across India may lead to the spread of zoonotic diseases from livestock to people. India has lost nearly 90% of its vultures to an illness that wildlife researchers suspect is caused by an avian virus.

    India lacks facilities for incineration and for sophisticated carcass processing, so slaughterhouse waste and dead livestock from farms have traditionally been dumped on the edge of towns and cities. “India relies extensively on vultures for clean up,” said Dr Vibhu Prakash, principal scientist with the Bombay Natural History Society. “With vultures here headed for extinction, India is losing its most efficient scavenger,” he said.

    Government epidemiologists, however, say that a more efficient disease tracking system may be responsible for the rise in the number of reported cases. “There is no evidence that the increase has resulted from the death of vultures,” said Dr Udai Rana, deputy director at the National Institute of Communicable Diseases.