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15 Contract Anthrax in Zimbabwe; Animals Suspected Source of Disease - 2001-10-26

Fifteen people have contracted anthrax in Zimbabwe. But infected animals -not terrorists - are believed to be responsible. Experts say such infections are not unusual and can occur in many parts of the world.

The outbreak of anthrax happened near the town of Kwekwe in central Zimbabwe. The state-run Herald newspaper says the 15 victims probably contracted the disease after butchering and eating infected cattle. The newspaper says five cattle have died of the disease in one local village.

Anthrax is naturally occurring in many parts of the world, including Zimbabwe. Nine people died of the disease last December near the capital, Harare.

Stephen Toovey of the Netcare Travel Clinic in Johannesburg said there are some key differences between the outbreak in Zimbabwe and the cases in the United States.

"The first thing to say is it's the same germ that causes it. It's just the route of entry into the body that's different," he said. "In the U.S., many people are breathing it in, so the germ is getting into the lungs and causing disease there. In the Zimbabwean outbreak, it's gastrointestinal, in other words people are eating infected meat and it's getting into the body through the digestive tract," he said. "The net result is often pretty much the same. It's a highly fatal disease."

Dr. Toovey said it is difficult to diagnose gastrointestinal anthrax, which means that even if doctors have the drugs to treat it, the patient is still likely to die.

But, Dr. Toovey said the naturally-occurring form of anthrax is not likely to be drug resistant.

"So the usual antibiotics will probably do the trick in Zimbabwe," he said. "We do know, however, that there are severe financial problems and severe logistical problems in Zimbabwe in the distribution of medicine. And I think we may well run into problems if it becomes a very large outbreak," he said.

Zimbabwe is home to the largest outbreak of human anthrax ever recorded in 1979 and 1980. According to the U.S. Centers for Disease Control, more than 6,000 people were infected, mostly with the less serious cutaneous (skin) form of the disease.

Dr. Toovey said an outbreak that size would probably be more than the Zimbabwean health system could handle. But the doctor also warns people against the indiscriminate use of antibiotics in the panic over anthrax - both in the United States and Zimbabwe.

"I think it's important to emphasize that the panic use of antibiotics is really not indicated," he said. "It's only people who have had a documented exposure or potential exposure to anthrax who need to take antibiotic prophylaxis," he explained. "So household contacts, people that you work with, people that you come across in the street or in the village, it's just not necessary for them to take it. It's only those who have been directly exposed to the germ who need to take the antibiotic."

Dr. Toovey said the key to controlling the disease in Zimbabwe is to stop it in animals before it gets to humans. But he says political instability has led to a breakdown in the veterinary disease control system.

"I think the essential point is that control is essentially a veterinary rather than a human problem in Zimbabwe," he said. "We do know for various reasons that vet disease control is no longer as good in Zimbabwe as it was in the past. That may well delay the control of this outbreak."

The Herald newspaper quotes local health officials as saying Zimbabwe's government has sent antibiotics to the Kwekewe area to treat the infected human patients. But the same officials complain to the Herald that there has not yet been any vaccination of cattle against the disease.