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. 2017 Sep;23(9):1471-1477.
doi: 10.3201/eid2309.161597.

Role of Food Insecurity in Outbreak of Anthrax Infections among Humans and Hippopotamuses Living in a Game Reserve Area, Rural Zambia

Mark W Lehman, Allen S Craig, Constantine Malama, Muzala Kapina-Kany'anga, Philip Malenga, Fanny Munsaka, Sergio Muwowo, Sean Shadomy, Melissa A Marx

Role of Food Insecurity in Outbreak of Anthrax Infections among Humans and Hippopotamuses Living in a Game Reserve Area, Rural Zambia

Mark W Lehman et al. Emerg Infect Dis. 2017 Sep.

Abstract

In September 2011, a total of 511 human cases of anthrax (Bacillus anthracis) infection and 5 deaths were reported in a game management area in the district of Chama, Zambia, near where 85 hippopotamuses (Hippopotamus amphibious) had recently died of suspected anthrax. The human infections generally responded to antibiotics. To clarify transmission, we conducted a cross-sectional, interviewer-administered household survey in villages where human anthrax cases and hippopotamuses deaths were reported. Among 284 respondents, 84% ate hippopotamus meat before the outbreak. Eating, carrying, and preparing meat were associated with anthrax infection. Despite the risk, 23% of respondents reported they would eat meat from hippopotamuses found dead again because of food shortage (73%), lack of meat (12%), hunger (7%), and protein shortage (5%). Chronic food insecurity can lead to consumption of unsafe foods, leaving communities susceptible to zoonotic infection. Interagency cooperation is necessary to prevent outbreaks by addressing the root cause of exposure, such as food insecurity.

Keywords: Bacillus anthracis; Chama; Zambia; anthrax; bacteria; food insecurity; food safety; hippopotamus; one health; zoonoses.

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Figures

Figure 1
Figure 1
Location of an anthrax outbreak that originated in a game management area along the South Luangwa River in the Chama District of northeastern Zambia, 2011. Inset map shows location of Zambia in Africa.
Figure 2
Figure 2
A family searching for water by digging deep into a dried riverbed during the dry season in northeastern Zambia.
Figure 3
Figure 3
Hippopotamus bones and hides left behind after butchering of animals that were found dead on a river bank and later identified as the source of anthrax causing an outbreak among humans in northeastern Zambia, 2011.
Figure 4
Figure 4
A dead hippopotamus floating down the South Luangwa River in northeastern Zambia during an anthrax outbreak in 2011.
See this image and copyright information in PMC

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