Appendix O: Anthrax
Anthrax is an acute and generally fatal disease of mammals, predominantly presented in cattle caused by the Bacillus Anthracis bacterium. It can infect all species of animals as well as humans. The flesh, blood, offal and discharges from an anthrax infected carcase can contain large numbers of anthrax bacteria and therefore pose a risk to other animals and humans.
The last outbreak of Anthrax in cattle was confirmed in two dead suckler cows at a farm in Wiltshire in October 2015. Prior to that case, there was an outbreak in Wales in 2006. The last case in Scotland was in 2002.
The control structures that would be set up by the Scottish Government in response to an anthrax outbreak are outlined in the Scottish Government's Exotic Diseases of Animal Contingency Framework Plan. However, the operational disease control response to anthrax is different to most other exotic notifiable diseases, with the operational response being led by the relevant local authority. APHA will take the lead on visiting, serving notices and applying licences. The OV (Official Vet) completes a Non-existence of Disease form. This form is available from APHA's website under 'Certification Procedures' and returns it to APHA if no disease is confirmed. If disease cannot be ruled out the APHA Veterinary Inspector (VI) will visit the premises and give a second opinion, take further samples, and undertake additional actions including:
- Serving restriction notices
- Advising the local authority (LA) on the need for carcase disposal and on the legal onus on the owner regarding cleansing and disinfection on the premises
- Packing and sending the samples off to the laboratory for analysis.
Legislation and National Contingency Plan
Disease Orders: The Animal Health Act (as amended)
Disease Orders: The Anthrax Order
Disease Orders: The Anthrax (Amendment) Order
Sector: Domestic agricultural industry
Detail: The incidence of anthrax in domestic livestock is relatively rare, but it is nevertheless an acute and generally fatal disease. In the last twenty years, a total of 30 carcases have been disposed of by incineration on IPs. Cattle are the farm animals most frequently affected in GB, but all species of mammals are susceptible.
Movement restrictions would be placed on any affected premises and the owner may be required to carry out C&D on any or all of the premises, and to arrange for vaccination and or treatment of specified animals if considered necessary to prevent the spread of disease.
Food Standard Scotland (FSS) guidance on dairy and meat products would need to be followed where livestock have been in contact with suspect/contact animals. If infection became established, there would be increased risk to agricultural workers.
Owners are not entitled to compensation for affected animals. Local authority will cover the costs for destruction of any carcases.
Sector: International trade
Detail: EU trade is not impacted by anthrax and third country restrictions for milk and meat would only affect the IP.
The EHC for hides and skins to China requires that during the past 6 months, the area of 50 km around the farm where the above mentioned products originated, the slaughterhouse, the plant and the intended port of departure has been free from rabies and anthrax.
Sector: General public
Detail: Anthrax is a zoonotic disease, but is rare in humans, and the risk to the general public would be extremely low [see public health below].
Detail: Scottish Government's primary objective in tackling any cases of anthrax will be to:
act swiftly and decisively, with its operational partners and stakeholders, to protect the health and safety of the public and those directly involved in controlling the disease; and minimise adverse impacts on animal welfare, the rural and wider economy, the public, rural communities and the environment.
Sector: Rural industry
Detail: Movement restrictions could have a negative impact on the rural economy, potentially affecting rural tourism and countryside activities.
Some animal gatherings and hunting may be banned, except under licence.
Sector: Public health
Detail: Anthrax is rare in humans, and the risk to human health is considered to be extremely low. At highest risk would be workers who have handled imported animal products or worked with infected animals (or their hides/by-products). People who have come into contact with suspected or confirmed infected animals could require post-exposure treatment, and resources would be needed to investigate all possible contacts with anthrax infected animals.
History, risk of introduction and spread of disease
Anthrax is a zoonotic disease (can be transferred from animals to humans) caused by the spore-producing bacterium Bacillus anthracis. Anthrax is primarily a disease of herbivorous animals, but all mammals may be susceptible to infection, and the spores can survive in the environment for decades. The disease is endemic in several regions of the world, including southern and eastern Europe.
Anthrax in humans is rare, but can occur following exposure to infected animals, their hides or other by-products. Symptoms usually take from one to seven days to appear depending on the amount and route of exposure (although it can take up to 60 days in some cases). There are three forms of disease in humans:
- cutaneous (skin) – in over 95% of cases, the infection is cutaneous, generally caught by direct contact with the tissues of infected animals and contaminating cuts or abrasions in the skin. Normally the skin infection responds to early treatment with appropriate antibiotics.
- inhalation (breathing in) - is rare and is caught by breathing in anthrax spores.
- intestinal (by mouth) - is very rare, and occurs from eating contaminated meat.
Cutaneous anthrax can be readily treated and cured with antibiotics. Mortality is often high with inhalation and intestinal anthrax, since successful treatment depends on early recognition of the disease. Antibiotic treatment is effective if given at an early stage.
Anyone concerned about the human health aspect should contact PHS for advice.
Control measures include the correct disposal of dead animals: disinfection, decontamination and disposal of contaminated materials and decontamination of the environment. Protective equipment must be used by workers. Vaccination of exposed animals and humans may be required.
Any person who is in charge of any animal or carcase has a duty to report any unexplained sudden deaths if they suspect disease to APHA. If anthrax cannot be ruled out following a veterinary enquiry into the existence of disease, samples will be sent to the Rare and Imported Pathogens Laboratory (RIPL) for diagnostic testing, and APHA will serve an infected premises notice (Form A) and apply any necessary restrictions or control measures.
The Anthrax Order requires local authorities to dispose of carcase(s) that are suspected or confirmed to be infected with the disease. APHA can provide advice on the appropriate carcase disposal options, although disposal is generally by incineration.
Local authorities may wish to consider collaborating to maintain capability of a shared incinerator. This would provide a cost effective method of accessing a mobile incinerator; and it would also reduce the burden of associated training and maintenance costs, as these could be shared by participating local authorities.
It is vital that any suspect carcases are disposed of as soon as possible. However, before considering whether to cremate or incinerate a suspect anthrax carcase, local authorities must liaise with APHA. Contact must also be made with the Scottish Environment Protection Agency (SEPA) to discuss potential pollution or soil contamination that may occur as a result of burning carcases. The preferred option is on-farm incineration using a permitted mobile incinerator. If a mobile incinerator or retained contractor who is paid to hold and supply the appropriate equipment cannot respond, then consideration should be given to disposing of the carcase(s) by cremation on an open pyre.
Overview of control measures that would be applied under the Anthrax Order 1991 and the Animal Health Act 1981 (as amended).
- Control of movement on to/out of premises
- Disposal of the affected carcase(s) by incineration, usually on site, by the local authority
- C&D of the affected premises, as directed by APHA
- Vaccination and/or treatment of animals
- Controls on the general movement of animals, and issuing of licences
Local authority staff should not knowingly enter premises with suspected or confirmed anthrax until veterinary controls are in place and biosecurity and Health and Safety Executive (HSE) compliance has been met:
- Vehicles should be left at the entrance to the premises
- Boots should be disinfected before entering and leaving the site
- Hands must be washed before leaving the premises
- Overalls and gloves to be suitably destroyed following the visit, unless they are waterproof and can be disinfected, in which case they must be disinfected upon leaving the premises
- Officers do NOT enter parts of the premises where livestock are, or are likely to be kept, unless complying with appropriate biosecurity measures and/or under veterinary supervision
- Any liquids that may have escaped from the body of an affected/suspect animal must be immediately and thoroughly mixed with a large excess of a disinfectant approved by Scottish Ministers for use with anthrax
Control Zones that may be declared
Statutory Instrument: Anthrax Order (1991)
Zone: Infected place
Stage declared: Minister believes or suspects existence of anthrax in the previous 56 days
Area: The area where anthrax is considered to exist or have existed in the previous 56 days, and any adjoining area that disease might spread to
Controls: Schedule 1
Lead responder control measures under Statutory and Regulatory powers and responsibilities
Local Authorities principal role
- Disposal of the carcase(s) on the premises
- Enforcement of restrictions on suspect premises and confirmed IPs, as per requirements of Parts I and II respectively of Schedule 1 to the Anthrax Control Order (as amended)
- Enforcement of movement restrictions and any associated licences
- Enforcement of any C&D, vaccination and treatment required on affected premises
Animal and Plant Health Agency (APHA) principal role
- APHA will lead on visiting affected premises, serving notices and applying restrictions
- If anthrax is confirmed, APHA will set-up both a Field Operation and a Veterinary and Technical Operations Team
- The role of the Field Operations Team will be to give field operational advice and guidance to local authorities, including access to APHA contracts for carcase disposal
- The role of the Vet and Technical Operations Team will be to provide veterinary and technical advice and to co-ordinate any operational response needed with operational partners in liaison with Scottish Government. In view of the potential risk of spill over of disease to humans, there will also be close liaison with both national and local health boards
NHS Boards principal role
- Provide pre-exposure immunisation to "at risk groups"
- Provide medical treatment and advice to persons presenting with potential anthrax exposure
- Carry out a risk assessment for requirement of post exposure prophylaxis (PEP)
- Provide representative to the National IMT
- Contribute to the Communications Strategy, risk communication and public facing messages in respect of matters affecting public health
Public Health Scotland (PHS) principal role
- Convene the National IMT to coordinate the public health response
- Provide expert public health advice to responding agencies
- Provide operational support to NHS boards in relation to the public health response to the incident
Police Scotland principal role
Under Article 4 of The Anthrax order (1991), there is a legal duty on any person who has in their possession or under their charge, any animal or carcase that they suspect is diseased, and any veterinary surgeon or other person who, in the course of their duties, suspects the presence of the disease on any premises to give notice of their suspicion as soon as practicable to the local APHA office. If Police Scotland take a report call, they should contact the local APHA office in Scotland immediately for advice. Police Scotland's main role would be to:
- Assist local authorities to enforce restrictions
- Provide support for any public disturbance/public safety issues
- Local authorities and Police Scotland have the power to seize animals if the owner fails to comply with any anthrax control provisions
- Deal with access issues to domestic dwellings
- Provide assistance to APHA through the provision of specialist knowledge in the area of management and co-ordination of major incidents Work in partnership with local authorities and APHA to consider local intelligence
- Ensure Corporate Communications are informed.
- If required, execute and enforce Section 60(1) of the Animal Health Act 1981, e.g. powers of entry, search and arrest
- If required, execute and enforce Section 49 and Schedule 1 of the Animal Health and Welfare (Scotland) Act 2006, e.g. entry and search, stopping and detaining vehicles and arrest without warrant
- If required, provide representation at an Amber Teleconference
- Maintain links between the resilience partnership, and attend meetings as required by the relevant disease control structures put in place to control the outbreak
Scottish Government principal role
- Scottish Government Resilience Room will monitor the progress and brief Scottish Ministers
- Ensure necessary legislation is in place
- Make and disseminate decisions, guidance and information on policy relating to disease control
- Lead on policy issues relating to public health and animal health and welfare
- Communicate with field staff and enforcement bodies (e.g. local authorities)
- Handle policy issues, as well as share disease control developments with SGoR and other UK Rural Affairs departments, and lead communications to ensure consistency of message.
If anyone has been in contact with any suspect animal, they should immediately contact their local GP or PHS. Cutaneous anthrax can be readily treated and cured with antibiotics. Mortality is often high with inhalation and gastrointestinal anthrax, since successful treatment depends on early recognition of the disease; therefore a full and expert risk assessment must be promptly carried out and appropriate management agreed in consultation with the local NHS Board.
Additional sources of information on immunisation against infectious disease:
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