Anthrax Outbreak in Gunung Kidul, Yogyakarta: Understanding of Anthrax and Preventing Its Spread
Anthrax is a contagious disease caused by the bacterium Bacillus anthracis. This disease can affect both humans and animals, although it is more common in livestock and wild animals, such as cattle. The disease can occur in herbivorous animals through inhalation or direct consumption of spores while grazing in the wild. Carnivorous animals become infected by consuming herbivorous animals that are affected, while human infection usually occurs through contact with spores, either through consumption, inhalation, or direct contact. The disease does not spread directly from an infected person but rather through the spores, which act as the source of infection. The major virulence factors of B. anthracis are its capsule polypeptide and anthrax toxins, consisting of three proteins: protective antigen, edema factor, and lethal factor, which are non-toxic individually but work synergistically. Human anthrax has three main clinical forms: cutaneous, inhalation, and gastrointestinal.
Bacillus anthracis spores are highly resistant to environmental conditions and can survive for several decades in the environment. Spores can enter the body, causing serious outbreaks in tropical and subtropical countries with high rainfall, such as the anthrax case in Gunung Kidul, Yogyakarta, Indonesia.
The Anthrax case in Gunung Kidul occurred in the Semanu district, where it was discovered that a 73-year-old resident died after consuming beef. According to information from the Gunung Kidul District Health Office, the consumed beef was obtained from a slaughtered cow infected with anthrax, and it is suspected that the cow was already dead and buried before consumption and distribution to 125 local residents. Dewi Irawati, the Head of the Gunungkidul District Health Office, stated that 125 individuals had their blood samples taken, and 85 of them tested positive for anthrax, with almost no symptoms. Additionally, three individuals who were suspected of being anthrax positive died. According to the Director of Disease Prevention and Control at the Ministry of Health, Imran Pambudi, there were three deaths attributed to anthrax: one person died as a suspected anthrax case, while the other two were not examined but were known to have close contact with the deceased cow, which was the source of anthrax.
This incident was influenced by a local tradition known as “Brandu”, which involves collecting contributions to be given to the owner of dead or sick livestock, and then distributing the meat to the contributors. While the tradition aims to help those who suffer significant losses due to the death of their livestock, it also poses a potential health hazard, as dead animals can transmit diseases such as anthrax.
Due to the disease spreading to many people through its spores, the government of Gunung Kidul, Yogyakarta, sought solutions to prevent further spread. They deactivated the burial site of anthrax-infected cows and conducted disinfectant spraying in the area. Nanung Danar Dono, a lecturer at the Faculty of Animal Husbandry, Gadjah Mada University (UGM), stated that the area should not be used for any activities, including livestock pens or agricultural land. To ensure that the area is no longer used, the government needs to allocate funds to purchase the land and build a high fence around it to prevent access. Furthermore, there must be public announcements declaring the area hazardous, so it is not utilized for any activities.
Diagnosing the disease is relatively easy in cases of cutaneous anthrax, as it is characterized by a black eschar. Severe intoxication and collapse during the course of the disease, bronchopneumonia, or hemorrhagic enteritis should raise suspicion of anthrax. Treatment with antibiotics is essential. If left untreated, anthrax in any form can lead to septicemia and death. To manage the spread of anthrax, quarantining affected properties, vaccinating potentially exposed livestock, burying dead animals, and disinfecting contaminated sites are recommended. The quarantine should not be lifted until anthrax cases have ceased for at least six weeks since the last vaccination round, and individuals exposed to the disease may receive anthrax vaccine as a preventive measure. Bacillus anthracis is susceptible to various antibiotics, such as penicillin, chloramphenicol, streptomycin, tetracycline, and erythromycin. While concrete burial of infected animals might minimize the spread, it may not be a long-term effective solution as spores can still resurface undisturbed. Adding lime during anthrax carcass burial to raise soil pH might be counterproductive in minimizing long-term spore contamination.