1^st, November 2023

Today, I wish to update the nation on events threatening the public health security of our country, Zambia.

Allow me to remind you that the Government of the Republic of Zambia, through the  excellent  leadership our Republican President His Excellency Mr. Hakainde Hichilema, attaches great importance to securing the health of our people and the nation at large.

Using a multidisciplinary and multisectoral approach, our Ministry of Health, has been responding to outbreaks of various diseases in various parts of our country. These include Cholera,  Measles, Anthrax, Rabies, and Scabies.

Furthermore, our multisectoral response teams have put in place various measures to mitigate and prevent any polio outbreak that may occur in the country. In this regard, Polio vaccination campaigns are currently being conducted in high-risk districts. This is in addition to the routine polio vaccination services going on country-wide.

Members of the Press, Country Men and Women,

Now allow me to update the house on the current human anthrax outbreak in the country.

Anthrax is a serious infectious disease caused by a certain form of  bacteria that affects humans and animals. It is transmitted from Animals to  Human beings. It occurs naturally in soil in a dormant form called “anthrax spore”.  It commonly affects domestic and wild animals around the world. People can get sick with anthrax if they come in contact with infected animals or contaminated animal products.

Members of the Press, Country Men and Women,

Anthrax is a big public health security threat to our country and the subregion as well. When anthrax gets inside the body and is activated, it can multiply, spread out in the body, produce toxins, and cause severe illness.  The symptoms of anthrax depend on the type of infection and can take anywhere from 1 day to more than 2 months to appear.  All types of anthrax have the potential, if untreated, to spread throughout the body and cause severe illness and even death.

Anthrax can present in four forms as:

• Anthrax of the Skin:  this is the most common form of anthrax infection, and it is also considered to be the least dangerous. Infection usually develops from 1 to 7 days after exposure. Anthrax spores get into the skin, usually through a cut or scrape. This can happen when a person handles infected animals or contaminated animal products like wool, hides, or hair. Once in the skin, the spores are activated and  cause a group of small blisters or bumps that may itch. Swelling can occur around the sore. A painless skin sore or ulcer with a black center appears later on. Most often the sore will be on the face, neck, arms, or hands.

Without treatment, up to 20% of people with anthrax of the skin die. However, with proper treatment, almost all patients with this form of anthrax survive.

• Anthrax of the Lungs: this type of anthrax is considered to be the most deadly form of anthrax. Infection usually develops within a week after exposure, but it can take up to 2 months. Exposure is through a person breathing in anthrax spores. The infection presents with fever and chills, chest discomfort, shortness of breath and cough. It may also present with sweats (often drenching), extreme tiredness, body aches, confusion or dizziness, nausea, vomiting, or stomach pains.

Without treatment this form is almost always fatal. However, with aggressive treatment, about 55% of patients survive.

• Anthrax of the digestive or gastrointestinal system: Infection usually develops from 1 to 7 days after exposure. When a person eats raw or undercooked meat from an animal infected with anthrax, they can develop this form of anthrax. Once ingested, anthrax spores can affect the upper digestive tract (throat), stomach, and intestines, causing a wide variety of symptoms. These include swelling of the neck or neck glands, sore throat, painful swallowing, nausea and vomiting, diarrhea which can be bloody, stomach pain or swelling. Fever and chills, voice hoarseness, headache, red eyes and fainting may also occur. Without treatment, more than half of patients with this form of anthrax die. However, with proper treatment, 60% of patients survive.
• Injection Anthrax: This is a rare type of anthrax infection which was recently identified in heroin-injecting drug users. Symptoms may be similar to those of  anthrax of the skin. Infection or an abscess deep under the skin or in the muscle where the drug was injected may develop. Injection anthrax can spread throughout the body faster and be harder to recognize and treat.

Members of the Press, Country Men and Women,

There are a number of options for treating patients with anthrax. These include antibiotics and drugs to neutralize the toxins (anti-toxin). Patients with serious cases of anthrax need to be hospitalized. They may require aggressive treatment, and help breathing through ventilation. All these measures can only be performed by well-trained health care workers and specialists.

Though not available in Zambia, there is an Anthrax vaccine approved for use in adults 18 to 65 years of age. The vaccine is only given to those  who may be at risk of coming in contact with anthrax because of their job. These include certain laboratory workers who work with anthrax and some people who handle animals or animal products.

Members of the Press, Country Men and Women,

Allow me to highlight where we have the current outbreak of Anthrax in our country.

A cumulative 335 cases and 4 deaths have been reported across the country in the following provinces:

Southern Province:

Two hundred and sixty-nine (269) cases and 2 deaths have been reported in the province. They are distributed as Sinazongwe with 242 cases including 2 deaths; Kazungula with 17 cases; Livingstone with 6 cases; Monze with 2 cases; and 1 case each in Choma and Kalomo.

Western Province:

Nineteen (19) cases have been reported in the province distributed as 9 in Sesheke, 6 in Mongu, 3 in Nalolo and 1  in Sioma.

Eastern Province:

Thirty (30) cases have been reported in Eastern Province. Lumezi district has recorded 28 cases with 1 death whereas Lundazi has recorded 2  cases.

Lusaka Province:

The province has reported 13 cases in Lusaka District with 5 in Kanyama and 6 in Matero, 1 in chelstone and 1 in chilenje sub-districts.

Northwestern Province:

One (1) case has been reported in Kasempa District. The patient is said to have travelled from Southern Province with a history of eating meat from a carcass with unknown cause of death.

Muchinga Province:

Three (3) cases have just been reported in Mpika District of Muchinga province from Nabwalya Rural Health Center. Sadly we have lost a 12 year old boy among the 3 cases. Nabwalya is an area  which  borders Mambwe district in Eastern province. As we speak a multisectoral team from Health and Agriculture is on the way to the area.

All these patients presented with skin sores or ulcers with some of them having nausea, vomiting and fever. A few have presented with chest discomfort and difficulty in breathing. While the majority of patients are being treated from home, six (6) are currently under admission in Maamba, Choma and Livingstone hospitals.

Members of the Press, Country Men and Women,

We have implemented a range of public health measures following a ‘One Health Approach’ to contain and prevent the spread of anthrax. These measures include:

1. Re-orientation of staff on disease identification and management to ensure early diagnosis and treatment
2. Enhanced event-based surveillance and early case detection
3. Ensuring that all facilities have an adequate supply of personal protective equipment (PPE) and medication needed for treatment
4. Public sensitization and community engagement
5. Ongoing monitoring and clinical evaluation of discharged patients

Working together with officers from Ministry of Livestock and fisheries, robust teams have been mobilised to ensure the spread of this disease among humans and animals is curtailed.

Members of the Press, Country Men and Women,

In conclusion, I would like to appeal to all stakeholders to remain committed and actively contribute to enhancing community engagement. Those that may develop symptoms suggestive of Anthrax need to visit the nearest health facilities for urgent evaluation and management.

I thank you

Honorable Sylvia T. Masebo, MP

Minister of Health