title: An outbreak of cutaneous anthrax in a non-endemic district--Visakhapatnam in Andhra Pradesh.
abstract: BACKGROUND
  Anthrax is a disease of herbivorous animals, and humans incidentally acquire the disease by handling infected dead animals and their products. Sporadic cases of human anthrax have been reported from Southern India.
  
  
  METHODS
  Five tribal men presented with painless ulcers with vesiculation and edema of the surrounding skin on the extremities without any constitutional symptoms. There was a history of slaughtering and consumption of a dead goat ten days prior to the development of skin lesions. Clinically cutaneous anthrax was suspected and smears, swabs and punch biopsies were taken for culture and identification by polymerase chain reaction (PCR). All the cases were treated with intravenous followed by oral antibiotics. Appropriate health authorities were alerted and proper control measures were employed.
  
  
  RESULTS
  Smears from the cutaneous lesions of all five patients were positive for Bacillus anthracis and this was confirmed by a positive culture and PCR of the smears in four of the five cases. All the cases responded to antibiotics.
  
  
  CONCLUSIONS
  We report five cases of cutaneous anthrax in a non-endemic district, Visakhapatnam, Andhra Pradesh, for the first time.
authors.affiliation: Department of Dermatology, Andhra Medical College, Visakhapatnam, India. graghuramarao@hotmail.com
authors.forename: G Raghu Rama
authors.initials: GR
authors.lastname: Rao
authors.forename: Jyothi
authors.initials: J
authors.lastname: Padmaja
authors.forename: M K
authors.initials: MK
authors.lastname: Lalitha
authors.forename: P V Krishna
authors.initials: PV
authors.lastname: Rao
authors.forename: K V T
authors.initials: KV
authors.lastname: Gopal
authors.forename: Hari Kishan Y
authors.initials: HK
authors.lastname: Kumar
authors.forename: Promila
authors.initials: P
authors.lastname: Mohanraj
mesh_terms: D000328:Adult; D000881:Anthrax / Q000175:diagnosis / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology*