title: Human anthrax outbreak associated with livestock exposure: Georgia, 2012.
abstract: Human anthrax cases reported in the country of Georgia increased 75% from 2011 (n = 81) to 2012 (n = 142). This increase prompted a case-control investigation using 67 culture- or PCR-confirmed cases and 134 controls matched by residence and gender to investigate risk factor(s) for infection during the month before case onset. Independent predictors most strongly associated with disease in the multivariable modelling were slaughtering animals [odds ratio (OR) 7·3, 95% confidence interval (CI) 2·9-18·1, P 1 km; 15 (12%) of 125 had sick livestock; and 11 (9%) of 128 respondents reported finding dead livestock. We recommend joint public health and veterinary anthrax case investigations to identify areas of increased risk for livestock anthrax outbreaks, annual anthrax vaccination of livestock in those areas, and public awareness education.
authors.affiliation: Georgia National Center for Disease Control and Public Health,Georgia Ministry of Health,Tbilisi,Georgia.
authors.forename: A
authors.initials: A
authors.lastname: Navdarashvili
authors.affiliation: Epidemic Intelligence Service,Centers for Disease Control and Prevention,Atlanta,GA,USA.
authors.forename: T J
authors.identifier: http://orcid.org/0000-0001-8920-4912
authors.initials: TJ
authors.lastname: Doker
authors.affiliation: South Caucasus Field Epidemiology and Laboratory Training Program,Tbilisi,Georgia.
authors.forename: M
authors.initials: M
authors.lastname: Geleishvili
authors.affiliation: Division of High Consequence Diseases and Pathology,Centers for Disease Control and Prevention,Atlanta,GA,USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Haberling
authors.affiliation: Bacterial Special Pathogens Branch,Division of High-Consequence Pathogens and Pathology,Centers for Disease Control and Prevention,Atlanta,GA,USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Kharod
authors.affiliation: South Caucasus Field Epidemiology and Laboratory Training Program,Tbilisi,Georgia.
authors.forename: T H
authors.initials: TH
authors.lastname: Rush
authors.affiliation: South Caucasus Field Epidemiology and Laboratory Training Program,Tbilisi,Georgia.
authors.forename: E
authors.initials: E
authors.lastname: Maes
authors.affiliation: Georgia National Center for Disease Control and Public Health,Georgia Ministry of Health,Tbilisi,Georgia.
authors.forename: K
authors.initials: K
authors.lastname: Zakhashvili
authors.affiliation: Georgia National Center for Disease Control and Public Health,Georgia Ministry of Health,Tbilisi,Georgia.
authors.forename: P
authors.initials: P
authors.lastname: Imnadze
authors.affiliation: Bacterial Special Pathogens Branch,Division of High-Consequence Pathogens and Pathology,Centers for Disease Control and Prevention,Atlanta,GA,USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Bower
authors.affiliation: Bacterial Special Pathogens Branch,Division of High-Consequence Pathogens and Pathology,Centers for Disease Control and Prevention,Atlanta,GA,USA.
authors.forename: H T
authors.initials: HT
authors.lastname: Walke
authors.affiliation: Bacterial Special Pathogens Branch,Division of High-Consequence Pathogens and Pathology,Centers for Disease Control and Prevention,Atlanta,GA,USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Shadomy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000881:Anthrax / Q000453:epidemiology* / Q000382:microbiology; D001408:Bacillus anthracis / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D058751:Livestock; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
keywords: Anthrax; bacterial infections; control; epidemiology; zoonoses