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Sverdlovsk anthrax outbreak 1979 – outbreak detection

Sverdlovsk anthrax outbreak 1979 - outbreak detection
DAVID HESLOP: The initial cases of the outbreak presented to the polyclinics and hospitals serving the southern part of Sverdlovsk starting on the 4th of April, 1979. Within three days, it was clear to clinicians that an unusual epidemic event was occurring. Predominately fit and young workers were the most affected, with the subsequent and rapid decline and death of most of the infected. Cases presented over a six week period, with the peak of new cases occurring on the 19th of April with 10. It was also found at the time that animal cases of anthrax had occurred at the same time as human cases, classifying this as an epizootic outbreak.
The animal cases were found to have occurred in a long and narrow band running to the south of Sverdlovsk. Health authorities initially had to rely on the detection of clinical cases through the recognition of typical symptoms and signs in patients presenting with flu-like illness or other features, raising the possibility of anthrax as a diagnosis. Even as the epidemic progressed and more and more advanced detection techniques become available that allowed confirmation of an infection as anthrax as resources were released from central authorities, the mainstay of initial detection remained clinical suspicion and presumptive diagnosis followed by the laboratory confirmation. The investigators used a variety of techniques to confirm a clinical case. Cases that were deceased underwent autopsy.
Autopsy is a systematic analysis of the remains of the deceased in order to determine the cause of death. A secondary goal of autopsy is to provide materials to assist with an ongoing crisis where the results of the autopsy may provide benefit. A number of techniques were used during the autopsy, including analysis of the pathological pattern of disease attack within the body, including body systems affected and the nature in which they had been affected, the taking of samples for microbiological and biochemical analysis. Microbiological analysis available at the time included the ability to culture and stain using standard techniques, and visualise any microscopic organisms using a microscope. The results of the autopsy in the microbiological investigation strongly supported a diagnosis of anthrax.
The Sverdlovsk anthrax outbreak 1979 – outbreak detection – Detection
In this presentation you will explore how the 1979 Sverdlovsk anthrax outbreak was detected. We will focus on the following issues:
  • The kinds of detection strategies that were used
  • The various forms of diagnosis of infectious diseases
  • How the detection of this event was handled by authorities
After watching this video, in the comments section below discuss your answers to the following questions:
  1. Without laboratory testing, how easy do you think it is to correctly diagnose anthrax?
  2. Infectious disease can be diagnosed by clinical syndrome, by culture or special testing of a sample from a live patient, or at autopsy following death. Which do you think is the most reliable method of diagnosis?
  3. If this event occurred in your jurisdiction or country, how do you think local and national authorities might react?
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Biosecurity and Bioterrorism: Public Health Dimensions

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