Epidemiology of human cutaneous anthrax in the country of Georgia 2010-2012

In Georgia the incidence of human cutaneous anthrax (HCA) has increased over the last decade. Anthrax is a soil-borne zoonotic disease; human transmission is often associated with direct contact with infected animals or contaminated materials. Epidemiologic and spatial analysis was used to indentify risk factors for anthrax. Data on HCA during 2010-2012 were obtain by the National Center for Disease Control and Public Health in Georgia were analyzed. Epidemiologic data was stratified by age, gender, and source of infection. National incidence rate ratios (IRR) were calculated fitting the stratified data with a negative binomial generalized linear model. Spatial cluster analysis was performed in SaTScan to identify areas with an increased risk. The most common source of infection among males was slaughtering cattle (62%) while processing and handling meat was more common among females (65%). The adjusted model showed a strong association of risk in males (IRR: 4.92 [95% CI: 2.99, 8.09]) compared to females. Individuals age 50-64 years were at a greater risk of infection. The SaTScan analysis identified significant spatial clustering. Two clusters were identified in the southeast and one in the northwestern part of the country. The findings indicate important risk factors for the transmission of HCA and show the disease is concentrated in specific areas of the country. This information may help provide guidance for public health interventions to reduce human cases of cutaneous anthrax such as targeted livestock vaccination and increased awareness of the disease.