Anthrax, hides and drums: Q&As

What is anthrax?

Anthrax is an acute, and potentially fatal, disease caused by the spore-forming organism Bacillus anthracis. The spores can survive in the environment, e.g. in soil, for many years. Human beings and many species of animals, particularly livestock, can contract the disease. In the past in the UK, cattle were most often affected although outbreaks in pigs also occurred. However, it is now rare to find infected animals in the United Kingdom; only 4 cases have been reported in the past 10 years.

Anthrax can occur in humans following exposure to infected animals, their hides or other by-products. The disease used to be known as 'wool-sorters disease' and was a recognised occupational hazard for some workers, including those in wool mills, abattoirs, tanners, and those who process hides, hair, bone and bone products. However, it is now extremely uncommon in humans in the UK.

What are the symptoms of anthrax?

There are three forms of human disease depending on how infection is acquired. They are:

Cutaneous - through the skin
Inhalational - breathing in spores
Ingestion - by mouth

Cutaneous anthrax usually occurs on the hands or forearms. The lesion (which is usually single) develops from an inflamed pimple into an ulcer with a black centre and extensive swelling. The infection usually responds well to early treatment with appropriate antibiotics.
Inhalation anthrax is rare. Symptoms begin with a 'flu-like illness followed by severe breathing difficulties and blood poisoning after 2-6 days.
Ingestion anthrax is a very rare form of severe food poisoning which follows eating undercooked meat from an infected animal.

All forms of anthrax are serious and can be fatal. However they can be treated effectively with antibiotics if identified early enough. For more detailed information about anthrax, see Anthrax in Humans Q&A

Am I at risk of anthrax from animal hides or hair, or by making a drum from these products?

Anthrax infections associated with the handling of untanned animal hides are now extremely rare in the UK. Imported animal hides from countries where anthrax is endemic in animals (for example, in Africa and Asia) may pose a higher risk for exposure than domestic (UK origin) hides. Historically, the industrial processing of hides or hair, often in enclosed or poorly ventilated settings, was associated with increased risk of anthrax: most cases of anthrax which followed such an exposure were the cutaneous (less serious) form.

The risk of contracting Bacillus anthracis from simply handling individual hides imported from endemic areas is very low. However, there is a small risk of anthrax in people who manipulate (for example, scraping fur or hair off the hide with a razor) untanned animal hides. The first known case of inhalation anthrax related to using animal hides in drum making occurred in 2006 in New York. The patient was a man who made drums from dried (but otherwise untreated) animal hides brought in from West Africa. A similar case occurred in London in 2008.

In 2007, a case of cutaneous anthrax occurred in Connecticut USA, in a drum maker who had been working with untreated goat hides from Guinea in West Africa. A relative of this case also acquired cutaneous anthrax after contamination of the environment.

Am I at risk of anthrax from my animal hide drum?

The risk of acquiring anthrax from an animal hide drum is very low. A single case of cutaneous (skin) anthrax associated with a goat hide bongo drum purchased in Haiti occurred in 1974: this is the only such case ever reported. Rare cases of anthrax have occurred as a result of making drums from untanned animal hides (see above). Worldwide, a single case of disseminated anthrax has been reported to have been associated with using or handling animal hide drums. In this case (Scotland 2006), it was concluded that the patient, who may have had increased susceptibility to infection, became infected as a result of using or handling West African style drums at drumming classes/ workshops.

I attend drumming events. Am I at risk of getting anthrax?

The risk of being exposed to anthrax spores through drumming alone or merely handling African hide drums is very low. However, drum owners or players should report any unexplained fever or new skin lesions to their GP, and describe their recent contact with animal hide drums.

What should I do with my animal hide drum?

There is no evidence to suggest that you need take any action with existing hides or drums. Contamination has only rarely been found and would be at a very low level in finished drums. This is unlikely to present a risk to human health in normal use.

How can I further protect myself if I work with hides that may be potentially contaminated with anthrax spores?

Persons engaged in making drums should only use animal hides that have been processed to reduce the chance of infectious disease transmission. Anyone with ongoing exposure to untreated animal hides should consider adopting the following measures:

Conduct work in well-ventilated areas that do not exhaust to other work or living areas
Use disposable gloves when handling hides and cover all cuts, abrasions or broken skin with waterproof dressing. Avoid hand to mouth/eye contact
Avoid where possible shaking, beating or scraping hides vigorously
Wear a disposable face mask of FFP3 standard. Such a mask must be fitted properly to the face in order to provide the desired protection (instructions as per manufacturer's guidance)
Wash hands thoroughly with soap and water when gloves are removed, before eating, and when replacing torn or worn gloves. Soap and water will wash away most spores that may have contacted the skin. Disinfectant solutions are not needed
Carefully bag and dispose of any waste, and use a vacuum cleaner with HEPA (High Efficiency Particulate Air) standard filters (as for allergy sufferers). When emptying the vacuum cleaner or changing the filters, wear a disposable FFP3 face mask and gloves

Is there a way to treat cattle or goat hides to make them safe to produce drums?

Certain processing methods may reduce the risk of disease from handling animal hides.

Further details www.bt.cdc.gov/agent/anthrax/faq/pelt.asp (2006)

http://www.nyc.gov/html/doh/downloads/pdf/cd/anthrax_and_drummers.pdf (2008)

What if I worked with hides and I am concerned about exposure to anthrax?

If you are concerned that you may have handled an animal hide contaminated with anthrax spores you should not worry as the risk is extremely low. However if you develop any unexplained feverish illness or skin lesions, report these immediately to your GP. The history of contact with untreated or untanned animal hides should be explained.

May I import animal hides?

Importations of animal hides are required to undergo a veterinary inspection and must be accompanied by the relevant health certification. However these import requirements are not aimed at detecting the presence of anthrax.

Cattle or goat hides that have been tanned, hard-dried, pickled (soaked in a salt solution), or treated with lime are considered to pose less of a risk for infectious diseases and may be imported under certain conditions.

Further information on the import requirements for animal hides and skins can be found on the Department for Environment Food and Rural Affairs (DEFRA) website at http://www.defra.gov.uk/animalh/int-trde/imports/iins/hide/index.htm

Last reviewed: 30 July 2009