Epidemiological Data

Human Anthrax in England and Wales

Anthrax became a notifiable industrial disease under the Factories Act in 1895, and in December 1960 became a notifiable disease under the Public Health Act. Information about the morbidity of the disease in the general population is available only since 1961.

No cases were reported in 2009. The last reported case of anthrax in England and Wales occurred in October 2008, (See also  Eurosurveillance Report, external link). This was a fatal case of inhalation anthrax in a man whose exposure occurred during manipulation of animal hides while drum-making. This was the first death since 1974, when there were two fatal cases, both believed to be associated with bonemeal fertilizer. One had haemorrhagic septicaemia and generalised infection with Bacillus anthracis, and the second had gastrointestinal and pulmonary anthrax. Prior to that, the last reported case of pulmonary anthrax had been in 1965.

A death from anthrax occurred in Scotland in 2006; this was a case of atypical inhalation anthrax which probably followed exposure as a result of playing/handling animal hide drums (Scottish Report  external link). Since December 2009, cases of anthrax have been reported in heroin users in Scotland.

Data 1981-2008 (England and Wales)

Between 1981 and 2008, 21 possible cases of anthrax were notified under the Public Health (Control of Diseases) Act. There was one death. Two cases subsequently had alternative diagnoses, thus nineteen cases are considered to remain on the register.
Sixteen were male and three female, with ages ranging from 23 - 63 years. All but one were recorded as cases of cutaneous anthrax; one had pulmonary anthrax. For the cutaneous cases, the most common site of the lesion(s) was on the hands or arms. Confirmation by culture of Bacillus anthracis occurred for only two patients, one in 1995 and one in 2008. Serological confirmation was obtained in two cases, in 1982 and 2001. In all other cases, diagnosis was made on clinical grounds only. In five, bacteriological and/or serological tests were known to be negative.

Table 1: Shows the likely source of infection for notified cases 1981-2008 in England and Wales

Anthrax in Ireland and Scotland

Ireland - the last case was in 1993 (overseas travel related).
Scotland - the first case since 1991 occurred in August 2006; this was a fatal case of atypical inhalation anthrax which was probably acquired from handling/playing drums made with animal hides. Since December 2009, cases of anthrax have been reported in heroin users.