From the first outbreak to the arrival of RHBZ troops. anthrax in Yamal: a chronology of events
Image copyright RIA Novosti Image caption Anthrax kills 2,300 deer in region
After the first outbreak of anthrax in the last 75 years, the authorities of the Yamalo-Nenets autonomous region a lot of work will have to be done to identify old cattle burial grounds and restrict access to them, the deputy director for scientific work Central Research Institute of Epidemiology of Rospotrebnadzor Viktor Maleev.
Anthrax caused the death of a child who on Monday. The number of confirmed human cases has already reached 20, Irina Shestakova, chief freelance infectious disease specialist at the Ministry of Health, said on Tuesday.
According to Shestakova, eight of the 20 cases are children. A total of 90 people were hospitalized, who were in the focus of infection in the Yamal region, but in most of them the diagnosis is not confirmed.
The reason for hospitalization was the slightest ailment, including a runny nose and skin irritation.
"Several patients, who caused us concern a few days ago, today, according to the results of the morning round, showed a stable condition with a very clear positive trend," Shestakova said.
The cases are usually related to families of reindeer herders. 2.3 thousand deer died from anthrax in the region.
According to local authorities, deer in search of food stumbled upon the remains of an animal that died from anthrax and then infected each other.
The Yamalo-Nenets Autonomous Okrug authorities have already begun to vaccinate both animals and the families of reindeer herders. The first to receive the vaccine will be residents from the "clean zone", living near the outbreak of the disease.
Meanwhile, all people who were directly in the outbreak receive antibacterial drugs as part of the prevention, and three days after that they will be vaccinated.
BBC Russian Service talked to VictorohmMaleevth about how dangerous the outbreak is in the YNAO and what local authorities need to do now to avoid such incidents in the future.
Animal burial with security
BBC: What are the reasons for the outbreak of anthrax in the Yamalo-Nenets Autonomous Okrug and is it possible to say that this is some kind of out of the ordinary case?
Viktor Maleev: To say that this is something outstanding, of course, is impossible, because there were more outbreaks. The main reason is that the cattle burial grounds, which used to be under permafrost, apparently thawed, and the bacterium became more active. It is usually in spore form, but here it was in vegetative form.
One reason is that we may not know the location of all animal burial sites, and this bacterium can persist for hundreds of years.
When there was an outbreak of the disease many years ago, there was also a very high temperature. This is an animal disease, and now more than two thousand reindeer have died there.
Since people live there very closely, they live near the camps, that is, the sick are among them. So far, one child has died and had an intestinal form: he apparently consumed contaminated meat.
Now they are doing a lot important issue- disposal of dead animals and the creation of a new cattle burial ground for many years to come, with protection so that people no longer have the opportunity to catch this bacterium.
Image copyright Reuters Image caption Spores and vegetative cells of the anthrax pathogen - Bacillus anthracis - under a microscopeBBC: Does this mean that Nenets reindeer herding communities are in a very vulnerable position in relation to this and other diseases that are transmitted through animals?
V.M.: Probably, to some extent, yes. They have such a life, they communicate most closely with animals, and so it has been for many centuries. It's probably better when people are separate, animals are separate, but this is the type of life that exists in many parts of the world. Although, of course, children could be kept away, I guess.
BBC: How big is the public danger of this outbreak?Say, should people in Yamal, who are not reindeer herders and do not live close to them, be afraid of something?
V.M.: No, this infection is not transmitted in this way. It is dermal, that is, it is a contact route of transmission, only people who have contacted deer.
AT this case there is a skin form, only one boy had an intestinal form, and the skin form is dangerous only by contact. Since all patients with a cutaneous form are already isolated, it is impossible for someone to rub closely against this skin, so the contact route of transmission is not dangerous for others.
True, we need to watch others, because we do not know how many people interacted with deer.
Climate influence
BBC: What is the forecastandWhen is anthrax diagnosed in humans? What does it depend on?
V.M.: The prognosis depends on the time of initiation of treatment and on the form of the disease. When there were cases of bioterrorism in America, the disease was spread by airborne droplets. The pulmonary form, as in cases of bioterrorism, is worse, and when it is cutaneous, it is usually considered that the lethality is up to 10%.
BBC: AT last time anthrax was recorded in Yamal in 1941, 75 years ago. Why is the disease returning?
V.M.: Climate, climate. Climate change has a strong impact. Old cattle burial grounds: apparently, it was just that while there was permafrost, we did not fully know what was there.
These places are poorly explored, and cattle burial grounds for 100 years after burial are dangerous, and now this situation has turned out with a sharp warming of the climate.
In other regions of Russia, access to animal burial grounds is limited, they are known, they are protected, no activity is carried out there. And here all the same nomadic places, huge spaces.
BBC: It was reported that the manufacturer of the anthrax vaccine shipped a thousand doses to Yamal. Who is the primary target for the vaccine?
V.M.: Now we mainly vaccinate veterinarians and livestock breeders. Now we must be especially careful, because we do not know: maybe some deer have already suffered mild forms of the disease, and people communicate with them.
You also need to vaccinate laboratory workers who work with bacteria. Thank God there is a vaccine. It is not found in many other diseases.
Now the main thing is to return to the issue of these animal burial grounds in order to limit them so that the animals do not climb there.
There is no threat of anthrax spread beyond the quarantine zone. All animals and people are vaccinated. Vaccinated and all personnel airmobile group of the Ural Rescue Center, as well as contract servicemen who work in the affected area. This was told to the RG correspondent by phone by one of the members of the group of microbiologists who arrived in Yamal, the head of the observation network and laboratory control department of the Antistihiia Center of the Russian Emergencies Ministry, Alexander Ulyev.
When asked how dangerous a sharp outbreak of such a dangerous disease is, Uliev replied that now it is safe to say that the infection will not spread further. Several factors make this possible. Firstly, for several days there has been no loss of livestock. Secondly, almost the entire herd was quickly vaccinated, which is more than 30 thousand deer in the Yamal region. Reindeer herders and their families have also been vaccinated. Everyone who is in the area and is about to leave is under surveillance. The incubation period for the disease is 7 days. And during this period, people undergo observation. So you can be sure that no one will bring the disease to other regions in themselves or on clothes. According to the microbiologist of the Ministry of Emergency Situations, serious control has been established both on the part of the rescuers, and on the part of the Ministry of Health, the Ministry of Natural Resources.
Why did the outbreak of anthrax occur in Yamal?
Alexander Uliev: Epidemiologists are still dealing with this. Now it is clear that the disease passed to people from cattle. For some reason, it is deer that are most susceptible to rapid infection with an ulcer. And, say, cattle, our Russian cows, are more resistant to the disease. It is possible that the spores of the ulcer have thawed out after suspended animation since 1941, when an even more acute outbreak of anthrax was observed in Yamal.
But why in Yamal, because the current heat has affected not only these places?
Alexander Uliev: In other places there are cattle burial grounds where access is closed. And on Yamal in 1941, no one blew up the permafrost, they didn’t take all the dead cattle to the cattle burial grounds and didn’t burn them. Then the corpses of deer remained lying in the tundra. The spores of the ulcer froze, and now come to life. I personally see this version of what happened.
Alexander Ulyev did not rule out that the disease in 1941 was transmitted through a harness. In those days, a lot of belts, girths for horses were made from animal skins. It is possible that some of the leather items were made from the skins of diseased animals. But then the country was not up to it, and there was no time to understand. Now all concerned departments are not only sounding the alarm, but are also actively involved in the fight against the spread of the infection.
Today, the press service of the Ministry of Emergency Situations of Russia reported that 30 rescuers who arrived the day before from Chelyabinsk began to deploy tent camps for reindeer herders evacuated from remote areas.
The tents, bedding sets, stoves and food delivered to Salekhard the day before by the aviation of the Ministry of Emergency Situations are currently being transferred to the settlement of Yar-Sale, from where their helicopters of the Ministry of Emergency Situations Mi-8 and Mi-26 will be delivered to the tundra in a clean zone, where the rescuers of the Leader Center "and the Ural Training and Rescue Rescue Center of the Ministry of Emergencies, eight life support camps will be deployed," said Colonel Alexei Vagutovich, head of the press service of the Russian Emergencies Ministry.
In addition, the press service of the regional governor gave a TASS correspondent the latest figures on the situation on the peninsula. According to local authorities, in the Yamal region, 200 km north locality Yar-Sale on a remote pasture from anthrax killed more than 2.3 thousand deer. Total population livestock in the quarantine zone exceeds 41 thousand heads. For preventive purposes, 256 people, including 132 children, were evacuated from the reindeer herders' camp. Of these, 90 people, including 53 children, were hospitalized in the infectious diseases departments of medical institutions in Salekhard and Yar-Sale, according to doctors. Suspicion of the disease "Anthrax" was found in 28 people, including 15 children. The area of the buffer zone around the anthrax outbreak in Yamal is 11,000 square meters. km.
Veterinarians intend to vaccinate the entire Yamal livestock against anthrax - more than 700 thousand heads. First of all, vaccination will cover the herd roaming in the Yamal region, where an anthrax outbreak has been recorded. Tazovsky and Priuralsky districts are next in line. There is not a single case of illness, but when we are talking about biological safety, it is better to play it safe, - noted in the press service of the governor.
Governor of Yamal Dmitry Kobylkin introduced quarantine in the Yamal region. Reason - death of 1 thousand 200 deer, reported the press service of the head of the region.
Last week, from the Yamal tundra, it was reported that the reindeer could not cope with the abnormally high temperature. By the weekend, the most difficult situation was observed among private reindeer herders near the Tarko-Sale trading post and in the reindeer herding brigade nearby. Today, the total losses are 1,200 deer.
Analysis of samples taken by specialists working group in animals over the past week, showed the cause of death of animals: part of the death of deer is caused by anthrax spores. Working groups consisting of members of the government, city administrations went to find out the reasons for the incident. Animals were autopsied, samples were taken for analysis, tundra people were examined, and the necessary recommendations were given to reindeer herders. According to the results complex analyzes experts confirmed: the animals died both from the heat and from anthrax.
Experts emphasize - threats people don't, all tundra dwellers have been thoroughly examined: all are healthy. Next to 63 reindeer herders is a doctor-therapist. All nomads from this camp will be relocated for vaccination. The helicopter has already been sent to the parking lot.
The probable cause of reindeer infection, according to experts, is the site of a long-standing death of a sick animal that was opened due to the heat. There are no cattle burial grounds in this area, but given the viability of the anthrax pathogen - 100 years or more, and its resistance to temperature changes - professionals suggest that deer, in search of food, stumbled upon the place of an animal that died from anthrax and then infected each other. Therefore, the local place of this grazing - the deer path - will be fenced off with special landmarks. Traditionally, local residents bypass these areas even after many years.
The bodies of the dead are disposed of. Healthy deer of the affected herd will undergo additional vaccination: the serum has been ordered and will most likely be delivered from Moscow to Yamal today. Funds for cleaning up the places of death of animals will be allocated from the reserve fund of the district budget.
The governor of the district demanded that maximum precautions be taken for the health of specialists and nomads when carrying out activities under quarantine. On July 25, the issue of providing people with everything necessary was resolved. After determining the damage to the reindeer herders, the issue of compensation will be considered. Specialists of the veterinary service, departments of the agro-industrial complex, indigenous peoples of the North, and health continue to work in the region. The situation is under constant control.
Note that the last time an anthrax outbreak in Yamal was in 1941. In 2015, more than 480 thousand reindeer were vaccinated.
The first victims of anthrax appeared in Yamal - the infection caused the death of a 12-year-old child. Eight more tundra dwellers who found themselves in the zone of anthrax were diagnosed, and just over 200 people are in quarantine. About what happened in Yamal and what anthrax is for modern man, epidemiological experts told MedNovosti.
On Monday, it became known about the death of a 12-year-old child infected with anthrax. According to the press service of the governor of the Yamalo-Nenets Autonomous Okrug, a sick boy from the focus of a dangerous infection was sent to the Salekhard district hospital. He was ill with an intestinal form of anthrax, which is difficult to diagnose.
Another eight residents of Yamal, who found themselves in the zone of occurrence of anthrax, were diagnosed. All of them receive intensive treatment. In relation to other tundra dwellers from the quarantine zone and the territories closest to the outbreak - and there are 211 of them - preventive measures are being taken. There are 72 people in the Salekhard hospital, including 41 children.
According to official data, 2.3 thousand deer died from anthrax in the region, the infection from which was transmitted to people. Now, thanks to the prompt vaccination of healthy deer in the tundra and the treatment of sick ones, the death of animals has practically stopped.
Expert epidemiologists told MedNovosti about what happened in Yamal and what anthrax is for a modern person.
Elena Volchkova: “It is impossible to get anthrax in your kitchen”
Elena Volchkova, Head of the Department of Infectious Diseases, PMSMU named after I.I. THEM. Sechenov. Photo: Azj.rus4all.ru
As explained by the Department of Infectious Diseases of the First Moscow State Medical University. Sechenov, Professor Elena Volchkova, since anthrax is a natural focal disease, it cannot be completely eradicated. The bacteria themselves Vasillaceae quickly die under the influence of factors environment, but the spores are very resistant to these factors and can persist for decades in soil and for years in water. And if the natural reservoirs of accumulation of anthrax spores are violated, then both an animal and a person can become infected with this infection. Now in Yamal, as a result of abnormal heat, natural foci have opened up and, possibly, old burials have come to the surface. And the deer that ate the reindeer moss growing there fell ill.
Most often, cattle and livestock are the first to fall ill; anthrax is transmitted to humans mainly by contact. You can become infected when slaughtering and butchering a sick animal, during processing or any other contact with its skin. First of all, the hands that come into contact with the infection suffer. However, any wound on the skin, including on the legs, can become the entrance gate for infection. That is why you should not once again walk barefoot through unknown meadows and fields, in the soil of which a source of natural focal disease can accumulate and multiply. In general, it is always worth trying to protect the skin whenever you are in nature, because there are still a lot of other dangers - from ticks to blood-sucking insects that carry many infections.
What happens when you get infected and is there a cure for anthrax?
When infected with anthrax, reddening of the skin initially appears, then a bubble forms at the site of the spot, which bursts and an ulcerative lesion appears. After about a week, the skin lesion takes the form of a carbuncle. And all this against the background of a temperature reaction, general malaise, weakness.
This so-called skin form illness. Theoretically, it can be confused with another skin disease. But, since isolated cases of the disease are very rare, and outbreaks of infection in humans immediately follow outbreaks in animals, the correct diagnosis is established quickly enough. The cutaneous form of anthrax is well treated with modern antibiotics, especially with timely hospitalization. In addition, detoxification of the patient's body is carried out, immunoglobulins are used, and general therapy is prescribed. If untreated, mortality is 10-20%.
The so-called generalized form infection that occurs as a result of getting into the human body with infected meat, or by airborne droplets (during the same processing of skins and wool). The generalized form, in which the entire body suffers, can also develop with the skin form of the disease, if the infection enters the bloodstream. But, as a rule, skin forms begin to heal quickly, and the possibility of their generalization is unlikely. But the initially generalized forms are really very severe and their mortality, especially without treatment, can reach 90-95%.
There is no danger for the inhabitants of central Russia and Siberia today. Maps of animal burial grounds have been preserved and are under protection. True, sometimes people themselves provoke problems when, not knowing that there were burials on these lands, they begin their unauthorized development, intensive private construction. Theoretically, in addition to cattle burial grounds, former farmlands or grazing areas for a large number of animals can be dangerous. It is impossible to get anthrax in your kitchen. The main thing is in no case to buy untested meat in unknown outlets, along the roads, that is, wherever there is no sanitary supervision. Unfortunately, there are many unscrupulous livestock owners who, in the event of an illness of an animal, quickly slaughter it and drag it for sale.
Mikhail Shchelkanov: “The monitoring system for cattle burial grounds should work like clockwork”
Mikhail Shchelkanov, Head of the Laboratory of Virological Research, Center for Hygiene and Epidemiology in the Primorsky Territory. Photo: Ok.ru
As the professor of the Far Eastern Federal University(FEFU), Mikhail Shchelkanov, head of the virological research laboratory of the Center for Hygiene and Epidemiology in the Primorsky Territory, the emergency in Yamal provoked an extremely hot summer, due to which one of the old forgotten deer burial grounds thawed and opened.
In permafrost conditions, the already extremely tenacious anthrax spores can remain in alkaline soil for more than a hundred years. Moreover, being well preserved in a natural refrigerator - a half-meter soft “cushion” of reindeer moss and various dead plants located above the ice - anthrax can periodically germinate, forming new spores. When the temperature rises, bacteria can melt out of the permafrost layer - and this is the most dangerous option.
Fortunately, due to the low population density, the outbreak in Yamal was quickly contained. Of course, this required serious efforts by local specialists, who had to be thrown into the tundra by helicopters, but there was no need to take any measures on a national scale. It would have been much more difficult in a more densely populated region or in the case of intensive transport links between this territory and the European part of the country. And then it turned out such a natural quarantine.
When and where the ill-fated burial ground was created, it is impossible to say - this is information for official use. Moreover, even the localization of the place of death of animals in the case of anthrax is classified information. Because the same bioterrorists can go there in hot pursuit and collect deadly material. But the conclusion from the situation is obvious: the monitoring system of animal burial grounds should work like clockwork. And if in some regions there seems to be a situation of epizootic well-being for some infections (that is, there is no threat of the spread of this or that infection among animals), this is no reason to relax.
Anthrax is called anthrax because the vast expanses of Western and Eastern Siberia are one of the most intense epizootic and, as a result, epidemic (if there is contact with a person) natural foci of this disease. Just like the northern territories of the country. Large herds of animals graze here. And if, God forbid, a case occurs, giant burial grounds appear, which must be strictly controlled. But there is no one to do this. And in general, it's like with the disposal of radioactive waste - no matter how reliable protection you set up, sooner or later a leak will occur.
Therefore, it is better not to arrange burials, but to debug the system of burning the carcasses of dead animals. Veterinarians have such capacities, but they are simply not enough in the event of a mass death. This means that mobile incinerators and purposeful investments in this are not so big. And we will have enough problems with the old burial grounds for many years to come.
“Literally in May, we had a conference at FEFU, at which one of my students, a guy from Uzbekistan, made a report on this topic,” Shchelkanov said. - I thought it was very important, because in Central Asia a lot of forgotten burial grounds. But I did not imagine that we also have such burial grounds in the North, about which we do not know everything. And one of them worked."
The number of people hospitalized from an anthrax outbreak in Yamal has risen from nine to 13, mostly children, local authorities say.
"Four more tundra workers from the Yamal tundra were taken to the Salekhard Clinical Hospital for additional examination and observation," TASS quoted the press service of the region's governor Dmitry Kobylkin as saying.
"The medical staff is conducting proactive treatment and is awaiting the final analysis of experts from Moscow. In parallel, children are being screened for other diseases," the ministry said.
It is noted that representatives of the YaNAO government and the district health department are in constant contact with the Ministry of Health of the Russian Federation and relevant federal departments.
On the this moment more than 20 different specialists work at the site of the outbreak, air sanitation is on duty around the clock. "At a distance of 80 km from the site, six 10-seat tents from the material reserve of the YNAO in case of emergency have already been deployed. First of all, women and children are transported by helicopters to a safe place. Some heads of nomadic families expressed their intention to stay to help veterinarians and sanitary specialists - no more than 10 people," the press service added.
It is also reported that 500 deer were vaccinated with the anthrax vaccine on Monday. "Today (specialists will work until late at night) 2.5 thousand heads will be vaccinated and tomorrow, July 27 - 1 thousand heads. Vaccination is carried out in a portable corral, which was delivered to the territory by helicopter the day before," the press service notes. In addition, places are being prepared for the disposal of fallen deer.
Anthrax outbreak recorded in Yamal for the first time in 75 years. To date, more than 1.5 thousand reindeer have died from it. Quarantine has been introduced in the Yamal region, the authorities assure that there is no threat to the population.
According to preliminary data from the authorities, the reason for the infection of the deer was an unusually warm summer. During the month, the Yamal was anomalously hot - up to 35 degrees above zero. " The thawed tundra contributed to the manifestation of the source of infection- the remains of an animal that fell a long time ago, - the site of the governor of the Yamalo-Nenets Autonomous District reports. “The deer in this area were extremely weakened due to the heat, which contributed to their infection.”
According to the Rosselkhoznadzor, sporadic cases of anthrax in animals are registered in Russia: annually two or three points are unfavorable for the disease and from two to seven sick animals. At the same time, between 2009 and 2014, 40 cases of human anthrax were registered in the country (43% more than in the previous five years) in three federal districts: 20 - in the North Caucasus, 11 - in the Siberian and nine - in the South.
In 2015, three residents of the Balashovsky district of the Saratov region were diagnosed with anthrax. It turned out that all three participated in the slaughter of a bull.
Anthrax is especially dangerous infectious disease agricultural and wild animals of all kinds, as well as humans. The source of infection are wild animals and livestock, the disease is not transmitted from person to person.
Infection occurs by contact, the incubation period of the disease lasts an average of three to five days. The disease proceeds at lightning speed, is characterized by hemorrhagic inflammation of the skin, lymph nodes and internal organs.
