National Strategy for the prevention and control of anthrax in humans and animals in Kenya (2021-2036)

a NATIONAL STRATEGY FOR THE PREVENTION AND CONTROL OF ANTHRAX IN HUMANS AND ANIMALS IN KENYA (2021-2036) Anthrax Strategy 2021 Revised 8.indd 1 11/2/21 2:23 PM Anthrax Strategy 2021 Revised 8.indd 39 11/2/21 2:23 PM ©2021ZDU ZDU copyright this publication. It is licensed for use under the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License. To view this license, visit http:// creativecommons.org/licenses/by-nc-sa/3.0/. Unless otherwise noted, you are free to copy, duplicate, or reproduce, and distribute, display, or transmit any part of this publication or portions thereof without permission, and to make translations, adaptations, or other derivative works under the following conditions: Any part of this document may be freely reviewed, quoted, reproduced or translated in full or in part, provided that the source is properly acknowledged. It may not be sold or used in conjunction with commercial purposes or for profit. This publication was made possible by the generous contribution of the American people through USAID support to FAO. The contents of this document are the sole responsibility of the government of Kenya and does not necessarily reflect the views of USAID or the United States Government Suggested citation: Zoonotic Disease Unit: National Strategy for the prevention and control of Anthrax in humans and animals in Kenya (2021-2036), Nairobi: Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Ministry of Health; 2021. Published by: The Zoonotic Disease Unit P.O. Box 20811- 00202, Nairobi, Kenya Cover photo: @FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM NATIONAL STRATEGY FOR THE PREVENTION AND CONTROL OF ANTHRAX IN HUMANS AND ANIMALS IN KENYA (2021-2036) Ministry of Agriculture, Livestock, Fisheries and Co-operatives and Ministry of Health November 2021 Anthrax Strategy 2021 Revised 8.indd 2 11/2/21 2:23 PM February 2022 Anthrax Strategy 2021 Revised 8.indd 39 11/2/21 2:23 PM ©2021ZDU ZDU copyright this publication. It is licensed for use under the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License. To view this license, visit http:// creativecommons.org/licenses/by-nc-sa/3.0/. Unless otherwise noted, you are free to copy, duplicate, or reproduce, and distribute, display, or transmit any part of this publication or portions thereof without permission, and to make translations, adaptations, or other derivative works under the following conditions: Any part of this document may be freely reviewed, quoted, reproduced or translated in full or in part, provided that the source is properly acknowledged. It may not be sold or used in conjunction with commercial purposes or for profit. This publication was made possible by the generous contribution of the American people through USAID support to FAO. The contents of this document are the sole responsibility of the government of Kenya and does not necessarily reflect the views of USAID or the United States Government Suggested citation: Zoonotic Disease Unit: National Strategy for the prevention and control of Anthrax in humans and animals in Kenya (2021-2036), Nairobi: Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Ministry of Health; 2021. Published by: The Zoonotic Disease Unit P.O. Box 20811- 00202, Nairobi, Kenya Cover photo: @FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM Anthrax Strategy 2021 Revised 8.indd 39 11/2/21 2:23 PM ©2021ZDU ZDU copyright this publication. It is licensed for use under the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License. To view this license, visit http:// creativecommons.org/licenses/by-nc-sa/3.0/. Unless otherwise noted, you are free to copy, duplicate, or reproduce, and distribute, display, or transmit any part of this publication or portions thereof without permission, and to make translations, adaptations, or other derivative works under the following conditions: Any part of this document may be freely reviewed, quoted, reproduced or translated in full or in part, provided that the source is properly acknowledged. It may not be sold or used in conjunction with commercial purposes or for profit. This publication was made possible by the generous contribution of the American people through USAID support to FAO. The contents of this document are the sole responsibility of the government of Kenya and does not necessarily reflect the views of USAID or the United States Government Suggested citation: Zoonotic Disease Unit: National Strategy for the prevention and control of Anthrax in humans and animals in Kenya (2021-2036), Nairobi: Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Ministry of Health; 2021. Published by: The Zoonotic Disease Unit P.O. Box 20811- 00202, Nairobi, Kenya Cover photo: @FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM i AU-IBR African Union Interafrican Bureau for Animal Resources AHSP Animal Health Service Providers BSL Biosafety Level CBO Community Based Organisation CDC Centers for Disease Control and Prevention Kenya CDVS County Director of Veterinary Services CEC County Executive Commitee COHUs County One Health Units CSF Cerebral Spinal fluid CVL Central Veterinary Laboratory CZC County Zoonotic Committee DG Director General DHIS District Health Information System DVS Director of Veterinary Services EOC Emergency Operation Centre FAO Food Agriculture Organization FBO Faith Based Organization FELTP Field Epidemiology and Laboratory Training Program FMD Foot and Mouth Disease IDSR Integrated Disease Surveillance and Response IGAD Intergovernmental Authority on Development IHR International health regulation. ILRI International Livestock Research Institute IM Intramuscular ISAVET In service Applied Veterinary Epidemiology Training IV Intravenous JEE Joint External Evaluation KABS Kenya Animal Bio surveillance System KALRO Kenya Agricultural and Livestock Research Organisation KEMRI Kenya Medical Research Institute. KEVEVAPI Kenya Veterinary Vaccine Production Institute KLWSS Kenya Livestock and Wildlife Syndromic Surveillance KVA Kenya Veterinary Association KWS Kenya Wildlife Service MALF Ministry of Agriculture, Livestock And Fisheries MOH Ministry of Health NAPCC National Anthrax Prevention And Control Committee NAPHS National Action Plan for Health Security ND1 Notifiable Disease form 1 NGO Non-Governmental Organization OHCEA One Health Central and Eastern Africa OH One Health OIE World Organization for Animal Health PCP Progressive Control Pathway PCR Polymerase Chain Reaction PEP Post Exposure Prophylaxis PHEOC Public Health Emergency Operations Center PVS Performance of Veterinary Services RVILs Regional Veterinary Investigation Laboratories SCVO Sub County Veterinary O�cer SCZC Sub County Zoonotic Committee SOPs Standard Operation Procedures UHC Universal Health Care USAID United States Agency for International Development VBM Valuable Biological Materials VEES Veterinary Epidemiology and Economics Section WHO World Health Organization WSU Washington State University ZDU Zoonotic Disease Unit ZTWG Zoonotic Technical Working Group List of Abbreviations Anthrax Strategy 2021 Revised 8.indd 1 11/2/21 2:23 PM ii Table of Contents List of Abbreviations i Table of Contents ii List of Figures iii List of Tables iv Foreword v Acknowledgements vi Executive Summary vii Chapter One 1 1.1 Introduction 1 1.2 Vision 1 1.3 Mission 1 1.4 Rationale and Justification of the Strategy 2 Chapter Two 3 2.1. Aetiology of Anthrax 3 2.2 Drivers of disease spread 3 2.3 Anthrax in animals 3 2.4 Pathogenesis of B. anthracis in animals 4 2.5 Clinical manifestation 4 2.6 Diagnosis 4 2.7 Prevention and control of Anthrax in animals. 4 2.8 Anthrax in humans 5 2.9 Socio-economic impacts of Anthrax 7 Chapter Three 8 3.1 Anthrax in Kenya- Situation Analysis 8 3.2 Anthrax Surveillance Systems in Kenya 9 3.3 Case definitions – Livestock 9 3.3.1 Suspect case definition 9 3.3.2 Probable case definition 9 3.3.3 Confirmed case definition 9 3.4 Case definitions in humans 10 3.4.1 Suspect case definition 10 3.4.2 Confirmed case 10 3.5 Anthrax Surveillance Systems in Animals 10 3.5.1 Passive surveillance and active surveillance 10 3.5.2 Laboratory surveillance in Kenya 10 3.5.3 Reporting system in Livestock sector 10 3.6 Surveillance System in Wildlife 11 3.7 Anthrax Surveillance System in Humans 12 3.7.1 Passive Surveillance in the health sector 12 3.7.2 Reporting and information system in Public health 12 3.7.3 Laboratory Surveillance in MOH 13 3.7.4 The role of national and county governments in Anthrax disease surveillance 13 3.8 Inter-Sectoral Coordination 13 3.9 Current Anthrax Prevention and Control Activities In Kenya 13 Anthrax Strategy 2021 Revised 8.indd 2 11/2/21 2:23 PM i AU-IBR African Union Interafrican Bureau for Animal Resources AHSP Animal Health Service Providers BSL Biosafety Level CBO Community Based Organisation CDC Centers for Disease Control and Prevention Kenya CDVS County Director of Veterinary Services CEC County Executive Commitee COHUs County One Health Units CSF Cerebral Spinal fluid CVL Central Veterinary Laboratory CZC County Zoonotic Committee DG Director General DHIS District Health Information System DVS Director of Veterinary Services EOC Emergency Operation Centre FAO Food Agriculture Organization FBO Faith Based Organization FELTP Field Epidemiology and Laboratory Training Program FMD Foot and Mouth Disease IDSR Integrated Disease Surveillance and Response IGAD Intergovernmental Authority on Development IHR International health regulation. ILRI International Livestock Research Institute IM Intramuscular ISAVET In service Applied Veterinary Epidemiology Training IV Intravenous JEE Joint External Evaluation KABS Kenya Animal Bio surveillance System KALRO Kenya Agricultural and Livestock Research Organisation KEMRI Kenya Medical Research Institute. KEVEVAPI Kenya Veterinary Vaccine Production Institute KLWSS Kenya Livestock and Wildlife Syndromic Surveillance KVA Kenya Veterinary Association KWS Kenya Wildlife Service MALF Ministry of Agriculture, Livestock And Fisheries MOH Ministry of Health NAPCC National Anthrax Prevention And Control Committee NAPHS National Action Plan for Health Security ND1 Notifiable Disease form 1 NGO Non-Governmental Organization OHCEA One Health Central and Eastern Africa OH One Health OIE World Organization for Animal Health PCP Progressive Control Pathway PCR Polymerase Chain Reaction PEP Post Exposure Prophylaxis PHEOC Public Health Emergency Operations Center PVS Performance of Veterinary Services RVILs Regional Veterinary Investigation Laboratories SCVO Sub County Veterinary O�cer SCZC Sub County Zoonotic Committee SOPs Standard Operation Procedures UHC Universal Health Care USAID United States Agency for International Development VBM Valuable Biological Materials VEES Veterinary Epidemiology and Economics Section WHO World Health Organization WSU Washington State University ZDU Zoonotic Disease Unit ZTWG Zoonotic Technical Working Group List of Abbreviations Anthrax Strategy 2021 Revised 8.indd 1 11/2/21 2:23 PM ii Table of Contents List of Abbreviations i Table of Contents ii List of Figures iii List of Tables iv Foreword v Acknowledgements vi Executive Summary vii Chapter One 1 1.1 Introduction 1 1.2 Vision 1 1.3 Mission 1 1.4 Rationale and Justification of the Strategy 2 Chapter Two 3 2.1. Aetiology of Anthrax 3 2.2 Drivers of disease spread 3 2.3 Anthrax in animals 3 2.4 Pathogenesis of B. anthracis in animals 4 2.5 Clinical manifestation 4 2.6 Diagnosis 4 2.7 Prevention and control of Anthrax in animals. 4 2.8 Anthrax in humans 5 2.9 Socio-economic impacts of Anthrax 7 Chapter Three 8 3.1 Anthrax in Kenya- Situation Analysis 8 3.2 Anthrax Surveillance Systems in Kenya 9 3.3 Case definitions – Livestock 9 3.3.1 Suspect case definition 9 3.3.2 Probable case definition 9 3.3.3 Confirmed case definition 9 3.4 Case definitions in humans 10 3.4.1 Suspect case definition 10 3.4.2 Confirmed case 10 3.5 Anthrax Surveillance Systems in Animals 10 3.5.1 Passive surveillance and active surveillance 10 3.5.2 Laboratory surveillance in Kenya 10 3.5.3 Reporting system in Livestock sector 10 3.6 Surveillance System in Wildlife 11 3.7 Anthrax Surveillance System in Humans 12 3.7.1 Passive Surveillance in the health sector 12 3.7.2 Reporting and information system in Public health 12 3.7.3 Laboratory Surveillance in MOH 13 3.7.4 The role of national and county governments in Anthrax disease surveillance 13 3.8 Inter-Sectoral Coordination 13 3.9 Current Anthrax Prevention and Control Activities In Kenya 13 Anthrax Strategy 2021 Revised 8.indd 2 11/2/21 2:23 PM iii 3.9.1 Prevention and control of Anthrax in animals 13 3.9.3 Prevention and control of Anthrax in humans 15 3.10 Policy, Legal And Institutional Framework Supporting Prevention And Control Of Anthrax 15 3.11 Stakeholders Mapping For Anthrax Prevention And Control 16 3.12 Analysis Of Strengths, Weakness, Opportunities And Threats (Swot) 16 Chapter Four 20 4.0 The Strategic Framework 20 4.1 Guiding Principles of the Strategy 20 4.2 Goal 20 4.3 Main Objective 20 4.4 Anthrax prevention and control strategy Pillars 20 Chapter Five 23 5.1.1 Phase 1: Preparatory and adoption phase 2021-2023 24 5.1.2 Phase 2: Prioritized implementation in high-risk zones, 2024-2027 28 5.1.3 Phase 3: Implementation of Anthrax prevention and control strategy in high and low-risk areas, 2028-2032 28 5.1.4 Phase 4: Elimination of Anthrax in Humans, 2033-2036 29 Chapter Six: 30 6.1 Monitoring and Evaluation 30 List Of Contributors 37 References 38 List of Figures Figure 1: Ecological cycle of infection for Anthrax 4 Figure 2: Trend of livestock Anthrax outbreak reports in Kenya, 1957-2017 8 Figure 3: Temporal distribution of Anthrax outbreaks in Kenyan wildlife, 1999-2017 9 Figure 4: Reporting system in the livestock sector (Source; DVS) 11 Figure 5: Wildlife reporting system in Kenya 11 Figure 6: Passive surveillance in the Ministry of Health 12 Figure 7: Implementation of the Anthrax elimination strategy, 2021-2036 23 Figure 8: Schematic diagram showing coordination structure of the Anthrax prevention and control strategy. 25 Figure 9: Spatial distribution of livestock Anthrax outbreaks by counties in Kenya, 1957 to 2017 (Gachohi et al 2018) 26 Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM 3.9.1 Prevention and control of Anthrax in animals 13 3.9.3 Prevention and control of Anthrax in humans 15 3.10 Policy, Legal And Institutional Framework Supporting Prevention And Control Of Anthrax 15 3.11 Stakeholders Mapping For Anthrax Prevention And Control 16 3.12 Analysis Of Strengths, Weakness, Opportunities And Threats (Swot) 17 Chapter Four 20 4.0 The Strategic Framework 20 4.1 Guiding Principles of the Strategy 20 4.2 Goal 20 4.3 Main Objective 20 4.4 Anthrax prevention and control strategy Pillars 20 Chapter Five 23 5.1.1 Phase 1: Preparatory and adoption phase 2021-2023 24 5.1.2 Phase 2: Prioritized implementation in high-risk zones, 2024-2027 28 5.1.3 Phase 3: Implementation of Anthrax prevention and control strategy in high and low-risk areas, 2028-2032 28 5.1.4 Phase 4: Elimination of Anthrax in Humans, 2033-2036 29 Chapter Six: 30 6.1 Monitoring and Evaluation 30 List Of Contributors 37 References 38 List of Figures Figure 1: Ecological cycle of infection for Anthrax 4 Figure 2: Trend of livestock Anthrax outbreak reports in Kenya, 1957-2017 8 Figure 3: Temporal distribution of Anthrax outbreaks in Kenyan wildlife, 1999-2017 9 Figure 4: Reporting system in the livestock sector (Source; DVS) 11 Figure 5: Wildlife reporting system in Kenya 11 Figure 6: Passive surveillance in the Ministry of Health 12 Figure 7: Implementation of the Anthrax elimination strategy, 2021-2036 23 Figure 8: Schematic diagram showing coordination structure of the Anthrax prevention and control strategy. 25 Figure 9: Spatial distribution of livestock Anthrax outbreaks by counties in Kenya, 1957 to 2017 (Gachohi et al 2018) 26 iv List of Tables Table 1: Diagnosis of Anthrax in humans 6 Table 2: Role of National level and county health authorities in anthrax surveillance 13 Table 3: Stakeholders for Anthrax prevention and Control 16 Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) regarding Anthrax Prevention and Control (SWOT Analysis) 17 Table 5: Anthrax prevention and control work-plan 30 Anthrax Strategy 2021 Revised 8.indd 4 11/2/21 2:23 PM iii 3.9.1 Prevention and control of Anthrax in animals 13 3.9.3 Prevention and control of Anthrax in humans 15 3.10 Policy, Legal And Institutional Framework Supporting Prevention And Control Of Anthrax 15 3.11 Stakeholders Mapping For Anthrax Prevention And Control 16 3.12 Analysis Of Strengths, Weakness, Opportunities And Threats (Swot) 16 Chapter Four 20 4.0 The Strategic Framework 20 4.1 Guiding Principles of the Strategy 20 4.2 Goal 20 4.3 Main Objective 20 4.4 Anthrax prevention and control strategy Pillars 20 Chapter Five 23 5.1.1 Phase 1: Preparatory and adoption phase 2021-2023 24 5.1.2 Phase 2: Prioritized implementation in high-risk zones, 2024-2027 28 5.1.3 Phase 3: Implementation of Anthrax prevention and control strategy in high and low-risk areas, 2028-2032 28 5.1.4 Phase 4: Elimination of Anthrax in Humans, 2033-2036 29 Chapter Six: 30 6.1 Monitoring and Evaluation 30 List Of Contributors 37 References 38 List of Figures Figure 1: Ecological cycle of infection for Anthrax 4 Figure 2: Trend of livestock Anthrax outbreak reports in Kenya, 1957-2017 8 Figure 3: Temporal distribution of Anthrax outbreaks in Kenyan wildlife, 1999-2017 9 Figure 4: Reporting system in the livestock sector (Source; DVS) 11 Figure 5: Wildlife reporting system in Kenya 11 Figure 6: Passive surveillance in the Ministry of Health 12 Figure 7: Implementation of the Anthrax elimination strategy, 2021-2036 23 Figure 8: Schematic diagram showing coordination structure of the Anthrax prevention and control strategy. 25 Figure 9: Spatial distribution of livestock Anthrax outbreaks by counties in Kenya, 1957 to 2017 (Gachohi et al 2018) 26 Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM 3.9.1 Prevention and control of Anthrax in animals 13 3.9.3 Prevention and control of Anthrax in humans 15 3.10 Policy, Legal And Institutional Framework Supporting Prevention And Control Of Anthrax 15 3.11 Stakeholders Mapping For Anthrax Prevention And Control 16 3.12 Analysis Of Strengths, Weakness, Opportunities And Threats (Swot) 17 Chapter Four 20 4.0 The Strategic Framework 20 4.1 Guiding Principles of the Strategy 20 4.2 Goal 20 4.3 Main Objective 20 4.4 Anthrax prevention and control strategy Pillars 20 Chapter Five 23 5.1.1 Phase 1: Preparatory and adoption phase 2021-2023 24 5.1.2 Phase 2: Prioritized implementation in high-risk zones, 2024-2027 28 5.1.3 Phase 3: Implementation of Anthrax prevention and control strategy in high and low-risk areas, 2028-2032 28 5.1.4 Phase 4: Elimination of Anthrax in Humans, 2033-2036 29 Chapter Six: 30 6.1 Monitoring and Evaluation 30 List Of Contributors 37 References 38 List of Figures Figure 1: Ecological cycle of infection for Anthrax 4 Figure 2: Trend of livestock Anthrax outbreak reports in Kenya, 1957-2017 8 Figure 3: Temporal distribution of Anthrax outbreaks in Kenyan wildlife, 1999-2017 9 Figure 4: Reporting system in the livestock sector (Source; DVS) 11 Figure 5: Wildlife reporting system in Kenya 11 Figure 6: Passive surveillance in the Ministry of Health 12 Figure 7: Implementation of the Anthrax elimination strategy, 2021-2036 23 Figure 8: Schematic diagram showing coordination structure of the Anthrax prevention and control strategy. 25 Figure 9: Spatial distribution of livestock Anthrax outbreaks by counties in Kenya, 1957 to 2017 (Gachohi et al 2018) 26 iv List of Tables Table 1: Diagnosis of Anthrax in humans 6 Table 2: Role of National level and county health authorities in anthrax surveillance 13 Table 3: Stakeholders for Anthrax prevention and Control 16 Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) regarding Anthrax Prevention and Control (SWOT Analysis) 17 Table 5: Anthrax prevention and control work-plan 30 Anthrax Strategy 2021 Revised 8.indd 4 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax, a bacterial zoonosis of global health security and public health importance. Anthrax primarily a�ects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known; however, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). The Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further o reduce livestock deaths, reduce human su�ering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the preventing and controlling of Anthrax in Kenya. Hon. Peter Munya , EGH Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries and Co-operatives Sen. Mutahi Kagwe, EGH Cabinet Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a bacterial zoonosis of global health security and public health importance that primarily affects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further reduce livestock deaths, reduce human suffering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives vi This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), drawing membership from the Ministry of Agriculture Livestock and Fisheries, Ministry of Health, Kenya wildlife Services and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture Organization (FAO), Global Health Security Agenda (GHSA) project financed by the United States Agency for International Development (USAID). We highly appreciate this support. We specifically acknowledge the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1. • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Acknowledgements Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Susan Mochache, CBS Principal Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 6 11/2/21 2:23 PM vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture Organization (FAO) -Global Health Security Agenda (GHSA) project, financed by the United States Agency for International Development (USAID). We highly appreciate this support. We specifically acknowledge the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health Mr. Harry Kimtai, CBS v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax, a bacterial zoonosis of global health security and public health importance. Anthrax primarily a�ects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known; however, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). The Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further o reduce livestock deaths, reduce human su�ering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the preventing and controlling of Anthrax in Kenya. Hon. Peter Munya , EGH Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries and Co-operatives Sen. Mutahi Kagwe, EGH Cabinet Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a bacterial zoonosis of global health security and public health importance that primarily affects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further reduce livestock deaths, reduce human suffering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax, a bacterial zoonosis of global health security and public health importance. Anthrax primarily a�ects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known; however, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). The Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further o reduce livestock deaths, reduce human su�ering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the preventing and controlling of Anthrax in Kenya. Hon. Peter Munya , EGH Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries and Co-operatives Sen. Mutahi Kagwe, EGH Cabinet Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a bacterial zoonosis of global health security and public health importance that primarily affects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further reduce livestock deaths, reduce human suffering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives vi This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), drawing membership from the Ministry of Agriculture Livestock and Fisheries, Ministry of Health, Kenya wildlife Services and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture Organization (FAO), Global Health Security Agenda (GHSA) project financed by the United States Agency for International Development (USAID). We highly appreciate this support. We specifically acknowledge the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1. • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Acknowledgements Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Susan Mochache, CBS Principal Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 6 11/2/21 2:23 PM vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health vi Acknowledgements This strategy was developed through a consultative process involving key stakeholders and experts on Anthrax prevention and control. The development of the strategy is a great achievement for Kenya, as it provides a systematic approach to reduce Anthrax in livestock, wildlife and with an ultimate goal of eliminating the disease in humans. The development of this strategy is in line with the priorities outlined in Kenya’s National Action Plan for Health Security (NAPHS). These priorities were derived from Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. The development process was coordinated by the Zoonotic Technical Working Group (ZTWG), which draws membership from the Ministry of Agriculture, Livestock, Fisheries and Cooperatives, the Ministry of Health, the Kenya Wildlife Service and partner organizations. The ZTWG coordinated the process with support and leadership from the Director of Veterinary Services and Director General for Health. The Zoonotic Disease Unit (ZDU), a collaborative unit between the MOH and MALF, led the drafting process. The development of the strategy was made possible through generous support from Food and Agriculture Organization (FAO) -Global Health Security Agenda (GHSA) project, financed by the United States Agency for International Development (USAID). We highly appreciate this support. We specifically acknowledge the institutions listed below whose representatives participated in the development of this strategy. A complete list of contributors has been included in Annex 1 Mr. Harry Kimutai, CBS Principal Secretary State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives • Council of Governors • County Governments • Food and Agriculture Organization • United States Agency for International Development • Centers for Disease Control and Prevention • Field Epidemiology and Laboratory Training Program • International Livestock Research Institute • Kenya Medical Research Institute • Kenya Society for the Protection & Care of Animals • Kenya Veterinary Association • Kenya Veterinary Vaccines Production Institute • Kenya Wildlife Service • Neglected Tropical Diseases Programme • World Animal Protection • Washington State University • University of Liverpool- HORN project • University of Nairobi • Zoonotic Diseases Unit Susan Mochache, CBS Principal Secretary Ministry of Health Mr. Harry Kimtai, CBS v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax, a bacterial zoonosis of global health security and public health importance. Anthrax primarily a�ects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known; however, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). The Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further o reduce livestock deaths, reduce human su�ering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the preventing and controlling of Anthrax in Kenya. Hon. Peter Munya , EGH Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries and Co-operatives Sen. Mutahi Kagwe, EGH Cabinet Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a bacterial zoonosis of global health security and public health importance that primarily affects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further reduce livestock deaths, reduce human suffering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives vii Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria, naturally found in soil and a�ects all warm-blooded animals, particularly herbivores. Humans are secondarily infected through contact with infected animals or contaminated animal products or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing while carnivores are infected by consuming the a�ected herbivores. Anthrax can also intentionally be used as a bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties where livestock, humans and wildlife are often a�ected. According to national medical and veterinary records, Kenya reports atleast ten outbreaks each year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores may show classic signs of high fever, oozing of non- clotting blood from natural orifices and incomplete rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively resistant to anthrax and the disease often presents as inflammation of the oral cavity with mild gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling of spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. Anthrax in livestock can be controlled through; isolation/separation of a�ected animals from the herd, treatment of a�ected animals and provision of prophylaxis for susceptible animals. Further spread can be controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days while severe inhalational and gastrointestinal infections require hospitalization and parenteral treatments. Severe cases recover fully with e�ective and timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in livestock and spill-over to humans. An e�ective surveillance system ensures early detection of disease incidences, confirmatory diagnosis and prompt reporting to responsible authorities, ensuring an e�ective and timely response. This national strategy for the prevention and control of Anthrax guides for the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the Global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported by specific guidelines which will be developed in the first phase of implementation. Executive Summary Anthrax Strategy 2021 Revised 8.indd 7 11/2/21 2:23 PM vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil and affects all warm-blooded animals, particularly herbivores. Humans are secondarily infected through contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while carnivores are infected by consuming the affected herbivores. Anthrax can also intentionally be used as a bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often affected. According to national medical and veterinary records, Kenya reports at least ten outbreaks each year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores may show classic signs of high fever, oozing of non- clotting blood from natural orifices and incomplete rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively resistant to anthrax, and the disease often presents as inflammation of the oral cavity with mild gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. Anthrax in livestock can be controlled through; isolation/separation of affected animals from the herd, treatment of affected animals and provision of prophylaxis for susceptible animals. Further spread can be controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal infections require hospitalization and parenteral treatments. Severe cases recover fully with effective and timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in livestock and spill-over to humans. An effective surveillance system ensures early detection of disease incidences, confirmatory diagnosis and prompt reporting to responsible authorities, ensuring an effective and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported by specific guidelines which will be developed in the first phase of implementation. viii The strategy has eight specific objectives: 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the Country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah Njagi, PhD,OGW Director of Veterinary Services Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health Anthrax Strategy 2021 Revised 8.indd 8 11/2/21 2:23 PM 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health The strategy has eight specific objectives: 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax, a bacterial zoonosis of global health security and public health importance. Anthrax primarily a�ects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known; however, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). The Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further o reduce livestock deaths, reduce human su�ering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the preventing and controlling of Anthrax in Kenya. Hon. Peter Munya , EGH Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries and Co-operatives Sen. Mutahi Kagwe, EGH Cabinet Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a bacterial zoonosis of global health security and public health importance that primarily affects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further reduce livestock deaths, reduce human suffering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives viii vii Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria, naturally found in soil and a�ects all warm-blooded animals, particularly herbivores. Humans are secondarily infected through contact with infected animals or contaminated animal products or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing while carnivores are infected by consuming the a�ected herbivores. Anthrax can also intentionally be used as a bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties where livestock, humans and wildlife are often a�ected. According to national medical and veterinary records, Kenya reports atleast ten outbreaks each year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores may show classic signs of high fever, oozing of non- clotting blood from natural orifices and incomplete rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively resistant to anthrax and the disease often presents as inflammation of the oral cavity with mild gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling of spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. Anthrax in livestock can be controlled through; isolation/separation of a�ected animals from the herd, treatment of a�ected animals and provision of prophylaxis for susceptible animals. Further spread can be controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days while severe inhalational and gastrointestinal infections require hospitalization and parenteral treatments. Severe cases recover fully with e�ective and timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in livestock and spill-over to humans. An e�ective surveillance system ensures early detection of disease incidences, confirmatory diagnosis and prompt reporting to responsible authorities, ensuring an e�ective and timely response. This national strategy for the prevention and control of Anthrax guides for the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the Global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported by specific guidelines which will be developed in the first phase of implementation. Executive Summary Anthrax Strategy 2021 Revised 8.indd 7 11/2/21 2:23 PM vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported vii Executive Summary Anthrax is a zoonotic disease caused by Bacillus anthracis, a spore-forming bacteria naturally found in soil and affects all warm-blooded animals, particularly herbivores. Humans are secondarily infected through contact with infected animals or contaminated animal products, or direct exposure to B. anthracis spores. Animals get infected through inhalation or by direct consumption of spores during grazing, while carnivores are infected by consuming the affected herbivores. Anthrax can also intentionally be used as a bio-warfare or bioterrorism agent because of its ease of manipulation in laboratory set-up and release into the environment. The disease is enzootic in several regions of Africa, Asia, European countries and countries/areas of north and South America. Livestock vaccinations and improved hygienic practices have reduced incidences in most developed countries. In Kenya, the disease is endemic in most parts of the country, especially in Nakuru, Murang’a, Kiambu, Narok and Meru Counties, where livestock, humans and wildlife are often affected. According to national medical and veterinary records, Kenya reports at least ten outbreaks each year involving animals and humans. Anthrax in animals presents in various forms; peracute, acute, subacute, and rarely, chronic. Commonly, herbivores are found dead without prior clinical signs due to rapid septicemia. Before death, herbivores may show classic signs of high fever, oozing of non- clotting blood from natural orifices and incomplete rigor mortis. Pigs and other scavenger animals like dogs who feed on infected carcasses are relatively resistant to anthrax, and the disease often presents as inflammation of the oral cavity with mild gastrointestinal manifestations. In humans, Anthrax causes three main clinical forms: cutaneous, gastrointestinal and inhalation. Cutaneous anthrax is the most common, accounting for more than 95%, but it usually causes a milder disease. Gastrointestinal anthrax causes mild or moderate to severe disease upon ingestion of raw or undercooked and contaminated meat. Inhalational Anthrax is rapidly fatal upon inhaling spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. Anthrax in livestock can be controlled through; isolation/separation of affected animals from the herd, treatment of affected animals and provision of prophylaxis for susceptible animals. Further spread can be controlled by proper disposal of carcasses through incineration or deep burial, decontamination of surfaces/equipment, vaccination of susceptible herds and quarantine in outbreak areas. Human cases are easily treated with a wide range of antibiotics, given orally or intravenously. Mild to moderate forms require oral antibiotics for 3-7 days, while severe inhalational and gastrointestinal infections require hospitalization and parenteral treatments. Severe cases recover fully with effective and timely treatment. Early detection and response to Anthrax outbreaks is key to preventing further spread of the disease in livestock and spill-over to humans. An effective surveillance system ensures early detection of disease incidences, confirmatory diagnosis and prompt reporting to responsible authorities, ensuring an effective and timely response. This national strategy for the prevention and control of Anthrax guides the country to systematically reduce the disease in livestock, wildlife and humans. Its development involved multiple stakeholders and subject matter experts. The general outline of the strategy emulates the global strategies for the elimination of Foot and Mouth Disease (FMD), Rinderpest and Rabies. Implementation of the strategy will be supported by specific guidelines which will be developed in the first phase of implementation. viii The strategy has eight specific objectives: 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the Country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah Njagi, PhD,OGW Director of Veterinary Services Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health Anthrax Strategy 2021 Revised 8.indd 8 11/2/21 2:23 PM 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health The strategy has eight specific objectives: 1. To enhance coordination, collaboration and partnership structures for anthrax prevention and control 2. To strengthen the prevention and control of anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of anthrax across the country 5. To promote risk communication among stakeholders on anthrax 6. To advocate for operational research on anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy Dr. Obadiah N. Njagi, PhD, OGW Director of Veterinary Services State Department of Livestock Ministry of Agriculture, Livestock and Fisheries and Co-operatives Dr. Patrick Amoth, EBS Ag. Director General for Health Ministry of Health v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax, a bacterial zoonosis of global health security and public health importance. Anthrax primarily a�ects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known; however, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). The Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further o reduce livestock deaths, reduce human su�ering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the preventing and controlling of Anthrax in Kenya. Hon. Peter Munya , EGH Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries and Co-operatives Sen. Mutahi Kagwe, EGH Cabinet Secretary Ministry of Health Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives v Foreword This document describes Kenya’s National Strategy for Prevention and Control of Anthrax. Anthrax is a bacterial zoonosis of global health security and public health importance that primarily affects herbivores and is characterized by sudden deaths of susceptible animals. Humans often get infected through exposure and contact with infected animals or products such as meat, animal hides, bones and other materials. Anthrax can easily be prevented and controlled through sustained livestock vaccinations, proper disposal of infected livestock carcasses, enhanced surveillance and community awareness of the disease. Prevention and control of the disease in livestock is, therefore, the key to protecting humans and livelihoods. Anthrax is distributed globally and remains enzootic in many regions of the world, particularly sub-Saharan Africa, Asia, Central and South America. The overall global disease burden and economic impact of anthrax in livestock is not fully known. However, epizootics occur every year, resulting in the deaths of hundreds to thousands of animals, and disease transmission to human with approximately 2000 to 20000 human anthrax cases annually worldwide. In Kenya, Anthrax is the highest ranked zoonotic disease, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases. According to national public health and veterinary records, an average of 10 Anthrax outbreaks involving animals with spill- over to humans occur every year. Anthrax is also a priority disease in Kenya’s National Action Plan for Health Security (NAPHS). In addition, the Joint External Evaluation (JEE) conducted in 2017 and Performance of Veterinary Services (PVS) conducted in 2019, jointly recommend developing and implementing an anthrax prevention and control strategy. Anthrax disease burden and economic impact in Kenya are often underestimated because of suboptimal surveillance systems in public health, livestock and wildlife sectors. Eliminating Anthrax from the livestock population and reduced incidence in wildlife is key to stopping human cases. Reduced Anthrax incidence and eventual elimination of the disease has been demonstrated in developed countries through livestock vaccinations and improved sanitary measures. Therefore, implementation of the anthrax prevention and control strategies in Kenya will further reduce livestock deaths, reduce human suffering and improve food security in line with the Big Four agenda. This National Anthrax Prevention and Control strategy will guide the country towards systematically reducing the disease risk through sustained livestock vaccinations, enhanced surveillance, proper carcass disposal and public education. The strategy is based on activities planned for the country to move from an endemic state to a disease elimination status by 2036. Successful implementation of this strategy requires a multi-sectoral collaborative approach with the involvement and support of many stakeholders. We are optimistic that each of our partners will join hands and play their role in the prevention and control of Anthrax in Kenya. Hon. Peter Munya, EGH Sen. Mutahi Kagwe, EGH Cabinet Secretary Cabinet Secretary Ministry of Agriculture, Livestock, Fisheries Ministry of Health and Co-operatives viii ©FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 9 11/2/21 2:23 PM 1 1.1 Introduction Anthrax is a zoonotic disease caused by Bacillus anthracis, a gram-positive, rod-shaped, spore-forming bacterium, naturally found in the soil1. The disease a�ects all warm-blooded animals, primarily domestic and wild herbivores, and it is transmitted through ingestion of bacterial spores from soil or vegetation1,2. Humans are secondarily infected through contact with infected animals or contaminated animal products or direct exposure to B. anthracis spores2. Other routes of infection include ingestion of contaminated animal products and inhalation of anthrax spores. Anthrax outbreaks are often detected late in livestock and wildlife through fatalities or spillover to humans. As a result, the natural prevalence of anthrax infection in animal populations is largely unknown 1 ,3,4. Humans can also be infected through the deliberate release of weaponized B. anthracis spores as an act of bioterrorism or biological warfare hence B. anthracis is classified as a class A highly infectious agent by the United States Centers for Disease Control and Prevention (CDC)5. Anthrax causes significant public health and economic impacts. The World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) classify Anthrax as a transboundary disease based on its negative impact on food security, nutrition, livestock production and trade6. Anthrax causes hundreds to thousands of animal deaths, and 2000 to 20000 human anthrax cases annually worldwide 7 The disease is enzootic in several regions of Africa, Asia, European countries and countries of North and South America 2,7. Anthrax occurs sporadically in most developed countries but incidence varies with implementation of national control and prevention strategies. The geographical distribution of anthrax is associated with specific ecological factors that promote the viability and survival of B. anthracis spores 7, 8. There is proof of concept that the disease can be eliminated through an integrated approach as is the case in many developed countries 2 . Anthrax is the highest ranked priority zoonotic disease in Kenya, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases11. The disease was also prioritized in the National Action Plan for Health Security (NAPHS) derived during the Joint External Evaluation (JEE) in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. Despite the significant burden of anthrax in the country, prevention and control e�orts are often inadequate and uncoordinated resulting in recurrent outbreaks and production losses. This strategy is based on guidelines from the OIE Terrestrial Animal Health Code, the OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals and WHO anthrax in humans and animals - 4th edition, existing zoonotic disease strategies and published data. 1.2 Vision Anthrax free Kenya 1.3 Mission To progressively reduce and eliminate animal and human Anthrax in Kenya through sustained surveillance, proper disposal of carcasses and contaminated materials, animal vaccination, treatment in humans and creating community awareness through the One Health approach. Chapter One Anthrax Strategy 2021 Revised 8.indd 1 11/2/21 2:23 PM ©FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 9 11/2/21 2:23 PM 1 1.1 Introduction Anthrax is a zoonotic disease caused by Bacillus anthracis, a gram-positive, rod-shaped, spore-forming bacterium, naturally found in the soil1. The disease a�ects all warm-blooded animals, primarily domestic and wild herbivores, and it is transmitted through ingestion of bacterial spores from soil or vegetation1,2. Humans are secondarily infected through contact with infected animals or contaminated animal products or direct exposure to B. anthracis spores2. Other routes of infection include ingestion of contaminated animal products and inhalation of anthrax spores. Anthrax outbreaks are often detected late in livestock and wildlife through fatalities or spillover to humans. As a result, the natural prevalence of anthrax infection in animal populations is largely unknown 1 ,3,4. Humans can also be infected through the deliberate release of weaponized B. anthracis spores as an act of bioterrorism or biological warfare hence B. anthracis is classified as a class A highly infectious agent by the United States Centers for Disease Control and Prevention (CDC)5. Anthrax causes significant public health and economic impacts. The World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) classify Anthrax as a transboundary disease based on its negative impact on food security, nutrition, livestock production and trade6. Anthrax causes hundreds to thousands of animal deaths, and 2000 to 20000 human anthrax cases annually worldwide 7 The disease is enzootic in several regions of Africa, Asia, European countries and countries of North and South America 2,7. Anthrax occurs sporadically in most developed countries but incidence varies with implementation of national control and prevention strategies. The geographical distribution of anthrax is associated with specific ecological factors that promote the viability and survival of B. anthracis spores 7, 8. There is proof of concept that the disease can be eliminated through an integrated approach as is the case in many developed countries 2 . Anthrax is the highest ranked priority zoonotic disease in Kenya, based on a systematic analysis of burden, socioeconomic impact, epidemic potential, and severity of zoonotic diseases11. The disease was also prioritized in the National Action Plan for Health Security (NAPHS) derived during the Joint External Evaluation (JEE) in 2017 and Performance of Veterinary Services (PVS) conducted in 2019. Despite the significant burden of anthrax in the country, prevention and control e�orts are often inadequate and uncoordinated resulting in recurrent outbreaks and production losses. This strategy is based on guidelines from the OIE Terrestrial Animal Health Code, the OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals and WHO anthrax in humans and animals - 4th edition, existing zoonotic disease strategies and published data. 1.2 Vision Anthrax free Kenya 1.3 Mission To progressively reduce and eliminate animal and human Anthrax in Kenya through sustained surveillance, proper disposal of carcasses and contaminated materials, animal vaccination, treatment in humans and creating community awareness through the One Health approach. Chapter One Anthrax Strategy 2021 Revised 8.indd 1 11/2/21 2:23 PM 2 1.4 Rationale and Justification of the Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health disease control strategies has resulted in uncoordinated disease prevention and control e�orts, with many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. he development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, and human health in the a�ected areas. Anthrax Strategy 2021 Revised 8.indd 2 11/2/21 2:23 PM 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 Rationale and Justification of the Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, and human health in affected areas. 3 Chapter Two 2.2 Drivers of Disease Spread The rate and extent of sporulation by vegetative cells shed from infected animals is a�ected in a complex manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all influencing factors 8. In addition, climate probably acts directly by influencing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly a�ecting the immune status of the host and thereby a�ecting the level of resistance to infection 9. E�ects of seasons, rainfall, temperature, soil, vegetation, condition of the animal and population density on the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a specific locality can be explained further by research12. 2.3 Anthrax in Animals Anthrax is primarily a disease of herbivores but it can also a�ect other species such as pigs, horses, dogs, cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting flies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected carcasses. Trade in animal products (meat, hides, hair,wool,bones and feedstu�s) may risk the spread of the disease if contaminated2. 2.1. Aetiology of Anthrax Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals 2. This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 2 1.4 Rationale and Justification of the Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health disease control strategies has resulted in uncoordinated disease prevention and control e�orts, with many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. he development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, and human health in the a�ected areas. Anthrax Strategy 2021 Revised 8.indd 2 11/2/21 2:23 PM 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 R Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, 2 1.4 Rationale and Justification of the Strategy Kenya has a vibrant livestock sector estimated to contribute about 12% of the gross domestic product (GDP)17. Animal diseases such as Anthrax are endemic, reducing reducing the growth potential of the sector. In addition, Kenya is renowned for its rich wildlife biodiversity and wildlife-based tourism is a major foreign exchange earner, second after agriculture. However, Anthrax is a threat to wildlife populations in many national parks and conservancies. Anthrax outbreaks hamper tourism resulting in reduced (GDP) and unexpected local decline in abundance of endangered animals. In the health sector, Anthrax cases are often misdiagnosed and this can result in preventable deaths. if untreated, anthrax is estimated to cause 5-20% of deaths among human cutaneous cases and 90-100% in the inhalation form. if cases are untreated. It is estimated that, Anthrax causes 5-20% deaths among cutaneous human cases and 90%-100% in the inhalation form. Health and Veterinary records show more than 10 anthrax outbreaks occur annually with the involvement of humans 3. This is still considered an under estimate of the true burden due to the passive nature of the surveillance system. The devolution system of governance in Kenya and separate devolvement of livestock and public health many cases of livestock and human diseases going either unreported or detected very late. The lack of One health strategy for anthrax prevention and control has further contributed to the increase in Anthrax cases in livestock, wildlife and humans. This was also acknowledged in the OIE led Performance of Veterinary Services (PVS) (2011 & 2018) and in the WHO Joint External Evaluation (JEE) of 2017. The development of the Anthrax prevention and control strategy will guide the country on how to progressively reduce the burden of the disease in humans and livestock, and improve livestock, wildlife, and human health in affected areas. 3 Chapter Two 2.2 Drivers of Disease Spread The rate and extent of sporulation by vegetative cells shed from infected animals is a�ected in a complex manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all influencing factors 8. In addition, climate probably acts directly by influencing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly a�ecting the immune status of the host and thereby a�ecting the level of resistance to infection 9. E�ects of seasons, rainfall, temperature, soil, vegetation, condition of the animal and population density on the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a specific locality can be explained further by research12. 2.3 Anthrax in Animals Anthrax is primarily a disease of herbivores but it can also a�ect other species such as pigs, horses, dogs, cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting flies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected carcasses. Trade in animal products (meat, hides, hair,wool,bones and feedstu�s) may risk the spread of the disease if contaminated2. 2.1. Aetiology of Anthrax Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals 2. This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. Anthrax Strategy 2021 Revised 8.indd 3 11/2/21 2:23 PM 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 3 Two manner by the environmental conditions into which they fall. Temperature, humidity, water activity (available water within the microenvironment), pH, oxygen availability, sunlight among others are all in uencing factors . In addition, climate probably acts directly by in encing the way in which the animal comes into contact with the spores: for example, grazing closer to the soil in dry periods when grass is short, or moving animals to restricted or or new areas in search for water and pasture or by indirectly . the epidemiology of anthrax have been hypothesized 13, 14. This is normally based on concepts of conditions under which B. anthracis may germinate and multiply in the environment. The varying observations on the association between the factors mentioned above and anthrax incidence and persistence in a speci c locality can be explained further by research12. cats and other vertebrates. Cattle, goat and sheep are highly susceptible and can have hyper-acute to acute disease, including sudden death without prior signs of illness. Pigs and carnivores may show subclinical signs as they are more resistant.10. The incubation period in livestock is typically 3 to 7 days (range 1 to 14 days)2. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies 10. 2.3.1. Transmission The source of infection is mainly a Bacillus anthracis spore in the environment. Animals become infected through ingestion of the spores when grazing or browsing from contaminated soil, plants, or water and re starting the cycle since B. anthracis is non-invasive12. Inhalation of spores during grazing is also responsible for spread of infection2(Figure 1) . Biting ies serve as mechanical vectors after feeding on infected carcasses and contaminating vegetation and appear to play an essential role in explosive outbreaks 2, 10. Carnivores and pigs acquire infection through ingestion of meat or food waste from Anthrax infected the disease if contaminated2. 2. Bacillus anthracis is a bacterium that occurs in two forms; vegetative form and spore form. The vegetative form: This is a fragile form that is easily inactivated by disinfectants, moderate temperatures and normal postmortem changes. This form is usually found within the host. Spore form: Large quantities of the B. anthracis are shed when an Anthrax infected animal dies, and once the bacteria are exposed to the air, sporulation starts, forming resistant spores contaminating the environment. Anthrax spores are resistant to heat, cold, pH changes, desiccation, chemicals, irradiation and other adverse conditions and can survive for years in soil, wool, and hair of infected animals . This becomes the source of infection for other susceptible hosts through inhalation, ingestion and cuts in the skin. The spores germinate to produce the vegetative forms that multiply, eventually killing the host and releasing spores in new areas, promoting the Anthrax cycle. 2 4 Figure 1: Ecological cycle of infection for Anthrax 2.4 Pathogenesis of B. anthracis in Animals When Anthrax spores enter the body, they get carried to the lymphatics, which they multiply and are released into the blood stream. The toxin produced in the blood stream destroys the endothelial cell lining of the blood vessels resulting in internal bleeding and oozing of non-clotting blood from the natural orifices (ears, nostril, mouth, anus, and vagina). 2.5 Clinical Manifestation Clinical manifestation varies among species reflecting the di�erence in susceptibility. In more susceptible animals such as herbivores, the disease presents as sudden death without any signs, and this could be accompanied by bloody discharges (dark tarry) from natural orifices, bloating and failure of blood to clot and incomplete rigor-mortis. In subacute conditions, signs include apnea and edematous swellings around the neck, flanks or lumbar region and di�culty in breathing. Death usually occurs in 2–3 days if no treatment is given. The main symptoms in carnivores and primates are local edema and swelling of the face, neck, and pharyngeal region. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies10. 2.6 Diagnosis 2.6.1 Clinical Diagnosis In non-vaccinated herbivores anthrax is usually a peracute disease characterized by sudden death, frequently with bleeding from orifices and subcutaneous haemorrhages. 2.6.2 Laboratory Diagnosis B. anthracis is classified as a level 3 pathogen (may cause serious or potentially lethal disease through inhalation) and its laboratory confirmation should be done using appropriate biocontainment equipment and trained personnel. Anthrax is diagnosed by examining blood (or other tissues) for the presence of the bacteria B. anthracis using; 1. Microscopy (gram staining) 2. Ascoli test (test for antigen using rabbit antiserum) 3. Culture and isolation 4. Immunohistochemical analysis 5. Polymerase Chain Reaction (PCR) Anthrax Strategy 2021 Revised 8.indd 4 11/2/21 2:23 PM 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 2.6.3 Di�erential Diagnosis in Animals Anthrax must be di�erentiated from other conditions that cause sudden death; these are 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2.7 Prevention and Control of Anthrax in Animals. The standard control of Anthrax involves breaking the cycle of infection2. In summary, the farmer should notify the local veterinary authority or registered veterinary o�cer in cases of sudden deaths. The veterinary o�cers should urgently confirm the outbreak (clinically or laboratory diagnosis). Upon confirmation; 1. Inform respective veterinary and public health authorities (One health approach) 2. All sick animals should be isolated and treated with e�ective antibiotics (if this is recommended). 3. Carcasses should not be opened and should be disposed o� and all contaminated grounds and materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting fly control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated materials. Vaccination campaigns e�ectively control anthrax outbreaks in livestock; however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8 Anthrax in Humans 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2.7 Prevention and Control of Anthrax in Animals The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer confirmation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting fly control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8 Anthrax in Humans 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 4 Figure 1: Ecological cycle of infection for Anthrax 2.4 Pathogenesis of B. anthracis in Animals When Anthrax spores enter the body, they get carried to the lymphatics, which they multiply and are released into the blood stream. The toxin produced in the blood stream destroys the endothelial cell lining of the blood vessels resulting in internal bleeding and oozing of non-clotting blood from the natural orifices (ears, nostril, mouth, anus, and vagina). 2.5 Clinical Manifestation Clinical manifestation varies among species reflecting the di�erence in susceptibility. In more susceptible animals such as herbivores, the disease presents as sudden death without any signs, and this could be accompanied by bloody discharges (dark tarry) from natural orifices, bloating and failure of blood to clot and incomplete rigor-mortis. In subacute conditions, signs include apnea and edematous swellings around the neck, flanks or lumbar region and di�culty in breathing. Death usually occurs in 2–3 days if no treatment is given. The main symptoms in carnivores and primates are local edema and swelling of the face, neck, and pharyngeal region. However, subclinical Anthrax infection has been reported in wildlife herbivores based on naturally occurring antibodies10. 2.6 Diagnosis 2.6.1 Clinical Diagnosis In non-vaccinated herbivores anthrax is usually a peracute disease characterized by sudden death, frequently with bleeding from orifices and subcutaneous haemorrhages. 2.6.2 Laboratory Diagnosis B. anthracis is classified as a level 3 pathogen (may cause serious or potentially lethal disease through inhalation) and its laboratory confirmation should be done using appropriate biocontainment equipment and trained personnel. Anthrax is diagnosed by examining blood (or other tissues) for the presence of the bacteria B. anthracis using; 1. Microscopy (gram staining) 2. Ascoli test (test for antigen using rabbit antiserum) 3. Culture and isolation 4. Immunohistochemical analysis 5. Polymerase Chain Reaction (PCR) Anthrax Strategy 2021 Revised 8.indd 4 11/2/21 2:23 PM 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 2.6.3 Di�erential Diagnosis in Animals Anthrax must be di�erentiated from other conditions that cause sudden death; these are 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2.7 Prevention and Control of Anthrax in Animals. The standard control of Anthrax involves breaking the cycle of infection2. In summary, the farmer should notify the local veterinary authority or registered veterinary o�cer in cases of sudden deaths. The veterinary o�cers should urgently confirm the outbreak (clinically or laboratory diagnosis). Upon confirmation; 1. Inform respective veterinary and public health authorities (One health approach) 2. All sick animals should be isolated and treated with e�ective antibiotics (if this is recommended). 3. Carcasses should not be opened and should be disposed o� and all contaminated grounds and materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting fly control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated materials. Vaccination campaigns e�ectively control anthrax outbreaks in livestock; however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8 Anthrax in Humans 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . Anthrax Strategy 2021 Revised 8.indd 5 11/2/21 2:23 PM 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2. The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer ation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting y control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 5 Samples must be collected and packaged to avoid to avoid contamination of the environment and prevent human exposure to the bacteria. 1. In bovine and ovine: Clostridial infections, Trypanosoma vivax, lightning strike, acute leptospirosis, bacillary hemoglobinuria, anaplasmosis, acute poisonings by bracken fern, sweet clover, and heavy metal poisoning e.g. lead 2. In equines: acute infectious anaemia, purpura, colic, lead poisoning, lightning strike, and sunstroke. 3. In swine: African swine fever and malignant pharyngeal oedema.. 4. In canines: acute systemic infections and pharyngeal swellings due to other causes. 2.7 Prevention and Control of Anthrax in Animals The standard control of Anthrax involves breaking the cycle of infection.2 In summary, the farmer confirmation; 1. Inform respective veterinary and public health authorities (One health approach) 2. recommended). 3. materials disinfected and decontaminated as per the guidelines. 4. Movement restriction of livestock and animal by-products from infected farms.. 5. Ring vaccination of the rest of the herd and surrounding herds (radius of 1-15 km- based on the production system from the index case). 6. Annual vaccination for three consecutive years after an outbreak to break the infection cycle in an area should be recommended. 7. Public education to emphasise on farmers to regularly inspect their animals, report illnesses or sudden deaths to authorities, and adhere to movement controls and dangers of handling infected animals. In addition, joint communication between the public health and veterinary teams will be helpful to allay fears in the community. 8. Conduct an epidemiological investigation to promptly identify the source of infection and to map out the extent of the outbreak. 9. Intensify surveillance and monitoring in areas surrounding the infected premises for early detection of additional cases. 10. In wildlife, controlling an outbreak primarily focuses on preventing transmission from dead animals: burning, covering, or burying carcasses to prevent access by scavengers, adopting fly control measures, restricting access to suspected contaminated areas or water sources, and when practical, safely disposing of animal carcasses and disinfection and disposal of contaminated however, control strategies for outbreaks in wildlife populations are limited. Vaccination in wildlife focuses primarily on endangered species. 2.8 Anthrax in Humans 2.8.1 Transmission Humans can get Anthrax infection by handling animal products from infected animals without protective gear or by inhaling anthrax spores from contaminated animal products. Anthrax can also be spread by eating undercooked meat from infected animals. The incubation period from 1 day to more than two months. Direct human to human transmission is possible but very rare, mainly through the cutaneous form2. In addition, human infections can be due to inhalation of spores as a result of bioterrorism acts and biological warfare 16 . 6 2.8.2 Forms of Anthrax in Human Three main forms of human Anthrax manifest depending on the route of transmission and are classified into; cutaneous, gastrointestinal and inhalation Anthrax. All forms can lead to systemic disease and death if untreated. Cutaneous Anthrax: This is the most common form globally accounting for more than 95% of all Anthrax cases and normally causing milder disease2,3. The bacterium (usually as spores) enters through a skin lesion (cuts, abrasion and rarely insect bites), during handling of an infected carcass, contaminated wool, hides, leather or hair products of infected animals. The incubation period ranges from 9 hours to 3 weeks, mostly 2-7 days. Skin infection begins as an initial itching at the a�ected sites (within 1-2 days) that develops into a papule, vesicle and then to a depressed black eschar (a characteristic black necrotic area in the center). The ulcer is painless and without pus unless there is secondary infection. Exposed sites like the head, neck, forearm, hand and legs are commonly a�ected. Gastrointestinal (ingestion) Anthrax: This form results from consuming of meat or blood contaminated with B. anthracis. This can present as oropharyngeal or intestinal Anthrax. The oropharyngeal form is characterized by fever, sore throat, painful swallowing and regional swollen lymph and death is usually due to toxaemia. The intestinal form is characterized by acute inflammation of the intestinal tract with signs like fever, nausea, vomiting, abdominal pain, loss of appetite, vomiting of blood, and severe (bloody) diarrhea. This form results in deaths in up to 60% of cases without treatment. Inhalational Anthrax: This is a rapidly fatal form of Anthrax and humans develop the disease through inhalation of spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. Deliberate release of anthrax spores (bio-aggression/bioterrorism) also leads to the rapidly fatal inhalational anthrax 2,3. The average incubation period is about 4 days ranging from 1-7 days although incubation period of up to 60 days has been reported 2. Initial symptoms are mild and non-specific but quickly progress to severe breathing problems, shock, disorientation with coma, and death. 2.8.3 Diagnosis of Human Anthrax A history of exposure to contaminated animal materials, occupational exposure and living in an endemic area is important when considering a diagnosis of Anthrax. Diagnosis in humans can be made through the clinical manifestation of a painless, pruritic papule, surrounding vesicles and oedema, with no pus usually on an exposed part of the body. Clinical diagnosis is confirmed by demonstrating of Gram-positive encapsulated bacilli from the lesion and/or positive culture for B. anthracis from the lesion following history of exposure (Table 1). Table 1: Diagnosis of Anthrax in humans Clinical Picture Clinical diagnosis Sample type Laboratory diagnosis Cutaneous Anthrax Clinical history and symptoms Aspirate from the lesion, biopsy Gram stain, culture or PCR Inhalational/ pulmonary Anthrax/ oropharyngeal Clinical history & symptoms, Chest X- ray, Sputum, tracheal aspirate, lung biopsy, blood , oropharyngeal aspirate Culture & Gram Stain/ Smear, PCR, ELISA Gastrointestinal Anthrax Clinical history & symptoms Stool, blood Culture , PCR Meningeal Anthrax Clinical history & symptoms CSF, blood Gram stain, Culture and PCR 2.8.4 Di�erential Diagnosis The di�erential diagnosis of cutaneous anthrax includes: boil (early lesion), arachnid bites, ulcers (mainly tropical); erysipelas, glanders, plague, syphilitic chancre, ulceroglandular ttularaemia, clostridial infection, rat-bite fever, leishmaniasis, or herpes. Generally these other diseases and conditions lack the characteristic oedema of Anthrax 2. Anthrax Strategy 2021 Revised 8.indd 6 11/2/21 2:23 PM 7 2.8.5 Treatment, Prevention and Control of Anthrax in Humans Anthrax prevention and control in human hinges on; • Prompt identification and treatment of infected persons- Treatment is given for 3-7 days and drugs of choice is penicillin given orally for mild to moderate cases. • For severe or potentially life threatening cases, treatment is given parenterally, in hospital settings for 10–14 days. Supportive care should be provided depending on the condition of the patient including analgesics, antipyretics and anti-inflammatory drugs. In very severe cases, assisted respiration, fluid and electrolyte supplements, cerebral oedema management or other measures may be taken. • Where penicillin is contraindicated, alternative choices include aminoglycosides, macrolides, quinolones and tetracycline. • In fatal cases, postmortem examinations should be discouraged; cremation is preferable to burial where local custom permits. The body should be placed in an impervious body bag for transport, then placed in a sealed co�n and buried without reopening. • Public education to create awareness in the community, with emphasis on dangers of handling infected animals and feeding on dead animals. Joint communication between the public health and veterinary teams will be helpful to allay fears in the community • Human Anthrax vaccines are available (not in Kenya) but are reserved for at-risk occupations e.g. Military personnel, scientists working with Anthrax, people in other high-risk professions. • For the general public, control of the disease should be done through control in livestock. 2.9 Socio-economic Impacts of Anthrax Globally, it is estimated 2000 to 20 000 human anthrax cases are occurring each year 3,9. Epizootics also occur in animals resulting in hundreds to thousands of animal deaths and disease transmission to human13. Estimates shows that 1.83 billion people live within regions of anthrax risk. More importantly, a total of 63.8 million poor livestock keepers and 1.1 billion livestock live within vulnerable regions15. In Anthrax-endemic areas, livelihoods are impacted negatively through herd deaths, milk withholding in a�ected dairy herds, complete condemnation of carcass/by-products closure of abattoirs, treatment of the sick and vaccination cost of the survivors 14. Placement of quarantine shocks livestock markets and may lead to non-compliance and further transmission15.The slaughtering of Anthrax infected carcasses for consumption and sale may increase exposure and infection of humans. The government incurs losses due to loss of productivity of the sick or dead. A surge in medical care may require setting up temporary care sites and free treatment to to the a�ected. Again, there is cost of destruction of carcasses, decontamination of the a�ected areas and reduced government revenue due to livestock market closure15. Loss of consumer confidence negatively a�ects businesses, leading to low meat consumption, which in-turn decreases the number of cattle slaughtered 16. Outbreaks among wildlife can have devastating e�ects on wildlife conservation, resulting in a significant reduction or complete loss of endangered animal species while fear among the public may stop them from visiting parks resulting in revenue loss 3,11. Anthrax Strategy 2021 Revised 8.indd 7 11/2/21 2:23 PM 6 2.8.2 Forms of Anthrax in Human Three main forms of human Anthrax manifest depending on the route of transmission and are classified into; cutaneous, gastrointestinal and inhalation Anthrax. All forms can lead to systemic disease and death if untreated. Cutaneous Anthrax: This is the most common form globally accounting for more than 95% of all Anthrax cases and normally causing milder disease2,3. The bacterium (usually as spores) enters through a skin lesion (cuts, abrasion and rarely insect bites), during handling of an infected carcass, contaminated wool, hides, leather or hair products of infected animals. The incubation period ranges from 9 hours to 3 weeks, mostly 2-7 days. Skin infection begins as an initial itching at the a�ected sites (within 1-2 days) that develops into a papule, vesicle and then to a depressed black eschar (a characteristic black necrotic area in the center). The ulcer is painless and without pus unless there is secondary infection. Exposed sites like the head, neck, forearm, hand and legs are commonly a�ected. Gastrointestinal (ingestion) Anthrax: This form results from consuming of meat or blood contaminated with B. anthracis. This can present as oropharyngeal or intestinal Anthrax. The oropharyngeal form is characterized by fever, sore throat, painful swallowing and regional swollen lymph and death is usually due to toxaemia. The intestinal form is characterized by acute inflammation of the intestinal tract with signs like fever, nausea, vomiting, abdominal pain, loss of appetite, vomiting of blood, and severe (bloody) diarrhea. This form results in deaths in up to 60% of cases without treatment. Inhalational Anthrax: This is a rapidly fatal form of Anthrax and humans develop the disease through inhalation of spores aerosolized during processing or contact with contaminated hides, bones, hair or wool. Deliberate release of anthrax spores (bio-aggression/bioterrorism) also leads to the rapidly fatal inhalational anthrax 2,3. The average incubation period is about 4 days ranging from 1-7 days although incubation period of up to 60 days has been reported 2. Initial symptoms are mild and non-specific but quickly progress to severe breathing problems, shock, disorientation with coma, and death. 2.8.3 Diagnosis of Human Anthrax A history of exposure to contaminated animal materials, occupational exposure and living in an endemic area is important when considering a diagnosis of Anthrax. Diagnosis in humans can be made through the clinical manifestation of a painless, pruritic papule, surrounding vesicles and oedema, with no pus usually on an exposed part of the body. Clinical diagnosis is confirmed by demonstrating of Gram-positive encapsulated bacilli from the lesion and/or positive culture for B. anthracis from the lesion following history of exposure (Table 1). Table 1: Diagnosis of Anthrax in humans Clinical Picture Clinical diagnosis Sample type Laboratory diagnosis Cutaneous Anthrax Clinical history and symptoms Aspirate from the lesion, biopsy Gram stain, culture or PCR Inhalational/ pulmonary Anthrax/ oropharyngeal Clinical history & symptoms, Chest X- ray, Sputum, tracheal aspirate, lung biopsy, blood , oropharyngeal aspirate Culture & Gram Stain/ Smear, PCR, ELISA Gastrointestinal Anthrax Clinical history & symptoms Stool, blood Culture , PCR Meningeal Anthrax Clinical history & symptoms CSF, blood Gram stain, Culture and PCR 2.8.4 Di�erential Diagnosis The di�erential diagnosis of cutaneous anthrax includes: boil (early lesion), arachnid bites, ulcers (mainly tropical); erysipelas, glanders, plague, syphilitic chancre, ulceroglandular ttularaemia, clostridial infection, rat-bite fever, leishmaniasis, or herpes. Generally these other diseases and conditions lack the characteristic oedema of Anthrax 2. Anthrax Strategy 2021 Revised 8.indd 6 11/2/21 2:23 PM 7 2.8.5 Treatment, Prevention and Control of Anthrax in Humans Anthrax prevention and control in human hinges on; • Prompt identification and treatment of infected persons- Treatment is given for 3-7 days and drugs of choice is penicillin given orally for mild to moderate cases. • For severe or potentially life threatening cases, treatment is given parenterally, in hospital settings for 10–14 days. Supportive care should be provided depending on the condition of the patient including analgesics, antipyretics and anti-inflammatory drugs. In very severe cases, assisted respiration, fluid and electrolyte supplements, cerebral oedema management or other measures may be taken. • Where penicillin is contraindicated, alternative choices include aminoglycosides, macrolides, quinolones and tetracycline. • In fatal cases, postmortem examinations should be discouraged; cremation is preferable to burial where local custom permits. The body should be placed in an impervious body bag for transport, then placed in a sealed co�n and buried without reopening. • Public education to create awareness in the community, with emphasis on dangers of handling infected animals and feeding on dead animals. Joint communication between the public health and veterinary teams will be helpful to allay fears in the community • Human Anthrax vaccines are available (not in Kenya) but are reserved for at-risk occupations e.g. Military personnel, scientists working with Anthrax, people in other high-risk professions. • For the general public, control of the disease should be done through control in livestock. 2.9 Socio-economic Impacts of Anthrax Globally, it is estimated 2000 to 20 000 human anthrax cases are occurring each year 3,9. Epizootics also occur in animals resulting in hundreds to thousands of animal deaths and disease transmission to human13. Estimates shows that 1.83 billion people live within regions of anthrax risk. More importantly, a total of 63.8 million poor livestock keepers and 1.1 billion livestock live within vulnerable regions15. In Anthrax-endemic areas, livelihoods are impacted negatively through herd deaths, milk withholding in a�ected dairy herds, complete condemnation of carcass/by-products closure of abattoirs, treatment of the sick and vaccination cost of the survivors 14. Placement of quarantine shocks livestock markets and may lead to non-compliance and further transmission15.The slaughtering of Anthrax infected carcasses for consumption and sale may increase exposure and infection of humans. The government incurs losses due to loss of productivity of the sick or dead. A surge in medical care may require setting up temporary care sites and free treatment to to the a�ected. Again, there is cost of destruction of carcasses, decontamination of the a�ected areas and reduced government revenue due to livestock market closure15. Loss of consumer confidence negatively a�ects businesses, leading to low meat consumption, which in-turn decreases the number of cattle slaughtered 16. Outbreaks among wildlife can have devastating e�ects on wildlife conservation, resulting in a significant reduction or complete loss of endangered animal species while fear among the public may stop them from visiting parks resulting in revenue loss 3,11. Anthrax Strategy 2021 Revised 8.indd 7 11/2/21 2:23 PM 8 3.1 Anthrax in Kenya- Situation Analysis Anthrax has been documented in livestock for the past 60 years in Kenya. Data from the Directorate of Veterinary Services (DVS) spanning from 1957 to 2017 show a total of 666 livestock anthrax outbreaks reported across the country. Counties with the highest number of reported outbreaks were; Kiambu with 191 outbreaks, Meru, Narok and Nyeri, reported between 50-60 outbreaks each, while Murang’a, Nakuru and Nairobi reported 25-40 outbreaks each (Figure 2). Figure 2: Trend of livestock Anthrax outbreak reports in Kenya, 1957-2017 (Source; Nderitu et al., 2021) Anthrax was more frequently reported in cattle than other animals, a trend that was maintained across all the 60 years. More than ten outbreaks were reported annually throughout the country since 1999 except in 2013 and 2014 (Figure 2), with more than 50 outbreaks occurring in 2006, 2007 and 2016. Outbreaks were evenly distributed across the years, reported during both the wet and dry seasons. According to the Kenya wildlife service (KWS) records between 1999 and 2017, a total of 51 Anthrax outbreaks were documented, causing 1014 Anthrax deaths across 22 wildlife conservation areas in Kenya, a�ecting 24 di�erent wildlife species (Figure 3). Generally, herbivores were the most (90%) a�ected species and they included, Bu�aloes, black rhinos and elephants. Like in livestock, Anthrax outbreaks were reported in both dry and wet seasons, but more than two-thirds of the outbreaks occurred during the seven months of dry seasons. Outbreaks involving endangered wildlife species have been documented in the Samburu wildlife ecosystem, where 53 Grevy zebra and 26 plain zebra’s Anthrax deaths were reported in 2005/2006. In 2011, 12 Rothschild’s gira�e died in Mwea National park while in 2015, Nakuru National park reported mortality of 687 animals of di�erent species among which 97% (669) were bu�alos and 0.7% (5) black rhinoceros. Chapter Three Anthrax Strategy 2021 Revised 8.indd 8 11/2/21 2:23 PM 9 Figure 3: Temporal distribution of Anthrax outbreaks in Kenyan wildlife, 1999-2017 (Source: Gachohi et al., 2019) In most cases, Anthrax outbreaks are detected when humans are a�ected. A review of 15 Anthrax outbreak investigations between 2005 and 2018 showed that 12 (80%) spilled-over to humans with a total of 155 human cases. Of these 127 (82%) were cutaneous, 19 (12.5%) intestinal form and 1(0.6%) inhalational form) with a case fatality of 5.2%. These outbreaks occurred in Nakuru, Kiambu, Murang’a, Samburu, Kirinyaga, Turkana, Vihiga and Bomet Counties. Data from the passive surveillance system in the Ministry of Health, District Health Information System (DHIS2) reported 276 and 79 Anthrax cases in 2017 and 2018 respectively. 3.2 Anthrax Surveillance Systems in Kenya Anthrax is a notifiable disease in both animal and human health surveillance systems. Anthrax cases definitions (A set of standard criteria for classifying whether a person/animal has a particular disease) are provided for the disease in both livestock and humans reporting systems. 3.3 Case definitions – Livestock These are according to FAO Anthrax case classifications20 3.3.1 Suspect Case Definition A suspected case is a case that is compatible with the clinical description. For example, in endemic areas all sudden deaths should be regarded as suspected anthrax cases. 3.3.2 Probable Case Definition A suspected case with dark tarry un-clotted blood on postmortem. 3.3.2 Confirmed Case Definition A suspected case of Anthrax accompanied by demonstration of gram-positive rod-shaped B. anthracis or growth of the bacteria on a blood agar plate Anthrax Strategy 2021 Revised 8.indd 9 11/2/21 2:23 PM 8 3.1 Anthrax in Kenya- Situation Analysis Anthrax has been documented in livestock for the past 60 years in Kenya. Data from the Directorate of Veterinary Services (DVS) spanning from 1957 to 2017 show a total of 666 livestock anthrax outbreaks reported across the country. Counties with the highest number of reported outbreaks were; Kiambu with 191 outbreaks, Meru, Narok and Nyeri, reported between 50-60 outbreaks each, while Murang’a, Nakuru and Nairobi reported 25-40 outbreaks each (Figure 2). Figure 2: Trend of livestock Anthrax outbreak reports in Kenya, 1957-2017 (Source; Nderitu et al., 2021) Anthrax was more frequently reported in cattle than other animals, a trend that was maintained across all the 60 years. More than ten outbreaks were reported annually throughout the country since 1999 except in 2013 and 2014 (Figure 2), with more than 50 outbreaks occurring in 2006, 2007 and 2016. Outbreaks were evenly distributed across the years, reported during both the wet and dry seasons. According to the Kenya wildlife service (KWS) records between 1999 and 2017, a total of 51 Anthrax outbreaks were documented, causing 1014 Anthrax deaths across 22 wildlife conservation areas in Kenya, a�ecting 24 di�erent wildlife species (Figure 3). Generally, herbivores were the most (90%) a�ected species and they included, Bu�aloes, black rhinos and elephants. Like in livestock, Anthrax outbreaks were reported in both dry and wet seasons, but more than two-thirds of the outbreaks occurred during the seven months of dry seasons. Outbreaks involving endangered wildlife species have been documented in the Samburu wildlife ecosystem, where 53 Grevy zebra and 26 plain zebra’s Anthrax deaths were reported in 2005/2006. In 2011, 12 Rothschild’s gira�e died in Mwea National park while in 2015, Nakuru National park reported mortality of 687 animals of di�erent species among which 97% (669) were bu�alos and 0.7% (5) black rhinoceros. Chapter Three Anthrax Strategy 2021 Revised 8.indd 8 11/2/21 2:23 PM 9 Figure 3: Temporal distribution of Anthrax outbreaks in Kenyan wildlife, 1999-2017 (Source: Gachohi et al., 2019) In most cases, Anthrax outbreaks are detected when humans are a�ected. A review of 15 Anthrax outbreak investigations between 2005 and 2018 showed that 12 (80%) spilled-over to humans with a total of 155 human cases. Of these 127 (82%) were cutaneous, 19 (12.5%) intestinal form and 1(0.6%) inhalational form) with a case fatality of 5.2%. These outbreaks occurred in Nakuru, Kiambu, Murang’a, Samburu, Kirinyaga, Turkana, Vihiga and Bomet Counties. Data from the passive surveillance system in the Ministry of Health, District Health Information System (DHIS2) reported 276 and 79 Anthrax cases in 2017 and 2018 respectively. 3.2 Anthrax Surveillance Systems in Kenya Anthrax is a notifiable disease in both animal and human health surveillance systems. Anthrax cases definitions (A set of standard criteria for classifying whether a person/animal has a particular disease) are provided for the disease in both livestock and humans reporting systems. 3.3 Case definitions – Livestock These are according to FAO Anthrax case classifications20 3.3.1 Suspect Case Definition A suspected case is a case that is compatible with the clinical description. For example, in endemic areas all sudden deaths should be regarded as suspected anthrax cases. 3.3.2 Probable Case Definition A suspected case with dark tarry un-clotted blood on postmortem. 3.3.2 Confirmed Case Definition A suspected case of Anthrax accompanied by demonstration of gram-positive rod-shaped B. anthracis or growth of the bacteria on a blood agar plate Anthrax Strategy 2021 Revised 8.indd 9 11/2/21 2:23 PM 10 3.4 Case Definitions in Humans These case definitions are adapted from the WHO Anthrax case classification 3.4.1 Suspect Case Definition A suspected case of Anthrax in a human may be defined as: • A clinically-compatible case of illness without isolation of B. anthracis and no alternative diagnosis, but with laboratory evidence of B. anthracis by one supportive laboratory test; or • A clinically-compatible case of Anthrax epidemiologically linked to a confirmed environmental exposure (infected animal product, contaminated fomite, or other sources) 3.4.2 Confirmed Case A confirmed case of Anthrax in a human can be defined as a clinically compatible case of cutaneous, inhalational or gastrointestinal illness that is laboratory-confirmed by: • Isolation of B. anthracis from an a­ected tissue or site; or • Other laboratory evidence of B. anthracis infection based on at least two supportive laboratory tests. Note: It may not be possible to demonstrate B. anthracis in clinical specimens if the patient has been treated with antimicrobial agents. 3.5 Anthrax Surveillance Systems in Animals 3.5.1 Passive Surveillance and Active Surveillance Passive surveillance is the routine reporting of the cases of diseases reaching veterinary practitioners for treatment or service. Early warning systems rely on passive surveillance where data has already been collected for some other purpose. Several tools are available for disease reporting; -Notifiable Disease Reporting forms (ND1)/ Sanitary report forms, Zero report form and Kenya Livestock and Wildlife Syndromic Surveillance (KLWSS)/Kenya Animal Bio Surveillance System (KABS). In active surveillance detailed disease search/investigations are planned following suspected cases of Anthrax. 3.5.2 Laboratory Surveillance in Kenya The country has six regional veterinary investigation laboratories (RVILs) namely; Kericho, Eldoret, Garissa, Karatina, Nakuru and Mariakani, two satellite laboratories (Ukunda and Witu) and the Central Veterinary Laboratory (CVL) at Kabete, Nairobi. The Faculty of veterinary medicine Laboratories, University of Nairobi, also receives and tests suspect Anthrax samples. Anthrax outbreaks are often confirmed through blood smears in laboratories. Monthly laboratory surveillance reports are submitted to the Veterinary Epidemiology and Economics Unit (VEES) at the Directorate of Veterinary Services (DVS). However, confirmatory diagnostic capacity with molecular techniques (PCR) or through culture using gamma phage is not yet established in the RVILs due to lack of biosafety and biosecurity infrastructure. 3.5.3 Reporting System in Livestock Sector Reporting of diseases in the livestock sector is done from the lowest level (Ward) to the National Level (DVS) as outlined in Figure 4. A standard form (ND1 form) is used to collect epidemiological data on the suspected animal cases and submitted to the DVS through the County Director of Veterinary Services (CDVS). A standard form (LB1 form) is also filled when samples are collected and submitted to the regional or Central Veterinary Laboratory (CVL) for confirmation. Anthrax Strategy 2021 Revised 8.indd 10 11/2/21 2:23 PM 11 Figure 4: Reporting system in the Livestock Sector (Source; DVS) 3.6 Surveillance System in Wildlife Kenya Wildlife Services has a Veterinary and Capture Services Department that provides veterinary services to wildlife in protected and dispersal areas nationally. It also monitors any outbreaks and makes appropriate recommendations. In addition, the department investigates the source of disease outbreaks and institute appropriate control measures. The department executes its mandate from its headquarters in Nairobi and eight satellite mobile veterinary units located in areas with a high concentration of wildlife where veterinary services are required most. A network of KWS scientists, wardens and rangers across the country assist in reporting suspicious cases to the department. For confirmation, samples collected from suspected anthrax cases are normally submitted to regional veterinary laboratories (VILs) or central veterinary laboratories (CVL). The KLWSS/KABS system has provided near real-time notification of wildlife diseases since 2016. Figure5: Wildlife diseases reporting system in Kenya. Anthrax Strategy 2021 Revised 8.indd 11 11/2/21 2:23 PM 10 3.4 Case Definitions in Humans These case definitions are adapted from the WHO Anthrax case classification 3.4.1 Suspect Case Definition A suspected case of Anthrax in a human may be defined as: • A clinically-compatible case of illness without isolation of B. anthracis and no alternative diagnosis, but with laboratory evidence of B. anthracis by one supportive laboratory test; or • A clinically-compatible case of Anthrax epidemiologically linked to a confirmed environmental exposure (infected animal product, contaminated fomite, or other sources) 3.4.2 Confirmed Case A confirmed case of Anthrax in a human can be defined as a clinically compatible case of cutaneous, inhalational or gastrointestinal illness that is laboratory-confirmed by: • Isolation of B. anthracis from an a­ected tissue or site; or • Other laboratory evidence of B. anthracis infection based on at least two supportive laboratory tests. Note: It may not be possible to demonstrate B. anthracis in clinical specimens if the patient has been treated with antimicrobial agents. 3.5 Anthrax Surveillance Systems in Animals 3.5.1 Passive Surveillance and Active Surveillance Passive surveillance is the routine reporting of the cases of diseases reaching veterinary practitioners for treatment or service. Early warning systems rely on passive surveillance where data has already been collected for some other purpose. Several tools are available for disease reporting; -Notifiable Disease Reporting forms (ND1)/ Sanitary report forms, Zero report form and Kenya Livestock and Wildlife Syndromic Surveillance (KLWSS)/Kenya Animal Bio Surveillance System (KABS). In active surveillance detailed disease search/investigations are planned following suspected cases of Anthrax. 3.5.2 Laboratory Surveillance in Kenya The country has six regional veterinary investigation laboratories (RVILs) namely; Kericho, Eldoret, Garissa, Karatina, Nakuru and Mariakani, two satellite laboratories (Ukunda and Witu) and the Central Veterinary Laboratory (CVL) at Kabete, Nairobi. The Faculty of veterinary medicine Laboratories, University of Nairobi, also receives and tests suspect Anthrax samples. Anthrax outbreaks are often confirmed through blood smears in laboratories. Monthly laboratory surveillance reports are submitted to the Veterinary Epidemiology and Economics Unit (VEES) at the Directorate of Veterinary Services (DVS). However, confirmatory diagnostic capacity with molecular techniques (PCR) or through culture using gamma phage is not yet established in the RVILs due to lack of biosafety and biosecurity infrastructure. 3.5.3 Reporting System in Livestock Sector Reporting of diseases in the livestock sector is done from the lowest level (Ward) to the National Level (DVS) as outlined in Figure 4. A standard form (ND1 form) is used to collect epidemiological data on the suspected animal cases and submitted to the DVS through the County Director of Veterinary Services (CDVS). A standard form (LB1 form) is also filled when samples are collected and submitted to the regional or Central Veterinary Laboratory (CVL) for confirmation. Anthrax Strategy 2021 Revised 8.indd 10 11/2/21 2:23 PM 11 Figure 4: Reporting system in the Livestock Sector (Source; DVS) 3.6 Surveillance System in Wildlife Kenya Wildlife Services has a Veterinary and Capture Services Department that provides veterinary services to wildlife in protected and dispersal areas nationally. It also monitors any outbreaks and makes appropriate recommendations. In addition, the department investigates the source of disease outbreaks and institute appropriate control measures. The department executes its mandate from its headquarters in Nairobi and eight satellite mobile veterinary units located in areas with a high concentration of wildlife where veterinary services are required most. A network of KWS scientists, wardens and rangers across the country assist in reporting suspicious cases to the department. For confirmation, samples collected from suspected anthrax cases are normally submitted to regional veterinary laboratories (VILs) or central veterinary laboratories (CVL). The KLWSS/KABS system has provided near real-time notification of wildlife diseases since 2016. Figure5: Wildlife diseases reporting system in Kenya. Anthrax Strategy 2021 Revised 8.indd 11 11/2/21 2:23 PM 12 3.7 Anthrax Surveillance System in Humans 3.7.1 Passive Surveillance in the Health Sector Kenya implements its disease surveillance through the Integrated Disease Surveillance and Response (IDSR) strategy (regional strategy for strengthening national disease surveillance systems in the African region). Anthrax is among 36 diseases prioritized for reporting through the IDSR indicator-based surveillance system. One confirmed case of Anthrax constitutes an outbreak in that locality. Anthrax cases and deaths are reported weekly in the IDSR system, however data on clinical information like the forms of anthrax is not collected. 3.7.2 Reporting and Information system in Public health Information is collected at the health facilities level and transmitted to the Sub-county level using standardized paper-based tools. The system then transits at this level into a web-based electronic-IDSR platform for onward transmission to county and national levels. All the data collected and transmitted through the IDSR system is stored in the District Health Information System (DHIS2), the national web based reporting system. The MOH established the Public Health Emergency Operations Center (PHEOC) in 2016 to enhance coordination of information and resources for managing public health emergencies including infectious diseases emergencies. The PHEOC often detects anthrax outbreaks through its elaborate network of information sources. Figure 6: Passive surveillance in the Ministry of Health Anthrax Strategy 2021 Revised 8.indd 12 11/2/21 2:23 PM 13 3.7.3 Laboratory Surveillance in MOH Kenya has a National Public Health Laboratory Services system that operates under the Ministry of Health. The laboratory system, just like the health facilities, is structured into four tiers: from primary to tertiary level (specialized labs). The main reference laboratories are based in Nairobi but there is an established network of health facility laboratories and research laboratories. Sample referral guidelines exists, and anthrax samples are also referred for confirmation as hazardous materials. . 3.7.4 The Role of National and County Governments in Anthrax Disease Surveillance National and County govenrments play an important role in protecting, preserving and promoting the health and safety of the public. These two levels of government work with synergy and their roles are described in the table below. Table 2: Role of National level and county health authorities in anthrax surveillance National authorities County/sub county authorities • Analyses and provide feedback data back to county and sub-county • Report to international bodies e.g. (WHO, OIE) • Formulate policies &guidelines, and allocate resources based on surveillance information • Provide technical support (laboratory services, epidemiologist, capacity building, educational materials) • Coordinates control and prevention activities • Support and coordinate disease control • Detect and report suspected anthrax cases to National authorities and stakeholders • Support and coordinate disease control at the County level • Diagnose and investigate anthrax outbreaks • Analyze received data and provide feedback to the county o�cers • Initiation of control and prevention measures • Implement policies 3.8 Inter-Sectoral Co-ordination In 2011, Kenya established a One Health referred to as the Zoonotic Disease Unit (ZDU), to establish and maintain active collaboration at the animal, human and ecosystem interface towards better prevention and control of zoonotic diseases. Therefore, the role of ZDU is to coordinate various government and non-government agencies and partners involved in zoonotic diseases prevention and control. The ZDU strengthens coordinated surveillance through routine joint risk assessment, surveillance and notification between the veterinary and human health sectors during zoonotic disease events, leads the development of guidelines for prevention and control of zoonotic diseases, and maintains databases zoonotic diseases. In addition, pilot County One Health Units (COHUs) were established to enhance collaboration between the human and livestock sectors. However, these COHUs need to be strengthened and more to be established for each County. 3.9 Current Anthrax Prevention and Control Activities in Kenya Kenya has lacked a clear and explicit national strategy, adequate institutional and legal framework for anthrax prevention and control, leading to fragmentation of e�orts by di�erent actors, with weak linkages and cross reporting. 3.9.1 Prevention and Control of Anthrax in Animals Anthrax control in animals is under the mandate of the DVS and various methods have been put in place to control the disease. Normally, routine vaccination should be practised as a preventive measure in counties where the disease is endemic. However, vaccination is often conducted as a reactionary measure to an outbreak. In wildlife, KWS often provide alternative watering points away from the outbreak zone to break the infection cycle. Carcass disposal is mostly though on-site incineration when few animals are involved while burying using heavy-duty machinery is employed in outbreaks a�ecting many animals. Vaccination via drop-o� darts is conducted to protect endangered species. However, the cost of control in wildlife is expensive due to the logistics Anthrax Strategy 2021 Revised 8.indd 13 11/2/21 2:23 PM 12 3.7 Anthrax Surveillance System in Humans 3.7.1 Passive Surveillance in the Health Sector Kenya implements its disease surveillance through the Integrated Disease Surveillance and Response (IDSR) strategy (regional strategy for strengthening national disease surveillance systems in the African region). Anthrax is among 36 diseases prioritized for reporting through the IDSR indicator-based surveillance system. One confirmed case of Anthrax constitutes an outbreak in that locality. Anthrax cases and deaths are reported weekly in the IDSR system, however data on clinical information like the forms of anthrax is not collected. 3.7.2 Reporting and Information system in Public health Information is collected at the health facilities level and transmitted to the Sub-county level using standardized paper-based tools. The system then transits at this level into a web-based electronic-IDSR platform for onward transmission to county and national levels. All the data collected and transmitted through the IDSR system is stored in the District Health Information System (DHIS2), the national web based reporting system. The MOH established the Public Health Emergency Operations Center (PHEOC) in 2016 to enhance coordination of information and resources for managing public health emergencies including infectious diseases emergencies. The PHEOC often detects anthrax outbreaks through its elaborate network of information sources. Figure 6: Passive surveillance in the Ministry of Health Anthrax Strategy 2021 Revised 8.indd 12 11/2/21 2:23 PM 13 3.7.3 Laboratory Surveillance in MOH Kenya has a National Public Health Laboratory Services system that operates under the Ministry of Health. The laboratory system, just like the health facilities, is structured into four tiers: from primary to tertiary level (specialized labs). The main reference laboratories are based in Nairobi but there is an established network of health facility laboratories and research laboratories. Sample referral guidelines exists, and anthrax samples are also referred for confirmation as hazardous materials. . 3.7.4 The Role of National and County Governments in Anthrax Disease Surveillance National and County govenrments play an important role in protecting, preserving and promoting the health and safety of the public. These two levels of government work with synergy and their roles are described in the table below. Table 2: Role of National level and county health authorities in anthrax surveillance National authorities County/sub county authorities • Analyses and provide feedback data back to county and sub-county • Report to international bodies e.g. (WHO, OIE) • Formulate policies &guidelines, and allocate resources based on surveillance information • Provide technical support (laboratory services, epidemiologist, capacity building, educational materials) • Coordinates control and prevention activities • Support and coordinate disease control • Detect and report suspected anthrax cases to National authorities and stakeholders • Support and coordinate disease control at the County level • Diagnose and investigate anthrax outbreaks • Analyze received data and provide feedback to the county o�cers • Initiation of control and prevention measures • Implement policies 3.8 Inter-Sectoral Co-ordination In 2011, Kenya established a One Health referred to as the Zoonotic Disease Unit (ZDU), to establish and maintain active collaboration at the animal, human and ecosystem interface towards better prevention and control of zoonotic diseases. Therefore, the role of ZDU is to coordinate various government and non-government agencies and partners involved in zoonotic diseases prevention and control. The ZDU strengthens coordinated surveillance through routine joint risk assessment, surveillance and notification between the veterinary and human health sectors during zoonotic disease events, leads the development of guidelines for prevention and control of zoonotic diseases, and maintains databases zoonotic diseases. In addition, pilot County One Health Units (COHUs) were established to enhance collaboration between the human and livestock sectors. However, these COHUs need to be strengthened and more to be established for each County. 3.9 Current Anthrax Prevention and Control Activities in Kenya Kenya has lacked a clear and explicit national strategy, adequate institutional and legal framework for anthrax prevention and control, leading to fragmentation of e�orts by di�erent actors, with weak linkages and cross reporting. 3.9.1 Prevention and Control of Anthrax in Animals Anthrax control in animals is under the mandate of the DVS and various methods have been put in place to control the disease. Normally, routine vaccination should be practised as a preventive measure in counties where the disease is endemic. However, vaccination is often conducted as a reactionary measure to an outbreak. In wildlife, KWS often provide alternative watering points away from the outbreak zone to break the infection cycle. Carcass disposal is mostly though on-site incineration when few animals are involved while burying using heavy-duty machinery is employed in outbreaks a�ecting many animals. Vaccination via drop-o� darts is conducted to protect endangered species. However, the cost of control in wildlife is expensive due to the logistics Anthrax Strategy 2021 Revised 8.indd 13 11/2/21 2:23 PM 14 ©FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 14 11/2/21 2:23 PM 15 3.9.2 Vaccination: In Kenya the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9.3 Prevention and Control of Anthrax in Humans Public education is usually conducted during outbreaks to communities a�ected. Suspect cases are often treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, Legal and Institutional Framework Supporting Prevention and Control of Anthrax The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identifies partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the specific objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : Defines the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Anthrax Strategy 2021 Revised 8.indd 15 11/2/21 2:23 PM 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: International Health Regulations (IHR) (2005) : Helps countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on a One Health approach. It captures national priorities for health security, security capacity development. National Action Plan on Prevention and Containment of Antimicrobial Resistance (NAPAMR, 2017-2022) : provides a common framework for action and management of AMR by multisectoral stakeholders in OIE/FAO/WHO : provides broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services World Health Organization (WHO) - in partnership with OIE has developed manuals for brucellosis prevention and control. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. AU-IBAR - Integrated regional coordination mechanism sets ways and multi-sectoral approaches for prevention and control of zoonoses. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access to livestock and livestock products to national, regional and international markets. Vision 2030 - Big four agenda : Kenya Universal Health Care (UHC) provides access to quality primary health care to address over 80% of a person’s health needs throughout the life cycle by focusing on preventive and promotive health interventions. i. ii. iii. iv. v. vi. vii. viii. ix. x. 15 3.9.2 Vaccination In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: International Health Regulations (IHR) (2005) : Helps countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on a One Health approach. It captures national priorities for health security, security capacity development. National Action Plan on Prevention and Containment of Antimicrobial Resistance (NAPAMR, 2017-2022) : provides a common framework for action and management of AMR by multisectoral stakeholders in OIE/FAO/WHO : provides broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services World Health Organization (WHO) - in partnership with OIE has developed manuals for brucellosis prevention and control. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. AU-IBAR - Integrated regional coordination mechanism sets ways and multi-sectoral approaches for prevention and control of zoonoses. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access to livestock and livestock products to national, regional and international markets. Vision 2030 - Big four agenda : Kenya Universal Health Care (UHC) provides access to quality primary health care to address over 80% of a person’s health needs throughout the life cycle by focusing on preventive and promotive health interventions. i. ii. iii. iv. v. vi. vii. viii. ix. x. 15 3.9.2 Vaccination In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: International Health Regulations (IHR) (2005) : Helps countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on a One Health approach. It captures national priorities for health security, brings sectors together, identifies partners and allocates resources for health security capacity development. National Action Plan on Prevention and Containment of Antimicrobial Resistance (NAPAMR, 2017-2022) : provides a common framework for action and management of AMR by multisectoral stakeholders in Kenya, human and animal health, agriculture, fisheries and environmental sectors OIE/FAO/WHO : provides broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services World Health Organization (WHO) - in partnership with OIE has developed manuals for brucellosis prevention and control. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. AU-IBAR - Integrated regional coordination mechanism sets ways and multi-sectoral approaches for prevention and control of zoonoses. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access to livestock and livestock products to national, regional and international markets. Vision 2030 - Big four agenda : Kenya Universal Health Care (UHC) provides access to quality primary health care to address over 80% of a person’s health needs throughout the life cycle by focusing on preventive and promotive health interventions. Kenya Veterinary Policy - It provides guidance on control and prevention of zoonotic diseases particularly the use of multi-sectoral collaboration using one Health approach. Kenya Health Policy (2014-2030) - The overall objective is to attain universal coverage of critical services that positively contribute to realising the overall policy goal. Among the objectives are to eliminate communicable diseases and strengthen collaboration with other sectors that have an impact on health. i. ii. iii. iv. v. vi. vii. viii. ix. x. xi. xii. 14 ©FAO/Luis Tato Anthrax Strategy 2021 Revised 8.indd 14 11/2/21 2:23 PM 15 3.9.2 Vaccination: In Kenya the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9.3 Prevention and Control of Anthrax in Humans Public education is usually conducted during outbreaks to communities a�ected. Suspect cases are often treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, Legal and Institutional Framework Supporting Prevention and Control of Anthrax The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identifies partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the specific objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : Defines the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Anthrax Strategy 2021 Revised 8.indd 15 11/2/21 2:23 PM 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination: In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: i. International Health Regulations (IHR) (2005) : Help countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. ii. OIE/FAO/WHO : provide broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases; a. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services b. World Health Organization (WHO) : in partnership with OIE has developed manuals for anthrax prevention and control. c. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. iii. The African Union Inter-African Bureau for Animal Resources (AU-IBAR) : Facilitate Integrated regional coordination mechanism by encouraging multi-sectoral approaches for prevention and control of zoonoses. iv. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access of livestock and livestock products to national, regional and international markets. v. Vision 2030, Big four agenda : Kenya Universal Health Care (UHC) seeks to provide access to quality primary health care addressing over 80% of a person’s health needs by focusing on preventive, promotive and comprehensive health interventions. vi. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on OH approach. It captures national priorities for health security, brings sectors together, identi es partners and allocates resources for health security capacity development. vii. Kenya Veterinary Policy (draft) 2016 : It guides control and prevention of zoonoses particularly the use of multi-sectoral collaboration using OH approach. viii. Kenya Health Policy (2014-2030) : The overall objective is to attain universal coverage of critical services that positively contribute to realising of the overall policy goal. Among the speci c objectives are to eliminate communicable conditions and strengthen collaboration with other sectors that have an impact on health. ix. Laboratory Biosafety and Biosecurity policy guidelines (MOH) : De nes the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments. Generally, it focuses on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). 15 3.9.2 Vaccination In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: International Health Regulations (IHR) (2005) : Helps countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on a One Health approach. It captures national priorities for health security, security capacity development. National Action Plan on Prevention and Containment of Antimicrobial Resistance (NAPAMR, 2017-2022) : provides a common framework for action and management of AMR by multisectoral stakeholders in OIE/FAO/WHO : provides broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services World Health Organization (WHO) - in partnership with OIE has developed manuals for brucellosis prevention and control. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. AU-IBAR - Integrated regional coordination mechanism sets ways and multi-sectoral approaches for prevention and control of zoonoses. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access to livestock and livestock products to national, regional and international markets. Vision 2030 - Big four agenda : Kenya Universal Health Care (UHC) provides access to quality primary health care to address over 80% of a person’s health needs throughout the life cycle by focusing on preventive and promotive health interventions. i. ii. iii. iv. v. vi. vii. viii. ix. x. 15 3.9.2 Vaccination In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: International Health Regulations (IHR) (2005) : Helps countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on a One Health approach. It captures national priorities for health security, security capacity development. National Action Plan on Prevention and Containment of Antimicrobial Resistance (NAPAMR, 2017-2022) : provides a common framework for action and management of AMR by multisectoral stakeholders in OIE/FAO/WHO : provides broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services World Health Organization (WHO) - in partnership with OIE has developed manuals for brucellosis prevention and control. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. AU-IBAR - Integrated regional coordination mechanism sets ways and multi-sectoral approaches for prevention and control of zoonoses. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access to livestock and livestock products to national, regional and international markets. Vision 2030 - Big four agenda : Kenya Universal Health Care (UHC) provides access to quality primary health care to address over 80% of a person’s health needs throughout the life cycle by focusing on preventive and promotive health interventions. i. ii. iii. iv. v. vi. vii. viii. ix. x. 15 3.9.2 Vaccination In Kenya, the DVS has approved the use of Blanthax® or Bivax® vaccine for active immunization of animals against anthrax and black quarter. It is imported by local pharmaceutical companies who may sell directly to county governments and Kenya Veterinary Vaccines Production Institute (KEVEVAPI). The vaccine is prepared from living spores of an encapsulated avirulent strain of Bacillus anthracis in alum precipitated Clostridium chauvoei. The vaccine is indicated for use in cattle, horses, camels, sheep and goats. 3.9 treated with mass administration of penicillin antibiotics since there is no strategy or guidelines for case management. During anthrax outbreaks, the response is coordinated by ZDU. 3.10 Policy, L The following policies, laws and regulations guide the prevention and control of Anthrax at national, regional and international levels: International Health Regulations (IHR) (2005) : Helps countries review and if necessary, strengthen their ability to detect, assess and respond to public health events. National Action Plan for Health Security (NAPHS) : Accelerates the implementation of IHR core capacities in a country and is based on a One Health approach. It captures national priorities for health security, brings sectors together, identifies partners and allocates resources for health security capacity development. National Action Plan on Prevention and Containment of Antimicrobial Resistance (NAPAMR, 2017-2022) : provides a common framework for action and management of AMR by multisectoral stakeholders in Kenya, human and animal health, agriculture, fisheries and environmental sectors OIE/FAO/WHO : provides broad guidance and protocols on disease surveillance, contingency planning, preparedness and response to zoonotic diseases. World Organization for Animal Health (OIE) terrestrial animal health code sets standards for the improvement of animal health and welfare and veterinary public health worldwide; OIE manual for diagnostic tests and vaccines for terrestrial animals and OIE Performance of veterinary services World Health Organization (WHO) - in partnership with OIE has developed manuals for brucellosis prevention and control. FAO/OIE: Progressive Control Pathways (PCPs) and the related roadmaps are staged, stepwise approaches increasingly used to structure the road to disease reduction and freedom for a range of human and animal diseases. AU-IBAR - Integrated regional coordination mechanism sets ways and multi-sectoral approaches for prevention and control of zoonoses. Intergovernmental Authority on Development (IGAD) : Provides an animal health framework that enhances domestic food security and increases access to livestock and livestock products to national, regional and international markets. Vision 2030 - Big four agenda : Kenya Universal Health Care (UHC) provides access to quality primary health care to address over 80% of a person’s health needs throughout the life cycle by focusing on preventive and promotive health interventions. Kenya Veterinary Policy - It provides guidance on control and prevention of zoonotic diseases particularly the use of multi-sectoral collaboration using one Health approach. Kenya Health Policy (2014-2030) - The overall objective is to attain universal coverage of critical services that positively contribute to realising the overall policy goal. Among the objectives are to eliminate communicable diseases and strengthen collaboration with other sectors that have an impact on health. i. ii. iii. iv. v. vi. vii. viii. ix. x. xi. xii. 16 x. Animal Diseases Act, Cap-364 : Provides the legislative framework and power to carry out all necessary disease control actions needed to control notifiable diseases in Kenya. xi. Public Health Act, Cap-242 : Grants powers to public health authorities protect the health of the public, including compulsory reporting of notifiable infectious diseases. xii. The County Government Act, No.17 of 2012 : gives the county governments powers to ensure e�ciency in service delivery and partnership with organizations for work, service or function within the county xiii. Veterinary Surgeons and veterinary para-professionals act (2011) : Regulate professional handling and reporting of anthrax cases. xiv. One Health (OH) Strategic plan for prevention and control of zoonoses : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH and conduct and promote applied research on zoonoses. 3.11 Stakeholders Mapping for Anthrax Prevention and Control Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 3.12 Situational Analysis of Strengths, Weakness, Opportunities and Threats (SWOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and control of Anthrax. In addition, weaknesses and threats which must be addressed for e�ective prevention and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization Anthrax Strategy 2021 Revised 8.indd 16 11/2/21 2:23 PM 3.11 Stak Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Kenya Veterinary Policy - It provides guidance on control and prevention of zoonotic diseases particularly the use of multi-sectoral collaboration using one Health approach. Kenya Health Policy (2014-2030) - The overall objective is to attain universal coverage of critical services that positively contribute to realising the overall policy goal. Among the objectives are to eliminate communicable diseases and strengthen collaboration with other sectors that have an impact on health. Biosafety and Biosecurity policy and guidelines : biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments, generally focusing on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Animal Diseases Act, Cap 364 : Provides the legislative framework and power to carry out all necessary Public Health Act - Cap 242 : Grants powers to local health authorities to protect the health of Meat Control Act, Cap 356 : Enables control to be exercised over meat and meat products intended for human consumption. The County Governments Act No.17 of 2012 : gives the county governments powers to ensure e¨ciency in service delivery and partnership with organizations for work, service or function within the county Veterinary Surgeons and veterinary para-professionals Act, Cap 366 : Gives Kenya Veterinary Board (KVB) powers to license, certify and discipline veterinary surgeons and veterinary para-professionals. One Health (OH) Strategic Plan : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH, and to conduct and promote applied research on zoonoses. xi. xii. xiii. xiv. xv. xvi. xvii. xviii. xix. 3.11 Stak Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Kenya Veterinary Policy - It provides guidance on control and prevention of zoonotic diseases particularly the use of multi-sectoral collaboration using one Health approach. Kenya Health Policy (2014-2030) - The overall objective is to attain universal coverage of critical services that positively contribute to realising the overall policy goal. Among the objectives are to eliminate communicable diseases and strengthen collaboration with other sectors that have an impact on health. Biosafety and Biosecurity policy and guidelines : biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments, generally focusing on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Animal Diseases Act, Cap 364 : Provides the legislative framework and power to carry out all necessary Public Health Act - Cap 242 : Grants powers to local health authorities to protect the health of Meat Control Act, Cap 356 : Enables control to be exercised over meat and meat products intended for human consumption. The County Governments Act No.17 of 2012 : gives the county governments powers to ensure e¨ciency in service delivery and partnership with organizations for work, service or function within the county Veterinary Surgeons and veterinary para-professionals Act, Cap 366 : Gives Kenya Veterinary Board (KVB) powers to license, certify and discipline veterinary surgeons and veterinary para-professionals. One Health (OH) Strategic Plan : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH, and to conduct and promote applied research on zoonoses. xi. xii. xiii. xiv. xv. xvi. xvii. xviii. xix. 3.11 Stakeholders Mapping for Anthrax Prevention and Control Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Biosafety and Biosecurity policy and guidelines : define the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments, generally focusing on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Animal Diseases Act, Cap 364 : Provides the legislative framework and power to carry out all necessary disease control actions needed to control notifiable diseases in Kenya. Public Health Act - Cap 242 : Grants powers to local health authorities to protect the health of members of the public, including compulsory reporting of notifiable infectious diseases. Meat Control Act, Cap 356 : Enables control to be exercised over meat and meat products intended for human consumption. The County Governments Act No.17 of 2012 : gives the county governments powers to ensure e¨ciency in service delivery and partnership with organizations for work, service or function within the county Veterinary Surgeons and veterinary para-professionals Act, Cap 366 : Gives Kenya Veterinary Board (KVB) powers to license, certify and discipline veterinary surgeons and veterinary para-professionals. One Health (OH) Strategic Plan : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH, and to conduct and promote applied research on zoonoses. xiii. xiii. xiv. xv. xvi. xvii. xviii. Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 17 ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identified as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries • Few trained technical sta� at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training of sta� • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • High turnover of sta� • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework Anthrax Strategy 2021 Revised 8.indd 17 11/2/21 2:23 PM Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 3. S W WOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identi ed as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 3. S W WOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identi ed as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework 3.12 Situational Analysis of Strengths, Weakness, Opportunities and Threats (SWOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identified as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework 16 x. Animal Diseases Act, Cap-364 : Provides the legislative framework and power to carry out all necessary disease control actions needed to control notifiable diseases in Kenya. xi. Public Health Act, Cap-242 : Grants powers to public health authorities protect the health of the public, including compulsory reporting of notifiable infectious diseases. xii. The County Government Act, No.17 of 2012 : gives the county governments powers to ensure e�ciency in service delivery and partnership with organizations for work, service or function within the county xiii. Veterinary Surgeons and veterinary para-professionals act (2011) : Regulate professional handling and reporting of anthrax cases. xiv. One Health (OH) Strategic plan for prevention and control of zoonoses : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH and conduct and promote applied research on zoonoses. 3.11 Stakeholders Mapping for Anthrax Prevention and Control Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 3.12 Situational Analysis of Strengths, Weakness, Opportunities and Threats (SWOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and control of Anthrax. In addition, weaknesses and threats which must be addressed for e�ective prevention and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization Anthrax Strategy 2021 Revised 8.indd 16 11/2/21 2:23 PM 3.11 Stak Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Kenya Veterinary Policy - It provides guidance on control and prevention of zoonotic diseases particularly the use of multi-sectoral collaboration using one Health approach. Kenya Health Policy (2014-2030) - The overall objective is to attain universal coverage of critical services that positively contribute to realising the overall policy goal. Among the objectives are to eliminate communicable diseases and strengthen collaboration with other sectors that have an impact on health. Biosafety and Biosecurity policy and guidelines : biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments, generally focusing on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Animal Diseases Act, Cap 364 : Provides the legislative framework and power to carry out all necessary Public Health Act - Cap 242 : Grants powers to local health authorities to protect the health of Meat Control Act, Cap 356 : Enables control to be exercised over meat and meat products intended for human consumption. The County Governments Act No.17 of 2012 : gives the county governments powers to ensure e¨ciency in service delivery and partnership with organizations for work, service or function within the county Veterinary Surgeons and veterinary para-professionals Act, Cap 366 : Gives Kenya Veterinary Board (KVB) powers to license, certify and discipline veterinary surgeons and veterinary para-professionals. One Health (OH) Strategic Plan : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH, and to conduct and promote applied research on zoonoses. xi. xii. xiii. xiv. xv. xvi. xvii. xviii. xix. 3.11 Stak Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Kenya Veterinary Policy - It provides guidance on control and prevention of zoonotic diseases particularly the use of multi-sectoral collaboration using one Health approach. Kenya Health Policy (2014-2030) - The overall objective is to attain universal coverage of critical services that positively contribute to realising the overall policy goal. Among the objectives are to eliminate communicable diseases and strengthen collaboration with other sectors that have an impact on health. Biosafety and Biosecurity policy and guidelines : biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments, generally focusing on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Animal Diseases Act, Cap 364 : Provides the legislative framework and power to carry out all necessary Public Health Act - Cap 242 : Grants powers to local health authorities to protect the health of Meat Control Act, Cap 356 : Enables control to be exercised over meat and meat products intended for human consumption. The County Governments Act No.17 of 2012 : gives the county governments powers to ensure e¨ciency in service delivery and partnership with organizations for work, service or function within the county Veterinary Surgeons and veterinary para-professionals Act, Cap 366 : Gives Kenya Veterinary Board (KVB) powers to license, certify and discipline veterinary surgeons and veterinary para-professionals. One Health (OH) Strategic Plan : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH, and to conduct and promote applied research on zoonoses. xi. xii. xiii. xiv. xv. xvi. xvii. xviii. xix. 3.11 Stakeholders Mapping for Anthrax Prevention and Control Anthrax prevention and control requires the support of multi-sectoral and multi-disciplinary stakeholders drawn from government and non-state agencies. Below is a summary of key stakeholders and their roles in Anthrax prevention and control (Table 3). Biosafety and Biosecurity policy and guidelines : define the scope and applicability of “laboratory biosecurity” recommendations, narrowing them strictly to human, veterinary and agricultural laboratory environments, generally focusing on dangerous pathogens and toxins, addressing the safekeeping of all valuable biological materials (VBM). Animal Diseases Act, Cap 364 : Provides the legislative framework and power to carry out all necessary disease control actions needed to control notifiable diseases in Kenya. Public Health Act - Cap 242 : Grants powers to local health authorities to protect the health of members of the public, including compulsory reporting of notifiable infectious diseases. Meat Control Act, Cap 356 : Enables control to be exercised over meat and meat products intended for human consumption. The County Governments Act No.17 of 2012 : gives the county governments powers to ensure e¨ciency in service delivery and partnership with organizations for work, service or function within the county Veterinary Surgeons and veterinary para-professionals Act, Cap 366 : Gives Kenya Veterinary Board (KVB) powers to license, certify and discipline veterinary surgeons and veterinary para-professionals. One Health (OH) Strategic Plan : Its main objective is to strengthen surveillance, prevention and control of zoonoses, establish structures and partnerships to promote OH, and to conduct and promote applied research on zoonoses. xiii. xiii. xiv. xv. xvi. xvii. xviii. Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 17 ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identified as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries • Few trained technical sta� at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training of sta� • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • High turnover of sta� • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework Anthrax Strategy 2021 Revised 8.indd 17 11/2/21 2:23 PM Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 3. S W WOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identi ed as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework Table 3: Stakeholders for Anthrax prevention and Control Thematic Area Stakeholders Coordination, Policy, standards and strategy development MOH, MoALF, Kenya Wildlife Service, Zoonotic Disease Unit, Council of Governors and County Governments Technical support, capacity building and resource mobilization WHO, FAO, OIE, Centers for Disease Control(US CDC), Africa CDC, USAID, IGAD, One health central and eastern Africa(OHCEA) AU IBAR, One Health Horn of Africa (HORN), East African Community (EAC), Technical training institutions and universities. Enforcement of Laws and regulations Ministry of Interior, MOH, MoALF, KWS County Governments Research and Training Local Institutions: Kenya Medical Research Institute (KeMRI), Kenya Agricultural& Livestock Research organization (KALRO), Local Universities, Human and Animal Health Training Institutes International Institutions: International Livestock Research Institute, Washington State University, US Centers for Disease Control, University of Liverpool among others. Vaccine Production, importation and distribution Kenya Veterinary Vaccine Production Institute, Local and international vaccine importers Biosafety and Biosecurity MOH, MoALF, Kenya Wildlife Service, Local Universities and colleges, Non-Governmental Organizations (NGOs). Laboratories;- Public Health Laboratories, CVL,RVL, KEMRI, KWS laboratories Public Awareness of Anthrax and risk communication MOH, MoALF, KWS, ZDU, Ministry of Interior, Private sectors (e.g. Safaricom) , learning institutions, Community based organizations, Non-governmental organizations, Media, County Governments Advocacy , Communication and social mobilization Professional bodies; Kenya Medical Association(KMA), Kenya Veterinary Association(KVA), Kenya Veterinary paraprofessional association, Farmers Organizations and associations, Religious Organizations, Ministry of Interior and Coordination of National Government., Relevant Non- governmental organizations Implementers of the Strategy MOH, MoALF, KWS, ZDU, County Governments, NGOs, Community based organisations (CBOs),Faith-Based organization(FBOs), Private Sector actors, Livestock farmers, Research institutes and Universities, Community and all relevant stakeholders. 3. S W WOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identi ed as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework 3.12 Situational Analysis of Strengths, Weakness, Opportunities and Threats (SWOT) This section outlines the strength and opportunities that could be harnessed to facilitate prevention and and control of the disease are highlighted below. The SWOT followed the following thematic areas; i. Institutional organization ii. Resource mobilization iii. Mechanism for Anthrax surveillance, prevention and control iv. Research and training development v. Advocacy, communication and social mobilization vi. Multi-sectoral collaboration vii. Biosafety and Biosecurity Table 4: Strengths, Weakness, Opportunities and Threats (SWOT) Thematic Area Strength Weaknesses Opportunity Threat Institutional organization • Presence of human and animal health infrastructure and institutions including OH coordination unit (ZDU) • Presence of OH Strategic plan for control and prevention of zoonoses • Skilled human resource at various levels (human, animal and environment) • Anthrax is top priority zoonotic disease and also identified as area of prioritization by Joint External Evaluation (JEE) of internal health regulation (IHR) • Devolved health and veterinary services • Existence of national sectoral policies, strategies and legal frameworks • Inadequate communication coordination and data sharing between the two line ministries at both national and County level • Lack of harmonized guidelines for anthrax prevention and control • Presence and support by International organizations (FAO, WHO, OIE etc.) • Presence of K-FELTP and ISAVET, OHCEA and other continuous professional development programs responsible for training • Availability of global guidelines and standards from international bodies like FAO, OlE, WHO, Global Health Security Agenda 2017 and International Health Regulations (IHR) • Technical support from local, regional and international partners • Inadequate resource allocation to health and livestock services • Emerging and re emerging diseases • Overlapping activities • Lack of legal OH framework 18 Thematic Area Strength Weaknesses Opportunity Threat Resource mobilization (Financial) • Annual budgetary allocation for disease control including surveillance, outbreak response and coordination by line ministries and County departments • Allocated funds are inadequate • Lack of mechanisms for sharing resources across the line ministries • Lack of single basket fund for Zoonoses control including anthrax • Partnerships with development and bilateral partners • National and International attention on OH and Zoonosis • Increase in allocation for devolved functions including public health and veterinary services • Competition for resources with other priority zoonoses and re emerging diseases • Other competing political interests Mechanism for anthrax surveillance, prevention and control • Availability of high quality vaccine • KEVEVAPI- an institution with expertise for high quality anthrax vaccine production and marketing • Availability of trained surveillance o�cers to conduct surveillance, outbreak investigation and response • Epidemiology in service Trainings; Basic, Intermediate and Advanced levels • International and local legal frameworks that support anthrax prevention and control • Reporting channels such as (IDSR) for humans,ND1 forms and KLWSS/KABS for livestock and wildlife • Presence of functioning emergency operating center (EOC) in MoH • Availability of laboratory diagnostic capacity for anthrax (in animals) countrywide • Inadequate funding allocation to surveillance and prevention e�orts • Low vaccination coverage in livestock • Inadequate training of some field o�cers to properly handle anthrax outbreaks • Low level of awareness of the disease by livestock farmers leading disease spread and spill-over to humans • Underreporting of suspected anthrax cases in human and livestock due to the passive nature of the surveillance • Weak enforcement of legal frameworks that obligates farmers and field o�cers to report diseases • Lack of indemnity and compensation mechanisms • Unregulated livestock and animal products movement across the country • Lack of diagnostic capacity for human anthrax in some parts of the country • Late reporting of animals cases lead to missed diagnosis • Lack of specific anthrax prevention and control guideline • Absence of a disease emergency operations center in the MoALF • Subsidy of vaccine costs with increased demand • International (OIE, IHR 2005) and local requirements for reporting of diseases • The Big Four Agenda (2019-2022) that seeks to ensure food security • Presence of reference laboratories that can provide expertise and training in anthrax diagnostics, as well as quality assurance and proficiency testing • The ongoing projects to upgrade animals and human health laboratories at the national level • Establishment of county diagnostic laboratories in the veterinary department • Re-emergence of anthrax in areas perceived to be low risk • Social-cultural practices • Changing priority of diseases in di�erent counties Research and training development • Presence of research and training Institutions (Kenya Universities, KEMRI, CDC, ILRI, WSU, K-FELTP) • Presence of strong research regulatory bodies • Political will by the government by allocating funds to students for research • KFELTP and ISAVET trains epidemiologists on outbreak investigations and other disease control interventions • Inadequate research that can enhance anthrax control for example, data on the burden of anthrax in the country, economic benefits of anthrax control, anthrax vaccination coverage is lacking • Low documentation of outbreak events and few published papers on anthrax • Trainings programs are largely donor funded • Increased interest on anthrax as a potential bioterrorism threat results in increased funding • Collaborations with international reference laboratories, and national and international research institutions • Counties increased interest in EPI training • Changing research priorities • Bioterrorist use of anthrax spores • Sustainability of the donor funded training programs Anthrax Strategy 2021 Revised 8.indd 18 11/2/21 2:23 PM 19 Thematic Area Strength Weaknesses Opportunity Threat Advocacy, communication and social mobilization • Existence of elaborate administrative infrastructure down from farmer for the both ministry of Health and livestock that can support information sharing. • Good mobile network in most parts of the country • Communication channels and media across the country including vernacular platforms • High cost to relay messages across most communication channels • Lack of context specific messages • Lack of a communication strategy • Free spots are available in some media channels • Challenging social and cultural practices • Social media can put out alarming unauthorized information. Multi-sectoral collaboration • Zoonotic technical working group (ZTWG) which is multi-sectoral (MoH, MoALF, WHO, FAO, AU-IBAR, KEMRI, CDC, KWS and others and its chaired by director of veterinary services(DVS) or director general in the MoH • Establishment of county one health unit(COHU) • The revision of the One Health strategic plan for prevention and control of Zoonoses (2021-2025) • Infrequent meetings and over-delegation • Lack of anthrax specific technical working group/ Taskforce • Lack of formal mechanisms for information exchange between sectors • Increasing awareness of OH and the need to collaborate between sectors • Available OH networks/ forums/ organizations both regionally and globally e.g. OHCEA • Devolution of public health and veterinary services • Institutional reorganizations Biosafety and Biosecurity • Existence of national reference laboratories, (NPHLs, CVL,) and other Research laboratories (CDC, KEMRI) that provides biosafety and biosecurity to suspected anthrax cases/samples • Biosafety and Biosecurity curriculum • Inadequate biosafety and biosecurity facilities at field level • Inadequate knowledge on biosecurity and biosafety issues of technical sta� and farmers • Lack of guidelines especially at low levels • Accreditation processes • Ability to use anthrax as a bioterrorist agent Anthrax Strategy 2021 Revised 8.indd 19 11/2/21 2:23 PM 18 Thematic Area Strength Weaknesses Opportunity Threat Resource mobilization (Financial) • Annual budgetary allocation for disease control including surveillance, outbreak response and coordination by line ministries and County departments • Allocated funds are inadequate • Lack of mechanisms for sharing resources across the line ministries • Lack of single basket fund for Zoonoses control including anthrax • Partnerships with development and bilateral partners • National and International attention on OH and Zoonosis • Increase in allocation for devolved functions including public health and veterinary services • Competition for resources with other priority zoonoses and re emerging diseases • Other competing political interests Mechanism for anthrax surveillance, prevention and control • Availability of high quality vaccine • KEVEVAPI- an institution with expertise for high quality anthrax vaccine production and marketing • Availability of trained surveillance o�cers to conduct surveillance, outbreak investigation and response • Epidemiology in service Trainings; Basic, Intermediate and Advanced levels • International and local legal frameworks that support anthrax prevention and control • Reporting channels such as (IDSR) for humans,ND1 forms and KLWSS/KABS for livestock and wildlife • Presence of functioning emergency operating center (EOC) in MoH • Availability of laboratory diagnostic capacity for anthrax (in animals) countrywide • Inadequate funding allocation to surveillance and prevention e�orts • Low vaccination coverage in livestock • Inadequate training of some field o�cers to properly handle anthrax outbreaks • Low level of awareness of the disease by livestock farmers leading disease spread and spill-over to humans • Underreporting of suspected anthrax cases in human and livestock due to the passive nature of the surveillance • Weak enforcement of legal frameworks that obligates farmers and field o�cers to report diseases • Lack of indemnity and compensation mechanisms • Unregulated livestock and animal products movement across the country • Lack of diagnostic capacity for human anthrax in some parts of the country • Late reporting of animals cases lead to missed diagnosis • Lack of specific anthrax prevention and control guideline • Absence of a disease emergency operations center in the MoALF • Subsidy of vaccine costs with increased demand • International (OIE, IHR 2005) and local requirements for reporting of diseases • The Big Four Agenda (2019-2022) that seeks to ensure food security • Presence of reference laboratories that can provide expertise and training in anthrax diagnostics, as well as quality assurance and proficiency testing • The ongoing projects to upgrade animals and human health laboratories at the national level • Establishment of county diagnostic laboratories in the veterinary department • Re-emergence of anthrax in areas perceived to be low risk • Social-cultural practices • Changing priority of diseases in di�erent counties Research and training development • Presence of research and training Institutions (Kenya Universities, KEMRI, CDC, ILRI, WSU, K-FELTP) • Presence of strong research regulatory bodies • Political will by the government by allocating funds to students for research • KFELTP and ISAVET trains epidemiologists on outbreak investigations and other disease control interventions • Inadequate research that can enhance anthrax control for example, data on the burden of anthrax in the country, economic benefits of anthrax control, anthrax vaccination coverage is lacking • Low documentation of outbreak events and few published papers on anthrax • Trainings programs are largely donor funded • Increased interest on anthrax as a potential bioterrorism threat results in increased funding • Collaborations with international reference laboratories, and national and international research institutions • Counties increased interest in EPI training • Changing research priorities • Bioterrorist use of anthrax spores • Sustainability of the donor funded training programs Anthrax Strategy 2021 Revised 8.indd 18 11/2/21 2:23 PM 19 Thematic Area Strength Weaknesses Opportunity Threat Advocacy, communication and social mobilization • Existence of elaborate administrative infrastructure down from farmer for the both ministry of Health and livestock that can support information sharing. • Good mobile network in most parts of the country • Communication channels and media across the country including vernacular platforms • High cost to relay messages across most communication channels • Lack of context specific messages • Lack of a communication strategy • Free spots are available in some media channels • Challenging social and cultural practices • Social media can put out alarming unauthorized information. Multi-sectoral collaboration • Zoonotic technical working group (ZTWG) which is multi-sectoral (MoH, MoALF, WHO, FAO, AU-IBAR, KEMRI, CDC, KWS and others and its chaired by director of veterinary services(DVS) or director general in the MoH • Establishment of county one health unit(COHU) • The revision of the One Health strategic plan for prevention and control of Zoonoses (2021-2025) • Infrequent meetings and over-delegation • Lack of anthrax specific technical working group/ Taskforce • Lack of formal mechanisms for information exchange between sectors • Increasing awareness of OH and the need to collaborate between sectors • Available OH networks/ forums/ organizations both regionally and globally e.g. OHCEA • Devolution of public health and veterinary services • Institutional reorganizations Biosafety and Biosecurity • Existence of national reference laboratories, (NPHLs, CVL,) and other Research laboratories (CDC, KEMRI) that provides biosafety and biosecurity to suspected anthrax cases/samples • Biosafety and Biosecurity curriculum • Inadequate biosafety and biosecurity facilities at field level • Inadequate knowledge on biosecurity and biosafety issues of technical sta� and farmers • Lack of guidelines especially at low levels • Accreditation processes • Ability to use anthrax as a bioterrorist agent Anthrax Strategy 2021 Revised 8.indd 19 11/2/21 2:23 PM 20 4.0 The Strategic Framework 4.1 Guiding Principles of the Strategy • Anthrax control requires a multi-sectoral and multi-disciplinary collaborative approach. • Prevention and control of Anthrax in animals e�ectively reduces negative impact on public health and the national economy. • Control of Anthrax involves breaking the cycle of infection which can only be achieved through early detection and notification of the disease and instituting proper control measures. • Community engagement is central in the prevention and control of Anthrax. 4.2 Goal To eliminate Anthrax in humans and reduce animal cases in Kenya through integrated interventions. 4.3 Main Objective To eliminate human Anthrax and reduce the incidence in animals to less than 1% of the 2020 baseline by 2036. 4.3.1 Specific Objectives 1. To enhance coordination, collaboration and partnership structures for Anthrax prevention and control 2. To strengthen prevention and control of Anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of Anthrax across the Country 5. To promote risk communication among stakeholders on Anthrax 6. To advocate for operational research and innovation on Anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy 4.4 Anthrax Prevention and Control Strategy Pillars This strategic plan will be deployed to prevent and control Anthrax in humans and animals in Kenya using a combination of the following pillars. 4.4.1 Coordination, Collaboration and Partnership Partnerships and multi-sectoral collaboration among national and county governments, NGOs, and the private sector will be required to implement the Anthrax prevention and control strategy successfully. The Inter-Governmental Relations Act number 2 of 2012 establishes a framework for consultation and co-operation between the national and county governments and among county governments; to establish mechanisms for resolving of inter-governmental disputes under Articles 6 and 189 of the Constitution and for connected purposes. Government agencies involved in Anthrax control include; Ministries (health, livestock, education, finance, interior and coordination of national government), regulatory bodies responsible for human and animal health, wildlife service and state law o�ce. Additional support will be required from regional and international partner organizations. All these are important in giving technical and financial support for the planning and implementation of the program. Chapter Four Anthrax Strategy 2021 Revised 8.indd 20 11/2/21 2:23 PM 21 A National Anthrax Prevention and Control Committee (NAPCC), with representation from the various sectors will be established to coordinate anthrax prevention and control strategy at the national level. In addition, similar coordination committees will be established; County Zoonotic Committee (CZC) at county level and Sub-County Zoonotic Committee (SCZC) at sub-county levels. 4.4.2 Surveillance, Reporting Systems and Outbreak Response Surveillance is a critical element in the prevention and control of Anthrax. E ective Anthrax surveillance will enhance early detection in animals before spilling over of disease to human. Surveillance generates data to monitor the progress or impact of the prevention and control e orts, essential for sustainable implementation. As control e orts progress towards Anthrax elimination in humans, surveillance becomes even more critical in ascertaining Anthrax elimination status. It will therefore be important to assess and enhance the existing surveillance systems. In addition, mechanisms for reporting and information sharing of anthrax surveillance data between the DVS and Director General (DG) and other relevant stakeholders will be strengthened. Community-based surveillance will be enhanced through community health volunteers (CHVs) and community disease reporters (CDRs). Capacity for field o�cers on sample collection and referral (packaging, transportation) will be strengthened. Coordinated joint outbreak preparedness and response plan using the one health approach will be developed. 4.5 Prevention and Control of Anthrax 4.5.1 Prevention and control of Anthrax in Animals Anthrax is primarily controlled through animal vaccination, prompt response to animal outbreaks and public health education. Anthrax control in animals hinges on; i. Immediate notification of suspected animal to a veterinary authority/registered practicing veterinary o�cer and restriction of animal movement. ii. Prompt sharing and verification of information between the veterinary and public health personnel that results in appropriate, timely prevention and control measures . iii. Enhance Anthrax vaccine availability (production, safety, quality, e�cacy and distribution) and coordinated mass vaccinations of animals in high risk areas. iv. Improving sanitary measures (carcass disposal, disinfection, avoid contact with infected livestock and livestock products) v. Community risk communication 4.5.2 Prevention and Control of Anthrax in Humans The prevention and control of Anthrax in humans depends on limited and appropriate human contact with infected animals and products. This will be achieved through: i. Enhanced safety regulations in handling suspected and confirmed Anthrax cases. ii. Prompt identification and treatment of infected people. iii. Antibiotic prophylaxis for exposed exposed individuals. iv. Enforcement of food safety regulations, e.g. meat inspection at abattoirs and re-inspection. v. Enhanced traceability of animals and animal products vi. Community education and awareness on Anthrax as a disease, prevention and control. NB: It is important to note that pre or post-exposure vaccination for the general public is not recommended in Kenya. The Anthrax vaccine is currently provided to high-risk populations such as members of the U.S. military and certain laboratory workers. 4.5.3 Anthrax Diagnostic Laboratory Capacity Laboratory capacity assessment includes identifying existing national, regional, and local laboratories performing Anthrax diagnostics. Various aspects of the laboratories such as the existing workforce, established diagnostic and logistic capacity, available equipment, facility infrastructure and waste management will be evaluated. The report will be used to determine need for appropriate training, facility improvements, and diagnostic algorithms to ensure the safety of all facility sta . Anthrax Strategy 2021 Revised 8.indd 21 11/2/21 2:23 PM 20 4.0 The Strategic Framework 4.1 Guiding Principles of the Strategy • Anthrax control requires a multi-sectoral and multi-disciplinary collaborative approach. • Prevention and control of Anthrax in animals e�ectively reduces negative impact on public health and the national economy. • Control of Anthrax involves breaking the cycle of infection which can only be achieved through early detection and notification of the disease and instituting proper control measures. • Community engagement is central in the prevention and control of Anthrax. 4.2 Goal To eliminate Anthrax in humans and reduce animal cases in Kenya through integrated interventions. 4.3 Main Objective To eliminate human Anthrax and reduce the incidence in animals to less than 1% of the 2020 baseline by 2036. 4.3.1 Specific Objectives 1. To enhance coordination, collaboration and partnership structures for Anthrax prevention and control 2. To strengthen prevention and control of Anthrax in animals and humans 3. To strengthen surveillance, reporting systems and outbreak response 4. To enhance laboratory diagnostic capacity of Anthrax across the Country 5. To promote risk communication among stakeholders on Anthrax 6. To advocate for operational research and innovation on Anthrax 7. To promote biosafety and biosecurity measures at all levels 8. To facilitate resource mobilization for the implementation of the strategy 4.4 Anthrax Prevention and Control Strategy Pillars This strategic plan will be deployed to prevent and control Anthrax in humans and animals in Kenya using a combination of the following pillars. 4.4.1 Coordination, Collaboration and Partnership Partnerships and multi-sectoral collaboration among national and county governments, NGOs, and the private sector will be required to implement the Anthrax prevention and control strategy successfully. The Inter-Governmental Relations Act number 2 of 2012 establishes a framework for consultation and co-operation between the national and county governments and among county governments; to establish mechanisms for resolving of inter-governmental disputes under Articles 6 and 189 of the Constitution and for connected purposes. Government agencies involved in Anthrax control include; Ministries (health, livestock, education, finance, interior and coordination of national government), regulatory bodies responsible for human and animal health, wildlife service and state law o�ce. Additional support will be required from regional and international partner organizations. All these are important in giving technical and financial support for the planning and implementation of the program. Chapter Four Anthrax Strategy 2021 Revised 8.indd 20 11/2/21 2:23 PM 21 A National Anthrax Prevention and Control Committee (NAPCC), with representation from the various sectors will be established to coordinate anthrax prevention and control strategy at the national level. In addition, similar coordination committees will be established; County Zoonotic Committee (CZC) at county level and Sub-County Zoonotic Committee (SCZC) at sub-county levels. 4.4.2 Surveillance, Reporting Systems and Outbreak Response Surveillance is a critical element in the prevention and control of Anthrax. E ective Anthrax surveillance will enhance early detection in animals before spilling over of disease to human. Surveillance generates data to monitor the progress or impact of the prevention and control e orts, essential for sustainable implementation. As control e orts progress towards Anthrax elimination in humans, surveillance becomes even more critical in ascertaining Anthrax elimination status. It will therefore be important to assess and enhance the existing surveillance systems. In addition, mechanisms for reporting and information sharing of anthrax surveillance data between the DVS and Director General (DG) and other relevant stakeholders will be strengthened. Community-based surveillance will be enhanced through community health volunteers (CHVs) and community disease reporters (CDRs). Capacity for field o�cers on sample collection and referral (packaging, transportation) will be strengthened. Coordinated joint outbreak preparedness and response plan using the one health approach will be developed. 4.5 Prevention and Control of Anthrax 4.5.1 Prevention and control of Anthrax in Animals Anthrax is primarily controlled through animal vaccination, prompt response to animal outbreaks and public health education. Anthrax control in animals hinges on; i. Immediate notification of suspected animal to a veterinary authority/registered practicing veterinary o�cer and restriction of animal movement. ii. Prompt sharing and verification of information between the veterinary and public health personnel that results in appropriate, timely prevention and control measures . iii. Enhance Anthrax vaccine availability (production, safety, quality, e�cacy and distribution) and coordinated mass vaccinations of animals in high risk areas. iv. Improving sanitary measures (carcass disposal, disinfection, avoid contact with infected livestock and livestock products) v. Community risk communication 4.5.2 Prevention and Control of Anthrax in Humans The prevention and control of Anthrax in humans depends on limited and appropriate human contact with infected animals and products. This will be achieved through: i. Enhanced safety regulations in handling suspected and confirmed Anthrax cases. ii. Prompt identification and treatment of infected people. iii. Antibiotic prophylaxis for exposed exposed individuals. iv. Enforcement of food safety regulations, e.g. meat inspection at abattoirs and re-inspection. v. Enhanced traceability of animals and animal products vi. Community education and awareness on Anthrax as a disease, prevention and control. NB: It is important to note that pre or post-exposure vaccination for the general public is not recommended in Kenya. The Anthrax vaccine is currently provided to high-risk populations such as members of the U.S. military and certain laboratory workers. 4.5.3 Anthrax Diagnostic Laboratory Capacity Laboratory capacity assessment includes identifying existing national, regional, and local laboratories performing Anthrax diagnostics. Various aspects of the laboratories such as the existing workforce, established diagnostic and logistic capacity, available equipment, facility infrastructure and waste management will be evaluated. The report will be used to determine need for appropriate training, facility improvements, and diagnostic algorithms to ensure the safety of all facility sta . Anthrax Strategy 2021 Revised 8.indd 21 11/2/21 2:23 PM 22 This will be achieved through: • Mapping and needs assessment of laboratories for both human and animal health • Strengthening national, regional and county laboratory capacity for Anthrax confirmatory diagnosis • Establishing/enhancing inter-sectoral, inter-laboratory networking (public and animal health) • Maintaining anthrax biosafety and biosecurity measures 4.5.4 Conduct and Promote Operational and Applied Research Operational research will be used to gather evidence to support the implementation of the strategy, document best practices and guide optimal solutions to implementation challenges. The output will ensure the best use of available resources and provide evidence on what is achievable. Priority research areas include; • Assess the Anthrax disease burden in animals and humans. • Determine the socio-economic impact of the disease • Develop and update Anthrax risk map. • Vaccination coverage and vaccine e�ectiveness studies. • Evaluate trends in Anthrax incidence in humans and animals. • Evaluation of Anthrax elimination interventions. • Ethno-veterinary practices in regards to Anthrax management. 4.5.5 Risk Communication Raising awareness on Anthrax prevention and control is essential in preventing exposures in humans. Enhanced awareness also improves anthrax control e�orts in animals by increasing reporting of potential animal cases and improving sanitary measures. A risk communication plan will be developed to implement this prevention and control strategy within which target audience(s), media and channels for distribution of messages will be identified. The objective of the communication plan will be: • To raise public awareness on the risk of Anthrax for communities. • To empower the community through behavioral change and communication. • To mobilize resources to support the Anthrax elimination program. • To improve the knowledge and skill of health and veterinary professionals 4.5.6 Biosafety and Biosecurity Good biosafety, laboratory biosecurity and biocontainment practices are fundamental to public health. Minimization of biosafety and biosecurity breaches (in field, laboratory, and clinic/hospital) should therefore be at the core of the operation of containment although such environments cannot be entirely free of risks. In the context of biological weapons threats (bioterrorism), biosecurity is the e�ective implementation measure that aims to prevent terrorists, criminals and spies from gaining access to dangerous pathogens and toxins. Related measures limit access to equipment, technologies and information that could be used for malicious purposes involving biological weapons. This will be mainly done by: • Capacity building. • Situational analysis to identify the critical control points. • Development of quality improvement plans. • Linkage with other stakeholders e.g. security agencies. 4.5.7 Resource Mobilization Implementation of the Anthrax prevention and control strategy requires resources including human resources, infrastructure and finances. A needs assessment will be important to identify areas of spending such as procurement of diagnostics and treatment supplies, capacity building, vaccines, and vaccine logistics, operational research, surveillance, monitoring and evaluation. A funding plan will be developed to ensure that resource needs are identified for every phase. Funds will be sourced from the line government ministries; Ministry of Agriculture, Livestock, Fisheries and cooperatives, Ministry of Health, the County Governments, research institutions as well as local and international partners. Anthrax Strategy 2021 Revised 8.indd 22 11/2/21 2:23 PM 23 5.1 Implementation of the Anthrax Elimination Strategy, 2021-2036 The implementation of the strategy will follow four phases (1- 4) with progressive reduction of the disease in animals towards elimination in humans. Each phase has a set of activities that will be synchronized to ensure synergy and leverage. The implementation phases for the Anthrax strategy is summarized in Figure 7 below: • Phase 1: Development and adoption of strategy and preparation for implementation: 2021-2023 • Phase 2: Prioritized implementation of Anthrax prevention and control strategy in high-risk zones: 2024-2027 • Phase 3: Full-scale implementation of Anthrax prevention and control strategy: 2028-2032 • Phase 4: Elimination of Anthrax in Humans: 2033-2036 Kenya is currently (2021) in phase 1 and a set of targets must be achieved for the country to move from one phase to the next. Figure 7: Implementation of the Anthrax elimination strategy, 2021-2036 Chapter Five Anthrax Strategy 2021 Revised 8.indd 23 11/2/21 2:23 PM 22 This will be achieved through: • Mapping and needs assessment of laboratories for both human and animal health • Strengthening national, regional and county laboratory capacity for Anthrax confirmatory diagnosis • Establishing/enhancing inter-sectoral, inter-laboratory networking (public and animal health) • Maintaining anthrax biosafety and biosecurity measures 4.5.4 Conduct and Promote Operational and Applied Research Operational research will be used to gather evidence to support the implementation of the strategy, document best practices and guide optimal solutions to implementation challenges. The output will ensure the best use of available resources and provide evidence on what is achievable. Priority research areas include; • Assess the Anthrax disease burden in animals and humans. • Determine the socio-economic impact of the disease • Develop and update Anthrax risk map. • Vaccination coverage and vaccine e�ectiveness studies. • Evaluate trends in Anthrax incidence in humans and animals. • Evaluation of Anthrax elimination interventions. • Ethno-veterinary practices in regards to Anthrax management. 4.5.5 Risk Communication Raising awareness on Anthrax prevention and control is essential in preventing exposures in humans. Enhanced awareness also improves anthrax control e�orts in animals by increasing reporting of potential animal cases and improving sanitary measures. A risk communication plan will be developed to implement this prevention and control strategy within which target audience(s), media and channels for distribution of messages will be identified. The objective of the communication plan will be: • To raise public awareness on the risk of Anthrax for communities. • To empower the community through behavioral change and communication. • To mobilize resources to support the Anthrax elimination program. • To improve the knowledge and skill of health and veterinary professionals 4.5.6 Biosafety and Biosecurity Good biosafety, laboratory biosecurity and biocontainment practices are fundamental to public health. Minimization of biosafety and biosecurity breaches (in field, laboratory, and clinic/hospital) should therefore be at the core of the operation of containment although such environments cannot be entirely free of risks. In the context of biological weapons threats (bioterrorism), biosecurity is the e�ective implementation measure that aims to prevent terrorists, criminals and spies from gaining access to dangerous pathogens and toxins. Related measures limit access to equipment, technologies and information that could be used for malicious purposes involving biological weapons. This will be mainly done by: • Capacity building. • Situational analysis to identify the critical control points. • Development of quality improvement plans. • Linkage with other stakeholders e.g. security agencies. 4.5.7 Resource Mobilization Implementation of the Anthrax prevention and control strategy requires resources including human resources, infrastructure and finances. A needs assessment will be important to identify areas of spending such as procurement of diagnostics and treatment supplies, capacity building, vaccines, and vaccine logistics, operational research, surveillance, monitoring and evaluation. A funding plan will be developed to ensure that resource needs are identified for every phase. Funds will be sourced from the line government ministries; Ministry of Agriculture, Livestock, Fisheries and cooperatives, Ministry of Health, the County Governments, research institutions as well as local and international partners. Anthrax Strategy 2021 Revised 8.indd 22 11/2/21 2:23 PM 23 5.1 Implementation of the Anthrax Elimination Strategy, 2021-2036 The implementation of the strategy will follow four phases (1- 4) with progressive reduction of the disease in animals towards elimination in humans. Each phase has a set of activities that will be synchronized to ensure synergy and leverage. The implementation phases for the Anthrax strategy is summarized in Figure 7 below: • Phase 1: Development and adoption of strategy and preparation for implementation: 2021-2023 • Phase 2: Prioritized implementation of Anthrax prevention and control strategy in high-risk zones: 2024-2027 • Phase 3: Full-scale implementation of Anthrax prevention and control strategy: 2028-2032 • Phase 4: Elimination of Anthrax in Humans: 2033-2036 Kenya is currently (2021) in phase 1 and a set of targets must be achieved for the country to move from one phase to the next. Figure 7: Implementation of the Anthrax elimination strategy, 2021-2036 Chapter Five Anthrax Strategy 2021 Revised 8.indd 23 11/2/21 2:23 PM 24 5.1.1 Phase 1: Preparatory and Adoption Phase 2021-2023 1. Development of guidelines and standard operating procedures (SOPs) to operationalize the strategy To support implementation of the strategy, several guidelines will be developed to standardize the implementation of activities across the country. These are: i. Guidelines for Anthrax human case management. ii. Guideline on Anthrax outbreak investigation. iii. Guidelines on Anthrax surveillance and information sharing between animal and human health sectors. iv. Guidelines for safe transportation, handling and disposal of carcasses. v. Guidelines for anthrax vaccination and treatment in animals. vi. Guidelines for decontamination, disinfection and waste disposal. vii. Guidelines for infection prevention and control. viii. Guidelines for sample management and Anthrax laboratory diagnosis ix. Communication guidelines. 2. Establishment of National Anthrax Prevention and Control Committee (NAPCC) To coordinate the implementation of the strategy, a National inter-sectoral taskforce will be established, with representation drawn from various organizations including but not limited to : i. Ministry of Health ii. Ministry of Agriculture, Livestock, Fisheries iii. Kenya Wildlife Service iv. Ministry of Interior and coordination of National government v. Ministry of Defense vi. Council of Governors and Chairs of County Executive Committee (CECs) members in charge of human and animal health vii. Ministry of Devolution and Planning viii. Research /Training Institutions/ Non-governmental organization involved in Anthrax prevention and control ix. Representation from International and Regional organizations e.g. FAO, WHO, OIE, CDC, ACDC, AU-IBAR x. Human and animal health professional and regulatory bodies xi. Private practitioners in animal health and medical diagnostic laboratories As illustrated in (Figure 8), the NAPCC will be a technical sub-committee of the Zoonotic Technical Working Group (ZTWG) and ZDU will be the secretariat. Roles of the NAPCC are : i. Overall responsibility for implementing the Anthrax prevention and control strategy ii. Provide technical guidance to county coordination structures iii. Resource mobilization iv. Provide periodic updates the public v. Monitoring and evaluation vi. Provide technical advice to ZTWG and periodic updates to the public and stakeholders vii. Propose changes and amendments of regulation and laws on Anthrax viii. Inter-county and international cross border engagements 3. Establishment of County Zoonotic Committee (CZC) The CZC will be formed at the county level to coordinate activities for the Anthrax prevention and control strategy. The County One Health Unit will act as secretariat to the CZC and the CZC will comprise of the following: i. County Executive Committee Member for Health ii. County Executive Committee Member for Agriculture Livestock and Fisheries iii. County Director for Health iv. County Director for Veterinary Services v. County Commissioner Anthrax Strategy 2021 Revised 8.indd 24 11/2/21 2:23 PM 25 vi. County administrator vii. County Wildlife Warden or equivalent o�cer at that level viii. County Director of Environment ix. Non-governmental organization(NGOs), Community based organizations (CBOs) and faith-based organizations (FBOs), training and research institutions x. Representatives from professional and paraprofessional bodies xi. Community representative Roles of the CZC • Coordinate Anthrax activities at the county level • Update NAPCC on anthrax activities • Advocacy and resource mobilization • Oversee activities at sub-counties Figure 8: Schematic diagram showing coordination structure of the Anthrax prevention and control strategy. 4. Formation of Sub County Zoonotic Committee (SCZC) The SCZC shall be formed at the sub-county level and will be co-chaired by the respective Sub-County Medical and Veterinary o�cers. The member of the SCZC will include; i. Sub-county Medical O�cer ii. Sub-county Veterinary o�cer iii. Deputy county commissioner iv. Sub-county administrator v. Community representatives vi. NGOs, FBOs and CBOs representatives Anthrax Strategy 2021 Revised 8.indd 25 11/2/21 2:23 PM 24 5.1.1 Phase 1: Preparatory and Adoption Phase 2021-2023 1. Development of guidelines and standard operating procedures (SOPs) to operationalize the strategy To support implementation of the strategy, several guidelines will be developed to standardize the implementation of activities across the country. These are: i. Guidelines for Anthrax human case management. ii. Guideline on Anthrax outbreak investigation. iii. Guidelines on Anthrax surveillance and information sharing between animal and human health sectors. iv. Guidelines for safe transportation, handling and disposal of carcasses. v. Guidelines for anthrax vaccination and treatment in animals. vi. Guidelines for decontamination, disinfection and waste disposal. vii. Guidelines for infection prevention and control. viii. Guidelines for sample management and Anthrax laboratory diagnosis ix. Communication guidelines. 2. Establishment of National Anthrax Prevention and Control Committee (NAPCC) To coordinate the implementation of the strategy, a National inter-sectoral taskforce will be established, with representation drawn from various organizations including but not limited to : i. Ministry of Health ii. Ministry of Agriculture, Livestock, Fisheries iii. Kenya Wildlife Service iv. Ministry of Interior and coordination of National government v. Ministry of Defense vi. Council of Governors and Chairs of County Executive Committee (CECs) members in charge of human and animal health vii. Ministry of Devolution and Planning viii. Research /Training Institutions/ Non-governmental organization involved in Anthrax prevention and control ix. Representation from International and Regional organizations e.g. FAO, WHO, OIE, CDC, ACDC, AU-IBAR x. Human and animal health professional and regulatory bodies xi. Private practitioners in animal health and medical diagnostic laboratories As illustrated in (Figure 8), the NAPCC will be a technical sub-committee of the Zoonotic Technical Working Group (ZTWG) and ZDU will be the secretariat. Roles of the NAPCC are : i. Overall responsibility for implementing the Anthrax prevention and control strategy ii. Provide technical guidance to county coordination structures iii. Resource mobilization iv. Provide periodic updates the public v. Monitoring and evaluation vi. Provide technical advice to ZTWG and periodic updates to the public and stakeholders vii. Propose changes and amendments of regulation and laws on Anthrax viii. Inter-county and international cross border engagements 3. Establishment of County Zoonotic Committee (CZC) The CZC will be formed at the county level to coordinate activities for the Anthrax prevention and control strategy. The County One Health Unit will act as secretariat to the CZC and the CZC will comprise of the following: i. County Executive Committee Member for Health ii. County Executive Committee Member for Agriculture Livestock and Fisheries iii. County Director for Health iv. County Director for Veterinary Services v. County Commissioner Anthrax Strategy 2021 Revised 8.indd 24 11/2/21 2:23 PM 25 vi. County administrator vii. County Wildlife Warden or equivalent o�cer at that level viii. County Director of Environment ix. Non-governmental organization(NGOs), Community based organizations (CBOs) and faith-based organizations (FBOs), training and research institutions x. Representatives from professional and paraprofessional bodies xi. Community representative Roles of the CZC • Coordinate Anthrax activities at the county level • Update NAPCC on anthrax activities • Advocacy and resource mobilization • Oversee activities at sub-counties Figure 8: Schematic diagram showing coordination structure of the Anthrax prevention and control strategy. 4. Formation of Sub County Zoonotic Committee (SCZC) The SCZC shall be formed at the sub-county level and will be co-chaired by the respective Sub-County Medical and Veterinary o�cers. The member of the SCZC will include; i. Sub-county Medical O�cer ii. Sub-county Veterinary o�cer iii. Deputy county commissioner iv. Sub-county administrator v. Community representatives vi. NGOs, FBOs and CBOs representatives Anthrax Strategy 2021 Revised 8.indd 25 11/2/21 2:23 PM 26 Roles of the SCZC • Implement anthrax prevention and control activities at the sub county level • Promote public awareness • Resource mobilization • Regular updates to CZC 5. Identification of High Risk and Low Risk Zones While Anthrax is endemic in Kenya, the disease is reported more often in certain areas than others. High-risk zones will be counties that have reported Anthrax outbreaks in both human and animals in the last five years (2014 to 2019). These will be identified through review of outbreak reports and risk mapping data. Within the high-risk zones, anthrax hotspots will be demarcated between one to 50km from an outbreak site depending on production systems. Any County with no reported Anthrax outbreak in the last 5 years will be considered to be Low-Risk. Any new outbreak in a low-risk County will move the county from low to high risk. Initial implementation activities including sustained vaccinations and enhanced surveillance will be done in the high-risk zones to demonstrate success and proof of concept. Currently, available data from DVS shows that, Narok, Kiambu, Nyeri, Meru, Nakuru and Murang’a are the leading Counties in anthrax anthrax outbreaks over 60 years. Di�erent counties have reported varying numbers of anthrax outbreaks over time as shown in (Figure 9). This will be used as the tentative risk map in the piloting phase as we await the ‘real’ risk map to be developed. Figure 9: Spatial distribution of livestock anthrax outbreaks by counties in Kenya, 1957 to 2017 (Nderitu et al., 2021) A new outbreak in a low-risk county will be considered as a hot spot, and measures will be taken accordingly. The main activities undertaken in the high-risk zones will be sustained livestock vaccinations and enhanced surveillance. Successful implementation of these activities will demonstrate proof of concept that can be applied countrywide. Anthrax Strategy 2021 Revised 8.indd 26 11/2/21 2:23 PM 27 6. Strengthen Surveillance Existing surveillance systems in MOH (IDSR), and MALF (KLWSS/KABS and laboratory surveillance) and rapid response will be enhanced to collect timely, accurate data on Anthrax in the country. Surveillance data to be collected will include; i. Anthrax cases in humans and animals ii. Livestock and wildlife vaccination figures iii. Establishing a national Anthrax database based on surveillance data iv. Improve capacity for human and animal health workers on case identification, notification, data management and outbreak investigation and response v. Improve the capacity of veterinary and human laboratories for Anthrax diagnosis 7. Prevention and Control Measures The prevention and control of animal anthrax will aim at reducing the economic e�ect associated with livestock loss, extinction of endangered wildlife species, environmental contamination and spill over to the human. Activities will include; i. Developing a vaccination plan ii. Enhance capacity for KEVEVAPI and other vaccine/drug producers/suppliers to provide high quality and a�ordable vaccines iii. Developing training modules for animal health care workers on diagnosis, treatment, vaccination, proper disposal of carcasses, decontamination and disinfection of materials iv. Developing training modules for human health workers on appropriate diagnosis & management of a�ected persons, infection prevention and control. v. Sensitizing communities to adopt and embrace practices that promote Anthrax prevention and control 8. Information, Education and Communication A communication plan will be developed to ensure responsible, accurate and informative reporting that promotes awareness and prevention of Anthrax in Kenya. Key components of the plan will include; • Identification of audience • Develop messages on awareness and risk reduction • Public awareness campaigns • Identify appropriate modes of communication • Targeted communication for each stage of an Anthrax outbreak Following the development of the communication plan, appropriate messages will be disseminated to relevant sectors 9. Promote and Co-ordinate Research To support the implementation of the strategy, research of the following key components will be promoted; i. Development of national Anthrax risk map ii. Assessment of the economic impact of Anthrax iii. Vaccine coverage studies iv. Vaccine quality studies-vaccine validation, safety and e�cacy v. E�ectiveness of vaccine delivery models vi. Knowledge, attitude and practice (KAP surveys) vii. Characterization of B. anthracis NB; The government will be required to fund the research Anthrax Strategy 2021 Revised 8.indd 27 11/2/21 2:23 PM 26 Roles of the SCZC • Implement anthrax prevention and control activities at the sub county level • Promote public awareness • Resource mobilization • Regular updates to CZC 5. Identification of High Risk and Low Risk Zones While Anthrax is endemic in Kenya, the disease is reported more often in certain areas than others. High-risk zones will be counties that have reported Anthrax outbreaks in both human and animals in the last five years (2014 to 2019). These will be identified through review of outbreak reports and risk mapping data. Within the high-risk zones, anthrax hotspots will be demarcated between one to 50km from an outbreak site depending on production systems. Any County with no reported Anthrax outbreak in the last 5 years will be considered to be Low-Risk. Any new outbreak in a low-risk County will move the county from low to high risk. Initial implementation activities including sustained vaccinations and enhanced surveillance will be done in the high-risk zones to demonstrate success and proof of concept. Currently, available data from DVS shows that, Narok, Kiambu, Nyeri, Meru, Nakuru and Murang’a are the leading Counties in anthrax anthrax outbreaks over 60 years. Di�erent counties have reported varying numbers of anthrax outbreaks over time as shown in (Figure 9). This will be used as the tentative risk map in the piloting phase as we await the ‘real’ risk map to be developed. Figure 9: Spatial distribution of livestock anthrax outbreaks by counties in Kenya, 1957 to 2017 (Nderitu et al., 2021) A new outbreak in a low-risk county will be considered as a hot spot, and measures will be taken accordingly. The main activities undertaken in the high-risk zones will be sustained livestock vaccinations and enhanced surveillance. Successful implementation of these activities will demonstrate proof of concept that can be applied countrywide. Anthrax Strategy 2021 Revised 8.indd 26 11/2/21 2:23 PM 27 6. Strengthen Surveillance Existing surveillance systems in MOH (IDSR), and MALF (KLWSS/KABS and laboratory surveillance) and rapid response will be enhanced to collect timely, accurate data on Anthrax in the country. Surveillance data to be collected will include; i. Anthrax cases in humans and animals ii. Livestock and wildlife vaccination figures iii. Establishing a national Anthrax database based on surveillance data iv. Improve capacity for human and animal health workers on case identification, notification, data management and outbreak investigation and response v. Improve the capacity of veterinary and human laboratories for Anthrax diagnosis 7. Prevention and Control Measures The prevention and control of animal anthrax will aim at reducing the economic e�ect associated with livestock loss, extinction of endangered wildlife species, environmental contamination and spill over to the human. Activities will include; i. Developing a vaccination plan ii. Enhance capacity for KEVEVAPI and other vaccine/drug producers/suppliers to provide high quality and a�ordable vaccines iii. Developing training modules for animal health care workers on diagnosis, treatment, vaccination, proper disposal of carcasses, decontamination and disinfection of materials iv. Developing training modules for human health workers on appropriate diagnosis & management of a�ected persons, infection prevention and control. v. Sensitizing communities to adopt and embrace practices that promote Anthrax prevention and control 8. Information, Education and Communication A communication plan will be developed to ensure responsible, accurate and informative reporting that promotes awareness and prevention of Anthrax in Kenya. Key components of the plan will include; • Identification of audience • Develop messages on awareness and risk reduction • Public awareness campaigns • Identify appropriate modes of communication • Targeted communication for each stage of an Anthrax outbreak Following the development of the communication plan, appropriate messages will be disseminated to relevant sectors 9. Promote and Co-ordinate Research To support the implementation of the strategy, research of the following key components will be promoted; i. Development of national Anthrax risk map ii. Assessment of the economic impact of Anthrax iii. Vaccine coverage studies iv. Vaccine quality studies-vaccine validation, safety and e�cacy v. E�ectiveness of vaccine delivery models vi. Knowledge, attitude and practice (KAP surveys) vii. Characterization of B. anthracis NB; The government will be required to fund the research Anthrax Strategy 2021 Revised 8.indd 27 11/2/21 2:23 PM 28 10. Resource Mapping and Resource Mobilization Resource mobilization is fundamental and central component of Anthrax prevention and control. Once resource mapping is done and the focus of work is set, resources are required to ensure successful implementation. This will involve; i. Developing a resource mobilization and resource mapping plan ii. Holding advocacy meetings with decision makers at the National and County levels Key indicators for success in Phase 1: • Resource map • Adoption and operationalization of the Anthrax Prevention and Control Committees • Existence of guidelines to support the implementation of the strategy • National Anthrax committee and County zoonotic committee in high-risk zones • Vaccination plan • National database of Anthrax outbreaks in animals and humans • Communication plan • Anthrax risk map 5.1.2 Phase 2: Prioritized Implementation in High-Risk Zones, 2024-2027 This stage focuses on implementation of the prevention and control of anthrax in high risk zones. Activities for this stage will include; • Advocacy, communication and social mobilization • Collective training of human and animal health personnel and other relevant personnel on case identification and notification, diagnosis, biosafety and biosecurity, prevention and control measures and community mobilization • Collating Anthrax outbreak data and feeding to national anthrax database • Procurement and distribution of livestock vaccines, drugs and laboratory commodities • Consecutive annual vaccination of livestock in high-risk zones, with vaccination coverage of at least 80%.to reduce outbreaks in humans and wildlife-based on the guideline • Conducting impact assessments and economic cost analysis of the interventions • Outbreak investigations and response in areas within and outside high-risk zones • Enhancing existing anthrax surveillance system in the high-risk areas. • Operational research and post-vaccination sero-surveillance • Cross border engagements to reduce the risk of re-introduction of disease in the implementation areas • Pre-positioning of vaccines, drugs and other consumables at national and subnational levels. • Inter-county and international cross border engagement Indicators to move from phase 2 to 3: • Three- year consecutive vaccination of livestock in the high-risk zones with at least 80% vaccination coverage. After three years, vaccination will be targeted based on the epidemiological unit. • Eighty percent (80%) of all anthrax cases reported are laboratory investigated • Reduction of Anthrax human cases by 50% of the baseline • Reduction of Anthrax incidences in livestock by 50% of the baseline • Reduction of Anthrax cases at human-livestock-wildlife interface by 50% of the baseline 5.1.3 Phase 3: Implementation of Anthrax Prevention and Control Strategy in High and Low-Risk Areas, 2028-2032 This stage will involve full implementation of the strategy countrywide. Activities in this stage will focus on sustaining the achievements of stage two and expanding the lessons learnt to the other low risk zones. This will include; i. Heightened anthrax surveillance in the entire country ii. Sustaining livestock vaccinations iii. Evaluation of the e�ectiveness of programs/ interventions iv. Review and update of the national anthrax risk map Anthrax Strategy 2021 Revised 8.indd 28 11/2/21 2:23 PM 29 v. Research on economic impact and cost analysis benefit vi. Advocacy, communication and social mobilization will continue in this phase vii. Inter-county, regional and International cross border engagements viii. Sustained and adequate vaccine stocks and resources for emergency response for containment of new outbreaks if they occur Key indicators of success in phase 3: a) Reduction of Anthrax cases in humans by 80% of baseline country wide b) Reduction of Anthrax incidences in livestock by 80% of baseline country wide c) Reduction of Anthrax cases at human-livestock-wildlife interface by 80% d) Comprehensive vaccination coverage of 80% of the susceptible animals 5.1.4 Phase 4: Elimination of Anthrax in Humans, 2033-2036 In this stage, Anthrax elimination in humans is defined by: • Zero human Anthrax cases in two years • Reduction of animal Anthrax outbreaks by 90% of the baseline. • Areas that do not report Anthrax outbreaks (in humans, livestock or wildlife) for two consecutive years are declared as achieved Anthrax elimination. • Activities in stages 2 and 3 will be sustained in areas still reporting Anthrax cases. • In areas declared free of Anthrax, surveillance will be sustained to detect new cases through zero reporting Anthrax Strategy 2021 Revised 8.indd 29 11/2/21 2:23 PM 28 10. Resource Mapping and Resource Mobilization Resource mobilization is fundamental and central component of Anthrax prevention and control. Once resource mapping is done and the focus of work is set, resources are required to ensure successful implementation. This will involve; i. Developing a resource mobilization and resource mapping plan ii. Holding advocacy meetings with decision makers at the National and County levels Key indicators for success in Phase 1: • Resource map • Adoption and operationalization of the Anthrax Prevention and Control Committees • Existence of guidelines to support the implementation of the strategy • National Anthrax committee and County zoonotic committee in high-risk zones • Vaccination plan • National database of Anthrax outbreaks in animals and humans • Communication plan • Anthrax risk map 5.1.2 Phase 2: Prioritized Implementation in High-Risk Zones, 2024-2027 This stage focuses on implementation of the prevention and control of anthrax in high risk zones. Activities for this stage will include; • Advocacy, communication and social mobilization • Collective training of human and animal health personnel and other relevant personnel on case identification and notification, diagnosis, biosafety and biosecurity, prevention and control measures and community mobilization • Collating Anthrax outbreak data and feeding to national anthrax database • Procurement and distribution of livestock vaccines, drugs and laboratory commodities • Consecutive annual vaccination of livestock in high-risk zones, with vaccination coverage of at least 80%.to reduce outbreaks in humans and wildlife-based on the guideline • Conducting impact assessments and economic cost analysis of the interventions • Outbreak investigations and response in areas within and outside high-risk zones • Enhancing existing anthrax surveillance system in the high-risk areas. • Operational research and post-vaccination sero-surveillance • Cross border engagements to reduce the risk of re-introduction of disease in the implementation areas • Pre-positioning of vaccines, drugs and other consumables at national and subnational levels. • Inter-county and international cross border engagement Indicators to move from phase 2 to 3: • Three- year consecutive vaccination of livestock in the high-risk zones with at least 80% vaccination coverage. After three years, vaccination will be targeted based on the epidemiological unit. • Eighty percent (80%) of all anthrax cases reported are laboratory investigated • Reduction of Anthrax human cases by 50% of the baseline • Reduction of Anthrax incidences in livestock by 50% of the baseline • Reduction of Anthrax cases at human-livestock-wildlife interface by 50% of the baseline 5.1.3 Phase 3: Implementation of Anthrax Prevention and Control Strategy in High and Low-Risk Areas, 2028-2032 This stage will involve full implementation of the strategy countrywide. Activities in this stage will focus on sustaining the achievements of stage two and expanding the lessons learnt to the other low risk zones. This will include; i. Heightened anthrax surveillance in the entire country ii. Sustaining livestock vaccinations iii. Evaluation of the e�ectiveness of programs/ interventions iv. Review and update of the national anthrax risk map Anthrax Strategy 2021 Revised 8.indd 28 11/2/21 2:23 PM 29 v. Research on economic impact and cost analysis benefit vi. Advocacy, communication and social mobilization will continue in this phase vii. Inter-county, regional and International cross border engagements viii. Sustained and adequate vaccine stocks and resources for emergency response for containment of new outbreaks if they occur Key indicators of success in phase 3: a) Reduction of Anthrax cases in humans by 80% of baseline country wide b) Reduction of Anthrax incidences in livestock by 80% of baseline country wide c) Reduction of Anthrax cases at human-livestock-wildlife interface by 80% d) Comprehensive vaccination coverage of 80% of the susceptible animals 5.1.4 Phase 4: Elimination of Anthrax in Humans, 2033-2036 In this stage, Anthrax elimination in humans is defined by: • Zero human Anthrax cases in two years • Reduction of animal Anthrax outbreaks by 90% of the baseline. • Areas that do not report Anthrax outbreaks (in humans, livestock or wildlife) for two consecutive years are declared as achieved Anthrax elimination. • Activities in stages 2 and 3 will be sustained in areas still reporting Anthrax cases. • In areas declared free of Anthrax, surveillance will be sustained to detect new cases through zero reporting Anthrax Strategy 2021 Revised 8.indd 29 11/2/21 2:23 PM 30 6.1 Monitoring and Evaluation Routine monitoring, periodic assessment and evaluation will be done under the program at all levels to ensure implementation as per the strategy. Zoonotic Disease Unit and other stakeholders will develop a set of objectively verifiable indicators to measure progress and assess the achievement of the program in line with the strategy. In addition, an external independent evaluation will be done to assess the progress and indicate a necessary modification in program implementation strategies. The NAPCC will conduct quarterly performance monitoring meetings to review the progress of implementation against targets in the annual work plan, address implementation bottlenecks and refocus as necessary. Bi-annual stakeholder performance monitoring and review meetings at county and national levels will review performance against targets, address any constraints to implementation and refocus activities if needed. Data audit: The national committee will conduct annual data quality audits and make o�cial routine anthrax surveillance data available. Annual review meeting: As part of the commitment to performance monitoring, all stakeholders will meet annually to review achievements against targets and milestones in the strategic and annual work plans. These meetings will also define and finalize priorities for the following year. Table 5: Anthrax Prevention and control Workplan Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 1.Enhanced Coordination, collaboration and partnership 1.Strengthening capacity for coordination of the anthrax control and prevention plan Development and adoption of the anthrax control and prevention plan Anthrax control and prevention plan MOH/MoALF/ Counties and other partners Identification of high risk and low Risk Zones Anthrax Risk map developed ZDU, Research & academic institutions Updating anthrax risk map Risk map updated ZDU, Research & academic institution, Development of anthrax control guidelines Number of signed guidelines MOH/MoALF/ Counties and other partners Establish and endorse National Anthrax committee and operationalize Committee in place MOH/MoALF/ Counties and other partners Establish and operationalization of zoonotic committees at county and sub county levels Documented and functioning committees ZDU, Counties and other stakeholders Chapter Six Anthrax Strategy 2021 Revised 8.indd 30 11/2/21 2:23 PM 31 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 1.Enhanced Coordination, collaboration and partnership 1.Strengthening capacity for coordination of the anthrax control and prevention plan Conduct regional Inter-county ,regional and International cross border engagements meetings Number of meetings documented NAPCC Conduct quarterly technical meetings Number of meetings documented NAPCC Identify stakeholders and focal persons to Spearhead implementation of the anthrax strategy List of stakeholders, Focal persons ZDU Develop policy advocacy plan to obtain buy-in from stakeholders Policy Advocacy plan ZDU and other stakeholders Develop anthrax legal framework in line with existing laws, strategy, policies and regulation Legal frame work MoH/MoALF Develop a budget for the implementation of the strategic plan and secure potential source of funding Developed budget ZDU and other stakeholders Develop monitoring and evaluation plan Monitoring and evaluation plan ZDU Conduct monitoring and supervision activities Number of monitoring and evaluation reports. Number of supervision reports NAPCC / CZC Conduct annual review meeting Number of meetings NAPCC / CZC 2.Surveillance, reporting systems and outbreak response To assess and enhance the existing surveillance system Evaluate the existing surveillance system and key indicators for anthrax reporting Evaluation report FELTP Collating anthrax outbreak data and feeding to anthrax database Updated Anthrax data base ZDU / NAPCC Conduct OH participatory epidemiology study. Cross-sectional study – to develop a community based case definition. lay Case definition in place ZDU/CZC Provide trainings to build surveillance capacity among animal and public health surveillance o�cers Number of trainings conducted Number of o�cers trained ZDU Procure data collection and reporting tools/ equipment Number of hard and soft data collection equipment MOH/ MoALF and development partners Develop anthrax surveillance guidelines Developed guidelines ZDU Review and strengthen standard anthrax reporting format and channels Defined Report formats and formal channels ZDU, Technical partners e.g. OIE/WHO Anthrax Strategy 2021 Revised 8.indd 31 11/2/21 2:23 PM 30 6.1 Monitoring and Evaluation Routine monitoring, periodic assessment and evaluation will be done under the program at all levels to ensure implementation as per the strategy. Zoonotic Disease Unit and other stakeholders will develop a set of objectively verifiable indicators to measure progress and assess the achievement of the program in line with the strategy. In addition, an external independent evaluation will be done to assess the progress and indicate a necessary modification in program implementation strategies. The NAPCC will conduct quarterly performance monitoring meetings to review the progress of implementation against targets in the annual work plan, address implementation bottlenecks and refocus as necessary. Bi-annual stakeholder performance monitoring and review meetings at county and national levels will review performance against targets, address any constraints to implementation and refocus activities if needed. Data audit: The national committee will conduct annual data quality audits and make o�cial routine anthrax surveillance data available. Annual review meeting: As part of the commitment to performance monitoring, all stakeholders will meet annually to review achievements against targets and milestones in the strategic and annual work plans. These meetings will also define and finalize priorities for the following year. Table 5: Anthrax Prevention and control Workplan Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 1.Enhanced Coordination, collaboration and partnership 1.Strengthening capacity for coordination of the anthrax control and prevention plan Development and adoption of the anthrax control and prevention plan Anthrax control and prevention plan MOH/MoALF/ Counties and other partners Identification of high risk and low Risk Zones Anthrax Risk map developed ZDU, Research & academic institutions Updating anthrax risk map Risk map updated ZDU, Research & academic institution, Development of anthrax control guidelines Number of signed guidelines MOH/MoALF/ Counties and other partners Establish and endorse National Anthrax committee and operationalize Committee in place MOH/MoALF/ Counties and other partners Establish and operationalization of zoonotic committees at county and sub county levels Documented and functioning committees ZDU, Counties and other stakeholders Chapter Six Anthrax Strategy 2021 Revised 8.indd 30 11/2/21 2:23 PM 31 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 1.Enhanced Coordination, collaboration and partnership 1.Strengthening capacity for coordination of the anthrax control and prevention plan Conduct regional Inter-county ,regional and International cross border engagements meetings Number of meetings documented NAPCC Conduct quarterly technical meetings Number of meetings documented NAPCC Identify stakeholders and focal persons to Spearhead implementation of the anthrax strategy List of stakeholders, Focal persons ZDU Develop policy advocacy plan to obtain buy-in from stakeholders Policy Advocacy plan ZDU and other stakeholders Develop anthrax legal framework in line with existing laws, strategy, policies and regulation Legal frame work MoH/MoALF Develop a budget for the implementation of the strategic plan and secure potential source of funding Developed budget ZDU and other stakeholders Develop monitoring and evaluation plan Monitoring and evaluation plan ZDU Conduct monitoring and supervision activities Number of monitoring and evaluation reports. Number of supervision reports NAPCC / CZC Conduct annual review meeting Number of meetings NAPCC / CZC 2.Surveillance, reporting systems and outbreak response To assess and enhance the existing surveillance system Evaluate the existing surveillance system and key indicators for anthrax reporting Evaluation report FELTP Collating anthrax outbreak data and feeding to anthrax database Updated Anthrax data base ZDU / NAPCC Conduct OH participatory epidemiology study. Cross-sectional study – to develop a community based case definition. lay Case definition in place ZDU/CZC Provide trainings to build surveillance capacity among animal and public health surveillance o�cers Number of trainings conducted Number of o�cers trained ZDU Procure data collection and reporting tools/ equipment Number of hard and soft data collection equipment MOH/ MoALF and development partners Develop anthrax surveillance guidelines Developed guidelines ZDU Review and strengthen standard anthrax reporting format and channels Defined Report formats and formal channels ZDU, Technical partners e.g. OIE/WHO Anthrax Strategy 2021 Revised 8.indd 31 11/2/21 2:23 PM 32 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 2.Surveillance, reporting systems and outbreak response To assess and enhance the existing surveillance system Conduct quarterly review meetings, and biannual workshops with stakeholders Number of meetings and minutes NAPCC / CZC Prepare and share regular joint anthrax national surveillance reports and provide feedback to the regional level Number of reports ZDU Perform retrospective analysis and publication of surveillance data at regional and national level Analysis report and publications ZDU/ FELTP Develop a communication plan for public disclosure of anthrax outbreaks Developed plan ZDU Develop a national guideline and SOPs for outbreak investigation and response, case management, infection prevention, environmental sanitation, field investigation forms Signed guidelines ZDU Establish a OH joint national and county rapid investigation and response teams for anthrax outbreaks Operational response teams NAPCC / CZC Prepare outbreak preparedness plan and ensure availability of supplies (vaccines, drugs, human resource, laboratory consumables, and equipment) for anthrax outbreak investigation and response Outbreak preparedness plan (updated on need basis) NAPCC / CZC and other stakeholders Conduct simulation exercises, trainings on outbreak investigation, sample collection, handling and transportation Number of simulation exercise ZDU and other stakeholders Conduct/implement joint outbreak investigation and response Anthrax investigation Reports ZDU 3.Prevention and control of anthrax in animals To enhance anthrax vaccine production, safety, quality, e�cacy, distribution and rational use of the vaccine in animals Quantify the national vaccine demand production, distribution and storage capacity of anthrax vaccine Assessment report DVS Develop and disseminate guidelines for vaccinations developed and signed guidelines DVS Anthrax Strategy 2021 Revised 8.indd 32 11/2/21 2:23 PM 33 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 3.Prevention and control of anthrax in animals To enhance anthrax vaccine production, safety, quality, e�cacy, distribution and rational use of the vaccine in animals Plan and implement vaccination campaigns and vaccination coverage determination methods Doses used and vaccination reports DVS /CDVS Impose and enforce quarantine and livestock movement restriction when needed Number of Quarantine imposed DVS /CDVS Improve KEVEPAPI vaccine production capacity to meet the estimated national demand Vaccines produced MoALF Automation of the vaccine supply chain management system and SOP for monitoring of vaccine, production, distribution, handling, storage (cold chain) and administration Automated supply chain management system and SOPs DVS/ CDVS Establish e�ective vaccines disposal system (expired, damaged, and inappropriately stored) Vaccine disposal system in place DVS/ CDVS Training animal health professionals and technicians on vaccine handling, transport, storage and administration, cold chain maintenance and calibration Number of trained animal health personnel DVS/ CDVS Develop SOP for proper destruction and disposal of infected animal carcasses, identification and protection of animal burial sites and disinfection of contaminated materials and premises Developed SOPs DVS/ CDVS Ensure availability of the necessary supplies and equipment’s (PPE) for disinfection/ environmental sanitation Adequate Supplies in the stores MoALF Train animal health workers on sanitary measures Number of trained personnel DVS / CDVS Conduct community education and awareness on anthrax prevention and control Number of awareness barazas held DVS / CDVS Anthrax Strategy 2021 Revised 8.indd 33 11/2/21 2:23 PM 32 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 2.Surveillance, reporting systems and outbreak response To assess and enhance the existing surveillance system Conduct quarterly review meetings, and biannual workshops with stakeholders Number of meetings and minutes NAPCC / CZC Prepare and share regular joint anthrax national surveillance reports and provide feedback to the regional level Number of reports ZDU Perform retrospective analysis and publication of surveillance data at regional and national level Analysis report and publications ZDU/ FELTP Develop a communication plan for public disclosure of anthrax outbreaks Developed plan ZDU Develop a national guideline and SOPs for outbreak investigation and response, case management, infection prevention, environmental sanitation, field investigation forms Signed guidelines ZDU Establish a OH joint national and county rapid investigation and response teams for anthrax outbreaks Operational response teams NAPCC / CZC Prepare outbreak preparedness plan and ensure availability of supplies (vaccines, drugs, human resource, laboratory consumables, and equipment) for anthrax outbreak investigation and response Outbreak preparedness plan (updated on need basis) NAPCC / CZC and other stakeholders Conduct simulation exercises, trainings on outbreak investigation, sample collection, handling and transportation Number of simulation exercise ZDU and other stakeholders Conduct/implement joint outbreak investigation and response Anthrax investigation Reports ZDU 3.Prevention and control of anthrax in animals To enhance anthrax vaccine production, safety, quality, e�cacy, distribution and rational use of the vaccine in animals Quantify the national vaccine demand production, distribution and storage capacity of anthrax vaccine Assessment report DVS Develop and disseminate guidelines for vaccinations developed and signed guidelines DVS Anthrax Strategy 2021 Revised 8.indd 32 11/2/21 2:23 PM 33 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 3.Prevention and control of anthrax in animals To enhance anthrax vaccine production, safety, quality, e�cacy, distribution and rational use of the vaccine in animals Plan and implement vaccination campaigns and vaccination coverage determination methods Doses used and vaccination reports DVS /CDVS Impose and enforce quarantine and livestock movement restriction when needed Number of Quarantine imposed DVS /CDVS Improve KEVEPAPI vaccine production capacity to meet the estimated national demand Vaccines produced MoALF Automation of the vaccine supply chain management system and SOP for monitoring of vaccine, production, distribution, handling, storage (cold chain) and administration Automated supply chain management system and SOPs DVS/ CDVS Establish e�ective vaccines disposal system (expired, damaged, and inappropriately stored) Vaccine disposal system in place DVS/ CDVS Training animal health professionals and technicians on vaccine handling, transport, storage and administration, cold chain maintenance and calibration Number of trained animal health personnel DVS/ CDVS Develop SOP for proper destruction and disposal of infected animal carcasses, identification and protection of animal burial sites and disinfection of contaminated materials and premises Developed SOPs DVS/ CDVS Ensure availability of the necessary supplies and equipment’s (PPE) for disinfection/ environmental sanitation Adequate Supplies in the stores MoALF Train animal health workers on sanitary measures Number of trained personnel DVS / CDVS Conduct community education and awareness on anthrax prevention and control Number of awareness barazas held DVS / CDVS Anthrax Strategy 2021 Revised 8.indd 33 11/2/21 2:23 PM 34 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 4.Anthrax prevention and control in Human Enhance safety regulations in handling suspected and confirmed anthrax cases Educate human health workers on detection of anthrax, e�ective treatment of anthrax and infection prevention and control Number of meetings held MoH 4.Anthrax prevention and control in Human Enhance safety regulations in handling suspected and confirmed anthrax cases Public education on the risks, prevention and control of anthrax specifically targeting high-risk populations Number of barazas held MoH/MoALF Community awareness in handling suspected and confirmed cases such as wearing protective clothing, improve food and occupational hygiene; avoid all blood-spilling operations such as slaughtering infected or suspect animals/ carcasses; appropriate disinfection measures before coming into contact with other persons or animals Number of barazas held MoH Prompt identification and treatment of a�ected people and prophylaxis of exposed individuals Number of people given prophylaxis Public health professional Training of health workers on standard precautions and safety regulation number of trained health workers MoH 5.Anthrax Diagnostic Laboratory Capacity Improving national and regional animal and public health laboratory capacity for anthrax diagnostic testing Assess national and regional public and animal health laboratory capacity for anthrax diagnostic testing Assessment report DVS, MoH Prepare a laboratory development plan Developed plan ZDU Organize trainings for public and animal health laboratory professionals and field sta� (sample collection, preservation and transport, submission, reporting and confirmatory diagnosis) Number of trained personnel ZDU Procurement of adequate and necessary laboratory supplies and equipment Procured supplies MoH,MoALF Establish and enhance inter sectoral inter laboratory networking (public and animal health) Establish an inter laboratory resource sharing networking mechanism such as memorandum of understanding (MoU) and terms of reference (ToR) Signed MoU and ToRs document MoALF, MoH Organize quarterly inter-laboratory fora (networking, information sharing, joint plan Number of fora ZDU Anthrax Strategy 2021 Revised 8.indd 34 11/2/21 2:23 PM 35 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 5.Anthrax Diagnostic Laboratory Capacity Maintaining anthrax biosafety and biosecurity Review laboratory sample SOPs for biosafety, biosecurity, handling, transport, processing and testing Reviewed SOPs MoALF, MoH 6.Information, Education and Communication Increasing community awareness and behavioral change regarding anthrax prevention and control Develop a communication plan Developed plan ZDU Develop and disseminate audience specific IEC materials Disseminate IEC materials ZDU Train health professionals on communication strategy, risk communication and messaging Number of trained professional ZDU Sensitize community on risk related to butchering dead carcasses, improper disposal of anthrax confirmed cases (biosecurity measures) and good husbandry practices Number of Sensitization barazas held ZDU/CZC Assess the knowledge and skills (KAP) of the professionals KAP publication and report FELTP Review existing educational materials for professionals Updated educational materials ZDU Develop training manuals and provide training to public, animal and environmental health professionals Published Manuals and number of trained professional ZDU Perform field level testing of the developed educational materials Approved field education materials NAPCC Distribute information and educational materials to relevant sectors Distributed educational materials NAPCC / CZC 7. Conduct and promote operational research Supporting applied and operational research initiatives and use research findings to support implementation Identify and implement research on the burden of anthrax in the country, economic impact and cost benefit analysis, vaccination coverage and sero survey, e�ciency of current vaccines, vaccine delivery model published papers, reports MoH, DVS and research institutions Introduce anthrax rapid diagnostic field tests; research on new testing method Functional rapid test kit MoH, DVS and research institutions Anthrax Strategy 2021 Revised 8.indd 35 11/2/21 2:23 PM 34 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 4.Anthrax prevention and control in Human Enhance safety regulations in handling suspected and confirmed anthrax cases Educate human health workers on detection of anthrax, e�ective treatment of anthrax and infection prevention and control Number of meetings held MoH 4.Anthrax prevention and control in Human Enhance safety regulations in handling suspected and confirmed anthrax cases Public education on the risks, prevention and control of anthrax specifically targeting high-risk populations Number of barazas held MoH/MoALF Community awareness in handling suspected and confirmed cases such as wearing protective clothing, improve food and occupational hygiene; avoid all blood-spilling operations such as slaughtering infected or suspect animals/ carcasses; appropriate disinfection measures before coming into contact with other persons or animals Number of barazas held MoH Prompt identification and treatment of a�ected people and prophylaxis of exposed individuals Number of people given prophylaxis Public health professional Training of health workers on standard precautions and safety regulation number of trained health workers MoH 5.Anthrax Diagnostic Laboratory Capacity Improving national and regional animal and public health laboratory capacity for anthrax diagnostic testing Assess national and regional public and animal health laboratory capacity for anthrax diagnostic testing Assessment report DVS, MoH Prepare a laboratory development plan Developed plan ZDU Organize trainings for public and animal health laboratory professionals and field sta� (sample collection, preservation and transport, submission, reporting and confirmatory diagnosis) Number of trained personnel ZDU Procurement of adequate and necessary laboratory supplies and equipment Procured supplies MoH,MoALF Establish and enhance inter sectoral inter laboratory networking (public and animal health) Establish an inter laboratory resource sharing networking mechanism such as memorandum of understanding (MoU) and terms of reference (ToR) Signed MoU and ToRs document MoALF, MoH Organize quarterly inter-laboratory fora (networking, information sharing, joint plan Number of fora ZDU Anthrax Strategy 2021 Revised 8.indd 34 11/2/21 2:23 PM 35 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 5.Anthrax Diagnostic Laboratory Capacity Maintaining anthrax biosafety and biosecurity Review laboratory sample SOPs for biosafety, biosecurity, handling, transport, processing and testing Reviewed SOPs MoALF, MoH 6.Information, Education and Communication Increasing community awareness and behavioral change regarding anthrax prevention and control Develop a communication plan Developed plan ZDU Develop and disseminate audience specific IEC materials Disseminate IEC materials ZDU Train health professionals on communication strategy, risk communication and messaging Number of trained professional ZDU Sensitize community on risk related to butchering dead carcasses, improper disposal of anthrax confirmed cases (biosecurity measures) and good husbandry practices Number of Sensitization barazas held ZDU/CZC Assess the knowledge and skills (KAP) of the professionals KAP publication and report FELTP Review existing educational materials for professionals Updated educational materials ZDU Develop training manuals and provide training to public, animal and environmental health professionals Published Manuals and number of trained professional ZDU Perform field level testing of the developed educational materials Approved field education materials NAPCC Distribute information and educational materials to relevant sectors Distributed educational materials NAPCC / CZC 7. Conduct and promote operational research Supporting applied and operational research initiatives and use research findings to support implementation Identify and implement research on the burden of anthrax in the country, economic impact and cost benefit analysis, vaccination coverage and sero survey, e�ciency of current vaccines, vaccine delivery model published papers, reports MoH, DVS and research institutions Introduce anthrax rapid diagnostic field tests; research on new testing method Functional rapid test kit MoH, DVS and research institutions Anthrax Strategy 2021 Revised 8.indd 35 11/2/21 2:23 PM 36 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 8.Resource mobilization Seeking resources from state and non state actors towards implementation of the anthrax prevention and control Develop comprehensive anthrax prevention and control budgets and justifications Budgets ZDU Resource mapping Needs assessment Report ZDU Advocate for budgetary allocation by the National and County governments Approved budgets NAPCC / CZC Invite interested development partners to participate and manage aspects of the program number of meeting held, invitation letters NAPCC/ZDU Anthrax Strategy 2021 Revised 8.indd 36 11/2/21 2:23 PM 37 NAME INSTITUTION Dr. Athman Mwatondo MOH- ZDU Dr. Mark Nanyingi University of Liverpool/University of Nairobi Dr. Mathew Muturi MALF -ZDU Dr. Harry Oyas MALF- VEES Dr. Stephen Gathogo MALF- Garissa County Dr. Romona Ndanyi MALF-CVL Dr. Micheal Kahara MALF-CVL Dr. Eunice Omondi MALF-CVL Dr Carolyne Nasimiyu MOH- ZDU Mr. Mathew Mutiiria MOH- ZDU Mr. Julius Kimitei MOH- ZDU Ms. Angela Mukami ZDU Dr. Lekopien Argeo FELTP Dr. Maurice Omondi FELTP Dr. Joseph Maina MOH-Narok Dr. Augusta Kivunzya MALF- Kitui County Prof. Lilly C. Bebora University of Nairobi Dr. Lilian Waiboci University of Nairobi Dr. Nickson Lang’at University of Nairobi Dr. Kennedy Mochabo University of Nairobi Dr. Hope Kameta University of Edinburgh Dr. Penina Munyua CDC-Kenya Dr Okunga Emmanuel MOH- DSRU Mr.Jackson Njoroge MOH- DSRU Dr. Zelalem Tedesse FAO Dr. Mark Obonyo FAO Dr. Stella Kiambi FAO Mr. Evans Tenge FAO Mr. John Njuguna FAO Dr. Mathew Mutinda Kenya Wildlife Service Dr. Isaac Lekolol Kenya Wildlife Service Dr. Ezekiel Bowen MOH- Nakuru County Dr. Githui Kaba MALF- Nakuru County Dr. Peter Wang’ombe MOH- Meru County Dr. Missi Mutungi MALF- Meru County Ms. Caroline Mbogori MOH-NPHL Mr. Wilson Kung’u MOH-NPHL Dr. Thomas Nyariki Consultant Dr. John Mwaniki KEMRI Dr. Eric Osoro Washington State University Dr. Isaac Ngere Washington State University Prof. Eric Fevre University of Liverpool and ILRI Ms. Lorraine Alumasa ILRI Dr Andrew Thaiyah USAID-GHSA Dr. Victor Okoth Ufya Ugavi Dr. Jones Mutua KEVEVAPI Appendix 4: List of Contributors Anthrax Strategy 2021 Revised 8.indd 37 11/2/21 2:23 PM 36 Strategy Objective Activities Indicators Phase 1 Phase 2 Phase 3 Phase 4 Responsibility2021 2023 2024 2027 2028 2032 2033 2036 8.Resource mobilization Seeking resources from state and non state actors towards implementation of the anthrax prevention and control Develop comprehensive anthrax prevention and control budgets and justifications Budgets ZDU Resource mapping Needs assessment Report ZDU Advocate for budgetary allocation by the National and County governments Approved budgets NAPCC / CZC Invite interested development partners to participate and manage aspects of the program number of meeting held, invitation letters NAPCC/ZDU Anthrax Strategy 2021 Revised 8.indd 36 11/2/21 2:23 PM 37 NAME INSTITUTION Dr. Athman Mwatondo MOH- ZDU Dr. Mark Nanyingi University of Liverpool/University of Nairobi Dr. Mathew Muturi MALF -ZDU Dr. Harry Oyas MALF- VEES Dr. Stephen Gathogo MALF- Garissa County Dr. Romona Ndanyi MALF-CVL Dr. Micheal Kahara MALF-CVL Dr. Eunice Omondi MALF-CVL Dr Carolyne Nasimiyu MOH- ZDU Mr. Mathew Mutiiria MOH- ZDU Mr. Julius Kimitei MOH- ZDU Ms. Angela Mukami ZDU Dr. Lekopien Argeo FELTP Dr. Maurice Omondi FELTP Dr. Joseph Maina MOH-Narok Dr. Augusta Kivunzya MALF- Kitui County Prof. Lilly C. Bebora University of Nairobi Dr. Lilian Waiboci University of Nairobi Dr. Nickson Lang’at University of Nairobi Dr. Kennedy Mochabo University of Nairobi Dr. Hope Kameta University of Edinburgh Dr. Penina Munyua CDC-Kenya Dr Okunga Emmanuel MOH- DSRU Mr.Jackson Njoroge MOH- DSRU Dr. Zelalem Tedesse FAO Dr. Mark Obonyo FAO Dr. Stella Kiambi FAO Mr. Evans Tenge FAO Mr. John Njuguna FAO Dr. Mathew Mutinda Kenya Wildlife Service Dr. Isaac Lekolol Kenya Wildlife Service Dr. Ezekiel Bowen MOH- Nakuru County Dr. Githui Kaba MALF- Nakuru County Dr. Peter Wang’ombe MOH- Meru County Dr. Missi Mutungi MALF- Meru County Ms. Caroline Mbogori MOH-NPHL Mr. Wilson Kung’u MOH-NPHL Dr. Thomas Nyariki Consultant Dr. John Mwaniki KEMRI Dr. Eric Osoro Washington State University Dr. Isaac Ngere Washington State University Prof. Eric Fevre University of Liverpool and ILRI Ms. Lorraine Alumasa ILRI Dr Andrew Thaiyah USAID-GHSA Dr. Victor Okoth Ufya Ugavi Dr. Jones Mutua KEVEVAPI Appendix 4: List of Contributors Anthrax Strategy 2021 Revised 8.indd 37 11/2/21 2:23 PM UoN/FAO-ECTAD 38 1. Turnbull PCB. Introduction: Anthrax History, Disease and Ecology. :1–19. 2. World Health Organisation. in humans and animals. i Anthrax n humans Anim. 2008;(Fourth edition). 3. Muturi M, Gachohi J, Mwatondo A, Lekolool I, Gakuya F, Bett A, et al. Recurrent Anthrax Outbreaks in Humans , Livestock , and Wildlife in the Same Locality ,. 2018;99(4):833–9. 4. Misgie F, Atnaf A, Surafel K. A Review on Anthrax and its Public Health and Economic Importance 1. 2015;4(3):196–204. 5. Diseases ZI. Framework for Enhancing Anthrax Prevention & Control. 6. Shadomy S, Idrissi A El, Raizman E, Bruni M, Palamara E, Pittiglio C, et al. empres watch. Empres Watch. 2016;37(september). 7. Carlson CJ, Kracalik IT, Ross N, Alexander KA, Hugh-jones ME, Fegan M, et al. and wildlife. Nat Microbiol [Internet]. Available from: http://dx.doi.org/10.1038/s41564-019-0435-4 8. Vieira AR, Salzer JS, Traxler RM, Hendricks KA, Kadzik ME, Marston CK, et al. Enhancing Surveillance andDiagnostics in Anthrax-Endemic Countries. 2017;23(December). 9. Animal diseases Act. 2015; 10. Case A, Gri¥th J, Blaney D, Shadomy S, Lehman M, Pesik N, et al. of Inhalation. Dispatches. 2014;20(2). 11. Munyua P, Bitek A, Osoro E, Pieracci EG, Muema J, Mwatondo A, et al. Prioritization of Zoonotic Diseases in Kenya ,. 2016;(August). 12. Nderitu, L.M., Gachohi, J., Otieno, F. et al. Spatial clustering of livestock Anthrax events associated with agro-ecological zones in Kenya, 1957–2017. BMC Infect Dis 21, 191 (2021). 13. Muoria PK, Muruthi P, Kariuki WK, Hassan BA, Mijele D, Oguge NO. Anthrax outbreak among Grevy ’ s zebra ( Equus grevyi ) in. 2007;483–9. 14. Blackburn JK. Ante And Postmortem Diagnostic Techniques for Anthrax : Rethinking Pathogen Exposure and The Geographic extent of the Disease in Wildlife. 2013;49(4):786–801. 15. WHO(2008), Anthrax in humans and Animals (4th Edition). 16. DTRA (2009), Economic Impacts of a Wide Area Release of Anthrax. (May 2009) 17. Chakraborty A, Khan SU, Hasnat MA, Parveen S, Islam MS, Mikolon A, et al. Anthrax Outbreaks in Bangladesh , 2009 – 2010. 2012;86(4):703–10. 18. Kaitho T, Ndeereh D, Ngoru B. An outbreak of anthrax in endangered Rothschild ’ s gira©es in Mwea National. 2013;45–8. 19. Engida E, Guthiga P, Nyota H, Karugia J. Ermias Engida, Paul Guthiga, Hannah Nyota and Joseph Karugia. (37). 20. Food and Agriculture Organization of the United Nations. Case Definition of Livestock Diseases. 2010;39. References Anthrax Strategy 2021 Revised 8.indd 38 11/2/21 2:23 PM 39 Anthrax Strategy 2021 Revised 8.indd 39 11/2/21 2:23 PM 38 1. Turnbull PCB. Introduction: Anthrax History, Disease and Ecology. :1–19. 2. World Health Organisation. in humans and animals. i Anthrax n humans Anim. 2008;(Fourth edition). 3. Muturi M, Gachohi J, Mwatondo A, Lekolool I, Gakuya F, Bett A, et al. Recurrent Anthrax Outbreaks in Humans , Livestock , and Wildlife in the Same Locality ,. 2018;99(4):833–9. 4. Misgie F, Atnaf A, Surafel K. A Review on Anthrax and its Public Health and Economic Importance 1. 2015;4(3):196–204. 5. Diseases ZI. Framework for Enhancing Anthrax Prevention & Control. 6. Shadomy S, Idrissi A El, Raizman E, Bruni M, Palamara E, Pittiglio C, et al. empres watch. Empres Watch. 2016;37(september). 7. Carlson CJ, Kracalik IT, Ross N, Alexander KA, Hugh-jones ME, Fegan M, et al. and wildlife. Nat Microbiol [Internet]. Available from: http://dx.doi.org/10.1038/s41564-019-0435-4 8. Vieira AR, Salzer JS, Traxler RM, Hendricks KA, Kadzik ME, Marston CK, et al. Enhancing Surveillance andDiagnostics in Anthrax-Endemic Countries. 2017;23(December). 9. Animal diseases Act. 2015; 10. Case A, Gri¥th J, Blaney D, Shadomy S, Lehman M, Pesik N, et al. of Inhalation. Dispatches. 2014;20(2). 11. Munyua P, Bitek A, Osoro E, Pieracci EG, Muema J, Mwatondo A, et al. Prioritization of Zoonotic Diseases in Kenya ,. 2016;(August). 12. Nderitu, L.M., Gachohi, J., Otieno, F. et al. Spatial clustering of livestock Anthrax events associated with agro-ecological zones in Kenya, 1957–2017. BMC Infect Dis 21, 191 (2021). 13. Muoria PK, Muruthi P, Kariuki WK, Hassan BA, Mijele D, Oguge NO. Anthrax outbreak among Grevy ’ s zebra ( Equus grevyi ) in. 2007;483–9. 14. Blackburn JK. Ante And Postmortem Diagnostic Techniques for Anthrax : Rethinking Pathogen Exposure and The Geographic extent of the Disease in Wildlife. 2013;49(4):786–801. 15. WHO(2008), Anthrax in humans and Animals (4th Edition). 16. DTRA (2009), Economic Impacts of a Wide Area Release of Anthrax. (May 2009) 17. Chakraborty A, Khan SU, Hasnat MA, Parveen S, Islam MS, Mikolon A, et al. Anthrax Outbreaks in Bangladesh , 2009 – 2010. 2012;86(4):703–10. 18. Kaitho T, Ndeereh D, Ngoru B. An outbreak of anthrax in endangered Rothschild ’ s gira©es in Mwea National. 2013;45–8. 19. Engida E, Guthiga P, Nyota H, Karugia J. Ermias Engida, Paul Guthiga, Hannah Nyota and Joseph Karugia. (37). 20. Food and Agriculture Organization of the United Nations. Case Definition of Livestock Diseases. 2010;39. References Anthrax Strategy 2021 Revised 8.indd 38 11/2/21 2:23 PM 39 Anthrax Strategy 2021 Revised 8.indd 39 11/2/21 2:23 PM a NATIONAL STRATEGY FOR THE PREVENTION AND CONTROL OF ANTHRAX IN HUMANS AND ANIMALS IN KENYA (2021-2036) Anthrax Strategy 2021 Revised 8.indd 1 11/2/21 2:23 PM