Comparison of spatiotemporal patterns of historic natural Anthrax outbreaks in Minnesota and Kazakhstan.

Disease spread in populations is a consequence of the interaction between host, pathogen, and environment, i.e. the epidemiological triad. Yet the influences of each triad component may vary dramatically for different settings. Comparison of environmental, demographic, socio-economic, and historical backgrounds may support tailoring site-specific control measures. Because of the long-term survival of Bacillus anthracis, Anthrax is a suitable example for studying the influence of triad components in different endemic settings. We compared the spatiotemporal patterns of historic animal Anthrax records in two endemic areas, located at northern latitudes in the western and eastern hemispheres. Our goal was to compare the spatiotemporal patterns in Anthrax progression, intensity, direction, and recurrence (disease hot spots), in relation to epidemiological factors and potential trigger events. Reported animal cases in Minnesota, USA (n = 289 cases between 1912 and 2014) and Kazakhstan (n = 3,997 cases between 1933 and 2014) were analyzed using the spatiotemporal directionality test and the spatial scan statistic. Over the last century Anthrax occurrence in Minnesota was sporadic whereas Kazakhstan experienced a long-term epidemic. Nevertheless, the seasonality was comparable between sites, with a peak in August. Declining number of cases at both sites was attributed to vaccination and control measures. The spatiotemporal directionality test detected a relative northeastern directionality in disease spread for long-term trends in Minnesota, whereas a southwestern directionality was observed in Kazakhstan. In terms of recurrence, the maximum timespans between cases at the same location were 55 and 60 years for Minnesota and Kazakhstan, respectively. Disease hotspots were recognized in both settings, with spatially overlapping clusters years apart. Distribution of the spatiotemporal cluster radii between study sites supported suggestion of site-specific control zones. Spatiotemporal patterns of Anthrax occurrence in both endemic regions were attributed to multiple potential trigger events including major river floods, changes in land use, agriculture, and susceptible livestock populations. Results here help to understand the long-term epidemiological dynamics of Anthrax while providing suggestions to the design and implementation of prevention and control programs, in endemic settings.

Spatio-temporal analysis and visualisation of the anthrax epidemic situation in livestock in Kazakhstan over the period 1933-2016.

An analysis of the anthrax epidemic situation among livestock animals in the Republic of Kazakhstan over the period 1933-2016 is presented. During this time, 4,064 anthrax outbreaks (mainly in cattle, small ruminants, pigs and horses) were recorded. They fall into five historical periods of increase and decrease in the annual anthrax incidence (1933-1953; 1954-1968; 1969-1983; 1984- 2001; and 2002-2016), which has been associated with changes in economic activity and veterinary surveillance. To evaluate the temporal trends of incidence variation for each of these time periods, the following methods were applied: i) spatio-temporal analysis using a space-time cube to assess the presence of hotspots (i.e., areas of outbreak clustering) and the trends of their emergence over time; and ii) a linear regression model that was used to evaluate the annual numbers of outbreaks as a function of time. The results show increasing trends during the first two periods followed by a decreasing trend up to now. The peak years of anthrax outbreaks occurred in 1965-1968 but outbreaks still continue with an average annual number of outbreaks of 1.2 (95% confidence interval: 0.6-1.8). The space-time analysis approach enabled visualisation of areas with statistically significant increasing or decreasing trends of outbreak clustering providing a practical opportunity to inform decision-makers and allowing the veterinary services to concentrate their efforts on monitoring the possible risk factors in the identified locations.