By Moses Okochi Wafula
Anthrax, locally named “Kooto” in Runyankore and “Kakooto” in Luganda, is one of the zoonotic diseases that continue to recur in Uganda, causing devastating effects on both livestock and human health.
Over the past decade, the country has faced recurring outbreaks, particularly in the districts of the cattle corridor.
For example, significant outbreaks occurred in Isingiro in 2017, Kiruhura and Kween in 2018, and more recently in Ibanda, Kyotera, Amudat, and Sembabule between 2023 and 2024, with a significant number of human cases and livestock deaths reported.
The year 2024 alone saw an unprecedented spread, with outbreaks in Kazo, Kanungu, and Sembabule claiming lives and necessitating quarantines.
This year, suspected cases in Kabale and a confirmed outbreak in Bushenyi of anthrax serve as reminders that it remains a persistent threat to public health.
Anthrax is a severe infectious disease caused by the bacterium Bacillus anthracis. The spores of this bacterium can survive in soil for decades, rendering it a persistent and long-lasting threat. Animals are infected when they ingest spores from contaminated soil, plants, or water.
The process is swift: spores begin to form within hours of an animal’s death if the carcass is opened and remain in the soil long afterwards.
In animals, anthrax often manifests with distress, loss of appetite, difficulty breathing, high fever, and sudden death. In humans, exposure can occur through contact with infected animals or contaminated products, inhalation of spores, or consumption of infected meat.
Once inside the body, the bacteria produce toxins that can cause severe illness or even death if untreated.
A recent co-creation engagement exercise with the community in Sembabule revealed how people perceived the disease. Many did not take anthrax seriously and dismissed it until deaths occurred.
Some community members believed that cooking meat would kill the disease or argued that “it is not the first disease to attack the community.”
Others pointed out that there was still a ready market for dead animals, and since business had to continue, they saw no reason for stopping to sell or eat the meat from infected animals. On the other hand, some took the disease seriously, especially once human and livestock deaths were confirmed.
“I only realised it was anthrax after the deaths of animals,” one participant shared, while others said the confirmation of anthrax cases pushed them to change their practices.
This mix of denial and delayed acceptance shows that the risk perception remains dangerously low until tragedy strikes.
When seeking care, communities reported first turning to traditional healers, small clinics, or pastors for prayers before eventually visiting government health facilities.
This suggests that, initially, people rely heavily on informal systems, which can delay access to life-saving antibiotics. As a result, such delays not only risk lives but also enable the disease to spread further.
The insights gathered from community engagement highlighted key pressing challenges: a significant underestimation of the risk associated with anthrax, the persistence of risky practices such as the butchering and consumption of beef from suddenly deceased animals, and delayed health-seeking behaviour exacerbating the situation.
The ongoing trade in and consumption of infected meat underscores how economic incentives can outweigh public health concerns. Importantly, anthrax is preventable, and communities must avoid handling, skinning, or consuming meat from animals that died under suspicious circumstances.
Reporting cases promptly to veterinary and health authorities is essential. Additionally, washing hands with soap after handling animals and seeking immediate medical attention if exposed are small but life-saving steps.
Populations most vulnerable to anthrax include herders, abattoir workers, butchers, veterinarians, livestock traders, and consumers of uninspected meat.
Similarly, women and young people face risks because they are often involved in food preparation or herding activities.
While anthrax has long been present in Uganda, ongoing outbreaks highlight a harsh reality: knowledge alone is not enough.
Communities must change their behaviour to prevent further loss of life. Risky beliefs such as “well-cooked meat is always safe” or “business must continue regardless” contribute to transmission.
The solution involves sustained social and behavioural change communication that encourages people to move from awareness to action, supported by trusted local figures such as LC leaders, religious and cultural organisations, health workers, and women’s groups, to shift norms and promote safer practices.
Communities should take the following actions. Do not touch, butcher, or eat meat from animals that have died suddenly or under suspicious circumstances, and report sudden animal deaths immediately to local authorities or the veterinary office to trigger a rapid investigation and safe carcass disposal.
Practise strict hygiene by washing hands thoroughly with soap and water after handling animals, hides, skins, or animal products, and seek prompt medical care if you notice skin sores, sudden fever, or breathing difficulty after contact with animals or animal products, as early treatment saves lives.
Any dead animal should be buried in a 2–4 metre bottomless pit under the supervision of a trained burial team to prevent anthrax infections.
In summary, anthrax continues to pose a threat in Uganda due to persistent risky behaviours. It will only be eradicated when people change their behaviour by reporting animal deaths, avoiding dangerous practices, and seeking prompt medical attention.
Only when behaviour change becomes a social norm, not just an individual choice, will the cycle of anthrax outbreaks finally be broken. Behaviour change is therefore the true “vaccine” against anthrax.
Mr Moses Okochi Wafula is a public health specialist by profession and researcher with the University of South Africa