Anthrax is rare in France, but it poses significant public health risks. Indeed:

• Certain clinical forms are fatal, particularly if not treated early;

• Highly resistant, Bacillus anthracis spores can survive for many years in the soil (this is the case in certain regions of France);

• Preventive measures apply to people exposed to infected animals or animal products;

• Bacillus anthracis spores can be used in malicious acts.

In this context, Santé publique France’s mission focuses on two main areas: surveillance and prevention.

Epidemiological surveillance of anthrax

One of Santé publique France’s missions is to monitor human anthrax in collaboration with its partners. To this end,

• we centralize reports of human anthrax cases in France.

• we provide scientific expertise to the Regional Health Agencies (ARS) for epidemiological investigations and support for the implementation of control or prevention measures

Mandatory Reporting

Mandatory reporting involves collecting as comprehensive information as possible regarding all cases of certain diseases known as “notifiable diseases” from laboratory technicians and physicians.

It involves two successive procedures: reporting and notification.

Physicians and laboratory professionals who suspect or diagnose a notifiable disease must report it immediately and by any appropriate means (phone, fax, email) to the physician at the Regional Health Agency (ARS) in their area of practice.

• The report allows the ARS physician to implement individual and collective preventive measures around the cases and, if necessary, to initiate investigations to identify the source of the infection and take action to reduce it.

• Notification occurs after the report and most often after confirmation of the diagnosis. Reporting physicians or laboratory scientists notify the ARS physician at their place of practice using a form specific to each disease. Notification enables the analysis and monitoring of the progression of these diseases within the population in order to better target local and national prevention efforts.

Bacillus anthracis is included on the list of pathogens that could be used in malicious acts or bioterrorist attacks. The immediate reporting of any confirmed, probable, or suspected case of anthrax infection enables the necessary investigations to be carried out to identify the source of exposure, whether natural or malicious.

Definition of reportable and notifiable anthrax cases

Surveillance Partners

• Regional Health Agencies

List and locations: http://www.ars.sante.fr

• The National Reference Center (CNR) – Expert Laboratory

Central Directorate of the Armed Forces Health
Service Head: Prof. Olivier GORGE
Tel.: 01 78 65 10 99 / 01 78 65 10 65
Email: olivier.gorge@intradef.gouv.fr

Address: Central Directorate of the Armed Forces Health Service
Bacteriology Unit
1 Place Général Valérie André - BP73- 91223 Brétigny-sur-Orge Cedex

Secretariat: 01 69 90 84 34 or 01 69 90 82 60 - Email: irba-cnrlecharbon.accueil.fct@def.gouv.fr

CNR-LE Charbon website: https://irba.sante.defense.gouv.fr/cnr-orthopoxvirus/#charbon

To learn more about the missions of the National Reference Centers, click here.

Preventive measures against anthrax

One of the challenges related to anthrax in France is preventing the disease in people exposed to infected animals or animal products. Outbreaks of animal anthrax occur every year during the summer in France, mainly in cattle herds. Thus, when animal anthrax outbreaks are detected in France, Santé publique France is notified by the Ministry of Agriculture to identify individuals exposed to these animals (livestock farmers, rendering plant staff, veterinarians, and livestock workers).

These individuals are then contacted by the Regional Health Agency in coordination with Santé publique France to clarify their contact with the infected animals and undergo an individual risk assessment that takes into account the nature of their exposure to these animals, its duration, and how long ago it occurred. When a risk of exposure is identified, these individuals are referred to a physician who decides, if necessary, on medical management.