Cutaneous anthrax in the Artibonite Valley of Haiti: 1992-2002.

More cutaneous anthrax cases were noted at Hospital Albert Schweitzer (HAS) in the Artibonite Valley of Haiti. We examine the incidence of anthrax in the Artibonite between 1992 and 2002, describe the clinical presentation of cutaneous anthrax, and determine risk factors for anthrax. In 1992 HAS reported 1 case of anthrax for an incidence of 4 cases per million persons/year. In 2002, there were 20 cases of anthrax for an incidence of 72 cases per million persons/year. This is a 17-fold increase (P = 0.0002). Causes of death from anthrax included asphyxiation from edema of the neck with tracheal compression and concurrent gastrointestinal anthrax. Butchering cattle that had died of illness was identified as a risk factor. The incidence of human anthrax has increased in the Artibonite Valley and is a cause of significant mortality. Control of anthrax in humans depends on improved animal vaccination programs.