Q & A: Anthrax and Animal Hide Drums

There are steps you can take to protect yourself against developing anthrax if you make or handle animal hide drums. Once you know the facts and learn how to protect yourself, you can work and play safely with animal hides or drums made from animal hides.

***** Know the facts. Stay safe! *****
What is anthrax, and what is the link between anthrax and animal hide drums?
How can I treat animal hides to make them safer to handle?
What is the risk of getting anthrax from an animal hide drum?
What is the risk of getting anthrax from attending drumming events?
How can I protect myself against anthrax if I handle animal hides?
How can I protect my friends and family against anthrax if I handle animal hides?
How can I make sure that my animal hide drum is safe to handle?
May I import animal hides into the United States?
May I import hide drums into the United States as souvenirs?
Where can I get more information about anthrax and animal hides?
References

What is anthrax, and what is the link between anthrax and animal hide drums?

Anthrax is a naturally-occurring disease of animals (e.g., sheep, goats, and cattle) caused by the bacterium Bacillus anthracis. The bacteria live in the soil in many parts of the world and form protective outer coats called spores (hereafter called anthrax spores). Spores are able to withstand harsh or adverse conditions that would normally kill bacteria. Animals can get anthrax by ingesting anthrax spores from the soil. Anthrax in animals occurs worldwide but can be controlled by vaccination of animals. In recent years, anthrax has been reported among animals in many countries, and is especially common in parts of Africa, Asia, and the Middle East. It occurs much less frequently in the United States, and animal health and inspection programs in the United States further help to prevent people from coming in contact with animals with anthrax, or the products from infected animals.

People may acquire anthrax by contact with infected animals or their products, such as hides or hair. Human anthrax has three forms depending on how the infection is acquired. Further information on the different types of anthrax infection in people can be found at: Questions and Answers About Anthrax

Historically, anthrax was known as 'wool sorters disease' and was considered an occupational hazard in workers in wool mills, slaughterhouses, and tanneries that processed animal hides, hair, and bone. The first documented case of anthrax linked to a hide drum was in Florida (USA) in 1974. In this case, the person developed cutaneous anthrax and survived. The source of the infection was a goat hide bongo drum bought in Haiti. In recent years, additional cases of anthrax in drummers and drum makers in the United States and United Kingdom have occurred.

2006 - Inhalation anthrax, non-fatal, from making hide drums in a poorly-ventilated work space
2006 - Inhalation anthrax, fatal, from handling contaminated hide drums
2007 - Two cutaneous anthrax cases, non-fatal, in a drum maker and his son
2008 - Inhalation anthrax, fatal, from making hide drums

How can I treat animal hides to make them safer to handle?

Animal hides can be treated to help reduce, but not eliminate, the risk of getting anthrax when handling them. Because spores are able to withstand harsh conditions, any method used to treat hides to kill the spores may damage the hides and reduce their quality for making drums. Air drying of hides will not kill the spores that can cause anthrax. Animal hides can be treated by decontamination, or by some processing methods. Decontaminate by fumigation with formaldehyde or ethylene oxide, or irradiation, prior to working with or processing them. Information on commercial irradiation facilities can be obtained from the Food Irradiation Processing Alliance (FIPA) site. Your local department of commerce may be able to provide you with information to find one nearest to you. A number of methods used to process hides can reduce the risk of contracting anthrax from handling animal hides^1,2, such as:

Heating the hide to a temperature of 95°C for 24 hours, or boiling for 30 minutes, or steam autoclaving at 120°C for 20 minutes to kill anthrax spores.
Tanning (using commercial or professional tanning and dehairing methods)
Chemically treating in acidic or alkaline solutions (soak in a solution with a pH less than 3.0 or more than 11.5 for 24 hrs)
Preserving in 2% formaldehyde
Pickling with hypertonic salts

What is the risk of getting anthrax from an animal hide drum?

The risk of developing anthrax from handling an animal hide drum is considered to be very low. However, the risk cannot be described as "zero risk". There is no risk linked to handling the hides of healthy animals, or drums made from the hides of healthy animals. Hides from countries where anthrax is common may pose a higher risk of exposure to anthrax spores than domestic (US-origin) hides.

A single case (Florida, USA) of cutaneous anthrax that occurred in 1974 was associated with a goat hide bongo drum purchased in Haiti, where anthrax is common. Worldwide, a single, fatal case of inhalation anthrax has been reported which was determined to be associated with using or handling animal hide drums. In this case (Scotland 2006), it was concluded that the patient, who may have had increased susceptibility to infectious diseases, became infected as a result of using or handling contaminated hide drums.

What is the risk of getting anthrax from attending drumming events?

The risk of being exposed to anthrax spores through attending drumming events where animal hide drums are played, or handling animal hide drums at such events is considered to be very low. Aside from a single case (Scotland in 2006) of inhalation anthrax in a person who handled contaminated hide drums, a more recent case (USA) of gastrointestinal anthrax has been identified in a person who attended an indoor drumming event. However, this case is still currently under investigation, and the exact manner of how the person became infected with anthrax has not been determined.

If you are a drum owner or player, or attended a recent drumming event and are experiencing any symptoms which might resemble anthrax, you should seek medical attention with your healthcare provider. It is important to discuss with your provider any recent contact or experience you had with animal hide drums.

How can I protect myself against anthrax if I handle animal hides?

It is possible that hides imported from other countries may come from areas where anthrax is common. Therefore, some imported hides may contain anthrax spores, and testing cannot be done to certify that they are free of spores. To protect yourself against anthrax spores, be sure to use hides that came from healthy animals, denoted by being from domestic origin or as having been imported with an international veterinary certificate showing that it has undergone the appropriate government inspection³. This is the best way to make sure that the hides are free of anthrax spores. You can also treat the hides to reduce the risk of contracting anthrax from handling them (see How can I treat animal hides to make them safer to handle?). You can also follow these safe workplace practices to reduce the risk of exposure to anthrax spores when you work with animal hides:

Work in a well-ventilated workspace
Use appropriate personal protective equipment (PPE), including:

Properly-fitted face mask or respirator (N-95⁴)
Eye protection
Protective gloves

Regularly wash your hands thoroughly with soap and warm water
Avoid putting your fingers in your eyes, nose, or mouth
Wear a designated pair of work shoes
Cover all exposed skin with clothing (pants, long sleeves)
Onsite removal and laundering (with regular detergent) of clothes worn during work
Maintain a clean workspace

The workspace should cleaned using a high-efficiency particulate air vacuum
Avoid vigorously shaking or beating hides, dry sweeping, or using compressed air
Avoid taking objects outside of the workspace

Following these safe workplace practices will reduce the amount of dust inhaled but cannot eliminate the risk of anthrax.

How can I protect my friends and family against anthrax if I handle animal hides?

In 2007, a drum maker's son got cutaneous anthrax from household contamination with anthrax spores. To protect your friends and family from potential anthrax spore exposure, follow the steps you would take to protect yourself against anthrax spores (see How can I protect myself against anthrax if I handle animal hides?). You can further protect your friends and family by taking the following actions:

Avoid taking objects from the workspace to other areas, including household and vehicle, because this can cause anthrax spores to contaminate these areas.
Avoid working in areas where other persons might be present
Tell your friends and family about the actions they can take to reduce their risk of getting anthrax (see How can I protect myself against anthrax if I handle animal hides?).

How can I make sure that my animal hide drum is safe to handle?

You cannot absolutely make certain a drum is safe. There is no test available to make sure that a hide or other animal product does not have anthrax spores. For a hide to be free from anthrax spores, it must come from a healthy animal and be removed and processed according to existing governmental regulations. Since there is currently no way to make sure that a hide is free from anthrax spores if the regulations have not been followed, drum makers should treat animal hides and handle them appropriately to reduce the risk of getting sick with anthrax. For more on treating animal hides, see How can I treat animal hides to make them safer to handle?

May I import animal hides into the United States?

Importation of animal products, including processed and unprocessed cattle and goat hides, is currently regulated by the United States Department of Agriculture (USDA). Animal hides are not allowed to enter the US if they have not been treated to make them less likely to spread disease. Animal hides that have been tanned, or pickled (soaked in a salt solution) are considered to be less likely to spread infectious diseases like anthrax, and may be imported under certain conditions. For more information about rules for importing animal products, go to the USDA website at USDA Animal and Plant Health Inspection Service website.

May I import hide drums into the United States as souvenirs?

Importation of animal products is regulated by the United States Department of Agriculture (USDA). Although the risk of getting cutaneous anthrax from untreated hide drums is low, there was a case of cutaneous anthrax previously linked to an imported souvenir goat hide drum. For more information about rules for importing animal products, go to the USDA website at USDA Animal and Plant Health Inspection Service website.

Where can I get more information about anthrax and animal hides?

United States Department of Agriculture (USDA)
World Organization for Animal Health (OIE)
Centers for Disease Control and Prevention (CDC):
Food Irradiation Processing Alliance (FIPA)

***** Know the facts. Stay safe! *****

References

WHO (World Health Organization) 1984, 'Guidelines on disinfection in animal husbandry for prevention and control of zoonotic diseases', WHO/VPH/84.4.
WHO (World Health Organization) 1998, 'Guidelines for the surveillance and control of anthrax in humans and animals', WHO/EMC/ZDI/98.6.
Terrestrial Animal Health Standards Commission Report, Sept 2009. Chapter 8.1, Anthrax. Retrieved on 29 Dec 2009.
Centers for Disease Control and Prevention. Cutaneous Anthrax Associated with Drum Making Using Goat Hides from West Africa - Connecticut, 2007. MMWR 2008; 57:628-631.