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orontalo province has once again been hit by an anthrax outbreak, with the number of people infected by the virus reportedly on the rise.

Initially, health officials detected that 11 residents, including a 4-year-old boy, were infected by skin anthrax in Pangadaa village in Dungaliyo subdistrict and Batulayar village in Bongomeme subdistrict. That number has now reached 14 people.

The anthrax outbreak initially came to light over the past week, when a community health center (puskesmas) in Dunggaliyo and Bongomeme subdistricts, Gorontalo regency, treated a toddler with a black blister over his eyes that caused the eyes to shut.

The boy is now being cared for at Dunda Limb Hospital, while 13 other residents in two villages have refused to be treated in hospital, despite three of them suffering severe infection.

“For the time being, they are being treated at home and given antibiotics. We are trying to persuade them to go to hospital,” Gorontalo regency Health Agency head Roni Sampir told The Jakarta Post on Monday.

According to Roni, residents infected by anthrax are reluctant to seek treatment in hospital because of the distance from their homes in remote villages.

Earlier, more than 20 cows in the two villages fell sick and abruptly died. Most of the people subsequently exposed to anthrax had slaughtered the infected cows or consumed beef contaminated with the virus. In addition, beef infected with anthrax was being sold in the surrounding villages. No deaths of livestock were reported to health officers or relevant agencies.

Anthrax initially broke out in the province in April around the shores of Lake Limboto. Five residents of Tilango subdistrict, Gorontalo regency, were forced to undergo intensive care after experiencing nausea and vomiting, followed by vesicular lesions on their skin. The outbreak also spread to Bone Bolango regency.

The Gorontalo Plantation and Livestock Agency declared two sub-districts to be suffering an anthrax epidemic, with more than 100 heads of cattle and buffalo infected with anthrax, and 8,000 heads vaccinated.

Animal husbandry officer Fenny Rimporok said the office was also forced to ask police to seal the beef section of Gorontalo Central Market, where infected beef had been sold.

The epidemic has hit beef sellers hard, their income plummeting 80 percent in recent months.

Bank Indonesia (BI) Gorontalo branch head Suryono said the outbreak had not adversely affected the wider economy, but had influenced people’s behavior.

“Stalls serving beef have now begun to reduce the amount of beef in dishes,” said Suryono.

The local BI branch has provided 15,000 doses of anthrax vaccine to combat the disease. According to Suryono, BI assists around 300 cattle ranchers in the province, with the number of cattle reaching 1,000.