Cutaneous Anthrax, West Bengal, India, 2007

Techapp.pdf), E. vittiventris cockroaches are considered to be harmless and have not been associated with human disease or transmission of pathogens. We did not observe any allergic reactions or an increase in colonization or infection rates of multidrugresistant organisms. B. germanica cockroaches are nocturnal, cannot fl y, are always encountered within human habitations, and require specialized measures for eradication (10). E. vittiventris cockroaches live in outdoor areas, do not avoid light, and are active during daytime. Buildings are not a natural habitat. In summer, adult insects can fl y inside at night, but because these cockroaches are unable to reproduce inside buildings (1), stopping entry from outside halts the infestation. Entry can be stopped by closing windows or using mosquito nets. There is no existing insecticide for eradication of E. vittiventris cockroaches (10), and even if there were, it would not be effective because insects from untreated areas outside would enter continuously (1). E. vittiventris cockroaches have been recently discovered in Geneva (10) and have become the most frequently encountered cockroaches in urban areas of Switzerland for several years (1). The reason for this fi nding remains unknown. The summer of 2003 was remarkably hot and dry in central Europe, thus representing a subtropical climate that usually favors the growth and development of cockroach populations (1,7). If this warming trend persists, populations of E. vittiventris cockroaches may continue to expand, and similar infestations may occur. In conclusion, effective control strategies for cockroach infestations depend on identifi cation of cockroach species. In this report, permanent closure of all windows was suffi cient to stop the infestation. However, to ensure compliance, it was critical to discuss the purposes of the intervention with HCWs. Acknowledgments We thank Rosemary Sudan for editorial assistance, the ICU team of the University of Geneva Hospitals for collaboration, and Manadou Diallo for expert advice.