Epidemiology of Human Anthrax in China, 1955−2014

Yu, Li; Yin, Wenwu; Hugh‐Jones, Martin; Wang, Liping; Mu, Di; Ren, Xiang; Zeng, Lingjia; Li, Wei; Wei, Jianchun; Lai, Shengjie; Zhou, Hang; Yu, Hongjie

doi:10.3201/eid2301.150947

Cited by 25 publications

(37 citation statements)

References 9 publications

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“…Although most developed countries report few sporadic cases in livestock and humans, the disease is still enzootic in parts of Africa (e.g., Zimbabwe and Chad), the Middle East, Central Asia, China, Pakistan, Bhutan, Bangladesh, and India. 1,2,[6][7][8][9][10][11][12][13][14][15] The geographic distribution of anthrax is associated with certain ecological factors. In some ecosystems, outbreaks occur late in the hot-dry season, whereas in others, outbreaks are associated with the end of heavy rains, suggesting that weather extremes may be an important trigger of outbreaks.…”

Section: Epidemiologymentioning

confidence: 99%

Cutaneous Anthrax—Still a Reality in India

Thappa

2019

ANAMS

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Anthrax, a toxigenic zoonosis, incidentally affecting humans has become rare but endemic outbreaks still continue to occur in tropical countries like India, parts of South America, and Europe where veterinary control of livestock is marginal and environmental conditions favor an animal–soil–animal cycle. India, with its largest population of livestock in the world, continues to have anthrax outbreaks with highest incidence reported from south, and the authors have reported an outbreak of 23 cases from 1998 to 2001 from south India. Children outnumbered adults and most of them had lesions on the exposed sites. However, there is a limited documentation of anthrax outbreaks from India warranting the need for sensitizing and creating awareness among health care professionals to identify and report these cases at the earliest so that appropriate actions are taken. Anthrax continues to retain a certain fascination and notoriety because of the potential for use of the bacillus spores in biologic warfare.

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Section: Epidemiologymentioning

confidence: 99%

Cutaneous Anthrax—Still a Reality in India

Thappa

2019

ANAMS

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“…17 Although the disease was affected by season and ecology conditions in China, we did not assess these conditions. 39 The mean of encapsulated pathogens from several other studies was 50.5%. Based on the results, it is necessary to plan for the prevention of 2 main forms of cutaneous and GI anthrax countrywide focusing on herds and farms.…”

Section: Countrywide Trends In the Anthrax Disease From Past Until Rementioning

confidence: 84%

The Anthrax Disease in Iran From 2000 to 2016: The Predominance of Cutaneous and Gastrointestinal Form

Ghasemian¹,

Nojoomi²,

Rajabi-Vardanjani³

2017

Int J Enteric Pathog

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Context: Anthrax is a zoonotic and occupational disease caused by bacterium Bacillus anthracis. The agent produces spores which persist in the environment for years. This review assessed previous reports on anthrax disease in Iran from 2000 to 2016. Evidence acquisition: The reports of anthrax from 2000 to 2016 were reviewed. The keywords "Bacillus anthracis", "Anthrax", "clinical signs", "Iran" and "zoonosis" were investigated in the searching databases such as "Google Scholar", "Google", "PubMed" and other sites. The reports of soil isolation and spores from environments were excluded. However, the clinical outcome of the cases, history of animal exposure, wool contaminations and meat in slaughterhouses were included. Results of Persian reports were also included in this review. Data were analyzed using Excel and GraphPad Prism version 6.1. The standardized mean difference (SMD) was used for data analysis.. Overall, 768 cases of anthrax were found in human, sheep, goats and cattle. Six hundred of the human cases aged between 2.5 and 71 years old were included. Four-hundred ten (68.33%) patients were male (mean age=28.1 ± 1.5) and 190 (31.66%) patients were female (mean age = 17±1.5). Clinical manifestations in patients were mostly in 2 cutaneous (56.6%) and gastrointestinal (42.83%) forms. Sporadic anthrax outbreaks occurred in the country in 2007, 2008 and 2011. No molecular typing has been performed for B. anthracis strains countrywide. The virulence factors encoded by the genes located on plasmids pXO1 and pXO2 were detected in various areas with high prevalence. Conclusion: Cutaneous and gastrointestinal anthrax are 2 main manifestations of the disease in Iran. Male patients were significantly more infected. Although rare, anthrax continues to be a dreadful consequence of herds or soil exposure and consumption of undercooked meat of infected animals. Education plans and proper animal vaccination plans with the consideration of virulence factors are helpful for the prevention of the disease.

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“…Human anthrax has been a continuous problem in many rural regions of China [13]. Ames lineage strains were found in the Inner Mongolia (n = 18), Xinjiang (n = 2), Liaoning (n = 8), Gansu (n = 1) and Guangxi Provinces (n = 1).…”

Section: Discussionmentioning

confidence: 99%

Genetic diversity of Bacillus anthracis Ames lineage strains in China

Zhang

et al. 2020

BMC Infect Dis

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Background: Anthrax is an endemic disease that persists in the rural regions of China. The global genetic population structure of B.anthracis has also been defined by the canonical single-nucleotide polymorphisms (canSNP) and multiple-locus variable-number tandem repeat analysis (MLVA). Five canSNP lineages were found in China, and the A.Br.Ames lineage has been the second predominant group in recent years in China. The objective of this study was to reveal genetic diversity of the Ames lineage strains by MLVA. Methods: Two molecular typing methods, canSNP and MLVA with 15markers were used to study the genetic relationship among the Ames lineage strains. The outbreak information associated with these strains was also collected and investigated. Results: From 2007 to 2018, a total of 21 human anthrax infection outbreaks (68 patients) associated with B. anthracis Ames lineage strains were reported in China. Ames lineage strain-associated human anthrax is mainly distributed in the northern part of China, including the provinces of Inner Mongolia, Liaoning, Gansu, and Xinjiang. In the study, a total of 30 Ames lineage strains were included and 10 MLVA15 genotypes were identified. These strains were mainly found in northeast China, Inner Mongolia and Liaoning. In recent years, the Ames lineage strains were isolated in the two provinces every year. The 18 Ames lineage strains isolated from Inner Mongolia were divided into eight MLVA15 genotypes. From 2010 to 2015, there were continuous reports of outbreaks in Keyouzhongqi County, Inner Mongolia, and the strains that were isolated annually in succession belonged to the MLVA15-30 genotype. Conclusions: The Ames lineage strains are widely distributed in northern China. Their genetic diversity can be illustrated by the results of the MLVA. The genetic characteristics of the Ames lineage strains from outbreaks in different provinces varied. In some areas, human anthrax outbreaks occurred annually in succession, and these related strains grouped together. These observations indicate that the local environment was persistently contaminated with B. anthracis spores, vaccination of livestock should become the fundamental control measure in the areas.

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Epidemiology of Human Anthrax in China, 1955−2014

Cited by 25 publications

References 9 publications

Cutaneous Anthrax—Still a Reality in India

Cutaneous Anthrax—Still a Reality in India

The Anthrax Disease in Iran From 2000 to 2016: The Predominance of Cutaneous and Gastrointestinal Form

Genetic diversity of Bacillus anthracis Ames lineage strains in China

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