Abstract
Using national surveillance data for 120,111 human anthrax cases recorded during 1955−2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China. After 1978, incidence decreased until 2013, when it reached a low of 0.014 cases/100,000 population. The case-fatality rate, cumulatively 3.6% during the study period, has also decreased since 1990. Cases occurred throughout the year, peaking in August. Geographic distribution decreased overall from west to east, but the cumulative number of affected counties increased during 2005−2014. The disease has shifted from industrial to agricultural workers; 86.7% of cases occurred in farmers and herdsmen. Most (97.7%) reported cases were the cutaneous form. Although progress has been made in reducing incidence, this study highlights areas that need improvement. Adequate laboratory diagnosis is lacking; only 7.6% of cases received laboratory confirmation. Geographic expansion of the disease indicates that livestock control programs will be essential in eradicating anthrax.
Highlights
Using national surveillance data for 120,111 human anthrax cases recorded during 1955-2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China
B. anthracis is always placed high on the list of potential agents with respect to biologic warfare and bioterrorism because of its robust nature and persistence of spores, the ability of aerosolized spores to readily infect by inhalation, and the high mortality rate for resultant anthrax cases (6)
Thereafter, incidence decreased until 2013, when it reached a low of 193 cases (0.014 cases/100,000 population) (Figure 1)
Summary
Using national surveillance data for 120,111 human anthrax cases recorded during 1955-2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China. Occurring human anthrax infections are caused by contact with infected animals or animal products; ingestion of undercooked infected meat; or exposure to large-scale processing of contaminated hides, wool, and hair in enclosed factory areas. Li); Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China Human anthrax was made a reportable disease in China during the 1950s. Over the past 60 years, great progress has been made in control and prevention, including development of human anthrax vaccine in China during the late 1950s and eradication of anthrax in industrial areas during the 1980s (8)
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