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Source and risk factors of a cutaneous anthrax outbreak, Jiangsu, Eastern China, 2012.

ABSTRACT: Anthrax is still a severe public health problem and threat to human health. A cutaneous anthrax outbreak occurred in Jiangsu Province, a non-endemic anthrax region of eastern China, from July to August 2012. Epidemiological and laboratory investigation were initiated to trace the source of infection and identify the risk factors of the outbreak. On 25 July 2012, 17 persons were exposed to a sick cow, which had been imported from northeast China a few days previously. Of the 17 exposed, eight developed symptoms between 1 and 8 days and were diagnosed as cutaneous anthrax cases. Three main genes of Bacillus anthracis were detected from both human and cow meat samples, indicating that the outbreak was associated with this infected cow. A retrospective cohort study showed that contact with blood and presence of skin damage contributed to the case infection with B. anthracis. The outbreak highlights the need to enhance quarantine for imported livestock, which should have been vaccinated prior to importation, the significance of education for high-risk individuals, and training for primary healthcare workers even in anthrax-free areas.

SUBMITTER: Hu JL

PROVIDER: S-EPMC9150473 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Source and risk factors of a cutaneous anthrax outbreak, Jiangsu, Eastern China, 2012.

Hu J L JL Cui L L LL Bao C J CJ Tan Z M ZM Rutherford S S Ying L L Zhang M L ML Zhu F C FC

Epidemiology and infection 20160609 12

Anthrax is still a severe public health problem and threat to human health. A cutaneous anthrax outbreak occurred in Jiangsu Province, a non-endemic anthrax region of eastern China, from July to August 2012. Epidemiological and laboratory investigation were initiated to trace the source of infection and identify the risk factors of the outbreak. On 25 July 2012, 17 persons were exposed to a sick cow, which had been imported from northeast China a few days previously. Of the 17 exposed, eight dev ...[more]

PMID: 27277672

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Project description:Toxoplasma gondii, an opportunistic protozoan, infects one-third of people worldwide and could lead to serious outcomes in immunodeficient or immunocompromised populations. The present study aimed to investigate the prevalence and risk factors for T. gondii infection among high-risk populations in Jiangsu Province, eastern China. We conducted a cross-sectional survey among 4 categories of populations in 13 prefectures including HIV/AIDS patients, livestock breeding/processing (B/P) staff, pregnant women, and cancer patients. We detected specific immunoglobulin G and M (IgG and IgM) levels for each participant using enzyme-linked immunosorbent assay (ELISA) and asked to complete a questionnaire for each participant that covered sociodemographic information as well as the basic knowledge of attitudes toward and the practices for the prevention of toxoplasmosis. A total of 5231 participants distributed across 13 prefecture-level cities was surveyed, including 2455 males and 2776 females. Total seropositivity rate in each population category was as follows: 9.08% (HIV/AIDS patients), 11.65% (livestock B/P staff), 5.50% (pregnant women), and 12.89% (cancer patients). We detected IgM positivity in HIV/AIDS patients (0.47%, 6/1289), livestock B/P staff (0.08%, 1/1330), and cancer patients (0.46%, 6/1303) but not in pregnant women. Further, we detected IgM+IgG positivity only in cancer patients (0.31%, 4/1303). The seropositivity rate for pregnant women was significantly lower, while cancer patients were significantly higher. Higher educational levels were associated with lower seropositivity rates for T. gondii infection. High seropositivity rates were associated with long period of HIV infection among HIV/AIDS patients, frequent contact with livestock among livestock breeding/processing staff and male older patients among cancer patients, respectively. Analysis of practices across all participants showed that frequent contact with pets in everyday life or using the same cutting board for both raw and cooked foods leads to higher seropositivity rates. Therefore, we obtained the seroprevalence and risk factors of toxoplasmosis among high-risk populations in Jiangsu Province which could provide evidence for the implementation of control measures in the near future.

Project description:ObjectivesTo determine the risk factors associated with cutaneous anthrax infection in humans.MethodsDuring 2013-2016, we investigated total 26 anthrax outbreaks across the country. We additionally conducted a case-control study to identify risk factors by recruiting four controls for each enrolled case. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated to identify risk factors using multivariate logistic regression.ResultsOver the study period, a total of 1,210 suspected cutaneous anthrax cases were identified in seven districts of Bangladesh. Most of the cases (61%, n = 744) were detected from Meherpur district. Cases were detected over the year, with the peak number of outbreaks occurring in May. The overall attack rate of suspected cutaneous anthrax cases for 16 outbreaks was 20%, with the highest rate occurring among individuals aged 40-49 years. Persons who had a cut injury (aOR 19.04, CI: 4.08-88.86), weighed raw meat (aOR 5.73, CI: 3.03-10.83), mixed bones and meat (aOR 4.64, CI: 3.03-7.09), observed livestock slaughtering (aOR 2.86, CI: 2.02-4.04), had direct contact to an anthrax suspected livestock (aOR 2.68, CI:1.61-4.45), slaughtered livestock (aOR 2.29, CI: 1.3-4.02), and who did not wash hands with soap and water after direct contact (aOR 2.57, CI: 1.89-3.5) were more likely to develop cutaneous anthrax than people who did not have these exposures.ConclusionPrior cut injuries on exposed body areas during meat handling and slaughtering of sick livestock were identified as potential risk factors for cutaneous anthrax, highlighting the importance of preventing the slaughter of sick animals. However, stopping slaughtering sick livestock, handling meat and livestock by-products to reduce anthrax exposures from livestock to humans may be difficult to achieve given the associated financial incentives in Bangladesh. Interventions such as hand washing with soap during slaughtering and processing meat can be targeted to affected communities to ameliorate some risk.

Project description:Objective: To describe the epidemiological characteristics of norovirus outbreaks in Jiangsu Province, utilize the total attack rate (TAR) and transmissibility (R unc) as the measurement indicators of the outbreak, and a statistical difference in risk factors associated with TAR and transmissibility was compared. Ultimately, this study aimed to provide scientific suggestions to develop the most appropriate prevention and control measures. Method: We collected epidemiological data from investigation reports of all norovirus outbreaks in Jiangsu Province from 2012 to 2018 and performed epidemiological descriptions, sequenced the genes of the positive specimens collected that were eligible for sequencing, created a database and calculated the TAR, constructed SEIAR and SEIARW transmission dynamic models to calculate R unc, and performed statistical analyses of risk factors associated with the TAR and R unc. Results: We collected a total of 206 reported outbreaks, of which 145 could be used to calculate transmissibility. The mean TAR in was 2.6% and the mean R unc was 12.2. The epidemiological characteristics of norovirus outbreaks showed an overall increasing trend in the number of norovirus outbreaks from 2012 to 2018; more outbreaks in southern Jiangsu than northern Jiangsu; more outbreaks in urban areas than in rural areas; outbreaks occurred mostly in autumn and winter. Most of the sites where outbreaks occurred were schools, especially primary schools. Interpersonal transmission accounted for the majority. Analysis of the genotypes of noroviruses revealed that the major genotypes of the viruses changed every 3 years, with the GII.2 [P16] type of norovirus dominating from 2016 to 2018. Statistical analysis of TAR associated with risk factors found statistical differences in all risk factors, including time (year, month, season), location (geographic location, type of settlement, type of premises), population (total number of susceptible people at the outbreak site), transmission route, and genotype (P < 0.05). Statistical analysis of transmissibility associated with risk factors revealed that only transmissibility was statistically different between sites. Conclusions: The number of norovirus outbreaks in Jiangsu Province continues to increase during the follow-up period. Our findings highlight the impact of different factors on norovirus outbreaks and identify the key points of prevention and control in Jiangsu Province.

Dataset Information

Source and risk factors of a cutaneous anthrax outbreak, Jiangsu, Eastern China, 2012.

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Source and risk factors of a cutaneous anthrax outbreak, Jiangsu, Eastern China, 2012.

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