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. 2017 Jan;23(1):14-21.
doi: 10.3201/eid2301.150947.

Epidemiology of Human Anthrax in China, 1955-2014

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

Epidemiology of Human Anthrax in China, 1955-2014

Yu Li et al. Emerg Infect Dis. 2017 Jan.

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.

Keywords: Bacillus anthracis; China; anthrax; bacteria; bioterrorism and preparedness; case-fatality rate; cases; epidemiology; human anthrax; respiratory infections; zoonoses.

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Figures

Figure 1
Figure 1
Cases of and deaths from probable and confirmed human anthrax, China, 1955–2014. A) No. human anthrax cases (n = 120,111) and incidence rate (no. cases/100,000 population) by year. B) No. human anthrax deaths (n = 4,341) and case-fatality rate (%) by year.
Figure 2
Figure 2
Monthly distribution of probable and confirmed human anthrax cases, China, 1955–2014.
Figure 3
Figure 3
Provincial distribution of probable and confirmed human anthrax cases, China, 1955–2014.
Figure 4
Figure 4
Trends in number of counties affected by probable and confirmed human anthrax, China, 2005–2014.
Figure 5
Figure 5
Geographic distribution of counties affected by probable and confirmed human anthrax, China, 2005–2014.
See this image and copyright information in PMC

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