Molecular Characterization of Bacillus anthracis Directly from Patients' Eschar and Beef in an Anthrax Outbreak in Jiangsu Province, China, 2012

An outbreak of anthrax was reported in Lianyungang, Jiangsu Province, China in 2012. Laboratory confirmation of cases was made by detection of Bacillus anthracis genes rpoB, pagA, and cap using real-time polymerase chain reaction (PCR); source tracking was conducted by multiple locus variable-number tandem-repeat analysis (MLVA) and pagA sequencing using DNA extracted from case specimens and meat from a suspected slaughtered cow. The genotypes were MLVA type 57 and pagA genotype I. Combined with the field epidemiological data, the four cutaneous anthrax cases most likely were caused by butchering of the sick cow. Backward tracing of animal cases identified the region of origin, and some public health measures, such as reactive or preventative animal vaccination for cattle, intersectoral cooperation, ensuring proper pre-slaughter inspection, and educating butchers and villagers about this disease, could be used to prevent B. anthracis infection.