title: Epidemiology of Human Anthrax in China, 1955-2014.
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.
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.forename: Wenwu
authors.initials: W
authors.lastname: Yin
authors.forename: Martin
authors.initials: M
authors.lastname: Hugh-Jones
authors.forename: Liping
authors.initials: L
authors.lastname: Wang
authors.forename: Di
authors.initials: D
authors.lastname: Mu
authors.forename: Xiang
authors.initials: X
authors.lastname: Ren
authors.forename: Lingjia
authors.initials: L
authors.lastname: Zeng
authors.forename: Qiulan
authors.initials: Q
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Jianchun
authors.initials: J
authors.lastname: Wei
authors.forename: Shengjie
authors.initials: S
authors.lastname: Lai
authors.forename: Hang
authors.initials: H
authors.lastname: Zhou
authors.forename: Hongjie
authors.initials: H
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000881:Anthrax / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D001408:Bacillus anthracis / Q000472:pathogenicity / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D058751:Livestock / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D014505:Urban Population; D015047:Zoonoses / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology
keywords: Bacillus anthracis; China; anthrax; bacteria; bioterrorism and preparedness; case-fatality rate; cases; epidemiology; human anthrax; respiratory infections; zoonoses