Genetic source tracking of an anthrax outbreak in Shaanxi province, China

Dong-Li Liu, Jian-Chun Wei, Qiu-Lan Chen, Xue-Jun Guo, En-Min Zhang, Li He, Xu-Dong Liang, Guo-Zhu Ma, Ti-Cao Zhou, Wen-Wu Yin, Wei Liu, Kai Liu, Yi Shi, Jian-Jun Ji, Hui-Juan Zhang, Lin Ma, Fa-Xin Zhang, Zhi-Kai Zhang, Hang Zhou, Hong-Jie Yu, Biao Kan, Jian-Guo Xu, Feng Liu, Wei Li

Anthrax is an acute zoonotic infectious disease caused by the bacterium known as Bacillus anthracis. From 26 July to 8 August 2015, an outbreak with 20 suspected cutaneous anthrax cases was reported in Ganquan County, Shaanxi province in China. The genetic source tracking analysis of the anthrax outbreak was performed by molecular epidemiological methods in this study. Three molecular typing methods, namely canonical single nucleotide polymorphisms (canSNP), multiple-locus variable-number tandem repeat analysis (MLVA), and single nucleotide repeat (SNR) analysis, were used to investigate the possible source of transmission and identify the genetic relationship among the strains isolated from human cases and diseased animals during the outbreak. Five strains isolated from diseased mules were clustered together with patients' isolates using canSNP typing and MLVA. The causative B. anthracis lineages in this outbreak belonged to the A.Br.001/002 canSNP subgroup and the MLVA15-31 genotype (the 31 genotype in MLVA15 scheme). Because nine isolates from another four provinces in China were clustered together with outbreak-related strains by the canSNP (A.Br.001/002 subgroup) and MLVA15 method (MLVA15-31 genotype), still another SNR analysis (CL10, CL12, CL33, and CL35) was used to source track the outbreak, and the results suggesting that these patients in the anthrax outbreak were probably infected by the same pathogen clone. It was deduced that the anthrax outbreak occurred in Shaanxi province, China in 2015 was a local occurrence.