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Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe

Price, Erin P., Seymour, Meagan L., Sarovich, Derek S., Latham, Jennie, Wolken, Spenser R., Mason, Joanne, Vincent, Gemma, Drees, Kevin P., Beckstrom-Sternberg, Stephen M., Phillippy, Adam M., Koren, Ssegey, Okinaka, Richard T., Chung, Wai-Kwan, Schupp, James M., Wagner, David M., Vipond, Richard, Foster, Jeffrey T., Bergman, Nicholas H., Burans, James, Keim, Paul and et al. (2012). Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe. Emerging Infectious Diseases,18(8):1307-1313.

Document type: Journal Article
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Title Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe
Author Price, Erin P.
Seymour, Meagan L.
Sarovich, Derek S.
Latham, Jennie
Wolken, Spenser R.
Mason, Joanne
Vincent, Gemma
Drees, Kevin P.
Beckstrom-Sternberg, Stephen M.
Phillippy, Adam M.
Koren, Ssegey
Okinaka, Richard T.
Chung, Wai-Kwan
Schupp, James M.
Wagner, David M.
Vipond, Richard
Foster, Jeffrey T.
Bergman, Nicholas H.
Burans, James
Keim, Paul
et al.
Journal Name Emerging Infectious Diseases
Publication Date 2012
Volume Number 18
Issue Number 8
ISSN 1080-6040   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84864482780
Start Page 1307
End Page 1313
Total Pages 7
Place of Publication United States
Publisher Centers for Disease Control and Prevention
HERDC Category C1 - Journal Article (DIISR)
Abstract In December 2009, two unusual cases of anthrax were diagnosed in heroin users in Scotland. A subsequent anthrax outbreak in heroin users emerged throughout Scotland and expanded into England and Germany, sparking concern of nefarious introduction of anthrax spores into the heroin supply. To better understand the outbreak origin, we used established genetic signatures that provided insights about strain origin. Next, we sequenced the whole genome of a representative Bacillus anthracis strain from a heroin user (Ba4599), developed Ba4599-specific single-nucleotide polymorphism assays, and genotyped all available material from other heroin users with anthrax. Of 34 case-patients with B. anthracis–positive PCR results, all shared the Ba4599 single-nucleotide polymorphism genotype. Phylogeographic analysis demonstrated that Ba4599 was closely related to strains from Turkey and not to previously identified isolates from Scotland or Afghanistan, the presumed origin of the heroin. Our results suggest accidental contamination along the drug trafficking route through a cutting agent or animal hides used to smuggle heroin into Europe.
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