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Volume 23, Number 1—January 2017
Research

Epidemiology of Human Anthrax in China, 1955−2014

Yu Li1, Wenwu Yin1, Martin Hugh-Jones1, Liping Wang, Di Mu, Xiang Ren, Lingjia Zeng, Qiulan Chen, Wei Li, Jianchun Wei, Shengjie Lai, Hang Zhou, and Sheng WeiComments to Author 
Author affiliations: The University of Hong Kong, Hong Kong, China (Y. Li); Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China (Y. Li, W. Yin, L. Wang, D. Mu, X. Ren, L. Zeng, Q. Chen, S. Lai, H. Zhou, H. Yu); Louisiana State University, Baton Rouge, Louisiana, USA (M. Hugh-Jones); National Institute for Communicable Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing (W. Li, J. Wei); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (H. Yu)

Main Article

Table

Demographic and diagnostic characteristics of patients with human anthrax, by diagnosis type, China, 2005–2014*

Characteristic Probable cases, n = 3,121 Confirmed cases, n = 258 Total, n = 3,379
Sex
M 2,273 (72.8) 210 (81.4) 2,483 (73.5)
F
848 (27.2)
48 (18.6)
896 (26.5)
Median age, y, (IQR)
38 (27–49)
40 (30–49)
38 (27–49)
Age group, y
0–14 229 (7.3) 11 (4.3) 240 (7.1)
15–19 158 (5.1) 8 (3.1) 166 (4.9)
20–24 230 (7.4) 20 (7.8) 250 (7.4)
25–29 309 (9.9) 25 (9.7) 334 (9.9)
30–34 352 (11.3) 24 (9.3) 376 (11.1)
35–39 415 (13.3) 34 (13.2) 449 (13.3)
40–44 379 (12.1) 39 (15.1) 418 (12.4)
45–49 282 (9.0) 38 (14.7) 320 (9.5)
50–54 212 (6.8) 18 (7.0) 230 (6.8)
55–59 201 (6.4) 22 (8.5) 223 (6.6)
60–64 167 (5.4) 11 (4.3) 178 (5.3)
>65
187 (6.0)
8 (3.1)
195 (5.8)
Occupation
Farmer or herdsman 2,700 (86.5) 231 (89.5) 2,931 (86.7)
Infants or students† 248 (7.9) 12 (4.7) 260 (7.7)
Other‡
173 (5.5)
15 (5.8)
188 (5.6)
Rural residence§
2,889 (92.6)
234 (90.7)
3,123 (92.4)
Fatal outcome
36 (1.2)
5 (1.9)
41 (1.2)
Clinical forms
Cutaneous 3,055 (97.9) 252 (97.7) 3,307 (97.9)
Inhalational 0 1 (0.4) 1 (0.0)
Gastrointestinal 5 (0.2) 1 (0.4) 6 (0.2)
Unknown¶
61 (2.0)
4 (1.6)
65 (1.9)
Median onset to diagnosis interval, d (IQR)
4.0 (2.0–6.7)
5.0 (3.0–8.3)
4.0 (2.4–7.0)
Year of illness onset
2005 497 (15.9) 38 (14.7) 535 (15.8)
2006 417 (13.4) 35 (13.6) 452 (13.4)
2007 400 (12.8) 26 (10.1) 426 (12.6)
2008 309 (9.9) 29 (11.2) 338 (10.0)
2009 334 (10.7) 17 (6.6) 351 (10.4)
2010 265 (8.5) 25 (9.7) 290 (8.6)
2011 279 (8.9) 30 (11.6) 309 (9.1)
2012 220 (7.1) 17 (6.6) 237 (7.0)
2013 181 (5.8) 12 (4.7) 193 (5.7)
2014 219 (7.0) 29 (11.2) 248 (7.3)

*Values are no. (%) unless otherwise indicated. Percentages may not total 100 because of rounding. IQR, interquartile range.
†Infants include children attending and not attending kindergarten. Students include primary, secondary, and college students.
‡Includes teacher, laborers, self-employed and unemployed, workers, food industry personnel, retired persons, and cadres of staff.
§If the residence community was connected to seats of county or municipal government through public facilities, residence facilities and other facilities, or mine area, development zone, research institutes, higher education establishments, farming communities or tree farming communities with >3,000 of permanent residents, it was considered an urban residence. Otherwise, the community was considered a rural residence.
¶No information was available.

Main Article

1These authors contributed equally to this article.

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