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

Erin P. Price, Meagan L. Seymour, Derek S. Sarovich, Jennie Latham, Spenser R. Wolken, Joanne Mason, Gemma Vincent, Kevin P. Drees, Stephen M. Beckstrom-Sternberg, Adam M. Phillippy, Sergey Koren, Richard T. Okinaka, Wai Kwan Chung, James M. Schupp, David M. Wagner, Richard Vipond, Jeffrey T. Foster, Nicholas H. Bergman, James Burans, Talima PearsonTim Brooks, And Paul Keim

Research output: Contribution to journalArticle

51 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1307-1313
Number of pages7
JournalEmerging infectious diseases
Volume18
Issue number8
DOIs
StatePublished - Aug 1 2012

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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  • Cite this

    Price, E. P., Seymour, M. L., Sarovich, D. S., Latham, J., Wolken, S. R., Mason, J., Vincent, G., Drees, K. P., Beckstrom-Sternberg, S. M., Phillippy, A. M., Koren, S., Okinaka, R. T., Chung, W. K., Schupp, J. M., Wagner, D. M., Vipond, R., Foster, J. T., Bergman, N. H., Burans, J., ... Keim, A. P. (2012). Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe. Emerging infectious diseases, 18(8), 1307-1313. https://doi.org/10.3201/eid1808.111343