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 R PearsonTim Brooks, And Paul Keim

Research output: Contribution to journalArticle

47 Citations (Scopus)

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 2012

Fingerprint

Anthrax
Heroin
Disease Outbreaks
Scotland
Bacillus anthracis
Single Nucleotide Polymorphism
Drug Trafficking
Afghanistan
Turkey
Spores
England
Germany
Genotype
Genome
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Epidemiology

Cite this

Price, E. P., Seymour, M. L., Sarovich, D. S., Latham, J., Wolken, S. R., Mason, 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

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, Sergey; Okinaka, Richard T.; Chung, Wai Kwan; Schupp, James M.; Wagner, David M; Vipond, Richard; Foster, Jeffrey T; Bergman, Nicholas H.; Burans, James; Pearson, Talima R; Brooks, Tim; Keim, And Paul.

In: Emerging Infectious Diseases, Vol. 18, No. 8, 08.2012, p. 1307-1313.

Research output: Contribution to journalArticle

Price, EP, Seymour, ML, Sarovich, DS, Latham, J, Wolken, SR, Mason, J, Vincent, G, Drees, KP, Beckstrom-Sternberg, SM, Phillippy, AM, Koren, S, Okinaka, RT, Chung, WK, Schupp, JM, Wagner, DM, Vipond, R, Foster, JT, Bergman, NH, Burans, J, Pearson, TR, Brooks, T & Keim, AP 2012, 'Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe', Emerging Infectious Diseases, vol. 18, no. 8, pp. 1307-1313. https://doi.org/10.3201/eid1808.111343
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, Sergey ; Okinaka, Richard T. ; Chung, Wai Kwan ; Schupp, James M. ; Wagner, David M ; Vipond, Richard ; Foster, Jeffrey T ; Bergman, Nicholas H. ; Burans, James ; Pearson, Talima R ; Brooks, Tim ; Keim, And Paul. / Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe. In: Emerging Infectious Diseases. 2012 ; Vol. 18, No. 8. pp. 1307-1313.
@article{6899f641dd894d52b147ce9226271412,
title = "Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe",
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.",
author = "Price, {Erin P.} and Seymour, {Meagan L.} and Sarovich, {Derek S.} and Jennie Latham and Wolken, {Spenser R.} and Joanne Mason and Gemma Vincent and Drees, {Kevin P.} and Beckstrom-Sternberg, {Stephen M} and Phillippy, {Adam M.} and Sergey Koren and Okinaka, {Richard T.} and Chung, {Wai Kwan} and Schupp, {James M.} and Wagner, {David M} and Richard Vipond and Foster, {Jeffrey T} and Bergman, {Nicholas H.} and James Burans and Pearson, {Talima R} and Tim Brooks and Keim, {And Paul}",
year = "2012",
month = "8",
doi = "10.3201/eid1808.111343",
language = "English (US)",
volume = "18",
pages = "1307--1313",
journal = "Emerging Infectious Diseases",
issn = "1080-6040",
publisher = "Centers for Disease Control and Prevention (CDC)",
number = "8",

}

TY - JOUR

T1 - Molecular epidemiologic investigation of an anthrax outbreak among heroin users, Europe

AU - Price, Erin P.

AU - Seymour, Meagan L.

AU - Sarovich, Derek S.

AU - Latham, Jennie

AU - Wolken, Spenser R.

AU - Mason, Joanne

AU - Vincent, Gemma

AU - Drees, Kevin P.

AU - Beckstrom-Sternberg, Stephen M

AU - Phillippy, Adam M.

AU - Koren, Sergey

AU - Okinaka, Richard T.

AU - Chung, Wai Kwan

AU - Schupp, James M.

AU - Wagner, David M

AU - Vipond, Richard

AU - Foster, Jeffrey T

AU - Bergman, Nicholas H.

AU - Burans, James

AU - Pearson, Talima R

AU - Brooks, Tim

AU - Keim, And Paul

PY - 2012/8

Y1 - 2012/8

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84864482780&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864482780&partnerID=8YFLogxK

U2 - 10.3201/eid1808.111343

DO - 10.3201/eid1808.111343

M3 - Article

C2 - 22840345

AN - SCOPUS:84864482780

VL - 18

SP - 1307

EP - 1313

JO - Emerging Infectious Diseases

JF - Emerging Infectious Diseases

SN - 1080-6040

IS - 8

ER -