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Applied and Environmental Microbiology, May 2008, p. 2928-2931, Vol. 74, No. 9
0099-2240/08/$08.00+0 doi:10.1128/AEM.02574-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Molecular Epidemiology of Bacillus anthracis: Determining the Correct Origin
Paola Pilo,
Vincent Perreten, and
Joachim Frey*
Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, Postfach, CH-3001 Bern, Switzerland
Received 15 November 2007/
Accepted 29 February 2008

ABSTRACT
We analyzed and compared strains of
Bacillus anthracis isolated
from husbandry and industrial anthrax cases in Switzerland between
1952 and 1981 with published data using multiple-locus variable-number
tandem repeat analysis. Strains isolated from autochthonous
cases of anthrax in cattle belong to genotype B2, together with
strains from continental Europe, while human
B. anthracis strains
clustered with genotype A4. These strains could be traced back
to outbreaks of human anthrax that occurred between 1978 and
1981 in a factory processing cashmere wool from the Indian subcontinent.
We interpret the worldwide occurrence of
B. anthracis strains
of cluster A4 to be due to the extensive global trade of untreated
cashmere wool during the last century.

INTRODUCTION
Bacillus anthracis, the causative agent of anthrax, is a gram-positive
and spore-forming bacterium. Anthrax is mainly a herbivore disease,
but human cases occur, primarily as a professional disease principally
among breeders and veterinarians (
9). Because of its history
as an agent of biological warfare and its worldwide dissemination,
it is essential to accurately subtype
B. anthracis in order
to react with appropriate measures in case of suspicious events.
Nowadays, canonical single-nucleotide polymorphism markers (canSNPs)
represent a fast way to discriminate among the major
B. anthracis sublineages (
13), while
multiple-
locus
variable-
number
tandem
repeat (VNTR)
analysis (MLVA) is the most suitable technique
to differentiate and subtype
B. anthracis strains (
7). Comparison
of MLVA data with published ones should help to trace back the
geographical origin of the strains (
3,
4,
5,
6,
8,
12). In Switzerland,
anthrax was eradicated in cattle in the 1960s by strictly prohibiting
the burial of dead animals or slaughtered waste and requiring
the burning of the carcasses of animals that died from diseases.
However, between 1978 and 1981, small outbreaks of human anthrax
occurred in a plant which processed synthetic fibers and goat
wool from the Indian subcontinent. In this study, we analyzed
and compared Swiss isolates of
B. anthracis from husbandry and
industrial anthrax cases with the published data from a worldwide
collection of
B. anthracis strains using MLVA (
6).
Swiss B. anthracis isolates (Table 1) were identified as described previously (11, 14). They were susceptible to the antibiotics most commonly used to treat gram-positive bacteria as determined by broth dilution (Table 1) (2, 8), except strain JF3852, which showed resistance to trimethoprim-sulfamethoxazole. Thirteen canSNPs (A.Br.001, A.Br.002, A.Br.003, A.Br.004, A.Br.006, A.Br.007, A.Br.008, A.Br.009, B.Br.001, B.Br.002, B.Br.003, B.Br.004, and A/B. Br.001) and eight VNTR markers for B. anthracis (VrrA, VrrB1, VrrB2, VrrC1, VrrC2, GC3, pXO1, and pXO2) were amplified by PCR using filtered lysates as template DNA (8) and sequenced as described elsewhere (6, 13). The canSNP sequences were compared to published data (13). Swiss strains belong to three major sublineages, A.Br.Aust94, A.Br.Vollum, and B.Br.CNEVA, according to the classification of Van Ert and colleagues (13). Strains JF3852, JF3854, JF3887, and JF3888, isolated from clinical cases in cattle between 1952 and 1962, have the same canSNP profile as the sublineage B.Br.CNEVA (with the following canSNP characteristics: A.Br.001, T; A.Br.002, G; A.Br.003, A; A.Br.004, T; A.Br.006, C; A.Br.007, T; A.Br.008, T; A.Br.009, A; B.Br.001, T; B.Br.002, G; B.Br.003, A; B.Br.004, C; and A/B.Br.001, A), while the cattle strain JF3853 belongs to the sublineage A.Br.Aust94 (with the following canSNP characteristics: A.Br.001, T; A.Br.002, G; A.Br.003, G; A.Br.004, C; A.Br.006, A; A.Br.007, T; A.Br.008, T; A.Br.009, A; B.Br.001, T; B.Br.002, G; B.Br.003, G; B.Br.004, T; and A/B.Br.001, A). All the other strains isolated from human clinical cases, goat hairs, and air filters during small iterative outbreaks of anthrax in a wool processing factory in the late 1970s and early 1980s belong to the sublineage A.Br.Vollum (with the following canSNP characteristics: A.Br.001, T; A.Br.002, G; A.Br.003, A; A.Br.004, T; A.Br.006, A; A.Br.007, C; A.Br.008, T; A.Br.009, A; B.Br.001, T; B.Br.002, G; B.Br.003, G; B.Br.004, T; and A/B.Br.001, A).
The sizes of the VNTR amplicons (Table
2) were compared to selected
published allele sizes (
6) as well as to the
B. anthracis genome
sequences from GenBank (
http://www.ncbi.nlm.nih.gov). A phylogenetic
tree was derived from allelic profile data by the unweighted
pair group method with arithmetic means with online software
(
http://pubmlst.org/) using the PHYLIP suite of programs (version
3.6; J. Felsenstein, University of Washington, Seattle, WA).
The MLVA of the strains isolated in Switzerland showed that
they belong to three distinct clusters according to their origin
(Fig.
1). Strains JF3852, JF3854, JF3887, and JF3888 (Fig.
1)
belong to cluster B2, together with strains from France, Croatia,
Slovakia, and Poland (
4,
6,
5). These strains represent autochthonous
cases from cattle that died from anthrax, a disease that was
common in most European countries in the first half of the 20th
century, when carcasses of perished animals were buried. These
strains therefore cluster in B2 with endemic, mostly bovine
strains from central Europe. The bovine strain JF3853, from
a 1952 case, which proved to belong to a separate canSNP sublineage,
clusters with the A3a genotype group and could represent an
imported infection (Fig.
1) (
6).
The third group of strains, isolated from wool processing factory
outbreaks (
10), represents a clonal population clustering with
the A4 genotype (
6). One strain, JF3889, isolated in Switzerland
in 1981 but whose exact origin was unknown, clustered within
the A4 branch, suggesting that it also originated from the outbreaks
in the wool factory in the same year and hence can be attributed
to the same series of outbreaks (Fig.
1). The factory handled
mainly imported cashmere wool from Pakistan. In the classification
of Keim and colleagues, the cluster also contains two strains
reported as Swiss strains (SWI1 and SWI2) as well as strains
from Pakistan (
6). The MLVA profile of strain SWI2 is identical
to the profiles of several strains from our collection that
were isolated during the wool factory outbreak in 1981, while
the profile of a strain analogous to SWI1 was not found in our
collection. The minor variations found in the strains from the
outbreaks of the wool factory from 1978 to 1981 are thought
to be due to several different introductions from the same origin
during a period of 3 years (
10).
In the molecular epidemiological study of Keim et al. (6), which represents a world analysis of B. anthracis strains, cluster A4 is striking in that it contains genetically closely related strains from unrelated geographical areas. This cluster contains two strains (SWI1 and SWI2) that were supplied by a university laboratory of southern Germany and reposted as Swiss strains (6). In this respect, it is worthwhile to note that the wool factory that caused the outbreaks from 1978 to 1981 was located close to the German border. Diagnosis and identification of strains were done simultaneously in institutes of Swiss and German universities, which also shared strains (10). Cluster A4, as determined by Keim and colleagues, also contains two strains reported as German strains, one of which has a genotype identical to strain SWI2 and some of our strains from the wool factory outbreak (6). Therefore, we suppose that the two German strains belonging to cluster A4 originated from the same outbreaks from 1978 to 1981 that were caused by contaminated cashmere goat wool.
Cashmere goat wool was processed in many wool factories worldwide during the last century and frequently caused human anthrax among workers (1). Taking into account our results and the fact that cluster A4 also contains strains from Pakistan, we interpret the geographically broad distribution of B. anthracis strains belonging to the genetically very tight cluster A4 (6) to be due to ovine strains from the Indian subcontinent that spread by the trading of unprocessed wool over the whole globe, causing human anthrax cases in very distant locations.
Although MLVA is a powerful molecular epidemiological method for tracing back the origin of strains, reliable epidemiological data must be available in order to draw sound conclusions on the global spread of B. anthracis.

ACKNOWLEDGMENTS
We thank M. Wittenbrink, who kindly provided strains JF3887,
JF3888, and JF3889.
This work was supported by the Swiss Federal Office of Public Health (BAG).

FOOTNOTES
* Corresponding author. Mailing address: Institute of Veterinary Bacteriology, University of Bern, Länggassstrasse 122, Postfach, CH-3001 Bern, Switzerland. Phone: 41 31 631 2430. Fax: 41 631 2634. E-mail:
joachim.frey{at}vbi.unibe.ch 
Published ahead of print on 7 March 2008. 

REFERENCES
1 - Carter, T. 2004. The dissemination of anthrax from imported wool: Kidderminster 1900-14. Occup. Environ. Med. 61:103-107.[Abstract/Free Full Text]
2 - Clinical and Laboratory Standards Institute. 2006. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, vol. 26, no. 2. Approved standard M7-A7, 7th ed. Clinical and Laboratory Standards Institute, Wayne, PA.
3 - Fasanella, A., M. Van Ert, S. A. Altamura, G. Garofolo, C. Buonavoglia, G. Leori, L. Huynh, S. Zanecki, and P. Keim. 2005. Molecular diversity of Bacillus anthracis in Italy. J. Clin. Microbiol. 43:3398-3401.[Abstract/Free Full Text]
4 - Fouet, A., K. L. Smith, C. Keys, J. Vaissaire, C. Le Doujet, M. Levy, M. Mock, and P. Keim. 2002. Diversity among French Bacillus anthracis isolates. J. Clin. Microbiol. 40:4732-4734.[Abstract/Free Full Text]
5 - Gierczynski, R., S. Kaluzewski, A. Rakin, M. Jagielski, A. Zasada, A. Jakubczak, B. Borkowska-Opacka, and W. Rastawicki. 2004. Intriguing diversity of Bacillus anthracis in eastern Poland—the molecular echoes of the past outbreaks. FEMS Microbiol. Lett. 239:235-240.[CrossRef][Medline]
6 - Keim, P., L. B. Price, A. M. Klevytska, K. L. Smith, J. M. Schupp, R. Okinaka, P. J. Jackson, and M. E. Hugh-Jones. 2000. Multiple-locus variable-number tandem repeat analysis reveals genetic relationships within Bacillus anthracis. J. Bacteriol. 182:2928-2936.[Abstract/Free Full Text]
7 - Lindstedt, B. A. 2005. Multiple-locus variable number tandem repeats analysis for genetic fingerprinting of pathogenic bacteria. Electrophoresis 26:2567-2582.[CrossRef][Medline]
8 - Maho, A., A. Rossano, H. Hächler, A. Holzer, E. Schelling, J. Zinsstag, M. H. Hassane, B. S. Toguebaye, A. J. Akakpo, M. Van Ert, P. Keim, L. Kenefic, J. Frey, and V. Perreten. 2006. Antibiotic susceptibility and molecular diversity of Bacillus anthracis strains in Chad: detection of a new phylogenetic subgroup. J. Clin. Microbiol. 44:3422-3425.[Abstract/Free Full Text]
9 - Mock, M., and A. Fouet. 2001. Anthrax. Annu. Rev. Microbiol. 55:647-671.[CrossRef][Medline]
10 - Pfisterer, R. M. 1991. An anthrax epidemic in Switzerland. Clinical, diagnostic and epidemiological aspects of a mostly forgotten disease. Schweiz. Med. Wochenschr. 121:813-825.
11 - Ramisse, V., G. Patra, H. Garrigue, J. L. Guesdon, and M. Mock. 1996. Identification and characterization of Bacillus anthracis by multiplex PCR analysis of sequences on plasmids pXO1 and pXO2 and chromosomal DNA. FEMS Microbiol. Lett. 145:9-16.[CrossRef][Medline]
12 - Ryu, C., K. Lee, H. J. Hawng, C. K. Yoo, W. K. Seong, and H. B. Oh. 2005. Molecular characterization of Korean Bacillus anthracis isolates by amplified fragment length polymorphism analysis and multilocus variable-number tandem repeat analysis. Appl. Environ. Microbiol. 71:4664-4671.[Abstract/Free Full Text]
13 - Van Ert, M. N., W. R. Easterday, L. Y. Huynh, R. T. Okinaka, M. E. Hugh-Jones, J. Ravel, S. R. Zanecki, T. Pearson, T. S. Simonson, J. M. U'Ren, S. M. Kachur, R. R. Leadem-Dougherty, S. D. Rhoton, G. Zinser, J. Farlow, P. R. Coker, K. L. Smith, B. Wang, L. J. Kenefic, C. M. Fraser-Liggett, D. M. Wagner, and P. Keim. 2007. Global genetic population structure of Bacillus anthracis. PLoS ONE 2:e461.[CrossRef]
14 - WHO. 1998. Guidelines for the surveillance and control of anthrax in humans and animals, 3rd ed. World Health Organization, Geneva, Switzerland.
Applied and Environmental Microbiology, May 2008, p. 2928-2931, Vol. 74, No. 9
0099-2240/08/$08.00+0 doi:10.1128/AEM.02574-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
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