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Background: On August 6, 2011, we received a report of 3 suspected cutaneous anthrax patients, all from a village in Anshan Prefecture where no human anthrax had occurred for 15 years.We investigated this outbreak to assess the magnitude, identify risk factors and recommend prevention measures.Methods: A suspected case was defined as onset from July 10 to August 30, 2011 of a skin lesion that progressed from papular to vesicular, to a depressed black eschar in an Anshan resident.A confirmed case was a suspected case with Bacillus anthracis isolated from blood or skin lesion.We conducted house-to-house search for cases in the village, requested reporting from hospitals, and reviewed medical records.We interviewed patients about exposures to implicated cattle and the origin of the cattle.Results: We identified 30 cutaneous anthrax cases (2 conformed, 28 suspected).Patients were from 2 counties, 6 townships and 10 villages.All patients had contact with sick or dying cattle.Exposures included slaughtering (57%) and transporting (27%) sick cattle, processing hides (3.3%), feeding cattle (3.3%).The implicated cattle were traced back to two different markets in different counties in Liaoning Province.However, their origin could not be determined.Conclusion: This cutaneous anthrax outbreak was caused by selling and transporting sick cattle infected with Bacillus anthracis.Chinese regulation required veterinarian inspection of animal market.We recommend that the Ministry of Agriculture search for the origin of the anthrax in these cattle.Public health surveillance for anthrax should continue.We wamed villagers not to transport, slaughter or salvage sick or dead cattle.