October 2019
Emerging Infectious Diseases Journal
Highlights: Emerging Infectious Diseases, Vol. 25, No. 10, October 2019
Important Note: Not all articles that EID publishes represent work done at CDC or by CDC staff. In your stories, please clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by CDC in the EID journal”). Opinions expressed by authors contributing to EID do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated. EID requests that, when possible, you include a live link to the actual journal article in your stories. Once the embargo lifts, this month’s articles will be found in the Ahead of Print section of the EID website at https://wwwnc.cdc.gov/eid/ahead-of-print.
The articles of interest summarized below will appear in the October 2019 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Emerging Viruses. The articles are embargoed until September 18, 2019, at 12 p.m. EDT.
1. Factoring Prior Treatment into Tuberculosis Infection Prevalence Estimates, United States, 2011–2012, Laura A. Vonnahme et al.
When tuberculosis (TB) bacteria enter the body, they can cause serious disease or remain inactive for years or decades (latent TB infection, in which the person is not ill). In the United States, most new cases of active TB disease result from progression of latent TB infection. Thus, TB elimination requires treating latent TB infection to prevent its progression to active TB disease. Previous estimates of how many people have TB infection have been based on results of the National Health and Nutrition Examination Survey, which used positive TB test results to determine that »5% of the US population had TB infection in 2011–2012. Test results, however, may remain positive even after a person has received effective treatment for TB disease or latent TB infection. Researchers therefore refined the NHANES-based estimate of TB infection by excluding from analysis people who reported having received treatment for TB disease or latent TB infection. They found that in the United States, about 12% of people previously reported as having TB infection had already received treatment; thus, potentially narrowing the field to 88% who could benefit from expanded screening and treatment for latent TB infection.
Contact: CDC Media Relations; phone: 404-639-3286 or email: media@cdc.gov
2. Global Epidemiology of Diphtheria, 2000–2017, Kristie E.N. Clarke et al.
Diphtheria is a serious illness caused by Corynebacterium diphtheriae bacteria. These bacteria can enter and attach to the lining of the respiratory system, where they produce a toxin that destroys healthy tissue. Within days, the dead tissue forms a thick, leathery coating over tissues in the nose, tonsils, voice box, and throat, making it very hard to breathe and swallow. Even with treatment, about 1 in 10 diphtheria patients die. Without treatment, up to half of patients can die from the disease. In 2017, a total of 8,819 cases of diphtheria were reported worldwide, the most since 2004. Newly revised recommendations from the World Health Organization in 2017 include a series of diphtheria toxoid-containing booster doses in childhood and adolescence. Researchers analyzed diphtheria incidence data and data from the available medical literature to better describe recent trends in the disease. As national vaccination coverage with the 3 standard doses of diphtheria–tetanus–pertussis (DTP3) in infancy increased, the proportion of case-patients <15 years of age decreased, indicating increased protection among young children. In countries with higher case counts, 66% of case-patients were unvaccinated and 63% were <15 years of age. In countries with sporadic cases, 32% of case-patients were unvaccinated and 66% were >15 years of age. These trends are concerning for decreasing immunity over time and support implementation of recommended booster doses. Worldwide, DTP3 vaccination levels are suboptimal and have not improved since 2010. Attaining high DTP3 vaccination coverage and implementing recommended booster doses are necessary to decrease diphtheria incidence. Moreover, the collection and use of data on subnational and booster dose vaccination, enhanced laboratory capacity, and newly recommended case-based surveillance would improve the quality of data available to combat this deadly disease.
Contact: CDC Media Relations; phone: 404-639-3286 or email: media@cdc.gov
3. Melioidosis after Hurricanes Irma and Maria, St. Thomas/St. John District, US Virgin Islands, October 2017, Irene Guendel et al.
Melioidosis is caused by bacteria mainly found in tropical regions worldwide. Infection occurs by direct skin contact, inhalation, or swallowing. Diagnosis is difficult because symptoms vary, and treatment is difficult because the bacteria are resistant to many antibiotics. Melioidosis is rare in the United States; most cases are travel related. However, melioidosis can emerge after extreme weather events; cases have probably been acquired from storm-related exposure to flooded soil, surface water runoff, or generation of aerosol particles. In September 2017, two category 5 hurricanes, Irma and Maria, struck the US Virgin Islands, after which melioidosis was diagnosed in 2 women. Both women had diabetes, a risk factor for melioidosis. Detection of melioidosis in the US Virgin Islands prompted public health actions. In January 2018, melioidosis was listed as a reportable disease in the US Virgin Islands. Future public health actions will include educating physicians and laboratory staff to avoid misdiagnoses and highlighting preventive measures for the public because risk factors (e.g., diabetes and other chronic diseases) are prevalent in the local population and might be exacerbated under disaster settings.
Contact: Esther M. Ellis, St. Thomas, VI 00802, USA; email: esther.ellis@doh.vi.gov
