December 2020
Emerging Infectious Diseases Journal
Highlights: Emerging Infectious Diseases, Vol. ##, No. #, Month 2019
The articles of interest summarized below will appear in the December 2020 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This article is embargoed until Thursday, November 12, 2020, at noon Eastern time.
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Note that the most recent EID COVID-19 papers are at the top of the journal’s home page and also included in the Coronavirus Spotlight.
1. Tuberculosis Among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa, , A. Mandalakas, et al.
People living with HIV are more likely than others to get tuberculosis (TB), and among this group, TB is the leading cause of death. For adults with HIV, receiving HIV treatment (antiretroviral therapy) reduces their risk of getting TB and their risk of dying from TB if they already have it. To learn if the same is true for children and teenagers with HIV, researchers analyzed data from 7 HIV/TB treatment centers for children in sub-Saharan Africa during 2013–2017. They found that antiretroviral therapy for children with HIV did indeed reduce their risk of getting or dying of TB. These findings show that HIV-infected children and adolescents benefit from early diagnosis and prompt and continued treatment.
Contact: Anna Mandalakas, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas; email: anna.mandalakas@bcm.edu
2. Control and Prevention of Anthrax, Texas, USA, 2019
Anthrax is a disease caused by the bacteria Bacillus anthracis and exists on nearly every continent. It is a disease of herbivores (plant-eating animals) that can infect humans through contact with animals that are ill or have died from anthrax or through contact with contaminated byproducts (e.g., hides and undercooked meat from infected animals). In the United States, anthrax risk to humans is mostly associated with handling carcasses of hooved livestock that have died of anthrax. The biggest risk for herbivores is ingestion of B. anthracis spores, which can persist in soils in a corridor stretching from Texas through Montana. The last known naturally occurring human case of cutaneous anthrax (anthrax affecting the skin) associated with livestock exposure in the United States was reported from South Dakota in 2002. Texas experienced an increase of animal cases in 2019 and consequently higher than usual human risk. The best way to prevent anthrax in humans is to prevent anthrax in animals (e.g., through vaccination).
Contact: CDC Press Office, media@cdc.gov or 404-639-3286.
3. Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018, Esther Kisaakye et al.
In April 2018, the Kween District Health Office in Kween District, Uganda, reported 7 suspected cases of human anthrax. Anthrax is an acute bacterial infection caused by Bacillus anthracis, a spore-forming bacteria that is thought to survive for as long as decades in the carcasses and burial sites of infected animals. A team from the Uganda Ministry of Health and its partners investigated and identified 49 cases, 3 confirmed and 46 suspected; no deaths were reported. Multiple exposures from handling the carcass of a cow that had died suddenly were significantly associated with cutaneous anthrax (anthrax lesions on the skin), whereas eating meat from that cow was associated with gastrointestinal anthrax. Eating undercooked meat was significantly associated with gastrointestinal anthrax, but boiling the meat for >60 minutes eliminated that danger. The research team recommended providing postexposure antimicrobial prophylaxis for all exposed persons, vaccinating healthy livestock in the area against anthrax, educating farmers to safely dispose of animal carcasses, and avoiding handling or eating meat from livestock that died of unknown causes.
Contact: Esther Kisaakye, Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda; email: estherkisaakye@musph.ac.ug
4. Human-Pathogenic Kasokero Virus in Field-Collected Ticks, Amy J. Schuh et al.
Kasokero virus (KASV) was first isolated in 1977 from Rousettus aegyptiacus bats captured at Kasokero Cave, Uganda. Four people associated with the laboratory where the virus was isolated subsequently became ill with KASV infection. Because most viruses within the same genus as KASV (Orthonairovirus) are ticks associated, and Ornithodoros (R.) faini ticks are known to feed on this species of bat, researchers explored whether KASV is also associated with ticks. During 2013 and 2017, they collected almost 4000 Ornithodoros (Reticulinasus) faini ticks from a large R. aegyptiacus bat cave (Python cave) frequented by tourists in western Uganda. The researchers separated these ticks into hundreds of pools of 5 ticks each, finding 43 of these to contain KASV RNA. Importantly, the researchers isolated virus from two of these pools, including one with ticks that had no evidence of having taken a recent blood meal from a R. aegyptiacus bat. These findings suggest that the KASV transmission cycle includes R. aegyptiacus bats and O. (R.) faini ticks. Because entering caves and mines occupied by R. aegyptiacus bats and O. (R.) faini ticks has been linked to other human infections, entering these types of environments could pose a risk for acquiring KASV infection. People most at risk of being bitten by an infected tick include miners, herders, tourists, and researchers.
Contact: CDC Media Relations, phone: 404-639-3286 or email: media@cdc.gov.
5. Hantavirus Cardiopulmonary Syndrome in Canada, Bryce M. Warner et al.
Hantavirus cardiopulmonary syndrome (HCPS) is a severe respiratory disease caused by Sin Nombre orthohantavirus (SNV) in North America. Researchers examined critical aspects of SNV biology and the epidemiology of infections in Canada over the past 25 years, including a genetic analysis of SNV from different geographic areas over time. As of January 1, 2020, 143 cases of HCPS have been laboratory confirmed in Canada. Each year, an average of 4–5 cases (range 0–13 cases) are confirmed in Canada. Although cases of HCPS have been diagnosed in every month, they are most common in spring and summer, peaking in May and June and gradually decreasing. Peaks in HCPS cases are probably driven by seasonal increases in deer mouse populations along with increased human contact with environments contaminated with SNV-infected rodent droppings. All cases except one have occurred in the four westernmost provinces of Manitoba, Saskatchewan, Alberta, and British Columbia. Most cases in these provinces have been in southern rural, often agricultural, settings. Although hantavirus infections in Canada remain rare, the high death rate and severe nature of the disease underscore the importance of surveillance-based awareness and risk prevention in at-risk populations and settings. Overall, close monitoring of SNV infections in Canada remains a key part of risk mitigation and will further understanding of HCPS.
Contact: David Safronetz, Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; email: david.safronetz@canada.ca or PHAC Media Relations at 613-957-2983 or email: hc.media.sc@canada.ca
