October 2021
Emerging Infectious Diseases Journal
Highlights: Emerging Infectious Diseases, Vol. 27, No. 10, September 2021
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 2021 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 15, 2021, at 12 p.m. EDT.
- Novel Outbreak-Associated Food Vehicles, United States, Hilary K. Whitham et al.
Every year in the United States, contaminated food causes illness in millions of people. Despite many regulatory and educational efforts to make food safer, outbreaks continue as a result of changing trends in how food is prepared or eaten, evolving disease-causing organisms, and the introduction of new foods. When researchers compared food vehicles identified in the United States during 1973–2006 with those identified during 2007–2016, they identified 28 novel food vehicles (foods not associated with previous outbreaks). The most common novel food vehicles were fish, nuts, fruits, and vegetables; one third were imported from other countries; and two thirds did not require cooking after purchase. Overall, outbreaks associated with novel food vehicles were larger (in case, hospitalization, and death counts), and more likely to involve multiple states and result in a food recall. Opportunities for food contamination can be reduced through expanding food safety measures with regard to how foods are grown, harvested, and processed. Identifying foods that are likely to lead to foodborne illness provides opportunities to detect outbreak sources earlier and stop the chain of transmission.
Contact: CDC Media Relations; phone (404) 639-3286 or email: media@cdc.gov.
2. Burden of Influenza-Associated Respiratory Hospitalizations, Vietnam, 2014–2016, Nguyen Cong Khanh et al.
Estimates of influenza burden are essential to informing prevention and control policies. In 2019, Vietnam successfully licensed the first locally manufactured seasonal influenza vaccine. To complement this development, researchers calculated provincial and national influenza-associated acute respiratory infection (ARI) and severe acute respiratory infection (SARI) hospitalization rates by using ARI hospitalization data, SARI surveillance data, and provincial population data from four provinces representing Vietnam’s major regions during 2014–2016. The mean influenza-associated hospitalization rates per 100,000 population were 218 for ARI and 134 for SARI. Influenza-associated SARI hospitalization rates per 100,000 population were highest among children <5 years old (1,123) and adults >65 years old (207), underscoring the need for prevention and control measures, such as vaccination, in these at-risk populations. These and future efforts to better quantify influenza disease burden can be used together with data about vaccine effectiveness and coverage to estimate potential illnesses prevented through vaccination, cost-effectiveness analyses, and to guide targeted communications to people at increased risk.
Contact: CDC Media Relations; phone (404) 639-3286 or email: media@cdc.gov.
3. Population-Based Study of Bloodstream Infection Incidence and Mortality Rates, Finland, 2004–2018, Keiju S.K. Kontula et al.
Bloodstream infections (BSIs) are a major cause of illness and death worldwide. The incidence of BSIs has increased over time and reported BSI rates range from 122 to 220 cases per 100,000 population. Rising incidence is probably related to an aging population and an increasing prevalence of underlying conditions and invasive procedures. Researchers in Finland evaluated the rate of occurrence, patient outcomes, and causative agents of BSIs in Finland during 2004–2018 by using data from national registries. They identified a total of 173,715 BSIs. Annual incidence increased from 150 to 309 cases per 100,000 population. BSI incidence rose most sharply among persons >80 years of age. The 1-month case-fatality rate (i.e., the percentage of patients dying from a BSI within 1 month of their first positive blood culture) decreased from 13.0% to 12.6%; however, the 1-month all-cause mortality rate nearly doubled, from 20 to 39 deaths per 100,000 population. The proportion of BSIs caused by Escherichia coli increased from 26% to 30%. BSIs caused by multidrug-resistant organisms rose from 0.4% to 2.8%, mostly because of extended-spectrum β-lactamase-producing E. coli. Community-acquired BSIs increased from 67% to 78%. The proportion of patients with severe underlying conditions rose from 14% to 23%. Additional public health and healthcare prevention efforts are needed in Finland to curb the increasing trend in BSIs, particularly community-acquired BSIs, and antimicrobial drug–resistant E. coli.
Contact: Keiju Kontula, Helsinki University Hospital, Helsinki, Finland; email: keiju.kontula@hus.fi
4. New Delhi Metallo-β-Lactamase–Producing Enterobacterales Bacteria, Switzerland, 2019–2020, Jacqueline Findlay et al.
Carbapenem-resistant Enterobacterales bacteria are a critical global health concern. Carbapenems are highly effective antibiotics used as drugs of last resort for treating severe or high-risk bacterial infections. Resistance to carbapenems is associated with New Delhi metallo-β-lactamase (NDM) enzymes, of which 32 variants have been found in multiple species of Enterobacterales worldwide. To determine the recent epidemiology of NDM-producing– Enterobacterales in Switzerland, researchers analyzed bacterial isolates submitted to their Swiss National Reference Centre for Emerging Antibiotic Resistance. They found that prevalence of NDM-producing Enterobacterales bacteria in Switzerland is increasing, mostly in Klebsiella pneumoniae and Escherichia coli. The most common NDM variants were NDM-1 and NDM-5., and many isolates were resistant to multiple drugs. They concluded that the increasing prevalence of NDM-producing Enterobacterales is driven mainly by transmission of successful plasmids (DNA molecules) within and between Enterobacterales species. Increasing prevalence of carbapenem-resistant Enterobacterales will limit the choices of antibiotics available for treating these infections.
Contact: Patrice Nordmann, University of Fribourg, Fribourg, Switzerland; e-mail: patrice.nordmann@unifr.ch
