Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 19, No. 6 (June 2013)

1. New Delhi Metallo-β-Lactamase–producing Enterobacteriaceae, United States, J. Kamile Rasheed et al.

Infections caused by Enterobacteriaceae are becoming harder to treat as these bacteria develop more resistance to antibiotics, including last-line agents such as carbapenems, by making carbapenemase enzymes that destroy the antibiotic. One enzyme produced by carbapenem-resistant Enterobacteriaceae (CRE), the New Delhi metallo-β-lactamase (NDM), was first reported in healthcare settings in India and Pakistan. In the three years since its identification, it has now been recognized in numerous countries worldwide. Although previously considered rare in the United States, a recent analysis of bacteria isolated from eight patients (all of whom had travelled to India or Pakistan and six of whom received inpatient health care while there) were found to produce NDM, as well as many other resistance mechanisms. Their spread worldwide will pose a major threat to public health. The relative ease with which this resistance mechanism seems to move within and between different types of bacteria and the mobility of humans carrying these bacteria highlight the need for reliable and rapid ways to detect them and prevent their spread.

Contact:
Melissa Dankel
Press Officer, CDC Division of Healthcare Quality Promotion
404-639-4718
mdankel@cdc.gov

2. Haemophilus influenzae Serotype an Invasive Disease among Alaska Native Children, United States, Michael G. Bruce et al.

Haemophilus influenzae (Hi) is a bacterium that can cause serious, even fatal disease, especially in young children. Before vaccine was available, rates of infection with type b (Hib) were among the highest in the world among Alaska Native children. But after Hib vaccine became available, type b infections decreased dramatically. Now, however, infection with type a (Hia), which was not present in Alaska before 2002 and is not covered by the vaccine, is emerging among Alaska Native children. Rates of infection are especially high among children in one region, where risk factors for respiratory infection (household crowding, decreased availability of in-home running water, indoor wood smoke, and poverty) are common. Infections seem to be spreading slowly, but persistently from person to person in this area. Although a vaccine for Hia could be modeled after the successful Hib vaccine, a vaccine for such a small population will probably not be produced any time soon. Meanwhile, efforts to decrease the spread of infection include giving preventive antimicrobial drugs to those in close contact with patients who have invasive Hia disease and reducing risk factors such as increasing availability of running water, improving housing ventilation, and decreasing indoor wood smoke.

Contact Dr. Michael G. Bruce via:
CDC Media Relations
404-639-3286
Media@cdc.gov

3. Hepatitis E Outbreak in Dadaab Refugee Camp, Kenya, 2012, Jamal A. Ahmed et al.

Hepatitis E virus is spread through the fecal–oral route. Infection is common in overcrowded areas with poor sanitation, such as refugee camps. In 2012, after 10 years with no reported cases among Somali refugees, an outbreak of hepatitis E was reported at Dadaab, located in eastern Kenya near the Somalia border, which is one of the largest refugee camps in the world.  This outbreak caused concern for several reasons primarily because implementing effective prevention measures under camp conditions was difficult, and the area was dangerous for aid workers. Among 339 patients, 10 died (nine new mothers and one child). In response, the United Nations High Commissioner for Refugees and the Centers for Disease Control and Prevention attempted to enhance disease tracking, improve patient care, and step up preventive measures. To minimize further disease spread, these agencies also trained health care workers, increased community awareness, promoted good hygiene practices (including hand washing), improved access to latrines by constructing new latrines, and increased clean water access especially in affected parts of the camp. As of February 2013, no new cases have been reported. Future outbreaks might be minimized when vaccines and tests that can be conducted on site become available.

Contact:
CDC Media Relations
404-639-3286

4. Effect of Travel on Influenza Epidemiology, Sanne-Meike Belderok et al.

International tourism has increased tremendously, and along with increased travel come increased health risks. Flu is easily spread by travel because it is highly contagious and because the time from exposure to the virus to actually getting sick (incubation period) is short. To more precisely measure the risk of getting flu while traveling, researchers analyzed blood samples collected before and after travel from the Netherlands to tropical and subtropical countries. Results confirmed that flu is one of the most frequently acquired infectious travel-related diseases. Persons at highest risk were those born in an African or Latin American country and those 55–64 years of age. Researchers estimated that about 12,000 travelers each year bring flu back to the Netherlands. Thus, travel to tropical or subtropical regions is probably a major factor in the spread of influenza.

Contact:
Martin Hommenga
Head of Communication
Department of Infectious Diseases, Public Health Service (GGD)
Amsterdam, the Netherlands
mhommenga@ggd.amsterdam.nl

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES