April 2016

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 22, No. 4, April 2016

The articles of interest summarized below will appear in the April 2016 issues of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Food Safety. The articles are embargoed until March 16, 2016, at 12 p.m. EDT.

Note: Not all articles published in EID represent work done at CDC. In your stories, please clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by CDC”). The opinions expressed by authors contributing to EID do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated.

1. Transmission of Middle East Respiratory Syndrome Coronavirus Infections in Healthcare Settings, Abu Dhabi, Jennifer C. Hunter et al.

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a respiratory illness caused by a virus. Illness can be severe and is often fatal. MERS-CoV spreads from ill people to others through close contact, such as caring for or living with an infected person. In spring of 2014, a sharp increase in the number of MERS-CoV cases in the Arabian Peninsula led to an investigation into where and how the infection was spreading. In Abu Dhabi, nearly half of these infections were associated with healthcare facilities. The illness spread predominantly when healthcare workers, patients, and visitors were exposed to an infected person before it was known that the person had MERS-CoV and therefore before appropriate precautions were taken to prevent infection. These findings underscore the need for early detection of MERS-CoV cases and interventions to limit its spread.

Contact:
CDC Press Office, 404-639-3286 or media@cdc.gov

2. Shiga Toxin 1–Producing Shigella sonnei Infections, California, United States, 2014–2015, Katherine Lamba et al.

Shiga toxins are produced by bacteria, usually Shigella dysenteriae and some kinds of E. coli. Infection with shiga-toxin–producing bacteria usually comes from contaminated food. Symptoms of infection include diarrhea and abdominal cramps, with the potential for severe and even fatal complications. In California during 2014–2015, Shiga-toxin illness in 56 patients was caused by a different bacteria, Shigella sonnei. Bloody diarrhea was a common symptom, but severe complications did not develop in any of the patients. Some of the first patients to get sick had traveled to Mexico and perhaps acquired the infection there; others had not traveled, indicating local spread of the infection. Although these cases in California were not severe, future cases could be severe. Continued surveillance (disease tracking) of Shiga toxin-producing Shigella sonnei infections may provide more information on how to reduce new infections.

Contact:
California Department of Public Health Office of Public Affairs, CDPHPress@cdph.ca.gov or 916-440-7259.

3. Quantifying Transmission of Clostridium difficile within and outside Healthcare Settings, David P. Durham et al.

Infection with the toxin-producing bacteria Clostridium difficile (often called C. diff) can result in severe diarrhea, especially among older people who are hospitalized or live in long-term care facilities. Studies have shown that less than half of infections acquired soon after admission to a hospital were caused by contact with symptomatic patients. But what are the other sources of infection? A model created from U.S. national data evaluated the role of patients who harbor the bacteria but have no symptoms (asymptomatic carriers) and people outside healthcare facilities (community sources).  Although the rate of spread from these sources was found to be less than that from symptomatic patients, the asymptomatic carriers and community sources contribute substantially to the spread of C. diff infection because of their comparatively large numbers. Therefore, measures to prevent and control C. diff infection should account for asymptomatic carriers and community sources as well as symptomatic patients.

Contact:
Ziba Kashef, Office of Public Affairs and Communications,
Yale University,
ziba.kashef@yale.edu or 203-436-9317.

4. Determinants and Drivers of Infectious Disease Threat Events in Europe, Jan C. Semenza et al.

Worldwide, the frequency of infectious disease threat events is increasing, threatening public health and straining government resources. But why are these events increasing, and what are the underlying factors (drivers) that lead to their occurrence? To answer those questions, researchers examined 116 events detected in Europe during 2008–2013. They identified 17 drivers and categorized them into 3 groups: globalization and environment, sociodemographic, and public health systems. Most events were caused by 2 or more drivers, especially those in the globalization and environment categories. The top 5 drivers identified were travel and tourism, food and water quality, natural environment, global trade, and climate. An understanding of the drivers behind infectious disease threat events can be used to reduce the chances that the events will happen and decrease the associated human and economic costs if they do.

Contact: 
ECDC press office, press@ecdc.europa.eu or
Media hotline: +46 (0)8 586 01 678

5. Nipah Virus Transmission from Bats to Humans Associated with Drinking Traditional Liquor Made from Date Palm Sap, Bangladesh, 2011–2014, M. Saiful Islam et al.

Infection with Nipah virus can cause encephalitis (inflammation of the brain), leading to coma and sometimes death. People can become infected through contact with infected bats, pigs, or other people. In Bangladesh, consuming fresh (raw) date palm sap contaminated with infected bat urine and saliva, is one way people can become infected with Nipah virus. However, during December 2010 through March 2014, the source of Nipah virus infection was unknown for 14 patients, none of whom had known contact with fresh date palm sap, bats, or sick animals. Investigation revealed that 8 of the patients, all of whom died, had regularly consumed an alcoholic drink, called tari, made from fermented date palm sap. The 6 patients who survived had each cared for 1 of the 8 patients. Investigation revealed bat urine and feces inside sap-collection pots and use of the same pot for several days without cleaning, indicating that sap is probably contaminated with bat excreta or saliva during collection and fermentation. These findings suggest that tari consumption is another source of Nipah virus infection and possibly other bat-borne infections. One way to prevent these infections might be use of barriers, such as bamboo skirts that cover the shaved part of the date palm tree and the sap-collection pots, to keep bats away from the sap.

Contact:
M. Saiful Islam, Centre for Communicable Diseases,
International Centre for Diarrhoeal Disease Research,
Bangladesh, 68 Tajuddin Ahmed Sarani, Mohakhali,
Dhaka 1212, Bangladesh; email: saiful@icddrb.org

###
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES