MMWR

Morbidity and Mortality Weekly Report

Outbreak of Histoplasmosis Among Travelers Returning from El Salvador

PRESS CONTACT: Phil Giaramita, Director of Communications
Virginia Department of Health
(804) 864-7008

Travelers working in histoplasmosis-endemic areas should be informed about the risk of histoplasmosis, should avoid working in areas likely to be heavily contaminated with Histoplasma spores, should wear personal protective equipment, and should use dust suppression methods to reduce the risk of acquiring histoplasmosis.  Histoplasmosis is a fungal disease acquired from inhaling dust containing Histoplasma capsulatum spores. The infection usually results in an asymptomatic or mild flu-like illness, but can result in loss of lung capacity. In February 2008, the Pennsylvania and Virginia Departments of Health investigated a cluster of respiratory illness among members of three church mission groups that had traveled to El Salvador to renovate a church. Twenty (61 percent) of 33 mission members became ill after returning to the United States. Certain activities (e.g. sweeping and cleaning outdoors, digging, and working in bird or bat roosting areas) were associated with an increased risk of becoming ill. Travelers and persons involved in construction activities should use personal protective equipment and decrease dust-generation when working in histoplasmosis-endemic areas. Clinicians should consider histoplasmosis as a possible cause of acute respiratory or flu-like illness in travelers returning from endemic areas.

Effects of New Penicillin Susceptibility Breakpoints for Streptococcus pneumoniae

PRESS CONTACT: CDC
Division of Media Relations
(404) 639-3286

Public health officials should be aware of the new definition for pneumococcus resistance to penicillin because they may cause an artificial decline in reports of antibiotic resistant pneumococcal cases. Streptococcus pneumoniae (pneumococcus) is a bacterial organism that commonly causes meningitis and pneumonia. Pneumococcal resistance to penicillin was redefined during the past year. Definitions now reflect the type of infection (meningitis versus other infections) and route of drug administration (intravenous or oral). The CDC regularly collects data to assess pneumococcal resistance to several antibiotics, penicillin among them.  Infections are categorized as susceptible (treatable), intermediate (possibly treatable) or resistant (not treatable). CDC retrospectively applied the new susceptibility definitions to data collected in 2006-2007 to assess the potential effect of the new definitions on reporting of resistant infections. The percentage of penicillin-susceptible nonmeningitis infections (e.g. pneumonia, bacteremia) increased from 75 percent to 93 percent; intermediate infections decreased from 15 percent to 6 percent; resistant nonmeningitis infections decreased from 10 percent to 1 percent.  Public health officials should be aware of these changes because they may cause an artificial decline in reports of antibiotic resistant pneumococcal cases. 

Respiratory Syncytial Virus Activity

PRESS CONTACT: CDC
Division of Media Relations
(404) 639-3286

As of December 6, 2008, the 2008–09 Respiratory syncytial virus (RSV) season has started in every U.S. Department of Health and Human Services Region except Region 7 (Kansas City) and Region 8 (Denver). Last year, the RSV season varied widely by region. Season onset dates ranged from mid October to mid December and offset dates ranged from early February to mid April. In Florida, the 2007–08 RSV season occurred from early July to late January.  RSV is the most common cause of bronchiolitis and pneumonia in children aged <1 year and is a major cause of respiratory illness in older adults. National Respiratory and Enteric Virus Surveillance System (NREVSS) data indicate that the 2007–08 U.S. RSV season varied by geographic location, with onset dates ranging from mid October to mid December and offset dates ranging from early February to mid April. The 2007–08 RSV season in Florida differed from that of other states in its U.S. Department of Health and Human Services (HHS) Region, occurring from early July to late January. As of December 6, 2008, the 2008–09 RSV season has started in every HHS Region, including Florida, except Region 7 (Kansas City) and Region 8 (Denver). Such data can be used to determine the optimal timing of RSV prophylaxis for those at high risk for infection.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES