MMWR – Morbidity and Mortality Weekly Report

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1. Progress Toward Global Eradication of Dracunculiasis — January 2012–June 2013

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With only 542 dracunculiasis (Guinea worm disease) cases reported in 2012 (the lowest annual total ever), only four endemic countries remaining, and 83 percent of cases in shrinking endemic areas of South Sudan, the goal of eradicating Guinea worm disease is closer than ever. In 1986, the World Health Assembly called for the elimination of dracunculiasis, a parasitic infection in humans caused by Dracunculus medinensis. At that time, an estimated 3.5 million cases occurred annually in 20 countries in Africa and Asia.  Since then, tremendous advancement has been made towards global dracunculiasis eradication.  In 2012, 542 cases were reported from four remaining endemic countries—Chad, Ethiopia, Mali, and South Sudan.  In 2013, progress toward global dracunculiasis eradication has accelerated.  During January–June 2013, only 89 cases were reported worldwide, a 77 percent reduction in cases from the same period in 2012.  Eradication is likely within the next few years if disruption of program operations can be minimized, particularly in northern Mali.

2. Histoplasmosis in a State Where It Is Not Known to Be Endemic — Montana, 2012–2013

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Four patients were diagnosed with histoplasmosis in Montana, a state where histoplasmosis is not known to commonly occur. Since 2012, four cases of histoplasmosis have been diagnosed among residents of Montana. Histoplasmosis is a potentially severe illness caused by infection with the fungus Histoplasma capsulatum. This fungus typically exists in the Ohio and Mississippi River valleys where it is found in soil contaminated with bird droppings and bat guano. Humans become ill after inhaling contaminated dust. Most infected persons do not become ill. However, persons with weakened immune systems have a higher risk for severe illness, such as pneumonia. All four patients in this report likely became infected in Montana, yet the fungus has not previously been known to exist commonly in Montana. Health-care providers are encouraged to consider the diagnosis of histoplasmosis in patients with clinically compatible illness.

3. Update: Influenza Activity — United States and Worldwide, May 19–September 28, 2013

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CDC recommends yearly influenza vaccination as the first and most important step in protecting against influenza viruses. Influenza vaccination is recommended for all persons aged ≥6 months. While vaccination is the best way to prevent influenza, treatment with influenza antiviral medications can reduce severe outcomes of influenza, especially when initiated early. Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who is hospitalized with severe, complicated, or progressive illness; or is at higher risk for influenza complications. While influenza activity was low in United States from May 19 to September 28, 2013, some influenza viruses were detected. Although CDC cannot predict which influenza viruses will be most common, nor how severe the season will be, most of the influenza viruses collected over the summer in the United States and internationally were like those that the 2013-2014 influenza vaccine is formulated to protect against. Additionally, from June 18 to September 28, 2013, a total of 20 cases of “variant” influenza A viruses (H3N2v and H1N1v) were reported from five states in the United States (Influenza viruses that normally circulate in pigs are called “variant” viruses when they are found in people).

4. Notes from the Field

• Strongyloidiasis in a Rural Setting — Harlan, Kentucky, 2013
• Strongyloides Infection Among Patients at a Long-Term Care Facility — Florida, 2010–2012

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES