Emerging Infectious Diseases Journal

Highlights: EID, Vol. 16, No. 10 (October 2010)

1. Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia

Jay K. Varma, et al.

People with HIV are at risk for infections in their blood, because their immune system is not strong. However, if blood infections are diagnosed and treated early, before the patient needs to be hospitalized, the patient has a better chance of surviving the infection. When researchers studied HIV-infected outpatients in Southeast Asia where HIV is common, they found that the pathogen most likely to cause blood infections was the one that causes tuberculosis. This bacterium is especially lethal and kills almost half the HIV patients it infects. Therefore, doctors should look for tuberculosis in their HIV patients so they can start treatment early. Even better, the study found that HIV patients who are receiving medicine to treat HIV are likely to avoid blood infections altogether, because their immune system is stronger.

Contact Dr. Jay Varma via:
Melinda Frost
CDC, US Embassy Beijing, CHINA
+86 139-1118-4372
mhf7@cdc.gov

2. Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

Ina Danquah, et al.

Type 2 diabetes, the most common type of diabetes, is increasing rapidly in sub-Saharan Africa, in part because many people are living an increasingly Western lifestyle. People with diabetes are more susceptible to other infections, so researchers explored whether diabetes increases risk for malaria infection, cause of another killer disease in this region. They found that the answer is yes. Having diabetes increases the chances of getting malaria infection by almost 50 percent; and the more uncontrolled the diabetes, the higher the risk.

Contact:
Dr. Frank Mockenhaupt
Institute of Tropical Medicine and International Health
Charité – University Medicine Berlin, Spandauer Damm 130, 14050 Berlin, Germany
+49 30 30116 815
frank.mockenhaupt@charite.de

3. Imported Lassa Fever, Pennsylvania, USA, 2010

Valerianna Amorosa, et al.

Lassa fever is commonly found in West Africa, but in the United States? It’s normally spread by rodents. However, it can also spread from person to person, and travelers can carry it into other countries. Because symptoms may not appear for up to two weeks after exposure, recently infected travelers can unknowingly spread the virus to travel companions and others after they return home. Such spread is what doctors feared when a Pennsylvania man became ill soon after returning from Liberia, where he had stayed in a primitive hut infested with rats and rat carcasses. Doctors diagnosed Lassa fever, reported it to health officials, and took precautions to prevent its spread. The patient recovered and no other cases were found in the United States. This was only the 6th case of Lassa fever in the United States.

Contact:
Dr. Valerianna Amorosa
Philadelphia VAMC–Medicine, University and Woodlawn, Philadelphia, PA
valerianna.amorosa@uphs.upenn.edu

4. Emergence of Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus in 48 Hours

Timothy Barkham

How fast can drug resistance develop in the pandemic flu virus? In 2 days. Although drug-resistant strains of pandemic flu virus have been found, most have been in immunocomprised patients and have taken 4-14 days of treatment to develop. But now a resistant virus has been shown to have developed in a previously healthy woman just 48 hours after she first received treatment with oseltamivir for pandemic flu. Testing confirmed that the resistance developed in this particular virus (as opposed to the patient having been infected with an already resistant virus). This case is a reminder that resistance can indeed develop quickly.

Contact Timothy Barkham, MBBS via:
Mr. Praveen Nagoya
Executive, Corporate Communications, Tan Tock Seng Hospital, Singapore
+65 6357 8434 (office)
+65 9423 2975 (cell)

5. Pandemic (H1N1) 2009 and Seasonal A (H1N1) Influenza Co-infection, New Zealand, 2009

M. Peacey, et al.

Getting both seasonal and pandemic flu at the same time is more than just a double-whammy for the patient. Such double infections could lead to a harmful new strain of virus, which could be harder to treat. This is how it works: if two viruses infect the same cell and one of them is resistant to drugs, genetic changes could pass that resistance to the other virus. If these viruses happen to be seasonal and pandemic flu viruses, a drug-resistant pandemic flu virus could evolve. After finding 11 patients in New Zealand in 2009 who were infected with both viruses, researchers concluded that this dangerous scenario is indeed possible.

Contact:
Matthew Peacey
Institute of Environmental Science & Research, Ltd.
National Centre for Biosecurity and Infectious Disease
+64 4 529 0610
mathew.peacey@esr.cri.nz

6. Epidemiology of Human Parvovirus 4 Infection in sub-Saharan Africa

Colin P. Sharp, et al.

Will the newly discovered parvovirus 4 (PARV4) spread rapidly around the world like HIV and hepatitis C virus? In Western countries, PARV4 infects injection drug users and others exposed to blood, likely through blood exposure from, for example, needle-sharing. But a new type of test recently showed that many in sub-Saharan Africa who are not injection drug users also have been exposed to this virus. These people were not infected by shared needles or medical procedures, so how did they become infected with PARV4? Why are non–drug users in sub-Saharan Africa but not in Western countries becoming infected? This unexpected information shows that PARV4 is being spread in Africa by a route almost entirely absent in Western countries. Although we do not understand what this route is, nor the diseases associations of PARV4 infection, the current distribution and evidence for its recent global spread shows alarming similarities to that of HIV and hepatitis C virus in the 20th century.

Contact:
Peter Simmonds
Centre for Infectious Diseases, University of Edinburgh, Scotland
+44 131 650 7927
peter.simmonds@ed.ac.uk

For further information on other Global Viral Forecasting Initiative projects, contact Carla Sacks, csacks@gvfi.org or 212-741-1000.

The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES