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Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 18, No. 6, June 2012


The articles of interest summarized below will appear in the June 2012 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature prions. The articles are embargoed until May 16, 2012, 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. Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment, Paul Brown et al.

The book on iatrogenic Creutzfeldt-Jakob disease (CJD) in humans is almost closed. This form of CJD transmission via medical misadventures was first detected in 1974. Today, only occasional CJD cases with exceptionally long incubation periods still appear. The main sources of the largest outbreaks were tissues from human cadavers with unsuspected CJD that were used for dura mater grafts and growth hormone extracts. A few additional cases resulted from neurosurgical instrument contamination, corneal grafts, gonadotrophic hormone, and secondary infections from blood transfusions. Although the final solution to the problem of iatrogenic CJD is still not available (a laboratory test to identify potential donors who harbor the infectious agent), certain other measures have worked well: applying special sterilization of penetrating surgical instruments, reducing the infectious potential of donor blood and tissue, and excluding donors known to have higher than normal risk for CJD.

Paul Brown
Bethesda, MD

2. Pretransplant Fecal Carriage of Extended-spectrum β-lactamase–producing Enterobacteriaceae and Infection after Liver Transplant, France, Frédéric Bert et al.

Bacterial infection after liver transplant is fairly common, mostly because liver transplant patients are severely ill and the surgery is very complex. Adding to the seriousness of this situation is that some bacteria are resistant to many antimicrobial drugs. However, treating all infections as drug resistant would lead to even more drug resistance, so only patients at highest risk should receive the most powerful drugs. But who is at highest risk? A recent study in France screened fecal samples of liver transplant candidates and found that post-operative infections were most likely for those patients who already had certain bacteria in their feces before surgery. Thus, fecal screening for those multiresistant bacteria should be considered for all liver transplant candidates so that if post-operative infection develops, those at high risk can receive the most specific drugs right away.

Frédéric Bert, PhD
Service de Microbiologie, Hôpital Beaujon
Clichy, France

3. Zoonotic Disease Pathogens in Fish used for Pedicure, David W. Verner-Jeffreys et al.

“Doctor” fish might not be such good doctors after all. These fish are used for the increasingly popular spa treatment called fish pedicures. During these sessions, spa patrons immerse their feet in water, allowing the live fish to feed on dead skin, mainly for cosmetic reasons. However, examinations of doctor fish destined for these spas found that they can carry harmful bacteria. Thus, although reports of human infection after fish pedicures are few, there may be some risks. Spa patrons who have underlying medical conditions (such as diabetes, immunosuppression, or even simple breaks in the skin) are already discouraged from taking such treatments. However, spas that offer fish pedicures should also consider using only disease-free fish reared in controlled facilities under high standards of husbandry and welfare.

David W. Verner-Jeffreys
CEFAS Weymouth Laboratory, Dorset, United Kingdom



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