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Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 18, No. 8, August 2012


The articles of interest summarized below will appear in the August July 2012 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature international health. The articles are embargoed until July 11, 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. Paragonimus kellicotti Flukes in Missouri, USA, Michael A. Lane, et al.

You don’t have to be a contestant on Fear Factor to eat unusual things. An investigation of nine new cases of lung fluke infection in Missouri found that in all cases, patients had eaten raw crayfish while on rafting or camping trips and most had been drinking alcohol. Although all patients recovered after treatment, a few whose diagnosis was delayed had unnecessary procedures and serious illness. Physicians should consider lung fluke infection in patients with nonspecific cough and fever, especially patients who have recently returned from a recreational river trip. Crayfish in Missouri rivers often carry lung flukes and should not be eaten raw.

Contact Dr. Michael Lane via:
Caroline Arbanas
Director, Medical Research News
Washington University School of Medicine, St. Louis, MO
(314) 286-0109

2. Infectious Disease Transmission during Organ and Tissue Transplantation, Melissa A. Greenwald, et al.

Transplantation of organs and tissues (bone, tendon, skin, cornea) will always be associated with some risk for transmission of infectious diseases from donor to recipient. Understanding and minimizing this risk is difficult for many reasons: donor screening processes vary, screening for every infectious organism is not possible, and assessment of recipient health after transplantation to determine possibility of disease transmission often is not adequate. In May 2010, the U.S. Food and Drug Administration held a meeting to address these challenges and establish a research agenda for minimizing these transplant transmission risks. Attendees agreed that the focus should be on standardizing donor screening, compiling disease transmissibility data, monitoring of transplant recipients’ health, and assessing effectiveness of measures to minimize disease transmission. Collaboration and sharing of perspectives, experiences, and resources of all stakeholders in the transplantation process (government, private industry, and health care providers) can improve the safety of organ and tissue transplantation.

Contact Dr. Melissa A. Greenwald via:
Rita Chappelle
FDA Press Office


Dr. Matt Kuehnert via:
CDC Press Office

3. Increasing Resistance to Ciprofloxacin and Other Antimicrobial Drugs in Neisseria gonorrhoeae, United States, Edward Goldstein, et al.

What would you do if you had a sexually transmitted disease that was untreatable with antibiotics? That is the situation we may be heading toward. In the United States, gonorrhea is the second most common reportable infection. Over the years the organism that causes it, N. gonorrhoeae, has acquired resistance to several classes of antibiotics including, most recently, the fluoroquinolones. In fact, widespread resistance led CDC to stop recommending fluoroquinolones for gonorrhea treatment in 2007. Today, cephalosporin-based combination therapy the last remaining option currently recommended for gonorrhea treatment. Understanding of the causes of drug resistance is needed so that control measures can be improved and the effectiveness of the few remaining drugs can be maintained. This paper investigates possible causes for the emergence of fluoroquinolone-resistant N. gonorrhoeae that occurred several years ago.  Fluoroquinolone-resistant strains spread in the United States in the late 1990s, and spread more rapidly among men who have sex with men (MSM) than heterosexual men. One possible explanation for the rise in drug resistance, especially among heterosexuals, is acquisition of resistant gonorrhea through travel. Certain drug-resistant strains of N. gonorrhoeae, particularly the multi-drug resistant strains (also resistant to penicillin and tetracycline) circulating among men who have sex with men (MSM), appeared to be able to reach high prevalence levels through domestic transmission, rather than through frequent importation. Once resistance emerged in a geographical area, resistant strains appeared among both MSM and heterosexuals within several months. When resistance is detected in either MSM or heterosexuals, prevention efforts should be directed toward both populations.

Edward Goldstein
Harvard School of Public Health, Boston, MA
(617) 432-7208


Dr. Robert Kirkcaldy via:
CDC NCHHSTP Media Relations
(404) 639-8895

4. Solid Organ Transplant–associated Lymphocytic Choriomeningitis, United States, 2011, Adam MacNeil, et al.

Lymphocytic choriomeningitis virus (LCMV) is carried by rodents. In very rare instances, it has been transmitted from person-to-person by organ transplantation. In 2011, a total of 14 organ recipients were infected with the virus of which 11 died in the United States.  The four most recent patients received organs from the same donor that resulted in two deaths. Only after these four organ recipients became sick was it discovered that the donor had been exposed to rodents. Had this exposure been known before transplantation, the organ recipients may have been more closely monitored. Early diagnosis and treatment might have improved their chances of survival. Although organ donor screening reduces the risk for transmission of some viruses, it is not possible to screen for all possible viruses, including LCMV. For patients who get severely ill after receiving a transplant, clinicians should add LCMV infection to their list of possible causes.

Craig Manning
CDC Viral Special Pathogens Branch



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