April 2014

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 20, No. 4, (April 2014)


The articles of interest summarized below will appear in the April 2014 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature coronaviruses and influenza viruses. The articles are embargoed until March 12, 2014, at 12 p.m. ET.

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.

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1. Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006, H. W. Chesson et al.

Antimicrobial resistance can hinder gonorrhea prevention and control efforts. In this study, CDC wanted to see if antimicrobial resistance could increase the number of gonorrhea cases. CDC analyzed antimicrobial resistance data from the Gonococcal Isolate Surveillance Project (GISP) and city-level gonorrhea incidence rates from surveillance data for 17 cities from 1991 to 2006. CDC’s analysis found a strong, positive association between ciprofloxacin resistance and increased gonorrhea cases at the city level. Due to widespread drug resistance, CDC has not recommended ciprofloxacin (a type of fluoroquinolone) be used to treat gonorrhea since 2007. While the number of gonorrhea cases has decreased since the 1970s, the organism is now becoming resistant to cephalosporins, the foundation of the last available treatment option.  Emerging cephalosporin resistance could have substantial health and economic consequences in the future.  Efforts to control the spread of resistant strains might reduce this potential burden.

Contact Harrell W. Chesson via:
NCHHSTP Press Office

2. High Acquisition Rates of Antimicrobial Drug Resistance Genes after International Travel, the Netherlands, C. J.H. von Wintersdorff et al.

The genes that code for resistance in bacteria do not discriminate and can be transferred from harmless to harmful bacteria and vice versa. Although antibiotic resistance in harmful bacteria has been thoroughly studied, the development of resistance genes in otherwise harmless bacteria could have unpredictable and immense health consequences if transferred to harmful bacteria. A study conducted in the Netherlands found that the risk of acquiring such bacteria with those genes increases during international travel. Any contact with food, water, soil, other people, or animals from foreign environments provides opportunities for travelers to introduce many resistance genes into their gastrointestinal tract. Although the consequences of acquiring these genes are difficult to predict, it is possible that international travelers could contribute to the spread of antibiotic resistance.

Petra F.G. Wolffs
Maastricht University Medical Center, Department of Medical Microbiology, Maastricht, The Netherlands.
+31 433976644

3. Regional Variation in Travel-related Illness Acquired in Africa, March 1997–May 2011, M. Mendelson et al.

Africa’s diverse geography, ecosystems, and climate make that continent a popular tourist destination, yet we do not clearly understand how that diversity affects travellers’ risks for exposure to various illnesses. A large collaborative effort using a database of travelers found that the highest risk for gastrointestinal illnesses and dog bites was in northern Africa; the greatest risk for illnesses with fever in sub-Saharan Africa; the highest risk for malaria in central and western Africa; the highest risk for schistosomiasis, strongyloidiasis, and dengue in eastern and western Africa; and the highest risk for eye worm infection in central Africa. Understanding what the greatest health risks are in different parts of Africa can help with dispensing travel advice, diagnosing illness in returned travelers, and deciding where in Africa to visit.

Marc Mendelson
University of Cape Town Division of Infectious Diseases & HIV Medicine, Department of Medicine

4. Pandemic Vibrio parahaemolyticus, Maryland, USA, August 2012, J. Haendiges et al.

When you think of a pandemic, you don’t first think of foodborne illnesses. However, a pandemic strain of bacteria that causes foodborne illness, Vibrio parahaemolyticus, has been emerging worldwide; these bacteria usually infect people who eat contaminated raw oysters. This strain is not commonly found in the United States, but in 2012 it caused an outbreak in Maryland. The affected patients had not eaten oysters, leaving cross-contamination during food preparation as a possible source of their illness. The presence of this dangerous strain in Maryland calls for public health measures to improve its tracking and shorten response times when it is found.

Contact Narjol Gonzalez-Escalona via:
Felicia Hogue
Food and Drug Administration, Center for Food and Applied Nutrition, College Park, MD      

5. Gnathostoma spinigerum in Live Asian Swamp Eels (Monopterus spp.) from Food Markets and Wild Populations, United States, R.A. Cole et al.

During 2005–2008, more than 1 billion live animals were legally imported into the United States for food or pet trade markets. One such animal, the swamp eel, can carry parasites (worms) called gnathostomes. If those eels are eaten undercooked or raw, this parasite can cause mild to serious (blindness, paralysis, and even death) consequences. This parasite is native to Southeast Asia but not to the United States. However, because swamp eels imported into the United States end up in ethnic food markets or are released into the wild, this situation is in flux. When researchers tested eels from US ethnic markets and open waters, they found that those eels do indeed carry this parasite and that they could be a source of infection for US consumers. Thus, consumers should be aware of this risk, and clinicians should consider their patients’ dietary history, not just travel history, when diagnosing this infection.

Contact Rebecca A. Cole via:
Gail Moede Rogall
Information Specialist
US Geological Survey
National Wildlife Health Center, Madison, Wisconsin


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