March 2015

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 21, No. 3, (March 2015)


The articles of interest summarized below will appear in the March 2015 issues of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature tuberculosis, in conjunction with World TB Day, designated by World Health Organization as March 24, the date on which Robert Koch announced discovery of the TB bacillus in 1882. The articles are embargoed until February 11, 2015, 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.

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1. Characteristics of Tuberculosis Cases that Started Outbreaks in the United States, 2002–2011, M.B. Haddad et al.

A CDC analysis of the initial cases leading to 26 tuberculosis (TB) outbreaks in the U.S. found many common characteristics among the source patients, including long infectious periods and several social risk factors. Specifically, source patients were mostly U.S.-born men and many had infectious periods lasting 10 months or longer, which is concerning because TB can spread to others and be fatal if not properly diagnosed and treated. Most reported substance abuse, half were incarcerated at some point previously, and nearly half were homeless in the year before diagnosis. These findings underscore the importance of timely diagnosis of TB cases and thorough efforts to identify contacts of those individuals in order to help reduce the risk for further transmission, especially among marginalized populations. Given the continued decline of TB in the U.S., it is also critical that providers remain alert for symptomatic patients to avoid later-stage diagnosis.

Contact Maryam B. Haddad via:
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
News Media Line: 404-639-8895

2. Epidemiology of Human Mycobacterium bovis Disease, California, USA, 2003–2011, Mark Gallivan et al.

Tuberculosis (TB) can be caused by more than one type of bacteria, one of which is Mycobacterium bovis. TB caused by M. bovis is of particular concern because of its predilection for children and the fact that infection can be acquired from animals and food. M. bovis is usually, but not exclusively, spread through consumption of unpasteurized, contaminated dairy products. The proportion of TB cases due to M. bovis in California has increased and the rate of M. bovis TB exceeds the national average. To identify risk factors associated with M. bovis TB in California, researchers reviewed surveillance records. They found that M. Bovis TB in California has increased, exceeding the national average. They also found risk factors to be Hispanic ethnicity, extrapulmonary (outside the lungs) TB, diabetes, and other conditions that weaken the immune system (except for HIV/AIDS). Therefore, efforts to prevent M. bovis TB should focus on educating Hispanic populations and adults who have medical conditions that weaken the immune system about their risk. In addition, efforts to limit the demand and distribution of unpasteurized dairy products, which can also be associated with other foodborne diseases, should continue.

Contact Mark Gallivan via:
Carlos Villatoro
Office of Public Affairs, California Department of Public Health, Sacramento, CA

3. Reemergence of Murine Typhus in Galveston, Texas, USA, 2013, Lucas S. Blanton et al.

Murine typhus is characterized by fever, rash, and headache. Typhus bacteria are spread to humans by rat fleas and cat fleas. The disease is common in tropical and subtropical coastal areas; but in Galveston, Texas, use of pesticides apparently eradicated the disease for eight decades—until now. Two cases in 2012 prompted increased testing, which indicated that murine typhus is reemerging in Galveston. Until the cause for this reemergence is better understood, physician awareness and vector control remain crucial. 

Contact Lucas S. Blanton via:
Raul Reyes or Donna Ramirez
Press Office
University of Texas Medical Branch, Galveston, Texas or


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