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January 2016

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 22, No. 1, January 2016

The articles of interest summarized below will appear in the November 2015 issues of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Ebola. The articles are embargoed until October 14, 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.

1. Prognostic Indicators for Ebola Patient Survival, Samuel J. Crowe, Matthew J. Maenner, et al.

During the peak of the recent Ebola epidemic in West Africa, many healthcare facilities were quickly filled beyond capacity, which often forced clinicians to make difficult decisions about patient treatment and what to tell patients’ families. These decisions would be easier if doctors had some early indicator of a patient’s chances of survival. Two potential indicators are 1) time from first getting sick to receiving medical care and 2) PCR cycle threshold (used to estimate the amount of virus in a person’s blood) at the time of diagnosis. Analysis of information available for patients in Sierra Leone during 2014–2015 found an association between cycle threshold and chances of survival (the lower the amount of virus, the better the patient’s chances). This readily available indicator could help doctors quickly decide the best course of action for each Ebola patient.

CDC Press Office

2. Identification of the Source of Brucella suis Infection of a Human by Using Whole Genome Sequencing, United States and Tonga, Christine Quance et al.

Brucellosis is an infectious disease caused by bacteria. Its symptoms can disappear on their own or they can linger. People can get the disease through contact with infected animals (usually sheep, cattle, goats, pigs, and dogs), contaminated animal products, or unpasteurized milk. Currently in the United States, the brucellosis organism of pigs (Brucella suis) is found only in feral pigs; commercial pig herds are considered to be brucellosis-free. Therefore, when brucellosis was diagnosed in a man who had purchased commercial pigs while in Oregon, USA, the question of whether US commercial pig herds had been re-infected was raised. However, comparison of the genetic make-up of the bacteria infecting the man with that of brucellosis bacteria from Tonga, Polynesia, his country of origin, indicated that the man had acquired the infection while in Tonga, not in the United States. Determining that the infection came from outside the United States averted costly and time-consuming investigations. Specifically, widespread testing of US commercial pig herds was not needed, US agricultural trade continued without restrictions, and treatment of others who had had contact with commercial pigs (via home pig slaughter or meat preparation) was not needed. This case highlights the benefits of coordination between public and animal health (including state, federal, and international) authorities, known as the One Health approach.

Suelee Robbe-Austerman
National Veterinary Services Laboratories
1920 Dayton Ave, Ames, IA 50010, USA