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February 2017

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 23, No. 3, March 2017

Note: Not all articles that EID publishes represent work done at CDC or by CDC staff. In your stories, please clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by CDC in the EID journal”). Opinions expressed by authors contributing to EID do not necessarily reflect the opinions of CDC or the institutions with which the authors are affiliated. EID requests that, when possible, you include a live link to the actual journal article in your stories.

The articles of interest summarized below will appear in the March 2017 issues of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Emerging Viruses. The articles are embargoed until February 15, 2017, at Noon ET.


1.      Outbreaks of Disease Associated with Food Imported into the United States, 1996–2014, L. Hannah Gould et al.

A small but increasing percentage of foodborne outbreaks in the United States are associated with imported foods. Presently, most seafood and half of fruits consumed in the U.S. are imported. To identify disease outbreaks associated with imported food, researchers reviewed outbreak reports submitted to the Centers for Disease Control and Prevention during 1973–2014. They obtained additional data for some outbreaks (e.g., country of origin) from the U.S. Food and Drug Administration and the U.S.D.A’s Food Safety and Inspection Service. From 1996 to 2000, 1% of foodborne outbreaks were linked to imported food, which was 3 outbreaks per year on average. From 2009-2014, 5% of foodborne outbreaks were linked to imported food, which was 18 outbreaks per year on average. Scombroid toxin (almost all from fish) and Salmonella (mostly from produce) were the most common causes of outbreaks linked to imported foods, most commonly fish from Asia and produce from Latin and South America. Seafood was responsible for 55% of outbreaks and 11% of outbreak-associated illnesses, whereas produce was responsible for 33% of outbreaks and 84% of outbreak-associated illnesses. The study shows the importance of national and global surveillance systems to find foodborne disease outbreaks and share the information to ensure the safety of our food supply.  Knowing what imported foods are most often linked to outbreaks can help focus efforts to improve food safety and prevent future illnesses.

Contact: CDC Press Office, or 404-639-3286.


2.      Ebola Virus RNA in Semen from an HIV-Positive Survivor of Ebola, Lawrence J. Purpura et al.

Ebola virus persists in semen of male survivors of Ebola virus disease (EVD). However, the maximum duration of this persistence and what influences that duration are unknown. Researchers examined the case of a 48-year-old EVD survivor in Liberia who had a preexisting HIV infection and whose semen was positive for Ebola virus RNA 565 days after his recovery from EVD. Despite being HIV positive, this patient had a favorable outcome for EVD, which highlights the need for continuing treatment for HIV infection in the setting of a large-scale Ebola outbreak. His case also highlights the need for a better understanding of the role that co-infection with HIV and other causes of immunosuppression might play in persistent detection of Ebola virus RNA in male survivors of EVD. Because HIV infection is treatable and testing is readily available in West Africa, semen testing programs for Ebola virus should consider offering HIV testing to male survivors of EVD. In addition, behavioral counseling on safe sex practices and condom distribution to male survivors of EVD (with or without HIV infection) and their sexual partners should remain integral to any Ebola response.

Contact: CDC Press Office, or 404-639-3286.


3.      Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis, Rachel M. Smith et al.

Each year in the United States, »30,000 organ transplantations are performed, and up to 2% of those organs may carry infectious organisms. In the rare event an infection develops in an organ recipient, the causative organism must quickly be identified and other patients who received organs from the same donor must also be identified and notified. In April 2014, one such case of donor-derived infection occurred. About 10 weeks after receiving a kidney transplant, the recipient showed signs of encephalitis and later died. Two other patients who had received organs from the same donor were quickly identified and found to also have nervous system problems. Clinicians, laboratory scientists, the organ procurement organization, and public health agencies cooperated during an extensive evaluation to determine the cause of this illness, but the process took around 6 weeks. Microsporidiosis was not initially considered because it typically causes gastrointestinal, not neurologic, signs. Microsporidiosis was diagnosed only after an autopsy was performed on the recipient who died and specialized studies were conducted at CDC’s Pathology laboratory. Therefore, for organ recipients with unexplained encephalitis, clinicians should consider donor-derived microsporidiosis, even when gastrointestinal signs are absent.

Contact: CDC Press Office, or 404-639-3286


4.      Successful Treatment of Human Plague with Oral Ciprofloxacin, Titus Apangu et al.

Plague is a life-threatening disease caused by Yersinia pestis. Animals that carry this bacterium live on several continents; however, most human cases of Y. pestis infection occur in resource-poor areas in sub-Saharan Africa. In the absence of effective antibiotic treatment, plague is frequently fatal. Drugs approved by the US Food and Drug Administration (FDA) for treatment of plague include streptomycin and doxycycline. Fluoroquinolones, including ciprofloxacin, have recently been approved by the FDA for treatment of plague.  This approval, however, is based on animal and laboratory studies. To learn more about the  safety and effectiveness of ciprofloxacin for treating plague in people, during 2011–2014, in the West Nile region of Uganda, researchers studied this drug in 5 patients with plague. After treatment with ciprofloxacin, all 5 patients recovered from their fevers within 2 days and were discharged and able to resume normal activities at 14 days. These results add to the growing body of evidence supporting broader use of oral ciprofloxacin for treating plague in people, especially in resource-poor areas where intravenous treatment is limited.

Contact: CDC Press Office, or 404-639-3286