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August 2017

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 23, No. 9, September 2017

The articles of interest summarized below will appear in the September issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Zoonoses. The articles are embargoed until August 16, 2017, at Noon EDT.

NEW THIS MONTH: The Emerging Infectious Diseases website has added two new, enhanced search features. The Advanced Article Search enables readers to find and sort articles by keywords, names of authors, type of articles, and specified date ranges. The interactive Articles by Country Map allows readers to generate tailored lists of articles with content about that country and to sort by date of publication and type of article. Search results can also be bookmarked for later reference.

Important 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 link directly to the actual journal article in your stories. Once the embargo lifts, this month’s articles will be found in the Ahead of Print section of the EID website at

1.      Role of Food Insecurity in Outbreak of Anthrax Infections among Humans and Hippopotamuses Living in a Game Reserve Area, Rural Zambia, Mark W. Lehman et al.

Anthrax is a rare but potentially deadly infectious disease caused by bacteria known as Bacillus anthracis. People can become ill with anthrax if they come in contact with infected animals or contaminated animal products. In September 2011, authorities reported 511 human cases of anthrax infection and 5 deaths in a game management area in the district of Chama, Zambia, near where 85 hippopotamuses had recently died of suspected anthrax. Most of the human infections responded to antibiotics. To better understand how transmission occurred, researchers surveyed household members in villages where human anthrax cases and hippopotamus deaths had been reported. Among 284 respondents, 84% had eaten hippopotamus meat before the outbreak. Eating, carrying, and preparing meat were associated with anthrax infection. Despite the risk, 23% of respondents reported they would eat meat from hippopotamuses found dead again because of lack of food (73%), lack of meat (12%), hunger (7%), and lack of protein (5%). Chronic food insecurity can lead to consumption of unsafe foods, leaving communities susceptible to anthrax and other infectious diseases transmitted through animals. Interagency cooperation can help prevent outbreaks by addressing the root cause of exposure, such as food insecurity.

Contact: Brandon Howard, Communications and Marketing Manager, Department of International Health, Johns Hopkins Bloomberg School of Public Health, (410) 502-9059, or

2.   Conveyance Contact Investigation for Imported Middle East Respiratory Syndrome Cases, United States, May 2014, Susan A. Lippold et al.

In May 2014, two cases of imported Middle East respiratory syndrome (MERS) in the United States were confirmed in travelers from Saudi Arabia. Because both persons were symptomatic at the time of travel, CDC initiated conveyance contact investigations, in which investigators attempted to contact passengers and crew who may have been exposed to MERS coronavirus (MERS-CoV). The investigations covered all passengers and crew (large-scale investigations) on four international and domestic flights and one bus. There were three objectives: 1) notify travelers about the possible exposure, 2) identify symptomatic contacts and facilitate prompt evaluation and isolation, and 3) determine the extent of onboard transmission. Of 655 contacts identified, 78% were interviewed; 33% had serologic testing for evidence of infection. No secondary cases were identified. The results of these and other investigations suggest the risk for MERS coronavirus transmission on conveyances is low. Conveyance contact investigations require extensive time, resources, and partner and passenger compliance. Based on these findings, CDC recommends that future aircraft contact investigations for MERS include only passengers seated within two rows of the index case-patient, although modifications could be made depending on circumstances.

Contact: CDC Media Relations, 404-639-3286,

3.     Epidemiology of Salmonella enterica Serotype Dublin Infections among Humans, United States, 1968–2013, R. Reid Harvey et al.

Salmonella enterica serotype Dublin is a bacterium that mainly affects cattle but can also cause infections in humans. To summarize demographic, clinical, and antimicrobial resistance characteristics of human Salmonella Dublin infections, researchers analyzed data from five U.S. disease-tracking (surveillance) systems. They found that Salmonella Dublin infections have increased in incidence in the last decade. They also found that more than half of Salmonella Dublin infections have been resistant to seven antimicrobial classes and clinical outcomes have worsened in that period. It is well established that the use of antibiotics in humans and animals is a major driving force for the global surge in antimicrobial resistance. Therefore, careful evaluation of management practices and judicious use of antibiotics in humans and animals is critical to protect human and animal health.

Contact: CDC Media Relations, 404-639-3286,

4.    Influenza A (H3N2) Virus in Swine at Agricultural Fairs and Transmission to Humans, Michigan and Ohio, USA, 2016, Andrew S. Bowman et al.

Agricultural fairs pose a unique risk for infectious disease transmission from animals to humans. This report details how swine exhibitions at agricultural fairs have emerged as an important source for amplification of swine-lineage influenza A virus. In fact, these events have generated most of the cases of variant influenza in humans reported in the United States. This report underscores the need to control intraspecies and interspecies disease transmission at animal shows, petting zoos, live-animal markets, and similar venues. Continued surveillance of animal populations also will be essential to help detect novel strains of viruses and bacteria that could threaten animal and human health.

Contact: Shantay Piazza, Director of Communications, College of Veterinary Medicine, The Ohio State University, (614) 292-3752, or