October 2018

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 24, No. 11, November 2018

The articles of interest summarized below will appear in the November 2018 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. The articles are embargoed until October 10, 2018, at 12 p.m. EDT.

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 https://wwwnc.cdc.gov/eid/ahead-of-print.

1.     Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018, Sheikh Taslim Ali et al.

In Hong Kong, influenza (flu) epidemics occur every winter and attempts to mitigate them have included closing schools. During the winter of 2017–2018, an epidemic caused by influenza B/Yamagata in Hong Kong was especially concerning because cases were severe, the number of cases was higher than in previous years, and a concurrent severe flu epidemic was ongoing in the United States. To mitigate that epidemic, the Hong Kong government closed schools for 2.5 weeks (1 week before the Chinese New Year celebrations, a time of social mingling, but after the epidemic had peaked). To determine the effects of this school closure on virus spread in the community, researchers reviewed surveillance data on flu and flu-like illness in Hong Kong. They found that the effect of closing schools was small; new cases were reduced by only 4.2%. The best prevention against flu is vaccination; however, in Hong Kong, not enough people get vaccinated. Therefore, the researchers recommend implementing school-based flu vaccination programs for the upcoming 2018–2019 winter season.

Contact: Benjamin J. Cowling, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, via Evelyn Chan, Li Ka Shing Faculty of Medicine, The University of Hong Kong, evelync@hku.hk, +852 3917 9244

2.   Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA, Jay. E. Gee, et al.

The bacterium Burkholderia thailandensis occurs naturally in the environment, and is typically found in moist soil in warm climates. B. thailandensis infections in people are rare; when they do occur, they are often the result of an injury that exposes a wound to soil. B. thailandensis is similar to other bacteria and can be difficult to identify by common laboratory methods. In April 2017, a 29-year-old woman in Arkansas crashed into a large metal trash bin while driving an all-terrain vehicle, resulting in an open bone fracture of her forearm. About 3 months after receiving treatment for her injury, she returned to the hospital because her arm had been swollen for 2 weeks. She received antibiotics and recovered. A sample from deep in her wound was confirmed by CDC as B. thailandensis after being ruled out as another bacterium by the Arkansas Department of Health. This case, in addition to the 2 other documented cases of B. thailandensis infections in the United States (1 in Louisiana and 1 in Texas), suggests that B. thailandensis might be underreported in the continental United States. However, because of the limited number of reports, this bacterium’s geographic range and its ability to cause infections in North America remains unknown.

Contact: Jay E. Gee, via CDC Media Relations, 404-639-3286 or media@cdc.gov

3.     Timing the Origin of sensu stricto, Southeastern United States, Shawn R. Lockhart et al.

The Cryptococcus gattii species complex is a fungus that lives in the environment in many tropical and subtropical areas of the world as well as the Pacific Northwest region of the United States and Canada. In rare cases, people can suffer infections of the lungs, central nervous system, or both after inhaling the fungus. The C. gattii strain in the Pacific Northwest (C. deuterogattii) probably emerged in the region as little as 60–100 years ago. However, another member of this species complex, C. gattii sensu stricto, about which much less is known, is thought to have arrived in the southeastern United States much earlier. To substantiate this hypothesis, researchers conducted molecular clock analysis of gene sequences from C. gattii sensu stricto in the southeastern United States. Their results indicated that C. gattii arrived in the southeastern United States from South America approximately 9,000–19,000 years ago, much earlier indeed than the arrival of C. deuterogattii in the Pacific Northwest. However, far fewer C. gattii infections are detected in the southeastern United States than in the Pacific Northwest—and probably not because they are being overlooked in the southeast. C. gattii infections warrant extensive diagnostic workups, given that they typically are associated with devastating infections of the brain (e.g., meningitis and meningoencephalitis). Questions of whether nonsymptomatic cases might be going undetected, whether the distribution of the fungus in the environment might be lower in the southeast, or whether the fungus does not regularly infect humans remain unanswered.

Contact: Shawn R. Lockhart, via CDC Media Relations, 404-639-3286 or media@cdc.gov



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