June 2021

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 27, No. 6, June 2021

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 include a live link 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.

The articles of interest summarized below will appear in the June 2021 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. This issue will feature Emerging Viruses. The articles are embargoed until May 12, 2021, at 12 p.m. EDT.


1.  Reflections on 40 Years of AIDS, K.M. De Cock et al.
Note: this article is not embargoed and is available at: https://wwwnc.cdc.gov/eid/article/27/6/21-0284_article

By the time the first AIDS cases were reported in June 1981, millions of people around the world had been infected with HIV. It took 2–3 years to identify the cause of AIDS (HIV) and even more to identify the source (chimpanzees). Forty years later, the medical, scientific, and public health community has made progress on all response priorities by improving interventions, optimizing HIV testing and antiretroviral therapy for prevention and treatment, continuing research, and ensuring the sustainability of the response. Despite financial crises, the world has maintained levels of funding and kept focus on the Sustainable Development Goals. The history of HIV/AIDS demonstrates the best and worst of human nature, exemplary leadership as well as discrimination. Although initially slow, the HIV/AIDS response over the years has served as a global health guide for respect for individuals and their rights and for health equity. Lessons learned may be relevant to COVID-19 and other future epidemics.

Contact: Kevin M. De Cock, MD, Phone: +254-722 515 294 or Email; kevinmdecock@outlook.com


2.  Association between Birth Region and Time to Tuberculosis Diagnosis among Non–US-Born Persons in the United States, Amish Talwar et al.

Approximately 70% of tuberculosis (TB) cases in the United States occur in people who were not born in the United States, and more than 85% of those cases occur when latent TB infection (LTBI), in which the person is infected but is asymptomatic and noncontagious, progresses to TB disease. CDC recommends that efforts to eliminate TB in the United States focus, in part, on detecting and treating LTBI among non–US-born persons. To help inform those efforts, researchers at CDC investigated whether birthplace is associated with time to disease progression among non–US-born persons in whom TB disease developed. Using a mathematical model, they compared differences in time to TB diagnosis after US entry among persons born in 19 different regions. The median time to TB diagnosis was lowest among persons from Middle Africa (128 months for males and 121 months for females). Birth region can serve as a prognostic indicator for progression of latent TB infection to TB disease. Understanding this indicator and other factors associated with LTBI progression can guide public health authorities in concentrating TB prevention resources on persons with LTBI who are at greatest risk for developing TB disease.

Contact: CDC Media Relations, Phone: (404) 639-3286 or Email: media@cdc.gov.


3.  Increased Incidence of Antimicrobial-Resistant Nontyphoidal Salmonella Infections, USA, 2004–2016, Felicita Medalla et al.

Salmonella bacteria are a major cause of foodborne illness in the United States, and antimicrobial-resistant strains pose a serious and growing threat to public health. Using mathematical modelling and data from two disease surveillance systems, researchers at CDC estimated changes in the national incidence of resistant nontyphoidal Salmonella infections. Comparing the period 2004–2008 with 2015–2016, they estimated a 40% increase in the annual incidence of infections with clinically important resistance to any of three antimicrobial drugs recommended to treat severe infections (i.e., resistant to ceftriaxone or ampicillin or nonsusceptible to ciprofloxacin). Changes in the incidence of resistance varied by Salmonella serotype. Serotypes I 4,[5],12:i:- and Enteritidis were responsible for two thirds of the increased incidence. These estimates can guide public health authorities as they set targets and prioritize resources in their efforts to prevent Salmonella infections.

Contact: CDC Media Relations, Phone: (404) 639-3286 or Email: media@cdc.gov.


4.  Rocky Mountain Spotted Fever in Large Metropolitan Center, Mexico–United States Border, 2009–2019, Oscar E. Zazueta et al.

Rocky Mountain spotted fever (RMSF) is a severe and potentially deadly tickborne disease caused by Rickettsia rickettsii bacteria. Outbreaks often occur in areas with large numbers of dogs heavily infested with ticks. Outbreaks in urban areas are rare and are usually limited in size and duration. These characteristics make the 11-year outbreak of RMSF in Mexicali, the capital city of Baja California, Mexico, unique. When researchers analyzed serologic (antibody levels) and molecular (DNA detected by PCR) test results from patients, they determined that PCR was more useful for confirming infection. The outbreak in Mexicali is particularly concerning because the contributing conditions (e.g., high-density, low-income neighborhoods with large numbers of free-roaming dogs and abundant brown dog tick populations) exist within many other metropolitan areas across Mexico and Latin America and therefore could lead to outbreaks in other urban locations. The human and economic costs associated with epidemic RMSF will undoubtedly continue without adoption and use of well-supported and carefully integrated efforts (e.g., intensified clinical and public education, rapid diagnosis, and appropriate treatment) that directly address this ongoing issue.

Contact: Oscar E. Zazueta, Mexicali, B.C., Mexico; email: oez512@mail.harvard.edu.

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Page last reviewed: May 10, 2021