September 2021

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 27, No. 9, Month 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

The articles of interest summarized below will appear in the September 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 August 11, 2021, at 12 p.m. EDT.

1. Gram-Negative Bacteria Harboring Multiple Carbapenemase Genes, United States, 2012–2019, Cal Ham et al.

Carbapenems are powerful antibiotic agents used for treating severe bacterial infections. Some strains of bacteria become resistant to carbapenems by acquiring genes enabling them to produce carbapenemases, enzymes that inactivate β-lactam antibiotics including carbapenems, making the bacteria resistant to multiple classes of antibiotics. This report focuses on the emergence of bacteria harboring multiple carbapenemase genes. CDC receives reports of carbapenemase-producing, carbapenem-resistant organisms from health departments, public health laboratories, healthcare facilities, and isolates that are sent to CDC for confirmatory testing. In 2016, CDC established the Antibiotic Resistance Laboratory Network (AR Lab Network) to support nationwide lab capacity to rapidly detect antibiotic resistance and inform local responses to prevent spread and protect people. Through the AR Lab Network, public health laboratories test carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Acinetobacter baumannii isolates for carbapenemases. During October 2012–April 2019, CDC documented 151 isolates harboring multiple carbapenemase genes from 100 patients in the United States. Possible risk factors for acquisition of these strains included a recent history of international travel, accessing inpatient healthcare abroad, and receiving a solid organ or bone marrow transplant. Several measures might prevent further spread, including having clinicians screen patients who were recently hospitalized outside the United States to prevent additional introductions of carbapenemase genes not commonly found in the United States, and having public health officials assess the risk for potential transmission when one of these organisms is identified.

Contact: CDC Media Relations; phone (404) 639-3286 or email:

2. Epidemiology, Clinical Features, and Outcomes of Coccidioidomycosis, Utah, 2006–2015, Adrienne Carey et al.

Coccidioidomycosis, also known as Valley fever, is an infection caused by Coccidioides fungi found in the soil of the southwestern United States, Mexico, and Central and South America. People can get Valley fever by breathing in the microscopic fungal spores that become airborne when the soil in which they are naturally found is disturbed by activities such as construction or sandstorms. Some people have no symptoms, others get better on their own, but some people at higher risk may become severely ill. Coccidioidomycosis is well-described in California and Arizona. It is also considered endemic in Utah, but here the epidemiology and characteristics of this disease have not previously been described. Researchers from the University of Utah, Intermountain Healthcare and the Utah Department of Health conducted the most comprehensive description of the incidence, geographic distribution and characteristics of coccidioidomycosis in Utah to date. Researchers analyzed the climate and environmental factors that may be responsible as well as the clinical illness and patient outcomes. Using data from cases reported to the Utah Department of Health during 2009–2015 and patient data from the Intermountain Healthcare System during 2006–2015, they found that regional variations were associated with mean annual temperature, population, and new construction. They used that information to create a model to predict regions in which Coccidioides infections might increase, one of which was northeastern Utah. Increasing the awareness of healthcare providers in southwestern Utah would promote early recognition and clinical management of the disease, and enhanced clinical surveillance in northeastern Utah might detect more cases there as well.

Contact: Jess Gomez, Intermountain Healthcare, or Julie Kiefer, University of Utah Health,

3. Geographically Targeted Interventions versus Mass Drug Administration to Control Taenia solium Cysticercosis, Peru, Seth E. O’Neal et al.

Taenia solium is a tapeworm that infects pigs and humans. The infection (cysticercosis) in humans can remain dormant for years, but it can affect the brain (neurocysticercosis) and lead to seizures and occasionally death.  Cysticercosis is more common in countries where food and water safety are inadequate.  Infection is transmitted to humans or pigs by unintentional ingestion of T. solium eggs in human feces. Several methods for infection control have been attempted. To determine which may be the most effective, researchers compared 3 methods in Peru: 1) screening subgroups of people in high-risk areas (i.e., near farms with infected pigs) and offering treatment to those who were infected; 2) offering treatment to all people in high-risk areas, regardless of their infection status; and 3) offering treatment to all people, regardless whether they were in a high-risk area. They also determined whether treating the pigs provided additional control benefits. They found that all 3 control methods reduced infection of pigs by about 65%, and all 3 were accepted broadly within the study communities. Treating the pigs themselves did not provide additional benefits. Thus, control programs using various approaches can be effective and may help meet the 2011 World Health Organization roadmap target of overcoming neglected tropical diseases, such as cysticercosis.

Contact: Seth O’Neal, School of Public Health, Oregon Health & Science University – Portland State University, Portland, OR, USA; email: or phone: (503) 494-0300.



Page last reviewed: August 13, 2021