June 2022

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 28, No. 6, June 2022

The articles of interest summarized below will appear in the June 2022 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. The articles are embargoed until May 11, 2022, at noon Eastern time.

Important Note: Most articles that EID publishes do not represent work done at CDC or by CDC staff. In your stories, please use our suggested language to clarify whether a study was conducted by CDC (“a CDC study”) or by another institution (“a study published by ____ 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.

Please link directly to the actual journal article in your stories. Once the embargo lifts, this month’s articles will be found in the Early Release section of the EID website.

EID is publishing many articles on the COVID-19 pandemic. Because we publish those articles on an expedited track, and we have no embargo on their content, we do not include them in these monthly press notices. You may wish to subscribe to receive email notifications when EID publishes expedited articles as well as other types of articles.

Note that the most recent EID COVID-19 papers are at the top of the journal’s home page and also included in the Coronavirus Spotlight.

  1. Economic Burden of Reported Lyme Disease in High-Incidence Areas, United States, 2014–2016, Sarah A. Hook et al.
    In CDC’s most comprehensive evaluation of the economic burden of Lyme disease to date, researchers estimated that the total cost of diagnosed Lyme disease cases could be nearly $1 billion annually in the United States. The study occurred between September 2014–January 2016 and followed reported cases in four states where the tickborne disease is common: Connecticut, Maryland, Minnesota, and New York. In addition to direct medical costs, this study also included data for nonmedical costs and losses in productivity. Researchers measured costs incurred from the patient’s perspective (i.e., “out-of-pocket” costs) and from the societal perspective (i.e., all costs, no matter who pays them, whether the patient, healthcare system, third party payer/insurance, or government). They found that the average out-of-pocket cost was about $1,200 per patient and the average societal cost was about $2,000 per patient. Using this data and additional information on the estimated number of Lyme disease cases diagnosed in the United States, researchers estimated that the annual total cost of diagnosed Lyme disease could be $345 million–968 million (2016 U.S. dollars). Lyme disease is the most common vector-borne disease in the United States, and approximately 476,000 cases of Lyme disease are diagnosed and treated each year nationally. Lyme disease is caused by the bacterium Borrelia burgdorferi and rarely, B. mayonii, which is transmitted to people through the bite of an infected blacklegged tick. Early symptoms can include rash and flu-like symptoms. If untreated, later signs and symptoms can include facial palsy, arthritis, nerve pain, and heart palpitations or an irregular heartbeat. This study’s findings underscore the importance of effective prevention and early and accurate diagnosis and treatment of Lyme disease to reduce illness and associated costs. The results can be used in cost-effectiveness analyses of current and future prevention methods, such as a vaccine. This study did not include costs associated with suspected, undiagnosed, or non-acute cases. Those costs would further increase the total economic burden attributable to Lyme disease in the United States and should be evaluated in future studies.
    Contact: CDC Media Relations, phone: 404-639-3286 or email: media@cdc.gov
  2. Public Health Response to Multistate Salmonella Typhimurium Outbreak Associated with Packaged Chicken Salad, 2018, Bradford Greening, Jr., et al.
    Each year in the United States, Salmonella bacteria cause an estimated 1.35 million infections and 420 deaths. Food is the source for most of these illnesses. An investigation into a foodborne disease outbreak in 2018 provides an example of how timely interventions can help reduce illnesses and other impacts of an outbreak. On February 5, 2018, Iowa State Hygienic Laboratory staff noted a dramatically increased number of Salmonella-positive samples being reported. Over the next 3 days, interviews of infected persons and testing of suspected sources identified a prepackaged chicken salad at a grocery store chain as the likely origin. In addition, cross-comparison of genetic samples revealed additional cases in seven surrounding states. By February 9, the store selling the product voluntarily removed it from all its Iowa stores; and, by February 13, the Iowa Department of Health and Department of Inspections and Appeals issued a consumer advisory. Using mathematical modeling, researchers estimated that the rapid response potentially prevented 106 cases and saved $715,458 in medical costs and productivity losses. This study illustrates how quantitatively estimating the impact of outbreak response actions using direct and relatable outcome indicators (e.g., cases averted) helps demonstrate the importance of sustained investment in a capable public health infrastructure.
    Contact: CDC Media Relations, phone: 404-639-3286 or email: media@cdc.gov
  3. Foodborne Illness Outbreaks Reported to National Surveillance, United States, 2009–2018, Alice E. White, et al.
    CDC estimates that each year 48 million people get a foodborne illness and 3,000 die. Foodborne illness outbreaks are investigated by local, state, and territorial health departments, CDC, the US Food and Drug Administration, and the Food Safety and Inspection Service of the United States Department of Agriculture. These outbreaks are reported to the CDC Foodborne Disease Outbreak Reporting Surveillance System. To determine the factors that influence which outbreaks are detected, investigated, and reported, researchers analyzed structural factors (for example, funding, jurisdiction infrastructure and capacity) and characteristics of outbreaks (for example, size, geographic location, pathogen) that were reported during 2009–2018. They found that the number and types of foodborne outbreaks reported varied substantially across states. High-reporting states reported 4 times more outbreaks than low reporters. Low reporters were more likely than high reporters to report larger outbreaks and less likely to implicate a setting or food vehicle, However, the types of food vehicles identified did not differ significantly. They also found that per capita infectious disease funding was strongly associated with increased reporting, indicating that investments in public health programming measurably affect outbreak reporting.
    Contact: Tonya Ewers, Director of Communications and Marketing, Office of the Dean, Colorado School of Public Health, Aurora, CO; tonya.ewers@cuanschutz.edu
  4. Divergent Rabies Virus Variant of Probable Bat Origin in 2 Gray Foxes, New Mexico, USA, Rene E. Condori et al.
    A new variant of the rabies virus has been discovered in foxes in New Mexico. Rabies is a lethal viral disease that infects the central nervous system of mammals, causing severe damage to the brain and eventual death. The virus can spread from animals to people, as well as among some animal species. In New Mexico, skunks, bats, and gray foxes are known to sometime carry rabies and represent a public health risk due to their encounters with people. During 2015 and 2019, two gray foxes in Lincoln County, New Mexico were infected with a previously undescribed rabies virus variant. Genetic analysis revealed that the isolates represent a novel rabies virus variant that is most closely related to rabies viruses found in tree-dwelling species of bats. These two cases most likely represent repeated spillover events (in which the virus jumps from one species to another) from bats to gray foxes. Additional molecular analysis of rabies cases across New Mexico identified other cross-species transmission events caused by rabies viral variants previously known to be carried by animals. Detecting a previously unrecognized rabies variant along with other cross-species transmission was possible because of a robust rabies public health surveillance system in New Mexico capable of detecting animal-borne pathogens, and advanced sequencing capacity at the CDC’s National Rabies Reference Laboratory in Atlanta.
    Contact: CDC Media Relations, phone: 404-639-3286 or email: media@cdc.gov


Page last reviewed: May 11, 2022