July 2014

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 20, No. 7, (July 2014)

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1. Socioeconomic Status and Campylobacteriosis, Connecticut, USA, 1999–2009, Kelley Bemis et al.

In the United States, campylobacteriosis is the second most common foodborne gastrointestinal illness caused by bacteria; in Connecticut, it is the most common such illness. The more we know about who is at risk for this illness, the better we can direct prevention and control.  In Connecticut, a study to learn whether this illness is associated with socioeconomic status found that for people 10 years of age and older, more cases occurred among those of higher socioeconomic status, but for children younger than 10, more cases occurred among those of lower socioeconomic status. This finding that risk is higher for children living in poorer neighborhoods could reflect increased exposure to the organism in the home, but this hypothesis needs verification. Control efforts, at least in Connecticut, should especially focus on those in the age and socioeconomic groups at highest risk.

Contact:
James L. Hadler
Emerging Infections Program, Yale School of Public Health, New Haven, CT
hadler-epi@att.net  

2. Carbapenemase-Producing Organism in Food, 2014, Joseph E. Rubin et al.

Carbapenems are a type of antibiotic, and carbapenemases are enzymes that some organisms can produce to render these antibiotics ineffective. The recent global emergence of carbapenemase-producing organisms adds to the growing problem of antibiotic resistance, to the point of its being considered a public health emergency. Carbapenem-resistant organisms have been found in the environment and in animals used for food; but in the United States and Canada, they had not been found in food itself—until now. In January 2014, routine testing identified a carbapenemase-producing organism in a squid for sale in a Chinese grocery store in Saskatoon, Canada. The squid had probably been imported from South Korea. This finding expands the list of those at risk for carbapenem-resistant infections from a select group of people to the general public.  Specifically, it expands the previously known risks of travel to certain destinations, previous use of antibiotics, or prior hospitalization, to the more widespread risk of consumption of contaminated food.  Finding a carbapenemase-producing organism in food in North America creates an urgent need to expand tracking and monitoring (surveillance) of these organisms.

Contact:
Joseph E. Rubin
Western College of Veterinary Medicine
University of Saskatchewan
Saskatoon, Canada
jer298@mail.usask.ca

3. Lessons for Control of Heroin-Associated Anthrax in Europe from 2009–2010 Outbreak Case Studies, London, Aula Abbara et al.

Anthrax is unique in that it can occur in several forms: cutaneous (acquired when spores enter a cut or scrape in the skin), gastrointestinal (acquired by eating food or drinking water that is contaminated with spores), and inhalational (acquired by breathing in spores). Adding to the diversity of this illness is a relatively new form, injection anthrax, which is acquired when anthrax-contaminated heroin is injected into or around a blood vessel or just under the skin (skin popping). Many of the diagnosed cases of heroin-associated anthrax are severe and often fatal, and cases now also display new and varied symptoms, which clinicians might not recognize as anthrax. Recent detection of injection anthrax cases in northern Europe indicates that batches of anthrax-contaminated heroin are circulating and that clinicians and heroin users should be made aware of heroin-associated anthrax. Because these cases might just represent the tip of the iceberg, surveillance should be conducted to determine the full extent of the problem, and diagnostic testing should be conducted whenever anthrax is suspected.

Contact:
Alison Holmes
Professor of Infectious Diseases
Imperial College London, United Kingdom
alison.holmes@imperial.ac.uk

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES