MMWR News Synopsis for January 29, 2015

Outbreaks of Unexplained Neurologic Illness — Muzaffarpur, India, 2013–2014

CDC Media Relations
404-639-3286

The Indian National Centre for Disease Control, U.S. CDC, and partners are closer to solving recurring outbreaks of an unexplained neurologic illness affecting children in Muzaffarpur, Bihar, India. Current recommendations are focused on reducing mortality through rapid assessment and correction of low blood sugar in affected children. Since 1995, seasonal outbreaks of an unexplained neurologic illness with a high death rate have affected young children in Muzaffarpur, India. Collaborative investigations launched by the Indian National Centre for Disease Control and CDC in 2013 and 2014 concluded that the illness is a noninflammatory encephalopathy (an illness that affects brain function and mental status).Low blood glucose is a prominent feature. Although the cause of this illness is not confirmed, investigators are working to determine if it is linked to a toxin found in the seed of litchi (lychee) fruit, harvested in Muzaffarpur every year at the time of the outbreak. Current public health recommendations are focused on reducing mortality by urging affected families to seek prompt medical care, and ensuring rapid correction of low blood sugar in ill children.

Fetal Alcohol Syndrome Among Children Aged 7–9 Years — Arizona, Colorado, and New York, 2010

CDC Media Relations
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Fetal alcohol syndrome is an under-recognized birth defect and developmental disability that is completely preventable if a woman does not drink alcohol during pregnancy. Using medical and other records, a CDC study conducted in Arizona, Colorado, and New York found 0.3 cases of fetal alcohol syndrome (FAS) per 1,000 children aged 7 to 9 years. Prevalence of FAS was highest among American Indian/Alaska Native children with 2.0 cases per 1,000 children; and lowest among Hispanic children with 0.2 cases per 1,000 children. These estimates are substantially lower than those reported by other studies that used in-person assessment of school-aged children thus indicating that fetal alcohol syndrome is an under-recognized birth defect and developmental disability. Recognition of children with FAS is critically important to ensure their access to appropriate services and interventions so that they may reach their full developmental potential.

Tickborne Relapsing Fever — United States, 1990–2011

CDC Media Relations
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Tickborne relapsing fever is a zoonosis caused by a spirochete. It is endemic in the mountainous regions of the western United States. Infection results in clinical illness characterized by recurrent bouts of fever, headache, and malaise. Most cases are treated effectively with antibiotics. Because tick infested buildings can serve as a source of infection for years, all TBRF cases should be investigated to identify the likely location of exposure and guide remediation of rodent and tick infestations Tickborne relapsing fever (TBRF) is a zoonosis caused by spirochetes in the genus Borrelia and transmitted to humans by Ornithodoros spp. ticks. The geographic distribution of human TBRF cases is concentrated in certain states, and in specific locations within each state that are often vacation destinations; travel-associated infections are common. The characteristic clinical feature of TBRF is the occurrence of relapsing febrile episodes lasting 3 to 5 days, separated by 5 to 7 days of apparent recovery. Although TBRF is usually a mild illness and treatable with antibiotics, severe sequelae and death can occur. Persons living in or vacationing in areas where TBRF has been reported should be aware of the disease and seek medical attention if they develop febrile illness. Because tick infested buildings can serve as a source of infection for years, all TBRF cases should be investigated to identify the likely location of exposure and guide remediation of rodent and tick infestations.

Update: Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection, and Guidance for the Public, Clinicians, and Public Health Authorities — January 2015

CDC Media Relations
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Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause infections in the Arabian Peninsula. Health care professionals in the U.S. should consider the diagnosis of MERS-CoV infection in people with fever and respiratory illness who have recently traveled from countries in or near the Arabian Peninsula. Middle East respiratory syndrome coronavirus (MERS-CoV), first reported to cause human infection in September 2012, continues to cause severe respiratory illness and death today, mostly in Saudi Arabia and other countries in or near the Arabian Peninsula. As of January 23, 2015, 956 laboratory-confirmed cases, including at least 351 deaths, have been reported worldwide. Only two patients in the United States have ever tested positive for MERS-CoV — both in May 2014 — while more than 500 have tested negative through nationwide surveillance. However, because cases continue to occur in the Arabian Peninsula, CDC urges health care professionals in the U.S. to consider MERS-CoV infection in people with fever and respiratory illness who have recently traveled from countries in or near the Arabian Peninsula.

Notes from the Field: 

Identification of a Taenia Tapeworm Carrier — Los Angeles County, California, 2014

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES