Top Infectious Disease News of the Week—July 7, 2019

#5: Skin Microbiome Changes After Ocean Swimming, Raising Risk of Infection

Swimming in the ocean alters the skin microbiome, raising concerns about the potential for infection, according to a new study.

The data, presented recently at the annual meeting of the American Society for Microbiology (ASM Microbe 2019), found that ocean bacteria remained on the skin after drying and for as long as 24 hours after leaving the water.

“We were surprised by the significant changes in the microbiome after swimming. While we expected some change, we did not expect that all participants would have completely different microbial communities after swimming,” lead author Marisa Chattman Nielsen, MS, a PhD student at the University of California, Irvine, told Contagion^®.

Read more about the risk of infection.

#4: Popular Dog Treat Linked to MDR Salmonella Outbreak

Dogs may be considered man’s best friend, but federal health officials are warning pet owners that contact with a popular dog treat could be making humans sick.

The US Centers for Disease Control and Prevention (CDC) has announced the investigation of a multistate outbreak of multidrug-resistant Salmonella I 4,[5],12:i:- infections linked to contact with pig ear dog treats.

As of July 2, 2019, there have been 45 outbreak cases documented across 13 states. Isolates from 30 of the ill individuals underwent whole genome sequencing and predicted antibiotic resistance or decreased susceptibility to ampicillin, ciprofloxacin, gentamicin, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Based on these results, these infections may be difficult to treat with first-line antibiotics and may require an alternative antibiotic choice.

Read more about the MDR Salmonella Outbreak.

#3: Arizona's Roadmap to Containing a Hepatitis A Outbreak

Arizona is facing an unusual spike in cases of hepatitis A virus (HAV) that are challenging public health and health care efforts. Although HAV is a vaccine-preventable disease and there has been a decrease in cases over the last decade, several outbreaks since 2015 have increased case counts. Unfortunately, Arizona is facing an outbreak among 2 very vulnerable patient populations: displaced individuals and people who inject drugs.

HAV is often transmitted via the fecal-oral route or through consumption of contaminated food or water. Symptoms often resolve in less than 2 months and those infected tend to experience symptoms such as fatigue, loss of appetite, stomach pain, jaundice, and nausea. The good news is that once resolved an infected person has protective antibodies that offer life-long protection against the viral infection. Ultimately though, the best way to avoid HAV is through vaccination.

Despite making great strides in reducing the burden of HAV, Arizona is experiencing a growing outbreak that began in late 2018. Currently, there have been 424 cases and 3 deaths documented since November 2018, with a 79% hospitalization rate. The outbreak has spread to 7 counties within Arizona, including the largest—Maricopa.

Read more about Arizona’s effort to control a hepatitis A outbreak.

#2: ACIP Updates Hepatitis A Vaccine Recommendations

Currently, the US Centers for Disease Control and Prevention (CDC) recommends the hepatitis A vaccine for children 12 to 23 months and catch-up vaccinations for any individuals over 2 years of age.

However, the CDC’s Advisory Committee on Immunization Practices (ACIP) has voted to update recommendations on the use of vaccines to protect against hepatitis A.

The committee voted unanimously to recommend that all children and adolescents between the ages of 2 and 18 years who have not previously received the hepatitis A vaccine should receive a catch-up vaccination. ACIP also voted unanimously to recommend updating the language around using the hepatitis A vaccine in the Vaccines for Children program.

Read more about the updated hepatitis A recommendations.

#1: US Measles Cases Taper Off After Record-Breaking Year

After a worrisome first half of the year, new measles cases in the United States have begun to slow, according to new figures released by the US Centers for Disease Control and Prevention (CDC).

Measles has been a cause for concern for parents, clinicians, and public health officials alike as the vaccine-preventable disease has made a resurgence in the United States in 2019. On April 24, 2019, the United States officially documented the greatest number of measles cases in a given year since the disease was declared eliminated in 2000.

As of July 3, 2019, there have been 1109 cases of measles confirmed across 28 states in 2019. This figure is nearly 3 times the cumulative number of cases confirmed in 2018.

The highest number of weekly measles cases was documented during the week ending on March 23, 2019, during which 87 new cases of measles were confirmed. During the week ending June 26, 2019, 18 new cases were documented and during the week ending July 3, 2019, 14 new cases of the highly contagious disease were recorded. As such, the past 2 weeks represent a considerable decline and could be a sign that the active measles outbreaks are close to being controlled.

According to the most recent data from the CDC, which was released on Monday, July 8, 2019, the number of ongoing measles outbreaks has also declined. Measles outbreaks, defined as 3 or more cases, have sprung up from coast-to-coast in 2019.

The 2 largest outbreaks of measles this year have been documented in New York, with a combined total of 897 cases of measles confirmed between Rockland County and New York City.

At this point in time, a measles outbreak remains ongoing in Butte County, California, which has documented a total of 21 cases in 2019.

Apart from New York and California, the only other state with an ongoing measles outbreak is Washington. This particular outbreak is the second measles outbreak in the state this year, the first of which documented more than 70 cases and was declared over earlier in the spring. The ongoing outbreak has documented 10 cases since May.

Read more about the status of the measles outbreaks.