Summer 2012 brought many ID outbreaks around the world

Issue: September 2012

This summer seemed to usher in what many may think is a higher-than-usual number of infectious disease outbreaks. However, they were not a surprise to Rima Khabbaz, MD, CDC deputy director for infectious diseases and director of CDC’s Office of Infectious Diseases.

“There does seem to be a large number of outbreaks this summer, but this is not very unusual from CDC’s perspective,” Khabbaz told Infectious Diseases in Children.

Rima Khabbaz

Khabbaz said that many factors contribute to disease outbreaks, including constantly changing interactions among microbes, animals, humans, and the environment.

“We will definitely see more emerging infectious diseases over the next decade. We can’t predict from year to year, but new diseases will emerge and existing ones will reemerge when you have the right conditions,” she said.

International outbreaks

Cases of an unknown illness among children were first reported in Cambodia in April. Health officials confirmed in mid-July that the illnesses and deaths among children in 14 Cambodian provinces were caused by a severe form of hand, foot, and mouth disease caused by enterovirus 71. The last reported numbers totaled more than 78 illnesses and 54 deaths, according to WHO reports.

In July, an outbreak of cholera was reported in the Democratic Republic of Congo. The latest available numbers indicate that as of early July, 368 new cases were reported in a single week. The security issues in the region could result in additional severe and fatal cases, according to a WHO press release.

Also during the month July, an Ebola hemorrhagic fever outbreak was reported in Uganda, with 24 probable and confirmed cases and 16 deaths; 10 cases were laboratory confirmed. These numbers, however, reflect fewer cases than first released by WHO.

“The good news is that laboratory confirmation showed that the number of cases was actually lower than originally thought,” Khabbaz said.

US outbreaks

The US has also seen some out-of-the-ordinary disease activity.

As of mid-August, CDC had the highest number of West Nile virus disease cases reported to the agency through this same time of year since the virus was first detected in the United States in 1999. Forty-three states reported positive findings for the virus, with 693 human cases and 26 deaths; of these cases, 406 (59%) were classified as neuroinvasive disease. More than 80% of the cases have been reported from six states (Texas, Mississippi, Louisiana, Oklahoma, South Dakota and California), and nearly half were reported from Texas, according to the CDC.

CDC has also seen an increase in cases of another emerging disease this summer: influenza A/H3N2 variant virus. As of early August, 145 confirmed cases have been reported since these infections were first detected in July 2011.

“These infections have occurred primarily in children, and most have been associated with contact with swine at agricultural fairs,” Khabbaz said. “There has also been limited human-to-human transmission, but this can change as we see more infections; fortunately, the disease has been mild so far. Preliminary work is currently being done in case a vaccine against A/H3N2v might be needed. These outbreaks are a reminder of the need to have adequate public health capacity domestically and around the world to detect and respond to them.” – by Cassandra A. Richards

Disclosures:

Dr. Khabbaz reports no relevant financial disclosures.