TB transmission in Nebraska, the story of one Ebola outbreak, Zika’s impact on travelers and more . . . We’re reading a ‘local threats are global threats’ edition of the MMWR

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MMWR0303It’s a small world after all, the CDC’s Morbidity and Mortality Weekly Report released today shows

Possible Airborne Person-to-Person Transmission of Mycobacterium bovis – A bacteria that mainly affects cattle, Myobacterium bovis is a type of TB that can spread to humans who consume unpasteurized dairy products. That’s what public health officials believe happened to a Mexico-born Nebraska man diagnosed with the disease in April 2014. Before his arrival in the United States four years earlier he had worked on a dairy farm and had consumed raw milk. When, four months later, a teenage girl who went to the same church as he also was diagnosed with tuberculosis, examinations of 181 people who had had contact with them found 39 were infected with the bacteria. None, with the exception of the original patient, reported having consumed raw dairy products, and the bacteria has not been found in Nebraska dairies since the late 1970s. While the authors of the report on the investigation note that not enough is known about the time that lapsed between infection and disease to be certain of the origins of transmission, test results for six of those checked indicated their infection was recent. The investigation strengthened evidence that the zoonotic infection could be passed from person to person, the authors wrote, and its findings highlight the need to control the disease globally.

Cluster of Ebola Virus Disease Linked to a Single Funeral – During the first week of September 2014, few weeks after the World Health Organization’s belated recognition that the Ebola outbreak in West Africa constituted a public health emergency of international concern, a well-known pharmacist died and was buried in the Moyamba District of Sierra Leone. With resources to track and respond to the Ebola crisis still lagging far behind need, his death was not investigated, and his mourners were not protected. Within the next couple of weeks, 28 of them fell ill. Eight of them died. Another eight people were infected with the virus by contact with those infected, one of whom died. The report on the outbreak in this week’s MMWR includes a chart of the chain of transmission, which highlights, the authors note, the need for capacities that allow vigilant surveillance and rapid response to disease outbreaks.

Zika Virus Infection Among U.S. Pregnant Travelers – Between last August and the second week of February, 257 requests for Zika virus testing for pregnant women came into the U.S. Centers for Disease Control and Prevention. This report follows what happened in the cases of nine with confirmed Zika virus, all of whom had traveled to areas where the virus was prevalent. Their outcomes include two miscarriages, two abortions, and three live births — two of healthy infants and one child with severe microcephaly. The CDC has established a registry for pregnant U.S. women with confirmed disease and their infants.

Transmission of Zika Virus through Sexual Contact with Travelers to Areas of Ongoing Transmission – This report describes three cases of apparently sexually transmitted Zika virus, all from men who had just travelled to places where the virus was prevalent to their female partners who had not, and concludes that sexual transmission of the virus may be more common than previously indicated.

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