NewsBites: Spotlight on CDC's Parasitic Disease Work

 
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3rd Quarter 2016


What's Inside:


Mark Your Calendar

Sir Ronald Ross

World Mosquito Day - August 20th

The Zika virus reminds us of why the mosquito has been called the “most dangerous animal in the world,” given its role in spreading serious and sometimes life-threatening diseases including Zika, yellow fever, and malaria. Recognition of this insect’s impact on human health is observed annually on August 20, marking Sir Ronald Ross's discovery in 1897 that female mosquitoes transmit malaria between people. Learn more about CDC’s history with malaria and how CDC is studying mosquitoes to identify ways to prevent and control malaria.


Featured Parasite: Toxocara

Toxocara

Toxocariasis is a parasitic disease that is a leading cause of preventable blindness in an estimated 2,000 children each year. Toxocariasis is caused by infection by one of two species of Toxocara roundworms: Toxocara canis from dogs and, less commonly, Toxocara cati from cats. Toxocariasis is one of the Neglected Parasitic Infections, a group of five parasitic diseases that have been targeted by CDC for public health action. Anyone can become infected with Toxocara. People who get sick from the infection may develop ocular toxocariasis (when Toxocara larvae migrate to the eye, causing vision loss, eye inflammation, or damage to the retina); or visceral toxocariaris (when Toxocara larvae migrate to various body organs, causing fever, fatigue, coughing, wheezing, or abdominal pain).

Young children and owners of dogs or cats have a higher chance of becoming infected. The most severe cases are rare but are more likely to occur in young children, who often play in dirt, or eat dirt (pica) contaminated by dog or cat feces.

Risk can be reduced by washing hands with soap and water after playing with pets or other animals, after outdoor activities, and before handling food. Children should also not be allowed to play in areas that are soiled with pet or other animal feces, and they should be taught that it’s dangerous to eat dirt or soil. Approximately 13.9% of the U.S. population has antibodies to Toxocara, which suggests that tens of millions of Americans may have been exposed to the parasite.  


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Welcome to NewsBites

A quarterly e-update designed to inform you about CDC's efforts to protect the public from parasitic diseases.

Interested in a program update? Use the links to the left under 'What's Inside' to navigate to the full story or scroll below.  


Original CDC Building

Happy Anniversary, CDC!

This July, CDC commemorates 70 years of making people healthier.

On July 1, 1946, the Communicable Disease Center (CDC) settled into the old offices of Malaria Control in War Areas (MCWA), located on the 6th floor of the Volunteer Building on Peachtree Street in Atlanta, with a satellite campus in Chamblee, Georgia. Then, its mission was simply to prevent malaria from spreading across the nation. Today, the agency, now known as the Centers for Disease Control and Prevention, has grown to become the nation's premiere health promotion, prevention, and preparedness agency. We continue to protect the public’s health from the threat of malaria and other parasitic diseases as well as many other important health issues.

CDC is globally recognized for its evidence-based approach to conducting and applying research to improve people′s daily lives and responding to health emergencies. Learn more about CDC’s rich history, and how its success in fighting malaria domestically has led to progress around the world.   

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Malaria Around the World

Guinea Kindia Launch

Guinea: Revitalizing malaria control post-Ebola

With support from the U.S. President’s Malaria Initiative (PMI) in May, the Government of Guinea launched its second national universal coverage bednet campaign — the first since the Ebola crisis — to distribute long-lasting insecticide-treated mosquito nets. PMI is collaborating with Guinea’s National Malaria Control Program and partners to distribute eight million mosquito nets across the country with the goal of increasing mosquito net ownership and use to prevent malaria transmission. Malaria prevention through bednet use is a critical strategy in Guinea to reduce malaria-related illness and death, particularly in a country working to revitalize health service delivery in the post-Ebola context. 

Scaling up malaria capacity in Nigeria

Multiple programs across CDC are supporting a new project of the National Malaria Elimination Program (NMEP) to control malaria in Zamfara and Kano states. The Nigeria Malaria Frontline Project is being implemented by the Nigeria Field Epidemiology and Laboratory Training Program (NFELTP), the National Stop Transmission of Polio Program (NSTOP), and PMI. The frontline project is using the NSTOP structures and strategy for polio elimination to train newly hired NSTOP/NFELTP malaria officers. The training is designed similar to that of the NSTOP polio training; there are nine modules made up of classroom work and field practicum. The project will use its improved surveillance data to help partners in Zamfara and Kano to further reduce malaria burden and improve health. The frontline project will begin with a baseline malaria assessment to establish the level of community interventions to date; another assessment at the end of the project will help provide a comparison with project outcomes.

A tough lesson learned

We don’t often think about malaria risk in the United States. However, each year approximately 1,500 U.S.-based travelers acquire malaria while visiting a country where there is malaria. CDC’s malaria website features a series of cautionary tales about travelers who became ill after being infected with malaria. The most recent cautionary tale relays the story of a 16-year-old young man who learned a tough lesson about the importance of adhering to malaria prevention guidance related to preventive medicines, insect repellant, and protective clothing. Read more about his and others’ first-hand experiences with malaria.

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Neglected Tropical Diseases

Multiple benefits to MDA

Mass drug administration (MDA) for elimination of lymphatic filariasis (LF) has also been shown to help reduce the number of soil-transmitted helminth (STH) infections in a community. With more countries passing transmission assessment surveys (TAS) to document that transmission is interrupted and then stopping MDA, programs have to consider how to further reduce STH infections after MDA for LF has stopped. Experts from CDC and the Task Force for Global Health have begun reviewing the research and progress related to the two diseases, and are working to provide guidance to help countries sustain the progress on STH control.

Filarial Test Strip

Making sure it works

The Filarial Test Strip (FTS) was developed to detect lymphatic fliariasis (LF). The FTS is more sensitive and thus detects evidence of LF infection in many people that previous tests had missed. Implementation of an automated test reader for FTS and other point-of-care tests addresses some of the previous challenges related to subjective visual reading by providing quantitative results. CDC staff are working with colleagues from the Haiti Ministry of Health, IMA World Health, the Task Force for Global Health, and Mobile Assay to evaluate and calibrate the FTS reader to determine its feasibility in field settings. Another slightly revised version of the FTS is also being tested in the Democratic Republic of Congo. Findings will inform improvements to the automated reader.

A new tool to detect trachoma

CDC staff traveled to Colombia to train laboratory staff there on the new Pgp3 ELISA technique for detection of antibodies (proteins the body makes to fight infection) against the parasite that causes trachoma. This technique could provide a useful alternative to clinical exams for trachoma in the context of stopping MDA, and help in monitoring for disease re-occurrence after elimination is declared. There are several advantages to antibody-based testing over clinical exams, as it measures exposure over time and uses blood samples that may be collected for other surveys assessing vaccine coverage or malaria. The latter advantage can be cost-effective for programs. Read more about laboratory tests for detecting trachoma.

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Parasites in the United States

An ounce of prevention…

In an effort to detect and respond to cases of cyclosporiasis (a food- or waterborne parasitic infection) in Florida, colleagues from the Florida Bureau of Public Health Laboratories visited CDC to receive laboratory training in cyclosporiasis outbreak detection. Training participants learned best practices and conducted hands-on laboratory exercises to detect the parasite in stool.  Additionally, a new resource has been developed for health departments to assist during foodborne illness investigations in differentiating between the most common peas in the United States.

Teaching health care providers about U.S. parasitic infections

CDC developed a new online continuing education resource to educate health care providers about neurocysticercosis (NCC) in the United States. The course, Neurocysticercosis: Diagnosis and Management of Patients Living in the United States,” is designed to educate health care providers about the basic epidemiology of the disease, diagnosis and evaluation techniques, and patient care. The course provides a maximum of 1.5 AMA PRA Category 1 Credits™ of continuing medical education or 1.3 contact hours of continuing nursing education credits.

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Publication Highlights

Assessing the availability of LLINs for continuous distribution through routine antenatal care and the Expanded Programme on Immunizations in sub-Saharan Africa

In addition to mass distribution campaigns, the World Health Organization (WHO) recommends the continuous distribution of long-lasting insecticidal nets (LLINs) to all pregnant women attending antenatal care (ANC) and all infants attending the Expanded Programme on Immunization (EPI) services in countries implementing mosquito nets for malaria control. This report assesses policy and practice in implementing these recommendations and compares the numbers of LLINs available through ANC and EPI services with the numbers of women and children attending these services.

In vivo efficacy of artemether-lumefantrine and artesunate-amodiaquine for uncomplicated Plasmodium falciparum malaria in Malawi, 2014

Malaria causes significant illness in Malawi, with an estimated five million cases in 2014. Artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) are the first- and second-line drug treatments for uncomplicated malaria, but reports of emerging resistance threatens their efficacy. In order to understand whether AL and ASAQ are still useful in Malawi, a therapeutic efficacy trial was conducted. The results of the trial confirmed that both AL and ASAQ remain efficacious in treating malaria and underscore the need to continue to scale-up use.

An Operational Framework for Insecticide Resistance Management Planning

This article describes the development and implementation of a resistance management plan for mosquito vectors of human disease in Zambia. The article details challenges, steps taken to address the challenges, and future direction.

Symptoms and immune markers in Plasmodium/ Dengue virus coinfection compared with monoinfection with either in Peru

Dengue and malaria are two serious diseases spread by mosquitoes. The two diseases have some of the same symptoms, and both can be fatal. In addition, these diseases are common in many places throughout the world. Despite this, only a handful of reports of co-infection with dengue virus and Plasmodium species have been reported. The findings indicate that symptoms and markers of immunity were not higher or more common in co-infected individuals.

Integration of Multiplex Bead Assays for Parasitic Diseases into a National, Population-Based Serosurvey of Women 15–39 Years of Age in Cambodia

In many tropical and sub-tropical countries, the disease burden represented by NTDs is substantial, yet information on the prevalence and distribution of these diseases is limited because of the significant costs associated with disease-specific surveys. Even with the recent scale-up of preventive chemotherapy programs targeting NTDs, routine assessments to monitor the impact of these programs, when they occur, are often restricted to sentinel sites and may not be representative of all program areas. For some diseases such as strongyloidiasis, prevalence data for many regions of the world are lacking, and no public health strategy has been developed for control of the disease. This publication demonstrates that the multiplex bead assay for antibody detection is an effective approach to utilizing blood samples to provide surveillance data on a number of infections. As much of the cost of surveys is associated with sample collection, being able to use one sample for surveillance of multiple pathogens has important reduced cost implications for NTD control. 

Gaining and sustaining schistosomiasis control: study protocol and baseline data prior to different treatment strategies in five African countries

The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), funded by the Bill & Melinda Gates Foundation through a five-year grant to the University of Georgia Research Foundation (UGARF), in which CDC is a co-collaborator, was established in 2008 to answer important questions about schistosomiasis control. SCORE activities have helped to provide managers of schistosomiasis control programs with the information they need to do their job better — both programmatically and in terns of the tools needed. This article discussed the baseline data collected from one of the seven studies being implemented in five African countries on the most effective frequency of preventive chemotherapy (PCT) with the drug praziquantel (PZQ). The study results will help determine potential approaches to controlling and eliminating schistosomiasis and inform use of new tools for control programs.  

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