It’s that time again to go over the past year and determine what I believe are the most important infectious disease and outbreak news stories.

Every year this is a difficult task and 2018 is no different.

Not everyone will be on board with my list, and that’s OK. So let’s take a look at my “10 Most Important Infectious Disease Stories of 2018”:

10. Rat hepatitis E virus (HEV) in humans

Hong Kong researchers conclusively proved for the first time in the world that rat HEV can infect humans to cause clinical infection. We eventually learn that two human cases were discovered. This news should keep us constantly alert for new and possible zoonotic infections not seen before.

9. Tickborne diseases up in the US

Ixodes scapularis/CDC

The Centers for Disease Control and Prevention (CDC) reported that all tickborne diseases, from Lyme disease to Powassan virus, were up in 2017. There were 48,610 total cases in 2016 and it rose to  59,349 cases in 2017.

Using the CDC’s general estimation figure of 10 times, the 42,743 Lyme disease cases reported would equate to 427,430 estimated cases.

8. Monkeypox in Nigeria and the exported cases

We haven’t seen so much coverage on monkeypox since the 2003 outbreak in the United States. Nigeria saw well over 100 confirmed cases since Sept. 2017. Outbreaks were also reported in Cameroon, Central African Republic and the Democratic Republic of the Congo.

What likely caught the most attention; however, was the three exported cases from Nigeria to England (2) and Israel.

7. Foodborne outbreaks

It seemed as if there wasn’t a moment in the United States in 2018 when there wasn’t a foodborne outbreaks actively going on. We saw everything from E. coli O157:H7 outbreaks in romaine lettuce, to Salmonella outbreaks in Kellogg’s Honey Smacks cereal to the huge number of cyclospora cases linked to Del Monte vegetable trays and Fresh Express salads sold at McDonald’s.

AncestryDNA: Genetic Testing Ethnicity

Cyclospora: CDC reports 2,173 domestically acquired cases since the spring

6. Hepatitis A outbreaks grow in US

Since the the middle of 2016, a number of states declared hepatitis A outbreaks that were not foodborne. Transmission of the virus appears to be through direct person-to-person spread with homelessness and illicit drug use being important risk factors.

Here is a breakdown of the states experiencing outbreaks:

State                               Case count                Deaths

Kentucky                            3265                         21
Michigan                              909                         28
West Virginia                      2137                         12
Ohio                                      1200                          2
Indiana                                  814                           2
Tennessee                             597                           2
Massachusetts                      234                          4
North Carolina                        51                           1
Florida                                   413                           0
Missouri                                236                           0
Arkansas                               229                           0
Utah                                       281                           2

Just a sample….enough said.

5. African swine fever in China

Although not an infection in people, African swine fever (ASF) can be 100 percent fatal to infected pigs, thus having enormous potential to cause economic damage.

The virus was first seen in China in August and since has been reported in two dozen Chinese provinces across the country.

At a September meeting of the UN’s Food and Agriculture Organization (FAO), it was stated that ASF is “here to stay” and that African Swine Fever in Asia: ‘Just the tip of the iceberg’

4. Nipah outbreak in India

Pteropus fruit bat Image/Video Screen Shot
Pteropus fruit bat
Image/Video Screen Shot

For the first time in India in 11 years and anywhere in the world since 2015, Nipah virus reared it’s ugly head in Kerala State. A total of 19 Nipah virus (NiV) cases, including 17 deaths were reported.

Nipah virus: An introduction

3. Measles and other vaccine preventable diseases

In my 2017 list, I rated the Measles outbreak in Europe as the 9th most important story of that year. At that time, some 14,000 cases were reported.

I remember at least one individual on Twitter commenting it didn’t belong on the annual list; however, as it was easy to observe the anti-vaccine trend in Europe, I stuck to my guns believing it would only continue to get worse.

Turn the clock to 2018 and the first six months of the year saw more than 40,000 cases in Europe. Ukraine will report more than 50,000 cases by years end.

In South America, Venezuela and Brazil have reported thousands of cases. In Africa, Madagascar has seen 10,000 cases in the last three months of 2018.

In addition, other vaccine preventable outbreaks are reported across the globe–Diphtheria cases mount in Venezuela and Japan is reporting a record rubella outbreak as two examples.

2. Venezuela

The health crisis in Venezuela was #3 on my list last year and due to a plethora of infectious disease, health and outbreak situations that continue and get worse as time goes by, Venezuela is moved up to #2 in 2018.

Venezuela malaria situation grows worse: 650K cases so far in 2018

1.Ebola outbreak in the Democratic Republic of the Congo (DRC)

Ebola image/NIAID
Ebola image/NIAID

The DRC saw two Ebola Virus Disease (EVD) outbreaks this year; however, the second and current ongoing outbreak is the top infectious disease news story of 2018.

It is the largest outbreak in DRC (which has seen 10 outbreaks since 1976) and the second largest ever behind the 2014-2016 West Africa outbreak.

Country health officials report as of this writing that since the beginning of the epidemic, the cumulative number of cases is 579 (531 confirmed), including more than 300 deaths.



The following stories didn’t make the cut but I want to mention them because of their importance, their potential or just because I thought they were interesting. The honorable mentions include: