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Emerging Infectious Diseases journal

Expedited Ahead-of-Print Articles

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Ebola Virus Infection Associated with Transmission from Survivors S. Den Boon et al. February 2019

Synopses

  • Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017 PDF Version[PDF - 2.07 MB - 9 pages]
    X. Pan et al.
        View Abstract

    On January 25, 2017, a physician from ZC Hospital in Hangzhou, China, reported to the Zhejiang Provincial Center for Disease Control and Prevention that a potential HIV outbreak might have occurred during lymphocyte immunotherapy (LIT) performed at the hospital on December 30, 2016. We immediately began investigating and identified the index case-patient as an LIT patient’s husband who donated lymphocytes for his wife’s LIT and later screened HIV-reactive. Subsequent contamination by a technician resulted in the potential exposure of 34 LIT patients. Acute HIV infection was diagnosed in 5 persons. Phylogenetic analysis confirmed that the HIV-1 gag, pol, and env gene sequences from the index and outbreak-related cases had >99.5% similarity. Rapid investigation and implementation of effective control measures successfully controlled the outbreak. This incident provides evidence of a lapse in infection control causing HIV transmission, highlighting the need for stronger measures to protect patients from infectious disease exposure.

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    EID Pan X, Jiang J, Ma Q, Zhang J, Yang J, Chen W, et al. Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017. Emerg Infect Dis. 2018;24(12):2141-2149. https://dx.doi.org/10.3201/eid2412.180117
    AMA Pan X, Jiang J, Ma Q, et al. Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017. Emerging Infectious Diseases. 2018;24(12):2141-2149. doi:10.3201/eid2412.180117.
    APA Pan, X., Jiang, J., Ma, Q., Zhang, J., Yang, J., Chen, W....Wu, Z. (2018). Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017. Emerging Infectious Diseases, 24(12), 2141-2149. https://dx.doi.org/10.3201/eid2412.180117.
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  • Medscape CME Activity
    Reemergence of St. Louis Encephalitis Virus in the Americas PDF Version[PDF - 1.71 MB - 8 pages]
    A. Diaz et al.
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    We summarize and analyze historical and current data regarding the reemergence of St. Louis encephalitis virus (SLEV; genus Flavivirus) in the Americas. Historically, SLEV caused encephalitis outbreaks in the United States; however, it was not considered a public health concern in the rest of the Americas. After the introduction of West Nile virus in 1999, activity of SLEV decreased considerably in the United States. During 2014–2015, SLEV caused a human outbreak in Arizona and caused isolated human cases in California in 2016 and 2017. Phylogenetic analyses indicate that the emerging SLEV in the western United States is related to the epidemic strains isolated during a human encephalitis outbreak in Córdoba, Argentina, in 2005. Ecoepidemiologic studies suggest that the emergence of SLEV in Argentina was caused by the introduction of a more pathogenic strain and increasing populations of the eared dove (amplifying host).

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    EID Diaz A, Coffey LL, Burkett-Cadena N, Day JF. Reemergence of St. Louis Encephalitis Virus in the Americas. Emerg Infect Dis. 2018;24(12):2150-2157. https://dx.doi.org/10.3201/eid2412.180372
    AMA Diaz A, Coffey LL, Burkett-Cadena N, et al. Reemergence of St. Louis Encephalitis Virus in the Americas. Emerging Infectious Diseases. 2018;24(12):2150-2157. doi:10.3201/eid2412.180372.
    APA Diaz, A., Coffey, L. L., Burkett-Cadena, N., & Day, J. F. (2018). Reemergence of St. Louis Encephalitis Virus in the Americas. Emerging Infectious Diseases, 24(12), 2150-2157. https://dx.doi.org/10.3201/eid2412.180372.
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  • Autochthonous Human Case of Seoul Virus Infection, the Netherlands PDF Version[PDF - 767 KB - 6 pages]
    C. Swanink et al.
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    Orthohantaviruses are a group of rodentborne viruses with a worldwide distribution. The orthohantavirus Seoul virus (SEOV) can cause hemorrhagic fever with renal syndrome in humans and is distributed worldwide, like its reservoir host, the rat. Cases of SEOV in wild and pet rats have been described in several countries, and human cases have been reported in the United Kingdom, France, Canada, and the United States. In the Netherlands, SEOV has previously been found in wild brown rats. We describe an autochthonous human case of SEOV infection in the Netherlands. This patient had nonspecific clinical symptoms of an orthohantavirus infection (gastrointestinal symptoms and distinct elevation of liver enzymes). Subsequent source investigation revealed 2 potential sources, the patient’s feeder rats and a feeder rat farm. At both sources, a high prevalence of SEOV was found in the rats. The virus closely resembled the Cherwell and Turckheim SEOV strains that were previously found in Europe.

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    EID Swanink C, Reimerink J, Gisolf J, de Vries A, Claassen M, Martens L, et al. Autochthonous Human Case of Seoul Virus Infection, the Netherlands. Emerg Infect Dis. 2018;24(12):2158-2163. https://dx.doi.org/10.3201/eid2412.180229
    AMA Swanink C, Reimerink J, Gisolf J, et al. Autochthonous Human Case of Seoul Virus Infection, the Netherlands. Emerging Infectious Diseases. 2018;24(12):2158-2163. doi:10.3201/eid2412.180229.
    APA Swanink, C., Reimerink, J., Gisolf, J., de Vries, A., Claassen, M., Martens, L....Maas, M. (2018). Autochthonous Human Case of Seoul Virus Infection, the Netherlands. Emerging Infectious Diseases, 24(12), 2158-2163. https://dx.doi.org/10.3201/eid2412.180229.
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  • Restaurant Inspection Letter Grades and Salmonella Infections, New York, New York, USA PDF Version[PDF - 506 KB - 5 pages]
    M. J. Firestone and C. W. Hedberg
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    Rates of Salmonella infection in the United States have not changed over the past 20 years. Restaurants are frequent settings for Salmonella outbreaks and sporadic infections. Few studies have examined the effect of posting letter grades for restaurant inspections on the incidence of foodborne illness. We compared Salmonella infection rates in New York, New York, USA (NYC), with those in the rest of New York state before and after implementation of a letter grade system for restaurant inspections in NYC. We calculated a segmented regression model for interrupted time series data. After implementation of letter grading, the rate of Salmonella infections decreased 5.3% per year in NYC versus the rest of New York state during 2011–2015, compared with the period before implementation, 2006–2010. Posting restaurant inspection results as letter grades at the point of service was associated with a decline in Salmonella infections in NYC and warrants consideration for broader use.

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    EID Firestone MJ, Hedberg CW. Restaurant Inspection Letter Grades and Salmonella Infections, New York, New York, USA. Emerg Infect Dis. 2018;24(12):2164-2168. https://dx.doi.org/10.3201/eid2412.180544
    AMA Firestone MJ, Hedberg CW. Restaurant Inspection Letter Grades and Salmonella Infections, New York, New York, USA. Emerging Infectious Diseases. 2018;24(12):2164-2168. doi:10.3201/eid2412.180544.
    APA Firestone, M. J., & Hedberg, C. W. (2018). Restaurant Inspection Letter Grades and Salmonella Infections, New York, New York, USA. Emerging Infectious Diseases, 24(12), 2164-2168. https://dx.doi.org/10.3201/eid2412.180544.
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Research

  • Spatial Analysis of Wildlife Tuberculosis Based on a Serologic Survey Using Dried Blood Spots, Portugal PDF Version[PDF - 1.70 MB - 7 pages]
    N. Santos et al.
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    We investigated the spatial epidemiology of bovine tuberculosis (TB) in wildlife in a multihost system. We surveyed bovine TB in Portugal by serologic analysis of elutes of dried blood spots obtained from hunted wild boar. We modeled spatial disease risk by using areal generalized linear mixed models with conditional autoregressive priors. Antibodies against Mycobaterium bovis were detected in 2.4% (95% CI 1.5%–3.8%) of 678 wild boar in 2 geographic clusters, and the predicted risk fits well with independent reports of M. bovis culture. Results show that elutes are an almost perfect substitute for serum (Cohen unweighted κ = 0.818), indicating that serologic tests coupled with dried blood spots are an effective strategy for large-scale bovine TB surveys, using wild boar as sentinel species. Results also show that bovine TB is an emerging wildlife disease and stress the need to prevent further geographic spread and prevalence increase.

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    EID Santos N, Nunes T, Fonseca C, Vieira-Pinto M, Almeida V, Gortázar C, et al. Spatial Analysis of Wildlife Tuberculosis Based on a Serologic Survey Using Dried Blood Spots, Portugal. Emerg Infect Dis. 2018;24(12):2169-2175. https://dx.doi.org/10.3201/eid2412.171357
    AMA Santos N, Nunes T, Fonseca C, et al. Spatial Analysis of Wildlife Tuberculosis Based on a Serologic Survey Using Dried Blood Spots, Portugal. Emerging Infectious Diseases. 2018;24(12):2169-2175. doi:10.3201/eid2412.171357.
    APA Santos, N., Nunes, T., Fonseca, C., Vieira-Pinto, M., Almeida, V., Gortázar, C....Correia-Neves, M. (2018). Spatial Analysis of Wildlife Tuberculosis Based on a Serologic Survey Using Dried Blood Spots, Portugal. Emerging Infectious Diseases, 24(12), 2169-2175. https://dx.doi.org/10.3201/eid2412.171357.
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  • Rat Lungworm Infection in Rodents across Post-Katrina New Orleans, Louisiana, USA PDF Version[PDF - 2.29 MB - 8 pages]
    R. C. Rael et al.
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    Rat lungworm (Angiostrongylus cantonensis), a parasitic nematode that can cause eosinophilic meningitis in humans, was first detected in New Orleans, Louisiana, USA, in the mid-1980s and now appears to be widespread in the southeastern United States. We assessed the distribution, prevalence, and intensity of A. cantonensis infection in New Orleans by examining lung biopsy samples of rodents trapped at 96 sites in 9 areas in Orleans Parish and 1 area in neighboring St. Bernard Parish during May 2015 through February 2017. These areas were selected to capture contrasting levels of income, flooding, and pos-disaster landscape management after Hurricane Katrina in 2005. We detected A. cantonensis in all areas and in 3 of the 4 rat species trapped. Overall prevalence was ≈38% but varied by area, host species, and host species co-occurrence. Infection intensity also varied by host species. These findings suggest that socioecological analysis of heterogeneity in definitive and intermediate host infection could improve understanding of health risks across the city.

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    EID Rael RC, Peterson AC, Ghersi-Chavez B, Riegel C, Lesen AE, Blum MJ. Rat Lungworm Infection in Rodents across Post-Katrina New Orleans, Louisiana, USA. Emerg Infect Dis. 2018;24(12):2176-2183. https://dx.doi.org/10.3201/eid2412.180056
    AMA Rael RC, Peterson AC, Ghersi-Chavez B, et al. Rat Lungworm Infection in Rodents across Post-Katrina New Orleans, Louisiana, USA. Emerging Infectious Diseases. 2018;24(12):2176-2183. doi:10.3201/eid2412.180056.
    APA Rael, R. C., Peterson, A. C., Ghersi-Chavez, B., Riegel, C., Lesen, A. E., & Blum, M. J. (2018). Rat Lungworm Infection in Rodents across Post-Katrina New Orleans, Louisiana, USA. Emerging Infectious Diseases, 24(12), 2176-2183. https://dx.doi.org/10.3201/eid2412.180056.
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  • Terrestrial Bird Migration and West Nile Virus Circulation, United States PDF Version[PDF - 2.70 MB - 11 pages]
    D. Swetnam et al.
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    Host migration and emerging pathogens are strongly associated, especially with regard to zoonotic diseases. West Nile virus (WNV), a mosquitoborne pathogen capable of causing severe, sometimes fatal, neuroinvasive disease in humans, is maintained in highly mobile avian hosts. Using phylogeographic approaches, we investigated the relationship between WNV circulation in the United States and the flight paths of terrestrial birds. We demonstrated southward migration of WNV in the eastern flyway and northward migration in the central flyway, which is consistent with the looped flight paths of many terrestrial birds. We also identified 3 optimal locations for targeted WNV surveillance campaigns in the United States—Illinois, New York, and Texas. These results illustrate the value of multidisciplinary approaches to surveillance of infectious diseases, especially zoonotic diseases.

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    EID Swetnam D, Widen SG, Wood TG, Reyna M, Wilkerson L, Debboun M, et al. Terrestrial Bird Migration and West Nile Virus Circulation, United States. Emerg Infect Dis. 2018;24(12):2184-2194. https://dx.doi.org/10.3201/eid2412.180382
    AMA Swetnam D, Widen SG, Wood TG, et al. Terrestrial Bird Migration and West Nile Virus Circulation, United States. Emerging Infectious Diseases. 2018;24(12):2184-2194. doi:10.3201/eid2412.180382.
    APA Swetnam, D., Widen, S. G., Wood, T. G., Reyna, M., Wilkerson, L., Debboun, M....Barrett, A. (2018). Terrestrial Bird Migration and West Nile Virus Circulation, United States. Emerging Infectious Diseases, 24(12), 2184-2194. https://dx.doi.org/10.3201/eid2412.180382.
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  • Capnocytophaga canimorsus Capsular Serovar and Disease Severity, Helsinki Hospital District, Finland, 2000–2017 PDF Version[PDF - 1.86 MB - 7 pages]
    E. Hess et al.
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    We assembled a collection of 73 Capnocytophaga canimorsus isolates obtained from blood cultures taken from patients treated at Helsinki University Hospital (Helsinki, Finland) during 2000–2017. We serotyped these isolates by PCR and Western blot and attempted to correlate pathogen serovar with patient characteristics. Our analyses showed, in agreement with previous research, that 3 C. canimorsus serovars (A–C) caused most (91.8%) human infections, despite constituting only 7.6% of isolates found in dogs. The 3 fatalities that occurred in our cohort were equally represented by these serovars. We found 2 untypeable isolates, which we designated serovars J and K. We did not detect an association between serovar and disease severity, immune status, alcohol abuse, or smoking status, but dog bites occurred more frequently among patients infected with non-A–C serovars. Future research is needed to confirm serovar virulence and develop strategies to reduce risk for these infections in humans.

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    EID Hess E, Renzi F, Karhunen P, Dol M, Lefèvre A, Antikainen J, et al. Capnocytophaga canimorsus Capsular Serovar and Disease Severity, Helsinki Hospital District, Finland, 2000–2017. Emerg Infect Dis. 2018;24(12):2195-2201. https://dx.doi.org/10.3201/eid2412.172060
    AMA Hess E, Renzi F, Karhunen P, et al. Capnocytophaga canimorsus Capsular Serovar and Disease Severity, Helsinki Hospital District, Finland, 2000–2017. Emerging Infectious Diseases. 2018;24(12):2195-2201. doi:10.3201/eid2412.172060.
    APA Hess, E., Renzi, F., Karhunen, P., Dol, M., Lefèvre, A., Antikainen, J....Cornelis, G. R. (2018). Capnocytophaga canimorsus Capsular Serovar and Disease Severity, Helsinki Hospital District, Finland, 2000–2017. Emerging Infectious Diseases, 24(12), 2195-2201. https://dx.doi.org/10.3201/eid2412.172060.
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  • Crimean-Congo Hemorrhagic Fever Virus, Mongolia, 2013–2014 PDF Version[PDF - 910 KB - 8 pages]
    M. A. Voorhees et al.
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    During 2013–2014, we collected 1,926 serum samples from humans and 4,583 ticks (Hyalomma asiaticum or Dermacentor nuttalli) in select regions of Mongolia to determine the risk for Crimean-Congo hemorrhagic fever virus (CCHFV) infection among humans in this country. Testing of human serum samples by ELISA demonstrated an overall CCHFV antibody prevalence of 1.4%; Bayankhongor Province had the highest prevalence, 2.63%. We pooled and analyzed tick specimens by real-time reverse transcription PCR; 1 CCHFV-positive H. asiaticum tick pool from Ömnögovi was identified. In phylogenetic analyses, the virus’s partial small segment clustered with CCHFV isolates from Central Asia, and the complete medium segment grouped with CCHFV isolates from Africa, Asia, and the Middle East. This study confirms CCHFV endemicity in Mongolia and provides information on risk for CCHFV infection. Further research is needed to better define the risk for CCHFV disease to improve risk mitigation, diagnostics, and surveillance.

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    EID Voorhees MA, Padilla SL, Jamsransuren D, Koehler JW, Delp KL, Adiyadorj D, et al. Crimean-Congo Hemorrhagic Fever Virus, Mongolia, 2013–2014. Emerg Infect Dis. 2018;24(12):2202-2209. https://dx.doi.org/10.3201/eid2412.180175
    AMA Voorhees MA, Padilla SL, Jamsransuren D, et al. Crimean-Congo Hemorrhagic Fever Virus, Mongolia, 2013–2014. Emerging Infectious Diseases. 2018;24(12):2202-2209. doi:10.3201/eid2412.180175.
    APA Voorhees, M. A., Padilla, S. L., Jamsransuren, D., Koehler, J. W., Delp, K. L., Adiyadorj, D....Schoepp, R. J. (2018). Crimean-Congo Hemorrhagic Fever Virus, Mongolia, 2013–2014. Emerging Infectious Diseases, 24(12), 2202-2209. https://dx.doi.org/10.3201/eid2412.180175.
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  • Novel Type of Chronic Wasting Disease Detected in Moose (Alces alces), Norway PDF Version[PDF - 2.31 MB - 9 pages]
    L. Pirisinu et al.
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    Chronic wasting disease (CWD) persists in cervid populations of North America and in 2016 was detected for the first time in Europe in a wild reindeer in Norway. We report the detection of CWD in 3 moose (Alces alces) in Norway, identified through a large scale surveillance program. The cases occurred in 13–14-year-old female moose, and we detected an abnormal form of prion protein (PrPSc) in the brain but not in lymphoid tissues. Immunohistochemistry revealed that the moose shared the same neuropathologic phenotype, characterized by mostly intraneuronal deposition of PrPSc. This pattern differed from that observed in reindeer and has not been previously reported in CWD-infected cervids. Moreover, Western blot revealed a PrPSc type distinguishable from previous CWD cases and from known ruminant prion diseases in Europe, with the possible exception of sheep CH1641. These findings suggest that these cases in moose represent a novel type of CWD.

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    EID Pirisinu L, Tran L, Chiappini B, Vanni I, Di Bari MA, Vaccari G, et al. Novel Type of Chronic Wasting Disease Detected in Moose (Alces alces), Norway. Emerg Infect Dis. 2018;24(12):2210-2218. https://dx.doi.org/10.3201/eid2412.180702
    AMA Pirisinu L, Tran L, Chiappini B, et al. Novel Type of Chronic Wasting Disease Detected in Moose (Alces alces), Norway. Emerging Infectious Diseases. 2018;24(12):2210-2218. doi:10.3201/eid2412.180702.
    APA Pirisinu, L., Tran, L., Chiappini, B., Vanni, I., Di Bari, M. A., Vaccari, G....Benestad, S. L. (2018). Novel Type of Chronic Wasting Disease Detected in Moose (Alces alces), Norway. Emerging Infectious Diseases, 24(12), 2210-2218. https://dx.doi.org/10.3201/eid2412.180702.
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  • Genomic Characterization of β-Glucuronidase–Positive Escherichia coli O157:H7 Producing Stx2a PDF Version[PDF - 2.97 MB - 9 pages]
    Y. Ogura et al.
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    Among Shiga toxin (Stx)–producing Escherichia coli (STEC) O157:H7 strains, those producing Stx2a cause more severe diseases. Atypical STEC O157:H7 strains showing a β-glucuronidase–positive phenotype (GP STEC O157:H7) have rarely been isolated from humans, mostly from persons with asymptomatic or mild infections; Stx2a-producing strains have not been reported. We isolated, from a patient with bloody diarrhea, a GP STEC O157:H7 strain (PV15-279) that produces Stx2a in addition to Stx1a and Stx2c. Genomic comparison with other STEC O157 strains revealed that PV15-279 recently emerged from the stx1a/stx2c-positive GP STEC O157:H7 clone circulating in Japan. Major virulence genes are shared between typical (β-glucuronidase–negative) and GP STEC O157:H7 strains, and the Stx2-producing ability of PV15-279 is comparable to that of typical STEC O157:H7 strains; therefore, PV15-279 presents a virulence potential similar to that of typical STEC O157:H7. This study reveals the importance of GP O157:H7 as a source of highly pathogenic STEC clones.

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    EID Ogura Y, Seto K, Morimoto Y, Nakamura K, Sato MP, Gotoh Y, et al. Genomic Characterization of β-Glucuronidase–Positive Escherichia coli O157:H7 Producing Stx2a. Emerg Infect Dis. 2018;24(12):2219-2227. https://dx.doi.org/10.3201/eid2412.180404
    AMA Ogura Y, Seto K, Morimoto Y, et al. Genomic Characterization of β-Glucuronidase–Positive Escherichia coli O157:H7 Producing Stx2a. Emerging Infectious Diseases. 2018;24(12):2219-2227. doi:10.3201/eid2412.180404.
    APA Ogura, Y., Seto, K., Morimoto, Y., Nakamura, K., Sato, M. P., Gotoh, Y....Hayashi, T. (2018). Genomic Characterization of β-Glucuronidase–Positive Escherichia coli O157:H7 Producing Stx2a. Emerging Infectious Diseases, 24(12), 2219-2227. https://dx.doi.org/10.3201/eid2412.180404.
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  • Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017
    H. M. De Nys et al.
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    To clarify the role of bats in the ecology of Ebola viruses, we assessed the prevalence of Ebola virus antibodies in a large-scale sample of bats collected during 2015–2017 from countries in Africa that have had previous Ebola outbreaks (Guinea, the Democratic Republic of the Congo) or are at high risk for outbreaks (Cameroon). We analyzed 4,022 blood samples of bats from >12 frugivorous and 27 insectivorous species; 2–37 (0.05%–0.92%) bats were seropositive for Zaire and 0–30 (0%–0.75%) bats for Sudan Ebola viruses. We observed Ebola virus antibodies in 1 insectivorous bat genus and 6 frugivorous bat species. Certain bat species widespread across Africa had serologic evidence of Zaire and Sudan Ebola viruses. No viral RNA was detected in the subset of samples tested (n = 665). Ongoing surveillance of bats and other potential animal reservoirs are required to predict and prepare for future outbreaks.

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    EID De Nys HM, Kingebeni P, Keita AK, Butel C, Thaurignac G, Villabona-Arenas C, et al. Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017. Emerg Infect Dis. 2018;24(12):2228-2240. https://dx.doi.org/10.3201/eid2412.180740
    AMA De Nys HM, Kingebeni P, Keita AK, et al. Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017. Emerging Infectious Diseases. 2018;24(12):2228-2240. doi:10.3201/eid2412.180740.
    APA De Nys, H. M., Kingebeni, P., Keita, A. K., Butel, C., Thaurignac, G., Villabona-Arenas, C....Peeters, M. (2018). Survey of Ebola Viruses in Frugivorous and Insectivorous Bats in Guinea, Cameroon, and the Democratic Republic of the Congo, 2015–2017. Emerging Infectious Diseases, 24(12), 2228-2240. https://dx.doi.org/10.3201/eid2412.180740.
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  • Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant PDF Version[PDF - 3.36 MB - 10 pages]
    S. Sridhar et al.
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    All hepatitis E virus (HEV) variants reported to infect humans belong to the species Orthohepevirus A (HEV-A). The zoonotic potential of the species Orthohepevirus C (HEV-C), which circulates in rats and is highly divergent from HEV-A, is unknown. We report a liver transplant recipient with hepatitis caused by HEV-C infection. We detected HEV-C RNA in multiple clinical samples and HEV-C antigen in the liver. The complete genome of the HEV-C isolate had 93.7% nt similarity to an HEV-C strain from Vietnam. The patient had preexisting HEV antibodies, which were not protective against HEV-C infection. Ribavirin was an effective treatment, resulting in resolution of hepatitis and clearance of HEV-C viremia. Testing for this zoonotic virus should be performed for immunocompromised and immunocompetent patients with unexplained hepatitis because routine hepatitis E diagnostic tests may miss HEV-C infection. HEV-C is also a potential threat to the blood product supply.

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    EID Sridhar S, Yip C, Wu S, Cai J, Zhang A, Leung K, et al. Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant. Emerg Infect Dis. 2018;24(12):2241-2250. https://dx.doi.org/10.3201/eid2412.180937
    AMA Sridhar S, Yip C, Wu S, et al. Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant. Emerging Infectious Diseases. 2018;24(12):2241-2250. doi:10.3201/eid2412.180937.
    APA Sridhar, S., Yip, C., Wu, S., Cai, J., Zhang, A., Leung, K....Yuen, K. (2018). Rat Hepatitis E Virus as Cause of Persistent Hepatitis after Liver Transplant. Emerging Infectious Diseases, 24(12), 2241-2250. https://dx.doi.org/10.3201/eid2412.180937.
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  • Influences of Community Interventions on Zika Prevention Behaviors of Pregnant Women, Puerto Rico, July 2016–June 2017 PDF Version[PDF - 1.62 MB - 11 pages]
    G. Earle-Richardson et al.
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    We assessed how community education efforts influenced pregnant women’s Zika prevention behaviors during the 2016 Centers for Disease Control and Prevention–Puerto Rico Department of Health Zika virus response. Efforts included Zika virus training, distribution of Zika prevention kits, a mass media campaign, and free home mosquito spraying. We used telephone interview data from pregnant women participating in Puerto Rico’s Women, Infants, and Children Program to test associations between program participation and Zika prevention behaviors. Behavior percentages ranged from 4% (wearing long-sleeved shirt) to 90% (removing standing water). Appropriate mosquito repellent use (28%) and condom use (44%) were common. Receiving a Zika prevention kit was significantly associated with larvicide application (odds ratio [OR] 8.0) and bed net use (OR 3.1), suggesting the kit's importance for lesser-known behaviors. Offer of free residential spraying was associated with spraying home for mosquitoes (OR 13.1), indicating that women supported home spraying when barriers were removed.

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    EID Earle-Richardson G, Prue C, Turay K, Thomas D. Influences of Community Interventions on Zika Prevention Behaviors of Pregnant Women, Puerto Rico, July 2016–June 2017. Emerg Infect Dis. 2018;24(12):2251-2261. https://dx.doi.org/10.3201/eid2412.181056
    AMA Earle-Richardson G, Prue C, Turay K, et al. Influences of Community Interventions on Zika Prevention Behaviors of Pregnant Women, Puerto Rico, July 2016–June 2017. Emerging Infectious Diseases. 2018;24(12):2251-2261. doi:10.3201/eid2412.181056.
    APA Earle-Richardson, G., Prue, C., Turay, K., & Thomas, D. (2018). Influences of Community Interventions on Zika Prevention Behaviors of Pregnant Women, Puerto Rico, July 2016–June 2017. Emerging Infectious Diseases, 24(12), 2251-2261. https://dx.doi.org/10.3201/eid2412.181056.
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  • Emerging Multidrug-Resistant Hybrid Pathotype Shiga Toxin–Producing Escherichia coli O80 and Related Strains of Clonal Complex 165, Europe PDF Version[PDF - 2.19 MB - 8 pages]
    A. Cointe et al.
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    Enterohemorrhagic Escherichia coli serogroup O80, involved in hemolytic uremic syndrome associated with extraintestinal infections, has emerged in France. We obtained circularized sequences of the O80 strain RDEx444, responsible for hemolytic uremic syndrome with bacteremia, and noncircularized sequences of 35 O80 E. coli isolated from humans and animals in Europe with or without Shiga toxin genes. RDEx444 harbored a mosaic plasmid, pR444_A, combining extraintestinal virulence determinants and a multidrug resistance–encoding island. All strains belonged to clonal complex 165, which is distantly related to other major enterohemorrhagic E. coli lineages. All stx-positive strains contained eae-ξ, ehxA, and genes characteristic of pR444_A. Among stx-negative strains, 1 produced extended-spectrum β-lactamase, 1 harbored the colistin-resistance gene mcr1, and 2 possessed genes characteristic of enteropathogenic and pyelonephritis E. coli. Because O80–clonal complex 165 strains can integrate intestinal and extraintestinal virulence factors in combination with diverse drug-resistance genes, they constitute dangerous and versatile multidrug-resistant pathogens.

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    EID Cointe A, Birgy A, Mariani-Kurkdjian P, Liguori S, Courroux C, Blanco J, et al. Emerging Multidrug-Resistant Hybrid Pathotype Shiga Toxin–Producing Escherichia coli O80 and Related Strains of Clonal Complex 165, Europe. Emerg Infect Dis. 2018;24(12):2262-2269. https://dx.doi.org/10.3201/eid2412.180272
    AMA Cointe A, Birgy A, Mariani-Kurkdjian P, et al. Emerging Multidrug-Resistant Hybrid Pathotype Shiga Toxin–Producing Escherichia coli O80 and Related Strains of Clonal Complex 165, Europe. Emerging Infectious Diseases. 2018;24(12):2262-2269. doi:10.3201/eid2412.180272.
    APA Cointe, A., Birgy, A., Mariani-Kurkdjian, P., Liguori, S., Courroux, C., Blanco, J....Bonacorsi, S. (2018). Emerging Multidrug-Resistant Hybrid Pathotype Shiga Toxin–Producing Escherichia coli O80 and Related Strains of Clonal Complex 165, Europe. Emerging Infectious Diseases, 24(12), 2262-2269. https://dx.doi.org/10.3201/eid2412.180272.
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  • Comparison of 2016–17 and Previous Epizootics of Highly Pathogenic Avian Influenza H5 Guangdong Lineage in Europe PDF Version[PDF - 6.06 MB - 14 pages]
    P. Alarcon et al.
        View Abstract

    We analyzed the highly pathogenic avian influenza (HPAI) H5 epizootic of 2016–17 in Europe by epidemiologic and genetic characteristics and compared it with 2 previous epizootics caused by the same H5 Guangdong lineage. The 2016–17 epizootic was the largest in Europe by number of countries and farms affected and greatest diversity of wild birds infected. We observed significant differences among the 3 epizootics regarding region affected, epidemic curve, seasonality, and outbreak duration, making it difficult to predict future HPAI epizootics. However, we know that in 2005–06 and 2016–17 the initial peak of wild bird detections preceded the peak of poultry outbreaks within Europe. Phylogenetic analysis of 2016–17 viruses indicates 2 main pathways into Europe. Our findings highlight the need for global surveillance of viral changes to inform disease preparedness, detection, and control.

        Cite This Article
    EID Alarcon P, Brouwer A, Venkatesh D, Duncan D, Dovas CI, Georgiades G, et al. Comparison of 2016–17 and Previous Epizootics of Highly Pathogenic Avian Influenza H5 Guangdong Lineage in Europe. Emerg Infect Dis. 2018;24(12):2270-2283. https://dx.doi.org/10.3201/eid2412.171860
    AMA Alarcon P, Brouwer A, Venkatesh D, et al. Comparison of 2016–17 and Previous Epizootics of Highly Pathogenic Avian Influenza H5 Guangdong Lineage in Europe. Emerging Infectious Diseases. 2018;24(12):2270-2283. doi:10.3201/eid2412.171860.
    APA Alarcon, P., Brouwer, A., Venkatesh, D., Duncan, D., Dovas, C. I., Georgiades, G....Brown, I. H. (2018). Comparison of 2016–17 and Previous Epizootics of Highly Pathogenic Avian Influenza H5 Guangdong Lineage in Europe. Emerging Infectious Diseases, 24(12), 2270-2283. https://dx.doi.org/10.3201/eid2412.171860.
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  • CTX-M-65 Extended-Spectrum β-Lactamase–Producing Salmonella enterica Serotype Infantis, United States PDF Version[PDF - 762 KB - 7 pages]
    A. C. Brown et al.
        View Abstract

    Extended-spectrum β-lactamases (ESBLs) confer resistance to clinically important third-generation cephalosporins, which are often used to treat invasive salmonellosis. In the United States, ESBLs are rarely found in Salmonella. However, in 2014, the US Food and Drug Administration found blaCTX-M-65 ESBL-producing Salmonella enterica serotype Infantis in retail chicken meat. The isolate had a rare pulsed-field gel electrophoresis pattern. To clarify the sources and potential effects on human health, we examined isolates with this pattern obtained from human surveillance and associated metadata. Using broth microdilution for antimicrobial susceptibility testing and whole-genome sequencing, we characterized the isolates. Of 34 isolates, 29 carried the blaCTX-M-65 gene with <9 additional resistance genes on 1 plasmid. Of 19 patients with travel information available, 12 (63%) reported recent travel to South America. Genetically, isolates from travelers, nontravelers, and retail chicken meat were similar. Expanded surveillance is needed to determine domestic sources and potentially prevent spread of this ESBL-containing plasmid.

        Cite This Article
    EID Brown AC, Chen JC, Watkins LK, Campbell D, Folster JP, Tate H, et al. CTX-M-65 Extended-Spectrum β-Lactamase–Producing Salmonella enterica Serotype Infantis, United States. Emerg Infect Dis. 2018;24(12):2284-2291. https://dx.doi.org/10.3201/eid2412.180500
    AMA Brown AC, Chen JC, Watkins LK, et al. CTX-M-65 Extended-Spectrum β-Lactamase–Producing Salmonella enterica Serotype Infantis, United States. Emerging Infectious Diseases. 2018;24(12):2284-2291. doi:10.3201/eid2412.180500.
    APA Brown, A. C., Chen, J. C., Watkins, L. K., Campbell, D., Folster, J. P., Tate, H....Friedman, C. R. (2018). CTX-M-65 Extended-Spectrum β-Lactamase–Producing Salmonella enterica Serotype Infantis, United States. Emerging Infectious Diseases, 24(12), 2284-2291. https://dx.doi.org/10.3201/eid2412.180500.
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  • Medscape CME Activity
    Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men PDF Version[PDF - 1.35 MB - 11 pages]
    M. Hoenigl et al.
        View Abstract

    The effectiveness of oral HIV preexposure prophylaxis (PrEP) strongly depends on maintaining adherence. We investigated the association between substance use and PrEP adherence, as well as incident sexually transmitted infections (STIs) in a high-risk cohort of 394 participants (391 men who have sex with men and 3 transgender women) who were enrolled in a PrEP demonstration project. We assessed baseline and ongoing substance use over a 48-week period for stimulants and nonstimulant substances and for each substance separately. We measured PrEP adherence by using dried blood spots to obtain levels of tenofovir diphosphate. No differences in these levels were found between substance users and nonsubstance users. Baseline stimulant use was strongly associated (odds ratio 3.4; p<0.001) with incident STIs during the study. Thus, PrEP adherence was not decreased by substance use. Because substance users had increased rates of STIs, indicating higher-risk behavior, they might be excellent candidates for PrEP.

        Cite This Article
    EID Hoenigl M, Jain S, Moore D, Collins D, Sun X, Anderson PL, et al. Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men. Emerg Infect Dis. 2018;24(12):2292-2302. https://dx.doi.org/10.3201/eid2412.180400
    AMA Hoenigl M, Jain S, Moore D, et al. Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men. Emerging Infectious Diseases. 2018;24(12):2292-2302. doi:10.3201/eid2412.180400.
    APA Hoenigl, M., Jain, S., Moore, D., Collins, D., Sun, X., Anderson, P. L....Morris, S. (2018). Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men. Emerging Infectious Diseases, 24(12), 2292-2302. https://dx.doi.org/10.3201/eid2412.180400.
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  • Highly Pathogenic Clone of Shiga Toxin–Producing Escherichia coli O157:H7, England and Wales PDF Version[PDF - 808 KB - 6 pages]
    L. Byrne et al.
        View Abstract

    We used whole-genome sequencing to investigate the evolutionary context of an emerging highly pathogenic strain of Shiga toxin–producing Escherichia coli (STEC) O157:H7 in England and Wales. A timed phylogeny of sublineage IIb revealed that the emerging clone evolved from a STEC O157:H7 stx-negative ancestor ≈10 years ago after acquisition of a bacteriophage encoding Shiga toxin (stx) 2a, which in turn had evolved from a stx2c progenitor ≈20 years ago. Infection with the stx2a clone was a significant risk factor for bloody diarrhea (OR 4.61, 95% CI 2.24–9.48; p<0.001), compared with infection with other strains within sublineage IIb. Clinical symptoms of cases infected with sublineage IIb stx2c and stx-negative clones were comparable, despite the loss of stx2c. Our analysis highlighted the highly dynamic nature of STEC O157:H7 Stx-encoding bacteriophages and revealed the evolutionary history of a highly pathogenic clone emerging within sublineage IIb, a sublineage not previously associated with severe clinical symptoms.

        Cite This Article
    EID Byrne L, Dallman TJ, Adams N, Mikhail A, McCarthy N, Jenkins C. Highly Pathogenic Clone of Shiga Toxin–Producing Escherichia coli O157:H7, England and Wales. Emerg Infect Dis. 2018;24(12):2303-2308. https://dx.doi.org/10.3201/eid2412.180409
    AMA Byrne L, Dallman TJ, Adams N, et al. Highly Pathogenic Clone of Shiga Toxin–Producing Escherichia coli O157:H7, England and Wales. Emerging Infectious Diseases. 2018;24(12):2303-2308. doi:10.3201/eid2412.180409.
    APA Byrne, L., Dallman, T. J., Adams, N., Mikhail, A., McCarthy, N., & Jenkins, C. (2018). Highly Pathogenic Clone of Shiga Toxin–Producing Escherichia coli O157:H7, England and Wales. Emerging Infectious Diseases, 24(12), 2303-2308. https://dx.doi.org/10.3201/eid2412.180409.
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  • Prevalence of Avian Influenza A(H5) and A(H9) Viruses in Live Bird Markets, Bangladesh PDF Version[PDF - 1.59 MB - 8 pages]
    Y. Kim et al.
        View Abstract

    We conducted a cross-sectional study in live bird markets (LBMs) in Dhaka and Chittagong, Bangladesh, to estimate the prevalence of avian influenza A(H5) and A(H9) viruses in different types of poultry and environmental areas by using Bayesian hierarchical logistic regression models. We detected these viruses in nearly all LBMs. Prevalence of A(H5) virus was higher in waterfowl than in chickens, whereas prevalence of A(H9) virus was higher in chickens than in waterfowl and, among chicken types, in industrial broilers than in cross-breeds and indigenous breeds. LBMs with >1 wholesaler were more frequently contaminated by A(H5) virus than retail-only LBMs. Prevalence of A(H9) virus in poultry and level of environmental contamination were also higher in LBMs with >1 wholesaler. We found a high level of circulation of both avian influenza viruses in surveyed LBMs. Prevalence was influenced by type of poultry, environmental site, and trading.

        Cite This Article
    EID Kim Y, Biswas PK, Giasuddin M, Hasan M, Mahmud R, Chang Y, et al. Prevalence of Avian Influenza A(H5) and A(H9) Viruses in Live Bird Markets, Bangladesh. Emerg Infect Dis. 2018;24(12):2309-2316. https://dx.doi.org/10.3201/eid2412.180879
    AMA Kim Y, Biswas PK, Giasuddin M, et al. Prevalence of Avian Influenza A(H5) and A(H9) Viruses in Live Bird Markets, Bangladesh. Emerging Infectious Diseases. 2018;24(12):2309-2316. doi:10.3201/eid2412.180879.
    APA Kim, Y., Biswas, P. K., Giasuddin, M., Hasan, M., Mahmud, R., Chang, Y....Fournié, G. (2018). Prevalence of Avian Influenza A(H5) and A(H9) Viruses in Live Bird Markets, Bangladesh. Emerging Infectious Diseases, 24(12), 2309-2316. https://dx.doi.org/10.3201/eid2412.180879.
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  • Human Exposure to Novel Bartonella Species from Contact with Fruit Bats PDF Version[PDF - 795 KB - 7 pages]
    Y. Bai et al.
        View Abstract

    Twice a year in southwestern Nigeria, during a traditional bat festival, community participants enter designated caves to capture bats, which are then consumed for food or traded. We investigated the presence of Bartonella species in Egyptian fruit bats (Rousettus aegyptiacus) and bat flies (Eucampsipoda africana) from these caves and assessed whether Bartonella infections had occurred in persons from the surrounding communities. Our results indicate that these bats and flies harbor Bartonella strains, which multilocus sequence typing indicated probably represent a novel Bartonella species, proposed as Bartonella rousetti. In serum from 8 of 204 persons, we detected antibodies to B. rousetti without cross-reactivity to other Bartonella species. This work suggests that bat-associated Bartonella strains might be capable of infecting humans.

        Cite This Article
    EID Bai Y, Osinubi M, Osikowicz L, McKee C, Vora NM, Rizzo M, et al. Human Exposure to Novel Bartonella Species from Contact with Fruit Bats. Emerg Infect Dis. 2018;24(12):2317-2323. https://dx.doi.org/10.3201/eid2412.181204
    AMA Bai Y, Osinubi M, Osikowicz L, et al. Human Exposure to Novel Bartonella Species from Contact with Fruit Bats. Emerging Infectious Diseases. 2018;24(12):2317-2323. doi:10.3201/eid2412.181204.
    APA Bai, Y., Osinubi, M., Osikowicz, L., McKee, C., Vora, N. M., Rizzo, M....Kosoy, M. Y. (2018). Human Exposure to Novel Bartonella Species from Contact with Fruit Bats. Emerging Infectious Diseases, 24(12), 2317-2323. https://dx.doi.org/10.3201/eid2412.181204.
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Historical Review

  • Emergent Sand Fly–Borne Phleboviruses in the Balkan Region PDF Version[PDF - 1.85 MB - 7 pages]
    N. Ayhan and R. N. Charrel
        View Abstract

    Sand fly–borne phleboviruses are associated with febrile diseases and nervous system infections in the Mediterranean basin. Sandfly fever was first reported in the Balkan Peninsula at the end of the 19th century. Since then, accumulating data show that the Balkan Peninsula, as a transboundary region between Asia and Europe, plays a major role in the emergence of vectorborne diseases in Europe. To provide an inclusive approach, we collected published data on phleboviruses in the Balkan countries and used them to evaluate the impact of these pathogens from virologic, epidemiologic, and public health perspectives. Recent findings show a high diversity of phleboviruses belonging to 3 species or serocomplexes circulating heavily in the Balkans. Focusing on undisputable human pathogens, we found direct and indirect laboratory documentation for Toscana virus, Sandfly fever Sicilian virus, and Adria virus. These data demonstrate that the Balkans are a hotspot for phleboviruses transmitted by sand flies.

        Cite This Article
    EID Ayhan N, Charrel RN. Emergent Sand Fly–Borne Phleboviruses in the Balkan Region. Emerg Infect Dis. 2018;24(12):2324-2330. https://dx.doi.org/10.3201/eid2412.171626
    AMA Ayhan N, Charrel RN. Emergent Sand Fly–Borne Phleboviruses in the Balkan Region. Emerging Infectious Diseases. 2018;24(12):2324-2330. doi:10.3201/eid2412.171626.
    APA Ayhan, N., & Charrel, R. N. (2018). Emergent Sand Fly–Borne Phleboviruses in the Balkan Region. Emerging Infectious Diseases, 24(12), 2324-2330. https://dx.doi.org/10.3201/eid2412.171626.
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Dispatches

  • Isolation of Burkholderia pseudomallei from a Pet Green Iguana, Belgium PDF Version[PDF - 1.49 MB - 3 pages]
    T. Hellebuyck et al.
        View Abstract

    We isolated Burkholderia pseudomallei, the causative agent of melioidosis, from liver granulomas of a pet green iguana (Iguana iguana) in Belgium. This case highlights a risk for imported green iguanas acting as a reservoir for introduction of this high-threat, zoonotic pathogen into nonendemic regions.

        Cite This Article
    EID Hellebuyck T, Wattiau P, Boyen F, Moeremans I, Roosens NH, Vanneste K, et al. Isolation of Burkholderia pseudomallei from a Pet Green Iguana, Belgium. Emerg Infect Dis. 2018;24(12):2331-2333. https://dx.doi.org/10.3201/eid2412.171661
    AMA Hellebuyck T, Wattiau P, Boyen F, et al. Isolation of Burkholderia pseudomallei from a Pet Green Iguana, Belgium. Emerging Infectious Diseases. 2018;24(12):2331-2333. doi:10.3201/eid2412.171661.
    APA Hellebuyck, T., Wattiau, P., Boyen, F., Moeremans, I., Roosens, N. H., Vanneste, K....Haesebrouck, F. (2018). Isolation of Burkholderia pseudomallei from a Pet Green Iguana, Belgium. Emerging Infectious Diseases, 24(12), 2331-2333. https://dx.doi.org/10.3201/eid2412.171661.
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  • Neglected Hosts of Small Ruminant Morbillivirus PDF Version[PDF - 1.36 MB - 4 pages]
    C. Schulz et al.
        View Abstract

    Eradication of small ruminant morbillivirus (PPRV) is targeted for 2030. PPRV lineage IV is found in much of Asia and Africa. We used PPRV lineage IV strain Kurdistan/2011 in transmission trials to investigate the role of pigs, wild boar, and small ruminants as PPRV reservoirs. Suids were a possible source of infection.

        Cite This Article
    EID Schulz C, Fast C, Schlottau K, Hoffmann B, Beer M. Neglected Hosts of Small Ruminant Morbillivirus. Emerg Infect Dis. 2018;24(12):2334-2337. https://dx.doi.org/10.3201/eid2412.180507
    AMA Schulz C, Fast C, Schlottau K, et al. Neglected Hosts of Small Ruminant Morbillivirus. Emerging Infectious Diseases. 2018;24(12):2334-2337. doi:10.3201/eid2412.180507.
    APA Schulz, C., Fast, C., Schlottau, K., Hoffmann, B., & Beer, M. (2018). Neglected Hosts of Small Ruminant Morbillivirus. Emerging Infectious Diseases, 24(12), 2334-2337. https://dx.doi.org/10.3201/eid2412.180507.
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  • Vaccinia Virus among Domestic Dogs and Wild Coatis, Brazil, 2013–2015 PDF Version[PDF - 2.12 MB - 5 pages]
    G. Costa et al.
        View Abstract

    To determine their potential role as a source of human infection, we tested domestic dogs (urban) and wild coatis (wild) in Brazil for vaccinia virus. Our findings of positive neutralizing antibodies and quantitative PCR results for 35/184 dogs and 13/90 coatis highlight a potential public health risk.

        Cite This Article
    EID Costa G, Ribeiro de Almeida L, Cerqueira A, Mesquita W, Silva de Oliveira J, Miranda J, et al. Vaccinia Virus among Domestic Dogs and Wild Coatis, Brazil, 2013–2015. Emerg Infect Dis. 2018;24(12):2338-2342. https://dx.doi.org/10.3201/eid2412.171584
    AMA Costa G, Ribeiro de Almeida L, Cerqueira A, et al. Vaccinia Virus among Domestic Dogs and Wild Coatis, Brazil, 2013–2015. Emerging Infectious Diseases. 2018;24(12):2338-2342. doi:10.3201/eid2412.171584.
    APA Costa, G., Ribeiro de Almeida, L., Cerqueira, A., Mesquita, W., Silva de Oliveira, J., Miranda, J....Trindade, G. (2018). Vaccinia Virus among Domestic Dogs and Wild Coatis, Brazil, 2013–2015. Emerging Infectious Diseases, 24(12), 2338-2342. https://dx.doi.org/10.3201/eid2412.171584.
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  • Highly Pathogenic Avian Influenza A(H5N6) in Domestic Cats, South Korea PDF Version[PDF - 2.43 MB - 5 pages]
    K. Lee et al.
        View Abstract

    In December 2016, highly pathogenic avian influenza (HPAI) infection with systemic pathologic lesions was found in cats in South Korea. Genetic analyses indicated that the feline isolates were similar to HPAI H5N6 viruses isolated in chicken farms nearby. This finding highlights the need for monitoring of domestic mammals during HPAI outbreaks.

        Cite This Article
    EID Lee K, Lee E, Lee H, Heo G, Lee Y, Jung J, et al. Highly Pathogenic Avian Influenza A(H5N6) in Domestic Cats, South Korea. Emerg Infect Dis. 2018;24(12):2343-2347. https://dx.doi.org/10.3201/eid2412.180290
    AMA Lee K, Lee E, Lee H, et al. Highly Pathogenic Avian Influenza A(H5N6) in Domestic Cats, South Korea. Emerging Infectious Diseases. 2018;24(12):2343-2347. doi:10.3201/eid2412.180290.
    APA Lee, K., Lee, E., Lee, H., Heo, G., Lee, Y., Jung, J....Choi, E. (2018). Highly Pathogenic Avian Influenza A(H5N6) in Domestic Cats, South Korea. Emerging Infectious Diseases, 24(12), 2343-2347. https://dx.doi.org/10.3201/eid2412.180290.
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  • Candidatus Cryptoplasma Associated with Green Lizards and Ixodes ricinus Ticks, Slovakia, 2004–2011 PDF Version[PDF - 942 KB - 4 pages]
    B. Kočíková et al.
        View Abstract

    During 2004–2011, we collected green lizards and Ixodes ricinus ticks in Slovak Karst National Park in Slovakia; 90% (36/40) of lizards and 37% of ticks removed from lizards were infected with family Anaplasmataceae bacteria. Only Candidatus Cryptoplasma sp. REP (reptile) was identified in these samples. Green lizards transmit this bacterium.

        Cite This Article
    EID Kočíková B, Majláth I, Víchová B, Maliničová L, Pristaš P, Connors VA, et al. Candidatus Cryptoplasma Associated with Green Lizards and Ixodes ricinus Ticks, Slovakia, 2004–2011. Emerg Infect Dis. 2018;24(12):2348-2351. https://dx.doi.org/10.3201/eid2412.161958
    AMA Kočíková B, Majláth I, Víchová B, et al. Candidatus Cryptoplasma Associated with Green Lizards and Ixodes ricinus Ticks, Slovakia, 2004–2011. Emerging Infectious Diseases. 2018;24(12):2348-2351. doi:10.3201/eid2412.161958.
    APA Kočíková, B., Majláth, I., Víchová, B., Maliničová, L., Pristaš, P., Connors, V. A....Majláthová, V. (2018). Candidatus Cryptoplasma Associated with Green Lizards and Ixodes ricinus Ticks, Slovakia, 2004–2011. Emerging Infectious Diseases, 24(12), 2348-2351. https://dx.doi.org/10.3201/eid2412.161958.
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  • Excess Mortality and Causes Associated with Chikungunya, Puerto Rico, 2014–2015 PDF Version[PDF - 625 KB - 4 pages]
    A. Freitas et al.
        View Abstract

    During 2014–2015, a total of 31 deaths were associated with the first chikungunya epidemic in Puerto Rico. We analyzed excess mortality from various causes for the same months during the previous 4 years and detected 1,310 deaths possibly attributable to chikungunya. Our findings raise important questions about increased mortality rates associated with chikungunya.

        Cite This Article
    EID Freitas A, Donalisio M, Alarcón-Elbal P. Excess Mortality and Causes Associated with Chikungunya, Puerto Rico, 2014–2015. Emerg Infect Dis. 2018;24(12):2352-2355. https://dx.doi.org/10.3201/eid2412.170639
    AMA Freitas A, Donalisio M, Alarcón-Elbal P. Excess Mortality and Causes Associated with Chikungunya, Puerto Rico, 2014–2015. Emerging Infectious Diseases. 2018;24(12):2352-2355. doi:10.3201/eid2412.170639.
    APA Freitas, A., Donalisio, M., & Alarcón-Elbal, P. (2018). Excess Mortality and Causes Associated with Chikungunya, Puerto Rico, 2014–2015. Emerging Infectious Diseases, 24(12), 2352-2355. https://dx.doi.org/10.3201/eid2412.170639.
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  • Borrelia miyamotoi Infections in Small Mammals, California, USA PDF Version[PDF - 790 KB - 4 pages]
    D. J. Salkeld et al.
        View Abstract

    Surveillance to investigate the wildlife–vector transmission cycle of the human pathogen Borrelia miyamotoi in California, USA, revealed infections in dusky-footed woodrats, brush mice, and California mice. Phylogenetic analyses suggest a single, well-supported clade of B. miyamotoi is circulating in California.

        Cite This Article
    EID Salkeld DJ, Nieto NC, Bonilla DL, Yoshimizu MH, Padgett KA. Borrelia miyamotoi Infections in Small Mammals, California, USA. Emerg Infect Dis. 2018;24(12):2356-2359. https://dx.doi.org/10.3201/eid2412.171632
    AMA Salkeld DJ, Nieto NC, Bonilla DL, et al. Borrelia miyamotoi Infections in Small Mammals, California, USA. Emerging Infectious Diseases. 2018;24(12):2356-2359. doi:10.3201/eid2412.171632.
    APA Salkeld, D. J., Nieto, N. C., Bonilla, D. L., Yoshimizu, M. H., & Padgett, K. A. (2018). Borrelia miyamotoi Infections in Small Mammals, California, USA. Emerging Infectious Diseases, 24(12), 2356-2359. https://dx.doi.org/10.3201/eid2412.171632.
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  • In-Host Adaptation of Salmonella enterica Serotype Dublin during Prosthetic Hip Joint Infection PDF Version[PDF - 565 KB - 4 pages]
    F. El Sayed et al.
        View Abstract

    Genome degradation has been central to the adaptation of Salmonella enterica serotypes to their hosts throughout evolution. We witnessed the patho-adaptation of a strain of Salmonella Dublin (a cattle-adapted serotype) to a human host during the course of a recurrent prosthetic hip joint infection evolving over several years.

        Cite This Article
    EID El Sayed F, Sapriel G, Fawal N, Gruber A, Bauer T, Heym B, et al. In-Host Adaptation of Salmonella enterica Serotype Dublin during Prosthetic Hip Joint Infection. Emerg Infect Dis. 2018;24(12):2360-2363. https://dx.doi.org/10.3201/eid2412.180214
    AMA El Sayed F, Sapriel G, Fawal N, et al. In-Host Adaptation of Salmonella enterica Serotype Dublin during Prosthetic Hip Joint Infection. Emerging Infectious Diseases. 2018;24(12):2360-2363. doi:10.3201/eid2412.180214.
    APA El Sayed, F., Sapriel, G., Fawal, N., Gruber, A., Bauer, T., Heym, B....Le Hello, S. (2018). In-Host Adaptation of Salmonella enterica Serotype Dublin during Prosthetic Hip Joint Infection. Emerging Infectious Diseases, 24(12), 2360-2363. https://dx.doi.org/10.3201/eid2412.180214.
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  • Risk Factors for Acquiring Scrub Typhus among Children in Deoria and Gorakhpur Districts, Uttar Pradesh, India, 2017 PDF Version[PDF - 384 KB - 4 pages]
    J. Thangaraj et al.
        View Abstract

    Scrub typhus is associated with outbreaks of acute encephalitis syndrome in Uttar Pradesh, India. A case-control study indicated that children residing, playing, or visiting fields; living with firewood stored indoors; handling cattle fodder; and practicing open defecation were at increased risk for scrub typhus. Communication messages should focus on changing these behaviors.

        Cite This Article
    EID Thangaraj J, Vasanthapuram R, Machado L, Arunkumar G, Sodha SV, Zaman K, et al. Risk Factors for Acquiring Scrub Typhus among Children in Deoria and Gorakhpur Districts, Uttar Pradesh, India, 2017. Emerg Infect Dis. 2018;24(12):2364-2367. https://dx.doi.org/10.3201/eid2412.180695
    AMA Thangaraj J, Vasanthapuram R, Machado L, et al. Risk Factors for Acquiring Scrub Typhus among Children in Deoria and Gorakhpur Districts, Uttar Pradesh, India, 2017. Emerging Infectious Diseases. 2018;24(12):2364-2367. doi:10.3201/eid2412.180695.
    APA Thangaraj, J., Vasanthapuram, R., Machado, L., Arunkumar, G., Sodha, S. V., Zaman, K....Murhekar, M. (2018). Risk Factors for Acquiring Scrub Typhus among Children in Deoria and Gorakhpur Districts, Uttar Pradesh, India, 2017. Emerging Infectious Diseases, 24(12), 2364-2367. https://dx.doi.org/10.3201/eid2412.180695.
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  • Using PCR-Based Sequencing to Diagnose Haycocknema perplexum Infection in Human Myositis Case, Australia PDF Version[PDF - 400 KB - 3 pages]
    A. V. Koehler et al.
        View Abstract

    We report a case of myositis in a male patient in Australia who had progressive weakness and wasting in his left lower limb. Although clinical, pathologic, and laboratory assessments were inconclusive, a new, nested PCR–coupled sequencing method enabled the unequivocal diagnosis of myositis caused by the enigmatic nematode Haycocknema perplexum.

        Cite This Article
    EID Koehler AV, Leung P, McEwan B, Gasser RB. Using PCR-Based Sequencing to Diagnose Haycocknema perplexum Infection in Human Myositis Case, Australia. Emerg Infect Dis. 2018;24(12):2368-2370. https://dx.doi.org/10.3201/eid2412.181240
    AMA Koehler AV, Leung P, McEwan B, et al. Using PCR-Based Sequencing to Diagnose Haycocknema perplexum Infection in Human Myositis Case, Australia. Emerging Infectious Diseases. 2018;24(12):2368-2370. doi:10.3201/eid2412.181240.
    APA Koehler, A. V., Leung, P., McEwan, B., & Gasser, R. B. (2018). Using PCR-Based Sequencing to Diagnose Haycocknema perplexum Infection in Human Myositis Case, Australia. Emerging Infectious Diseases, 24(12), 2368-2370. https://dx.doi.org/10.3201/eid2412.181240.
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Research Letters

  • Chuzan Virus in Yaks, Qinghai-Tibetan Plateau, China PDF Version[PDF - 436 KB - 3 pages]
    M. Wang et al.
        View Abstract

    We detected Chuzan virus (CHUV) in domestic yaks from the Qinghai-Tibetan Plateau, western China, indicating CHUV probably has been transmitted to yaks in recent years. Awareness for CHUV surveillance and transmission and livestock health management in these special regions should be raised to avoid outbreaks and animal loss.

        Cite This Article
    EID Wang M, Wang Y, Baloch A, Pan Y, Tian L, Xu F, et al. Chuzan Virus in Yaks, Qinghai-Tibetan Plateau, China. Emerg Infect Dis. 2018;24(12):2371-2373. https://dx.doi.org/10.3201/eid2412.171414
    AMA Wang M, Wang Y, Baloch A, et al. Chuzan Virus in Yaks, Qinghai-Tibetan Plateau, China. Emerging Infectious Diseases. 2018;24(12):2371-2373. doi:10.3201/eid2412.171414.
    APA Wang, M., Wang, Y., Baloch, A., Pan, Y., Tian, L., Xu, F....Zeng, Q. (2018). Chuzan Virus in Yaks, Qinghai-Tibetan Plateau, China. Emerging Infectious Diseases, 24(12), 2371-2373. https://dx.doi.org/10.3201/eid2412.171414.
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  • Conservation of White Rhinoceroses Threatened by Bovine Tuberculosis, South Africa, 2016–2017 PDF Version[PDF - 356 KB - 3 pages]
    M. A. Miller et al.
        View Abstract

    During 2016–2017, when Kruger National Park, South Africa, was under quarantine to limit bovine tuberculosis spread, we examined 35 white and 5 black rhinoceroses for infection. We found 6 infected white rhinoceroses during times of nutritional stress. Further research on Mycobacterium bovis pathogenesis in white rhinoceroses is needed.

        Cite This Article
    EID Miller MA, Buss P, Parsons S, Roos E, Chileshe J, Goosen WJ, et al. Conservation of White Rhinoceroses Threatened by Bovine Tuberculosis, South Africa, 2016–2017. Emerg Infect Dis. 2018;24(12):2373-2375. https://dx.doi.org/10.3201/eid2412.180293
    AMA Miller MA, Buss P, Parsons S, et al. Conservation of White Rhinoceroses Threatened by Bovine Tuberculosis, South Africa, 2016–2017. Emerging Infectious Diseases. 2018;24(12):2373-2375. doi:10.3201/eid2412.180293.
    APA Miller, M. A., Buss, P., Parsons, S., Roos, E., Chileshe, J., Goosen, W. J....van Helden, P. (2018). Conservation of White Rhinoceroses Threatened by Bovine Tuberculosis, South Africa, 2016–2017. Emerging Infectious Diseases, 24(12), 2373-2375. https://dx.doi.org/10.3201/eid2412.180293.
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  • Lung Involvement in Chronic Schistosomiasis with Bladder Squamous Cell Carcinoma PDF Version[PDF - 1.30 MB - 4 pages]
    A. Saade et al.
        View Abstract

    We report a case of chronic Schistosoma haematobium infection with pseudometastatic pulmonary nodules and high-grade squamous cell carcinoma in a 30-year-old man in Mali. Lung biopsies revealed chronic pulmonary involvement of S. haematobium and ruled out lung metastases.

        Cite This Article
    EID Saade A, Carton E, Mansuet-Lupo A, Jouffroy R, Damotte D, Yera H, et al. Lung Involvement in Chronic Schistosomiasis with Bladder Squamous Cell Carcinoma. Emerg Infect Dis. 2018;24(12):2375-2378. https://dx.doi.org/10.3201/eid2412.180355
    AMA Saade A, Carton E, Mansuet-Lupo A, et al. Lung Involvement in Chronic Schistosomiasis with Bladder Squamous Cell Carcinoma. Emerging Infectious Diseases. 2018;24(12):2375-2378. doi:10.3201/eid2412.180355.
    APA Saade, A., Carton, E., Mansuet-Lupo, A., Jouffroy, R., Damotte, D., Yera, H....Goldwasser, F. (2018). Lung Involvement in Chronic Schistosomiasis with Bladder Squamous Cell Carcinoma. Emerging Infectious Diseases, 24(12), 2375-2378. https://dx.doi.org/10.3201/eid2412.180355.
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  • Strongyloidiasis and Culture-Negative Suppurative Meningitis, Japan, 1993–2015 PDF Version[PDF - 333 KB - 3 pages]
    M. Mukaigawara et al.
        View Abstract

    Community-acquired Enterobacteriaceae infection and culture-negative meningitis are rare and atypical subtypes of meningitis in adults. Of 37 patients who had atypical suppurative meningitis during 1993–2015 in Okinawa, Japan, 54.5% had strongyloidiasis, of which 9.1% cases were hyperinfections and 3.0% dissemination. Strongyloidiasis should be considered an underlying cause of atypical suppurative meningitis.

        Cite This Article
    EID Mukaigawara M, Nakayama I, Gibo K. Strongyloidiasis and Culture-Negative Suppurative Meningitis, Japan, 1993–2015. Emerg Infect Dis. 2018;24(12):2378-2380. https://dx.doi.org/10.3201/eid2412.180375
    AMA Mukaigawara M, Nakayama I, Gibo K. Strongyloidiasis and Culture-Negative Suppurative Meningitis, Japan, 1993–2015. Emerging Infectious Diseases. 2018;24(12):2378-2380. doi:10.3201/eid2412.180375.
    APA Mukaigawara, M., Nakayama, I., & Gibo, K. (2018). Strongyloidiasis and Culture-Negative Suppurative Meningitis, Japan, 1993–2015. Emerging Infectious Diseases, 24(12), 2378-2380. https://dx.doi.org/10.3201/eid2412.180375.
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  • Use of Next-Generation Sequencing for Diagnosis of West Nile Virus Infection in Patient Returning to Belgium from Hungary PDF Version[PDF - 484 KB - 3 pages]
    E. Wollants et al.
        View Abstract

    An elderly patient in Belgium who became critically ill after returning from Hungary was tested for pathogens using routine diagnostic tests. All results were negative. However, using next-generation sequencing on a cultured respiratory sample, laboratorians detected a complete West Nile virus genome, similar to strains isolated in southeastern Europe.

        Cite This Article
    EID Wollants E, Smolders D, Naesens R, Bruynseels P, Lagrou K, Matthijnssens J, et al. Use of Next-Generation Sequencing for Diagnosis of West Nile Virus Infection in Patient Returning to Belgium from Hungary. Emerg Infect Dis. 2018;24(12):2380-2382. https://dx.doi.org/10.3201/eid2412.180494
    AMA Wollants E, Smolders D, Naesens R, et al. Use of Next-Generation Sequencing for Diagnosis of West Nile Virus Infection in Patient Returning to Belgium from Hungary. Emerging Infectious Diseases. 2018;24(12):2380-2382. doi:10.3201/eid2412.180494.
    APA Wollants, E., Smolders, D., Naesens, R., Bruynseels, P., Lagrou, K., Matthijnssens, J....Van Ranst, M. (2018). Use of Next-Generation Sequencing for Diagnosis of West Nile Virus Infection in Patient Returning to Belgium from Hungary. Emerging Infectious Diseases, 24(12), 2380-2382. https://dx.doi.org/10.3201/eid2412.180494.
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  • Disseminated Spiroplasma apis Infection in Patient with Agammaglobulinemia, France PDF Version[PDF - 380 KB - 5 pages]
    N. Etienne et al.
        View Abstract

    We report a disseminated infection caused by Spiroplasma apis, a honeybee pathogen, in a patient in France who had X-linked agammaglobulinemia. Identification was challenging because initial bacterial cultures and direct examination by Gram staining were negative. Unexplained sepsis in patients with agammaglobulinemia warrants specific investigation to identify fastidious bacteria such as Spiroplasma spp.

        Cite This Article
    EID Etienne N, Bret L, Le Brun C, Lecuyer H, Moraly J, Lanternier F, et al. Disseminated Spiroplasma apis Infection in Patient with Agammaglobulinemia, France. Emerg Infect Dis. 2018;24(12):2382-2386. https://dx.doi.org/10.3201/eid2412.180567
    AMA Etienne N, Bret L, Le Brun C, et al. Disseminated Spiroplasma apis Infection in Patient with Agammaglobulinemia, France. Emerging Infectious Diseases. 2018;24(12):2382-2386. doi:10.3201/eid2412.180567.
    APA Etienne, N., Bret, L., Le Brun, C., Lecuyer, H., Moraly, J., Lanternier, F....Lortholary, O. (2018). Disseminated Spiroplasma apis Infection in Patient with Agammaglobulinemia, France. Emerging Infectious Diseases, 24(12), 2382-2386. https://dx.doi.org/10.3201/eid2412.180567.
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  • Mycoplasma ovipneumoniae in Wildlife Species beyond Subfamily Caprinae PDF Version[PDF - 399 KB - 3 pages]
    M. A. Highland et al.
        View Abstract

    Elucidating the emergence of Mycoplasma ovipneumoniae–associated respiratory disease in ruminants requires identification of the pathogen host range. This bacterium was thought to be host restricted to subfamily Caprinae, but we describe its identification in healthy moose, caribou, and mule deer and diseased mule and white-tailed deer, all species in subfamily Capreolinae.

        Cite This Article
    EID Highland MA, Herndon DR, Bender SC, Hansen L, Gerlach RF, Beckmen KB. Mycoplasma ovipneumoniae in Wildlife Species beyond Subfamily Caprinae. Emerg Infect Dis. 2018;24(12):2384-2386. https://dx.doi.org/10.3201/eid2412.180632
    AMA Highland MA, Herndon DR, Bender SC, et al. Mycoplasma ovipneumoniae in Wildlife Species beyond Subfamily Caprinae. Emerging Infectious Diseases. 2018;24(12):2384-2386. doi:10.3201/eid2412.180632.
    APA Highland, M. A., Herndon, D. R., Bender, S. C., Hansen, L., Gerlach, R. F., & Beckmen, K. B. (2018). Mycoplasma ovipneumoniae in Wildlife Species beyond Subfamily Caprinae. Emerging Infectious Diseases, 24(12), 2384-2386. https://dx.doi.org/10.3201/eid2412.180632.
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  • Locally Acquired Leptospirosis in Expedition Racer, Manitoba, Canada PDF Version[PDF - 325 KB - 3 pages]
    S. S. Kassim et al.
        View Abstract

    Leptospirosis is found worldwide, except in northern regions. We report a case associated with a backcountry adventure race in Manitoba, Canada. Initially, nonspecific symptomatology and diagnostic pitfalls contributed to a delay in identification. Careful attention needs to be paid to exposure to and risk for leptospirosis in northern and temperate climates.

        Cite This Article
    EID Kassim SS, Dibernardo A, Lindsay L, Wuerz TC. Locally Acquired Leptospirosis in Expedition Racer, Manitoba, Canada. Emerg Infect Dis. 2018;24(12):2386-2388. https://dx.doi.org/10.3201/eid2412.181015
    AMA Kassim SS, Dibernardo A, Lindsay L, et al. Locally Acquired Leptospirosis in Expedition Racer, Manitoba, Canada. Emerging Infectious Diseases. 2018;24(12):2386-2388. doi:10.3201/eid2412.181015.
    APA Kassim, S. S., Dibernardo, A., Lindsay, L., & Wuerz, T. C. (2018). Locally Acquired Leptospirosis in Expedition Racer, Manitoba, Canada. Emerging Infectious Diseases, 24(12), 2386-2388. https://dx.doi.org/10.3201/eid2412.181015.
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About the Cover

  • An Icy Vista from a Golden Age PDF Version[PDF - 1.73 MB - 2 pages]
    B. Breedlove
            Cite This Article
    EID Breedlove B. An Icy Vista from a Golden Age. Emerg Infect Dis. 2018;24(12):2389-2390. https://dx.doi.org/10.3201/eid2412.ac2412
    AMA Breedlove B. An Icy Vista from a Golden Age. Emerging Infectious Diseases. 2018;24(12):2389-2390. doi:10.3201/eid2412.ac2412.
    APA Breedlove, B. (2018). An Icy Vista from a Golden Age. Emerging Infectious Diseases, 24(12), 2389-2390. https://dx.doi.org/10.3201/eid2412.ac2412.
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