Emerging Infectious Diseases journal
Culex pipiens and Aedes triseriatus Mosquito Susceptibility to Zika Virus M. T. Aliota et al. October 2016
Volume 22, Number 8—August 2016 PDF Version [PDF - 80.97 MB - 204 pages]
Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo
PDF Version [PDF - 4.50 MB - 7 pages]
D. Tappe et al.View SummaryView Abstract
Results of PCR and histology indicate this infection is endemic to this country.
Snakeborne Armillifer pentastomiasis is an emerging human parasitic infection in rural tropical areas where snake meat is eaten. After a series of severe ocular A. grandis larval infections and anecdotal abdominal infection in Sankuru District, Democratic Republic of the Congo, during 2014–2015, we systematically investigated possible pentastomid etiology in patients who underwent surgery in the region. Histologic and molecular analyses by established pentastomid 18S rDNA- and newly developed Armillifer-specific cytochrome oxidase PCRs revealed larval pentastomid lesions in 3.7% of patients. Some persons had A. armillatus and A. grandis co-infections. Another pentastomid larva, Raillietiella sp., was molecularly detected in 1 patient who had concomitant A. grandis and A. armillatus infection. The PCRs used were suitable for detecting pentastomid species even in highly necrotic tissues. Phylogenetic analyses of Armillifer cytochrome oxidase genes detected multiple local strains.
Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013–2014
PDF Version [PDF - 936 KB - 8 pages]
D. Schnabel et al.View SummaryView Abstract
Infections in 6 states were linked to persons traveling to undergo cosmetic surgical procedures.
During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment.
Probable Rabies Virus Transmission through Organ Transplantation, China, 2015
PDF Version [PDF - 710 KB - 5 pages]
H. Zhou et al.View SummaryView Abstract
Implementation of an effective regulatory system for testing donors would decrease the occurrence of donor-derived infectious diseases.
During July 2015, physicians at a hospital in Beijing, China, diagnosed rabies in 2 patients who had each received a kidney from a common organ donor who had died from acute progressive encephalitis of unknown cause. The patients had rabies incubation periods of 42 and 48 days. Altered mental status developed in both patients and progressively worsened to deep coma within 80 days after transplantation; both patients died. Two other transplant recipients received corneas but remained well after receiving timely rabies prophylaxis. An effective regulatory system for testing donors should be implemented to decrease the occurrence of donor-derived infectious diseases. In addition, health education should be improved to enhance public awareness of transplant-associated infectious diseases. Transplant recipients and other persons with exposure to organs or tissues from donors with rabies must be provided consistent health monitoring and follow-up, including rabies postexposure prophylaxis; any remaining organs and tissues must be quarantined and not transplanted.
Virulence and Evolution of West Nile Virus, Australia, 1960–2012
PDF Version [PDF - 1.60 MB - 10 pages]
N. A. Prow et al.View SummaryView Abstract
Despite the absence of disease in humans and animals, virulent virus strains have been circulating for >30 years.
Worldwide, West Nile virus (WNV) causes encephalitis in humans, horses, and birds. The Kunjin strain of WNV (WNVKUN) is endemic to northern Australia, but infections are usually asymptomatic. In 2011, an unprecedented outbreak of equine encephalitis occurred in southeastern Australia; most of the ≈900 reported cases were attributed to a newly emerged WNVKUN strain. To investigate the origins of this virus, we performed genetic analysis and in vitro and in vivo studies of 13 WNVKUN isolates collected from different regions of Australia during 1960–2012. Although no disease was recorded for 1984, 2000, or 2012, isolates collected during those years (from Victoria, Queensland, and New South Wales, respectively) exhibited levels of virulence in mice similar to that of the 2011 outbreak strain. Thus, virulent strains of WNVKUN have circulated in Australia for >30 years, and the first extensive outbreak of equine disease in Australia probably resulted from a combination of specific ecologic and epidemiologic conditions.
Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013
PDF Version [PDF - 2.18 MB - 8 pages]
X. Xu et al.View SummaryView Abstract
Malaria was concentrated in a few townships along the China–Myanmar border.
To identify township-level high-risk foci of malaria transmission in Yunnan Province, China, along the international border, we retrospectively reviewed data collected in hospitals and clinics of 58 townships in 4 counties during 2011–2013. We analyzed spatiotemporal distribution, especially hot spots of confirmed malaria, using geographic information systems and Getis-Ord Gi*(d) cluster analysis. Malaria incidence, transmission seasonality, and Plasmodium vivax:P. falciparum ratio remained almost unchanged from 2011 to 2013, but heterogeneity in distribution increased. The number of townships with confirmed malaria decreased significantly during the 3 years; incidence became increasingly concentrated within a few townships. High-/low-incidence clusters of P. falciparum shifted in location and size every year, whereas the locations of high-incidence P. vivax townships remained unchanged. All high-incidence clusters were located along the China–Myanmar border. Because of increasing heterogeneity in malaria distribution, microgeographic analysis of malaria transmission hot spots provided useful information for designing targeted malaria intervention during the elimination phase.
Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia
PDF Version [PDF - 2.73 MB - 10 pages]
R. Yusof et al.View SummaryView Abstract
Sequence analyses of genes derived from human and macaque samples led to the proposal that 2 distinct types exist.
Infections of humans with the zoonotic simian malaria parasite Plasmodium knowlesi occur throughout Southeast Asia, although most cases have occurred in Malaysia, where P. knowlesi is now the dominant malaria species. This apparently skewed distribution prompted an investigation of the phylogeography of this parasite in 2 geographically separated regions of Malaysia, Peninsular Malaysia and Malaysian Borneo. We investigated samples collected from humans and macaques in these regions. Haplotype network analyses of sequences from 2 P. knowlesi genes, type A small subunit ribosomal 18S RNA and cytochrome c oxidase subunit I, showed 2 genetically distinct divergent clusters, 1 from each of the 2 regions of Malaysia. We propose that these parasites represent 2 distinct P. knowlesi types that independently became zoonotic. These types would have evolved after the sea-level rise at the end of the last ice age, which separated Malaysian Borneo from Peninsular Malaysia.
Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria
PDF Version [PDF - 887 KB - 6 pages]
F. Kurth et al.View SummaryView Abstract
Clinicians should be aware of hemolysis in malaria patients with anemia who were given these drugs.
Episodes of delayed hemolysis 2–6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3–2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR −0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia.
Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014
PDF Version [PDF - 972 KB - 8 pages]
N. Aliabadi et al.View SummaryView Abstract
Odds of this viral infection in the nasopharynx were 10 times greater for children with this condition than for controls.
During August 8, 2014–October 14, 2014, a total of 11 children with acute flaccid myelitis and distinctive neuroimaging changes were identified near Denver, Colorado, USA. A respiratory prodrome was experienced by 10, and nasopharyngeal specimens were positive for enterovirus D68 (EV-D68) for 4. To determine whether an association exists between EV-D68 infection and acute flaccid myelitis, we conducted a retrospective case–control study comparing these patients with 2 groups of outpatient control children (1 group tested for acute respiratory illness and 1 for Bordetella pertussis infection). Adjusted analyses indicated that, for children with acute flaccid myelitis, the odds of having EV-D68 infection were 10.3 times greater than for those tested for acute respiratory infection and 4.5 times greater than for those tested for B. pertussis infection. No statistical association was seen between acute flaccid myelitis and non–EV-D68 enterovirus or rhinovirus infection. These findings support an association between EV-D68 infection and acute flaccid myelitis.
Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014
PDF Version [PDF - 2.04 MB - 8 pages]
M. Arwady et al.View SummaryView Abstract
Casual contact was not associated with transmission, and serologic methods were more sensitive than real-time reverse transcription-PCR.
Risk factors for human-to-human transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) are largely unknown. After MERS-CoV infections occurred in an extended family in Saudi Arabia in 2014, relatives were tested by using real-time reverse transcription PCR (rRT-PCR) and serologic methods. Among 79 relatives, 19 (24%) were MERS-CoV positive; 11 were hospitalized, and 2 died. Eleven (58%) tested positive by rRT-PCR; 8 (42%) tested negative by rRT-PCR but positive by serology. Compared with MERS-CoV–negative adult relatives, MERS-CoV–positive adult relatives were older and more likely to be male and to have chronic medical conditions. Risk factors for household transmission included sleeping in an index patient’s room and touching respiratory secretions from an index patient. Casual contact and simple proximity were not associated with transmission. Serology was more sensitive than standard rRT-PCR for identifying infected relatives, highlighting the value of including serology in future investigations.
Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households, Sierra Leone
PDF Version [PDF - 1.13 MB - 9 pages]
H. Bower et al.View SummaryView Abstract
Risk for disease correlated with level of exposure and was lowest for children 5–19 years of age.
Using histories of household members of Ebola virus disease (EVD) survivors in Sierra Leone, we calculated risk of EVD by age and exposure level, adjusting for confounding and clustering, and estimated relative risks. Of 937 household members in 94 households, 448 (48%) had had EVD. Highly correlated with exposure, EVD risk ranged from 83% for touching a corpse to 8% for minimal contact and varied by age group: 43% for children <2 years of age; 30% for those 5–14 years of age; and >60% for adults >30 years of age. Compared with risk for persons 20–29 years of age, exposure-adjusted relative risks were lower for those 5–9 (0.70), 10–14 (0.64), and 15–19 (0.71) years of age but not for children <2 (0.92) or 2–4 (0.97) years of age. Lower risk for 5–19-year-olds, after adjustment for exposure, suggests decreased susceptibility in this group.
Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014
PDF Version [PDF - 900 KB - 8 pages]
S. Haviari et al.View SummaryView Abstract
Multiple cases of prostatitis resulted from improper infection control measures.
We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13–October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case–control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.
Medscape CME Activity
Cutaneous Melioidosis Cluster Caused by Contaminated Wound Irrigation Fluid PDF Version [PDF - 1.17 MB - 8 pages]A. J. Merritt et al.View SummaryView Abstract
Burkholderia pseudomallei can cause healthcare-associated infections outside its recognized tropical zone.
Melioidosis usually occurs after environmental exposure to Burkholderia pseudomallei in the tropics. A cluster of 5 cutaneous melioidosis cases occurred in suburban southwest Australia after an earlier case in January 2012. We collected environmental samples at the first patient’s home in January 2012 and from a nearby health center in December 2013 after 2 new cases occurred in the same postal district. We isolated genotypically identical B. pseudomallei from the first patient and 5 other patients in the district. Environmental sampling implicated an opened bottle of saline wound irrigation fluid containing >106 B. pseudomallei/mL. The bottle included instructions to discard within 24 hours of opening. No further cases of B. pseudomallei infection occurred after removing the contaminated bottle. This cutaneous melioidosis cluster demonstrates that B. pseudomallei can survive and disseminate in widely used medical fluids beyond its known geographic distribution, highlighting a need to use these products according to manufacturers’ instructions.
Possible Role of Fish and Frogs as Paratenic Hosts of Dracunculus medinensis, Chad
PDF Version [PDF - 320 KB - 3 pages]
M. L. Eberhard et al.View SummaryView Abstract
Tadpoles fed infected copepods can harbor infective D. medinensis larvae and thus serve as potential paratenic hosts.
Copepods infected with Dracunculus medinensis larvae collected from infected dogs in Chad were fed to 2 species of fish and tadpoles. Although they readily ingested copepods, neither species of fish, Nile tilapia (Oreochromis niloticus) nor fathead minnow (Pimephalis promelas), were found to harbor Dracunculus larvae when examined 2–3 weeks later. Tadpoles ingested copepods much more slowly; however, upon examination at the same time interval, tadpoles of green frogs (Lithobates [Rana] clamitans) were found to harbor small numbers of Dracunculus larvae. Two ferrets (Mustela putorius furo) were fed fish or tadpoles that had been exposed to infected copepods. Only the ferret fed tadpoles harbored developing Dracunculus larvae at necropsy 70–80 days postexposure. These observations confirm that D. medinensis, like other species in the genus Dracunculus, can readily survive and remain infective in potential paratenic hosts, especially tadpoles.
Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015
PDF Version [PDF - 1010 KB - 7 pages]
R. Ratnayake et al.View SummaryView Abstract
Case detection improved, but many false alerts were generated, suggesting a need for additional staff training.
In 2015, community event–based surveillance (CEBS) was implemented in Sierra Leone to assist with the detection of Ebola virus disease (EVD) cases. We assessed the sensitivity of CEBS for finding EVD cases during a 7-month period, and in a 6-week subanalysis, we assessed the timeliness of reporting cases with no known epidemiologic links at time of detection. Of the 12,126 CEBS reports, 287 (2%) met the suspected case definition, and 16 were confirmed positive. CEBS detected 30% (16/53) of the EVD cases identified during the study period. During the subanalysis, CEBS staff identified 4 of 6 cases with no epidemiologic links. These CEBS-detected cases were identified more rapidly than those detected by the national surveillance system; however, too few cases were detected to determine system timeliness. Although CEBS detected EVD cases, it largely generated false alerts. Future versions of community-based surveillance could improve case detection through increased staff training and community engagement.
Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil
PDF Version [PDF - 618 KB - 7 pages]
I. Paploski et al.View SummaryView Abstract
There is strong evidence of a temporal relationship between virus infection in pregnant women and birth outcome.
Zika virus infection emerged as a public health emergency after increasing evidence for its association with neurologic disorders and congenital malformations. In Salvador, Brazil, outbreaks of acute exanthematous illness (AEI) attributed to Zika virus, Guillain-Barré syndrome (GBS), and microcephaly occurred in 2015. We investigated temporal correlations and time lags between these outbreaks to identify a common link between them by using epidemic curves and time series cross-correlations. Number of GBS cases peaked after a lag of 5–9 weeks from the AEI peak. Number of suspected cases of microcephaly peaked after a lag of 30–33 weeks from the AEI peak, which corresponded to time of potential infections of pregnant mothers during the first trimester. These findings support the association of GBS and microcephaly with Zika virus infection and provide evidence for a temporal relationship between timing of arboviral infection of pregnant women during the first trimester and birth outcome.
Human Babesiosis, Bolivia, 2013
PDF Version [PDF - 626 KB - 3 pages]
S. Gabrielli et al.View Abstract
To investigate human babesiosis in the Bolivian Chaco, in 2013 we tested blood samples from 271 healthy persons living in 2 rural communities in this region. Microscopy and PCR indicated that 3.3% of persons were positive for Babesia microti parasites (US lineage); seroprevalence was 45.7%. Appropriate screening should mitigate the risk for transfusion-associated babesiosis.
Use of Unamplified RNA/cDNA–Hybrid Nanopore Sequencing for Rapid Detection and Characterization of RNA Viruses
PDF Version [PDF - 826 KB - 4 pages]
A. Kilianski et al.View Abstract
Nanopore sequencing, a novel genomics technology, has potential applications for routine biosurveillance, clinical diagnosis, and outbreak investigation of virus infections. Using rapid sequencing of unamplified RNA/cDNA hybrids, we identified Venezuelan equine encephalitis virus and Ebola virus in 3 hours from sample receipt to data acquisition, demonstrating a fieldable technique for RNA virus characterization.
Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia
PDF Version [PDF - 1.37 MB - 4 pages]
L. A. Messenger et al.View Abstract
We report the characterization of Trypanosoma cruzi of southern South American origin among humans, domestic vectors, and peridomestic hosts in Colombia using high-resolution nuclear and mitochondrial genotyping. Expanding our understanding of the geographic range of lineage TcVI, which is associated with severe Chagas disease, will help clarify risk of human infection for improved disease control.
Lyssavirus in Indian Flying Foxes, Sri Lanka
PDF Version [PDF - 1.01 MB - 4 pages]
P. S. Gunawardena et al.View Abstract
A novel lyssavirus was isolated from brains of Indian flying foxes (Pteropus medius) in Sri Lanka. Phylogenetic analysis of complete virus genome sequences, and geographic location and host species, provides strong evidence that this virus is a putative new lyssavirus species, designated as Gannoruwa bat lyssavirus.
Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures
PDF Version [PDF - 457 KB - 4 pages]
S. Dittrich et al.View Abstract
Orientia tsutsugamushi, which requires specialized facilities for culture, is a substantial cause of disease in Asia. We demonstrate that O. tsutsugamushi numbers increased for up to 5 days in conventional hemocultures. Performing such a culture step before molecular testing could increase the sensitivity of O. tsutsugamushi molecular diagnosis.
Multilocus Sequence Typing Tool for Cyclospora cayetanensis
PDF Version [PDF - 1.00 MB - 4 pages]
Y. Guo et al.View Abstract
Because the lack of typing tools for Cyclospora cayetanensis has hampered outbreak investigations, we sequenced its genome and developed a genotyping tool. We observed 2 to 10 geographically segregated sequence types at each of 5 selected loci. This new tool could be useful for case linkage and infection/contamination source tracking.
Chagas Disease Screening in Maternal Donors of Publicly Banked Umbilical Cord Blood, United States
PDF Version [PDF - 1.20 MB - 3 pages]
J. M. Edwards et al.View Abstract
To assess patterns of Chagas disease, we reviewed results of screening umbilical cord blood from a US public cord blood bank during 2007–2014. Nineteen maternal donors tested positive for Trypanosoma cruzi parasites (0.04%). Because perinatal transmission of Chagas disease is associated with substantial illness, targeted prenatal programs should screen for this disease.
Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015
PDF Version [PDF - 1.51 MB - 3 pages]
D. A. Jobe et al.View Abstract
We confirmed Borrelia miyamotoi infection in 7 patients who had contracted an illness while near La Crosse, Wisconsin, USA, an area where Ixodes scapularis ticks are endemic. B. miyamatoi infection should now be considered among differential diagnoses for patients from the midwestern United States who have signs and symptoms suggestive of tickborne illness.
Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014
PDF Version [PDF - 429 KB - 3 pages]
J. S. Barkley et al.View Abstract
In November 2014, the Rhode Island Department of Health investigated a cluster of 3 listeriosis cases. Using whole-genome sequencing to support epidemiologic, laboratory, and environmental investigations, the department identified 1 restaurant as the likely source of the outbreak and also linked the establishment to a listeriosis case that occurred in 2013.
Onchocerca lupi Nematodes in Dogs Exported from the United States into Canada
PDF Version [PDF - 576 KB - 3 pages]
G. G. Verocai et al.View Abstract
The Onchocerca lupi nematode is an emerging helminth capable of infecting pets and humans. We detected this parasite in 2 dogs that were imported into Canada from the southwestern United States, a region to which this nematode is endemic. We discuss risk for establishment of O. lupi in Canada.
Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA
PDF Version [PDF - 1018 KB - 5 pages]
C. Langelier et al.View Abstract
After severe neurocognitive decline developed in an otherwise healthy 63-year-old man, brain magnetic resonance imaging showed eosinophilic meningoencephalitis and enhancing lesions. The patient tested positive for antibodies to Baylisascaris spp. roundworms, was treated with albendazole and dexamethasone, and showed improvement after 3 months. Baylisascariasis should be considered for all patients with eosinophilic meningitis.
Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick
PDF Version [PDF - 385 KB - 3 pages]
A. J. Henningsson et al.View Abstract
We report a case of human tick-borne encephalitis (TBE) in which the TBE virus was isolated from the biting tick. Viral growth and sequence were characterized and compared with those of a reference strain. Virus isolation from ticks from patients with TBE may offer a new approach for studies of epidemiology and pathogenicity.
Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues
PDF Version [PDF - 433 KB - 3 pages]
A. Bouin et al.View Abstract
We performed deep sequencing analysis of the enterovirus 5′ noncoding region in cardiac biopsies from a patient with dilated cardiomyopathy. Results displayed a mix of deleted and full-length coxsackievirus B3, characterized by a low viral RNA load (8.102 copies/μg of nucleic acids) and a low viral RNA positive-sense to RNA negative-sense ratio of 4.8.
Seroconversions for Coxiella and Rickettsial Pathogens among US Marines Deployed to Afghanistan, 2001–2010
PDF Version [PDF - 429 KB - 3 pages]
C. M. Farris et al.View Abstract
We assessed serum samples from 1,000 US Marines deployed to Afghanistan during 2001–2010 to find evidence of 4 rickettsial pathogens. Analysis of predeployment and postdeployment samples showed that 3.4% and 0.5% of the Marines seroconverted for the causative agents of Q fever and spotted fever group rickettsiosis, respectively.
Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda
PDF Version [PDF - 1.38 MB - 5 pages]
M. E. Roh et al.View Abstract
A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections.
Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014
PDF Version [PDF - 327 KB - 2 pages]
M. Baldi et al.
Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border
PDF Version [PDF - 354 KB - 3 pages]
M. Boullé et al.
Meningococcal Group W Disease in Infants and Potential Prevention by Vaccination
PDF Version [PDF - 850 KB - 3 pages]
S. R. Parikh et al.
Novel Reassortant Avian Influenza A(H5N6) Viruses in Humans, Guangdong, China, 2015
PDF Version [PDF - 444 KB - 3 pages]
Y. Shen et al.
Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia
PDF Version [PDF - 838 KB - 3 pages]
C. V. Moore et al.
Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013
PDF Version [PDF - 344 KB - 2 pages]
S. Puzelli et al.
Increase in Eyeworm Infections in Eastern Europe
PDF Version [PDF - 374 KB - 3 pages]
V. Colella et al.
Febrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panama
PDF Version [PDF - 480 KB - 3 pages]
D. Araúz et al.
Influenza D Virus Infection in Herd of Cattle, Japan
PDF Version [PDF - 704 KB - 3 pages]
S. Murakami et al.
Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24
PDF Version [PDF - 349 KB - 2 pages]
A. Kerdsin et al.
Zika Virus Disease in Traveler Returning from Vietnam to Israel
PDF Version [PDF - 399 KB - 2 pages]
E. Meltzer et al.
Books and Media
Adventures of a Female Medical Detective: In Pursuit of Smallpox and AIDS
PDF Version [PDF - 203 KB - 1 page]
About the Cover
Toward Developing a Preventive MERS-CoV Vaccine—Report from a Workshop Organized by the Saudi Arabia Ministry of Health and the International Vaccine Institute, Riyadh, Saudi Arabia, November 14–15, 2015
PDF Version [PDF - 822 KB - 7 pages]
J. Excler et al.View Abstract
Middle East respiratory syndrome (MERS) remains a serious international public health threat. With the goal of accelerating the development of countermeasures against MERS coronavirus (MERS-CoV), funding agencies, nongovernmental organizations, and researchers across the world assembled in Riyadh, Saudi Arabia, on November 14–15, 2015, to discuss vaccine development challenges. The meeting was spearheaded by the Saudi Ministry of Health and co-organized by the International Vaccine Institute, South Korea. Accelerating the development of a preventive vaccine requires a better understanding of MERS epidemiology, transmission, and pathogenesis in humans and animals. A combination of rodent and nonhuman primate models should be considered in evaluating and developing preventive and therapeutic vaccine candidates. Dromedary camels should be considered for the development of veterinary vaccines. Several vaccine technology platforms targeting the MERS-CoV spike protein were discussed. Mechanisms to maximize investment, provide robust data, and affect public health are urgently needed.
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