Emerging Infectious Diseases journal
Detection of Autochthonous Zika Virus Transmission in Sincelejo, Colombia E. Camacho et al. May 2016
Volume 22, Number 2—February 2016 PDF Version [PDF - 9.00 MB - 204 pages]
Ebola and Its Control in Liberia, 2014–2015
PDF Version [PDF - 525 KB - 9 pages]
T. G. Nyenswah et al.View SummaryView Abstract
Several factors explain the successful response to the outbreak in this country.
The severe epidemic of Ebola virus disease in Liberia started in March 2014. On May 9, 2015, the World Health Organization declared Liberia free of Ebola, 42 days after safe burial of the last known case-patient. However, another 6 cases occurred during June–July; on September 3, 2015, the country was again declared free of Ebola. Liberia had by then reported 10,672 cases of Ebola and 4,808 deaths, 37.0% and 42.6%, respectively, of the 28,103 cases and 11,290 deaths reported from the 3 countries that were heavily affected at that time. Essential components of the response included government leadership and sense of urgency, coordinated international assistance, sound technical work, flexibility guided by epidemiologic data, transparency and effective communication, and efforts by communities themselves. Priorities after the epidemic include surveillance in case of resurgence, restoration of health services, infection control in healthcare settings, and strengthening of basic public health systems.
Epidemiology of Epidemic Ebola Virus Disease in Conakry and Surrounding Prefectures, Guinea, 2014–2015
PDF Version [PDF - 524 KB - 6 pages]
A. Rico et al.View SummaryView Abstract
The capital and neighboring areas remain a focal point of transmission, requiring continued public health vigilance.
In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea’s capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea.
Hospital Preparations for Viral Hemorrhagic Fever Patients and Experience Gained from Admission of an Ebola Patient
PDF Version [PDF - 1.01 MB - 8 pages]
J. Haverkort et al.View SummaryView Abstract
Clear protocols, a buddy system, and intensive staff training increased the sense of safety and motivation among staff.
The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital’s preparations for an outbreak of viral hemorrhagic fever and its experience during admission of a patient with Ebola virus disease showed that the use of the buddy system, frequent training, and information sessions for staff and their relatives greatly increased the sense of safety and motivation among staff. Differing procedures among ambulance services limited the number of services used for transporting patients. Waste management was the greatest concern, and destruction of waste had to be outsourced. The admission of an Ebola patient proceeded without incident but led to considerable demands on staff. The maximum time allowed for wearing personal protective equipment was 45 minutes to ensure safety, and an additional 20 minutes was needed for recovery.
Trematode Fluke Procerovum varium as Cause of Ocular Inflammation in Children, South India
PDF Version [PDF - 772 KB - 9 pages]
L. Arya et al.View SummaryView Abstract
Larvae of this fluke are novel causes of granulomatous eye disease in children.
Trematodes are recognized as a group of emerging parasites in tropical countries. We identified a trematode as a cause of ocular granulomas that developed in children who bathed in ponds or rivers in South India. DNA was isolated from patients’ surgically excised granulomas and from the trematode cercariae (larvae) released by the snail Melanoides tuberculata in water in which the children bathed. Real-time and conventional PCRs were performed that targeted ribosomal DNA regions spanning the internal transcribed spacer 2 and 28S sequences of this trematode. The PCR-amplified products were subjected to bidirectional sequencing. Analysis of sequences for the granuloma samples and the trematode cercariae showed maximum sequence similarity with Procerovum varium (family Heterophyidae). Our results confirmed the etiology of the ocular infection, implicating snail vectors as environmental risk factors for ocular parasitosis.
Association between Landscape Factors and Spatial Patterns of Plasmodium knowlesi Infections in Sabah, Malaysia
PDF Version [PDF - 551 KB - 9 pages]
K. M. Fornace et al.View SummaryView Abstract
Forest loss and other environmental changes correlate with increased malaria incidence.
The zoonotic malaria species Plasmodium knowlesi has become the main cause of human malaria in Malaysian Borneo. Deforestation and associated environmental and population changes have been hypothesized as main drivers of this apparent emergence. We gathered village-level data for P. knowlesi incidence for the districts of Kudat and Kota Marudu in Sabah state, Malaysia, for 2008–2012. We adjusted malaria records from routine reporting systems to reflect the diagnostic uncertainty of microscopy for P. knowlesi. We also developed negative binomial spatial autoregressive models to assess potential associations between P. knowlesi incidence and environmental variables derived from satellite-based remote-sensing data. Marked spatial heterogeneity in P. knowlesi incidence was observed, and village-level numbers of P. knowlesi cases were positively associated with forest cover and historical forest loss in surrounding areas. These results suggest the likelihood that deforestation and associated environmental changes are key drivers in P. knowlesi transmission in these areas.
Feasibility of Xpert Ebola Assay in Médecins Sans Frontières Ebola Program, Guinea
PDF Version [PDF - 564 KB - 7 pages]
R. Van den Bergh et al.View SummaryView Abstract
This assay provides results in less time than routine PCR and is equally sensitive.
Rapid diagnostic methods are essential in control of Ebola outbreaks and lead to timely isolation of cases and improved epidemiologic surveillance. Diagnosis during Ebola outbreaks in West Africa has relied on PCR performed in laboratories outside this region. Because time between sampling and PCR results can be considerable, we assessed the feasibility and added value of using the Xpert Ebola Assay in an Ebola control program in Guinea. A total of 218 samples were collected during diagnosis, treatment, and convalescence of patients. Median time for obtaining results was reduced from 334 min to 165 min. Twenty-six samples were positive for Ebola virus. Xpert cycle thresholds were consistently lower, and 8 (31%) samples were negative by routine PCR. Several logistic and safety issues were identified. We suggest that implementation of the Xpert Ebola Assay under programmatic conditions is feasible and represents a major advance in diagnosis of Ebola virus disease without apparent loss of assay sensitivity.
Prognostic Indicators for Ebola Patient Survival
PDF Version [PDF - 578 KB - 7 pages]
S. J. Crowe et al.View SummaryView Abstract
Odds of survival were greatest when first Ebola virus–positive blood sample collected had low viral load.
To determine whether 2 readily available indicators predicted survival among patients with Ebola virus disease in Sierra Leone, we evaluated information for 216 of the 227 patients in Bo District during a 4-month period. The indicators were time from symptom onset to healthcare facility admission and quantitative real-time reverse transcription PCR cycle threshold (Ct), a surrogate for viral load, in first Ebola virus–positive blood sample tested. Of these patients, 151 were alive when detected and had reported healthcare facility admission dates and Ct values available. Time from symptom onset to healthcare facility admission was not associated with survival, but viral load in the first Ebola virus–positive blood sample was inversely associated with survival: 52 (87%) of 60 patients with a Ct of >24 survived and 20 (22%) of 91 with a Ct of <24 survived. Ct values may be useful for clinicians making treatment decisions or managing patient or family expectations.
Invasive Group A Streptococcus Infection among Children, Rural Kenya
PDF Version [PDF - 812 KB - 9 pages]
A. C. Seale et al.View SummaryView Abstract
These infections cause serious illness, especially in neonates.
To determine the extent of group A Streptococcus (GAS) infections in sub-Saharan Africa and the serotypes that cause disease, we analyzed surveillance data for 64,741 hospital admissions in Kilifi, Kenya, during 1998–2011. We evaluated incidence, clinical presentations, and emm types that cause invasive GAS infection. We detected 370 cases; of the 369 for which we had data, most were skin and soft tissue infections (70%), severe pneumonia (23%), and primary bacteremia (14%). Overall case-fatality risk was 12%. Incidence of invasive GAS infection was 0.6 cases/1,000 live births among neonates, 101/100,000 person-years among children <1 year of age, and 35/100,000 among children <5 years of age. Genome sequencing identified 88 emm types. GAS causes serious disease in children in rural Kenya, especially neonates, and the causative organisms have considerable genotypic diversity. Benefit from the most advanced GAS type–specific vaccines may be limited, and efforts must be directed to protect against disease in regions of high incidence.
Randomized Controlled Trial of Hospital-Based Hygiene and Water Treatment Intervention (CHoBI7) to Reduce Cholera
PDF Version [PDF - 602 KB - 9 pages]
C. George et al.View SummaryView Abstract
This intervention significantly reduced symptomatic Vibrio cholerae infection.
The risk for cholera infection is >100 times higher for household contacts of cholera patients during the week after the index patient seeks hospital care than it is for the general population. To initiate a standard of care for this high-risk population, we developed Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7), which promotes hand washing with soap and treatment of water. To test CHoBI7, we conducted a randomized controlled trial among 219 intervention household contacts of 82 cholera patients and 220 control contacts of 83 cholera patients in Dhaka, Bangladesh, during 2013–2014. Intervention contacts had significantly fewer symptomatic Vibrio cholerae infections than did control contacts and 47% fewer overall V. cholerae infections. Intervention households had no stored drinking water with V. cholerae and 14 times higher odds of hand washing with soap at key events during structured observation on surveillance days 5, 6, or 7. CHoBI7 presents a promising approach for controlling cholera among highly susceptible household contacts of cholera patients.
Medscape CME Activity
Sustained Transmission of Pertussis in Vaccinated, 1–5-Year-Old Children in a Preschool, Florida, USA PDF Version [PDF - 496 KB - 5 pages]J. Matthias et al.View SummaryView Abstract
Monitoring of vaccine performance is necessary to identify outbreaks or emerging epidemiologic trends.
In September 2013, local county health officials in Tallahassee, Florida, USA, were notified of a laboratory-confirmed pertussis case in a 1-year-old preschool attendee. During a 5-month period, 26 (22%) students 1–5 years of age, 2 staff from the same preschool, and 11 family members met the national case definition for pertussis. Four persons during this outbreak were hospitalized for clinical management of pertussis symptoms. Only 5 students, including 2 students with pertussis, had not received the complete series of vaccinations for pertussis. Attack rates in 1 classroom for all students who received the complete series of vaccinations for pertussis approached 50%. This outbreak raises concerns about vaccine effectiveness in this preschool age group and reinforces the idea that recent pertussis vaccination should not dissuade physicians from diagnosing, testing, or treating persons with compatible illness for pertussis.
Medscape CME Activity
Molecular Characterization of Invasive Streptococcus dysgalactiae subsp. equisimilis, Japan PDF Version [PDF - 606 KB - 8 pages]T. Wajima et al.View SummaryView Abstract
This infection is an increasing threat to aging populations.
We collected β-hemolytic streptococci (1,611 isolates) from patients with invasive streptococcal infections in Japan during April 2010–March 2013. Streptococcus dysgalactiae subsp. equisimilis (SDSE) was most common (n = 693); 99% of patients with SDSE infections were elderly (mean age 75 years, SD ±15 years). We aimed to clarify molecular and epidemiologic characteristics of SDSE isolates and features of patient infections. Bacteremia with no identified focus of origin and cellulitis were the most prevalent manifestations; otherwise, clinical manifestations resembled those of S. pyogenes infections. Clinical manifestations also differed by patient’s age. SDSE isolates were classified into 34 emm types; stG6792 was most prevalent (27.1%), followed by stG485 and stG245. Mortality rates did not differ according to emm types. Multilocus sequence typing identified 46 sequence types and 12 novel types. Types possessing macrolide- and quinolone-resistance genes were 18.4% and 2.6%, respectively; none showed β-lactam resistance. Among aging populations, invasive SDSE infections are an increasing risk.
Population Effects of Influenza A(H1N1) Pandemic among Health Plan Members, San Diego, California, USA, October–December 2009
PDF Version [PDF - 411 KB - 6 pages]
R. A. BitarView SummaryView Abstract
Population-specific data were collected and analyzed to improve planning for influenza pandemics.
Lacking population-specific data, activity of seasonal and pandemic influenza is usually tracked by counting the number of diagnoses and visits to medical facilities above a baseline. This type of data does not address the delivery of services in a specific population. To provide population-specific data, this retrospective study of patients with influenza-like illness, influenza, and pneumonia among members of a Kaiser Permanente health plan in San Diego, California, USA, during October–December 2009 was initiated. Population data included the number of outpatients accessing healthcare; the number of patients diagnosed with pneumonia; antimicrobial therapy administered; number of patients hospitalized with influenza, influenza-like illness, or pneumonia; level of care provided; and number of patients requiring specialized treatments (e.g., oxygen, ventilation, vasopressors). The rate of admissions specific to weeks and predictions of 2 epidemiologic models shows the strengths and weaknesses of those tools. Data collected in this study may improve planning for influenza pandemics.
Epidemiology of Serotype 1 Invasive Pneumococcal Disease, South Africa, 2003–2013
PDF Version [PDF - 665 KB - 10 pages]
C. von Mollendorf et al.View SummaryView Abstract
Because of the epidemic nature of this disease and its distinctive clinical features in this area, surveillance should continue.
In South Africa, 7-valent pneumococcal conjugate vaccine (PCV) was introduced in April 2009 and replaced with 13-valent PCV in April 2011. We describe the epidemiology of serotype 1 Streptococcus pneumoniae disease during the pre- and post-PCV eras (2003–2013). Using laboratory-based invasive pneumococcal disease (IPD) surveillance, we calculated annual incidences, identified IPD clusters, and determined serotype 1–associated factors. Of 46,483 IPD cases, 4,544 (10%) were caused by serotype 1. Two clusters of serotype 1 infection were detected during 2003–2004 and 2008–2012, but incidence decreased after 2011. Among children <5 years of age, those who had non–serotype 1 IPD had shorter hospital stays, fewer cases of penicillin-nonsusceptible disease, and lower HIV prevalence and in-hospital death rates than did those with serotype 1 IPD; similar factors were noted for older patients. Serotype 1 IPD had distinctive clinical features in South Africa, and annual incidences fluctuated, with decreases noted after the introduction of PCV13.
Dogs and Opossums Positive for Vaccinia Virus during Outbreak Affecting Cattle and Humans, São Paulo State, Brazil
PDF Version [PDF - 364 KB - 3 pages]
M. G. Peres et al.View Abstract
During a vaccinia virus (VACV) outbreak in São Paulo State, Brazil, blood samples were collected from cows, humans, other domestic animals, and wild mammals. Samples from 3 dogs and 3 opossums were positive for VACV by PCR. Results of gene sequencing yielded major questions regarding other mammalian species acting as reservoirs of VACV.
Hemorrhagic Fever with Renal Syndrome, Zibo City, China, 2006–2014
PDF Version [PDF - 379 KB - 3 pages]
L. Wang et al.View Abstract
Analysis of hemorrhagic fever with renal syndrome cases in Zibo City, China, during 2006–2014 showed that it occurred year-round. Peaks in spring and fall/winter were caused by Hantaan and Seoul viruses, respectively. Rodent hosts were the striped field mouse for Hantaan virus and the brown rat and house mouse for Seoul virus.
African Buffalo Movement and Zoonotic Disease Risk across Transfrontier Conservation Areas, Southern Africa
PDF Version [PDF - 553 KB - 4 pages]
A. Caron et al.View Abstract
We report on the long-distance movements of subadult female buffalo within a Transfrontier Conservation Area in Africa. Our observations confirm that bovine tuberculosis and other diseases can spread between buffalo populations across national parks, community land, and countries, thus posing a risk to animal and human health in surrounding wildlife areas.
Anaplasmataceae-Specific PCR for Diagnosis and Therapeutic Guidance for Symptomatic Neoehrlichiosis in Immunocompetent Host
PDF Version [PDF - 405 KB - 4 pages]
M. Schwameis et al.View Abstract
Candidatus Neoehrlichia is increasingly being recognized worldwide as a tickborne pathogen. We report a case of symptomatic neoehrlichiosis in an immunocompetent Austria resident who had recently returned from travel in Tanzania. The use of Anaplasmataceae-specific PCR to determine the duration of antimicrobial therapy seems reasonable to avert recrudescence.
Candidatus Coxiella massiliensis Infection
PDF Version [PDF - 1017 KB - 4 pages]
E. Angelakis et al.View Abstract
Bacteria genetically related to Coxiella burnetii have been found in ticks. Using molecular techniques, we detected Coxiella-like bacteria, here named Candidatus Coxiella massiliensis, in skin biopsy samples and ticks removed from patients with an eschar. This organism may be a common agent of scalp eschar and neck lymphadenopathy after tick bite.
Ebola Virus Persistence in Semen Ex Vivo
PDF Version [PDF - 311 KB - 3 pages]
R. J. Fischer et al.View Abstract
On March 20, 2015, a case of Ebola virus disease was identified in Liberia that most likely was transmitted through sexual contact. We assessed the efficiency of detecting Ebola virus in semen samples by molecular diagnostics and the stability of Ebola virus in ex vivo semen under simulated tropical conditions.
Ebola Virus RNA Stability in Human Blood and Urine in West Africa’s Environmental Conditions
PDF Version [PDF - 439 KB - 3 pages]
F. Janvier et al.View Abstract
We evaluated RNA stability of Ebola virus in EDTA blood and urine samples collected from infected patients and stored in West Africa’s environmental conditions. In blood, RNA was stable for at least 18 days when initial cycle threshold values were <30, but in urine, RNA degradation occurred more quickly.
Uveitis and Systemic Inflammatory Markers in Convalescent Phase of Ebola Virus Disease
PDF Version [PDF - 290 KB - 3 pages]
J. R. Chancellor et al.View Abstract
We report a case of probable Zaire Ebola virus–related ophthalmologic complications in a physician from the United States who contracted Ebola virus disease in Liberia. Uveitis, immune activation, and nonspecific increase in antibody titers developed during convalescence. This case highlights immune phenomena that could complicate management of Ebola virus disease–related uveitis during convalescence.
Louseborne Relapsing Fever among East African Refugees, Italy, 2015
PDF Version [PDF - 426 KB - 4 pages]
A. Lucchini et al.View Abstract
During June 9–September 30, 2015, five cases of louseborne relapsing fever were identified in Turin, Italy. All 5 cases were in young refugees from Somalia, 2 of whom had lived in Italy since 2011. Our report seems to confirm the possibility of local transmission of louse-borne relapsing fever.
Mediterranean Fin Whales (Balaenoptera physalus) Threatened by Dolphin MorbilliVirus
PDF Version [PDF - 533 KB - 4 pages]
S. Mazzariol et al.View Abstract
During 2011–2013, dolphin morbillivirus was molecularly identified in 4 stranded fin whales from the Mediterranean Sea. Nucleoprotein, phosphoprotein, and hemagglutinin gene sequences of the identified strain were highly homologous with those of a morbillivirus that caused a 2006–2007 epidemic in the Mediterranean. Dolphin morbillivirus represents a serious threat for fin whales.
Blastomyces gilchristii as Cause of Fatal Acute Respiratory Distress Syndrome
PDF Version [PDF - 339 KB - 3 pages]
D. Dalcin et al.View Abstract
Since the 2013 description of Blastomyces gilchristii, research describing the virulence or clinical outcome of B. gilchristii infection has been lacking. We report molecular evidence of B. gilchristii as an etiologic agent of fatal acute respiratory distress syndrome. B. gilchristii infection was confirmed by PCR and sequence analysis.
Effectiveness of Meningococcal B Vaccine against Endemic Hypervirulent Neisseria meningitidis W Strain, England
PDF Version [PDF - 321 KB - 3 pages]
S. N. Ladhani et al.View Abstract
Serum samples from children immunized with a meningococcal serogroup B vaccine demonstrated potent serum bactericidal antibody activity against the hypervirulent Neisseria meningitidis serogroup W strain circulating in England. The recent introduction of this vaccine into the United Kingdom national immunization program should also help protect infants against this endemic strain.
Frequency and Distribution of Rickettsiae, Borreliae, and Ehrlichiae Detected in Human-Parasitizing Ticks, Texas, USA
PDF Version [PDF - 416 KB - 4 pages]
E. A. Mitchell et al.View Abstract
To describe the presence and distribution of tickborne bacteria and their vectors in Texas, USA, we screened ticks collected from humans during 2008–2014 for Rickettsia, Borrelia, and Ehrlichia spp. Thirteen tick species were identified, and 23% of ticks carried bacterial DNA from at least 1 of the 3 genera tested.
High Prevalence of Borrelia miyamotoi among Adult Blacklegged Ticks from White-Tailed Deer
PDF Version [PDF - 480 KB - 3 pages]
S. Han et al.View Abstract
We compared the prevalence of Borrelia miyamotoi infection in questing and deer-associated adult Ixodes scapularis ticks in Wisconsin, USA. Prevalence among deer-associated ticks (4.5% overall, 7.1% in females) was significantly higher than among questing ticks (1.0% overall, 0.6% in females). Deer may be a sylvatic reservoir for this newly recognized zoonotic pathogen.
Bordetella pertussis Strain Lacking Pertactin and Pertussis Toxin
PDF Version [PDF - 371 KB - 4 pages]
M. M. Williams et al.View Abstract
A Bordetella pertussis strain lacking 2 acellular vaccine immunogens, pertussis toxin and pertactin, was isolated from an unvaccinated infant in New York State in 2013. Comparison with a French strain that was pertussis toxin–deficient, pertactin wild-type showed that the strains carry the same 28-kb deletion in similar genomes.
The Merits of Malaria Diagnostics during an Ebola Virus Disease Outbreak
PDF Version [PDF - 483 KB - 4 pages]
E. de Wit et al.View Abstract
Malaria is a major public health concern in the countries affected by the Ebola virus disease epidemic in West Africa. We determined the feasibility of using molecular malaria diagnostics during an Ebola virus disease outbreak and report the incidence of Plasmodium spp. parasitemia in persons with suspected Ebola virus infection.
Microevolution of Outbreak-Associated Middle East Respiratory Syndrome Coronavirus, South Korea, 2015
PDF Version [PDF - 416 KB - 4 pages]
M. Seong et al.View Abstract
During the 2015 Middle East respiratory syndrome coronavirus outbreak in South Korea, we sequenced full viral genomes of strains isolated from 4 patients early and late during infection. Patients represented at least 4 generations of transmission. We found no evidence of changes in the evolutionary rate and no reason to suspect adaptive changes in viral proteins.
Nanopore Sequencing as a Rapidly Deployable Ebola Outbreak Tool
PDF Version [PDF - 501 KB - 4 pages]
T. Hoenen et al.View Abstract
Rapid sequencing of RNA/DNA from pathogen samples obtained during disease outbreaks provides critical scientific and public health information. However, challenges exist for exporting samples to laboratories or establishing conventional sequencers in remote outbreak regions. We successfully used a novel, pocket-sized nanopore sequencer at a field diagnostic laboratory in Liberia during the current Ebola virus outbreak.
Acute Colitis Caused by Helicobacter trogontum in Immunocompetent Patient
PDF Version [PDF - 330 KB - 2 pages]
F. Dutasta et al.
Accuracy of Dengue Reporting by National Surveillance System, Brazil
PDF Version [PDF - 384 KB - 4 pages]
M. Silva et al.
Aberrant Ascaris suum Nematode Infection in Cattle, Missouri, USA
PDF Version [PDF - 328 KB - 2 pages]
H. L. Taylor et al.
Vectorborne Infections, Mali
PDF Version [PDF - 322 KB - 3 pages]
D. Safronetz et al.
Transdermal Diagnosis of Malaria Using Vapor Nanobubbles
PDF Version [PDF - 347 KB - 2 pages]
M. Rebelo et al.
Malaria in French Guiana Linked to Illegal Gold Mining
PDF Version [PDF - 353 KB - 3 pages]
V. Pommier de Santi et al.
Importation of Fosfomycin Resistance fosA3 Gene to Europe
PDF Version [PDF - 293 KB - 3 pages]
A. C. Mendes et al.
Mycoplasma pneumoniae Monoclonal P1 Type 2c Outbreak, Russia, 2013
PDF Version [PDF - 335 KB - 3 pages]
I. Edelstein et al.
Initial Costs of Ebola Treatment Centers in the United States
PDF Version [PDF - 312 KB - 3 pages]
J. J. Herstein et al.
Detection of Influenza D Virus among Swine and Cattle, Italy
PDF Version [PDF - 374 KB - 3 pages]
C. Chiapponi et al.
AP92-like Crimean-Congo Hemorrhagic Fever Virus in Hyalomma aegyptium Ticks, Algeria
PDF Version [PDF - 453 KB - 3 pages]
M. Kautman et al.
Transdermal Diagnosis of Malaria Using Vapor Nanobubbles
PDF Version [PDF - 270 KB - 1 page]
E. Lukianova-Hleb et al.
About the Cover
- Page created: January 25, 2016
- Page last updated: January 25, 2016
- Page last reviewed: January 25, 2016
- Centers for Disease Control and Prevention,
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