Early Release

Synopses

• Retrospective Analysis of Historical Listeria monocytogenes Clinical Isolates, New York, USA, 2000–2021
  H. Samut et al. View Abstract

  We used whole-genome sequencing data to investigate historical Listeria monocytogenes clinical (n = 1,046) and nonclinical (n = 1,325) isolates from New York, USA. Applying a threshold of <20 single-nucleotide polymorphism differences for single-linkage clustering, 321 clinical isolates clustered into 85 clusters ranging from 2–33 isolates per cluster. Fourteen clusters included isolates with outbreak codes (4 clusters with New York codes and 10 with multistate codes). Three New York outbreak codes were assigned to isolates that were genetically highly related and from cases <2 months apart. Fifteen clusters included isolates that were obtained >10 years apart; 33 clusters included isolates from the same or contiguous counties. Seventeen clusters included food and environmental isolates highly related to clinical isolates. These findings suggest that some listeriosis clusters can be local and span a long period, demonstrating the importance of investigating small, localized listeriosis cases with closely related isolates, even over long timeframes.

• Transmission of Rickettsia typhi from Organ Donor to 2 Kidney Transplant Recipients, Texas, USA, 2024
  J. C. Jones et al.

Research

• Spotted Fever Group Rickettsioses among Hospitalized Patients and Circulation of Rickettsia in Ticks, Kazakhstan, 2019
  Y. V. Bumburidi et al. View Abstract

  Testing for spotted fever group rickettsioses (SFGR) and the criteria for identifying suspected patients are not routinely used in Kazakhstan. In 2019, we performed a cross-sectional study in 6 sentinel hospitals in the Pavlodar region. We tested 105 hospitalized patients with SFGR-like symptoms by using PCR or indirect immunofluorescence antibody assay and identified 62 cases of SFGR. Most (78%) cases of disease were caused by Rickettsia sibirica and R. raoultii. Cutaneous signs (eschar or rash) were found in 87% of SFGR patients; 79% had a rash, 48% had an eschar, and 13% had neither. Testing of suspected rickettsia cases resulted in a 27% increase in laboratory-detected SFGR over the mean of the previous 3 years (62 vs. 49). Broadening the case definition by including fever, headache, or myalgia and expanding routine testing for suspected cases of SFGR could contribute to improved case detection and earlier treatment.

• Reptile Exposure among Human Salmonellosis Cases and Salmonella Serotypes Isolated from Reptiles, Ontario, Canada, 2015–2022
  K. Paphitis et al.
• Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017
  C. Rabault et al.
• Comparative Epidemiology of Salmonella Paratyphi A and Salmonella Typhi Causing Enteric Fever, Bangladesh, 2018–2020
  S. Rahman et al. View Abstract

  Enteric fever remains a public health challenge. We analyzed data from a cluster-randomized Vi-tetanus toxoid conjugate vaccine trial to compare the epidemiology between Salmonella enterica serovars Paratyphi A, which causes paratyphoid fever, and Typhi, which causes typhoid fever. The overall incidence rate of paratyphoid fever was 27 (95% CI 23–32)/100,000 person-years (PY) and of typhoid fever was 216 (95% CI 198–236)/100,000 PY. We observed the highest incidence for both diseases in children 2–4 years of age: 72 (95% CI 41–117)/100,000 PY for paratyphoid and 887 (95% CI 715–1,088)/100,000 PY for typhoid. Lack of private toilets and safe drinking water were associated with both diseases. Prevalence of multidrug resistance was significantly higher in Salmonella Typhi (20.2%) than in Salmonella Paratyphi A (0.8%) (p<0.001). Our data suggest that integrated control measures targeting water, sanitation, and hygiene measures and bivalent vaccine targeting both pathogens are promising strategies to control both diseases.

• Prolonged Monkeypox Virus Infections, California, USA, May 2022–August 2024
  S. Schildhauer et al. View Abstract

  Monkeypox virus (MPXV) infection typically lasts 14–28 days. Prolonged MPXV infection, in which symptoms or test positivity last >28 days, has been documented but not fully characterized. We used the California Department of Public Health (California, USA) mpox registry to compare prolonged (>28 days) and nonprolonged (<28 days) mpox cases by demographics, HIV status, and JYNNEOS vaccination status. Of 6,469 cases, 82 (1.3%) were prolonged. Persons with prolonged MPXV infections were more likely to be Black or African American (prolonged, 20.7%, vs. nonprolonged, 11.6%) and to have HIV (prolonged, 61.0%, vs. nonprolonged, 39.9%). Among persons with HIV, prolonged infections were more likely among those with lower (<200) CD4 counts (prolonged, 10.0%, vs. nonprolonged, 3.9%) or not engaged in HIV care (prolonged, 46.0%, vs. nonprolonged, 18.1%). No prolonged infections occurred in persons who received 2 JYNNEOS vaccine doses. Groups disproportionately affected by prolonged mpox should be prioritized for mpox vaccine education and outreach.

• Differences in COVID-19 Fatality Rates among Ethnic Groups, Hawaii, USA, 2020–2022
  G. Devendra et al. View Abstract

  Asian American, Native Hawaiian, and Pacific Islander populations have been underrepresented in research on COVID-19 outcomes. We conducted a cross-sectional study of 5,494 electronic medical records of patients in a large tertiary care health system in the ethnically diverse state of Hawaii, USA. We compared fatality rates for hospitalized patients on the basis of race or ethnicity, age, vaccination status, and sequential organ failure assessment (SOFA) score at admission. Fatality rates varied between racial and ethnic groups but were associated with increasing age across all groups. Fatality rates were closely associated with increasing SOFA score and were inversely associated with the number of COVID-19 vaccinations received. We found that Asian and Pacific Islander groups experienced higher rates of in-hospital death and that death was strongly associated with increased age and SOFA score and with <1 COVID-19 vaccination. Clinicians should be aware of these outcomes when treating COVID-19 patients from these ethnic groups.

• Effect of Seasonal Influenza Vaccines on Avian Influenza A(H5N1) Clade 2.3.4.4b Virus Infection in Ferrets
  X. Sun et al. View Abstract

  Highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b viruses have infected >1,000 herds of dairy cattle and hundreds of poultry flocks in the United States since the beginning of 2024. Seventy human cases have been reported during that period, mainly through occupational exposure. Although prior influenza A(H1N1)pdm09 virus infection has been shown to confer protection against influenza A(H5N1) clade 2.3.4.4b virus infection in the ferret model, it remains unclear if influenza vaccines, known to elicit a less potent and narrower cross-reactive immune response, can achieve a similar effect. In this article, we demonstrate that immunization with commercially available human seasonal influenza vaccines also confers partial protection against disease caused by H5N1 clade 2.3.4.4b virus in ferrets, which is partially associated with the presence of cross-reactive antibodies targeting H5N1 virus antigens.

• Multidrug-Resistant pESI-Harboring Salmonella Muenchen ST82 in Poultry and Humans, Israel, 2020–2023
  J. Perry et al.

Dispatches

• Escherichia coli Sequence Type 131-H22 in Parrots from Illegal Pet Trade, Brazil, 2024
  V. Rocha et al. View Abstract

  Escherichia coli sequence type 131:H:22 is a consequential lineage of extraintestinal pathogenic E. coli, associated with human pyelonephritis and sepsis. We report the transmission of avian pathogenic E. coli in a parrot rehabilitation center in Brazil and the presence of a high-risk zoonotic lineage of extraintestinal pathogenic E. coli sequence type 131-H22.

• Detection of Monkeypox Virus Clade Ib in Wastewater Solids at Wastewater Treatment Plants, United States
  A. B. Boehm et al. View Abstract

  We used a sensitive and specific PCR to detect monkeypox virus clade Ib DNA from >3,000 wastewater samples collected prospectively across the United States. Monkeypox virus clade Ib DNA was detected in 1 sample from a location with a confirmed case; it was not detected in locations with no confirmed cases.

• Fatal Pneumocephalus Caused by Hypervirulent Klebsiella pneumoniae, Germany
  N. Gläser et al. View Abstract

  We report a fatal case of pneumocephalus in Germany caused by hypervirulent Klebsiella pneumoniae sequence type 23, confirmed by using clinical, histopathologic, and genomic analyses. The patient reported no travel history, suggesting local emergence. This unusual case reveals an unclear pathogen prevalence and demonstrates the need for increased awareness of global spread.

• Genomic Investigation of Disseminated Gonococcal Infections, Minnesota, USA, 2024
  D. Evans et al. View Abstract

  This article summarizes a genomic investigation of a 4-fold increase in disseminated gonococcal infections in Minnesota, USA, in 2024. We detected the emergence of a Neisseria gonorrhoeae strain of a rarely observed sequence type, which carries a porB1a allele previously associated with disseminated disease and lacks a gonococcal genetic island.

• Emergence and Polyclonal Dissemination of bla_NDM-7–Carrying InX3 Plasmid in Enterobacter cloacae Complex, France, 2021–2023
  I. Rezzoug et al. View Abstract

  Among 3,367 New Delhi metallo-β-lactamase–producing Enterobacterales isolates collected in France during 2021–2023, we found the bla_NDM-7 gene systematically localized on 2 closely related InX3 plasmids known to harbor antimicrobial resistance and virulence factors. Enhanced surveillance to monitor spread of antimicrobial resistance is needed among New Delhi metallo-β-lactamase–producing Enterobacterales.

• Antimicrobial-Resistant Clonal Complex 11 Neisseria meningitidis–Associated Urethritis Cluster, Thailand
  J. C. Cartee et al. View Abstract

  Sexually transmitted infections clinics in Bangkok, Thailand, reported increasing numbers of men with Neisseria meningitidis–associated urethritis during 2017–2023. Genomic analysis indicated global expansion of the nongroupable clonal complex 11 N. meningitidis urethritis clade. Continued global surveillance is needed to monitor the spread of antimicrobial-resistant N. meningitidis with urethral adaptability.

• Genetic Cluster of Extended-Spectrum β-lactamase–Producing Klebsiella pneumoniae in Humans and Food, Switzerland, 2018–2019
  L. Aguilar-Bultet et al. View Abstract

  We describe a cluster of genetically related extended-spectrum β-lactamase–producing Klebsiella pneumoniae sequence type 14 recovered from human clinical samples and an alfalfa-cress sample collected by systematic food sampling in Basel, Switzerland. Our findings suggest food could represent a reservoir contributing to spread of extended-spectrum β-lactamase–producing Enterobacterales.

• Bat-Associated Hemotropic Mycoplasmas in Immunosuppressed Children, Spain, 2024
  F. Esperón et al. View Abstract

  We report the detection of hemotropic mycoplasmas in 4 immunosuppressed pediatric patients in Spain: 2 solid organ transplant recipients, 1 hematopoietic stem cell transplant recipient, and 1 cancer patient. Sequences were 100% identical to a strain previously identified in Miniopterus schreibersii bats, which raises concerns about unnoticed zoonotic transmission.

• Emergence of Bordetella holmesii–Associated Pertussis-Like Illness, Northern India, 2019–2023
  N. Shekhar et al. View Abstract

  We investigated Bordetella holmesii and Bordetella pertussis in 935 suspected pertussis cases in northern India (2019–2023) using PCR and serology. B. holmesii showed increased prevalence in pertussis cases, particularly in older children, highlighting its emerging role and the need for ongoing surveillance and adjusted prevention strategies.

• Seoul Virus Infection Acquired at Private Pet Rat Breeding Facility, Germany, 2024
  F. Baalmann et al. View Abstract

  We report a case of severe acute kidney injury in a patient in Germany infected with Seoul virus. Clinical and laboratory analysis linked the infection to a pet rat breeding facility in central Germany. Increased surveillance and a One Health approach are needed, given the rising popularity of pet rats.

• Investigation of Possible Intraoperative Transmission of Brucella melitensis, Slovenia
  I. Potparić et al.
• Zoonotic Baylisascaris procyonis in Raccoons, Mississippi, USA, 2023–2024
  B. L. Huerta-Beltrán et al.
• Zoonotic Soil-Transmitted Helminth Infections among Humans, Gabon
  H. Zhao et al. View Abstract

  We report human infections with Necator gorillae and Strongyloides fuelleborni, zoonotic helminths from nonhuman primates, in Gabon. We also detected a cryptic Ancylostoma species helminth. Infections occurred in settings of localized deforestation and environmental degradation, which increase human–animal contact. Surveillance to clarify the extent of human infections is needed.

• Zoonotic Baylisascaris procyonis Infection in Raccoons, Mississippi, USA, 2023–2024
  B. L. Huerta-Beltrán et al. View Abstract

  Baylisascaris procyonis, an emerging zoonotic parasite, causes clinically significant visceral, ophthalmologic, and neurologic disease in humans. We screened raccoons (n = 46) collected from central and southern Mississippi for B. procyonis by necropsy (13.0% prevalence) and droplet digital PCR of feces (26.7% prevalence). Further surveillance to determine raccoon infection rates throughout Mississippi is indicated.

Research Letters

• Disseminated Blastomycosis Mimicking Tuberculosis, China
  C. Guo et al. View Abstract

  Blastomycosis is endemic in central and southern North America but rare in China. It can mimic community-acquired pneumonia, tuberculosis, or cancer. We describe a patient who initially had tuberculosis diagnosed and later had blastomycosis diagnosed through metagenomic detection, which aided diagnosis and treatment. Clinicians should consider blastomycosis in differential diagnoses for respiratory diseases.

• Angiostrongylus cantonensis Lungworms in Definitive and Intermediate Hosts, Madagascar, 2024
  L. A. Maminirina et al. View Abstract

  We assessed the prevalence of the rat lungworm, Angiostrongylus cantonensis, in rats and snails in Toamasina, Madagascar, using molecular techniques. Although no human cases of neuroangiostrongyliasis have been reported in Madagascar, the pathogen’s presence in definitive hosts (2.5%, 2/78) and intermediate hosts (26.9%, 35/130) reveals active circulation and potential zoonotic risk.

• Cutaneous Coccidioidomycosis Mimicking Rosacea in Immunosuppressed Patient, Arizona, USA, 2024
  S. Obagi et al. View Abstract

  An immunocompromised patient in Arizona, USA, experienced cutaneous coccidioidomycosis mimicking rosacea-like dermatitis; she was receiving vandetanib therapy. Histopathology confirmed the diagnosis despite inconclusive serologic results. Lesions resolved with fluconazole treatment, but blue-gray hyperpigmentation persisted, likely linked to vandetanib. This case highlights diagnostic challenges in endemic fungal infections and rare drug-associated hyperpigmentation.

• Jorge Lobo’s Disease in Child with Tick Exposure, Brazil
  F. Gonçalves et al. View Abstract

  Jorge Lobo’s disease (JLD), caused by Paracoccidioides lobogeorgii, primarily affects inhabitants of the Amazon Forest. We report a 9-year-old boy in Brazil who had JLD diagnosed after a tick bite. The rarity of pediatric cases likely reflects surveillance gaps. Increased clinical awareness is crucial for early JLD detection and intervention, especially in endemic regions.

• Detection of Immunity Gap before Measles Outbreak, Ho Chi Minh City, Vietnam, 2024
  T. Ong et al. View Abstract

  In 2022, we established a residual sample serosurveillance program in Ho Chi Minh City, Vietnam. During September 2022–April 2024, we found low measles antibody seroprevalence in children in the city’s western region, where a measles outbreak began in May 2024. Serosurveillance could be a useful tool for outbreak prediction and prevention.

• Crimean-Congo Hemorrhagic Fever Virus Circulation in Wild European Rabbits, Portugal, 2018−2023
  C. Baptista et al. View Abstract

  Crimean-Congo hemorrhagic fever virus is considered a public health risk in southwestern Europe. We surveyed serum samples from 667 European rabbits across Portugal, a rabbit species known to host immature Hyalomma lusitanicum ticks. We found low levels of virus antibodies (>1%), with a localized cluster reaching 5.77% in southern populations.

• Neonatal Gonococcal Conjunctivitis Caused by Fluoroquinolone-Resistant Neisseria gonorrhoeae
  H. Mizushima et al. View Abstract

  Prophylaxis for ophthalmia neonatorum remains in use despite decreased incidence of the condition. We report a breakthrough case of neonatal conjunctivitis in Japan caused by a levofloxacin-resistant Neisseria gonorrhoeae bacteria strain, co-infected with Chlamydia trachomatis bacteria. This case highlights failures in screening, prophylaxis, and treatment, underscoring the need to reassess prevention strategies.

• Increased Rates of Purpureocillium lilacinum among Laboratory Culture Results, United States
  D. J. Smith et al.
• Detection of Burkholderia thailandensis in Soil Samples, Suriname
  J. Savelkoel et al.

Letters

• Emerging Sexual Transmission of Trichophyton mentagrophytes Genotype VII Infections, United States
  P. Anand et al. View Abstract

  Trichophyton mentagrophytes genotype VII (TMVII) is an emerging dermatophyte strain associated with sexual transmission among men who have sex with men. A hypothesis-generating query of US infectious diseases specialists found that 56% had heard of TMVII and 23% knew how to treat TMVII infections, underscoring a need for increased clinician education.

• Invasive urogenital Neisseria meningitidis serogroup Y multilocus Sequence Type 1466
  C. R. George et al.

Etymologia

• Malassezia [mal″ə-sē′zhə]
  F. P. Sellera et al.

About the Cover

• A Personal Journey Through the Microbial World in Quilting
  L. Mitchell

Supplement

• Long-Term Illness in Adults Hospitalized for Respiratory Syncytial Virus Disease, United States, February 2022–September 2023
  A. M. Leis et al.
• Nonspecific Symptoms Attributable to Lyme Disease in High-Incidence Areas, United States
  C. C. Nawrocki et al.
• Persistence of Symptoms among Commercially Insured Patients with Coccidioidomycosis, United States, 2017–2023
  I. Hennessee et al.
• Progress Toward Understanding Infection-Associated Chronic Conditions and Illnesses
  A. E. Fiore

Synopses

• Haematospirillum jordaniae Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020
  M. Dulcey et al.
• Trichosporon austroamericanum Infections among Hospitalized Patients, France, 2022–2024
  E. Burel et al.

Research

• Pregnancy Outcomes after Exposure to Tuberculosis Treatment in Phase 3 Clinical Trial, 2016–2020
  E. V. Kurbatova et al.

Dispatch

• Borrelia afzelii Hepatitis in Patient Treated with Venetoclax and Obinutuzumab, Switzerland
  G. Capoferri et al.

Research Letters

• Two Cases of Autochthonous West Nile Virus Encephalitis, Paris, France, 2025
  N. Hassold-Rugolino et al. View Abstract

  We report 2 cases of febrile lymphocytic meningitis with encephalitis in patients in France. One patient had not traveled outside Paris; the other had traveled to eastern France. Laboratory findings revealed acute West Nile virus infection. The cases occurred days apart, raising concern the virus has spread further in France.

• Molecular Evidence of Dengue Virus Type 2 Emergence from Returning Travelers, Sinai Peninsula
  N. S. Zuckerman et al.