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Volume 10, Number 10—October 2004

Volume 10, Number 10—October 2004   PDF Version [PDF - 7.92 MB - 187 pages]

Perspective

  • Current Epidemiology of Pneumocystis Pneumonia PDF Version [PDF - 230 KB - 8 pages]
    A. Morris et al.
        View Abstract

    Pneumocystis pneumonia (PCP) has historically been one of the leading causes of disease among persons with AIDS. The introduction of highly active antiretroviral therapy in industrialized nations has brought about dramatic declines in the incidence of AIDS-associated complications, including PCP. In the adult population, the incidence of PCP has significantly decreased, but it remains among the most common AIDS-defining infections. Similar declines have been documented in the pediatric population. In much of the developing world, PCP remains a significant health problem, although its incidence among adults in sub-Saharan Africa has been debated. This review discusses the epidemiology of PCP during the current era of the AIDS epidemic. Although fewer cases of PCP occur in the industrialized countries, increasing drug-resistant HIV infections, possible drug-resistant PCP, and to the tremendous number of AIDS cases in developing countries make this disease of continued public health importance.

        Cite This Article
    EID Morris A, Lundgren JD, Masur H, Walzer PD, Hanson DL, Frederick T, et al. Current Epidemiology of Pneumocystis Pneumonia. Emerg Infect Dis. 2004;10(10):1713-1720. https://dx.doi.org/10.3201/eid1010.030985
    AMA Morris A, Lundgren JD, Masur H, et al. Current Epidemiology of Pneumocystis Pneumonia. Emerging Infectious Diseases. 2004;10(10):1713-1720. doi:10.3201/eid1010.030985.
    APA Morris, A., Lundgren, J. D., Masur, H., Walzer, P. D., Hanson, D. L., Frederick, T....Kaplan, J. E. (2004). Current Epidemiology of Pneumocystis Pneumonia. Emerging Infectious Diseases, 10(10), 1713-1720. https://dx.doi.org/10.3201/eid1010.030985.
  • Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance PDF Version [PDF - 244 KB - 8 pages]
    L. Huang et al.
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    Pneumocystis pneumonia (PCP) remains a major cause of illness and death in HIV-infected persons. Sulfa drugs, trimethoprim-sulfamethoxazole (TMP-SMX) and dapsone are mainstays of PCP treatment and prophylaxis. While prophylaxis has reduced the incidence of PCP, its use has raised concerns about development of resistant organisms. The inability to culture human Pneumocystis, Pneumocystis jirovecii, in a standardized culture system prevents routine susceptibility testing and detection of drug resistance. In other microorganisms, sulfa drug resistance has resulted from specific point mutations in the dihydropteroate synthase (DHPS) gene. Similar mutations have been observed in P. jirovecii. Studies have consistently demonstrated a significant association between the use of sulfa drugs for PCP prophylaxis and DHPS gene mutations. Whether these mutations confer resistance to TMP-SMX or dapsone plus trimethoprim for PCP treatment remains unclear. We review studies of DHPS mutations in P. jirovecii and summarize the evidence for resistance to sulfamethoxazole and dapsone.

        Cite This Article
    EID Huang L, Crothers K, Atzori C, Benfield T, Miller R, Rabodonirina M, et al. Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance. Emerg Infect Dis. 2004;10(10):1721-1728. https://dx.doi.org/10.3201/eid1010.030994
    AMA Huang L, Crothers K, Atzori C, et al. Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance. Emerging Infectious Diseases. 2004;10(10):1721-1728. doi:10.3201/eid1010.030994.
    APA Huang, L., Crothers, K., Atzori, C., Benfield, T., Miller, R., Rabodonirina, M....Helweg-Larsen, J. (2004). Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance. Emerging Infectious Diseases, 10(10), 1721-1728. https://dx.doi.org/10.3201/eid1010.030994.
  • Strain Typing Methods and Molecular Epidemiology of Pneumocystis Pneumonia PDF Version [PDF - 148 KB - 7 pages]
    C. Ben Beard et al.
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    Pneumocystis pneumonia (PCP) caused by the opportunistic fungal agent Pneumocystis jirovecii (formerly Pneumocystis carinii) continues to cause illness and death in HIV-infected patients. In the absence of a culture system to isolate and maintain live organisms, efforts to type and characterize the organism have relied on polymerase chain reaction–based approaches. Studies using these methods have improved understanding of PCP epidemiology, shedding light on sources of infection, transmission patterns, and potential emergence of antimicrobial resistance. One concern, however, is the lack of guidance regarding the appropriateness of different methods and standardization of these methods, which would facilitate comparing results reported by different laboratories.

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    EID Ben Beard C, Roux P, Nevez G, Hauser PM, Kovacs JA, Unnasch TR, et al. Strain Typing Methods and Molecular Epidemiology of Pneumocystis Pneumonia. Emerg Infect Dis. 2004;10(10):1729-1735. https://dx.doi.org/10.3201/eid1010.030981
    AMA Ben Beard C, Roux P, Nevez G, et al. Strain Typing Methods and Molecular Epidemiology of Pneumocystis Pneumonia. Emerging Infectious Diseases. 2004;10(10):1729-1735. doi:10.3201/eid1010.030981.
    APA Ben Beard, C., Roux, P., Nevez, G., Hauser, P. M., Kovacs, J. A., Unnasch, T. R....Lundgren, B. (2004). Strain Typing Methods and Molecular Epidemiology of Pneumocystis Pneumonia. Emerging Infectious Diseases, 10(10), 1729-1735. https://dx.doi.org/10.3201/eid1010.030981.
  • West Nile Virus Economic Impact, Louisiana, 2002 PDF Version [PDF - 141 KB - 9 pages]
    A. Zohrabian et al.
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    2002 WNV epidemic in Louisiana incurred substantial short-term economic costs

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    West Nile virus (WNV) is transmitted by mosquitoes and can cause illness in humans ranging from mild fever to encephalitis. In 2002, a total of 4,156 WNV cases were reported in the United States; 329 were in Louisiana. To estimate the economic impact of the 2002 WNV epidemic in Louisiana, we collected data from hospitals, a patient questionnaire, and public offices. Hospital charges were converted to economic costs by using Medicare cost-to-charge ratios. The estimated cost of the Louisiana epidemic was $20.1 million from June 2002 to February 2003, including a $10.9 million cost of illness ($4.4 million medical and $6.5 million nonmedical costs) and a $9.2 million cost of public health response. These data indicate a substantial short-term cost of the WNV disease epidemic in Louisiana.

        Cite This Article
    EID Zohrabian A, Meltzer MI, Ratard R, Billah K, Molinari NA, Roy K, et al. West Nile Virus Economic Impact, Louisiana, 2002. Emerg Infect Dis. 2004;10(10):1736-1744. https://dx.doi.org/10.3201/eid1010.030925
    AMA Zohrabian A, Meltzer MI, Ratard R, et al. West Nile Virus Economic Impact, Louisiana, 2002. Emerging Infectious Diseases. 2004;10(10):1736-1744. doi:10.3201/eid1010.030925.
    APA Zohrabian, A., Meltzer, M. I., Ratard, R., Billah, K., Molinari, N. A., Roy, K....Petersen, L. R. (2004). West Nile Virus Economic Impact, Louisiana, 2002. Emerging Infectious Diseases, 10(10), 1736-1744. https://dx.doi.org/10.3201/eid1010.030925.

Research

  • Virus-specific RNA and Antibody from Convalescent-phase SARS Patients Discharged from Hospital PDF Version [PDF - 104 KB - 6 pages]
    H. N. Leong et al.
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    Severe acute respiratory syndrome (SARS) is caused by a novel coronavirus (SARS-CoV). In a longitudinal cross-sectional study, we determined the prevalence of virus in bodily excretions and time of seroconversion in discharged patients with SARS. Conjunctival, throat, stool, and urine specimens were collected weekly from 64 patients and tested for SARS-CoV RNA by real-time polymerase chain reaction; serum samples were collected weekly and tested for SARS-CoV antibody with indirect enzyme immunoassay and immunofluorescence assay. In total, 126 conjunctival, 124 throat swab, 116 stool, and 124 urine specimens were analyzed. Five patients had positive stool samples, collected weeks 5–9. Two patients seroconverted in weeks 7 and 8; the others were seropositive at the first serum sample collection. In this study, 5 (7.8%) of 64 patients continued to shed viral RNA in stool samples only, for up to week 8 of illness. Most seroconversions occurred by week 6 of illness.

        Cite This Article
    EID Leong HN, Chan KP, Khan A, Oon L, Se-Thoe SY, Bai XL, et al. Virus-specific RNA and Antibody from Convalescent-phase SARS Patients Discharged from Hospital. Emerg Infect Dis. 2004;10(10):1745-1750. https://dx.doi.org/10.3201/eid1010.040026
    AMA Leong HN, Chan KP, Khan A, et al. Virus-specific RNA and Antibody from Convalescent-phase SARS Patients Discharged from Hospital. Emerging Infectious Diseases. 2004;10(10):1745-1750. doi:10.3201/eid1010.040026.
    APA Leong, H. N., Chan, K. P., Khan, A., Oon, L., Se-Thoe, S. Y., Bai, X. L....Ling, A. E. (2004). Virus-specific RNA and Antibody from Convalescent-phase SARS Patients Discharged from Hospital. Emerging Infectious Diseases, 10(10), 1745-1750. https://dx.doi.org/10.3201/eid1010.040026.
  • Fluoroquinolone Resistance in Penicillin-resistant Streptococcus pneumoniae Clones, Spain PDF Version [PDF - 203 KB - 9 pages]
    A. G. de la Campa et al.
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    Among 2,882 Streptococcus pneumoniae sent to the Spanish Reference Laboratory during 2002, 75 (2.6%) were ciprofloxacin-resistant. Resistance was associated with older patients (3.9% in adults and 7.2% in patients >65 years of age), with isolation from noninvasive sites (4.3% vs. 1.0%), and with penicillin and macrolide resistance. Among 14 low-level resistant (MIC 4–8 μg/mL) strains, 1 had a fluoroquinolone efflux phenotype, and 13 showed single ParC changes. The 61 high-level ciprofloxacin-resistant (MIC ≥16 μg/mL) strains showed either two or three changes at ParC, ParE, and GyrA. Resistance was acquired either by point mutation (70 strains) or by recombination with viridans streptococci (4 strains) at the topoisomerase II genes. Although 36 pulsed-field gel electrophoresis patterns were observed, 5 international multiresistant clones (Spain23F-1, Spain6B-2, Spain9V-3, Spain14-5 and Sweden15A-25) accounted for 35 (46.7%) of the ciprofloxacin-resistant strains. Continuous surveillance is needed to prevent the dissemination of these clones.

        Cite This Article
    EID de la Campa AG, Balsalobre L, Ardanuy C, Fenoll A, Pérez-Trallero E, Liñares J, et al. Fluoroquinolone Resistance in Penicillin-resistant Streptococcus pneumoniae Clones, Spain. Emerg Infect Dis. 2004;10(10):1751-1759. https://dx.doi.org/10.3201/eid1010.040382
    AMA de la Campa AG, Balsalobre L, Ardanuy C, et al. Fluoroquinolone Resistance in Penicillin-resistant Streptococcus pneumoniae Clones, Spain. Emerging Infectious Diseases. 2004;10(10):1751-1759. doi:10.3201/eid1010.040382.
    APA de la Campa, A. G., Balsalobre, L., Ardanuy, C., Fenoll, A., Pérez-Trallero, E., & Liñares, J. (2004). Fluoroquinolone Resistance in Penicillin-resistant Streptococcus pneumoniae Clones, Spain. Emerging Infectious Diseases, 10(10), 1751-1759. https://dx.doi.org/10.3201/eid1010.040382.
  • Sulfa Use, Dihydropteroate Synthase Mutations, and Pneumocystis jirovecii Pneumonia PDF Version [PDF - 141 KB - 6 pages]
    C. R. Stein et al.
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    A systematic review was conducted to examine the associations in Pneumocystis jirovecii pneumonia (PCP) patients between dihydropteroate synthase (DHPS) mutations and sulfa or sulfone (sulfa) prophylaxis and between DHPS mutations and sulfa treatment outcome. Selection criteria included study populations composed entirely of PCP patients and mutation or treatment outcome results for all patients, regardless of exposure status. Based on 13 studies, the risk of developing DHPS mutations is higher for PCP patients receiving sulfa prophylaxis than for PCP patients not receiving sulfa prophylaxis (p < 0.001). Results are too heterogeneous (p < 0.001) to warrant a single summary effect estimate. Estimated effects are weaker after 1996 and stronger in studies that included multiple isolates per patient. Five studies examined treatment outcome. The effect of DHPS mutations on treatment outcome has not been well studied, and the few studies that have been conducted are inconsistent even as to the presence or absence of an association.

        Cite This Article
    EID Stein CR, Poole C, Kazanjian P, Meshnick S. Sulfa Use, Dihydropteroate Synthase Mutations, and Pneumocystis jirovecii Pneumonia. Emerg Infect Dis. 2004;10(10):1760-1765. https://dx.doi.org/10.3201/eid1010.040362
    AMA Stein CR, Poole C, Kazanjian P, et al. Sulfa Use, Dihydropteroate Synthase Mutations, and Pneumocystis jirovecii Pneumonia. Emerging Infectious Diseases. 2004;10(10):1760-1765. doi:10.3201/eid1010.040362.
    APA Stein, C. R., Poole, C., Kazanjian, P., & Meshnick, S. (2004). Sulfa Use, Dihydropteroate Synthase Mutations, and Pneumocystis jirovecii Pneumonia. Emerging Infectious Diseases, 10(10), 1760-1765. https://dx.doi.org/10.3201/eid1010.040362.
  • Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients PDF Version [PDF - 298 KB - 7 pages]
    M. Rabodonirina et al.
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    Ten Pneumocystis jirovecii pneumonia (PCP) cases were diagnosed in renal transplant recipients (RTRs) during a 3-year period. Nosocomial transmission from HIV-positive patients with PCP was suspected because the these patients shared the same hospital building, were not isolated, and were receiving no or suboptimal anti-PCP prophylaxis. P. jirovecii organisms were typed with the multitarget polymerase chain reaction–single-strand conformation polymorphism method. Among the 45 patients with PCP hospitalized during the 3-year period, 8 RTRs and 6 HIV-infected patients may have encountered at least 1 patient with active PCP within the 3 months before the diagnosis of their own PCP episode. In six instances (five RTRs, one HIV-infected patient), the patients harbored the same P. jirovecii molecular type as that found in the encountered PCP patients. The data suggest that part of the PCP cases observed in this building, particularly those observed in RTRs, were related to nosocomial interhuman transmission.

        Cite This Article
    EID Rabodonirina M, Vanhems P, Couray-Targe S, Gillibert R, Ganne C, Nizard N, et al. Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients. Emerg Infect Dis. 2004;10(10):1767-1773. https://dx.doi.org/10.3201/eid1010.040453
    AMA Rabodonirina M, Vanhems P, Couray-Targe S, et al. Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients. Emerging Infectious Diseases. 2004;10(10):1767-1773. doi:10.3201/eid1010.040453.
    APA Rabodonirina, M., Vanhems, P., Couray-Targe, S., Gillibert, R., Ganne, C., Nizard, N....Hauser, P. M. (2004). Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients. Emerging Infectious Diseases, 10(10), 1767-1773. https://dx.doi.org/10.3201/eid1010.040453.
  • Laboratory Diagnosis of Four Recent Sporadic Cases of Community-acquired SARS, Guangdong Province, China PDF Version [PDF - 196 KB - 8 pages]
    G. Liang et al.
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    Four cases of severe acute respiratory syndrome (SARS) that occurred between December 16, 2003, and January 8, 2004, in Guangzhou city, Guangdong Province, China, were investigated. Four cases of severe acute respiratory syndrome (SARS) that occurred from December 16, 2003, to January 8, 2004, in the city of Guangzhou, Guangdong Province, China, were investigated. Clinical specimens collected from these patients were tested by provincial and national laboratories in China as well as members of the World Health Organization SARS Reference and Verification Laboratory Network in a collaborative effort to identify and confirm SARS-associated coronavirus (SARS-CoV) infection. Although SARS-CoV was not isolated from any patient, specimens from three patients were positive for viral RNA by reverse transcription–polymerase chain reaction assay, and all patients had detectable rises in SARS-CoV–specific antibodies. This study shows the effectiveness of a collaborative, multilaboratory response to diagnose SARS.

        Cite This Article
    EID Liang G, Chen Q, Xu J, Liu Y, Lim W, Peiris J, et al. Laboratory Diagnosis of Four Recent Sporadic Cases of Community-acquired SARS, Guangdong Province, China. Emerg Infect Dis. 2004;10(10):1774-1781. https://dx.doi.org/10.3201/eid1010.040445
    AMA Liang G, Chen Q, Xu J, et al. Laboratory Diagnosis of Four Recent Sporadic Cases of Community-acquired SARS, Guangdong Province, China. Emerging Infectious Diseases. 2004;10(10):1774-1781. doi:10.3201/eid1010.040445.
    APA Liang, G., Chen, Q., Xu, J., Liu, Y., Lim, W., Peiris, J....Deng, Y. (2004). Laboratory Diagnosis of Four Recent Sporadic Cases of Community-acquired SARS, Guangdong Province, China. Emerging Infectious Diseases, 10(10), 1774-1781. https://dx.doi.org/10.3201/eid1010.040445.
  • Egg Quality Assurance Programs and Egg-associated Salmonella Enteritidis Infections, United States PDF Version [PDF - 242 KB - 8 pages]
    G. A. Mumma et al.
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    A Salmonella enterica serovar Enteritidis epidemic in the United States began in 1978, spread to much of the country in the following decade, and began declining in 1996. We examined correlations between annual changes in S. Enteritidis incidence in humans and introductions of egg quality assurance programs (EQAPs) in some states to reduce S. Enteritidis contamination of eggs. Before EQAPs, 62% of the changes in S. Enteritidis incidence were higher than the baseline for each state. After EQAPs, 73%–84% of the changes were below the baseline. Regression analysis showed that a 1% increase in the number of eggs produced under an EQAP was associated with a 0.14% decrease in S. Enteritidis incidence (p < 0.05). These data indicate that EQAPs probably played a major role in reducing S. Enteritidis illness in these states.

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    EID Mumma GA, Griffin PM, Meltzer MI, Braden CR, Tauxe RV. Egg Quality Assurance Programs and Egg-associated Salmonella Enteritidis Infections, United States. Emerg Infect Dis. 2004;10(10):1782-1789. https://dx.doi.org/10.3201/eid1010.040189
    AMA Mumma GA, Griffin PM, Meltzer MI, et al. Egg Quality Assurance Programs and Egg-associated Salmonella Enteritidis Infections, United States. Emerging Infectious Diseases. 2004;10(10):1782-1789. doi:10.3201/eid1010.040189.
    APA Mumma, G. A., Griffin, P. M., Meltzer, M. I., Braden, C. R., & Tauxe, R. V. (2004). Egg Quality Assurance Programs and Egg-associated Salmonella Enteritidis Infections, United States. Emerging Infectious Diseases, 10(10), 1782-1789. https://dx.doi.org/10.3201/eid1010.040189.
  • Dengue Emergence and Adaptation to Peridomestic Mosquitoes PDF Version [PDF - 115 KB - 7 pages]
    A. C. Moncayo et al.
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    Phylogenetic evidence suggests that endemic and epidemic dengue viruses (DENV), transmitted among humans by the anthropophilic mosquitoes Aedes aegypti and Ae. albopictus, emerged when ancestral, sylvatic DENV transmitted among nonhuman primates by sylvatic Aedes mosquitoes adapted to these peridomestic vectors. We tested this hypothesis by retrospectively examining evidence for adaptation of epidemic and endemic versus sylvatic strains of DENV-2 to Ae. albopictus and Ae. aegypti. First and second-generation offspring of mosquitoes from different geographic regions in the Americas and Southeast Asia were tested for their susceptibility to epidemic/endemic and sylvatic DENV-2 isolates from West Africa, Southeast Asia, and Oceania. Both Aedes species were highly susceptible (up to 100% infected) to endemic/epidemic DENV-2 strains after ingesting artificial blood meals but significantly less susceptible (as low as 0%) to sylvatic DENV-2 strains. Our findings support the hypothesis that adaptation to peridomestic mosquito vectors mediated dengue emergence from sylvatic progenitor viruses.

        Cite This Article
    EID Moncayo AC, Fernandez Z, Ortiz D, Diallo M, Sall AA, Hartman S, et al. Dengue Emergence and Adaptation to Peridomestic Mosquitoes. Emerg Infect Dis. 2004;10(10):1790-1796. https://dx.doi.org/10.3201/eid1010.030846
    AMA Moncayo AC, Fernandez Z, Ortiz D, et al. Dengue Emergence and Adaptation to Peridomestic Mosquitoes. Emerging Infectious Diseases. 2004;10(10):1790-1796. doi:10.3201/eid1010.030846.
    APA Moncayo, A. C., Fernandez, Z., Ortiz, D., Diallo, M., Sall, A. A., Hartman, S....Weaver, S. C. (2004). Dengue Emergence and Adaptation to Peridomestic Mosquitoes. Emerging Infectious Diseases, 10(10), 1790-1796. https://dx.doi.org/10.3201/eid1010.030846.
  • Escherichia coli and Community-acquired Gastroenteritis, Melbourne, Australia PDF Version [PDF - 231 KB - 9 pages]
    R. M. Robins-Browne et al.
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    As part of a study to determine the effects of water filtration on the incidence of community-acquired gastroenteritis in Melbourne, Australia, we examined fecal samples from patients with gastroenteritis and asymptomatic persons for diarrheagenic strains of Escherichia coli. Atypical strains of enteropathogenic E. coli (EPEC) were the most frequently identified pathogens of all bacterial, viral, and parasitic agents in patients with gastroenteritis. Moreover, atypical EPEC were more common in patients with gastroenteritis (89 [12.8%] of 696) than in asymptomatic persons (11 [2.3%] of 489, p < 0.0001). Twenty-two random isolates of atypical EPEC that were characterized further showed marked heterogeneity in terms of serotype, genetic subtype, and carriage of virulence-associated determinants. Apart from the surface protein, intimin, no virulence determinant or phenotype was uniformly present in atypical EPEC strains. This study shows that atypical EPEC are an important cause of gastroenteritis in Melbourne.

        Cite This Article
    EID Robins-Browne RM, Bordun A, Tauschek M, Bennett-Wood VR, Russell J, Oppedisano F, et al. Escherichia coli and Community-acquired Gastroenteritis, Melbourne, Australia. Emerg Infect Dis. 2004;10(10):1797-1805. https://dx.doi.org/10.3201/eid1010.031086
    AMA Robins-Browne RM, Bordun A, Tauschek M, et al. Escherichia coli and Community-acquired Gastroenteritis, Melbourne, Australia. Emerging Infectious Diseases. 2004;10(10):1797-1805. doi:10.3201/eid1010.031086.
    APA Robins-Browne, R. M., Bordun, A., Tauschek, M., Bennett-Wood, V. R., Russell, J., Oppedisano, F....Hellard, M. E. (2004). Escherichia coli and Community-acquired Gastroenteritis, Melbourne, Australia. Emerging Infectious Diseases, 10(10), 1797-1805. https://dx.doi.org/10.3201/eid1010.031086.
  • Syndromic Surveillance for Influenzalike Illness in Ambulatory Care Setting PDF Version [PDF - 198 KB - 6 pages]
    B. Miller et al.
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    Conventional disease surveillance mechanisms that rely on passive reporting may be too slow and insensitive to rapidly detect a large-scale infectious disease outbreak; the reporting time from a patient’s initial symptoms to specific disease diagnosis takes days to weeks. To meet this need, new surveillance methods are being developed. Referred to as nontraditional or syndromic surveillance, these new systems typically rely on prediagnostic data to rapidly detect infectious disease outbreaks, such as those caused by bioterrorism. Using data from a large health maintenance organization, we discuss the development, implementation, and evaluation of a time-series syndromic surveillance detection algorithm for influenzalike illness in Minnesota.

        Cite This Article
    EID Miller B, Kassenborg H, Dunsmuir W, Griffith J, Hadidi M, Nordin JD, et al. Syndromic Surveillance for Influenzalike Illness in Ambulatory Care Setting. Emerg Infect Dis. 2004;10(10):1806-1811. https://dx.doi.org/10.3201/eid1010.030789
    AMA Miller B, Kassenborg H, Dunsmuir W, et al. Syndromic Surveillance for Influenzalike Illness in Ambulatory Care Setting. Emerging Infectious Diseases. 2004;10(10):1806-1811. doi:10.3201/eid1010.030789.
    APA Miller, B., Kassenborg, H., Dunsmuir, W., Griffith, J., Hadidi, M., Nordin, J. D....Danila, R. N. (2004). Syndromic Surveillance for Influenzalike Illness in Ambulatory Care Setting. Emerging Infectious Diseases, 10(10), 1806-1811. https://dx.doi.org/10.3201/eid1010.030789.
  • Disease Susceptibility to ST11 Complex Meningococci Bearing Serogroup C or W135 Polysaccharide Capsules, North America PDF Version [PDF - 110 KB - 4 pages]
    A. J. Pollard et al.
        View Abstract

    Clusters of meningococcal disease caused by a hyperinvasive lineage of Neisseria meningitidis, the ST11 complex, bearing a serogroup C polysaccharide capsule, have been prominent in Europe and North America since the early 1990s. This situation has led to expensive public health measures for outbreak control and, finally, to the introduction of a serogroup C glyconjugate vaccine into the primary immunization schedule in the United Kingdom and elsewhere. ST11 complex meningococci may also express serogroup W135 polysaccharide capsules. We investigated the level of population immunity to this hyperinvasive clone in association with the appearance of outbreaks of meningococcal disease in southern British Columbia. We found that most adults and almost all children were apparently susceptible to infection with ST11 complex meningococci bearing both C and W135 polysaccharide capsules, which suggests that a vaccine program directed against only serogroup C meningococci may be insufficient to prevent hyperinvasive ST11 disease.

        Cite This Article
    EID Pollard AJ, Ochnio J, Ho M, Callaghan M, Bigham M, Dobson S, et al. Disease Susceptibility to ST11 Complex Meningococci Bearing Serogroup C or W135 Polysaccharide Capsules, North America. Emerg Infect Dis. 2004;10(10):1812-1815. https://dx.doi.org/10.3201/eid1010.040335
    AMA Pollard AJ, Ochnio J, Ho M, et al. Disease Susceptibility to ST11 Complex Meningococci Bearing Serogroup C or W135 Polysaccharide Capsules, North America. Emerging Infectious Diseases. 2004;10(10):1812-1815. doi:10.3201/eid1010.040335.
    APA Pollard, A. J., Ochnio, J., Ho, M., Callaghan, M., Bigham, M., & Dobson, S. (2004). Disease Susceptibility to ST11 Complex Meningococci Bearing Serogroup C or W135 Polysaccharide Capsules, North America. Emerging Infectious Diseases, 10(10), 1812-1815. https://dx.doi.org/10.3201/eid1010.040335.
  • Genetic and Transmission Analysis of Helicobacter pylori Strains within a Family PDF Version [PDF - 266 KB - 6 pages]
    J. Raymond et al.
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    To look for evidence of intrafamilial infection, we isolated 107 Helicobacter pylori clones from biopsied specimens taken from both parents and four children. We compared the sequences of two housekeeping genes (hspA and glmM) from these clones with those of 131 unrelated strains from patients living in different geographic regions. Strain relationships within the family were determined by analyzing allelic variation at both loci and building phylogenetic trees and by using multilocus sequence typing. Both hspA- and glmM-based phylogenetic trees showed East Asian and African branches. All samples from family members showed natural mixed infection. Identical alleles found in some strains isolated from the children and parents, but not in the strains isolated from unrelated patients, demonstrated that strains have circulated within the family. Several mechanisms, such as point mutations, intragenic recombination, and introduction of foreign (African) alleles, were shown to enhance strain diversity within the family.

        Cite This Article
    EID Raymond J, Thiberge J, Chevalier C, Kalach N, Bergeret M, Labigne A, et al. Genetic and Transmission Analysis of Helicobacter pylori Strains within a Family. Emerg Infect Dis. 2004;10(10):1816-1821. https://dx.doi.org/10.3201/eid1010.040042
    AMA Raymond J, Thiberge J, Chevalier C, et al. Genetic and Transmission Analysis of Helicobacter pylori Strains within a Family. Emerging Infectious Diseases. 2004;10(10):1816-1821. doi:10.3201/eid1010.040042.
    APA Raymond, J., Thiberge, J., Chevalier, C., Kalach, N., Bergeret, M., Labigne, A....Dauga, C. (2004). Genetic and Transmission Analysis of Helicobacter pylori Strains within a Family. Emerging Infectious Diseases, 10(10), 1816-1821. https://dx.doi.org/10.3201/eid1010.040042.
  • Geographic and Temporal Trends in Influenzalike Illness, Japan, 1992–1999 PDF Version [PDF - 255 KB - 5 pages]
    T. Sakai et al.
        View Abstract

    From 1992 to 1999, we analyzed >2.5 million cases of influenzalike illness (ILI). Nationwide influenza epidemics generally lasted 3–4 months in winter. Kriging analysis, which illustrates geographic movement, showed that the starting areas of peak ILI activity were mostly found in western Japan. Two spreading patterns, monotonous and multitonous, were observed. Monotonous patterns in two seasons featured peak ILI activity that covered all of Japan within 3 to 5 weeks in larger epidemics with new antigenic variants of A/H3N2. Multitonous patterns, observed in the other five seasons, featured peak ILI activity within 12 to 15 weeks in small epidemics without new variants. Applying the kriging method allowed better visualization and understanding of spatiotemporal trends in seasonal ILI activity. This method will likely be an important tool for future influenza surveillance in Japan.

        Cite This Article
    EID Sakai T, Suzuki H, Sasaki A, Saito R, Tanabe N, Taniguchi K, et al. Geographic and Temporal Trends in Influenzalike Illness, Japan, 1992–1999. Emerg Infect Dis. 2004;10(10):1822-1826. https://dx.doi.org/10.3201/eid1010.040147
    AMA Sakai T, Suzuki H, Sasaki A, et al. Geographic and Temporal Trends in Influenzalike Illness, Japan, 1992–1999. Emerging Infectious Diseases. 2004;10(10):1822-1826. doi:10.3201/eid1010.040147.
    APA Sakai, T., Suzuki, H., Sasaki, A., Saito, R., Tanabe, N., & Taniguchi, K. (2004). Geographic and Temporal Trends in Influenzalike Illness, Japan, 1992–1999. Emerging Infectious Diseases, 10(10), 1822-1826. https://dx.doi.org/10.3201/eid1010.040147.
  • Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003 PDF Version [PDF - 240 KB - 8 pages]
    B. A. Lopman et al.
        View Abstract

    Healthcare-associated outbreaks of gastroenteritis are an increasingly recognized problem, but detailed knowledge of the epidemiology of these events is lacking. We actively monitored three hospital systems in England for outbreaks of gastroenteritis in 2002 to 2003. A total of 2,154 patients (2.21 cases/1,000-hospital-days) and 1,360 healthcare staff (0.47 cases/1,000-hospital-days) were affected in 227 unit outbreaks (1.33 outbreaks/unit-year). Norovirus, detected in 63% of outbreaks, was the predominant etiologic agent. Restricting new admissions to affected units resulted in 5,443 lost bed-days. The cost of bed-days lost plus staff absence was calculated to be £635,000 (U.S.$ 1.01 million) per 1,000 beds. By our extrapolation, gastroenteritis outbreaks likely cost the English National Health Service £115 (U.S.$ 184) million in 2002 to 2003. Outbreaks were contained faster (7.9 vs. 15.4 days, p = 0.0023) when units were rapidly closed to new admissions (<4 days). Implementing control measures rapidly may be effective in controlling outbreaks.

        Cite This Article
    EID Lopman BA, Reacher MH, Vipond IB, Hill D, Perry C, Halladay T, et al. Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003. Emerg Infect Dis. 2004;10(10):1827-1834. https://dx.doi.org/10.3201/eid1010.030941
    AMA Lopman BA, Reacher MH, Vipond IB, et al. Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003. Emerging Infectious Diseases. 2004;10(10):1827-1834. doi:10.3201/eid1010.030941.
    APA Lopman, B. A., Reacher, M. H., Vipond, I. B., Hill, D., Perry, C., Halladay, T....Sarangi, J. (2004). Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003. Emerging Infectious Diseases, 10(10), 1827-1834. https://dx.doi.org/10.3201/eid1010.030941.

Dispatches

  • Fatal Naegleria fowleri Meningoencephalitis, Italy PDF Version [PDF - 347 KB - 3 pages]
    P. E. Cogo et al.
        View Abstract

    We report the first case of primary amebic meningoencephalitis in Italy, in a 9-year-old boy. Clinical course was fulminant, and diagnosis was made by identifying amebas in stained brain sections and by indirect immunofluorescence analysis. Naegleria fowleri was characterized as genotype I on the basis of polymerase chain reaction test results.

        Cite This Article
    EID Cogo PE, Scaglia M, Gatti S, Rossetti F, Alaggio R, Laverda AM, et al. Fatal Naegleria fowleri Meningoencephalitis, Italy. Emerg Infect Dis. 2004;10(10):1835-1837. https://dx.doi.org/10.3201/eid1010.040273
    AMA Cogo PE, Scaglia M, Gatti S, et al. Fatal Naegleria fowleri Meningoencephalitis, Italy. Emerging Infectious Diseases. 2004;10(10):1835-1837. doi:10.3201/eid1010.040273.
    APA Cogo, P. E., Scaglia, M., Gatti, S., Rossetti, F., Alaggio, R., Laverda, A. M....Visvesvara, G. S. (2004). Fatal Naegleria fowleri Meningoencephalitis, Italy. Emerging Infectious Diseases, 10(10), 1835-1837. https://dx.doi.org/10.3201/eid1010.040273.
  • Scrub Typhus in the Republic of Palau, Micronesia PDF Version [PDF - 308 KB - 3 pages]
    A. M. Durand et al.
        View Abstract

    In October 2001, an outbreak of febrile illness began in the southwest islands group of the Republic of Palau. Through October 2003, a total of 15 southwest islanders experienced fever >39.5°C and abdominal distress, both lasting >7days. Orientia tsutsugamushi, the agent of scrub typhus, was subsequently identified as the cause.

        Cite This Article
    EID Durand AM, Kuartei S, Togamae I, Sengebau M, Demma L, Nicholson WL, et al. Scrub Typhus in the Republic of Palau, Micronesia. Emerg Infect Dis. 2004;10(10):1838-1840. https://dx.doi.org/10.3201/eid1010.040288
    AMA Durand AM, Kuartei S, Togamae I, et al. Scrub Typhus in the Republic of Palau, Micronesia. Emerging Infectious Diseases. 2004;10(10):1838-1840. doi:10.3201/eid1010.040288.
    APA Durand, A. M., Kuartei, S., Togamae, I., Sengebau, M., Demma, L., Nicholson, W. L....O’Leary, M. (2004). Scrub Typhus in the Republic of Palau, Micronesia. Emerging Infectious Diseases, 10(10), 1838-1840. https://dx.doi.org/10.3201/eid1010.040288.
  • Long-term SARS Coronavirus Excretion from Patient Cohort, China PDF Version [PDF - 186 KB - 3 pages]
    W. Cao et al.
        View Abstract

    This study investigated the long-term excretion of severe acute respiratory syndrome–associated coronavirus in sputum and stool specimens from 56 infected patients. The median (range) duration of virus excretion in sputa and stools was 21 (14–52) and 27 (16–126) days, respectively. Coexisting illness or conditions were associated with longer viral excretion in stools.

        Cite This Article
    EID Cao W, Tang F, Fontanet A, Zhan L, Zhao Q, Zhang P, et al. Long-term SARS Coronavirus Excretion from Patient Cohort, China. Emerg Infect Dis. 2004;10(10):1841-1843. https://dx.doi.org/10.3201/eid1010.040297
    AMA Cao W, Tang F, Fontanet A, et al. Long-term SARS Coronavirus Excretion from Patient Cohort, China. Emerging Infectious Diseases. 2004;10(10):1841-1843. doi:10.3201/eid1010.040297.
    APA Cao, W., Tang, F., Fontanet, A., Zhan, L., Zhao, Q., Zhang, P....Liu, W. (2004). Long-term SARS Coronavirus Excretion from Patient Cohort, China. Emerging Infectious Diseases, 10(10), 1841-1843. https://dx.doi.org/10.3201/eid1010.040297.
  • Campylobacteriosis, Eastern Townships, Québec PDF Version [PDF - 269 KB - 3 pages]
    S. Michaud et al.
        View Abstract

    Independent risk factors for campylobacteriosis (eating raw, rare, or undercooked poultry; consuming raw milk or raw milk products; and eating chicken or turkey in a commercial establishment) account for <50% of cases in Québec. Substantial regional and seasonal variations in campylobacteriosis were not correlated with campylobacter in chickens and suggested environmental sources of infection, such as drinking water.

        Cite This Article
    EID Michaud S, Ménard S, Arbeit RD. Campylobacteriosis, Eastern Townships, Québec. Emerg Infect Dis. 2004;10(10):1844-1847. https://dx.doi.org/10.3201/eid1010.040228
    AMA Michaud S, Ménard S, Arbeit RD. Campylobacteriosis, Eastern Townships, Québec. Emerging Infectious Diseases. 2004;10(10):1844-1847. doi:10.3201/eid1010.040228.
    APA Michaud, S., Ménard, S., & Arbeit, R. D. (2004). Campylobacteriosis, Eastern Townships, Québec. Emerging Infectious Diseases, 10(10), 1844-1847. https://dx.doi.org/10.3201/eid1010.040228.
  • Laboratory-acquired Brucellosis PDF Version [PDF - 176 KB - 3 pages]
    S. Noviello et al.
        View Abstract

    We report two laboratory-acquired Brucella melitensis infections that were shown to be epidemiologically related. Blood culture isolates were initially misidentified because of variable Gram stain results, which led to misdiagnoses and subsequent laboratory exposures. Notifying laboratory personnel who unknowingly processed cultures from brucellosis patients is an important preventive measure.

        Cite This Article
    EID Noviello S, Gallo R, Kelly M, Limberger RJ, DeAngelis K, Cain L, et al. Laboratory-acquired Brucellosis. Emerg Infect Dis. 2004;10(10):1848-1850. https://dx.doi.org/10.3201/eid1010.040076
    AMA Noviello S, Gallo R, Kelly M, et al. Laboratory-acquired Brucellosis. Emerging Infectious Diseases. 2004;10(10):1848-1850. doi:10.3201/eid1010.040076.
    APA Noviello, S., Gallo, R., Kelly, M., Limberger, R. J., DeAngelis, K., Cain, L....Dumas, N. (2004). Laboratory-acquired Brucellosis. Emerging Infectious Diseases, 10(10), 1848-1850. https://dx.doi.org/10.3201/eid1010.040076.
  • Emerging Enteropathogenic Escherichia coli Strains? PDF Version [PDF - 388 KB - 5 pages]
    T. A. Gomes et al.
        View Abstract

    Escherichia coli strains of nonenteropathogenic serogroups carrying eae but lacking the enteropathogenic E. coli adherence factor plasmid and Shiga toxin DNA probe sequences were isolated from patients (children, adults, and AIDS patients) with and without diarrhea in Brazil. Although diverse in phenotype and genotype, some strains are potentially diarrheagenic.

        Cite This Article
    EID Gomes TA, Irino K, Girão DM, Girão VB, Guth BE, Vaz TM, et al. Emerging Enteropathogenic Escherichia coli Strains?. Emerg Infect Dis. 2004;10(10):1851-1855. https://dx.doi.org/10.3201/eid1010.031093
    AMA Gomes TA, Irino K, Girão DM, et al. Emerging Enteropathogenic Escherichia coli Strains?. Emerging Infectious Diseases. 2004;10(10):1851-1855. doi:10.3201/eid1010.031093.
    APA Gomes, T. A., Irino, K., Girão, D. M., Girão, V. B., Guth, B. E., Vaz, T. M....Vieira, M. A. (2004). Emerging Enteropathogenic Escherichia coli Strains?. Emerging Infectious Diseases, 10(10), 1851-1855. https://dx.doi.org/10.3201/eid1010.031093.
  • Escherichia coli O157 Cluster Evaluation PDF Version [PDF - 243 KB - 3 pages]
    A. Gupta et al.
        View Abstract

    We investigated a multistate cluster of Escherichia coli O157:H7 isolates; pulsed-field gel electrophoresis subtyping, using a single enzyme, suggested an epidemiologic association. An investigation and additional subtyping, however, did not support the association. Confirmation E. coli O157 clusters with two or more restriction endonucleases is necessary before public health resources are allocated to follow-up investigations.

        Cite This Article
    EID Gupta A, Hunter SB, Bidol SA, Dietrich S, Kincaid J, Salehi E, et al. Escherichia coli O157 Cluster Evaluation. Emerg Infect Dis. 2004;10(10):1856-1858. https://dx.doi.org/10.3201/eid1010.040374
    AMA Gupta A, Hunter SB, Bidol SA, et al. Escherichia coli O157 Cluster Evaluation. Emerging Infectious Diseases. 2004;10(10):1856-1858. doi:10.3201/eid1010.040374.
    APA Gupta, A., Hunter, S. B., Bidol, S. A., Dietrich, S., Kincaid, J., Salehi, E....Brooks, J. T. (2004). Escherichia coli O157 Cluster Evaluation. Emerging Infectious Diseases, 10(10), 1856-1858. https://dx.doi.org/10.3201/eid1010.040374.
  • Mycobacterium triplex Pulmonary Disease in Immunocompetent Host PDF Version [PDF - 286 KB - 4 pages]
    C. Piersimoni et al.
        View Abstract

    Mycobacterium triplex, a recently described, potentially pathogenic species, caused disease primarily in immunocompromised patients. We report a case of pulmonary infection due to this mycobacterium in an immunocompetent patient and review the characteristics of two other cases. In our experience, Mycobacterium triplex pulmonary infection is unresponsive to antimycobacterial chemotherapy.

        Cite This Article
    EID Piersimoni C, Zitti P, Mazzarelli G, Mariottini A, Nista D, Zallocco D, et al. Mycobacterium triplex Pulmonary Disease in Immunocompetent Host. Emerg Infect Dis. 2004;10(10):1859-1862. https://dx.doi.org/10.3201/eid1010.040217
    AMA Piersimoni C, Zitti P, Mazzarelli G, et al. Mycobacterium triplex Pulmonary Disease in Immunocompetent Host. Emerging Infectious Diseases. 2004;10(10):1859-1862. doi:10.3201/eid1010.040217.
    APA Piersimoni, C., Zitti, P., Mazzarelli, G., Mariottini, A., Nista, D., & Zallocco, D. (2004). Mycobacterium triplex Pulmonary Disease in Immunocompetent Host. Emerging Infectious Diseases, 10(10), 1859-1862. https://dx.doi.org/10.3201/eid1010.040217.
  • Arcobacter Species in Humans PDF Version [PDF - 378 KB - 5 pages]
    O. Vandenberg et al.
        View Abstract

    During an 8-year study period, Arcobacter butzleri was the fourth most common Campylobacter-like organism isolated from 67,599 stool specimens. Our observations suggest that A. butzleri displays microbiologic and clinical features similar to those of Camplobacter jejuni; however, A. butzleri is more frequently associated with a persistent, watery diarrhea.

        Cite This Article
    EID Vandenberg O, Dediste A, Houf K, Ibekwem S, Souayah H, Cadranel S, et al. Arcobacter Species in Humans. Emerg Infect Dis. 2004;10(10):1863-1867. https://dx.doi.org/10.3201/eid1010.040241
    AMA Vandenberg O, Dediste A, Houf K, et al. Arcobacter Species in Humans. Emerging Infectious Diseases. 2004;10(10):1863-1867. doi:10.3201/eid1010.040241.
    APA Vandenberg, O., Dediste, A., Houf, K., Ibekwem, S., Souayah, H., Cadranel, S....Vandamme, P. (2004). Arcobacter Species in Humans. Emerging Infectious Diseases, 10(10), 1863-1867. https://dx.doi.org/10.3201/eid1010.040241.
  • Mycobacterium goodii Infections Associated with Surgical Implants at Colorado Hospital PDF Version [PDF - 248 KB - 4 pages]
    D. D. Ferguson et al.
        View Abstract

    From February to October 2003, Mycobacterium goodii wound infections were identified among three patients who received surgical implants at a Colorado hospital. This report summarizes the investigation of the first reported nosocomial outbreak of M. goodii. Increased awareness is needed about the potential for nontuberculous mycobacteria to cause postoperative wound infections.

        Cite This Article
    EID Ferguson DD, Gershman K, Jensen BJ, Arduino MJ, Yakrus M, Cooksey RC, et al. Mycobacterium goodii Infections Associated with Surgical Implants at Colorado Hospital. Emerg Infect Dis. 2004;10(10):1868-1871. https://dx.doi.org/10.3201/eid1010.040402
    AMA Ferguson DD, Gershman K, Jensen BJ, et al. Mycobacterium goodii Infections Associated with Surgical Implants at Colorado Hospital. Emerging Infectious Diseases. 2004;10(10):1868-1871. doi:10.3201/eid1010.040402.
    APA Ferguson, D. D., Gershman, K., Jensen, B. J., Arduino, M. J., Yakrus, M., Cooksey, R. C....Srinivasan, A. (2004). Mycobacterium goodii Infections Associated with Surgical Implants at Colorado Hospital. Emerging Infectious Diseases, 10(10), 1868-1871. https://dx.doi.org/10.3201/eid1010.040402.
  • Nosocomial Acquisition of Dengue PDF Version [PDF - 194 KB - 2 pages]
    D. Wagner et al.
        View Abstract

    Recent transmission of dengue viruses has increased in tropical and subtropical areas and in industrialized countries because of international travel. We describe a case of nosocomial transmission of dengue virus in Germany by a needlestick injury. Diagnosis was made by TaqMan reverse transcription–polymerase chain reaction when serologic studies were negative.

        Cite This Article
    EID Wagner D, de With K, Huzly D, Hufert F, Weidmann M, Breisinger S, et al. Nosocomial Acquisition of Dengue. Emerg Infect Dis. 2004;10(10):1872-1873. https://dx.doi.org/10.3201/eid1010.031037
    AMA Wagner D, de With K, Huzly D, et al. Nosocomial Acquisition of Dengue. Emerging Infectious Diseases. 2004;10(10):1872-1873. doi:10.3201/eid1010.031037.
    APA Wagner, D., de With, K., Huzly, D., Hufert, F., Weidmann, M., Breisinger, S....Bauer, T. M. (2004). Nosocomial Acquisition of Dengue. Emerging Infectious Diseases, 10(10), 1872-1873. https://dx.doi.org/10.3201/eid1010.031037.
  • Novel Recombinant Sapovirus PDF Version [PDF - 302 KB - 3 pages]
    K. Katayama et al.
        View Abstract

    We determined the complete genome sequences of two sapovirus strains isolated in Thailand and Japan. One of these strains represented a novel, naturally occurring recombinant sapovirus. Evidence suggested the recombination site was at the polymerase-capsid junction within open reading frame one.

        Cite This Article
    EID Katayama K, Miyoshi T, Uchino K, Oka T, Tanaka T, Takeda N, et al. Novel Recombinant Sapovirus. Emerg Infect Dis. 2004;10(10):1874-1876. https://dx.doi.org/10.3201/eid1010.040395
    AMA Katayama K, Miyoshi T, Uchino K, et al. Novel Recombinant Sapovirus. Emerging Infectious Diseases. 2004;10(10):1874-1876. doi:10.3201/eid1010.040395.
    APA Katayama, K., Miyoshi, T., Uchino, K., Oka, T., Tanaka, T., Takeda, N....Hansman, G. S. (2004). Novel Recombinant Sapovirus. Emerging Infectious Diseases, 10(10), 1874-1876. https://dx.doi.org/10.3201/eid1010.040395.

Letters

  • SARS Patients and Need for Treatment PDF Version [PDF - 25 KB - 2 pages]
    J. W. Chan and S. Lee
            Cite This Article
    EID Chan JW, Lee S. SARS Patients and Need for Treatment. Emerg Infect Dis. 2004;10(10):1877-1878. https://dx.doi.org/10.3201/eid1010.040091
    AMA Chan JW, Lee S. SARS Patients and Need for Treatment. Emerging Infectious Diseases. 2004;10(10):1877-1878. doi:10.3201/eid1010.040091.
    APA Chan, J. W., & Lee, S. (2004). SARS Patients and Need for Treatment. Emerging Infectious Diseases, 10(10), 1877-1878. https://dx.doi.org/10.3201/eid1010.040091.
  • Occupational Malaria Following Needlestick Injury PDF Version [PDF - 33 KB - 3 pages]
    A. P. Tarantola et al.
            Cite This Article
    EID Tarantola AP, Rachline AC, Konto C, Houzé S, Lariven S, Fichelle A, et al. Occupational Malaria Following Needlestick Injury. Emerg Infect Dis. 2004;10(10):1878-1880. https://dx.doi.org/10.3201/eid1010.040277
    AMA Tarantola AP, Rachline AC, Konto C, et al. Occupational Malaria Following Needlestick Injury. Emerging Infectious Diseases. 2004;10(10):1878-1880. doi:10.3201/eid1010.040277.
    APA Tarantola, A. P., Rachline, A. C., Konto, C., Houzé, S., Lariven, S., Fichelle, A....Bouvet, E. (2004). Occupational Malaria Following Needlestick Injury. Emerging Infectious Diseases, 10(10), 1878-1880. https://dx.doi.org/10.3201/eid1010.040277.
  • Nosocomial Transmission of Dengue PDF Version [PDF - 27 KB - 2 pages]
    Z. Nemes et al.
            Cite This Article
    EID Nemes Z, Kiss G, Madarassi EP, Peterfi Z, Ferenczi E, Bakonyi T, et al. Nosocomial Transmission of Dengue. Emerg Infect Dis. 2004;10(10):1880-1881. https://dx.doi.org/10.3201/eid1010.040464
    AMA Nemes Z, Kiss G, Madarassi EP, et al. Nosocomial Transmission of Dengue. Emerging Infectious Diseases. 2004;10(10):1880-1881. doi:10.3201/eid1010.040464.
    APA Nemes, Z., Kiss, G., Madarassi, E. P., Peterfi, Z., Ferenczi, E., Bakonyi, T....Ternak, G. (2004). Nosocomial Transmission of Dengue. Emerging Infectious Diseases, 10(10), 1880-1881. https://dx.doi.org/10.3201/eid1010.040464.
  • Human Crimean-Congo Hemorrhagic Fever, Sénégal PDF Version [PDF - 25 KB - 2 pages]
    P. Nabeth et al.
            Cite This Article
    EID Nabeth P, Thior M, Faye O, Simon F. Human Crimean-Congo Hemorrhagic Fever, Sénégal. Emerg Infect Dis. 2004;10(10):1881-1882. https://dx.doi.org/10.3201/eid1010.040586
    AMA Nabeth P, Thior M, Faye O, et al. Human Crimean-Congo Hemorrhagic Fever, Sénégal. Emerging Infectious Diseases. 2004;10(10):1881-1882. doi:10.3201/eid1010.040586.
    APA Nabeth, P., Thior, M., Faye, O., & Simon, F. (2004). Human Crimean-Congo Hemorrhagic Fever, Sénégal. Emerging Infectious Diseases, 10(10), 1881-1882. https://dx.doi.org/10.3201/eid1010.040586.
  • Influenza among U.K. Pilgrims to Hajj, 2003 PDF Version [PDF - 28 KB - 2 pages]
    H. El Bashir et al.
            Cite This Article
    EID El Bashir H, Haworth E, Zambon M, Shafi S, Zuckerman J, Booy R, et al. Influenza among U.K. Pilgrims to Hajj, 2003. Emerg Infect Dis. 2004;10(10):1882-1883. https://dx.doi.org/10.3201/eid1010.040151
    AMA El Bashir H, Haworth E, Zambon M, et al. Influenza among U.K. Pilgrims to Hajj, 2003. Emerging Infectious Diseases. 2004;10(10):1882-1883. doi:10.3201/eid1010.040151.
    APA El Bashir, H., Haworth, E., Zambon, M., Shafi, S., Zuckerman, J., & Booy, R. (2004). Influenza among U.K. Pilgrims to Hajj, 2003. Emerging Infectious Diseases, 10(10), 1882-1883. https://dx.doi.org/10.3201/eid1010.040151.
  • Streptomyces thermovulgaris Bacteremia in Crohn’s Disease Patient PDF Version [PDF - 37 KB - 3 pages]
    M. B. Ekkelenkamp et al.
            Cite This Article
    EID Ekkelenkamp MB, de Jong W, Hustinx W, Thijsen S. Streptomyces thermovulgaris Bacteremia in Crohn’s Disease Patient. Emerg Infect Dis. 2004;10(10):1883-1885. https://dx.doi.org/10.3201/eid1010.040300
    AMA Ekkelenkamp MB, de Jong W, Hustinx W, et al. Streptomyces thermovulgaris Bacteremia in Crohn’s Disease Patient. Emerging Infectious Diseases. 2004;10(10):1883-1885. doi:10.3201/eid1010.040300.
    APA Ekkelenkamp, M. B., de Jong, W., Hustinx, W., & Thijsen, S. (2004). Streptomyces thermovulgaris Bacteremia in Crohn’s Disease Patient. Emerging Infectious Diseases, 10(10), 1883-1885. https://dx.doi.org/10.3201/eid1010.040300.
  • Human West Nile Virus, France
    P. Del Giudice et al.
            Cite This Article
    EID Del Giudice P, Schuffenecker I, Vandenbos F, Evelyne C, Zeller H. Human West Nile Virus, France. Emerg Infect Dis. 2004;10(10):1885-1886. https://dx.doi.org/10.3201/eid1010.031021
    AMA Del Giudice P, Schuffenecker I, Vandenbos F, et al. Human West Nile Virus, France. Emerging Infectious Diseases. 2004;10(10):1885-1886. doi:10.3201/eid1010.031021.
    APA Del Giudice, P., Schuffenecker, I., Vandenbos, F., Evelyne, C., & Zeller, H. (2004). Human West Nile Virus, France. Emerging Infectious Diseases, 10(10), 1885-1886. https://dx.doi.org/10.3201/eid1010.031021.
  • SARS in Teaching Hospital, Taiwan PDF Version [PDF - 26 KB - 2 pages]
    Y. Chen et al.
            Cite This Article
    EID Chen Y, Chen M, Liu S, Romeis JC, Lee Y. SARS in Teaching Hospital, Taiwan. Emerg Infect Dis. 2004;10(10):1886-1887. https://dx.doi.org/10.3201/eid1010.040356
    AMA Chen Y, Chen M, Liu S, et al. SARS in Teaching Hospital, Taiwan. Emerging Infectious Diseases. 2004;10(10):1886-1887. doi:10.3201/eid1010.040356.
    APA Chen, Y., Chen, M., Liu, S., Romeis, J. C., & Lee, Y. (2004). SARS in Teaching Hospital, Taiwan. Emerging Infectious Diseases, 10(10), 1886-1887. https://dx.doi.org/10.3201/eid1010.040356.
  • Boiling and Bacillus Spores PDF Version [PDF - 35 KB - 2 pages]
    E. W. Rice et al.
            Cite This Article
    EID Rice EW, Rose LJ, Johnson CH, Boczek LA, Arduino MJ, Reasoner DJ, et al. Boiling and Bacillus Spores. Emerg Infect Dis. 2004;10(10):1887-1888. https://dx.doi.org/10.3201/eid1010.040158
    AMA Rice EW, Rose LJ, Johnson CH, et al. Boiling and Bacillus Spores. Emerging Infectious Diseases. 2004;10(10):1887-1888. doi:10.3201/eid1010.040158.
    APA Rice, E. W., Rose, L. J., Johnson, C. H., Boczek, L. A., Arduino, M. J., & Reasoner, D. J. (2004). Boiling and Bacillus Spores. Emerging Infectious Diseases, 10(10), 1887-1888. https://dx.doi.org/10.3201/eid1010.040158.

About the Cover

  • Molecular Techniques and the True Content of Reality PDF Version [PDF - 118 KB - 2 pages]
    P. Potter
            Cite This Article
    EID Potter P. Molecular Techniques and the True Content of Reality. Emerg Infect Dis. 2004;10(10):1892-1893. https://dx.doi.org/10.3201/eid1010.AC1010
    AMA Potter P. Molecular Techniques and the True Content of Reality. Emerging Infectious Diseases. 2004;10(10):1892-1893. doi:10.3201/eid1010.AC1010.
    APA Potter, P. (2004). Molecular Techniques and the True Content of Reality. Emerging Infectious Diseases, 10(10), 1892-1893. https://dx.doi.org/10.3201/eid1010.AC1010.

Corrections

  • Correction, vol. 10, no. 9 PDF Version [PDF - 26 KB - 1 page]
            Cite This Article
    EID Correction, vol. 10, no. 9. Emerg Infect Dis. 2004;10(10):1890. https://dx.doi.org/10.3201/eid1010.C11010
    AMA Correction, vol. 10, no. 9. Emerging Infectious Diseases. 2004;10(10):1890. doi:10.3201/eid1010.C11010.
    APA (2004). Correction, vol. 10, no. 9. Emerging Infectious Diseases, 10(10), 1890. https://dx.doi.org/10.3201/eid1010.C11010.

News and Notes

  • In Memoriam, Aniru Conteh, 1942–2004 
On the Front Lines of Lassa Fever PDF Version [PDF - 41 KB - 2 pages]
    D. G. Bausch et al.
            Cite This Article
    EID Bausch DG, Sesay SS, Oshin B. In Memoriam, Aniru Conteh, 1942–2004 
On the Front Lines of Lassa Fever. Emerg Infect Dis. 2004;10(10):1889-1890. https://dx.doi.org/10.3201/eid1010.040556
    AMA Bausch DG, Sesay SS, Oshin B. In Memoriam, Aniru Conteh, 1942–2004 
On the Front Lines of Lassa Fever. Emerging Infectious Diseases. 2004;10(10):1889-1890. doi:10.3201/eid1010.040556.
    APA Bausch, D. G., Sesay, S. S., & Oshin, B. (2004). In Memoriam, Aniru Conteh, 1942–2004 
On the Front Lines of Lassa Fever. Emerging Infectious Diseases, 10(10), 1889-1890. https://dx.doi.org/10.3201/eid1010.040556.
  • Conference on New and Re-Emerging Infectious Diseases PDF Version [PDF - 26 KB - 1 page]
    R. Docampo
            Cite This Article
    EID Docampo R. Conference on New and Re-Emerging Infectious Diseases. Emerg Infect Dis. 2004;10(10):1891. https://dx.doi.org/10.3201/eid1010.040531
    AMA Docampo R. Conference on New and Re-Emerging Infectious Diseases. Emerging Infectious Diseases. 2004;10(10):1891. doi:10.3201/eid1010.040531.
    APA Docampo, R. (2004). Conference on New and Re-Emerging Infectious Diseases. Emerging Infectious Diseases, 10(10), 1891. https://dx.doi.org/10.3201/eid1010.040531.
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