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Volume 10, Number 6—June 2004

Volume 10, Number 6—June 2004   PDF Version [PDF - 6.09 MB - 219 pages]

Perspective

  • Chronic Wasting Disease and Potential Transmission to Humans PDF Version [PDF - 93 KB - 8 pages]
    E. D. Belay et al.
        View Abstract

    Chronic wasting disease (CWD) of deer and elk is endemic in a tri-corner area of Colorado, Wyoming, and Nebraska, and new foci of CWD have been detected in other parts of the United States. Although detection in some areas may be related to increased surveillance, introduction of CWD due to translocation or natural migration of animals may account for some new foci of infection. Increasing spread of CWD has raised concerns about the potential for increasing human exposure to the CWD agent. The foodborne transmission of bovine spongiform encephalopathy to humans indicates that the species barrier may not completely protect humans from animal prion diseases. Conversion of human prion protein by CWD-associated prions has been demonstrated in an in vitro cell-free experiment, but limited investigations have not identified strong evidence for CWD transmission to humans. More epidemiologic and laboratory studies are needed to monitor the possibility of such transmissions.

        Cite This Article
    EID Belay ED, Maddox RA, Williams ES, Miller MW, Gambetti P, Schonberger LB, et al. Chronic Wasting Disease and Potential Transmission to Humans. Emerg Infect Dis. 2004;10(6):977-984. https://dx.doi.org/10.3201/eid1006.031082
    AMA Belay ED, Maddox RA, Williams ES, et al. Chronic Wasting Disease and Potential Transmission to Humans. Emerging Infectious Diseases. 2004;10(6):977-984. doi:10.3201/eid1006.031082.
    APA Belay, E. D., Maddox, R. A., Williams, E. S., Miller, M. W., Gambetti, P., & Schonberger, L. B. (2004). Chronic Wasting Disease and Potential Transmission to Humans. Emerging Infectious Diseases, 10(6), 977-984. https://dx.doi.org/10.3201/eid1006.031082.
  • Salmonella-based Rodenticides and Public Health PDF Version [PDF - 80 KB - 3 pages]
    J. A. Painter et al.
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    Several countries still permit strains of Salmonella enterica serotype Enteritidis, a leading cause of gastrointestinal illness in humans, to be used in rat baits. To assess the human health risk associated with such rat bait, we first reviewed historic data on health hazards associated with Ratin, a rodenticide that was used in Europe until the early 1960s. Ratin caused outbreaks of human illness, including several deaths. We then compared S. Enteritidis isolated from a current commercial product, Biorat, with S. Enteritidis from Ratin and found that the strains were both phage type 6a. Based on the similarity of the strains, currently available Salmonella-based rodenticides likely are as great a threat to public health as historic strains were. Health officials should be aware that the continued use of Salmonella-based rodenticides is a risk to public health and should take appropriate measures to prevent use in their jurisdictions.

        Cite This Article
    EID Painter JA, Mølbak K, Sonne-Hansen J, Barrett T, Wells JG, Tauxe RV, et al. Salmonella-based Rodenticides and Public Health. Emerg Infect Dis. 2004;10(6):985-987. https://dx.doi.org/10.3201/eid1006.030790
    AMA Painter JA, Mølbak K, Sonne-Hansen J, et al. Salmonella-based Rodenticides and Public Health. Emerging Infectious Diseases. 2004;10(6):985-987. doi:10.3201/eid1006.030790.
    APA Painter, J. A., Mølbak, K., Sonne-Hansen, J., Barrett, T., Wells, J. G., & Tauxe, R. V. (2004). Salmonella-based Rodenticides and Public Health. Emerging Infectious Diseases, 10(6), 985-987. https://dx.doi.org/10.3201/eid1006.030790.
  • First Report from the Asian Rotavirus Surveillance Network PDF Version [PDF - 207 KB - 8 pages]
    J. Bresee et al.
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    Rotavirus remains the most common cause of severe, dehydrating diarrhea among children worldwide. Several rotavirus vaccines are under development. Decisions about new vaccine introduction will require reliable data on disease impact. The Asian Rotavirus Surveillance Network, begun in 2000 to facilitate collection of these data, and is a regional collaboration of 36 hospitals in nine countries or areas that conduct surveillance for rotavirus hospitalizations using a uniform World Health Organization protocol. We summarize the Network’s organization and experience from August 2001 through July 2002. During this period, 45% of acute diarrheal hospitalizations among children 0–5 years were attributable to rotavirus, higher than previous estimates. Rotavirus was detected in all sites year-round. This network is a novel, regional approach to surveillance for vaccine-preventable diseases. Such a network should provide increased visibility and advocacy, enable more efficient data collection, facilitate training, and serve as the paradigm for rotavirus surveillance activities in other regions.

        Cite This Article
    EID Bresee J, Fang Z, Wang B, Nelson E, Tam J, Soenarto Y, et al. First Report from the Asian Rotavirus Surveillance Network. Emerg Infect Dis. 2004;10(6):988-995. https://dx.doi.org/10.3201/eid1006.030519
    AMA Bresee J, Fang Z, Wang B, et al. First Report from the Asian Rotavirus Surveillance Network. Emerging Infectious Diseases. 2004;10(6):988-995. doi:10.3201/eid1006.030519.
    APA Bresee, J., Fang, Z., Wang, B., Nelson, E., Tam, J., Soenarto, Y....Glass, R. (2004). First Report from the Asian Rotavirus Surveillance Network. Emerging Infectious Diseases, 10(6), 988-995. https://dx.doi.org/10.3201/eid1006.030519.
  • Airborne Infection with Bacillus anthracis—from Mills to Mail PDF Version [PDF - 129 KB - 6 pages]
    K. P. Fennelly et al.
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    The lack of identified exposures in 2 of the 11 cases of bioterrorism-related inhalation anthrax in 2001 raised uncertainty about the infectious dose and transmission of Bacillus anthracis. We used the Wells-Riley mathematical model of airborne infection to estimate 1) the exposure concentrations in postal facilities where cases of inhalation anthrax occurred and 2) the risk for infection in various hypothetical scenarios of exposure to B. anthracis aerosolized from contaminated mail in residential settings. These models suggest that a small number of cases of inhalation anthrax can be expected when large numbers of persons are exposed to low concentrations of B. anthracis. The risk for inhalation anthrax is determined not only by bacillary virulence factors but also by infectious aerosol production and removal rates and by host factors.

        Cite This Article
    EID Fennelly KP, Davidow AL, Miller SL, Connell N, Ellner JJ. Airborne Infection with Bacillus anthracis—from Mills to Mail. Emerg Infect Dis. 2004;10(6):996-1001. https://dx.doi.org/10.3201/eid1006.020738
    AMA Fennelly KP, Davidow AL, Miller SL, et al. Airborne Infection with Bacillus anthracis—from Mills to Mail. Emerging Infectious Diseases. 2004;10(6):996-1001. doi:10.3201/eid1006.020738.
    APA Fennelly, K. P., Davidow, A. L., Miller, S. L., Connell, N., & Ellner, J. J. (2004). Airborne Infection with Bacillus anthracis—from Mills to Mail. Emerging Infectious Diseases, 10(6), 996-1001. https://dx.doi.org/10.3201/eid1006.020738.

Research

  • Environmental Sources of Prion Transmission in Mule Deer PDF Version [PDF - 93 KB - 4 pages]
    M. W. Miller et al.
        View Abstract

    Whether transmission of the chronic wasting disease (CWD) prion among cervids requires direct interaction with infected animals has been unclear. We report that CWD can be transmitted to susceptible animals indirectly, from environments contaminated by excreta or decomposed carcasses. Under experimental conditions, mule deer (Odocoileus hemionus) became infected in two of three paddocks containing naturally infected deer, in two of three paddocks where infected deer carcasses had decomposed in situ ≈1.8 years earlier, and in one of three paddocks where infected deer had last resided 2.2 years earlier. Indirect transmission and environmental persistence of infectious prions will complicate efforts to control CWD and perhaps other animal prion diseases.

        Cite This Article
    EID Miller MW, Williams ES, Hobbs NT, Wolfe LL. Environmental Sources of Prion Transmission in Mule Deer. Emerg Infect Dis. 2004;10(6):1003-1006. https://dx.doi.org/10.3201/eid1006.040010
    AMA Miller MW, Williams ES, Hobbs NT, et al. Environmental Sources of Prion Transmission in Mule Deer. Emerging Infectious Diseases. 2004;10(6):1003-1006. doi:10.3201/eid1006.040010.
    APA Miller, M. W., Williams, E. S., Hobbs, N. T., & Wolfe, L. L. (2004). Environmental Sources of Prion Transmission in Mule Deer. Emerging Infectious Diseases, 10(6), 1003-1006. https://dx.doi.org/10.3201/eid1006.040010.
  • Sporadic Cryptosporidiosis, North Cumbria, England, 1996–2000 PDF Version [PDF - 136 KB - 9 pages]
    S. Goh et al.
        View Abstract

    Risk factors for sporadic cryptosporidiosis were determined in 152 patients and 466 unmatched controls who resided in two local government districts in North Cumbria, North West England, from March 1, 1996, to February 29, 2000. Risk was associated with the usual daily volume of cold unboiled tap water drunk (odds ratio [OR] 1.40, 95% confidence intervals [CI] 1.14 to 1.71 per pint consumed per day [p = 0.001]) and short visits to farms (OR 2.02, 95% CI 1.04 to 3.90, p = 0.04). Fifty-six (84%) of 67 fecal specimens from patients obtained from January 1, 1998, and February 29, 2000, were Cryptosporidium parvum genotype 2 (animal and human strain). Livestock fecal pollution of water sources appears to be the leading cause of human sporadic cryptosporidiosis in this population and shows the need for better protection of water catchments from livestock and improved drinking water treatment in this area of England.

        Cite This Article
    EID Goh S, Reacher M, Casemore DP, Verlander NQ, Chalmers R, Knowles M, et al. Sporadic Cryptosporidiosis, North Cumbria, England, 1996–2000. Emerg Infect Dis. 2004;10(6):1007-1015. https://dx.doi.org/10.3201/eid1006.030325
    AMA Goh S, Reacher M, Casemore DP, et al. Sporadic Cryptosporidiosis, North Cumbria, England, 1996–2000. Emerging Infectious Diseases. 2004;10(6):1007-1015. doi:10.3201/eid1006.030325.
    APA Goh, S., Reacher, M., Casemore, D. P., Verlander, N. Q., Chalmers, R., Knowles, M....Richards, S. (2004). Sporadic Cryptosporidiosis, North Cumbria, England, 1996–2000. Emerging Infectious Diseases, 10(6), 1007-1015. https://dx.doi.org/10.3201/eid1006.030325.
  • Environmental Exposure and Leptospirosis, Peru PDF Version [PDF - 207 KB - 7 pages]
    M. A. Johnson et al.
        View Abstract

    Human infection by leptospires has highly variable clinical manifestations, ranging from subclinical infection to fulminant disease. We conducted a population-based, cross-sectional seroepidemiologic study in Peru to determine potential relationships of environmental context to human exposure to Leptospira and disease associated with seroconversion. Three areas were studied: a flooded, urban slum in the Peruvian Amazon city of Iquitos; rural, peri-Iquitos villages; and a desert shantytown near Lima. Seroprevalence in Belen was 28% (182/650); in rural areas, 17% (52/316); and in a desert shantytown, 0.7% (1/150). Leptospira-infected peridomestic rats were found in all locales. In Belen, 20 (12.4%) of 161 patients seroconverted between dry and wet seasons (an incidence rate of 288/1,000); seroconversion was associated with history of febrile illness; severe leptospirosis was not seen. Human exposure to Leptospira in the Iquitos region is high, likely related both to the ubiquity of leptospires in the environment and human behavior conducive to transmission from infected zoonotic sources.

        Cite This Article
    EID Johnson MA, Smith H, Joseph P, Gilman RH, Bautista CT, Campos KJ, et al. Environmental Exposure and Leptospirosis, Peru. Emerg Infect Dis. 2004;10(6):1016-1022. https://dx.doi.org/10.3201/eid1006.030660
    AMA Johnson MA, Smith H, Joseph P, et al. Environmental Exposure and Leptospirosis, Peru. Emerging Infectious Diseases. 2004;10(6):1016-1022. doi:10.3201/eid1006.030660.
    APA Johnson, M. A., Smith, H., Joseph, P., Gilman, R. H., Bautista, C. T., Campos, K. J....Vinetz, J. M. (2004). Environmental Exposure and Leptospirosis, Peru. Emerging Infectious Diseases, 10(6), 1016-1022. https://dx.doi.org/10.3201/eid1006.030660.
  • Swab Materials and Bacillus anthracis Spore Recovery from Nonporous Surfaces PDF Version [PDF - 305 KB - 7 pages]
    L. Rose et al.
        View Abstract

    Four swab materials were evaluated for their efficiency in recovery of Bacillus anthracis spores from steel coupons. Cotton, macrofoam, polyester, and rayon swabs were used to sample coupons inoculated with a spore suspension of known concentration. Three methods of processing for the removal of spores from the swabs (vortexing, sonication, or minimal agitation) and two swab preparations (premoistened and dry) were evaluated. Results indicated that premoistened swabs were more efficient at recovering spores than dry swabs (14.3% vs. 4.4%). Vortexing swabs for 2 min during processing resulted in superior extraction of spores when compared to sonicating them for 12 min or subjecting them to minimal agitation. Premoistened macrofoam and cotton swabs that were vortexed during processing recovered the greatest proportions of spores with a mean recovery of 43.6% (standard deviation [SD] 11.1%) and 41.7% (SD 14.6%), respectively. Premoistened and vortexed polyester and rayon swabs were less efficient at 9.9% (SD 3.8%) and 11.5% (SD 7.9%), respectively.

        Cite This Article
    EID Rose L, Jensen BJ, Peterson A, Banerjee SN, Arduino MJ. Swab Materials and Bacillus anthracis Spore Recovery from Nonporous Surfaces. Emerg Infect Dis. 2004;10(6):1023-1029. https://dx.doi.org/10.3201/eid1006.030716
    AMA Rose L, Jensen BJ, Peterson A, et al. Swab Materials and Bacillus anthracis Spore Recovery from Nonporous Surfaces. Emerging Infectious Diseases. 2004;10(6):1023-1029. doi:10.3201/eid1006.030716.
    APA Rose, L., Jensen, B. J., Peterson, A., Banerjee, S. N., & Arduino, M. J. (2004). Swab Materials and Bacillus anthracis Spore Recovery from Nonporous Surfaces. Emerging Infectious Diseases, 10(6), 1023-1029. https://dx.doi.org/10.3201/eid1006.030716.
  • Epidemiologic Clues to SARS Origin in China PDF Version [PDF - 179 KB - 7 pages]
    R. Xu et al.
        View Abstract

    An epidemic of severe acute respiratory syndrome (SARS) began in Foshan municipality, Guangdong Province, China, in November 2002. We studied SARS case reports through April 30, 2003, including data from case investigations and a case series analysis of index cases. A total of 1,454 clinically confirmed cases (and 55 deaths) occurred; the epidemic peak was in the first week of February 2003. Healthcare workers accounted for 24% of cases. Clinical signs and symptoms differed between children (<18 years) and older persons (>65 years). Several observations support the hypothesis of a wild animal origin for SARS. Cases apparently occurred independently in at least five different municipalities; early case-patients were more likely than later patients to report living near a produce market (odds ratio undefined; lower 95% confidence interval 2.39) but not near a farm; and 9 (39%) of 23 early patients, including 6 who lived or worked in Foshan, were food handlers with probable animal contact.

        Cite This Article
    EID Xu R, He J, Evans MR, Peng G, Field H, Yu D, et al. Epidemiologic Clues to SARS Origin in China. Emerg Infect Dis. 2004;10(6):1031-1037. https://dx.doi.org/10.3201/eid1006.030852
    AMA Xu R, He J, Evans MR, et al. Epidemiologic Clues to SARS Origin in China. Emerging Infectious Diseases. 2004;10(6):1031-1037. doi:10.3201/eid1006.030852.
    APA Xu, R., He, J., Evans, M. R., Peng, G., Field, H., Yu, D....Schnur, A. (2004). Epidemiologic Clues to SARS Origin in China. Emerging Infectious Diseases, 10(6), 1031-1037. https://dx.doi.org/10.3201/eid1006.030852.
  • Mycobacterium ulcerans Treatment Costs, Australia PDF Version [PDF - 141 KB - 6 pages]
    C. Drummond and J. R. Butler
        View Abstract

    Mycobacterium ulcerans gives rise to severe skin ulceration that can be associated with considerable illness. The cost of diagnosis, treatment, and lost income has never been assessed in Australia. A survey of 26 confirmed cases of the disease in Victoria was undertaken. Data were collected on demographic details, diagnostic tests, treatment, time off work, and travel to obtain treatment. All costs are reported in Australian dollars in 1997–98 prices. The cost varies considerably with disease severity. For mild cases, the average direct cost is $6,800, and for severe cases $27,681. Hospitalization accounts for 61% to 90% of costs, and indirect costs amount to 24% of the total per case. M. ulcerans can be an expensive disease to diagnose and treat. Costs can be reduced by early diagnosis and definitive treatment. Research is needed to find cost-effective therapies for this disease.

        Cite This Article
    EID Drummond C, Butler JR. Mycobacterium ulcerans Treatment Costs, Australia. Emerg Infect Dis. 2004;10(6):1038-1043. https://dx.doi.org/10.3201/eid1006.030428
    AMA Drummond C, Butler JR. Mycobacterium ulcerans Treatment Costs, Australia. Emerging Infectious Diseases. 2004;10(6):1038-1043. doi:10.3201/eid1006.030428.
    APA Drummond, C., & Butler, J. R. (2004). Mycobacterium ulcerans Treatment Costs, Australia. Emerging Infectious Diseases, 10(6), 1038-1043. https://dx.doi.org/10.3201/eid1006.030428.
  • Bovine Spongiform Encephalopathy Infectivity in Greater Kudu (Tragelaphus strepsiceros) PDF Version [PDF - 219 KB - 6 pages]
    A. A. Cunningham et al.
        View Abstract

    Of all the species exposed naturally to the bovine spongiform encephalopathy (BSE) agent, the greater kudu (Tragelaphus strepsiceros), a nondomesticated bovine from Africa, appears to be the most susceptible to the disease. We present the results of mouse bioassay studies to show that, contrary to findings in cattle with BSE in which the tissue distribution of infectivity is the most limited recorded for any of the transmissible spongiform encephalopathies (TSE), infectivity in greater kudu with BSE is distributed in as wide a range of tissues as occurs in any TSE. Agent was also detected in skin, conjunctiva, and salivary gland, tissues in which infectivity has not previously been reported in any naturally occurring TSE. The distribution of infectivity in greater kudu with BSE suggests possible routes for transmission of the disease and highlights the need for further research into the distribution of TSE infectious agents in other host species.

        Cite This Article
    EID Cunningham AA, Kirkwood JK, Dawson M, Spencer YI, Green RB, Wells GA, et al. Bovine Spongiform Encephalopathy Infectivity in Greater Kudu (Tragelaphus strepsiceros). Emerg Infect Dis. 2004;10(6):1044-1049. https://dx.doi.org/10.3201/eid1006.030615
    AMA Cunningham AA, Kirkwood JK, Dawson M, et al. Bovine Spongiform Encephalopathy Infectivity in Greater Kudu (Tragelaphus strepsiceros). Emerging Infectious Diseases. 2004;10(6):1044-1049. doi:10.3201/eid1006.030615.
    APA Cunningham, A. A., Kirkwood, J. K., Dawson, M., Spencer, Y. I., Green, R. B., & Wells, G. A. (2004). Bovine Spongiform Encephalopathy Infectivity in Greater Kudu (Tragelaphus strepsiceros). Emerging Infectious Diseases, 10(6), 1044-1049. https://dx.doi.org/10.3201/eid1006.030615.
  • Nursing Home Residents and Enterobacteriaceae Resistant to Third-Generation Cephalosporins PDF Version [PDF - 76 KB - 6 pages]
    C. Sandoval et al.
        View Abstract

    Limited data identify the risk factors for infection with Enterobacteriaceae resistant to third-generation cephalosporins among residents of long-term-care facilities. Using a nested case-control study design, nursing home residents with clinical isolates of Enterobacteriaceae resistant to third-generation cephalosporins were compared to residents with isolates of Enterobacteriaceae susceptible to third-generation cephalosporins. Data were collected on antimicrobial drug exposure 10 weeks before detection of the isolates, facility-level demographics, hygiene facilities, and staffing levels. Logistic regression models were built to adjust for confounding variables. Twenty-seven case-residents were identified and compared to 85 controls. Exposure to any cephalosporin (adjusted odds ratio [OR] 4.0, 95% confidence interval [CI] 1.2 to13.6) and log percentage of residents using gastrostomy tubes within the nursing home (adjusted OR 3.9, 95% CI 1.3 to 12.0) were associated with having a clinical isolate resistant to third-generation cephalosporins.

        Cite This Article
    EID Sandoval C, Walter SD, McGeer A, Simor AE, Bradley SF, Moss LM, et al. Nursing Home Residents and Enterobacteriaceae Resistant to Third-Generation Cephalosporins. Emerg Infect Dis. 2004;10(6):1050-1055. https://dx.doi.org/10.3201/eid1006.030662
    AMA Sandoval C, Walter SD, McGeer A, et al. Nursing Home Residents and Enterobacteriaceae Resistant to Third-Generation Cephalosporins. Emerging Infectious Diseases. 2004;10(6):1050-1055. doi:10.3201/eid1006.030662.
    APA Sandoval, C., Walter, S. D., McGeer, A., Simor, A. E., Bradley, S. F., Moss, L. M....Loeb, M. B. (2004). Nursing Home Residents and Enterobacteriaceae Resistant to Third-Generation Cephalosporins. Emerging Infectious Diseases, 10(6), 1050-1055. https://dx.doi.org/10.3201/eid1006.030662.
  • Quinolone-resistant Campylobacter Infections in Denmark: Risk Factors and Clinical Consequences PDF Version [PDF - 75 KB - 8 pages]
    J. Engberg et al.
        View Abstract

    We integrated data on quinolone and macrolide susceptibility patterns with epidemiologic and typing data from Campylobacter jejuni and C. coli infections in two Danish counties. The mean duration of illness was longer for 86 patients with quinolone-resistant C. jejuni infections (median 13.2 days) than for 381 patients with quinolone-sensitive C. jejuni infections (median 10.3 days, p = 0.001). Foreign travel, eating fresh poultry other than chicken and turkey, and swimming were associated with increased risk of quinolone-resistant C. jejuni infection. Eating fresh chicken (of presumably Danish origin) was associated with a decreased risk. Typing data showed an association between strains from retail food products and broiler chickens and quinolone-sensitive domestically acquired C. jejuni infections. An association between treatment with a fluoroquinolone before stool-specimen collection and having a quinolone-resistant C. jejuni infection was not observed.

        Cite This Article
    EID Engberg J, Neimann J, Nielsen E, Aarestrup F, Fussing V. Quinolone-resistant Campylobacter Infections in Denmark: Risk Factors and Clinical Consequences1. Emerg Infect Dis. 2004;10(6):1056-1063. https://dx.doi.org/10.3201/eid1006.030669
    AMA Engberg J, Neimann J, Nielsen E, et al. Quinolone-resistant Campylobacter Infections in Denmark: Risk Factors and Clinical Consequences1. Emerging Infectious Diseases. 2004;10(6):1056-1063. doi:10.3201/eid1006.030669.
    APA Engberg, J., Neimann, J., Nielsen, E., Aarestrup, F., & Fussing, V. (2004). Quinolone-resistant Campylobacter Infections in Denmark: Risk Factors and Clinical Consequences1. Emerging Infectious Diseases, 10(6), 1056-1063. https://dx.doi.org/10.3201/eid1006.030669.
  • Yellow Fever Outbreak, Imatong, Southern Sudan PDF Version [PDF - 52 KB - 5 pages]
    C. O. Onyango et al.
        View Abstract

    In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin (Ig) M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription–polymerase chain reaction with both the genus Flavivirus reactive primers and yellow fever virus–specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak.

        Cite This Article
    EID Onyango CO, Ofula VO, Sang RC, Konongoi SL, Sow A, De Cock KM, et al. Yellow Fever Outbreak, Imatong, Southern Sudan. Emerg Infect Dis. 2004;10(6):1064-1068. https://dx.doi.org/10.3201/eid1006.030738
    AMA Onyango CO, Ofula VO, Sang RC, et al. Yellow Fever Outbreak, Imatong, Southern Sudan. Emerging Infectious Diseases. 2004;10(6):1064-1068. doi:10.3201/eid1006.030738.
    APA Onyango, C. O., Ofula, V. O., Sang, R. C., Konongoi, S. L., Sow, A., De Cock, K. M....Coldren, R. L. (2004). Yellow Fever Outbreak, Imatong, Southern Sudan. Emerging Infectious Diseases, 10(6), 1064-1068. https://dx.doi.org/10.3201/eid1006.030738.
  • Newborn Screening for Congenital Infectious Diseases PDF Version [PDF - 51 KB - 5 pages]
    E. C. Neto et al.
        View Abstract

    To estimate the prevalence of congenital toxoplasmosis, Chagas disease, cytomegalovirus, and rubella, blood samples on dried blood spot (DBS) from neonates (day 3–20 of life) were screened for immunoglobulin (Ig) M against Toxoplasma gondii, cytomegalovirus, rubella virus, and IgG against Trypanosoma cruzi by methods used for serum and adapted for use with DBS. Positive samples were further analyzed for IgM and IgG in serum from neonates and mothers. DBS samples from 364,130 neonates were tested for Toxoplasma gondii–specific IgM, and 15,873 neonates were also tested for IgM against cytomegalovirus, rubella virus, and for Trypanosoma cruzi–specific IgG. A total of 195 were diagnosed with congenital toxoplasmosis, 16 with cytomegalovirus, and 11 with congenital rubella. One newborn had a confirmed result for Chagas disease, and 21 mothers had positive serum antibodies. These results suggest that infectious diseases should be considered for future inclusion in programs for newborn screening of metabolic diseases in disease-endemic areas.

        Cite This Article
    EID Neto EC, Rubin R, Schulte J, Giugliani R. Newborn Screening for Congenital Infectious Diseases. Emerg Infect Dis. 2004;10(6):1069-1073. https://dx.doi.org/10.3201/eid1006.030830
    AMA Neto EC, Rubin R, Schulte J, et al. Newborn Screening for Congenital Infectious Diseases. Emerging Infectious Diseases. 2004;10(6):1069-1073. doi:10.3201/eid1006.030830.
    APA Neto, E. C., Rubin, R., Schulte, J., & Giugliani, R. (2004). Newborn Screening for Congenital Infectious Diseases. Emerging Infectious Diseases, 10(6), 1069-1073. https://dx.doi.org/10.3201/eid1006.030830.
  • Candida parapsilosis Characterization in an Outbreak Setting PDF Version [PDF - 378 KB - 8 pages]
    D. M. Kuhn et al.
        View Abstract

    Candida parapsilosis is an important non-albicans species which infects hospitalized patients. No studies have correlated outbreak infections of C. parapsilosis with multiple virulence factors. We used DNA fingerprinting to determine genetic variability among isolates from a C. parapsilosis outbreak and from our clinical database. We compared phenotypic markers of pathogenesis, including adherence, biofilm formation, and protein secretion (secretory aspartic protease [SAP] and phospholipase). Adherence was measured as colony counts on silicone elastomer disks immersed in agar. Biofilms formed on disks were quantified by dry weight. SAP expression was measured by hydrolysis of bovine albumin; a colorimetric assay was used to quantitate phospholipase. DNA fingerprinting indicated that the outbreak isolates were clonal and genetically distinct from our database. Biofilm expression by the outbreak clone was greater than that of sporadic isolates (p ≤ 0.0005). Adherence and protein secretion did not correlate with strain pathogenicity. These results suggest that biofilm production plays a role in C. parapsilosis outbreaks.

        Cite This Article
    EID Kuhn DM, Mukherjee PK, Clark TA, Pujol C, Chandra J, Hajjeh RA, et al. Candida parapsilosis Characterization in an Outbreak Setting. Emerg Infect Dis. 2004;10(6):1074-1081. https://dx.doi.org/10.3201/eid1006.030873
    AMA Kuhn DM, Mukherjee PK, Clark TA, et al. Candida parapsilosis Characterization in an Outbreak Setting. Emerging Infectious Diseases. 2004;10(6):1074-1081. doi:10.3201/eid1006.030873.
    APA Kuhn, D. M., Mukherjee, P. K., Clark, T. A., Pujol, C., Chandra, J., Hajjeh, R. A....Ghannoum, M. A. (2004). Candida parapsilosis Characterization in an Outbreak Setting. Emerging Infectious Diseases, 10(6), 1074-1081. https://dx.doi.org/10.3201/eid1006.030873.
  • Limited Spread of Penicillin-Nonsusceptible Pneumococci, Skåne County, Sweden PDF Version [PDF - 118 KB - 6 pages]
    E. Melander et al.
        View Abstract

    In response to increasing frequencies of penicillin-nonsusceptible pneumococci (PNSP), for which the MIC of penicillin was ≥0.12 mg/L, in Skåne County, southern Sweden, national recommendations were initiated in 1995 to limit the spread of pneumococci with high MICs (≥0.5 mg/L) of penicillin (penicillin-resistant pneumococci [PRP]), especially among children of preschool age. Traditional communicable disease control measures were combined with actions against inappropriate antimicrobial drug use. During the first 6 years that these recommendations were applied in Skåne County, the average frequency of penicillin-resistant pneumococci has been stable at ≈2.6%, as has the average PNSP frequency (7.4%). However, PNSP have been unevenly distributed in the county, with the highest frequencies in the southwest. Simultaneously, the rate of antimicrobial drug use for children <6 years of age was reduced by 20%. Thus the spread of PNSP between and within the municipalities in the county has been limited.

        Cite This Article
    EID Melander E, Hansson H, Persson K, Ringberg H. Limited Spread of Penicillin-Nonsusceptible Pneumococci, Skåne County, Sweden. Emerg Infect Dis. 2004;10(6):1082-1087. https://dx.doi.org/10.3201/eid1006.030488
    AMA Melander E, Hansson H, Persson K, et al. Limited Spread of Penicillin-Nonsusceptible Pneumococci, Skåne County, Sweden. Emerging Infectious Diseases. 2004;10(6):1082-1087. doi:10.3201/eid1006.030488.
    APA Melander, E., Hansson, H., Persson, K., & Ringberg, H. (2004). Limited Spread of Penicillin-Nonsusceptible Pneumococci, Skåne County, Sweden. Emerging Infectious Diseases, 10(6), 1082-1087. https://dx.doi.org/10.3201/eid1006.030488.
  • Antimicrobial Resistance Incidence and Risk Factors among Helicobacter pylori–Infected Persons, United States PDF Version [PDF - 331 KB - 7 pages]
    W. M. Duck et al.
        View Abstract

    Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer. H. pylori infection is curable with regimens of multiple antimicrobial agents, and antimicrobial resistance is a leading cause of treatment failure. The Helicobacter pylori Antimicrobial Resistance Monitoring Program (HARP) is a prospective, multicenter U.S. network that tracks national prevalence rates of H. pylori antimicrobial resistance. Of 347 clinical H. pylori isolates collected from December 1998 through 2002, 101 (29.1%) were resistant to one antimicrobial agent, and 17 (4.8%) were resistant to two or more antimicrobial agents. Eighty-seven (25.1%) isolates were resistant to metronidazole, 45 (12.9%) to clarithromycin, and 3 (0.9%) to amoxicillin. On multivariate analysis, black race was the only significant risk factor (p < 0.01, hazard ratio 2.04) for infection with a resistant H. pylori strain. Formulating pretreatment screening strategies or providing alternative therapeutic regimens for high-risk populations may be important for future clinical practice.

        Cite This Article
    EID Duck WM, Sobel J, Pruckler JM, Song Q, Swerdlow DL, Friedman C, et al. Antimicrobial Resistance Incidence and Risk Factors among Helicobacter pylori–Infected Persons, United States. Emerg Infect Dis. 2004;10(6):1088-1094. https://dx.doi.org/10.3201/eid1006.030744
    AMA Duck WM, Sobel J, Pruckler JM, et al. Antimicrobial Resistance Incidence and Risk Factors among Helicobacter pylori–Infected Persons, United States. Emerging Infectious Diseases. 2004;10(6):1088-1094. doi:10.3201/eid1006.030744.
    APA Duck, W. M., Sobel, J., Pruckler, J. M., Song, Q., Swerdlow, D. L., Friedman, C....Gold, B. D. (2004). Antimicrobial Resistance Incidence and Risk Factors among Helicobacter pylori–Infected Persons, United States. Emerging Infectious Diseases, 10(6), 1088-1094. https://dx.doi.org/10.3201/eid1006.030744.
  • Respiratory Picornaviruses and Respiratory Syncytial Virus as Causative Agents of Acute Expiratory Wheezing in Children PDF Version [PDF - 299 KB - 7 pages]
    T. Jartti et al.
        View Abstract

    Suggested citation for this article: Jartti T, Lehtinen P, Vuorinen T, Österback R, van den Hoogen B, Osterhaus ADME, et al. Respiratory picornaviruses and respiratory syncytial virus as causative agents of expiratory wheezing in children. Emerg Infect Dis [serial on the Internet]. 2004 Jun [date cited]. Available from: http://www.cdc.gov/ncidod/EID/vol10no6/03-0629.htm

        Cite This Article
    EID Jartti T, Lehtinen P, Vuorinen T, Österback R, van den Hoogen BG, Osterhaus A, et al. Respiratory Picornaviruses and Respiratory Syncytial Virus as Causative Agents of Acute Expiratory Wheezing in Children. Emerg Infect Dis. 2004;10(6):1095-1101. https://dx.doi.org/10.3201/eid1006.030629
    AMA Jartti T, Lehtinen P, Vuorinen T, et al. Respiratory Picornaviruses and Respiratory Syncytial Virus as Causative Agents of Acute Expiratory Wheezing in Children. Emerging Infectious Diseases. 2004;10(6):1095-1101. doi:10.3201/eid1006.030629.
    APA Jartti, T., Lehtinen, P., Vuorinen, T., Österback, R., van den Hoogen, B. G., Osterhaus, A....Ruuskanen, O. (2004). Respiratory Picornaviruses and Respiratory Syncytial Virus as Causative Agents of Acute Expiratory Wheezing in Children. Emerging Infectious Diseases, 10(6), 1095-1101. https://dx.doi.org/10.3201/eid1006.030629.
  • Antimicrobial Resistance among Campylobacter Strains, United States, 1997–2001 PDF Version [PDF - 140 KB - 8 pages]
    A. Gupta et al.
        View Abstract

    We summarize antimicrobial resistance surveillance data in human and chicken isolates of Campylobacter. Isolates were from a sentinel county study from 1989 through 1990 and from nine state health departments participating in National Antimicrobial Resistance Monitoring System for enteric bacteria (NARMS) from 1997 through 2001. None of the 297 C. jejuni or C. coli isolates tested from 1989 through 1990 was ciprofloxacin-resistant. From 1997 through 2001, a total of 1,553 human Campylobacter isolates were characterized: 1,471 (95%) were C. jejuni, 63 (4%) were C. coli, and 19 (1%) were other Campylobacter species. The prevalence of ciprofloxacin-resistant Campylobacter was 13% (28 of 217) in 1997 and 19% (75 of 384) in 2001; erythromycin resistance was 2% (4 of 217) in 1997 and 2% (8 of 384) in 2001. Ciprofloxacin-resistant Campylobacter was isolated from 10% of 180 chicken products purchased from grocery stores in three states in 1999. Ciprofloxacin resistance has emerged among Campylobacter since 1990 and has increased in prevalence since 1997.

        Cite This Article
    EID Gupta A, Nelson JM, Barrett TJ, Tauxe RV, Rossiter SP, Friedman CR, et al. Antimicrobial Resistance among Campylobacter Strains, United States, 1997–2001. Emerg Infect Dis. 2004;10(6):1102-1109. https://dx.doi.org/10.3201/eid1006.030635
    AMA Gupta A, Nelson JM, Barrett TJ, et al. Antimicrobial Resistance among Campylobacter Strains, United States, 1997–2001. Emerging Infectious Diseases. 2004;10(6):1102-1109. doi:10.3201/eid1006.030635.
    APA Gupta, A., Nelson, J. M., Barrett, T. J., Tauxe, R. V., Rossiter, S. P., Friedman, C. R....Angulo, F. J. (2004). Antimicrobial Resistance among Campylobacter Strains, United States, 1997–2001. Emerging Infectious Diseases, 10(6), 1102-1109. https://dx.doi.org/10.3201/eid1006.030635.

Historical Review

  • Emerging Issues in Infective Endocarditis PDF Version [PDF - 146 KB - 7 pages]
    B. C. Millar and J. E. Moore
        View Abstract

    Infective endocarditis, a serious infection of the endocardium of the heart, particularly the heart valves, is associated with a high degree of illness and death. It generally occurs in patients with altered and abnormal heart architecture, in combination with exposure to bacteria through trauma and other potentially high-risk activities involving transient bacteremia. Knowledge about the origins of endocarditis stems from the work of Fernel in the early 1500s, and yet this infection still presents physicians with major diagnostic and management dilemmas. Endocarditis is caused by a variety of bacteria and fungi, as well as emerging infectious agents, including Tropheryma whipelli, Bartonella spp., and Rickettsia spp. We review the evolution of endocarditis and compare its progression with discoveries in microbiology, science, and medicine.

        Cite This Article
    EID Millar BC, Moore JE. Emerging Issues in Infective Endocarditis. Emerg Infect Dis. 2004;10(6):1110-1116. https://dx.doi.org/10.3201/eid1006.030848
    AMA Millar BC, Moore JE. Emerging Issues in Infective Endocarditis. Emerging Infectious Diseases. 2004;10(6):1110-1116. doi:10.3201/eid1006.030848.
    APA Millar, B. C., & Moore, J. E. (2004). Emerging Issues in Infective Endocarditis. Emerging Infectious Diseases, 10(6), 1110-1116. https://dx.doi.org/10.3201/eid1006.030848.

Dispatches

  • SARS Exposure and Emergency Department Workers PDF Version [PDF - 165 KB - 3 pages]
    W. Chang et al.
        View Abstract

    Of 193 emergency department workers exposed to severe acute respiratory syndrome (SARS), 9 (4.7%) were infected. Pneumonia developed in six workers, and assays showed anti-SARS immunoglobulin (Ig) M and IgG. The other three workers were IgM-positive and had lower IgG titers; in two, mild illness developed, and one remained asymptomatic.

        Cite This Article
    EID Chang W, Kao C, Chung M, Chen S, Lin S, Chiang W, et al. SARS Exposure and Emergency Department Workers. Emerg Infect Dis. 2004;10(6):1117-1119. https://dx.doi.org/10.3201/eid1006.030972
    AMA Chang W, Kao C, Chung M, et al. SARS Exposure and Emergency Department Workers. Emerging Infectious Diseases. 2004;10(6):1117-1119. doi:10.3201/eid1006.030972.
    APA Chang, W., Kao, C., Chung, M., Chen, S., Lin, S., Chiang, W....Yang, P. (2004). SARS Exposure and Emergency Department Workers. Emerging Infectious Diseases, 10(6), 1117-1119. https://dx.doi.org/10.3201/eid1006.030972.
  • Antibody Prevalence of West Nile Virus in Birds, Illinois, 2002 PDF Version [PDF - 242 KB - 5 pages]
    A. M. Ringia et al.
        View Abstract

    Antibodies to West Nile virus were detected in 94 of 1,784 Illinois birds during 2002. Captive and urban birds had higher seropositivity than did birds from natural areas, and northern and central Illinois birds’ seropositivity was greater than that from birds from the southern sites. Adult and hatch-year exposure rates did not differ significantly.

        Cite This Article
    EID Ringia AM, Blitvich BJ, Koo H, Van de Wyngaerde M, Brawn JD, Novak RJ, et al. Antibody Prevalence of West Nile Virus in Birds, Illinois, 2002. Emerg Infect Dis. 2004;10(6):1120-1124. https://dx.doi.org/10.3201/eid1006.030644
    AMA Ringia AM, Blitvich BJ, Koo H, et al. Antibody Prevalence of West Nile Virus in Birds, Illinois, 2002. Emerging Infectious Diseases. 2004;10(6):1120-1124. doi:10.3201/eid1006.030644.
    APA Ringia, A. M., Blitvich, B. J., Koo, H., Van de Wyngaerde, M., Brawn, J. D., & Novak, R. J. (2004). Antibody Prevalence of West Nile Virus in Birds, Illinois, 2002. Emerging Infectious Diseases, 10(6), 1120-1124. https://dx.doi.org/10.3201/eid1006.030644.
  • Reference Group Choice and Antibiotic Resistance Outcomes PDF Version [PDF - 71 KB - 4 pages]
    K. S. Kaye et al.
        View Abstract

    Two types of cohort studies examining patients infected with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) were contrasted, using different reference groups. Cases were compared to uninfected patients and patients infected with the corresponding, susceptible organism. VRE and MRSA were associated with adverse outcomes. The effect was greater when uninfected control patients were used.

        Cite This Article
    EID Kaye KS, Engemann JJ, Mozaffari E, Carmeli Y. Reference Group Choice and Antibiotic Resistance Outcomes. Emerg Infect Dis. 2004;10(6):1125-1128. https://dx.doi.org/10.3201/eid1006.020665
    AMA Kaye KS, Engemann JJ, Mozaffari E, et al. Reference Group Choice and Antibiotic Resistance Outcomes. Emerging Infectious Diseases. 2004;10(6):1125-1128. doi:10.3201/eid1006.020665.
    APA Kaye, K. S., Engemann, J. J., Mozaffari, E., & Carmeli, Y. (2004). Reference Group Choice and Antibiotic Resistance Outcomes. Emerging Infectious Diseases, 10(6), 1125-1128. https://dx.doi.org/10.3201/eid1006.020665.
  • Enhancing West Nile Virus Surveillance, United States PDF Version [PDF - 417 KB - 5 pages]
    J. S. Brownstein et al.
        View Abstract

    We provide a method for constructing a county-level West Nile virus risk map to serve as an early warning system for human cases. We also demonstrate that mosquito surveillance is a more accurate predictor of human risk than monitoring dead and infected wild birds.

        Cite This Article
    EID Brownstein JS, Holford TR, Fish D. Enhancing West Nile Virus Surveillance, United States. Emerg Infect Dis. 2004;10(6):1129-1133. https://dx.doi.org/10.3201/eid1006.030457
    AMA Brownstein JS, Holford TR, Fish D. Enhancing West Nile Virus Surveillance, United States. Emerging Infectious Diseases. 2004;10(6):1129-1133. doi:10.3201/eid1006.030457.
    APA Brownstein, J. S., Holford, T. R., & Fish, D. (2004). Enhancing West Nile Virus Surveillance, United States. Emerging Infectious Diseases, 10(6), 1129-1133. https://dx.doi.org/10.3201/eid1006.030457.
  • Bacteriophages and Diffusion of β-Lactamase Genes PDF Version [PDF - 117 KB - 4 pages]
    M. Muniesa et al.
        View Abstract

    We evaluated the presence of various β-lactamase genes within the bacteriophages in sewage. Results showed the occurrence of phage particles carrying sequences of blaOXA-2, blaPSE-1 or blaPSE-4 and blaPSE-type genes. Phages may contribute to the spread of some β-lactamase genes.

        Cite This Article
    EID Muniesa M, García A, Miró E, Mirelis B, Prats G, Jofre J, et al. Bacteriophages and Diffusion of β-Lactamase Genes. Emerg Infect Dis. 2004;10(6):1134-1137. https://dx.doi.org/10.3201/eid1006.030472
    AMA Muniesa M, García A, Miró E, et al. Bacteriophages and Diffusion of β-Lactamase Genes. Emerging Infectious Diseases. 2004;10(6):1134-1137. doi:10.3201/eid1006.030472.
    APA Muniesa, M., García, A., Miró, E., Mirelis, B., Prats, G., Jofre, J....Navarro, F. (2004). Bacteriophages and Diffusion of β-Lactamase Genes. Emerging Infectious Diseases, 10(6), 1134-1137. https://dx.doi.org/10.3201/eid1006.030472.
  • Predominant Tuberculosis Spoligotypes, Delhi, India PDF Version [PDF - 292 KB - 5 pages]
    U. Singh et al.
        View Abstract

    One hundred five Mycobacterium tuberculosis clinical isolates from the Delhi area were typed by spoligotyping; 45 patterns were identified. Comparison with an international spoligotype database showed type 26, Delhi type (22%), type 54 (12%), and type 1, Beijing type (8%), as the most common. Eighteen spoligotypes did not match any existing database pattern.

        Cite This Article
    EID Singh U, Suresh N, Bhanu N, Arora J, Pant H, Sinha S, et al. Predominant Tuberculosis Spoligotypes, Delhi, India. Emerg Infect Dis. 2004;10(6):1138-1142. https://dx.doi.org/10.3201/eid1006.030575
    AMA Singh U, Suresh N, Bhanu N, et al. Predominant Tuberculosis Spoligotypes, Delhi, India. Emerging Infectious Diseases. 2004;10(6):1138-1142. doi:10.3201/eid1006.030575.
    APA Singh, U., Suresh, N., Bhanu, N., Arora, J., Pant, H., Sinha, S....Seth, P. (2004). Predominant Tuberculosis Spoligotypes, Delhi, India. Emerging Infectious Diseases, 10(6), 1138-1142. https://dx.doi.org/10.3201/eid1006.030575.
  • SARS and Common Viral Infections PDF Version [PDF - 85 KB - 4 pages]
    J. K. Louie et al.
        View Abstract

    In California, molecular testing was useful in decreasing suspicion for severe acute respiratory syndrome (SARS), by detecting common respiratory pathogens (influenza A/B, human metapneumovirus, picornavirus, Mycoplasma pneumoniae, Chlamydia spp., parainfluenza virus, respiratory syncytial virus, and adenovirus) in 23 (45%) of 51 patients with suspect SARS and 9 (47%) of 19 patients with probable SARS.

        Cite This Article
    EID Louie JK, Hacker JK, Mark J, Gavali SS, Yagi S, Espinosa A, et al. SARS and Common Viral Infections. Emerg Infect Dis. 2004;10(6):1143-1146. https://dx.doi.org/10.3201/eid1006.030863
    AMA Louie JK, Hacker JK, Mark J, et al. SARS and Common Viral Infections. Emerging Infectious Diseases. 2004;10(6):1143-1146. doi:10.3201/eid1006.030863.
    APA Louie, J. K., Hacker, J. K., Mark, J., Gavali, S. S., Yagi, S., Espinosa, A....Vugia, D. J. (2004). SARS and Common Viral Infections. Emerging Infectious Diseases, 10(6), 1143-1146. https://dx.doi.org/10.3201/eid1006.030863.
  • Multistate Shigellosis Outbreak and Commercially Prepared Food PDF Version [PDF - 43 KB - 3 pages]
    A. C. Kimura et al.
        View Abstract

    In 2000, shigellosis traced to a commercially prepared dip developed in 406 persons nationwide. An ill employee is suspected to have inadvertently contaminated processing equipment. This outbreak demonstrates the vulnerability of the food supply and how infectious organisms can rapidly disseminate through point-source contamination of a widely distributed food item.

        Cite This Article
    EID Kimura AC, Johnson K, Palumbo MS, Hopkins J, Boase JC, Reporter R, et al. Multistate Shigellosis Outbreak and Commercially Prepared Food. Emerg Infect Dis. 2004;10(6):1147-1149. https://dx.doi.org/10.3201/eid1006.030599
    AMA Kimura AC, Johnson K, Palumbo MS, et al. Multistate Shigellosis Outbreak and Commercially Prepared Food. Emerging Infectious Diseases. 2004;10(6):1147-1149. doi:10.3201/eid1006.030599.
    APA Kimura, A. C., Johnson, K., Palumbo, M. S., Hopkins, J., Boase, J. C., Reporter, R....Vugia, D. J. (2004). Multistate Shigellosis Outbreak and Commercially Prepared Food. Emerging Infectious Diseases, 10(6), 1147-1149. https://dx.doi.org/10.3201/eid1006.030599.
  • Antibacterial Resistance, Wayampis Amerindians, French Guyana PDF Version [PDF - 73 KB - 4 pages]
    K. Grenet et al.
        View Abstract

    Drug resistance in fecal bacteria was high in Wayampis American Indians who did not take antibacterial agents and were not hospitalized for 1 year. In Amerindians, an isolated, traditional community in French Guyana, antibacterial use was 0.64 treatments per person per year. Hospitalization rate was 6.1% per year. Antibacterial drug–resistant bacteria can spread in persons who are not taking these agents.

        Cite This Article
    EID Grenet K, Guillemot D, Jarlier V, Moreau B, Dubourdieu S, Ruimy R, et al. Antibacterial Resistance, Wayampis Amerindians, French Guyana. Emerg Infect Dis. 2004;10(6):1150-1153. https://dx.doi.org/10.3201/eid1006.031015
    AMA Grenet K, Guillemot D, Jarlier V, et al. Antibacterial Resistance, Wayampis Amerindians, French Guyana. Emerging Infectious Diseases. 2004;10(6):1150-1153. doi:10.3201/eid1006.031015.
    APA Grenet, K., Guillemot, D., Jarlier, V., Moreau, B., Dubourdieu, S., Ruimy, R....Andremont, A. (2004). Antibacterial Resistance, Wayampis Amerindians, French Guyana. Emerging Infectious Diseases, 10(6), 1150-1153. https://dx.doi.org/10.3201/eid1006.031015.
  • Global Genetic Diversity of Human Metapneumovirus Fusion Gene PDF Version [PDF - 270 KB - 4 pages]
    G. Boivin et al.
        View Abstract

    We analyzed 64 human metapneumovirus strains from eight countries. Phylogenetic analysis identified two groups (A and B, amino acid identity 93%–96%) and four subgroups. Although group A strains predominated, accounting for 69% of all strains, as many B as A strains were found in persons ≥3 years of age.

        Cite This Article
    EID Boivin G, Mackay IM, Sloots TP, Madhi SA, Freymuth F, Wolf D, et al. Global Genetic Diversity of Human Metapneumovirus Fusion Gene. Emerg Infect Dis. 2004;10(6):1154-1157. https://dx.doi.org/10.3201/eid1006.031097
    AMA Boivin G, Mackay IM, Sloots TP, et al. Global Genetic Diversity of Human Metapneumovirus Fusion Gene. Emerging Infectious Diseases. 2004;10(6):1154-1157. doi:10.3201/eid1006.031097.
    APA Boivin, G., Mackay, I. M., Sloots, T. P., Madhi, S. A., Freymuth, F., Wolf, D....Leblanc, É. (2004). Global Genetic Diversity of Human Metapneumovirus Fusion Gene. Emerging Infectious Diseases, 10(6), 1154-1157. https://dx.doi.org/10.3201/eid1006.031097.

Commentaries

  • Antibiotics in Animal Feed and Spread of Resistant Campylobacter from Poultry to Humans PDF Version [PDF - 146 KB - 2 pages]
    N. M. Iovine and M. J. Blaser
            Cite This Article
    EID Iovine NM, Blaser MJ. Antibiotics in Animal Feed and Spread of Resistant Campylobacter from Poultry to Humans. Emerg Infect Dis. 2004;10(6):1158-1159. https://dx.doi.org/10.3201/eid1006.040403
    AMA Iovine NM, Blaser MJ. Antibiotics in Animal Feed and Spread of Resistant Campylobacter from Poultry to Humans. Emerging Infectious Diseases. 2004;10(6):1158-1159. doi:10.3201/eid1006.040403.
    APA Iovine, N. M., & Blaser, M. J. (2004). Antibiotics in Animal Feed and Spread of Resistant Campylobacter from Poultry to Humans. Emerging Infectious Diseases, 10(6), 1158-1159. https://dx.doi.org/10.3201/eid1006.040403.

Another Dimension

  • The Medical Kipling—Syphilis, Tabes Dorsalis, and Romberg’s Test PDF Version [PDF - 61 KB - 3 pages]
    S. K. Vora and R. W. Lyons
        View Abstract

    Born of expatriate parents in Bombay, India, in 1865, Rudyard Kipling was the first English author to win the Nobel Prize for literature. He received this honor when he was not yet 42 years old. Indeed, Kipling’s career is remarkable for its precocious success. His collection of verse Departmental Ditties was published when he was 20 years old. When he first went to England in 1889, he was already a well-known writer.

        Cite This Article
    EID Vora SK, Lyons RW. The Medical Kipling—Syphilis, Tabes Dorsalis, and Romberg’s Test. Emerg Infect Dis. 2004;10(6):1160-1162. https://dx.doi.org/10.3201/eid1006.031117
    AMA Vora SK, Lyons RW. The Medical Kipling—Syphilis, Tabes Dorsalis, and Romberg’s Test. Emerging Infectious Diseases. 2004;10(6):1160-1162. doi:10.3201/eid1006.031117.
    APA Vora, S. K., & Lyons, R. W. (2004). The Medical Kipling—Syphilis, Tabes Dorsalis, and Romberg’s Test. Emerging Infectious Diseases, 10(6), 1160-1162. https://dx.doi.org/10.3201/eid1006.031117.

Letters

  • CTX-M–Type β-Lactamases Affect Community Escherichia coli Treatment, Greece PDF Version [PDF - 28 KB - 2 pages]
    S. Pournaras et al.
            Cite This Article
    EID Pournaras S, Ikonomidis A, Sofianou D, Tsakris A, Maniatis AN. CTX-M–Type β-Lactamases Affect Community Escherichia coli Treatment, Greece. Emerg Infect Dis. 2004;10(6):1163-1164. https://dx.doi.org/10.3201/eid1006.031031
    AMA Pournaras S, Ikonomidis A, Sofianou D, et al. CTX-M–Type β-Lactamases Affect Community Escherichia coli Treatment, Greece. Emerging Infectious Diseases. 2004;10(6):1163-1164. doi:10.3201/eid1006.031031.
    APA Pournaras, S., Ikonomidis, A., Sofianou, D., Tsakris, A., & Maniatis, A. N. (2004). CTX-M–Type β-Lactamases Affect Community Escherichia coli Treatment, Greece. Emerging Infectious Diseases, 10(6), 1163-1164. https://dx.doi.org/10.3201/eid1006.031031.
  • Age and Transmissible Spongiform Encephalopathies PDF Version [PDF - 27 KB - 2 pages]
    D. M. Heisey and D. O. Joly
            Cite This Article
    EID Heisey DM, Joly DO. Age and Transmissible Spongiform Encephalopathies. Emerg Infect Dis. 2004;10(6):1164-1165. https://dx.doi.org/10.3201/eid1006.031130
    AMA Heisey DM, Joly DO. Age and Transmissible Spongiform Encephalopathies. Emerging Infectious Diseases. 2004;10(6):1164-1165. doi:10.3201/eid1006.031130.
    APA Heisey, D. M., & Joly, D. O. (2004). Age and Transmissible Spongiform Encephalopathies. Emerging Infectious Diseases, 10(6), 1164-1165. https://dx.doi.org/10.3201/eid1006.031130.
  • SARS Epidemiology Modeling PDF Version [PDF - 25 KB - 3 pages]
    Y. Hsieh et al.
            Cite This Article
    EID Hsieh Y, Chang H, Lee J. SARS Epidemiology Modeling. Emerg Infect Dis. 2004;10(6):1165-1167. https://dx.doi.org/10.3201/eid1006.031023
    AMA Hsieh Y, Chang H, Lee J. SARS Epidemiology Modeling. Emerging Infectious Diseases. 2004;10(6):1165-1167. doi:10.3201/eid1006.031023.
    APA Hsieh, Y., Chang, H., & Lee, J. (2004). SARS Epidemiology Modeling. Emerging Infectious Diseases, 10(6), 1165-1167. https://dx.doi.org/10.3201/eid1006.031023.
  • Diagnostic Criteria during SARS Outbreak in Hong Kong PDF Version [PDF - 38 KB - 3 pages]
    L. Y. Chan et al.
            Cite This Article
    EID Chan LY, Lee N, Chan P, Wu A, Rainer TH, Li PK, et al. Diagnostic Criteria during SARS Outbreak in Hong Kong. Emerg Infect Dis. 2004;10(6):1168-1170. https://dx.doi.org/10.3201/eid1006.030618
    AMA Chan LY, Lee N, Chan P, et al. Diagnostic Criteria during SARS Outbreak in Hong Kong. Emerging Infectious Diseases. 2004;10(6):1168-1170. doi:10.3201/eid1006.030618.
    APA Chan, L. Y., Lee, N., Chan, P., Wu, A., Rainer, T. H., Li, P. K....Sung, J. J. (2004). Diagnostic Criteria during SARS Outbreak in Hong Kong. Emerging Infectious Diseases, 10(6), 1168-1170. https://dx.doi.org/10.3201/eid1006.030618.
  • Malaria Control and Public Health PDF Version [PDF - 26 KB - 2 pages]
    D. Roberts et al.
            Cite This Article
    EID Roberts D, Curtis C, Tren R, Sharp B, Shiff C, Bate R, et al. Malaria Control and Public Health. Emerg Infect Dis. 2004;10(6):1170-1171. https://dx.doi.org/10.3201/eid1006.030787
    AMA Roberts D, Curtis C, Tren R, et al. Malaria Control and Public Health. Emerging Infectious Diseases. 2004;10(6):1170-1171. doi:10.3201/eid1006.030787.
    APA Roberts, D., Curtis, C., Tren, R., Sharp, B., Shiff, C., & Bate, R. (2004). Malaria Control and Public Health. Emerging Infectious Diseases, 10(6), 1170-1171. https://dx.doi.org/10.3201/eid1006.030787.
  • CTX-M and Plasmid-mediated AmpC-Producing Enterobacteriaceae, Singapore PDF Version [PDF - 137 KB - 3 pages]
    T. H. Koh et al.
            Cite This Article
    EID Koh TH, Wang GC, Sng L, Yi Z, Koh TY. CTX-M and Plasmid-mediated AmpC-Producing Enterobacteriaceae, Singapore. Emerg Infect Dis. 2004;10(6):1172-1174. https://dx.doi.org/10.3201/eid1006.030726
    AMA Koh TH, Wang GC, Sng L, et al. CTX-M and Plasmid-mediated AmpC-Producing Enterobacteriaceae, Singapore. Emerging Infectious Diseases. 2004;10(6):1172-1174. doi:10.3201/eid1006.030726.
    APA Koh, T. H., Wang, G. C., Sng, L., Yi, Z., & Koh, T. Y. (2004). CTX-M and Plasmid-mediated AmpC-Producing Enterobacteriaceae, Singapore. Emerging Infectious Diseases, 10(6), 1172-1174. https://dx.doi.org/10.3201/eid1006.030726.

Books and Media

  • Risk Analysis of Prion Diseases in Animals PDF Version [PDF - 152 KB - 2 pages]
    B. W. Mahy
            Cite This Article
    EID Mahy BW. Risk Analysis of Prion Diseases in Animals. Emerg Infect Dis. 2004;10(6):1177-1178. https://dx.doi.org/10.3201/eid1006.030948
    AMA Mahy BW. Risk Analysis of Prion Diseases in Animals. Emerging Infectious Diseases. 2004;10(6):1177-1178. doi:10.3201/eid1006.030948.
    APA Mahy, B. W. (2004). Risk Analysis of Prion Diseases in Animals. Emerging Infectious Diseases, 10(6), 1177-1178. https://dx.doi.org/10.3201/eid1006.030948.
  • Quinolone Antimicrobial Agents, 3rd Edition PDF Version [PDF - 16 KB - 1 page]
    G. J. Anderson
            Cite This Article
    EID Anderson GJ. Quinolone Antimicrobial Agents, 3rd Edition. Emerg Infect Dis. 2004;10(6):1177. https://dx.doi.org/10.3201/eid1006.040025
    AMA Anderson GJ. Quinolone Antimicrobial Agents, 3rd Edition. Emerging Infectious Diseases. 2004;10(6):1177. doi:10.3201/eid1006.040025.
    APA Anderson, G. J. (2004). Quinolone Antimicrobial Agents, 3rd Edition. Emerging Infectious Diseases, 10(6), 1177. https://dx.doi.org/10.3201/eid1006.040025.

About the Cover

  • Unicorn Tapestries, Horned Animals, and Prion Disease PDF Version [PDF - 321 KB - 2 pages]
    P. Potter
            Cite This Article
    EID Potter P. Unicorn Tapestries, Horned Animals, and Prion Disease. Emerg Infect Dis. 2004;10(6):1181-1182. https://dx.doi.org/10.3201/eid1006.AC1006
    AMA Potter P. Unicorn Tapestries, Horned Animals, and Prion Disease. Emerging Infectious Diseases. 2004;10(6):1181-1182. doi:10.3201/eid1006.AC1006.
    APA Potter, P. (2004). Unicorn Tapestries, Horned Animals, and Prion Disease. Emerging Infectious Diseases, 10(6), 1181-1182. https://dx.doi.org/10.3201/eid1006.AC1006.

News and Notes

  • Segue: Brief summaries of articles on pertinent emerging issues published elsewhere. PDF Version [PDF - 25 KB - 2 pages]
    J. E. McDade
            Cite This Article
    EID McDade JE. Segue: Brief summaries of articles on pertinent emerging issues published elsewhere.. Emerg Infect Dis. 2004;10(6):1175-1176. https://dx.doi.org/10.3201/eid1006.030312
    AMA McDade JE. Segue: Brief summaries of articles on pertinent emerging issues published elsewhere.. Emerging Infectious Diseases. 2004;10(6):1175-1176. doi:10.3201/eid1006.030312.
    APA McDade, J. E. (2004). Segue: Brief summaries of articles on pertinent emerging issues published elsewhere.. Emerging Infectious Diseases, 10(6), 1175-1176. https://dx.doi.org/10.3201/eid1006.030312.
  • International Network to Promote Household Water Treatment and Safe Storage PDF Version [PDF - 56 KB - 2 pages]
    T. F. Clasen and E. D. Mintz
            Cite This Article
    EID Clasen TF, Mintz ED. International Network to Promote Household Water Treatment and Safe Storage. Emerg Infect Dis. 2004;10(6):1179-1180. https://dx.doi.org/10.3201/eid1006.040243
    AMA Clasen TF, Mintz ED. International Network to Promote Household Water Treatment and Safe Storage. Emerging Infectious Diseases. 2004;10(6):1179-1180. doi:10.3201/eid1006.040243.
    APA Clasen, T. F., & Mintz, E. D. (2004). International Network to Promote Household Water Treatment and Safe Storage. Emerging Infectious Diseases, 10(6), 1179-1180. https://dx.doi.org/10.3201/eid1006.040243.
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