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Volume 10, Number 6—June 2004
Volume 10, Number 6—June 2004 PDF Version [PDF - 6.09 MB - 219 pages]
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.
Salmonella-based Rodenticides and Public Health
PDF Version [PDF - 80 KB - 3 pages]
J. A. Painter et al.View Abstract
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.
First Report from the Asian Rotavirus Surveillance Network
PDF Version [PDF - 207 KB - 8 pages]
J. Bresee et al.View Abstract
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.
Airborne Infection with Bacillus anthracis—from Mills to Mail
PDF Version [PDF - 129 KB - 6 pages]
K. P. Fennelly et al.View Abstract
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.
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.
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.
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.
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.
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.
Mycobacterium ulcerans Treatment Costs, Australia
PDF Version [PDF - 141 KB - 6 pages]
C. Drummond and J. R. ButlerView 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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
Emerging Issues in Infective Endocarditis
PDF Version [PDF - 146 KB - 7 pages]
B. C. Millar and J. E. MooreView 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
The Medical Kipling—Syphilis, Tabes Dorsalis, and Romberg’s Test
PDF Version [PDF - 61 KB - 3 pages]
S. K. Vora and R. W. LyonsView 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.
CTX-M–Type β-Lactamases Affect Community Escherichia coli Treatment, Greece
PDF Version [PDF - 28 KB - 2 pages]
S. Pournaras et al.
Age and Transmissible Spongiform Encephalopathies
PDF Version [PDF - 27 KB - 2 pages]
D. M. Heisey and D. O. Joly
SARS Epidemiology Modeling
PDF Version [PDF - 25 KB - 3 pages]
Y. Hsieh et al.
Diagnostic Criteria during SARS Outbreak in Hong Kong
PDF Version [PDF - 38 KB - 3 pages]
L. Y. Chan et al.
Malaria Control and Public Health
PDF Version [PDF - 26 KB - 2 pages]
D. Roberts et al.
CTX-M and Plasmid-mediated AmpC-Producing Enterobacteriaceae, Singapore
PDF Version [PDF - 137 KB - 3 pages]
T. H. Koh et al.
Books and Media
Risk Analysis of Prion Diseases in Animals
PDF Version [PDF - 152 KB - 2 pages]
B. W. Mahy
Quinolone Antimicrobial Agents, 3rd Edition
PDF Version [PDF - 16 KB - 1 page]
G. J. Anderson
About the Cover
Unicorn Tapestries, Horned Animals, and Prion Disease
PDF Version [PDF - 321 KB - 2 pages]
News and Notes
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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- Page created: July 10, 2012
- Page last updated: July 10, 2012
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