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Volume 11, Number 11—November 2005
Volume 11, Number 11—November 2005 PDF Version [PDF - 6.32 MB - 163 pages]
Emergence of Toscana Virus in Europe
PDF Version [PDF - 216 KB - 7 pages]
R. N. Charrel et al.View SummaryView Abstract
In southern Europe, Toscana virus is one of the three leading causes of aseptic meningitis.
Toscana virus (TOSV) is an arthropodborne virus first identified in 1971 from the sandfly Phlebotomus perniciosus in central Italy. Many case reports in travelers and clinical research and epidemiologic studies conducted around the Mediterranean region have shown that TOSV has a tropism for the central nervous system (CNS) and is a major cause of meningitis and encephalitis in countries in which it circulates. In central Italy, TOSV is the most frequent cause of meningitis from May to October, far exceeding enteroviruses. In other northern Mediterranean countries, TOSV is among the 3 most prevalent viruses associated with meningitis during the warm seasons. Therefore, TOSV must be considered an emerging pathogen. Here, we review the epidemiology of TOSV in Europe and determine questions that should be addressed in future studies. Despite increasing evidence of its major role in medicine as an emerging cause of CNS infections, TOSV remains an unstudied pathogen, and few physicians are aware of its potential to cause CNS infections.
Highly Pathogenic Avian Influenza H5N1, Thailand, 2004
PDF Version [PDF - 662 KB - 9 pages]
T. Tiensin et al.View SummaryView Abstract
Early detection and control curtail outbreaks.
In January 2004, highly pathogenic avian influenza (HPAI) virus of the H5N1 subtype was first confirmed in poultry and humans in Thailand. Control measures, e.g., culling poultry flocks, restricting poultry movement, and improving hygiene, were implemented. Poultry populations in 1,417 villages in 60 of 76 provinces were affected in 2004. A total of 83% of infected flocks confirmed by laboratories were backyard chickens (56%) or ducks (27%). Outbreaks were concentrated in the Central, the southern part of the Northern, and Eastern Regions of Thailand, which are wetlands, water reservoirs, and dense poultry areas. More than 62 million birds were either killed by HPAI viruses or culled. H5N1 virus from poultry caused 17 human cases and 12 deaths in Thailand; a number of domestic cats, captive tigers, and leopards also died of the H5N1 virus. In 2005, the epidemic is ongoing in Thailand.
Coltiviruses and Seadornaviruses in North America, Europe, and Asia
PDF Version [PDF - 223 KB - 7 pages]
H. Attoui et al.View SummaryView Abstract
Neurotropic virus disease is often misdiagnosed as Japanese encephalitis.
Coltiviruses are tickborne viruses of the genus Coltivirus. The type species, Colorado tick fever virus (from North America), has been isolated from patients with flulike syndromes, meningitis, encephalitis, and other severe complications. Another coltivirus, Eyach virus, has been isolated from ticks in France and Germany and incriminated in febrile illnesses and neurologic syndromes. Seadornaviruses are endemic in Southeast Asia, particularly Indonesia and China. The prototype virus of the genus, Banna virus (BAV), has been isolated from many mosquito species, humans with encephalitis, pigs, and cattle. Two other seadornaviruses, Kadipiro and Liao Ning, were isolated only from mosquitoes. The epidemiology of seadornaviruses remains poorly documented. Evidence suggests that BAV is responsible for encephalitis in humans. Infection with BAV may be underreported because it circulates in regions with a high incidence of Japanese encephalitis and could be misdiagnosed as this disease.
Cervical Human Papillomavirus Screening among Older Women
PDF Version [PDF - 83 KB - 6 pages]
M. J. Grainge et al.View SummaryView AbstractHPV-negative women >50 years of age still require cervical screening.
Rates of acquisition and clearance of cervical human papillomavirus (HPV) during a 3-year period in women 51 years of age were compared with rates in younger women to provide data on cervical screening for women >50 years of age. Paired, cytologically negative, archived cervical smears taken 3 years apart from 710 women in Nottingham, United Kingdom, were retrieved and tested for HPV infection with polymerase chain reaction (PCR) with GP5+/6+ primers. Seventy-one (21.3%) of 333 women 51 years of age who were HPV negative at baseline were positive 3 years later. This percentage was higher than the corresponding acquisition rates among women 21 (15.2%), 31 (14.1%), and 41 (13.3%) years of age, although these differences were not significant. This retrospective study shows that HPV-negative women >50 years of age can acquire HPV and, therefore, require cervical screening.
Cryptococcus gattii in AIDS Patients, Southern California
PDF Version [PDF - 255 KB - 7 pages]
S. Chaturvedi et al.View SummaryView Abstract
A molecular analysis of pheromone genes showed a notable prevalence of Cryptococcus gattii isolates from AIDS patients in southern California.
Cryptococcus isolates from AIDS patients in southern California were characterized by molecular analyses. Pheromone MFα1 and MFa1 gene fragments were polymerase chain reaction–amplified with fluorescently labeled primers and analyzed by capillary electrophoresis (CE) on DNA analyzer. CE–fragment-length analyses (CE-FLAs) and CE–single-strand conformation polymorphisms (CE-SSCPs) were used to determine Cryptococcus gattii (Cg), C. neoformans (Cn) varieties neoformans (CnVN) and grubii (CnVG), mating types, and hybrids. Corroborative tests carried out in parallel included growth on specialized media and serotyping with a commercial kit. All 276 clinical strains tested as haploid MATα by CE-FLA. CE-SSCP analyses of MFα1 showed 219 (79.3%) CnVG, 23 (8.3%) CnVN, and 34 (12.3%) Cg isolates. CE-FLA and CE-SSCP are promising tools for high-throughput screening of Cryptococcus isolates. The high prevalence of Cg was noteworthy, in view of its sporadic reports from AIDS patients in North America and its recent emergence as a primary pathogen on Vancouver Island, Canada.
Rift Valley Fever in Small Ruminants, Senegal, 2003
PDF Version [PDF - 225 KB - 8 pages]
V. Chevalier et al.View SummaryView Abstract
Serologic incidence was estimated at 2.9%.
During the 2003 rainy season, the clinical and serologic incidence of Rift Valley fever was assessed in small ruminant herds living around temporary ponds located in the semi-arid region of the Ferlo, Senegal. No outbreak was detected by the surveillance system. Serologic incidence was estimated at 2.9% (95% confidence interval 1.0–8.7) and occurred in 5 of 7 ponds with large variations in the observed incidence rate (0%–20.3%). The location of ponds in the Ferlo Valley and small ponds were correlated with higher serologic incidence (p = 0.0005 and p = 0.005, respectively). Rift Valley fever surveillance should be improved to allow early detection of virus activity. Ruminant vaccination programs should be prepared to confront the foreseeable higher risks for future epidemics of this disease.
Toscana Virus in Spain
PDF Version [PDF - 214 KB - 7 pages]
S. Sanbonmatsu-Gámez et al.View SummaryView Abstract
At least 2 virus lineages are circulating in the Mediterranean basin.
Toscana virus (TOSV, Phlebovirus, family Bunyaviridae) infection is one of the most prevalent arboviruses in Spain. Within the objectives of a multidisciplinary network, a study on the epidemiology of TOSV was conducted in Granada, in southern Spain. The overall seroprevalence rate was 24.9%, significantly increasing with age. TOSV was detected in 3 of 103 sandfly pools by viral culture or reverse transcription–polymerase chain reaction from a region of the L gene. Nucleotide sequence homology was 99%–100% in TOSV from vectors and patients and 80%–81% compared to the Italian strain ISS Phl.3. Sequencing of the N gene of TOSV isolates from patients and vectors indicated 87%–88% and 100% homology at the nucleotide and amino acid levels, respectively, compared to the Italian strain. These findings demonstrate the circulation of at least 2 different lineages of TOSV in the Mediterranean basin, the Italian lineage and the Spanish lineage.
Tickborne Pathogen Detection, Western Siberia, Russia
PDF Version [PDF - 275 KB - 8 pages]
V. A. Rar et al.View SummaryView Abstract
Ixodes and Dermacentor ticks harbor Borrelia, Anaplasma/Ehrlichia, Bartonella, and Babesia species.
Ixodes persulcatus (n = 125) and Dermacentor reticulatus (n = 84) ticks from Western Siberia, Russia, were tested for infection with Borrelia, Anaplasma/Ehrlichia, Bartonella, and Babesia spp. by using nested polymerase chain reaction assays with subsequent sequencing. I. persulcatus ticks were infected with Borrelia burgdorferi sensu lato (37.6% ± 4.3% [standard deviation]), Anaplasma phagocytophilum (2.4% ± 1.4%), Ehrlichia muris (8.8% ± 2.5%), and Bartonella spp. (37.6% ± 4.3%). D. reticulatus ticks contained DNA of B. burgdorferi sensu lato (3.6% ± 2.0%), Bartonella spp. (21.4% ± 4.5%), and Babesia canis canis (3.6% ± 2.0%). Borrelia garinii, Borrelia afzelii, and their mixed infections were observed among I. persulcatus, whereas B. garinii NT29 DNA was seen in samples from D. reticulatus. Among the I. persulcatus ticks studied, no Babesia spp. were observed, whereas B. canis canis was the single subspecies found in D. reticulatus.
Norovirus Outbreaks from Drinking Water
PDF Version [PDF - 139 KB - 6 pages]
L. Maunula et al.View SummaryView Abstract
Norovirus contamination calls for viral monitoring of drinking water.
As part of an intensified monitoring program for foodborne disease outbreaks in Finland, waterborne outbreaks were investigated for viruses. The diagnostic procedure included analysis of patients' stool samples by electron microscopy and reverse transcription–polymerase chain reaction (RT-PCR) for noroviruses and astroviruses. When these test results were positive for a virus, the water sample was analyzed. Virus concentration was based on positively charged filters from 1-L samples. Of the total 41 waterborne outbreaks reported during the observation period (1998–2003), samples from 28 outbreaks were available for analysis. As judged by RT-PCR results from patient samples, noroviruses caused 18 outbreaks. In 10 outbreaks, the water sample also yielded a norovirus. In all but 1 instance, the amplicon sequence was identical to that recovered from the patients. The ubiquity of waterborne norovirus outbreaks calls for measures to monitor water for viruses.
Typing African Relapsing Fever Spirochetes
PDF Version [PDF - 198 KB - 8 pages]
J. Scott et al.View SummaryView Abstract
Sequencing distinguished relapsing fever from other borrelial species but not B. duttonii from B. recurrentis.
Relapsing fever Borrelia spp. challenge microbiologic typing because they possess segmented genomes that maintain essential genes on large linear plasmids. Antigenic variation further complicates typing. Intergenic spacer (IGS, between 16S–23S genes) heterogeneity provides resolution among Lyme disease–associated and some relapsing fever spirochetes. We used an IGS fragment for typing East African relapsing fever Borrelia spp. Borrelia recurrentis and their louse vectors showed 2 sequence types, while 4 B. duttonii and their tick vectors had 4 types. IGS typing was unable to discriminate between the tick- and louseborne forms of disease. B. crocidurae, also present in Africa, was clearly resolved from the B. recurrentis/B. duttonii complex. IGS analysis of ticks showed relapsing fever Borrelia spp. and a unique clade, distant from those associated with relapsing fever, possibly equivalent to a novel species in ticks from this region. Clinical significance of this spirochete is undetermined.
Neutralizing Antibody Response and SARS Severity
PDF Version [PDF - 351 KB - 8 pages]
M. Ho et al.View SummaryView Abstract
Antibody response correlates with severity of infection.
Using the Taiwan nationwide laboratory-confirmed severe acute respiratory syndrome (SARS) database, we analyzed neutralizing antibody in relation to clinical outcomes. With a linear mixed model, neutralizing antibody titer was shown to peak between week 5 and week 8 after onset and to decline thereafter, with a half-life of 6.4 weeks. Patients with a longer illness showed a lower neutralizing antibody response than patients with a shorter illness duration (p = 0.008). When early responders were compared with most patients, who seroconverted on and after week 3 of illness, the small proportion (17.4%) of early responders (antibody detectable within 2 weeks) had a higher death rate (29.6% vs. 7.8%) (Fisher exact test, p = 0.004), had a shorter survival time of <2 weeks (Fisher exact test, p = 0.013), and were more likely to be > 60 years of age (Fisher exact test, p = 0.01). Our findings have implications for understanding the pathogenesis of SARS and for SARS vaccine research and development.
Respiratory Infections during SARS Outbreak, Hong Kong, 2003
PDF Version [PDF - 296 KB - 4 pages]
J. Lo et al.View Abstract
The effect of community hygienic measures during the outbreak of severe acute respiratory syndrome in Hong Kong was studied by comparing the proportion of positive specimens of various respiratory viruses in 2003 with those from 1998 to 2002. Community hygienic measures significantly reduced the incidence of various respiratory viral infections.
Bartonella quintana and Rickettsia felis in Gabon
PDF Version [PDF - 129 KB - 3 pages]
J. Rolain et al.View Abstract
We detected Rickettsia felis DNA in Ctenocephalides felis and Bartonella quintana DNA in 3 Pulex irritans fleas taken from a pet Cercopithecus cephus monkey in Gabon, sub-Saharan Africa. This is the first report of B. quintana in the human flea.
African Trypanosomiasis Gambiense, Italy
PDF Version [PDF - 81 KB - 3 pages]
Z. Bisoffi et al.View Abstract
African trypanosomiasis caused by Trypanosoma brucei gambiense has not been reported in Italy. We report 2 cases diagnosed in the summer of 2004. Theses cases suggest an increased risk for expatriates working in trypanosomiasis-endemic countries. Travel medicine clinics should be increasingly aware of this potentially fatal disease.
Australian Public and Smallpox
PDF Version [PDF - 90 KB - 3 pages]
D. N. Durrheim et al.View Abstract
A national survey of 1,001 Australians found that most were concerned about a bioterrorist attack and were ill-informed about smallpox prevention and response. Since general practitioners were commonly identified as the initial point of care, they should become a focus of bioterrorism response planning in Australia.
Evaluation of West Nile Virus Education Campaign
PDF Version [PDF - 133 KB - 3 pages]
E. Averett et al.View Abstract
We evaluated the 2003 Kansas West Nile virus public education campaign. Awareness was widespread but compliance was low. Spanish-speaking persons were poorly informed. Relevant factors included population segment variability, campaign content, media choice, and materials delivery methods.
Long-term Death Rates, West Nile Virus Epidemic, Israel, 2000
PDF Version [PDF - 200 KB - 4 pages]
M. S. Green et al.View Abstract
We studied the 2-year death rate of 246 adults discharged from hospital after experiencing acute West Nile Virus infection in Israel during 2000. The age- and sex-adjusted death rates were significantly higher than in the general population. This excess was greater for men. Significant adverse prognostic factors were age, male sex, diabetes mellitus, and dementia.
Vibrio cholerae Pathogenic Clones
PDF Version [PDF - 122 KB - 3 pages]
A. Salim et al.View Abstract
We resolved the relationships between 2 pandemic clones of Vibrio cholerae. Using 26 housekeeping genes, we showed that the US Gulf clone, the Australian clone, and 3 El Tor strains isolated before the seventh pandemic were related to the seventh pandemic clone. The sixth pandemic clone was well separated from them.
Methicillin-resistant Staphylococcus aureus in Taiwan
PDF Version [PDF - 143 KB - 3 pages]
F. Chen et al.View Abstract
We found a virulent closely related clone (Panton-Valentine leukocidin–positive, SCCmec V:ST59) of methicillin-resistant Staphylococcus aureus in inpatients and outpatients in Taiwan. The isolates were found mostly in wounds but were also detected in blood, ear, respiratory, and other specimens; all were susceptible to ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole.
Salmonella Paratyphi A Rates, Asia
PDF Version [PDF - 187 KB - 3 pages]
R. Ochiai et al.View Abstract
Little is known about the causes of enteric fever in Asia. Most cases are believed to be caused by Salmonella enterica serovar Typhi and the remainder by S. Paratyphi A. We compared their incidences by using standardized methods from population-based studies in China, Indonesia, India, and Pakistan.
Social Factors Associated with AIDS and SARS
PDF Version [PDF - 69 KB - 3 pages]
D. C. Des Jarlais et al.View Abstract
We conducted a survey of 928 New York City area residents to assess knowledge and worry about AIDS and SARS. Specific sociodemographic groups of persons were more likely to be less informed and more worried about contracting the diseases.
Assays to Detect West Nile Virus in Dead Birds
PDF Version [PDF - 205 KB - 4 pages]
W. B. Stone et al.View Abstract
Using oral swab samples to detect West Nile virus in dead birds, we compared the Rapid Analyte Measurement Platform (RAMP) assay with VecTest and real-time reverse-transcriptase–polymerase chain reaction. The sensitivities of RAMP and VecTest for testing corvid species were 91.0% and 82.1%, respectively.
West Nile Virus Epidemic, Northeast Ohio, 2002
PDF Version [PDF - 390 KB - 4 pages]
A. M. Mandalakas et al.View Abstract
Serum samples and sociodemographic data were obtained from 1,209 Ohio residents. West Nile virus immunoglobulin M (IgM) and IgG antibodies were detected by enzyme-linked immunosorbent assay and confirmed. Children were 4.5 times more likely to become infected yet 110× less likely to have neuroinvasive disease develop.
Quarantine Stressing Voluntary Compliance
PDF Version [PDF - 20 KB - 2 pages]
C. DiGiovanni et al.View Abstract
A 1-day table-top exercise in San Diego, California, in December 2004 emphasized voluntary compliance with home quarantine to control an emerging infectious disease outbreak. The exercise heightened local civilian-military collaboration in public health emergency management. Addressing concerns about lost income by residents in quarantine was particularly challenging.
Anaplasma phagocytophilum–infected Ticks, Japan
PDF Version [PDF - 190 KB - 4 pages]
N. Ohashi et al.View Abstract
We report Anaplasma phagocytophilum infection of Ixodes persulcatus and I. ovatus ticks in Japan. Unique p44/msp2 paralogs (and/or 16S rRNA genes) were detected in tick tissues, salivary glands, and spleens of experimentally infected mice. These findings indicate the public health threat of anaplasmosis in Japan.
Tickborne Relapsing Fever in Israel
PDF Version [PDF - 169 KB - 3 pages]
G. Sidi et al.View Abstract
We evaluated the epidemiology of relapsing fever from 1971 to 2003 in Israel. In civilians, incidence declined from 0.35 to 0.11 cases per 100,000 persons annually; in military personnel it averaged 6.4 cases per 100,000 persons annually. These data imply that the pathogen and vector continue to exist in Israel.
Slow Epidemic of Lymphogranuloma Venereum L2b Strain
PDF Version [PDF - 46 KB - 2 pages]
J. Spaargaren et al.View Abstract
We traced the Chlamydia trachomatis L2b variant in Amsterdam and San Francisco. All recent lymphogranuloma venereum cases in Amsterdam were caused by the L2b variant. This variant was also present in the 1980s in San Francisco. Thus, the current "outbreak" is most likely a slowly evolving epidemic.
Adventitious Viruses and Smallpox Vaccine
PDF Version [PDF - 19 KB - 1 page]
Ehrlichia ruminantium, Sudan
PDF Version [PDF - 56 KB - 2 pages]
Y. Muramatsu et al.
Borrelia spielmanii Erythema Migrans, Hungary
PDF Version [PDF - 40 KB - 2 pages]
G. Földvári et al.
Profiling Mycobacterium ulcerans with hsp65
PDF Version [PDF - 40 KB - 2 pages]
S. Leão et al.
Spelling of Emerging Pathogens
PDF Version [PDF - 41 KB - 2 pages]
J. E. Moore and B. Millar
Staphylococcus aureus Bacteremia, Europe
PDF Version [PDF - 45 KB - 2 pages]
E. W. Tiemersma et al.
Family Clustering of Avian Influenza A (H5N1)
PDF Version [PDF - 50 KB - 3 pages]
S. J. Olsen et al.
Imported Tickborne Relapsing Fever, France
PDF Version [PDF - 53 KB - 3 pages]
B. Wyplosz et al.
Neonatal Moraxella osloensis Ophthalmia
PDF Version [PDF - 24 KB - 2 pages]
A. Walls and E. Wald
African Tick-bite Fever in French Travelers
PDF Version [PDF - 111 KB - 3 pages]
P. H. Consigny et al.
Fluoroquinolone Use in Food Animals
PDF Version [PDF - 74 KB - 4 pages]
Books and Media
The AIDS Pandemic: Impact on Science and Society
PDF Version [PDF - 21 KB - 2 pages]
J. L. Stephens
Tick-Borne Diseases of Humans
R. P. Smith
Microbe: Are We Ready for the Next Plague?
P. B. Jahrling
About the Cover
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: February 17, 2012
- Page last updated: May 04, 2012
- Page last reviewed: May 04, 2012
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