Volume 13, Number 10—October 2007
Volume 13, Number 10—October 2007 PDF Version [PDF - 21.67 MB - 183 pages]
Global Poverty and Human Development
Preparedness for Highly Pathogenic Avian Influenza Pandemic in Africa
PDF Version [PDF - 207 KB - 6 pages]
R. F. Breiman et al.View Abstract
Global concerns about an impending influenza pandemic escalated when highly pathogenic influenza A subtype H5N1 appeared in Nigeria in January 2006. The potential devastation from emergence of a pandemic strain in Africa has led to a sudden shift of public health focus to pandemic preparedness. Preparedness and control activities must work within the already strained capacity of health infrastructure in Africa to respond to immense existing public health problems. Massive attention and resources directed toward influenza could distort priorities and damage critical public health programs. Responses to concerns about pandemic influenza should strengthen human and veterinary surveillance and laboratory capacity to help address a variety of health threats. Experiences in Asia should provide bases for reassessing strategies for Africa and elsewhere. Fowl depopulation strategies will need to be adapted for Africa. Additionally, the role of avian vaccines should be comprehensively evaluated and clearly defined.
Plague Reappearance in Algeria after 50 Years, 2003
PDF Version [PDF - 127 KB - 4 pages]
E. Bertherat et al.View Abstract
An outbreak of plague occurred in the region of Oran, Algeria, from June to July 2003. Algeria had not reported this disease for >50 years. Eighteen bubonic cases were identified, and Yersinia pestis was isolated from 6 patients. Except for the index case-patient, all patients recovered. Targeted chemoprophylaxis, sanitation, and vector control played a crucial role in controlling the outbreak. Epidemiologic and biomolecular findings strongly suggested the existence of a local animal reservoir during this period, but its origin (resurgence or re-importation) could not be determined. This sudden and unexpected reemergence of plague, close to an important commercial seaport, is a textbook illustration of a public health event of international importance. It also demonstrates that the danger of plague reoccurrence is not limited to the currently indexed natural foci.
HIV and Tuberculosis in Ho Chi Minh City, Vietnam, 1997–2002
PDF Version [PDF - 228 KB - 7 pages]
T. N. Buu et al.View Abstract
In Ho Chi Minh City, Vietnam, reporting rates for tuberculosis (TB) are rising in an emerging HIV epidemic. To describe the HIV epidemic among TB patients and quantify its impact on rates of reported TB, we performed a repeated cross-sectional survey from 1997 through 2002 in a randomly selected sample of inner city TB patients. We assessed effect by adjusting TB case reporting rates by the fraction of TB cases attributable to HIV infection. HIV prevalence in TB patients rose exponentially from 1.5% to 9.0% during the study period. Young (<35 years), single, male patients were mostly affected; injection drug use was a potent risk factor. After correction for HIV infection, the trend in TB reporting rates changed from a 1.9% increase to a 0.4% decrease per year. An emerging HIV epidemic, concentrated in young, male, injection drug users, is responsible for increased TB reporting rates in urban Vietnam.
Epidemiology of Schistosomiasis in the People’s Republic of China, 2004
PDF Version [PDF - 250 KB - 7 pages]
X. Zhou et al.View Abstract
Results from the third nationwide cluster sampling survey on the epidemiology of schistosomiasis in the People’s Republic of China, conducted by the Ministry of Health in 2004, are presented. A stratified cluster random sampling technique was used, and 239 villages were selected in 7 provinces where Schistosoma japonicum remains endemic. A total of 250,987 residents 6–65 years of age were included in the survey. Estimated prevalence rates in the provinces of Hunan, Hubei, Jiangxi, Anhui, Yunnan, Sichuan, and Jiangsu were 4.2%, 3.8%, 3.1%, 2.2%, 1.7%, 0.9%, and 0.3%, respectively. The highest prevalence rates were in the lake and marshland region (3.8%) and the lowest rates were in the plain region with waterway networks (0.06%). Extrapolation to all residents in schistosome-endemic areas indicated 726,112 infections. This indicates a reduction of 16.1% compared with a nationwide survey conducted in 1995. However, human infection rates increased by 3.9% in settings where transmission is ongoing.
Dengue Fever Seroprevalence and Risk Factors, Texas–Mexico Border, 2004
PDF Version [PDF - 175 KB - 7 pages]
J. M. Brunkard et al.View Abstract
Reported autochthonous dengue fever transmission in the United States has been limited to 5 south Texas border counties since 1980. We conducted a cross-sectional serosurvey in Brownsville, Texas, and Matamoros, Tamaulipas, Mexico (n = 600), in 2004 to assess dengue seroprevalence. Recent dengue infection was detected in 2% (95% confidence interval [CI] 0.5%–3.5%) and 7.3% (95% CI 4.3%–10.3%) of residents in Brownsville and Matamoros, respectively. Past infection was detected in 40% (95% CI 34%–45%) of Brownsville residents and 78% (95% CI 74%–83%) of Matamoros residents. For recent infection, only weekly family income <$100 was a significant predictor (adjusted odds ratio 3.2, 95% CI 1.3–8.0). Risk factors that predicted past dengue infection were presence of larval habitat, absence of air-conditioning and street drainage, and weekly family income <$100. Mosquito larvae were present in 30% of households in both cities. Our results show that dengue fever is endemic in this area of the southern Texas–Mexico border.
Cost-effectiveness of Algorithms for Confirmation Test of Human African Trypanosomiasis
PDF Version [PDF - 626 KB - 7 pages]
P. Lutumba et al.View Abstract
The control of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) is compromised by low sensitivity of the routinely used parasitologic confirmation tests. More sensitive alternatives, such as mini-anion exchange centrifugation technique (mAECT) or capillary tube centrifugation (CTC), are more expensive. We used formal decision analysis to assess the cost-effectiveness of alternative HAT confirmation algorithms in terms of cost per life saved. The effectiveness of the standard method, a combination of lymph node puncture (LNP), fresh blood examination (FBE), and thick blood film (TBF), was 36.8%; the LNP-FBE-CTC-mAECT sequence reached almost 80%. The cost per person examined ranged from €1.56 for LNP-FBE-TBF to €2.99 for LNP-TBF-CTC-mAECT-CATT (card agglutination test for trypanosomiasis) titration. LNP-TBF-CTC-mAECT was the most cost-effective in terms of cost per life saved. HAT confirmation algorithms that incorporate concentration techniques are more effective and efficient than the algorithms that are currently and routinely used by several T.b. gambiense control programs.
Public Transportation and Pulmonary Tuberculosis, Lima, Peru
PDF Version [PDF - 129 KB - 3 pages]
O. J. Horna-Campos et al.View Abstract
The association between public transportation for commuting and pulmonary tuberculosis (TB) was analyzed in workers in Lima, Peru. Traveling in minibuses was a risk factor for pulmonary TB. Preventive measures need to be taken by health services to prevent spread of this disease.
Prevalence of Plasmodium falciparum Infection in Rainy Season, Artibonite Valley, Haiti, 2006
PDF Version [PDF - 130 KB - 3 pages]
T. P. Eisele et al.View Abstract
We conducted a population-based survey to estimate the prevalence of Plasmodium falciparum infection among persons older than 1 month in the Artibonite Valley of Haiti during the high malaria transmission season in 2006. Results from PCR for 714 persons showed a prevalence of 3.1% for P. falciparum infection.
Evaluating Tuberculosis Case Detection in Eritrea
PDF Version [PDF - 246 KB - 3 pages]
M. J. van der Werf et al.View Abstract
We used results from a national tuberculosis prevalence survey in Eritrea to calculate case detection rate (CDR) and compared it with the published CDR. The CDR obtained from the survey was ≈40%, whereas the CDR published by the World Health Organization was 3× lower (14%).
West Nile Virus Infection among the Homeless, Houston, Texas
PDF Version [PDF - 164 KB - 4 pages]
T. E. Meyer et al.View Abstract
Among 397 homeless participants studied, the overall West Nile virus (WNV) seroprevalence was 6.8%. Risk factors for WNV infection included being homeless >1 year, spending >6 hours outside daily, regularly taking mosquito precautions, and current marijuana use. Public health interventions need to be directed toward this high-risk population.
Schistosoma hematobium and S. mansoni among Children, Southern Sudan
PDF Version [PDF - 575 KB - 3 pages]
R. Deganello et al.View Abstract
We conducted a survey of schistosomiasis among schoolchildren in 2 villages in Southern Sudan. In Lui (West Equatoria region), prevalence of Schistosoma mansoni infection was 51.5%; no cases of S. hematobium infection were detected. In Nyal (Upper Nile region), prevalence of S. hematobium infection was 73% and S. mansoni infection, 70%.
Influenza A and B Infection in Children in Urban Slum, Bangladesh
PDF Version [PDF - 28 KB - 2 pages]
W. A. Brooks et al.
Identification of Rickettsiae, Uganda and Djibouti
PDF Version [PDF - 27 KB - 2 pages]
C. Socolovschi et al.
Skin and Soft Tissue Infections and Vascular Disease among Drug Users, England
PDF Version [PDF - 52 KB - 2 pages]
C. Irish et al.
Volume 13, Number 10—October 2007 - Continued
Confronting Potential Influenza A (H5N1) Pandemic with Better Vaccines
PDF Version [PDF - 196 KB - 7 pages]
A. Haque et al.View Abstract
Influenza A (H5N1) viruses are strong candidates for causing the next influenza pandemic if they acquire the ability for efficient human-to-human transmission. A major public health goal is to make efficacious vaccines against these viruses by using novel approaches, including cell-culture system, reverse genetics, and adjuvant development. Important consideration for the strategy includes preparation of vaccines from a currently circulating strain to induce broad-spectrum immunity toward newly emerged human H5 strains. This strategy would be a good solution early in a pandemic until an antigenically matched and approved vaccine is produced. The concept of therapeutic vaccines (e.g., antidisease vaccine) directed at diminishing the cytokine storm frequently seen in subtype H5N1–infected persons is underscored. Better understanding of host–virus interaction is essential to identify tools to produce effective vaccines against influenza (H5N1).
Antigenic Diversity of Human Sapoviruses
PDF Version [PDF - 324 KB - 7 pages]
G. S. Hansman et al.View Abstract
Sapovirus (SaV) is a causative agent of gastroenteritis. On the basis of capsid protein (VP1) nucleotide sequences, SaV can be divided into 5 genogroups (GI–GV), of which the GI, GII, GIV, and GV strains infect humans. SaV is uncultivable, but expression of recombinant VP1 in insect cells results in formation of viruslike particles (VLPs) that are antigenically similar to native SaV. In this study, we newly expressed SaV GII and GIV VLPs to compare genetic and antigenic relationships among all human SaV genogroups. Hyperimmune antiserum samples against VLPs reacted strongly with homologous VLPs. However, several antiserum samples weakly cross-reacted against heterologous VLPs in an antibody ELISA. Conversely, an antigen ELISA showed that VLPs of SaV in all human genogroups were antigenically distinct. These findings indicate a likely correspondence between SaV antigenicity and VP1 genogrouping and genotyping.
Evolutionary Relationships between Bat Coronaviruses and Their Hosts
PDF Version [PDF - 273 KB - 7 pages]
J. Cui et al.View Abstract
Recent studies have suggested that bats are the natural reservoir of a range of coronaviruses (CoVs), and that rhinolophid bats harbor viruses closely related to the severe acute respiratory syndrome (SARS) CoV, which caused an outbreak of respiratory illness in humans during 2002–2003. We examined the evolutionary relationships between bat CoVs and their hosts by using sequence data of the virus RNA-dependent RNA polymerase gene and the bat cytochrome b gene. Phylogenetic analyses showed multiple incongruent associations between the phylogenies of rhinolophid bats and their CoVs, which suggested that host shifts have occurred in the recent evolutionary history of this group. These shifts may be due to either virus biologic traits or host behavioral traits. This finding has implications for the emergence of SARS and for the potential future emergence of SARS-CoVs or related viruses.
Rapid Increase of Genetically Diverse Methicillin-Resistant Staphylococcus aureus, Copenhagen, Denmark
PDF Version [PDF - 213 KB - 8 pages]
M. D. Bartels et al.View Abstract
In Copenhagen, methicillin-resistant Staphylococcus aureus (MRSA) accounted for <15 isolates per year during 1980–2002. However, since 2003 an epidemic increase has been observed, with 33 MRSA cases in 2003 and 110 in 2004. We analyzed these 143 cases epidemiologically and characterized isolates by pulsed-field gel electrophoresis, Staphylococcus protein A (spa) typing, multilocus sequence typing, staphylococcal chromosome cassette (SCC) mec typing, and detection of Panton-Valentine leukocidin (PVL) genes. Seventy-one percent of cases were community-onset MRSA (CO-MRSA); of these, 36% had no identified risk factors. We identified 29 spa types (t) and 16 sequence types (STs) belonging to 8 clonal complexes and 3 ST singletons. The most common clonal types were t024/ST8-IV, t019/ST30-IV, t044/ST80-IV, and t008/ST8-IV (USA300). A total of 86% of isolates harbored SCCmec IV, and 44% had PVL. Skin and soft tissue infections dominated. CO-MRSA with diverse genetic backgrounds is rapidly emerging in a low MRSA prevalence area.
Personal Protective Equipment and Antiviral Drug Use during Hospitalization for Suspected Avian or Pandemic Influenza
PDF Version [PDF - 294 KB - 7 pages]
A. Swaminathan et al.View Abstract
For pandemic influenza planning, realistic estimates of personal protective equipment (PPE) and antiviral medication required for hospital healthcare workers (HCWs) are vital. In this simulation study, a patient with suspected avian or pandemic influenza (API) sought treatment at 9 Australian hospital emergency departments where patient–staff interactions during the first 6 hours of hospitalization were observed. Based on World Health Organization definitions and guidelines, the mean number of “close contacts” of the API patient was 12.3 (range 6–17; 85% HCWs); mean “exposures” were 19.3 (range 15–26). Overall, 20–25 PPE sets were required per patient, with variable HCW compliance for wearing these items (93% N95 masks, 77% gowns, 83% gloves, and 73% eye protection). Up to 41% of HCW close contacts would have qualified for postexposure antiviral prophylaxis. These data indicate that many current national stockpiles of PPE and antiviral medication are likely inadequate for a pandemic.
SurvNet Electronic Surveillance System for Infectious Disease Outbreaks, Germany
PDF Version [PDF - 279 KB - 8 pages]
G. Krause et al.View Abstract
In 2001, the Robert Koch Institute (RKI) implemented a new electronic surveillance system (SurvNet) for infectious disease outbreaks in Germany. SurvNet has captured 30,578 outbreak reports in 2001–2005. The size of the outbreaks ranged from 2 to 527 cases. For outbreaks reported in 2002–2005, the median duration from notification of the first case to the local health department until receipt of the outbreak report at RKI was 7 days. Median outbreak duration ranged from 1 day (caused by Campylobacter) up to 73 days (caused by Mycobacterium tuberculosis). The most common settings among the 10,008 entries for 9,946 outbreaks in 2004 and 2005 were households (5,262; 53%), nursing homes (1,218; 12%), and hospitals (1,248; 12%). SurvNet may be a useful tool for other outbreak surveillance systems because it minimizes the workload of local health departments and captures outbreaks even when causative pathogens have not yet been identified.
Borrelia burgdorferi Infection and Cutaneous Lyme Disease, Mexico
PDF Version [PDF - 249 KB - 3 pages]
G. Gordillo-Pérez et al.View Abstract
Four patients who had received tick bites while visiting forests in Mexico had skin lesions that met the case definition of erythema migrans, or borrelial lymphocytoma. Clinical diagnosis was supported with histologic, serologic, and molecular tests. This study suggests the Borrelia burgdorferi infection is in Mexico.
Using Death Certificate Reports to Find Severe Leptospirosis Cases, Brazil
PDF Version [PDF - 184 KB - 3 pages]
A. Spichler et al.View Abstract
Severe leptospirosis with pulmonary hemorrhage is emerging globally. Measures to control leptospirosis through sanitation depend on accurate case finding and reporting. Rapid death certificate reporting, plus necropsy of persons who died of leptospirosis, facilitates public health intervention and could provide an important tool in assessing the global burden of leptospirosis.
Duration of Antibody Responses after Severe Acute Respiratory Syndrome
PDF Version [PDF - 226 KB - 3 pages]
L. Wu et al.View Abstract
Among 176 patients who had had severe acute respiratory syndrome (SARS), SARS-specific antibodies were maintained for an average of 2 years, and significant reduction of immunoglobulin G–positive percentage and titers occurred in the third year. Thus, SARS patients might be susceptible to reinfection >3 years after initial exposure.
Isolation of Bartonella sp. from Sheep Blood
PDF Version [PDF - 264 KB - 3 pages]
D. A. Bemis and S. A. KaniaView Abstract
A Bartonella sp. was isolated from sheep blood. Bacterial identification was conducted by using electron microscopy and DNA sequencing of the 16S rRNA, citrate synthase, riboflavin synthase, and RNAase P genes. To our knowledge, this is the first report of ovine Bartonella infection.
Predominance of Rotavirus PG2 in a Vaccinated Population, Brazil
PDF Version [PDF - 364 KB - 3 pages]
R. Q. Gurgel et al.View Abstract
We identified 21 rotaviruses in 129 patients with diarrhea in a Brazilian city with high rotavirus vaccine coverage. All rotaviruses were genotype PG2 with 1 mixed infection with P[NT]G9. Although virus predominance could have occurred randomly, the vaccine may be less protective against PG2. Prospective surveillance is urgently needed.
Novel Variant of Tickborne Encephalitis Virus, Russia
PDF Version [PDF - 362 KB - 5 pages]
V. A. Ternovoi et al.View Abstract
We isolated a novel strain of tickborne encephalitis virus (TBEV), Glubinnoe/2004, from a patient with a fatal case in Russia. We sequenced the strain, whose landmark features included 57 amino acid substitutions and 5 modified cleavage sites. Phylogenetically, Glubinnoe/2004 is a novel variant that belongs to the Eastern type of TBEV.
Multidrug-Resistant Salmonella Typhimurium, Pacific Northwest, United States
PDF Version [PDF - 232 KB - 4 pages]
M. A. Davis et al.View Abstract
We compared human and bovine isolates of Salmonella enterica using antimicrobial-drug resistance profiles and pulsed-field gel electrophoresis. From 2000 through 2006, we observed an increase in a novel multidrug-resistant clone of S. Typhimurium with no recognized phage type. This clone may represent an emerging epidemic strain in the Pacific Northwest.
Emergence of Human Rotavirus Group A Genotype G9 Strains, Wuhan, China
PDF Version [PDF - 172 KB - 3 pages]
J. Yang et al.View Abstract
Of 322 stool specimens collected from children with diarrhea from October 2005 through September 2006 in Wuhan, China, group A rotavirus was identified in 101 (31.4%). The most prevalent group A rotavirus genotype was G3P (62.6%), followed by G1P(17.6%), G1+G3P(8.8%), G3P(6.6%), G1P(2.2%), and G9P(2.2%). The G9 strains were first detected in Wuhan.
International Epidemic Intelligence at the Institut de Veille Sanitaire, France
PDF Version [PDF - 278 KB - 3 pages]
B. Rotureau et al.View Abstract
The French Institute for Public Health Surveillance monitors health events of potential international importance occurring worldwide to provide timely warning to French health authorities. We reviewed the nature and place of occurrence of the last 200 events. From an individual country’s perspective, the need for multiple sources is emphasized.
Foot-and-Mouth Disease Virus Serotype A in Egypt
PDF Version [PDF - 262 KB - 4 pages]
N. J. Knowles et al.View Abstract
We describe the characterization of a foot-and-mouth disease (FMD) serotype A virus responsible for recent outbreaks of disease in Egypt. Phylogenetic analysis of VP1 nucleotide sequences demonstrated a close relationship to recent FMD virus isolates from East Africa, rather than to viruses currently circulating in the Middle East.
Malaria Diagnosis and Hospitalization Trends, Brazil
PDF Version [PDF - 282 KB - 4 pages]
P. D. Santos-Ciminera et al.View Abstract
We focused on rates of malaria in the state of Amazonas and city of Manaus, Brazil. Plasmodium vivax accounted for an increased number and rate of hospital admissions, while P. falciparum cases decreased. Our observations on malaria epidemiology suggest that the increased hospitalization rate could be due to increased severity of P. vivax infections.
Multifocal Avian Influenza (H5N1) Outbreak
PDF Version [PDF - 125 KB - 3 pages]
R. D. Balicer et al.View Abstract
During March 2006, an outbreak of highly pathogenic avian influenza (H5N1) occurred in multiple poultry farms in Israel. The epidemiologic investigation and review of outbreak mitigation efforts uncovered gaps in planning for and containing the outbreak, thus affording valuable lessons applicable to other countries in similar settings.
Rapid Field Immunoassay for Detecting Antibody to Sin Nombre Virus in Deer Mice
PDF Version [PDF - 259 KB - 4 pages]
T. Schountz et al.View Abstract
We developed a 1-hour field enzyme immunoassay (EIA) for detecting antibody to Sin Nombre virus in deer mice (Peromyscus maniculatus). The assay specificity and sensitivity were comparable to those of a standard EIA. This test will permit identification of rodents with antibody to this and perhaps other hantaviruses.
Super-Sentinel Chickens and Detection of Low-Pathogenicity Influenza Virus
PDF Version [PDF - 212 KB - 3 pages]
P. I. Marcus et al.View Abstract
Chicken interferon-α administered perorally in drinking water acts on the oropharyngeal mucosal system as an adjuvant that causes chickens to rapidly seroconvert after natural infection by low-pathogenicity Influenza virus. These chickens, termed super sentinels, can serve as sensitive early detectors of clinically inapparent infections.
Human Metapneumovirus Infection among Children, Bangladesh
PDF Version [PDF - 135 KB - 3 pages]
W. A. Brooks et al.View Abstract
We confirmed circulation of human metapneumovirus (HMPV) among children with febrile and respiratory illness in an urban slum in Dhaka, Bangladesh, during active surveillance in 2001. HMPV was the most common single virus identified among febrile children and appears to contribute to the high rates of illness in this population.
Ciprofloxacin-Resistant Neisseria meningitidis, Delhi, India
PDF Version [PDF - 195 KB - 3 pages]
S. Singhal et al.View Abstract
Decreased susceptibility of Neisseria meningitidis isolates to ciprofloxacin emerged from an outbreak in Delhi, India. Results of antimicrobial susceptibility testing of the meningococcal isolates to ciprofloxacin and further sequencing of DNA gyrase A quinolone-resistance–determining region confirmed the emergence of ciprofloxacin resistance in the outbreak.
Exposure to Wild Primates among HIV-infected Persons
PDF Version [PDF - 425 KB - 4 pages]
M. LeBreton et al.View Abstract
HIV-1 is an immunosuppressive pathogen. Our behavioral data for 191 HIV-1–infected rural Cameroonians show frequent exposure to nonhuman primates through activities such as hunting and butchering. Immunosuppression among persons exposed to body fluids of wild nonhuman primates could favor the process of adaptation and subsequent emergence of zoonotic pathogens.
Chlorine Inactivation of Highly Pathogenic Avian Influenza Virus (H5N1)
PDF Version [PDF - 282 KB - 3 pages]
E. W. Rice et al.View Abstract
To determine resistance of highly pathogenic avian influenza (H5N1) virus to chlorination, we exposed allantoic fluid containing 2 virus strains to chlorinated buffer at pH 7 and 8, at 5°C. Free chlorine concentrations typically used in drinking water treatment are sufficient to inactivate the virus by >3 orders of magnitude.
Compliance with Exclusion Requirements to Prevent Mumps Transmission
PDF Version [PDF - 158 KB - 2 pages]
S. M. Borchardt et al.
Alveolar Echinococcosis, Lithuania
PDF Version [PDF - 236 KB - 2 pages]
R. Bružinskaitė et al.
Human Bocavirus and Gastroenteritis
PDF Version [PDF - 189 KB - 2 pages]
O. Schildgen et al.
About the Cover
- Page created: July 09, 2012
- Page last updated: July 09, 2012
- Page last reviewed: July 09, 2012
- Centers for Disease Control and Prevention,
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
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