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Volume 13, Number 5—May 2007
Volume 13, Number 5—May 2007 PDF Version [PDF - 4.51 MB - 139 pages]
Response to Malaria Epidemics in Africa
PDF Version [PDF - 68 KB - 6 pages]
T. A. AbekuView Abstract
Malaria epidemics affect nonimmune populations in many highland and semi-arid areas of Africa. Effective prevention of these epidemics is challenging, particularly in the highlands, where predictive accuracy of indicators is not sufficiently high to allow decisions involving expensive measures such as indoor residual spraying of insecticides. Advances in geographic information systems have proved useful in stratification of areas to guide selective targeting of interventions, including barrier application of insecticides in transmission foci to prevent spread of infection. Because rainfall is associated with epidemics in semi-arid areas, early warning methods based on seasonal climate predictions have been proposed. For most areas, response measures should focus on early recognition of anomalies and rapid mass drug administration. Vector control measures are useful if abnormal transmission is highly likely and if they can be selectively implemented at the early stages of an outbreak.
Plague and the Human Flea, Tanzania
PDF Version [PDF - 229 KB - 7 pages]
A. Laudisoit et al.View Abstract
Domestic fleas were collected in 12 villages in the western Usambara Mountains in Tanzania. Of these, 7 are considered villages with high plague frequency, where human plague was recorded during at least 6 of the 17 plague seasons between 1986 and 2004. In the remaining 5 villages with low plague frequency, plague was either rare or unrecorded. Pulex irritans, known as the human flea, was the predominant flea species (72.4%) in houses. The density of P. irritans, but not of other domestic fleas, was significantly higher in villages with a higher plague frequency or incidence. Moreover, the P. irritans index was strongly positively correlated with plague frequency and with the logarithmically transformed plague incidence. These observations suggest that in Lushoto District human fleas may play a role in plague epidemiology. These findings are of immediate public health relevance because they provide an indicator that can be surveyed to assess the risk for plague.
Trends for Influenza-related Deaths during Pandemic and Epidemic Seasons, Italy, 1969–2001
PDF Version [PDF - 377 KB - 6 pages]
C. Rizzo et al.View Abstract
Age-specific patterns of death from influenza vary, depending on whether the influenza season is epidemic or pandemic. We assessed age patterns and geographic trends in monthly influenza-related deaths in Italy from 1969 through 2001, focusing on differences between epidemic and pandemic seasons. We evaluated age-standardized excess deaths from pneumonia and influenza and from all causes, using a modified version of a cyclical Serfling model. Excess deaths were highest for elderly persons in all seasons except the influenza A (H3N2) pandemic season (1969–70), when rates were greater for younger persons, confirming a shift toward death of younger persons during pandemic seasons. When comparing northern, central, and southern Italy, we found a high level of synchrony in the amplitude of peaks of influenza-related deaths.
Respirator Donning in Post-Hurricane New Orleans
PDF Version [PDF - 369 KB - 8 pages]
K. J. Cummings et al.View Abstract
We evaluated correctness of N95 filtering facepiece respirator donning by the public in post-hurricane New Orleans, where respirators were recommended for mold remediation. We randomly selected, interviewed, and observed 538 participants, using multiple logistic regression for analysis. Only 129 (24%) participants demonstrated proper donning. Errors included nose clip not tightened (71%) and straps incorrectly placed (52%); 22% put on the respirator upside down. Factors independently associated with proper donning were as follows: ever having used a mask or respirator (odds ratio [OR] 5.28; 95% confidence interval [CI], 1.79–22.64); ever having had a respirator fit test (OR 4.40; 95% CI, 2.52–7.81); being male (OR 2.44; 95% CI, 1.50–4.03); Caucasian race (OR 2.09; 95% CI, 1.32–3.33); having a certified respirator (OR 1.99, 95% CI 1.20–3.28); and having participated in mold clean-up (OR 1.82; 95% CI,1.00–3.41). Interventions to improve respirator donning should be considered in planning for influenza epidemics and disasters.
Apoptosis and Pathogenesis of Avian Influenza A (H5N1) Virus in Humans
PDF Version [PDF - 299 KB - 5 pages]
M. Uiprasertkul et al.View Abstract
The pathogenesis of avian influenza A (H5N1) virus in humans has not been clearly elucidated. Apoptosis may also play an important role. We studied autopsy specimens from 2 patients who died of infection with this virus. Apoptosis was observed in alveolar epithelial cells, which is the major target cell type for the viral replication. Numerous apoptotic leukocytes were observed in the lung of a patient who died on day 6 of illness. Our data suggest that apoptosis may play a major role in the pathogenesis of influenza (H5N1) virus in humans by destroying alveolar epithelial cells. This pathogenesis causes pneumonia and destroys leukocytes, leading to leukopenia, which is a prominent clinical feature of influenza (H5N1) virus in humans. Whether observed apoptotic cells were a direct result of the viral replication or a consequence of an overactivation of the immune system requires further studies.
Genome Analysis Linking Recent European and African Influenza (H5N1) Viruses
PDF Version [PDF - 317 KB - 6 pages]
S. L. Salzberg et al.View Abstract
To better understand the ecology and epidemiology of the highly pathogenic avian influenza virus in its transcontinental spread, we sequenced and analyzed the complete genomes of 36 recent influenza A (H5N1) viruses collected from birds in Europe, northern Africa, and southeastern Asia. These sequences, among the first complete genomes of influenza (H5N1) viruses outside Asia, clearly depict the lineages now infecting wild and domestic birds in Europe and Africa and show the relationships among these isolates and other strains affecting both birds and humans. The isolates fall into 3 distinct lineages, 1 of which contains all known non-Asian isolates. This new Euro-African lineage, which was the cause of several recent (2006) fatal human infections in Egypt and Iraq, has been introduced at least 3 times into the European-African region and has split into 3 distinct, independently evolving sublineages. One isolate provides evidence that 2 of these sublineages have recently reassorted.
Pet Rodents and Fatal Lymphocytic Choriomeningitis in Transplant Patients
PDF Version [PDF - 180 KB - 7 pages]
B. R. Amman et al.View Abstract
In April 2005, 4 transplant recipients became ill after receiving organs infected with lymphocytic choriomeningitis virus (LCMV); 3 subsequently died. All organs came from a donor who had been exposed to a hamster infected with LCMV. The hamster was traced back through a Rhode Island pet store to a distribution center in Ohio, and more LCMV-infected hamsters were discovered in both. Rodents from the Ohio facility and its parent facility in Arkansas were tested for the same LCMV strain as the 1 involved in the transplant-associated deaths. Phylogenetic analysis of virus sequences linked the rodents from the Ohio facility to the Rhode Island pet store, the index hamster, and the transplant recipients. This report details the animal traceback and the supporting laboratory investigations.
International Spread of Multidrug-resistant Salmonella Schwarzengrund in Food Products
PDF Version [PDF - 173 KB - 6 pages]
F. M. Aarestrup et al.View Abstract
We compared 581 Salmonella enterica serotype Schwarzengrund isolates from persons, food, and food animals in Denmark, Thailand, and the United States by antimicrobial drug susceptibility and pulsed-field gel electrophoresis (PFGE) typing. Resistance, including resistance to nalidixic acid, was frequent among isolates from persons and chickens in Thailand, persons in the United States, and food imported from Thailand to Denmark and the United States. A total of 183 PFGE patterns were observed, and 136 (23.4%) isolates had the 3 most common patterns. Seven of 14 isolates from persons in Denmark had patterns found in persons and chicken meat in Thailand; 22 of 390 human isolates from the United States had patterns found in Denmark and Thailand. This study suggests spread of multidrug-resistant S. Schwarzengrund from chickens to persons in Thailand, and from imported Thai food products to persons in Denmark and the United States.
Rudolf Virchow and the Recognition of Alveolar Echinococcosis, 1850s
PDF Version [PDF - 1.30 MB - 4 pages]
D. Tappe and M. FroschView Abstract
Alveolar echinococcosis, which is caused by the larval stage of the fox tapeworm Echinococcus multilocularis, is one of the most dangerous parasitic diseases. It is endemic in many parts of the Northern Hemisphere and an emerging health problem in the People’s Republic of China. In Europe and North America, human cases are rare, but concomitant with an increase in the population of the final host, the red fox, an increase of human infections is expected. Rudolf Virchow, the father of the concept of cellular pathology, determined in the 1850s that an Echinococcus sp. was the causative agent of this enigmatic emerging disease. In his famous publication in 1855, he described the clinical course of the disease, its macroscopic aspects, and histopathologic findings in detail. He also identified the disease formerly known as alveolar colloid of the liver to be an infection with the larval stage of an Echinococcus sp.
Fatal Disseminated Acanthamoeba lenticulata Acanthamebiasis in a Heart Transplant Patient
PDF Version [PDF - 188 KB - 3 pages]
S. Barete et al.View Abstract
We report a fatal case of disseminated acanthamebiasis caused by Acanthamoeba lenticulata (genotype T5) in a 39-year-old heart transplant recipient. The diagnosis was based on skin histopathologic results and confirmed by isolation of the ameba from involved skin and molecular analysis of a partial 18S rRNA gene sequence (DF3).
Leptospirosis in Urban Wild Boars, Berlin, Germany
PDF Version [PDF - 395 KB - 4 pages]
A. Jansen et al.View Abstract
We found antibodies to leptospires in 25 (18%) of 141 wild boars from Berlin (95% confidence interval 12–25). Seropositivity was associated with chronic interstitial nephritis (odds ratio 10.5; p = 0.01), and leptospires were detected in kidney tissues. Wild boars represent a potential source for human leptospirosis in urban environments.
Mycobacterium liflandii Infection in European Colony of Silurana tropicalis
PDF Version [PDF - 385 KB - 4 pages]
P. Suykerbuyk et al.View Abstract
Mycobacterium liflandii causes a fatal frog disease in captive anurans. Here we report, to our knowledge, the first epizootic of mycobacteriosis in a European colony of clawed frogs (Silurana tropicalis), previously imported from a United States biologic supply company. Our findings suggest the emerging potential of this infection through international trade.
Environmental Source of Candida dubliniensis
PDF Version [PDF - 287 KB - 4 pages]
M. A. Nunn et al.View Abstract
We isolated Candida dubliniensis from a nonhuman source, namely, tick samples from an Irish seabird colony. The species was unambiguously identified by phenotypic and genotypic means. Analysis of the 5.8S rRNA gene showed that the environmental isolates belong to C. dubliniensis genotype 1.
Gulf Coast Ticks (Amblyomma maculatum) and Rickettsia parkeri, United States
PDF Version [PDF - 189 KB - 3 pages]
J. W. Sumner et al.View Abstract
Geographic distribution of Rickettsia parkeri in its US tick vector, Amblyomma maculatum, was evaluated by PCR. R. parkeri was detected in ticks from Florida, Georgia, Kentucky, Mississippi, Oklahoma, and South Carolina, which suggests that A. maculatum may be responsible for additional cases of R. parkeri rickettsiosis throughout much of its US range.
Outbreak of Yersinia enterocolitica Serogroup O:9 Infection and Processed Pork, Norway
PDF Version [PDF - 126 KB - 3 pages]
D. Grahek-Ogden et al.View Abstract
An outbreak involving 11 persons infected with Yersinia enterocolitica O:9 was investigated in Norway in February 2006. A case-control study and microbiologic investigation indicated a ready-to-eat pork product as the probable source. Appropriate control measures are needed to address consumer risk associated with this product.
Enteroaggregative Escherichia coli Related to Uropathogenic Clonal Group A
PDF Version [PDF - 187 KB - 4 pages]
F. Wallace-Gadsden et al.View Abstract
Enteroaggregative Escherichia coli (EAEC) are heterogeneous, diarrheagenic E. coli. Of EAEC strains from Nigeria, 10 independent antimicrobial-resistant isolates belonged to the multilocus sequence type 69 clonal complex, to which uropathogenic E. coli clonal group A belongs. This finding suggests a recent common ancestor for these distinct groups of pathogenic E. coli.
Antimicrobial Drugs and Community–acquired Clostridium difficile–associated Disease, UK
PDF Version [PDF - 215 KB - 3 pages]
J. A. Delaney et al.View Abstract
In a population-based case-control study of community-acquired Clostridium difficile–associated disease (CDAD), we matched 1,233 cases to 12,330 controls. CDAD risk increased 3-fold with use of any antimicrobial agent and 6-fold with use of fluoroquinolones. Prior use of antimicrobial agent did not affect risk for CDAD after 6 months.
Chikungunya Virus in US Travelers Returning from India, 2006
PDF Version [PDF - 213 KB - 4 pages]
R. S. Lanciotti et al.View Abstract
Chikungunya virus (CHIKV), a mosquitoborne alphavirus; is endemic in Africa and Asia. In 2005–2006, CHIKV epidemics were reported in islands in the Indian Ocean and in southern India. We present data on laboratory-confirmed CHIKV infections among travelers returning from India to the United States during 2006.
Chikungunya Virus, Cameroon, 2006
PDF Version [PDF - 228 KB - 4 pages]
C. N. Peyrefitte et al.View Abstract
We report the isolation of chikungunya virus from a patient during an outbreak of a denguelike syndrome in Cameroon in 2006. The virus was phylogenetically grouped in the Democratic Republic of the Congo cluster, indicating a continuous circulation of a genetically similar chikungunya virus population during 6 years in Central Africa.
Avian Influenza (H5N1) Virus in Waterfowl and Chickens, Central China
PDF Version [PDF - 299 KB - 4 pages]
Z. Yu et al.View Abstract
In 2004, 3 and 4 strains of avian influenza virus (subtype H5N1) were isolated from waterfowl and chickens, respectively, in central People’s Republic of China. Viral replication and pathogenicity were evaluated in chickens, quails, pigeons, and mice. We analyzed the sequences of the hemagglutinin and neuraminidase genes of the isolates and found broad diversity among them.
Tuberculosis Drug Resistance and HIV Infection, the Netherlands
PDF Version [PDF - 1.43 MB - 3 pages]
C. H. Haar et al.View Abstract
In the Netherlands during 1993–2001, multidrug-resistant tuberculosis among newly diagnosed patients was more frequent in those with HIV coinfection (5/308, 1.6%) than in those with no HIV infection (39/646, 0.6%; adjusted odds ratio 3.43, p = 0.015). Four of the 5 patients coinfected with multidrug-resistant tuberculosis and HIV were foreign-born. DNA fingerprint analysis suggested that transmission had occurred outside the Netherlands.
Detecting Epidemic Malaria, Uganda
PDF Version [PDF - 175 KB - 2 pages]
J. Cox et al.
Buruli Ulcer, Nigeria
PDF Version [PDF - 186 KB - 2 pages]
O. Chukwuekezie et al.
Acetobacter cibinongensis Bacteremia in Human
PDF Version [PDF - 167 KB - 2 pages]
A. Gouby et al.
Risk for Epidemics after Natural Disasters
PDF Version [PDF - 182 KB - 2 pages]
R. Michel et al.
Recombinant Sapovirus Gastroenteritis, Japan
PDF Version [PDF - 169 KB - 3 pages]
G. S. Hansman et al.
Salmonella Typhimurium in Hihi, New Zealand
PDF Version [PDF - 187 KB - 3 pages]
J. G. Ewen et al.
Travel-related Salmonella Agama, Gabon
PDF Version [PDF - 183 KB - 2 pages]
S. Bélard et al.
Small Anellovirus Infections in Korean Children
PDF Version [PDF - 195 KB - 3 pages]
J. Chung et al.
Antibodies against Leptospira spp. in Captive Collared Peccaries, Peru
PDF Version [PDF - 145 KB - 2 pages]
P. Mayor et al.
High Tuberculosis and HIV Coinfection Rate, Johannesburg
PDF Version [PDF - 139 KB - 2 pages]
M. John et al.
Tuberculosis Trends, Vietnam
PDF Version [PDF - 166 KB - 2 pages]
M. Vree et al.
Vancomycin-resistant Enterococci, Mexico City
PDF Version [PDF - 195 KB - 2 pages]
J. Cuellar-Rodríguez et al.
Disseminated Bacillus Calmette-Guérin Infection and Immunodeficiency
PDF Version [PDF - 210 KB - 3 pages]
E. A. Bernatowska et al.
Clindamycin-resistant Streptococcus pneumoniae
PDF Version [PDF - 170 KB - 2 pages]
F. Montagnani et al.
Expanded-spectrum β-Lactamase and Plasmid-mediated Quinolone Resistance
PDF Version [PDF - 173 KB - 3 pages]
L. Poirel et al.
Viral Load and Crimean-Congo Hemorrhagic Fever
PDF Version [PDF - 176 KB - 2 pages]
A. Papa et al.
Inactivated Whole Virus Influenza A (H5N1) Vaccine
PDF Version [PDF - 165 KB - 2 pages]
Z. Vajo et al.
Resistance to Dihydroartemisinin
PDF Version [PDF - 138 KB - 2 pages]
E. Legrand et al.
Extensively Drug-resistant Tuberculosis, Italy and Germany
PDF Version [PDF - 166 KB - 3 pages]
G. B. Migliori et al.
Books and Media
Exposure: A Guide to Sources of Infection
PDF Version [PDF - 147 KB - 1 page]
S. K. Schumacher
Several Worlds: Reminiscences and Reflections of a Chinese-American Physician
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: July 09, 2012
- Page last updated: July 09, 2012
- Page last reviewed: July 09, 2012
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