Volume 13, Number 8—August 2007
Volume 13, Number 8—August 2007 PDF Version [PDF - 5.16 MB - 151 pages]
Ecologic Immunology of Avian Influenza (H5N1) in Migratory Birds
PDF Version [PDF - 67 KB - 5 pages]
T. P. Weber and N. I. StilianakisView Abstract
The claim that migratory birds are responsible for the long-distance spread of highly pathogenic avian influenza viruses of subtype H5N1 rests on the assumption that infected wild birds can remain asymptomatic and migrate long distances unhampered. We critically assess this claim from the perspective of ecologic immunology, a research field that analyzes immune function in an ecologic, physiologic, and evolutionary context. Long-distance migration is one of the most demanding activities in the animal world. We show that several studies demonstrate that such prolonged, intense exercise leads to immunosuppression and that migratory performance is negatively affected by infections. These findings make it unlikely that wild birds can spread the virus along established long-distance migration pathways. However, infected, symptomatic wild birds may act as vectors over shorter distances, as appears to have occurred in Europe in early 2006.
Risk Factors for Colonization with Extended-Spectrum β-Lactamase–producing Bacteria and Intensive Care Unit Admission
PDF Version [PDF - 167 KB - 6 pages]
A. D. Harris et al.View Abstract
Extended-spectrum β-lactamase (ESBL)–producing bacteria are emerging pathogens. To analyze risk factors for colonization with ESBL-producing bacteria at intensive care unit (ICU) admission, we conducted a prospective study of a 3.5-year cohort of patients admitted to medical and surgical ICUs at the University of Maryland Medical Center. Over the study period, admission cultures were obtained from 5,209 patients. Of these, 117 were colonized with ESBL-producing Escherichia coli and Klebsiella spp., and 29 (25%) had a subsequent ESBL-positive clinical culture. Multivariable analysis showed the following to be statistically associated with ESBL colonization at admission: piperacillin-tazobactam (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.36–3.10), vancomycin (OR 2.11, 95% CI 1.34–3.31), age >60 years (OR 1.79, 95% CI 1.24–2.60), and chronic disease score (OR 1.15; 95% CI 1.04–1.27). Coexisting conditions and previous antimicrobial drug exposure are thus predictive of colonization, and a large percentage of these patients have subsequent positive clinical cultures for ESBL-producing bacteria.
Occupational Risks during a Monkeypox Outbreak, Wisconsin, 2003
PDF Version [PDF - 231 KB - 8 pages]
D. R. Croft et al.View Abstract
We determined factors associated with occupational transmission in Wisconsin during the 2003 outbreak of prairie dog–associated monkeypox virus infections. Our investigation included active contact surveillance, exposure-related interviews, and a veterinary facility cohort study. We identified 19 confirmed, 5 probable, and 3 suspected cases. Rash, headache, sweats, and fever were reported by >80% of patients. Occupationally transmitted infections occurred in 12 veterinary staff, 2 pet store employees, and 2 animal distributors. The following were associated with illness: working directly with animal care (p = 0.002), being involved in prairie dog examination, caring for an animal within 6 feet of an ill prairie dog (p = 0.03), feeding an ill prairie dog (p = 0.002), and using an antihistamine (p = 0.04). Having never handled an ill prairie dog (p = 0.004) was protective. Veterinary staff used personal protective equipment sporadically. Our findings underscore the importance of standard veterinary infection-control guidelines.
Venezuelan Equine Encephalitis Virus Infection of Cotton Rats
PDF Version [PDF - 370 KB - 8 pages]
A. Carrara et al.View Abstract
Venezuelan equine encephalitis virus (VEEV) is an emerging pathogen of equids and humans, but infection of its rodent reservoir hosts has received little study. To determine whether responses to infection vary among geographic populations, we inoculated 3 populations of cotton rats with 2 enzootic VEEV strains (Co97-0054 [enzootic ID subtype] and 68U201 [enzootic IE subtype]). The 3 populations were offspring from wild-caught cotton rats collected in a VEE-enzootic area of south Florida, USA; wild-caught cotton rats from a non–VEE-enzootic area of Texas, USA; and commercially available (Harlan) colony-reared cotton rats from a non–VEE-enzootic region. Although each population had similar early viremia titers, no detectable disease developed in the VEE-sympatric Florida animals, but severe disease and death affected the Texas and Harlan animals. Our findings suggest that the geographic origins of cotton rats are important determinants of the outcome of VEE infection and reservoir potential of these rodents.
Source of Variant Creutzfeldt-Jakob Disease outside United Kingdom
PDF Version [PDF - 191 KB - 4 pages]
P. Sanchez-Juan et al.View Abstract
We studied the occurrence of variant Creutzfeldt-Jakob disease (vCJD) outside the United Kingdom in relation to the incidence of indigenous bovine spongiform encephalopathy (BSE) and to the level of live bovines and bovine products imported from the UK during the 1980s and the first half of the 1990s. Our study provides evidence that a country’s number of vCJD cases correlates with the number of live bovines it imported from the UK from 1980 to 1990 (Spearman rank correlation coefficient [rs] 0.73, 95% confidence interval [CI] 0.42–0.89, p<0.001). Similar correlations were observed with the number of indigenous BSE cases (rs 0.70, 95% CI 0.37–0.87, p = 0.001) and carcass meat imported from the UK from 1980 to 1996 (rs 0.75, 95% CI 0.45–0.89; p<0.001) Bovine imports from the UK may have been an important source of human exposure to BSE and may have contributed to the global risk for disease.
Infection with Scedosporium apiospermum and S. prolificans, Australia
PDF Version [PDF - 325 KB - 8 pages]
L. Cooley et al.View Abstract
Scedosporium apiospermum and S. prolificans are fungi of increasing clinical importance, particularly in persons with underlying diseases. We reviewed the records of 59 patients in Australia from whom Scedosporium spp. were isolated from June 30, 1997, through December 31, 2003. S. apiospermum was isolated predominantly from the respiratory tracts of 28 of 31 patients with underlying lung diseases and resulted in 2 infections and 1 death. The annual number of S. apiospermum isolates remained constant. S. prolificans was isolated from 28 patients only after November 1999. Eight patients with acute myeloid leukemia or hematopoietic stem cell transplants had invasive infection; 4 had fungemia and 6 died from infection. S. prolificans caused locally invasive infection in 2 immunocompetent patients and was found in the respiratory tract of 18 patients with underlying respiratory disease but did not cause fungemia or deaths in these patients. Scedosporium spp. showed distinct clinical and epidemiologic features.
Genetic Diversity of Bartonella henselae in Human Infection Detected with Multispacer Typing
PDF Version [PDF - 187 KB - 6 pages]
W. Li et al.View Abstract
We applied multispacer typing (MST) by incorporating 9 variable intergenic spacers to Bartonella henselae DNA detected in lymph node biopsy specimens from 70 patients with cat-scratch disease (CSD), in cardiac valve specimens from 2 patients with endocarditis, and in 3 human isolates from patients with bacillary angiomatosis, CSD, and endocarditis. Sixteen MST genotypes were found, 5 previously identified in cats and 11 new. Of the studied DNA, 78.7% belonged to 2 genotypes, which were phylogenetically organized into 4 lineages. Human strains were mostly grouped within 2 lineages, previously identified as Marseille and Houston-1. Our results suggest a greater genetic diversity in human-infecting B. henselae than what has previously been evaluated by using other genotyping methods. However, the diversity is not significantly different from that of cat strains. MST is thus a suitable genotyping tool for evaluating the genetic heterogeneity of B. henselae among isolates obtained from human patients.
Human Noroviruses in Swine and Cattle
PDF Version [PDF - 213 KB - 5 pages]
K. Mattison et al.View Abstract
Human noroviruses are the predominant cause of foodborne gastroenteritis worldwide. Strains of norovirus also exist that are uniquely associated with animals; their contribution to the incidence of human illness remains unclear. We tested animal fecal samples and identified GIII (bovine), GII.18 (swine), and GII.4 (human) norovirus sequences, demonstrating for the first time, to our knowledge, that GII.4-like strains can be present in livestock. In addition, we detected GII.4-like noroviral RNA from a retail meat sample. This finding highlights a possible route for indirect zoonotic transmission of noroviruses through the food chain.
High Prevalence of Tuberculosis in Previously Treated Patients, Cape Town, South Africa
PDF Version [PDF - 188 KB - 6 pages]
S. den Boon et al.View Abstract
The tuberculosis (TB) notification rate is high and increasing in 2 communities in Cape Town, South Africa. In 2002, we conducted a prevalence survey among adults >15 years of age to determine the TB prevalence rate; 15% of households in these communities were randomly sampled. All persons living in sampled households were eligible for chest radiography and sputum examination. Of the 3,483 adults who completed a questionnaire, 2,608 underwent chest radiography and sputum examination. We detected 26 bacteriologically confirmed TB cases and a prevalence of 10.0/1,000 (95% confidence interval [CI] 6.2–13.8 per 1,000). We found 18 patients with smear-positive TB, of whom 8 were new patients (3.1/1,000, 95% CI 0.9–5.1/1,000). More than half of patients with smear-positive TB (10, 56%) had previously been treated. Such patients may contribute to transmission of Mycobacterium tuberculosis and the high TB prevalence rate. Successful treatment of TB patients must be a priority.
Skin and Soft Tissue Infections Caused by Methicillin-Resistant Staphylococcus aureus USA300 Clone
PDF Version [PDF - 289 KB - 6 pages]
J. K. Johnson et al.View Abstract
Until recently, methicillin-resistant Staphylococcus aureus (MRSA) has caused predominantly healthcare-associated infections. We studied MRSA infections and overall skin and soft tissue infections (SSTIs) in outpatients receiving care at the Baltimore Veterans Affairs Medical Center Emergency Care Service during 2001–2005. We found an increase in MRSA infections, from 0.2 to 5.9 per 1,000 visits (p<0.01); most were community-associated SSTIs. Molecular typing showed that >80% of MRSA infections were caused by USA300. In addition, SSTI visits increased from 20 to 61 per 1,000 visits (p<0.01). The proportion of SSTI cultures that yielded MRSA increased from 4% to 42% (p<0.01), while the proportion that yielded methicillin-sensitive S. aureus remained the same (10% to 13%, p = 0.5). The increase in community-associated MRSA infections and the overall increase in SSTIs in our population suggest that USA300 is becoming more virulent and has a greater propensity to cause SSTIs.
Classic Scrapie in Sheep with the ARR/ARR Prion Genotype in Germany and France
PDF Version [PDF - 311 KB - 7 pages]
M. H. Groschup et al.View Abstract
In the past, natural scrapie and bovine spongiform encephalopathy (BSE) infections have essentially not been diagnosed in sheep homozygous for the A136R154R171 haplotype of the prion protein. This genotype was therefore assumed to confer resistance to BSE and classic scrapie under natural exposure conditions. Hence, to exclude prions from the human food chain, massive breeding efforts have been undertaken in the European Union to amplify this gene. We report the identification of 2 natural scrapie cases in ARR/ARR sheep that have biochemical and transmission characteristics similar to cases of classic scrapie, although the abnormally folded prion protein (PrPSc) was associated with a lower proteinase-K resistance. PrPSc was clearly distinct from BSE prions passaged in sheep and from atypical scrapie prions. These findings strongly support the idea that scrapie prions are a mosaic of agents, which harbor different biologic properties, rather than a unique entity.
Babesia sp. EU1 from Roe Deer and Transmission within Ixodes ricinus
PDF Version [PDF - 305 KB - 3 pages]
S. Bonnet et al.View Abstract
We report in vitro culture of zoonotic Babesia sp. EU1 from blood samples of roe deer in France. This study provides evidence of transovarial and transstadial transmission of the parasite within Ixodes ricinus, which suggests that this tick could be a vector and reservoir of EU1.
Pathogenic Hantaviruses, Northeastern Argentina and Eastern Paraguay
PDF Version [PDF - 193 KB - 4 pages]
P. Padula et al.View Abstract
We describe the first, to our knowledge, cases of hantavirus pulmonary syndrome in northeastern Argentina and eastern Paraguay. Andes and Juquitiba (JUQ) viruses were characterized. JUQV was also confirmed in 5 Oligoryzomys nigripes reservoir species from Misiones. A novel Akodon-borne genetic hantavirus lineage was detected in 1 rodent from the Biologic Reserve of Limoy.
Migrating Birds and Tickborne Encephalitis Virus
PDF Version [PDF - 331 KB - 4 pages]
J. Waldenström et al.View Abstract
During spring and autumn 2001, we screened 13,260 migrating birds at Ottenby Bird Observatory, Sweden, and found 3.4% were infested with ticks. Four birds, each a different passerine species, carried tickborne encephalitis virus (TBEV)–infected ticks (Ixodes ricinus). Migrating birds may play a role in the geographic dispersal of TBEV-infected ticks.
Avian Influenza (H5N1) Susceptibility and Receptors in Dogs
PDF Version [PDF - 359 KB - 3 pages]
R. Maas et al.View Abstract
Inoculation of influenza (H5N1) into beagles resulted in virus excretion and rapid seroconversion with no disease. Binding studies that used labeled influenza (H5N1) showed virus attachment to higher and lower respiratory tract tissues. Thus, dogs that are subclinically infected with influenza (H5N1) may contribute to virus spread.
Molecular Epidemiology of Canine Parvovirus, Europe
PDF Version [PDF - 290 KB - 3 pages]
N. Decaro et al.View Abstract
Canine parvovirus (CPV), which causes hemorrhagic enteritis in dogs, has 3 antigenic variants: types 2a, 2b, and 2c. Molecular method assessment of the distribution of the CPV variants in Europe showed that the new variant CPV-2c is widespread in Europe and that the viruses are distributed in different countries.
Invasive Meningococcal Disease, Utah, 1995–2005
PDF Version [PDF - 184 KB - 3 pages]
R. B. Boulton et al.View Abstract
Trends in invasive meningococcal disease in Utah during 1995–2005 have differed substantially from US trends in incidence rate and serogroup and age distributions. Regional surveillance is essential to identify high-risk populations that might benefit from targeted immunization efforts.
Outbreak of Sporotrichosis, Western Australia
PDF Version [PDF - 246 KB - 4 pages]
K. T. Feeney et al.View Abstract
A cluster of sporotrichosis cases occurred in the Busselton-Margaret River region of Western Australia from 2000 to 2003. Epidemiologic investigation and mycologic culture for Sporothrix schenckii implicated hay initially distributed through a commercial hay supplier as the source of the outbreak. Declining infection rates have occurred after various community measures were instigated.
Rotavirus G5P in Child with Diarrhea, Vietnam
PDF Version [PDF - 234 KB - 4 pages]
K. Ahmed et al.View Abstract
We detected rotavirus G5P with a long RNA pattern in a Vietnamese child with diarrhea. Viral outer capsid protein VP7 and VP4 genes suggest that it likely originated from porcine rotavirus either by genetic reassortment or as whole virions. To our knowledge, this is the first report of human rotavirus G5 in Asia.
Possible Autochthonous Malaria from Marseille to Minneapolis
PDF Version [PDF - 177 KB - 3 pages]
B. Doudier et al.View Abstract
We report 2 cases of Plasmodium falciparum malaria in southern France in a French woman and an American man of Togolese origin who reported no recent travel to malaria-endemic countries. Both infections occurred after a stay near Marseille, which raises the possibility of autochthonous transmission. Entomologic and genotypic investigations are described.
Waddlia chondrophila, a Potential Agent of Human Fetal Death
PDF Version [PDF - 298 KB - 5 pages]
D. Baud et al.View Abstract
We investigated the zoonotic potential of Waddlia chondrophila, a new Chlamydia-like abortigenic agent in ruminants. Anti-Waddlia antibody reactivity was tested by immunofluorescence and Western blot. Waddlia seroprevalence was higher in women who had had sporadic and recurrent miscarriages than in control women (p<0.001). Waddlia spp. may represent a cause of human fetal loss.
Norovirus Detection and Genotyping for Children with Gastroenteritis, Brazil
PDF Version [PDF - 156 KB - 3 pages]
C. C. Soares et al.View Abstract
During 1998–2005, we analyzed stool samples from 289 children in Rio de Janeiro to detect and genotype norovirus strains. Previous tests showed all samples to be negative for rotavirus and adenovirus. Of 42 (14.5%) norovirus-positive specimens, 20 (47.6%) were identified as genogroup GI and 22 (52.3%) as GII.
Atypical Q Fever in US Soldiers
PDF Version [PDF - 233 KB - 3 pages]
J. D. Hartzell et al.View Abstract
Q fever is an emerging infectious disease among US soldiers serving in Iraq. Three patients have had atypical manifestations, including 2 patients with acute cholecystitis and 1 patient with acute respiratory distress syndrome. Providers must be aware of Q fever’s signs and symptoms to avoid delays in treatment.
Streptococcus sinensis Endocarditis outside Hong Kong
PDF Version [PDF - 284 KB - 3 pages]
I. Uçkay et al.View Abstract
Streptococcus sinensis has been described as a causative organism for infective endocarditis in 3 Chinese patients from Hong Kong. We describe a closely related strain in an Italian patient with chronic rheumatic heart disease. The case illustrates that S. sinensis is a worldwide emerging pathogen.
PCR versus Hybridization for Detecting Virulence Genes of Enterohemorrhagic Escherichia coli
PDF Version [PDF - 1.91 MB - 3 pages]
R. S. Gerrish et al.View Abstract
We compared PCR amplification of 9 enterohemorrhagic Escherichia coli virulence factors among 40 isolates (21 O/H antigenicity classes) with DNA hybridization. Both methods showed 100% of the chromosomal and phage genes: eae, stx, and stx2. PCR did not detect 4%–20% of hybridizable plasmid genes: hlyA, katP, espP, toxB, open reading frame (ORF) 1, and ORF2.
Multidrug-Resistant Bacteria in Southeastern Austria
PDF Version [PDF - 192 KB - 2 pages]
A. Badura et al.
Osteomyelitis of Parietal Bone in Melioidosis
PDF Version [PDF - 204 KB - 3 pages]
N. G. Miksić et al.
Chikungunya Fever, Andaman and Nicobar Islands, India
PDF Version [PDF - 159 KB - 2 pages]
S. P. Manimunda et al.
Alistipes finegoldii in Blood Cultures from Colon Cancer Patients
PDF Version [PDF - 210 KB - 3 pages]
L. Fenner et al.
Shiga Toxin–producing Escherichia coli, Idaho
PDF Version [PDF - 186 KB - 3 pages]
V. M. Lockary et al.
Imported Chikungunya Infection, Italy
PDF Version [PDF - 169 KB - 3 pages]
A. Beltrame et al.
Dyella japonica Bacteremia in Hemodialysis Patient
PDF Version [PDF - 151 KB - 2 pages]
P. Kiratisin et al.
Mycobacterium cosmeticum, Ohio and Venezuela
PDF Version [PDF - 195 KB - 3 pages]
R. C. Cooksey et al.
Ecoregional Dominance in Spatial Distribution of Avian Influenza (H5N1) Outbreaks
PDF Version [PDF - 280 KB - 3 pages]
R. Sengupta et al.
Nephropathia Epidemica in Metropolitan Area, Germany
PDF Version [PDF - 192 KB - 3 pages]
S. S. Essbauer et al.
Effect of Hurricane Katrina on Arboviral Disease Transmission
PDF Version [PDF - 316 KB - 3 pages]
J. A. Lehman et al.
Threat to Cefixime Treatment for Gonorrhea
PDF Version [PDF - 281 KB - 3 pages]
S. Yokoi et al.
Books and Media
Vector- and Rodent-borne Diseases in Europe and North America: Distribution, Public Health Burden and Control
PDF Version [PDF - 204 KB - 1 page]
About the Cover
Peer Reviewed Report Available Online OnlyDeveloping a Research Agenda and a Comprehensive National Prevention and Response Plan for Rift Valley Fever in the United States PDF Version [PDF - 35 KB - 2 pages]S. C. Britch and K. J. Linthicum
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