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Volume 14, Number 4—April 2008
Volume 14, Number 4—April 2008 PDF Version [PDF - 7.02 MB - 167 pages]
Bluetongue Epidemiology in the European Union
PDF Version [PDF - 270 KB - 6 pages]
C. Saegerman et al.View Abstract
Bluetongue (BT) is a reportable disease of considerable socioeconomic concern and of major importance in the international trade of animals and animal products. Before 1998, BT was considered an exotic disease in Europe. From 1998 through 2005, at least 6 BT virus strains belonging to 5 serotypes (BTV-1, BTV-2, BTV-4, BTV-9, and BTV-16) were continuously present in the Mediterranean Basin. Since August 2006, BTV-8 has caused a severe epizootic of BT in northern Europe. The widespread recrudescence and extension of BTV-8 infections in northern Europe during 2007 suggest that requirements for BTV establishment may now be fulfilled in this area. In addition, the radial extension of BTV-8 across Europe increases the risk for an encounter between this serotype and others, particularly those that occur in the Mediterranean Basin, where vector activity continues for more of the year. This condition increases the risk for reassortment of individual BTV gene segments.
Potential Use of Antiviral Agents in Polio Eradication
PDF Version [PDF - 227 KB - 7 pages]
A. M. De Palma et al.View Abstract
In 1988, the World Health Assembly launched the Global Polio Eradication Initiative, which aimed to use large-scale vaccination with the oral vaccine to eradicate polio worldwide by the year 2000. Although important progress has been made, polio remains endemic in several countries. Also, the current control measures will likely be inadequate to deal with problems that may arise in the postpolio era. A panel convoked by the National Research Council concluded that the use of antiviral drugs may be essential in the polio eradication strategy. We here report on a comparative study of the antipoliovirus activity of a selection of molecules that have previously been reported to be inhibitors of picornavirus replication and discuss their potential use, alone or in combination, for the treatment or prophylaxis of poliovirus infection.
Determination of Oseltamivir Quality by Colorimetric and Liquid Chromatographic Methods
PDF Version [PDF - 203 KB - 5 pages]
M. D. Green et al.View Abstract
We developed a colorimetric and chromatographic assay for oseltamivir to assess the authenticity of Tamiflu (F. Hoffmann-La Roche Ltd., Basel, Switzerland) because of a growing concern about counterfeit oseltamivir. The colorimetric assay is quantitative and relies on an extractable colored ion-pair complex of oseltamivir with Congo red or bromochlorophenol blue. The reverse-phase chromatographic assay uses an alkaline mobile phase with UV detection. Both methods were evaluated for variability and selectivity and subsequently applied to batches of oseltamivir products acquired through the Internet. The Congo red test showed greater assay sensitivity, linearity, and accuracy. Colorimetric and chromatographic analysis showed all batches of oseltamivir product were within ±15% of the stated amount of active ingredient.
Clonal Population of Flucytosine-Resistant Candida tropicalis from Blood Cultures, Paris, France
PDF Version [PDF - 230 KB - 9 pages]
M. Desnos-Ollivier et al.View Abstract
Candida tropicalis is a diploid ascomycetes yeast responsible for 4%–24% of candidemia. Resistance to flucytosine is rarely described for this species but was observed for 45 (35%) of 130 C. tropicalis isolates recovered from blood cultures in the Paris area in a 4-year survey. The aims of this study were to test the hypothesis that the flucytosine-resistant isolates could represent a subgroup and to determine the relationship between epidemiologic and genomic data. Epidemiologic data and gene sequences were analyzed, and molecular typing was performed. Our results suggest that a clone of flucytosine-resistant isolates, associated with malignancies and a lower mortality than that for other C. tropicalis isolates, is widespread in the Paris area. We propose the analysis of 2 polymorphic microsatellite markers coupled with URA3 sequencing to track the clone.
Emericella quadrilineata as Cause of Invasive Aspergillosis
PDF Version [PDF - 320 KB - 7 pages]
P. E. Verweij et al.View Abstract
We noted a cluster of 4 cases of infection or colonization by Emericella spp., identified by sequence-based analysis as E. quadrilineata. Sequence-based analysis of an international collection of 33 Emericella isolates identified 12 as E. nidulans, all 12 of which had previously been identified by morphologic methods as E. nidulans. For 12 isolates classified as E. quadrilineata, only 6 had been previously identified accordingly. E. nidulans was less susceptible than E. quadrilineata to amphotericin B (median MICs 2.5 and 0.5 mg/L, respectively, p<0.05); E. quadrilineata was less susceptible than E. nidulans to caspofungin (median MICs, 1.83 and 0.32 mg/L, respectively, p<0.05). These data indicate that sequence-based identification is more accurate than morphologic examination for identifying Emericella spp. and that correct species demarcation and in vitro susceptibility testing may affect patient management.
Control Measures Used during Lymphogranuloma Venereum Outbreak, Europe
PDF Version [PDF - 183 KB - 6 pages]
A. Timen et al.View Abstract
To assess the response to the reemergence of lymphogranuloma venereum, we conducted a cross-sectional survey by administering a structured questionnaire to representatives from 26 European countries. Responses were received from 18 countries. The ability to respond quickly and the measures used for outbreak detection and control varied. Evidence-based criteria were not consistently used to develop recommendations. We did not develop criteria to determine the effectiveness of the recommendations. The degree of preparedness for an unexpected outbreak, as well as the ability of countries to respond quickly to alerts, varied, which indicates weaknesses in the ability to control an outbreak. More guidance is needed to implement and evaluate control measures used during international outbreaks.
Medscape CME Activity
β-Herpesviruses in Febrile Children with CancerS. Yee-Guardino et al.View Abstract
We conducted a cross-sectional study of β-herpesviruses in febrile pediatric oncology patients (n = 30), with a reference group of febrile pediatric solid-organ transplant recipients (n = 9). One (3.3%) of 30 cancer patients and 3 (33%) of 9 organ recipients were PCR positive for cytomegalovirus. Four (13%) of 30 cancer patients and 3 (33%) of 9 transplant recipients had human herpesvirus 6B (HHV-6B) DNAemia, which was more common within 6 months of initiation of immune suppression (4 of 16 vs. 0 of 14 cancer patients; p = 0.050). HHV-6A and HHV-7 were not detected. No other cause was identified in children with HHV-6B or cytomegalovirus DNAemia. One HHV-6B–positive cancer patient had febrile disease with concomitant hepatitis. Other HHV-6B–positive children had mild “viral” illnesses, as did a child with primary cytomegalovirus infection. Cytomegalovirus and HHV-6B should be included in the differential diagnosis of febrile disease in children with cancer.
Seroprevalence and Risk Factors for Human Herpesvirus 8 Infection, Rural Egypt
PDF Version [PDF - 186 KB - 6 pages]
S. M. Mbulaiteye et al.View Abstract
To determine whether human herpesvirus 8 (HHV-8) is associated with schistosomal and hepatitis C virus infections in Egypt, we surveyed 965 rural household participants who had been tested for HHV-8 and schistosomal infection (seroprevalence 14.2% and 68.6%, respectively, among those <15 years of age, and 24.2% and 72.8%, respectively, among those ≥15 years of age). Among adults, HHV-8 seropositivity was associated with higher age, lower education, dental treatment, tattoos, >10 lifetime injections, and hepatitis C virus seropositivity. In adjusted analyses, HHV-8 seropositivity was associated with dental treatment among men (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1–5.2) and hepatitis C virus seropositivity among women (OR 3.3, 95% CI 1.4–7.9). HHV-8 association with antischistosomal antibodies was not significant for men (OR 2.1, 95% CI 0.3–16.4), but marginal for women (OR 1.5, 95% CI 1.0–2.5). Our findings suggest salivary and possible nosocomial HHV-8 transmission in rural Egypt.
Retrospective Analysis of Monkeypox Infection
PDF Version [PDF - 390 KB - 8 pages]
M. E. Dubois and M. K. SlifkaView Abstract
Serologic cross-reactivity between orthopoxviruses is a substantial barrier to laboratory diagnosis of specific orthopoxvirus infections and epidemiologic characterization of disease outbreaks. Historically, time-consuming and labor-intensive strategies such as cross-adsorbed neutralization assays, immunofluorescence assays, and hemagglutination-inhibition assays have been used to identify orthopoxvirus infections. We used cross-adsorption to develop a simple and quantitative postadsorption ELISA for distinguishing between monkeypox and vaccinia infections. Despite the difficulty of diagnosing clinically inapparent monkeypox in previously vaccinated persons, this technique exhibited 100% sensitivity and 100% specificity for identifying clinically overt monkeypox infection irrespective of vaccination history. We also describe a Western blot technique in which up to 3 diagnostic bands may be used to distinguish between vaccinia and monkeypox infection. The techniques described provide independent diagnostic tests suitable for retrospective analysis of monkeypox outbreaks.
Wild Ducks as Long-Distance Vectors of Highly Pathogenic Avian Influenza Virus (H5N1)
PDF Version [PDF - 1.13 MB - 8 pages]
J. Keawcharoen et al.View Abstract
Wild birds have been implicated in the expansion of highly pathogenic avian influenza virus (H5N1) outbreaks across Asia, the Middle East, Europe, and Africa (in addition to traditional transmission by infected poultry, contaminated equipment, and people). Such a role would require wild birds to excrete virus in the absence of debilitating disease. By experimentally infecting wild ducks, we found that tufted ducks, Eurasian pochards, and mallards excreted significantly more virus than common teals, Eurasian wigeons, and gadwalls; yet only tufted ducks and, to a lesser degree, pochards became ill or died. These findings suggest that some wild duck species, particularly mallards, can potentially be long-distance vectors of highly pathogenic avian influenza virus (H5N1) and that others, particularly tufted ducks, are more likely to act as sentinels.
Rapid Typing of Transmissible Spongiform Encephalopathy Strains with Differential ELISA
PDF Version [PDF - 474 KB - 9 pages]
S. Simon et al.View Abstract
The bovine spongiform encephalopathy (BSE) agent has been transmitted to humans, leading to variant Creutzfeldt-Jakob disease. Sheep and goats can be experimentally infected by BSE and have been potentially exposed to natural BSE; however, whether BSE can be transmitted to small ruminants is not known. Based on the particular biochemical properties of the abnormal prion protein (PrPsc) associated with BSE, and particularly the increased degradation induced by proteinase K in the N terminal part of PrPsc, we have developed a rapid ELISA designed to distinguish BSE from other scrapie strains. This assay clearly discriminates experimental ovine BSE from other scrapie strains and was used to screen 260 transmissible spongiform encephalopathy (TSE)–infected small ruminant samples identified by the French active surveillance network (2002/2003). In this context, this test has helped to identify the first case of natural BSE in a goat and can be used to classify TSE isolates based on the proteinase K sensitivity of PrPsc.
Hemorrhagic Fever with Renal Syndrome Caused by 2 Lineages of Dobrava Hantavirus, Russia
PDF Version [PDF - 326 KB - 9 pages]
B. Klempa et al.View Abstract
Dobrava-Belgrade virus (DOBV) is a European hantavirus that causes hemorrhagic fever with renal syndrome (HFRS); case-fatality rates in Balkan countries are as high as 12%. To determine causative agents, we examined 126 cases of DOBV-associated HFRS in central and southern European Russia. In central Russia (Lipetsk, Voronezh, Orel regions), outbreaks were caused by a DOBV variant (DOBV-Aa) carried by Apodemus agrarius. In southern Russia (Sochi district), where HFRS is endemic, HFRS cases were caused by a new DOBV variant (DOBV-Ap), found in A. ponticus, a novel hantavirus natural host. Both viruses, DOBV-Aa/Lipetsk and DOBV-Ap/Sochi, were isolated through Vero E6 cells, genetically characterized, and used for serotyping of the HFRS patients’ serum. The clinical severity of HFRS caused by DOBV-Aa resembles that of HFRS caused by Puumala virus (mild to moderate); clinical severity of disease caused by DOBV-Ap infections is more often moderate to severe.
Detection and Prevalence Patterns of Group I Coronaviruses in Bats, Northern Germany
F. Gloza-Rausch et al.View Abstract
We tested 315 bats from 7 different bat species in northern Germany for coronaviruses by reverse transcription–PCR. The overall prevalence was 9.8%. There were 4 lineages of group I coronaviruses in association with 4 different species of verspertilionid bats (Myotis dasycneme, M. daubentonii, Pipistrellus nathusii, P. pygmaeus). The lineages formed a monophyletic clade of bat coronaviruses found in northern Germany. The clade of bat coronaviruses have a sister relationship with a clade of Chinese type I coronaviruses that were also associated with the Myotis genus (M. ricketti). Young age and ongoing lactation, but not sex or existing gravidity, correlated significantly with coronavirus detection. The virus is probably maintained on the population level by amplification and transmission in maternity colonies, rather than being maintained in individual bats.
Multiple Sublineages of Influenza A Virus (H5N1), Vietnam, 2005−2007
PDF Version [PDF - 436 KB - 5 pages]
T. D. Nguyen et al.View Abstract
Phylogenetic analysis of influenza subtype H5N1 viruses isolated from Vietnam during 2005–2007 shows that multiple sublineages are present in Vietnam. Clade 2.3.4 viruses have replaced clade 1 viruses in northern Vietnam, and clade 1 viruses have been detected in southern Vietnam. Reassortment between these 2 sublineages has also occurred.
Reassortant Avian Influenza Virus (H5N1) in Poultry, Nigeria, 2007
PDF Version [PDF - 251 KB - 4 pages]
I. Monne et al.View Abstract
Genetic characterization of a selection of influenza virus (H5N1) samples, circulating in 8 Nigerian states over a 39-day period in early 2007, indicates that a new reassortant strain is present in 7 of the 8 states. Our study reports an entirely different influenza virus (H5N1) reassortant becoming predominant and widespread in poultry.
Neuroinvasion by Mycoplasma pneumoniae in Acute Disseminated Encephalomyelitis
PDF Version [PDF - 236 KB - 3 pages]
B. Stamm et al.View Abstract
We report the autopsy findings for a 45-year-old man with polyradiculoneuropathy and fatal acute disseminated encephalomyelitis after having Mycoplasma pneumoniae pneumonia. M. pneumoniae antigens were demonstrated by immunohistochemical analysis of brain tissue, indicating neuroinvasion as an additional pathogenetic mechanism in central neurologic complications of M. pneumoniae infection.
Chagas Disease, France
PDF Version [PDF - 172 KB - 3 pages]
F. Lescure et al.View Abstract
Chagas disease (CD) is endemic to Latin America; its prevalence is highest in Bolivia. CD is sometimes seen in the United States and Canada among migrants from Latin America, whereas it is rare in Europe. We report 9 cases of imported CD in France from 2004 to 2006.
Human Thelaziasis, Europe
PDF Version [PDF - 227 KB - 3 pages]
D. Otranto and M. DuttoView Abstract
Thelazia callipaeda eyeworm is a nematode transmitted by drosophilid flies to carnivores in Europe. It has also been reported in the Far East in humans. We report T. callipaeda infection in 4 human patients in Italy and France.
Rabies Virus in Raccoons, Ohio, 2004
PDF Version [PDF - 355 KB - 3 pages]
J. C. Henderson et al.View Abstract
In 2004, the raccoon rabies virus variant emerged in Ohio beyond an area where oral rabies vaccine had been distributed to prevent westward spread of this variant. Our genetic investigation indicates that this outbreak may have begun several years before 2004 and may have originated within the vaccination zone.
Single Nucleotide Polymorphism Typing of Bacillus anthracis from Sverdlovsk Tissue
PDF Version [PDF - 216 KB - 4 pages]
R. T. Okinaka et al.View Abstract
A small number of conserved canonical single nucleotide polymorphisms (canSNP) that define major phylogenetic branches for Bacillus anthracis were used to place a Sverdlovsk patient’s B. anthracis genotype into 1 of 12 subgroups. Reconstruction of the pagA gene also showed a unique SNP that defines a new lineage for B. anthracis.
Human Mycobacterium bovis Infection and Bovine Tuberculosis Outbreak, Michigan, 1994–2007
PDF Version [PDF - 190 KB - 4 pages]
M. J. Wilkins et al.View Abstract
Mycobacterium bovis is endemic in Michigan’s white-tailed deer and has been circulating since 1994. The strain circulating in deer has remained genotypically consistent and was recently detected in 2 humans. We summarize the investigation of these cases and confirm that recreational exposure to deer is a risk for infection in humans.
Mycobacterium avium Lymphadenopathy among Children, Sweden
PDF Version [PDF - 201 KB - 3 pages]
J. Thegerström et al.View Abstract
We studied Mycobacterium avium lymphadenopathy in 183 Swedish children (<7 years of age) from 1998 through 2003. Seasonal variation in the frequency of the disease, with a peak in October and a low point in April, suggests cyclic environmental factors. We also found a higher incidence of the disease in children who live close to water.
Kala-azar Epidemiology and Control, Southern Sudan
PDF Version [PDF - 177 KB - 3 pages]
J. H. Kolaczinski et al.View Abstract
Southern Sudan is one of the areas in eastern Africa most affected by visceral leishmaniasis (kala-azar), but lack of security and funds has hampered control. Since 2005, the return of stability has opened up new opportunities to expand existing interventions and introduce new ones.
Dengue Virus Type 4, Manaus, Brazil
PDF Version [PDF - 182 KB - 3 pages]
R. M. Pinto de Figueiredo et al.View Abstract
We report dengue virus type 4 (DENV-4) in Amazonas, Brazil. This virus was isolated from serum samples of 3 patients treated at a tropical medicine reference center in Manaus. All 3 cases were confirmed by serologic and molecular tests; 1 patient was co-infected with DENV-3 and DENV-4.
Rat-to-Elephant-to-Human Transmission of Cowpox Virus
PDF Version [PDF - 173 KB - 2 pages]
A. Kurth et al.
Avian Influenza Knowledge among Medical Students, Iran
PDF Version [PDF - 160 KB - 2 pages]
K. Ghabili et al.
Lorraine Strain of Legionella pneumophila Serogroup 1, France
PDF Version [PDF - 206 KB - 3 pages]
C. Ginevra et al.
Bluetongue in Captive Yaks
PDF Version [PDF - 186 KB - 2 pages]
A. Mauroy et al.
Murine Typhus, Algeria
PDF Version [PDF - 176 KB - 3 pages]
N. Mouffok et al.
Natural Coinfection with 2 Parvovirus Variants in Dog
PDF Version [PDF - 142 KB - 2 pages]
M. J. Vieira et al.
WU Polyomavirus Infection in Children, Germany
PDF Version [PDF - 151 KB - 2 pages]
F. Neske et al.
Hepatitis E, Central African Republic
PDF Version [PDF - 219 KB - 3 pages]
J. M. Escribà et al.
Rickettsia sibirica subsp. mongolitimonae Infection and Retinal Vasculitis
PDF Version [PDF - 179 KB - 2 pages]
J. Caron et al.
Rickettsia felis in Fleas, France
PDF Version [PDF - 168 KB - 3 pages]
J. Gilles et al.
Novel Nonstructural Protein 4 Genetic Group in Rotavirus of Porcine Origin
PDF Version [PDF - 160 KB - 3 pages]
P. Khamrin et al.
PorB2/3 Protein Hybrid in Neisseria meningitidis
PDF Version [PDF - 137 KB - 2 pages]
R. Abad et al.
West Nile Virus in Birds, Argentina
PDF Version [PDF - 169 KB - 3 pages]
L. A. Diaz et al.
Clostridium difficile Surveillance Trends, Saxony, Germany
PDF Version [PDF - 163 KB - 2 pages]
F. Burckhardt et al.
Books and Media
Travel Medicine: Tales Behind the Science
PDF Version [PDF - 141 KB - 1 page]
I. D. Carroll
Coronaviruses: Molecular and Cellular Biology
PDF Version [PDF - 144 KB - 2 pages]
J. L. Leibowitz
About the Cover
Peer Reviewed Report Available Online OnlyConference Report on Public Health and Clinical Guidelines for AnthraxE. J. Stern et al.
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: May 25, 2012
- Page last updated: May 25, 2012
- Page last reviewed: May 25, 2012
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