Volume 14, Number 6—June 2008
Volume 14, Number 6—June 2008 PDF Version [PDF - 3.76 MB - 143 pages]
Major Issues and Challenges of Influenza Pandemic Preparedness in Developing Countries
PDF Version [PDF - 41 KB - 6 pages]
H. Oshitani et al.View Abstract
Better preparedness for an influenza pandemic mitigates its impact. Many countries have started developing and implementing national influenza pandemic preparedness plans. However, the level of preparedness varies among countries. Developing countries encounter unique and difficult issues and challenges in preparing for a pandemic. Deaths attributable to an influenza pandemic could be substantially higher in developing countries than in industrialized countries. Pharmaceutical interventions such as vaccines and antiviral agents are less likely to be available in developing countries. The public health and clinical infrastructure of developing countries are often inadequate to deal with a widespread health crisis such as an influenza pandemic. Such an event will inevitably have a global effect. Therefore, improving pandemic preparedness in every country, particularly developing ones, is urgently needed.
Managing Potential Laboratory Exposure to Ebola Virus by Using a Patient Biocontainment Care Unit
PDF Version [PDF - 58 KB - 7 pages]
M. G. Kortepeter et al.View Abstract
In 2004, a scientist from the US Army Medical Research Institute of Infectious Diseases (USAMRIID) was potentially exposed to a mouse-adapted variant of the Zaire species of Ebola virus. The circumstances surrounding the case are presented, in addition to an update on historical admissions to the medical containment suite at USAMRIID. Research facilities contemplating work with pathogens requiring Biosafety Level 4 laboratory precautions should be mindful of the occupational health issues highlighted in this article.
Medscape CME Activity
Transmission of Human Papillomavirus in Heterosexual Couples PDF Version [PDF - 112 KB - 7 pages]B. Y. Hernandez et al.View Abstract
We examined the transmission of human papillomavirus (HPV) in 25 heterosexual, monogamous couples (25 men, 25 women), followed up over an average of 7.5 months. A total of 53 heterosexual transmission events were observed among 16 couples (14 male-to-female and 39 female-to-male). Sexual transmission involved 13 different oncogenic and nononcogenic HPV types; 8% were vaccine-covered types transmitted between partners. The overall rate of HPV transmission from the penis to the cervix was 4.9/100 person-months, which was substantially lower than that from the cervix to the penis (17.4/100 person-months). Transmission between the hands and genitals, as well as apparent self-inoculation events (primarily in men), were also observed. Couples who transmitted HPV were more sexually active and used condoms less frequently. These results have implications for HPV prevention and control strategies, including the targeting of prophylactic vaccines.
Population-Attributable Risk Estimates for Risk Factors Associated with Campylobacter Infection, Australia
PDF Version [PDF - 211 KB - 7 pages]
R. J. Stafford et al.View Abstract
In 2001–2002, a multicenter, prospective case-control study involving 1,714 participants >5 years of age was conducted in Australia to identify risk factors for Campylobacter infection. Adjusted population-attributable risks (PARs) were derived for each independent risk factor contained within the final multivariable logistic regression model. Estimated PARs were combined with adjusted (for the >5 years of age eligibility criterion) notifiable disease surveillance data to estimate annual Australian Campylobacter case numbers attributable to each risk factor. Simulated distributions of “credible values” were then generated to model the uncertainty associated with each case number estimate. Among foodborne risk factors, an estimated 50,500 (95% credible interval 10,000–105,500) cases of Campylobacter infection in persons >5 years of age could be directly attributed each year to consumption of chicken in Australia. Our statistical technique could be applied more widely to other communicable diseases that are subject to routine surveillance.
Influenza A Virus (H3N8) in Dogs with Respiratory Disease, Florida
PDF Version [PDF - 159 KB - 7 pages]
S. Payungporn et al.View Abstract
In 2004, canine influenza virus subtype H3N8 emerged in greyhounds in the United States. Subsequent serologic evidence indicated virus circulation in dog breeds other than greyhounds, but the virus had not been isolated from affected animals. In 2005, we conducted virologic investigation of 7 nongreyhound dogs that died from respiratory disease in Florida and isolated influenza subtype H3N8 virus. Antigenic and genetic analysis of A/canine/Jacksonville/2005 (H3N8) and A/canine/Miami/2005 (H3N8) found similarity to earlier isolates from greyhounds, which indicates that canine influenza viruses are not restricted to greyhounds. The hemagglutinin contained 5 conserved amino acid differences that distinguish canine from equine lineages. The antigenic homogeneity of the canine viruses suggests that measurable antigenic drift has not yet occurred. Continued surveillance and antigenic analyses should monitor possible emergence of antigenic variants of canine influenza virus.
Tuberculosis from Mycobacterium bovis in Binational Communities, United States
PDF Version [PDF - 174 KB - 8 pages]
T. C. Rodwell et al.View Abstract
The epidemiology of tuberculosis (TB) in the United States is changing as the incidence of disease becomes more concentrated in foreign-born persons. Mycobacterium bovis appears to be contributing substantially to the TB incidence in some binational communities with ties to Mexico. We conducted a retrospective analysis of TB case surveillance data from the San Diego, California, region from 1994 through 2005 to estimate incidence trends, identify correlates of M. bovis disease, and evaluate risk factors for deaths during treatment. M. bovis accounted for 45% (62/138) of all culture-positive TB cases in children (<15 years of age) and 6% (203/3,153) of adult cases. M. bovis incidence increased significantly (p = 0.002) while M. tuberculosis incidence declined (p<0.001). Almost all M. bovis cases from 2001 through 2005 were in persons of Hispanic ethnicity. Persons with M. bovis were 2.55× (p = 0.01) as likely to die during treatment than those with M. tuberculosis.
Validation of Syndromic Surveillance for Respiratory Pathogen Activity
PDF Version [PDF - 570 KB - 9 pages]
C. van den Wijngaard et al.View Abstract
Syndromic surveillance is increasingly used to signal unusual illness events. To validate data-source selection, we retrospectively investigated the extent to which 6 respiratory syndromes (based on different medical registries) reflected respiratory pathogen activity. These syndromes showed higher levels in winter, which corresponded with higher laboratory counts of Streptococcus pneumoniae, respiratory syncytial virus, and influenza virus. Multiple linear regression models indicated that most syndrome variations (up to 86%) can be explained by counts of respiratory pathogens. Absenteeism and pharmacy syndromes might reflect nonrespiratory conditions as well. We also observed systematic syndrome elevations in the fall, which were unexplained by pathogen counts but likely reflected rhinovirus activity. Earliest syndrome elevations were observed in absenteeism data, followed by hospital data (+1 week), pharmacy/general practitioner consultations (+2 weeks), and deaths/laboratory submissions (test requests) (+3 weeks). We conclude that these syndromes can be used for respiratory syndromic surveillance, since they reflect patterns in respiratory pathogen activity.
Antibodies against Lagos Bat Virus in Megachiroptera from West Africa
PDF Version [PDF - 235 KB - 3 pages]
D. T. Hayman et al.View Abstract
To investigate the presence of Lagos bat virus (LBV)–specific antibodies in megachiroptera from West Africa, we conducted fluorescent antibody virus neutralization tests. Neutralizing antibodies were detected in Eidolon helvum (37%), Epomophorus gambianus (3%), and Epomops buettikoferi (33%, 2/6) from Ghana. These findings confirm the presence of LBV in West Africa.
Increase in Adult Clostridium difficile–related Hospitalizations and Case-Fatality Rate, United States, 2000–2005
PDF Version [PDF - 305 KB - 3 pages]
M. D. Zilberberg et al.View Abstract
Virulence of and deaths from Clostridium difficile–associated disease (CDAD) are on the rise in the United States. The incidence of adult CDAD hospitalizations doubled from 5.5 cases per 10,000 population in 2000 to 11.2 in 2005, and the CDAD-related age-adjusted case-fatality rate rose from 1.2% in 2000 to 2.2% in 2004.
Syphilis and Hepatitis B Co-infection among HIV-Infected, Sex-Trafficked Women and Girls, Nepal
PDF Version [PDF - 140 KB - 3 pages]
J. G. Silverman et al.View Abstract
Sex trafficking may play a major role in spread of HIV across South Asia. We investigated co-infection with HIV and other sexually transmitted diseases among 246 sex-trafficked women and girls from Nepal. Those who were HIV positive were more likely than those who were HIV negative to be infected with syphilis and/or hepatitis B.
Underreporting of Human Alveolar Echinococcosis, Germany
PDF Version [PDF - 163 KB - 3 pages]
P. Jorgensen et al.View Abstract
We estimated the total number of human alveolar echinococcosis cases in Germany from 2003 through 2005 using the multiple source capture-recapture method. We found a 3-fold higher incidence of the disease than that shown by national surveillance data. We propose a revision of the reporting system to increase case ascertainment.
Rickettsial Seroepidemiology among Farm Workers, Tianjin, People’s Republic of China
PDF Version [PDF - 258 KB - 3 pages]
J. Zhang et al.View Abstract
High seroprevalence rates for Anaplasma phagocytophilum (8.8%), Coxiella burnetii (6.4%), Bartonella henselae (9.6%), and Rickettsia typhi (4.1%) in 365 farm workers near Tianjin, People’s Republic of China, suggest that human infections with these zoonotic bacteria are frequent and largely unrecognized. Demographic features of seropositive persons suggest distinct epidemiology, ecology, and risks.
Persistence of Yersinia pestis in Soil Under Natural Conditions
PDF Version [PDF - 141 KB - 3 pages]
R. J. Eisen et al.View Abstract
As part of a fatal human plague case investigation, we showed that the plague bacterium, Yersinia pestis, can survive for at least 24 days in contaminated soil under natural conditions. These results have implications for defining plague foci, persistence, transmission, and bioremediation after a natural or intentional exposure to Y. pestis.
Global Distribution of Novel Rhinovirus Genotype
PDF Version [PDF - 339 KB - 4 pages]
T. Briese et al.View Abstract
Global surveillance for a novel rhinovirus genotype indicated its association with community outbreaks and pediatric respiratory disease in Africa, Asia, Australia, Europe, and North America. Molecular dating indicates that these viruses have been circulating for at least 250 years.
Prevalence of Cryptosporidium spp. and Giardia intestinalis in Swimming Pools, Atlanta, Georgia
PDF Version [PDF - 211 KB - 3 pages]
J. M. Shields et al.View Abstract
Cryptosporidium spp. and Giardia intestinalis have been found in swimming pool filter backwash during outbreaks. To determine baseline prevalence, we sampled pools not associated with outbreaks and found that of 160 sampled pools, 13 (8.1%) were positive for 1 or both parasites; 10 (6.2%) for Giardia sp., 2 (1.2%) for Cryptosporidium spp., and 1 (0.6%) for both.
Spatial and Temporal Evolution of Bluetongue Virus in Wild Ruminants, Spain
PDF Version [PDF - 190 KB - 3 pages]
F. Ruiz-Fons et al.View Abstract
We confirmed the emergence of bluetongue virus (BTV) in 5 wild ruminant species in Spain. BTV seroprevalence was high and dispersed with time, with a south-to-north gradient. Our results suggest a complex epidemiology of BTV and underline the need for additional research on wildlife in Europe.
Ceftriaxone-Resistant Salmonella enterica Serotype Newport, France
PDF Version [PDF - 325 KB - 4 pages]
S. Egorova et al.View Abstract
The multidrug-resistant (MDR) Salmonella enterica serotype Newport strain that produces CMY-2 β-lactamase (Newport MDR-AmpC) was the source of sporadic cases and outbreaks in humans in France during 2000–2005. Because this strain was not detected in food animals, it was most likely introduced into France through imported food products.
Avian Influenza A Virus (H5N1) Outbreaks, Kuwait, 2007
PDF Version [PDF - 394 KB - 4 pages]
A. Al-Azemi et al.View Abstract
Phylogenetic analysis of influenza A viruses (H5N1) isolated from Kuwait in 2007 show that (H5N1) sublineage clade 2.2 viruses continue to spread across Europe, Africa, and the Middle East. Virus isolates were most closely related to isolates from central Asia and were likely vectored by migratory birds.
Land Use and West Nile Virus Seroprevalence in Wild Mammals
PDF Version [PDF - 336 KB - 4 pages]
A. Gómez et al.View Abstract
We examined West Nile virus (WNV) seroprevalence in wild mammals along a forest-to-urban gradient in the US mid-Atlantic region. WNV antibody prevalence increased with age, urbanization, and date of capture for juveniles and varied significantly between species. These findings suggest several requirements for using mammals as indicators of transmission.
High Failure Rates of Melarsoprol for Sleeping Sickness, Democratic Republic of Congo
PDF Version [PDF - 134 KB - 2 pages]
J. Robays et al.View Abstract
A retrospective chart review of 4,925 human African trypanosomiasis patients treated with melarsoprol in 2001–2003 in Equateur Nord Province of the Democratic Republic of Congo showed a treatment failure rate of 19.5%. This rate increased over the 3 years. Relapse rates were highest in the central part of the province.
Nosocomial Outbreaks Caused by Leuconostoc mesenteroides subsp. mesenteroides
PDF Version [PDF - 197 KB - 4 pages]
G. Bou et al.View Abstract
From July 2003 through October 2004, 42 patients became infected by strains of Leuconostoc mesenteroides subsp. mesenteroides (genotype 1) in different departments of Juan Canalejo Hospital in northwest Spain. During 2006, 6 inpatients, also in different departments of the hospital, became infected (genotypes 2–4). Parenteral nutrition was the likely source.
Anaplasma phagocytophilum Infection in Ixodes ricinus, Bavaria, Germany
PDF Version [PDF - 179 KB - 3 pages]
C. Silaghi et al.View Abstract
Anaplasma phagocytophilum DNA was detected by real-time PCR, which targeted the msp2 gene, in 2.9% of questing Ixodes ricinus ticks (adults and nymphs; n = 2,862), collected systematically from selected locations in Bavaria, Germany, in 2006. Prevalence was significantly higher in urban public parks in Munich than in natural forests.
Internet- versus Telephone-based Local Outbreak Investigations
PDF Version [PDF - 260 KB - 3 pages]
T. S. Ghosh et al.View Abstract
We compared 5 locally conducted, Internet-based outbreak investigations with 5 telephone-based investigations. Internet-based surveys required less completion time, and response rates were similar for both investigation methods. Participant satisfaction with Internet-based surveys was high.
Lack of Serologic Evidence of Neospora caninum in Humans, England
PDF Version [PDF - 176 KB - 3 pages]
C. M. McCann et al.View Abstract
Retrospective testing of 3,232 serum samples from the general population and 518 serum samples from a high-risk group showed no evidence of human exposure to Neospora caninum in England. Results were obtained by using immunofluorescence antibody testing and ELISA to analyze frequency distribution.
In Memoriam: Joshua Lederberg (1925–2008)
PDF Version [PDF - 206 KB - 3 pages]
J. M. Hughes and D. P. Drotman
Lethal Mycobacterium massiliense Sepsis, Italy
PDF Version [PDF - 127 KB - 2 pages]
E. Tortoli et al.
Bovine Kobuviruses from Cattle with Diarrhea
PDF Version [PDF - 125 KB - 2 pages]
P. Khamrin et al.
Vibrio cholerae O1 Hybrid El Tor Strains, Asia and Africa
PDF Version [PDF - 117 KB - 2 pages]
A. Safa et al.
Mycobacterium avium subsp. hominissuis Infection in 2 Pet Dogs, Germany
PDF Version [PDF - 192 KB - 3 pages]
V. Haist et al.
Serogroup Y Meningococcal Disease, Colombia
PDF Version [PDF - 144 KB - 2 pages]
C. I. Agudelo et al.
Extensively Drug-Resistant Tuberculosis, Lesotho
PDF Version [PDF - 127 KB - 2 pages]
H. Satti et al.
Inquilinus limosus and Cystic Fibrosis
F. Bittar et al.
Splenic Rupture and Malignant Mediterranean Spotted Fever
PDF Version [PDF - 210 KB - 3 pages]
L. Schmulewitz et al.
Acetobacter indonesiensis Pneumonia after Lung Transplant
PDF Version [PDF - 154 KB - 2 pages]
F. Bittar et al.
Coronavirus Antibodies in Bat Biologists
PDF Version [PDF - 124 KB - 2 pages]
L. J. Stockman et al.
Chagas Disease in Ancient Hunter-Gatherer Population, Brazil
PDF Version [PDF - 134 KB - 2 pages]
V. S. Lima et al.
Coxiella burnetii in Wild-caught Filth Flies
M. P. Nelder et al.
Conflict and Emerging Infectious Diseases
PDF Version [PDF - 131 KB - 2 pages]
L. A. Kelly-Hope
Books and Media
Legionella and the Prevention of Legionellosis
PDF Version [PDF - 109 KB - 1 page]
J. E. McDade
Global HIV/AIDS Medicine
PDF Version [PDF - 116 KB - 2 pages]
J. L. Lennox
PDF Version [PDF - 118 KB - 2 pages]
P. F. Walker et al.
Imported Skin Diseases
PDF Version [PDF - 111 KB - 1 page]
About the Cover
“As the Dew Is Dried Up by the Morning Sun, So Are Mankind’s Sins at the Sight of Himalaya”
PDF Version [PDF - 221 KB - 2 pages]
- Page created: July 09, 2010
- Page last updated: July 09, 2010
- Page last reviewed: July 09, 2010
- Centers for Disease Control and Prevention,
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