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Volume 15, Number 1—January 2009
Volume 15, Number 1—January 2009 PDF Version [PDF - 3.90 MB - 151 pages]
Past, Present, and Future of Japanese Encephalitis
PDF Version [PDF - 139 KB - 6 pages]
T. E. Erlanger et al.View Abstract
Japanese encephalitis (JE), a vector-borne viral disease, is endemic to large parts of Asia and the Pacific. An estimated 3 billion people are at risk, and JE has recently spread to new territories. Vaccination programs, increased living standards, and mechanization of agriculture are key factors in the decline in the incidence of this disease in Japan and South Korea. However, transmission of JE is likely to increase in Bangladesh, Cambodia, Indonesia, Laos, Myanmar, North Korea, and Pakistan because of population growth, intensified rice farming, pig rearing, and the lack of vaccination programs and surveillance. On a global scale, however, the incidence of JE may decline as a result of large-scale vaccination programs implemented in China and India.
Threat of Dengue to Blood Safety in Dengue-Endemic Countries
PDF Version [PDF - 46 KB - 4 pages]
A. Wilder-Smith et al.View Abstract
Dengue, the most common arbovirus infection globally, is transmitted by mosquito vectors. Healthcare-related transmission, including transmission by blood products, has been documented, although the frequency of these occurrences is unknown. Dengue is endemic to Singapore, a city-state in Asia. Using mathematical modeling, we estimated the risk for dengue-infected blood transfusions in Singapore in 2005 to be 1.625–6/10,000 blood transfusions, assuming a ratio of asymptomatic to symptomatic infections of 2:1 to 10:1. However, the level of viremia required to cause clinical dengue cases is person-dependent and unknown. Further studies are needed to establish the magnitude of the threat that dengue poses to blood safety in countries where it is endemic. It will then be possible after this information is obtained to assess whether screening is feasible and to identify approaches that are most cost-effective on the basis of characteristics of local populations and seasonality of dengue.
Medscape CME Activity
Sphingomonas paucimobilis Bloodstream Infections Associated with Contaminated Intravenous Fentanyl PDF Version [PDF - 1.56 MB - 8 pages]L. L. Maragakis et al.View SummaryView Abstract
Compounding pharmacies should be required to follow good manufacturing practices, including end-product sterility testing.
Nationally distributed medications from compounding pharmacies, which typically adhere to less stringent quality-control standards than pharmaceutical manufacturers, can lead to multistate outbreaks. We investigated a cluster of 6 patients in a Maryland hospital who had Sphingomonas paucimobilis bloodstream infections in November 2007. Of the 6 case-patients, 5 (83%) had received intravenous fentanyl within 48 hours before bacteremia developed. Cultures of unopened samples of fentanyl grew S. paucimobilis; the pulsed-field gel electrophoresis pattern was indistinguishable from that of the isolates of 5 case-patients. The contaminated fentanyl lot had been prepared at a compounding pharmacy and distributed to 4 states. Subsequently, in California, S. paucimobilis bacteremia was diagnosed for 2 patients who had received intravenous fentanyl from the same compounding pharmacy. These pharmacies should adopt more stringent quality-control measures, including prerelease product testing, when compounding and distributing large quantities of sterile preparations.
Human Infection with Highly Pathogenic Avian Influenza Virus (H5N1) in Northern Vietnam, 2004–2005
PDF Version [PDF - 143 KB - 4 pages]
N. D. Hien et al.View Abstract
We performed a retrospective case-series study of patients with influenza A (H5N1) admitted to the National Institute of Infectious and Tropical Diseases in Hanoi, Vietnam, from January 2004 through July 2005 with symptoms of acute respiratory tract infection, a history of high-risk exposure or chest radiographic findings such as pneumonia, and positive findings for A/H5 viral RNA by reverse transcription–PCR. We investigated data from 29 patients (mean age 35.1 years) of whom 7 (24.1%) had died. Mortality rates were 20% (5/25) and 50% (2/4) among patients treated with or without oseltamivir (p = 0.24), respectively, and were 33.3% (5/15) and 14.2% (2/14) among patients treated with and without methylprednisolone (p = 0.39), respectively. After exact logistic regression analysis was adjusted for variation in severity, no significant effectiveness for survival was observed among patients treated with oseltamivir or methylprednisolone.
Enhanced Hygiene Measures and Norovirus Transmission during an Outbreak
PDF Version [PDF - 124 KB - 7 pages]
J. C. Heijne et al.View Abstract
Control of norovirus outbreaks relies on enhanced hygiene measures, such as handwashing, surface cleaning, using disposable paper towels, and using separate toilets for sick and well persons. However, little is known about their effectiveness in limiting further spread of norovirus infections. We analyzed norovirus outbreaks in 7 camps at an international scouting jamboree in the Netherlands during 2004. Implementation of hygiene measures coincided with an 84.8% (95% predictive interval 81.2%–86.6%) reduction in reproduction number. This reduction was unexpectedly large but still below the reduction needed to contain a norovirus outbreak. Even more stringent control measures are required to break the chain of transmission of norovirus.
Selection Tool for Foodborne Norovirus Outbreaks
PDF Version [PDF - 145 KB - 8 pages]
L. Verhoef et al.View Abstract
Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non–genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks.
Venetian Rule and Control of Plague Epidemics on the Ionian Islands during 17th and 18th Centuries
PDF Version [PDF - 254 KB - 4 pages]
K. Konstantinidou et al.View Abstract
During the 17th and 18th centuries, measures were taken by the Venetian administration to combat plague on the Ionian Islands. At that time, although the scientific basis of plague was unknown, the Venetians recognized its infectious nature and successfully decreased its spread by implementing an information network. Additionally, by activating a system of inspection that involved establishing garrisons along the coasts, the Venetians were able to control all local movements in plague-infested areas, which were immediately isolated. In contrast, the neighboring coast of mainland Greece, which was under Ottoman rule, was a plague-endemic area during the same period. We conclude that even in the absence of scientific knowledge, close observation and social and political measures can effectively restrain infectious outbreaks to the point of disappearance.
Parapneumonic Empyema Deaths during Past Century, Utah
PDF Version [PDF - 100 KB - 5 pages]
J. M. Bender et al.View Abstract
Bacterial pneumonia with empyema is a serious complication of influenza and commonly resulted in death during the 1918 influenza pandemic. We hypothesize that deaths caused by parapneumonic empyema are increasing in Utah once again despite advances in critical care and the availability of antimicrobial drugs and new vaccines. In this study, we analyzed the historical relationship between deaths caused by empyema and influenza pandemics by using 100 years of data from Utah. Deaths caused by empyema have indeed increased from 2000–2004 when compared with the historic low death rates of 1950–1975. Vaccine strategies and antimicrobial drug stockpiling to control empyema will be important as we prepare for the next influenza pandemic.
Microsporidiosis and Malnutrition in Children with Persistent Diarrhea, Uganda
PDF Version [PDF - 136 KB - 3 pages]
S. M. Mor et al.View Abstract
We show that the microsporidian fungus Enterocytozoon bieneusi is associated with lower rates of weight gain in children in Uganda with persistent diarrhea. This relationship remained after controlling for HIV and concurrent cryptosporidiosis. Children with microsporidiosis were predicted to weigh 1.3 kg less than children without microsporidiosis at 5 years of age.
Invasive Disease Caused by Nontuberculous Mycobacteria, Tanzania
PDF Version [PDF - 135 KB - 3 pages]
J. A. Crump et al.View Abstract
Data on nontuberculous mycobacterial (NTM) disease in sub-Saharan Africa are limited. During 2006–2008, we identified 3 HIV-infected patients in northern Tanzania who had invasive NTM; 2 were infected with “Mycobacterium sherrisii” and 1 with M. avium complex sequevar MAC-D. Invasive NTM disease is present in HIV-infected patients in sub-Saharan Africa.
Experimental Infection of Dogs with Avian-Origin Canine Influenza A Virus (H3N2)
PDF Version [PDF - 657 KB - 3 pages]
D. Song et al.View Abstract
Susceptible dogs were brought into contact with dogs experimentally infected with an avian-origin influenza A virus (H3N2) that had been isolated from a pet dog with severe respiratory syndrome. All the experimentally infected and contact-exposed dogs showed elevated rectal temperatures, virus shedding, seroconversion, and severe necrotizing tracheobronchitis and bronchioalveolitis.
Personal Protective Equipment and Risk for Avian Influenza (H7N3)
PDF Version [PDF - 152 KB - 3 pages]
O. Morgan et al.View Abstract
An outbreak of avian influenza (H7N3) among poultry resulted in laboratory-confirmed disease in 1 of 103 exposed persons. Incomplete use of personal protective equipment (PPE) was associated with conjunctivitis and influenza-like symptoms. Rigorous use of PPE by persons managing avian influenza outbreaks may reduce exposure to potentially hazardous infected poultry materials.
Imported Case of Poliomyelitis, Melbourne, Australia, 2007
PDF Version [PDF - 141 KB - 3 pages]
A. J. Stewardson et al.View Abstract
Wild poliovirus–associated paralytic poliomyelitis has not been reported in Australia since 1977. We report type 1 wild poliovirus infection in a man who had traveled from Pakistan to Australia in 2007. Poliomyelitis should be considered for patients with acute flaccid paralysis or unexplained fever who have been to poliomyelitis-endemic countries.
Isolation of Candidatus Bartonella melophagi from Human Blood
PDF Version [PDF - 150 KB - 3 pages]
R. G. Maggi et al.View Abstract
Candidatus Bartonella melophagi was isolated by blood culture from 2 women, 1 of whom was co-infected with B. henselae. Partial 16S rRNA, RNA polymerase B, and citrate synthase genes and 16S–23S internal transcribed spacer sequences indicated that human isolates were similar to Candidatus B. melophagi.
Botulism from Drinking Pruno
PDF Version [PDF - 174 KB - 3 pages]
D. J. Vugia et al.View Abstract
Foodborne botulism occurred among inmates at 2 prisons in California in 2004 and 2005. In the first outbreak, 4 inmates were hospitalized, 2 of whom required intubation. In the second event, 1 inmate required intubation. Pruno, an alcoholic drink made illicitly in prisons, was the novel vehicle for these cases.
Isolation of Bordetella avium and Novel Bordetella Strain from Patients with Respiratory Disease
PDF Version [PDF - 202 KB - 2 pages]
A. T. Harrington et al.View Abstract
Bordetella avium is thought to be strictly an avian pathogen. However, 16S rRNA gene sequencing identified 2 isolates from 2 humans with respiratory disease as B. avium and a novel B. avium–like strain. Thus, B. avium and B. avium–like organisms are rare opportunistic human pathogens.
Clonal Multidrug-Resistant Corynebacterium striatum Strains, Italy
PDF Version [PDF - 305 KB - 4 pages]
F. Campanile et al.View Abstract
We assessed the clinical relevance and performed molecular characterization of 36 multidrug-resistant strains of Corynebacterium striatum. Pulsed-field gel electrophoresis confirmed a single clone, possessing erm(X), tetA/B, cmxA/B, and aphA1 genes, but few related subclones. This strain is emerging as a pathogen in Italy.
Enterovirus 71 Outbreak, Brunei
PDF Version [PDF - 135 KB - 3 pages]
S. AbuBakar et al.View Abstract
Enterovirus 71 (EV71) outbreaks occur periodically in the Asia-Pacific region. In 2006, Brunei reported its first major outbreak of EV71 infections, associated with fatalities from neurologic complications. Isolated EV71 strains formed a distinct lineage with low diversity within subgenogroup B5, suggesting recent introduction and rapid spread within Brunei.
Novel Human Rotavirus Genotype G5P from Child with Diarrhea, Cameroon
PDF Version [PDF - 141 KB - 4 pages]
M. D. Esona et al.View Abstract
We report characterization of a genotype G5P human rotavirus (HRV) from a child in Cameroon who had diarrhea. Sequencing of all 11 gene segments showed similarities to >5 genes each from porcine and human rotaviruses. This G5P strain exemplifies the importance of heterologous animal rotaviruses in generating HRV genetic diversity through reassortment.
Serotype G12 Rotaviruses, Lilongwe, Malawi
PDF Version [PDF - 207 KB - 3 pages]
N. A. Cunliffe et al.View Abstract
To assess diversity of rotavirus strains in Lilongwe, Malawi, we conducted a cross-sectional study of children with acute gastroenteritis, July 2005–June 2007. Serotype G12 was identified in 30 (5%) of 546 rotavirus-positive fecal specimens. The G12 strain possessed multiple electropherotypes and P-types, but their viral protein 7 sequences were closely related, indicating that reassortment has occurred.
G2 Strain of Rotavirus among Infants and Children, Bangladesh
PDF Version [PDF - 178 KB - 4 pages]
S. K. Dey et al.View Abstract
To determine G and P genotypes, we performed nested PCR on 307 rotavirus specimens collected in Dhaka, Bangladesh, during 2004–2005. G2 (43.3%) was detected at the highest frequency, followed by G4 (19.5%), G9 (13.7%), G1 (12.7%), and G3 (2.6%). P was the most predominant genotype (53.2%), followed by P (42.9%).
Rotavirus Genotype Distribution after Vaccine Introduction, Rio de Janeiro, Brazil
PDF Version [PDF - 111 KB - 2 pages]
F. A. Carvalho-Costa et al.View Abstract
Brazil introduced rotavirus vaccination in March 2006. We studied 133 rotavirus-positive fecal samples collected from February 2005 through December 2007. Genotype G2P was found in 1.4% of samples in 2005, in 44% in 2006, and in 96% in 2007. Rotavirus detection rate decreased from 38% in 2005 to 24% in 2007 (p = 0.012).
Rickettsia helvetica in Dermacentor reticulatus Ticks
PDF Version [PDF - 124 KB - 3 pages]
M. Dobec et al.View Abstract
We report on the molecular evidence that Dermacentor reticulatus ticks in Croatia are infected with Rickettsia helvetica (10%) or Rickettsia slovaca (2%) or co-infected with both species (1%). These findings expand the knowledge of the geographic distribution of R. helvetica and D. reticulatus ticks.
Variation in Antimicrobial Resistance in Sporadic and Outbreak-related Salmonella enterica Serovar Typhimurium
PDF Version [PDF - 103 KB - 3 pages]
E. Nielsen et al.View Abstract
The prevalence of different antimicrobial resistance profiles and variants of the Salmonella genomic island 1 (SGI1) was reported for Salmonella enterica serovar Typhimurium DT104 strains isolated from patients in Denmark. Variation in antimicrobial resistance and corresponding changes of SGI1 were shown among isolates from a foodborne outbreak.
Predicting High Risk for Human Hantavirus Infections, Sweden
PDF Version [PDF - 107 KB - 2 pages]
G. E. Olsson et al.View Abstract
An increased risk for hemorrhagic fever with renal syndrome caused by Puumala hantavirus was forecast for Sweden in 2007. The forecast was based on a predicted increase in the number of Myodes glareolus rodents (reservoir hosts). Despite raised awareness and preparedness, the number of human cases during July 2007–June 2008 was 1,483, a new high.
Polyomaviruses KI and WU in Immunocompromised Patients with Respiratory Disease
PDF Version [PDF - 139 KB - 3 pages]
T. Mourez et al.View Abstract
Polyomaviruses KI (KIPyV) and WU (WUPyV) were recently identified, mainly in respiratory specimens from children. Among 200 patients with respiratory disorders admitted to Saint Louis Hospital, Paris, France, KIPyV was detected in 8% and WUPyV in 1%. KIPyV was significantly more frequent among human stem cell transplant patients (17.8% vs. 5.1%; p = 0.01).
Hepatitis E Virus Genotype 3 Diversity, France
PDF Version [PDF - 230 KB - 4 pages]
F. Legrand-Abravanel et al.View Abstract
We characterized 42 hepatitis E virus (HEV) genotype 3 strains from infected patients in France in 3 parts of the genome and sequenced the full-length HEV genotype 3f genome found in Europe. These strains are closely related to swine strains in Europe, which suggests zoonotic transmission of HEV in France.
It Can’t Happen Here
Falciparum Malaria in Patient 9 Years after Leaving Malaria-Endemic Area
PDF Version [PDF - 113 KB - 2 pages]
C. Theunissen et al.
Linezolid-Resistant Staphylococcus cohnii, Greece
PDF Version [PDF - 147 KB - 3 pages]
E. Petinaki et al.
Buruli Ulcer in Long-Term Traveler to Senegal
PDF Version [PDF - 142 KB - 1 page]
K. Ezzedine et al.
Evidence of Maternal–Fetal Transmission of Parachlamydia acanthamoebae
PDF Version [PDF - 107 KB - 2 pages]
D. Baud et al.
Emerging Mycobacteria spp. in Cooling Towers
PDF Version [PDF - 108 KB - 1 page]
I. Pagnier et al.
Clostridium difficile–related Hospitalizations among US Adults, 2006
PDF Version [PDF - 102 KB - 3 pages]
M. D. Zilberberg
Pulmonary Tuberculosis and Mycobacterium bovis, Uganda
PDF Version [PDF - 103 KB - 1 page]
F. Byarugaba et al.
Vertical Transmission of Pneumocystis jirovecii in Humans
PDF Version [PDF - 119 KB - 2 pages]
M. A. Montes-Cano et al.
Avian Influenza Virus (H5N1) in Human, Laos
PDF Version [PDF - 127 KB - 2 pages]
P. Puthavathana et al.
Fatal HIV Encephalitis in HIV-Seronegative Patients
PDF Version [PDF - 157 KB - 3 pages]
T. M. Martin and J. D. Rich
Classical ctxB in Vibrio cholerae O1, Kolkata, India
PDF Version [PDF - 113 KB - 1 page]
A. Raychoudhuri et al.
Sphingomonas mucosissima Bacteremia in Patient with Sickle Cell Disease
PDF Version [PDF - 108 KB - 1 page]
E. Angelakis et al.
WU Polyomavirus in Fecal Specimens of Children with Acute Gastroenteritis, China
PDF Version [PDF - 96 KB - 2 pages]
L. Ren et al.
SCCmec Typing in Methicillin-Resistant Staphylococcus aureus Strains of Animal Origin
PDF Version [PDF - 106 KB - 1 page]
M. D. Jansen et al.
School Closure to Reduce Influenza Transmission
PDF Version [PDF - 95 KB - 2 pages]
L. M. Koonin and M. S. Cetron
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- Page created: September 24, 2012
- Page last updated: September 24, 2012
- Page last reviewed: September 24, 2012
- Centers for Disease Control and Prevention,
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