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Volume 16, Number 2—February 2010
Volume 16, Number 2—February 2010 PDF Version [PDF - 4.33 MB - 195 pages]
Effects of Coronavirus Infections in Children
N. Principi et al.View Abstract
The isolation of the coronavirus (CoV) identified as the cause of severe acute respiratory syndrome and the detection of 2 new human CoVs (HCoV-NL63 and HCoV-HKU1) have led to studies of the epidemiology and clinical and socioeconomic effects of infections caused by all HCoVs, including those known since the late 1960s (HCoV-229E and HCoV-OC43). HCoV infections can be associated with respiratory and extrarespiratory manifestations, including central nervous system involvement. Furthermore, unlike other RNA viruses, HCoVs can easily mutate and recombine when different strains infect the same cells and give rise to a novel virus with unpredictable host ranges and pathogenicity. Thus, circulating HCoVs should be closely monitored to detect the spread of particularly virulent strains in the community at an early stage and to facilitate the development of adequate preventive and therapeutic measures.
Imported Methicillin-Resistant Staphylococcus aureus, Sweden
PDF Version [PDF - 287 KB - 8 pages]
M. Stenhem et al.View Abstract
Countries such as Sweden that have a low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) offer the opportunity to discern and study transmission of imported cases of MRSA. We analyzed 444 imported cases of MRSA acquisition reported in Sweden during 2000–2003. Risk for MRSA in returning travelers ranged from 0.1 (95% confidence interval [CI] 0.01–0.4) per 1 million travelers to Nordic countries to 59.4 (95% CI 44.5–79.3) per 1 million travelers to North Africa and the Middle East. Most imported cases (246, 55%) were healthcare acquired, but regions with the highest risk for MRSA in travelers showed a correlation with community acquisition (r = 0.81, p = 0.001). Characteristic differences in MRSA strains acquired were dependent on the region from which they originated and whether they were community or healthcare acquired. Knowledge of differences in transmission of MRSA may improve control measures against imported cases.
Medscape CME Activity
Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA PDF Version [PDF - 189 KB - 7 pages]P. K. Kutty et al.View Abstract
We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6–48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5–17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9–28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9–64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1–13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.
Household Responses to Pandemic (H1N1) 2009–related School Closures, Perth, Western Australia
PDF Version [PDF - 176 KB - 7 pages]
P. V. Effler et al.View Abstract
School closure is often purported to reduce influenza transmission, but little is known about its effect on families. We surveyed families affected by pandemic (H1N1) 2009–related school closures in Perth, Western Australia, Australia. Surveys were returned for 233 (58%) of 402 students. School closure was deemed appropriate by 110 parents (47%); however, 91 (45%) parents of 202 asymptomatic students reported taking >1 day off work to care for their child, and 71 (35%) had to make childcare arrangements because of the class closures. During the week, 172 (74%) students participated in activities outside the home on >1 occasion, resulting in an average of 3.7 out-of-home activities for each student. In our survey, activities outside the home were commonly reported by students affected by school closure, the effect on families was substantial, and parental opinion regarding school closures as a means to mitigate the outbreak of pandemic (H1N1) 2009 was divided.
Employment and Compliance with Pandemic Influenza Mitigation Recommendations
PDF Version [PDF - 157 KB - 7 pages]
K. D. Blake et al.View Abstract
In the event of a serious pandemic influenza outbreak, businesses must play a key role in protecting employees' health and safety. With regard to pandemic influenza mitigation recommendations requiring social distancing, we examined whether some US employees would disproportionately fail to comply because of job insecurity and financial problems associated with missing work. We used the 2006 Harvard School of Public Health Pandemic Influenza Survey and multivariable logistic regression to determine whether employment characteristics such as inability to work from home, lack of pay when absent from work, and self-employment would be associated with less ability to comply with recommendations. We found that inability to work from home, lack of paid sick leave, and income are associated with working adults’ ability to comply and should be major targets for workplace interventions in the event of a serious outbreak.
Human Hendra Virus Encephalitis Associated with Equine Outbreak, Australia, 2008
PDF Version [PDF - 133 KB - 5 pages]
E. G. Playford et al.View Abstract
A recent Hendra virus outbreak at a veterinary clinic in Brisbane, Queensland, Australia, involved 5 equine and 2 human infections. In contrast to previous outbreaks, infected horses had predominantly encephalitic, rather than respiratory, signs. After an incubation period of 9–16 days, influenza-like illnesses developed in the 2 persons before progressing to encephalitis; 1 died. Both patients were given ribavirin. Basal serum and cerebrospinal fluid levels were 10–13 mg/L after intravenous administration and 6 mg/L after oral administration (isolate 90% inhibitory concentration 64 mg/L). Both patients were exposed to infected horses, 1 during the late incubation period in a horse. The attack rate for veterinary clinic staff exposed to infected horses was 10%. An isolate from this outbreak showed genetic heterogeneity with isolates from a concurrent, but geographically remote, outbreak and from previous outbreaks. Emergence of Hendra virus is a serious medical, veterinary, and public health challenge.
Cost-effectiveness of Pharmaceutical-based Pandemic Influenza Mitigation Strategies
PDF Version [PDF - 282 KB - 7 pages]
A. T. Newall et al.View Abstract
We used a hybrid transmission and economic model to evaluate the relative merits of stockpiling antiviral drugs and vaccine for pandemic influenza mitigation. In the absence of any intervention, our base-case assumptions generated a population clinical attack rate of 31.1%. For at least some parameter values, population prepandemic vaccination strategies were effective at containing an outbreak of pandemic influenza until the arrival of a matched vaccine. Because of the uncertain nature of many parameters, we used a probabilistic approach to determine the most cost-effective strategies. At a willingness to pay of >A$24,000 per life-year saved, more than half the simulations showed that a prepandemic vaccination program combined with antiviral treatment was cost-effective in Australia.
Domestic Animals and Epidemiology of Visceral Leishmaniasis, Nepal
PDF Version [PDF - 335 KB - 7 pages]
N. R. Bhattarai et al.View Abstract
On the Indian subcontinent, visceral leishmaniasis (VL) is considered an anthroponosis. To determine possible reasons for its persistence during interepidemic periods, we mapped Leishmania infections among healthy persons and animals in an area of active VL transmission in Nepal. During 4 months (September 2007–February 2008), blood was collected from persons, goats, cows, and buffaloes in 1 village. Leishmania infections were determined by using PCR. We found infections among persons (6.1%), cows (5%), buffaloes (4%), and goats (16%). Data were georeferenced and entered into a geographic information system. The bivariate K-function results indicated spatial clustering of Leishmania spp.–positive persons and domestic animals. Classification tree analysis determined that among several possible risk factors for Leishmania infection among persons, proximity of Leishmania spp.–positive goats ranked first. Although our data do not necessarily mean that goats constitute a reservoir host of L. donovani, these observations indicate the need for further investigation of goats’ possible role in VL transmission.
Investigating an Airborne Tularemia Outbreak, Germany
PDF Version [PDF - 154 KB - 6 pages]
A. M. Hauri et al.View Abstract
In November 2005, an outbreak of tularemia occurred among 39 participants in a hare hunt in Hesse, Germany. Previously reported tularemia outbreaks in Germany dated back to the 1950s. We conducted a retrospective cohort study among participants and investigated the environment to identify risk factors for infection. Ten participants had serologic evidence of acute Francisella tularensis infection; 1 other participant died before laboratory confirmation was obtained. Presence within 5 meters of the place where disemboweled hares were rinsed with a water hose was the risk factor most strongly associated with infection (risk ratio 22.1; 95% confidence interval 13.2–154.3). Swabs taken at the game chamber and water samples were PCR negative for F. tularensis. Eleven of 14 hare parts showed low-level concentrations of F. tularensis, compatible with cross-contamination. More than half of case-patients may have acquired infection through inhalation of aerosolized droplets containing F. tularensis generated during rinsing of infected hares.
Statewide School-located Influenza Vaccination Program for Children 5–13 Years of Age, Hawaii, USA
P. V. Effler et al.View Abstract
New guidance recommends annual influenza vaccination for all children 5–18 years of age in the United States. During 2007–2008, Hawaii offered inactivated and live attenuated influenza vaccine at school-located clinics for grades kindergarten through 8. Most (90%) public and private schools participated, and 622 clinics were conducted at 340 schools. Of 132,775 children 5–13 years of age, 60,760 (46%) were vaccinated. The proportion vaccinated peaked at 54% for those 6 years of age and declined for older cohorts. More than 90% of schoolchildren transited the clinic in <10 minutes. A total of 16,920 staff-hours were expended; estimated cost per dose administered was $27 and included vaccine purchase and administration, health staffing resources, printing costs, data management, and promotion. This program demonstrates the feasibility of conducting mass school-located influenza vaccination programs in public and private schools statewide, as might be indicated to respond to pandemic influenza.
Epidemiology of Cryptococcus gattii, British Columbia, Canada, 1999–2007
PDF Version [PDF - 115 KB - 7 pages]
E. Galanis et al.View SummaryView Abstract
Incidence is high, but the predominant strain does not seem to cause greater illness or death than do other strains.
British Columbia, Canada, has the largest reported population of Cryptococcus gattii–infected persons worldwide. To assess the impact of illness, we retrospectively analyzed demographic and clinical features of reported cases, hospitalizations, and deaths during 1999–2007. A total of 218 cases were reported (average annual incidence 5.8 per million persons). Most persons who sought treatment had respiratory illness (76.6%) or lung cryptococcoma (75.4%). Persons without HIV/AIDS hospitalized with cryptococcosis were more likely than those with HIV/AIDS to be older and admitted for pulmonary cryptococcosis. The 19 (8.7%) persons who died were more likely to be older and to have central nervous system disease and infection from the VGIIb strain. Although incidence in British Columbia is high, the predominant strain (VGIIa) does not seem to cause greater illness or death than do other strains. Further studies are needed to explain host and strain characteristics for regional differences in populations affected and disease outcomes.
Tropheryma whipplei in Patients with Pneumonia
PDF Version [PDF - 143 KB - 6 pages]
S. Bousbia et al.View Abstract
Tropheryma whipplei is the etiologic pathogenic agent of Whipple disease (WD), characterized by various clinical signs, such as diarrhea, weight loss, lymphadenopathy, and polyarthritis. PCR-based methods for diagnosis of WD have been developed. T. whipplei has been identified in saliva and stool samples from patients with WD and from healthy persons. T. whipplei DNA has also been found in bronchoalveolar lavage (BAL) samples of a child with pneumonia. We detected DNA of T. whipplei in 6 (3%) of 210 BAL samples collected in intensive care units by using 16S rDNA and specific quantitative PCR. We identified 4 novel genotypes of T. whipplei. In 1 case, T. whipplei was the only bacterium; in 4 others, it was associated with buccal flora. We suggest that T. whipplei should be investigated as an etiologic agent of pneumonia.
Emergence of Increased Resistance and Extensively Drug-Resistant Tuberculosis Despite Treatment Adherence, South Africa
PDF Version [PDF - 175 KB - 9 pages]
A. D. Calver et al.View Abstract
We investigated the emergence and evolution of drug-resistant tuberculosis (TB) in an HIV co-infected population at a South African gold mine with a well-functioning TB control program. Of 128 patients with drug-resistant TB diagnosed during January 2003–November 2005, a total of 77 had multidrug-resistant (MDR) TB, 26 had pre–extensively drug-resistant TB (XDR TB), and 5 had XDR TB. Genotyping suggested ongoing transmission of drug-resistant TB, and contact tracing among case-patients in the largest cluster demonstrated multiple possible points of contact. Phylogenetic analysis demonstrated stepwise evolution of drug resistance, despite stringent treatment adherence. These findings suggested that existing TB control measures were inadequate to control the spread of drug-resistant TB in this HIV co-infected population. Diagnosis delay and inappropriate therapy facilitated disease transmission and drug-resistance. These data call for improved infection control measures, implementation of rapid diagnostics, enhanced active screening strategies, and pharmacokinetic studies to determine optimal dosages and treatment regimens.
Associations between Mycobacterium tuberculosis Strains and Phenotypes
PDF Version [PDF - 341 KB - 3 pages]
T. Brown et al.View Abstract
To inform development of tuberculosis (TB) control strategies, we characterized a total of 2,261 Mycobacterium tuberculosis complex isolates by using multiple phenotypic and molecular markers, including polymorphisms in repetitive sequences (spoligotyping and variable-number tandem repeats [VNTRs]) and large sequence and single-nucleotide polymorphisms. The Beijing family was strongly associated with multidrug resistance (p = 0.0001), and VNTR allelic variants showed strong associations with spoligotyping families: >5 copies at exact tandem repeat (ETR) A, >2 at mycobacterial interspersed repetitive unit 24, and >3 at ETR-B associated with the East African–Indian and M. bovis strains. All M. tuberculosis isolates were differentiated into 4 major lineages, and a maximum parsimony tree was constructed suggesting a more complex phylogeny for M. africanum. These findings can be used as a model of pathogen global diversity.
New Hypothesis for Cause of Epidemic among Native Americans, New England, 1616–1619
J. S. Marr and J. T. CatheyView Abstract
In the years before English settlers established the Plymouth colony (1616–1619), most Native Americans living on the southeastern coast of present-day Massachusetts died from a mysterious disease. Classic explanations have included yellow fever, smallpox, and plague. Chickenpox and trichinosis are among more recent proposals. We suggest an additional candidate: leptospirosis complicated by Weil syndrome. Rodent reservoirs from European ships infected indigenous reservoirs and contaminated land and fresh water. Local ecology and high-risk quotidian practices of the native population favored exposure and were not shared by Europeans. Reduction of the population may have been incremental, episodic, and continuous; local customs continuously exposed this population to hyperendemic leptospiral infection over months or years, and only a fraction survived. Previous proposals do not adequately account for signature signs (epistaxis, jaundice) and do not consider customs that may have been instrumental to the near annihilation of Native Americans, which facilitated successful colonization of the Massachusetts Bay area.
Clonal Distribution of Invasive Pneumococci, Czech Republic, 1996–2003
PDF Version [PDF - 231 KB - 3 pages]
H. Žemličková et al.View Abstract
We conducted surveillance on invasive pneumococci isolated from adults in the Czech Republic during 1996–2003. The 7 most prevalent serotypes were characterized. Coverage with the 7-valent pneumococcal conjugate vaccine was low. Our observations confirm that detection methods may have modified the expected effect of this vaccine.
White-Nose Syndrome Fungus (Geomyces destructans) in Bat, France
PDF Version [PDF - 566 KB - 4 pages]
S. J. Puechmaille et al.View Abstract
White-nose syndrome is caused by the fungus Geomyces destructans and is responsible for the deaths of >1,000,000 bats since 2006. This disease and fungus had been restricted to the northeastern United States. We detected this fungus in a bat in France and assessed the implications of this finding.
Increasing Incidence of Nontuberculous Mycobacteria, Taiwan, 2000–2008
PDF Version [PDF - 280 KB - 3 pages]
C. Lai et al.View Abstract
To assess the species distribution and epidemiologic trends of nontuberculous mycobacteria, we examined isolates from patients in Taiwan. During 2000–2008, the proportion increased significantly from 32.3% to 49.8%. Associated disease incidence increased from 2.7 to 10.2 cases per 100,000 patients. Mycobacterium avium complex and M. abscessus were most frequently isolated.
Bordetella pertussis Clones Identified by Multilocus Variable-Number Tandem-Repeat Analysis
PDF Version [PDF - 233 KB - 4 pages]
J. Kurniawan et al.View Abstract
Multilocus variable-number tandem-repeat analysis (MLVA) of 316 Bordetella pertussis isolates collected over 40 years from Australia and 3 other continents identified 66 MLVA types (MTs), including 6 predominant MTs. Typing of genes encoding acellular vaccine antigens showed changes that may be vaccine driven in 2 MTs prevalent in Australia.
Plasmodium falciparum Malaria, Southern Algeria, 2007
PDF Version [PDF - 209 KB - 3 pages]
S. C. Boubidi et al.View Abstract
An outbreak of Plasmodium falciparum malaria occurred in Tinzaouatine in southern Algeria in 2007. The likely vector, Anopheles gambiae mosquitoes, had not been detected in Algeria. Genes for resistance to chloroquine were detected in the parasite. The outbreak shows the potential for an increase in malaria vectors in Algeria.
Sin Nombre Virus Infection in Field Workers, Colorado, USA
PDF Version [PDF - 178 KB - 3 pages]
F. Torres-Pérez et al.View Abstract
We report 2 cases of Sin Nombre virus (SNV) infection in field workers, possibly contracted through rodent bites. Screening for antibodies to SNV in rodents trapped in 2 seasons showed that 9.77% were seropositive. Quantitative real-time PCR showed that 2 of 79 deer mice had detectable titers of SNV RNA.
Pandemic (H1N1) 2009 Cases, Buenos Aires, Argentina
PDF Version [PDF - 200 KB - 3 pages]
M. Echavarría et al.View Abstract
To determine clinical and virologic characteristics of pandemic (H1N1) 2009 in Buenos Aires, Argentina, we conducted real-time reverse transcription–PCR on samples from patients with influenza-like illness, June 11–30, 2009. Of 513 patients tested, 54% were positive for influenza virus subtype H1N1. Infection rate was lowest for patients ≥60 years of age.
Extensive Mammalian Ancestry of Pandemic (H1N1) 2009 Virus
PDF Version [PDF - 276 KB - 4 pages]
N. A. Ilyushina et al.View Abstract
We demonstrate that the novel pandemic influenza (H1N1) viruses have human virus–like receptor specificity and can no longer replicate in aquatic waterfowl, their historic natural reservoir. The biological properties of these viruses are consistent with those of their phylogenetic progenitors, indicating longstanding adaptation to mammals.
Concurrent Silicosis and Pulmonary Mycosis at Death
PDF Version [PDF - 177 KB - 3 pages]
Y. Iossifova et al.View Abstract
To examine risk for mycosis among persons with silicosis, we examined US mortality data for 1979–2004. Persons with silicosis were more likely to die with pulmonary mycosis than were those without pneumoconiosis or those with more common pneumoconioses. Health professionals should consider enhanced risk for mycosis for silica-exposed patients.
Coccidioidomycosis among Scholarship Athletes and Other College Students, Arizona, USA
PDF Version [PDF - 195 KB - 3 pages]
N. G. Stern and J. N. GalgianiView Abstract
To compare coccidioidomycosis case rates among groups of young adults in a disease-endemic region, we reviewed medical charts for serologic testing and coding. Case rates were higher for scholarship athletes than for other students and paralleled 5× more serologic testing. Our findings underscore the need to routinely test patients for coccidioidomycosis.
Novel Human Bocavirus in Children with Acute Respiratory Tract Infection
PDF Version [PDF - 308 KB - 4 pages]
J. Song et al.View Abstract
Human bocavirus (HBoV) and HBoV2, two human bocavirus species, were found in 18 and 10 of 235 nasopharyngeal aspirates, respectively, from children hospitalized with acute respiratory tract infection. Our results suggest that, like HBoV, HBoV2 is distributed worldwide and may be associated with respiratory and enteric diseases.
Lymphocytic Choriomeningitis Virus Meningitis, New York, NY, USA, 2009
PDF Version [PDF - 357 KB - 3 pages]
D. S. Asnis et al.View Abstract
We describe a case of lymphocytic choriomeningitis virus (LCMV) meningitis in a New York, NY, resident who had no apparent risk factors. Clues leading to the diagnosis included aseptic meningitis during winter and the finding of hypoglycorrachia and lymphocytosis in the cerebrospinal fluid. LCMV continues to be an underdiagnosed zoonotic disease.
Severe Leptospirosis in Hospitalized Patients, Guadeloupe
PDF Version [PDF - 183 KB - 4 pages]
C. Herrmann-Storck et al.View Abstract
We evaluated prognostic factors for leptospirosis in 168 consecutive hospitalized patients in Guadeloupe. Factors independently associated with severity included chronic hypertension or chronic alcoholism, late initiation of antibacterial therapy, abnormal chest auscultation results, icterus, oligoanuria, disorders of consciousness, elevated aspartate aminotransferase levels, hyperamylasemia, and Leptospira interrogans serovar Icterohemorrhagiae.
Seropositivity for Enterocytozoon bieneusi, Czech Republic
PDF Version [PDF - 232 KB - 3 pages]
B. Sak et al.View Abstract
To determine seropositivity for Enterocytozoon bieneusi in the Czech Republic, we tested 115 serum samples from various groups. We found that 20% from HIV-positive persons, 33% from persons with occupational exposure to animals, and 10% from healthy persons were positive by indirect immunofluorescence assay. Proteins of 32 kDa were detected in serum samples from seropositive persons.
Hendra Virus Outbreak with Novel Clinical Features, Australia
H. E. Field et al.View Abstract
To determine the epidemiologic and clinical features of a 2008 outbreak of Hendra virus infection in a veterinary clinic in Australia, we investigated the equine case-series. Four of 5 infected horses died, as did 1 of 2 infected staff members. Clinical manifestation in horses was predominantly neurologic. Preclinical transmission appears likely.
Pandemic (H1N1) 2009 Outbreak on Pig Farm, Argentina
PDF Version [PDF - 423 KB - 4 pages]
A. Pereda et al.View Abstract
In June–July 2009, an outbreak of pandemic (H1N1) 2009 infection occurred on a pig farm in Argentina. Molecular analysis indicated that the virus was genetically related to the pandemic (H1N1) 2009 influenza virus strain. The outbreak presumably resulted from direct human-to-pig transmission.
The Critical Role of Permanent Voucher Specimens of Hosts and Vectors in Public Health and Epidemiology
PDF Version [PDF - 144 KB - 2 pages]
A. T. Peterson
Perinatal Pandemic (H1N1) 2009 Infection, Thailand
PDF Version [PDF - 126 KB - 2 pages]
W. Dulyachai et al.
Bronchial Casts and Pandemic (H1N1) 2009 Virus Infection
PDF Version [PDF - 132 KB - 3 pages]
M. Hasegawa et al.
Methicillin-Resistant Staphylococcus aureus ST398, Italy
PDF Version [PDF - 101 KB - 3 pages]
L. Soavi et al.
Neisseria meningitidis Serogroup W135, China
PDF Version [PDF - 85 KB - 2 pages]
Z. Shao et al.
Avian Influenza (H5N1) Outbreak among Wild Birds, Russia, 2009
PDF Version [PDF - 117 KB - 3 pages]
K. Sharshov et al.
Detection of Pandemic (H1N1) 2009 Virus in Patients Treated with Oseltamivir
PDF Version [PDF - 80 KB - 2 pages]
D. Boutolleau et al.
Marburg Virus in Fruit Bat, Kenya
PDF Version [PDF - 100 KB - 3 pages]
I. V. Kuzmin et al.
Human African Trypanosomiasis in Areas without Surveillance
PDF Version [PDF - 101 KB - 3 pages]
F. Chappuis et al.
Using Museum Collections to Detect Pathogens
PDF Version [PDF - 95 KB - 2 pages]
C. M. Pinto et al.
Aggression and Rabid Coyotes, Massachusetts, USA
PDF Version [PDF - 88 KB - 13 pages]
X. Wang et al.
Neisseria meningitidis Serogroup X Sequence Type 2888, Italy
PDF Version [PDF - 99 KB - 2 pages]
C. Fazio et al.
Antiphospholipid Syndrome and Acute HIV Infection
PDF Version [PDF - 102 KB - 2 pages]
J. S. Díaz et al.
Mycobacterium tuberculosis Beijing Strain, Bamako, Mali
PDF Version [PDF - 90 KB - 2 pages]
B. Diarra et al.
Hemorrhagic Fever with Renal Syndrome, Vietnam
PDF Version [PDF - 117 KB - 3 pages]
V. T. Huong et al.
Origin of Highly Pathogenic Porcine Reproductive and Respiratory Syndrome Virus, China
PDF Version [PDF - 101 KB - 3 pages]
T. An et al.
About the Cover
Etymologia: Cryptococcus gattii
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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