Volume 16, Number 4—April 2010
Volume 16, Number 4—April 2010 PDF Version [PDF - 5.32 MB - 175 pages]
Livestock-associated Methicillin-Resistant Staphylococcus aureus Sequence Type 398 in Humans, Canada
PDF Version [PDF - 387 KB - 8 pages]
G. R. Golding et al.View Abstract
Rates of colonization with livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) sequence type 398 have been high for pigs and pig farmers in Canada, but prevalence rates for the general human population are unknown. In this study, 5 LA-MRSA isolates, 4 of which were obtained from skin and soft tissue infections, were identified from 3,687 tested MRSA isolates from persons in Manitoba and Saskatchewan, Canada. Further molecular characterization determined that these isolates all contained staphylococcal cassette chromosome (SCC) mecV, were negative for Panton-Valentine leukocidin, and were closely related by macrorestriction analysis with the restriction enzyme Cfr91. The complete DNA sequence of the SCCmec region from the isolate showed a novel subtype of SCCmecV harboring clustered regularly interspaced short palindromic repeats and associated genes. Although prevalence of livestock-associated MRSA seems to be low for the general population in Canada, recent emergence of infections resulting from this strain is of public health concern.
Influenza A Strain-Dependent Pathogenesis in Fatal H1N1 and H5N1 Subtype Infections of Mice
PDF Version [PDF - 739 KB - 9 pages]
M. Garigliany et al.View Abstract
To determine if fatal infections caused by different highly virulent influenza A viruses share the same pathogenesis, we compared 2 different influenza A virus subtypes, H1N1 and H5N1. The subtypes, which had shown no pathogenicity in laboratory mice, were forced to evolve by serial passaging. Although both adapted viruses evoked diffuse alveolar damage and showed a similar 50% mouse lethal dose and the same peak lung concentration, each had a distinct pathologic signature and caused a different course of acute respiratory distress syndrome. In the absence of any virus labeling, a histologist could readily distinguish infections caused by these 2 viruses. The different histologic features described in this study here refute the hypothesis of a single, universal cytokine storm underlying all fatal influenza diseases. Research is thus crucially needed to identify sets of virulence markers and to examine whether treatment should be tailored to the influenza virus pathotype.
Clostridium difficile Infections among Hospitalized Children, United States, 1997–2006
PDF Version [PDF - 287 KB - 6 pages]
M. D. Zilberberg et al.View Abstract
We evaluated the annual rate (cases/10,000 hospitalizations) of pediatric hospitalizations with Clostridium difficile infection (CDI; International Classification of Diseases, 9th revision, clinical modification code 008.45) in the United States. We performed a time-series analysis of data from the Kids’ Inpatient Database within the Health Care Cost and Utilization Project during 1997–2006 and a cross-sectional analysis within the National Hospital Discharge Survey during 2006. The rate of pediatric CDI-related hospitalizations increased from 7.24 to 12.80 from 1997 through 2006; the lowest rate was for children <1 year of age. Although incidence was lowest for newborns (0.5), incidence for children <1 year of age who were not newborns (32.01) was similar to that for children 5–9 years of age (35.27), which in turn was second only to incidence for children 1–4 years of age (44.87). Pediatric CDI-related hospitalizations are increasing. A better understanding of the epidemiology and outcomes of CDI is urgently needed.
Phylogenetic Analysis of Enterohemorrhagic Escherichia coli O157, Germany, 1987–2008
PDF Version [PDF - 262 KB - 7 pages]
C. Jenke et al.View Abstract
Multilocus variable number tandem repeat analysis (MLVA) is a subtyping technique for characterizing human pathogenic bacteria such as enterohemorrhagic Escherichia coli (EHEC) O157. We determined the phylogeny of 202 epidemiologically unrelated EHEC O157:H7/H– clinical isolates through 8 MLVA loci obtained in Germany during 1987–2008. Biodiversity in the loci ranged from 0.66 to 0.90. Four of 8 loci showed null alleles and a frequency <44.1%. These loci were distributed among 48.5% of all strains. Overall, 141 MLVA profiles were identified. Phylogenetic analysis assigned 67.3% of the strains to 19 MLVA clusters. Specific MLVA profiles with an evolutionary persistence were identified, particularly within sorbitol-fermenting EHEC O157:H–.These pathogens belonged to the same MLVA cluster. Our findings indicate successful persistence of this clone.
Use of Norovirus Genotype Profiles to Differentiate Origins of Foodborne Outbreaks
PDF Version [PDF - 208 KB - 8 pages]
L. Verhoef et al.View Abstract
Because secondary transmission masks the connection between sources and outbreaks, estimating the proportion of foodborne norovirus infections is difficult. We studied whether norovirus genotype frequency distributions (genotype profiles) can enhance detection of the sources of foodborne outbreaks. Control measures differ substantially; therefore, differentiating this transmission mode from person-borne or food handler–borne outbreaks is of public health interest. Comparison of bivalve mollusks collected during monitoring (n = 295) and outbreak surveillance strains (n = 2,858) showed 2 distinguishable genotype profiles in 1) human feces and 2) source-contaminated food and bivalve mollusks; genotypes I.2 and I.4 were more frequently detected in foodborne outbreaks. Overall, ≈21% of all outbreaks were foodborne; further analysis showed that 25% of the outbreaks reported as food handler–associated were probably caused by source contamination of the food.
Reassortment of Human Rotavirus Gene Segments into G11 Rotavirus Strains
PDF Version [PDF - 203 KB - 6 pages]
J. Matthijnssens et al.View Abstract
G11 rotaviruses are believed to be of porcine origin. However, a limited number of G11 rotaviruses have been recently isolated from humans in combination with P, P, P, and P. To investigate the evolutionary relationships of these strains, we analyzed the complete genomes of 2 human G11P strains, 2 human G11P strains, and 3 porcine reference strains. Most of the 11 gene segments of these 7 strains belonged to genotype 1 (Wa-like). However, phylogenetic clustering patterns suggested that an unknown G11P strain with a new I12 VP6 genotype was transmitted to the human population, in which it acquired human genotype 1 gene segments through reassortment, resulting in a human G11P rotavirus strain with an entire human Wa-genogroup backbone. This Wa-like backbone is believed to have caused the worldwide spread of human G9 and G12 rotaviruses. G11 human rotavirus strains should be monitored because they may also become major human pathogens.
Household Transmission of Pandemic (H1N1) 2009, San Antonio, Texas, USA, April–May 2009
PDF Version [PDF - 253 KB - 7 pages]
O. W. Morgan et al.View Abstract
To assess household transmission of pandemic (H1N1) 2009 in San Antonio, Texas, USA, during April 15–May 8, 2009, we investigated 77 households. The index case-patient was defined as the household member with the earliest onset date of symptoms of acute respiratory infection (ARI), influenza-like illness (ILI), or laboratory-confirmed pandemic (H1N1) 2009. Median interval between illness onset in index and secondary case-patients was 4 days (range 1–9 days); the index case-patient was likely to be <18 years of age (p = 0.034). The secondary attack rate was 4% for pandemic (H1N1) 2009, 9% for ILI, and 13% for ARI. The secondary attack rate was highest for children <5 years of age (8%–19%) and lowest for adults >50 years of age (4%–12%). Early in the outbreak, household transmission primarily occurred from children to other household members and was lower than the transmission rate for seasonal influenza.
Escherichia albertii in Wild and Domestic Birds
PDF Version [PDF - 847 KB - 9 pages]
J. L. Oaks et al.View Abstract
Escherichia albertii has been associated with diarrhea in humans but not with disease or infection in animals. However, in December 2004, E. albertii was found, by biochemical and genetic methods, to be the probable cause of death for redpoll finches (Carduelis flammea) in Alaska. Subsequent investigation found this organism in dead and subclinically infected birds of other species from North America and Australia. Isolates from dead finches in Scotland, previously identified as Escherichia coli O86:K61, also were shown to be E. albertii. Similar to the isolates from humans, E. albertii isolates from birds possessed intimin (eae) and cytolethal distending toxin (cdtB) genes but lacked Shiga toxin (stx) genes. Genetic analysis of eae and cdtB sequences, multilocus sequence typing, and pulsed-field gel electrophoresis patterns showed that the E. albertii strains from birds are heterogeneous but similar to isolates that cause disease in humans.
Medscape CME Activity
Community-associated Methicillin-Resistant Staphylococcus aureus Strains in Pediatric Intensive Care Unit PDF Version [PDF - 351 KB - 9 pages]A. M. Milstone et al.View Abstract
Virulent community-associated methicillin-resistant Staphylococcus-aureus (CA-MRSA) strains have spread rapidly in the United States. To characterize the degree to which CA-MRSA strains are imported into and transmitted in pediatric intensive care units (PICU), we performed a retrospective study of children admitted to The Johns Hopkins Hospital PICU, March 1, 2007–May 31, 2008. We found that 72 (6%) of 1,674 PICU patients were colonized with MRSA. MRSA-colonized patients were more likely to be younger (median age 3 years vs. 5 years; p = 0.02) and African American (p<0.001) and to have been hospitalized within 12 months (p<0.001) than were noncolonized patients. MRSA isolates from 66 (92%) colonized patients were fingerprinted; 40 (61%) were genotypically CA-MRSA strains. CA-MRSA strains were isolated from 50% of patients who became colonized with MRSA and caused the only hospital-acquired MRSA catheter-associated bloodstream infection in the cohort. Epidemic CA-MRSA strains are becoming endemic to PICUs, can be transmitted to hospitalized children, and can cause invasive hospital-acquired infections. Further appraisal of MRSA control is needed.
Contribution of Streptococcus anginosus to Infections Caused by Groups C and G Streptococci, Southern India
PDF Version [PDF - 307 KB - 8 pages]
S. Reißmann et al.View Abstract
Vellore, a region in southern India, has a high incidence of severe human infections with β-hemolytic group C and G streptococci (GCGS). To determine the causative species in these infections, we conducted 16S rRNA gene sequencing: Streptococcus dysgalactiae subsp. equisimilis (81%) and S. anginosus (19%) were the causative organisms in the 2-year study period (2006–2007). We used PCR to detect the virulence-related emm gene; results showed that it was restricted to S. dysgalactieae subsp. equisimilis isolates of 99.2% tested positive. Due to a novel marker, S. anginosus and S. constellatus can be quickly and accurately distinguished from other members of the genus. The notable contribution of the anginosus group to human infections suggests that this group of obligate pathogens deserves more attention in healthcare and research.
Alfred Russel Wallace and the Antivaccination Movement in Victorian England
PDF Version [PDF - 219 KB - 5 pages]
T. P. WeberView Abstract
Alfred Russel Wallace, eminent naturalist and codiscoverer of the principle of natural selection, was a major participant in the antivaccination campaigns in late 19th-century England. Wallace combined social reformism and quantitative arguments to undermine the claims of provaccinationists and had a major impact on the debate. A brief account of Wallace’s background, his role in the campaign, and a summary of his quantitative arguments leads to the conclusion that it is unwarranted to portray Victorian antivaccination campaigners in general as irrational and antiscience. Public health policy can benefit from history, but the proper context of the evidence used should always be kept in mind.
Innovative Uses for Syndromic Surveillance
PDF Version [PDF - 231 KB - 3 pages]
E. K. O’Connell et al.View Abstract
To determine if expanded queries can be used to identify specific reportable diseases/conditions not detected by using automated syndrome categories, we developed new categories to use with the Electronic Surveillance System for the Early Notification of Community Based Epidemics. Results suggest innovative queries can enhance clinicians’ compliance with reportable disease requirements.
Plasmodium knowlesi in Human, Indonesian Borneo
PDF Version [PDF - 194 KB - 3 pages]
M. Figtree et al.View Abstract
Plasmodium knowlesi is now established as the fifth Plasmodium species to cause malaria in humans. We describe a case of P. knowlesi infection acquired in Indonesian Borneo that was imported into Australia. Clinicians need to consider this diagnosis in a patient who has acquired malaria in forest areas of Southeast Asia.
Fluoroquinolone Resistance and Clostridium difficile, Germany
PDF Version [PDF - 236 KB - 3 pages]
N. H. Zaiß et al.View Abstract
We characterized 670 Clostridium difficile isolates collected from patients in 84 hospitals in Germany in 2008. PCR ribotyping showed high prevalence of ribotype 001 and restricted dissemination of ribotype 027 strains. Fluoroquinolone resistance and associated gyrase mutations were frequent in various ribotypes, but no resistance to metronidazole or vancomycin was noted.
Hypervirulent Clostridium difficile Strains in Hospitalized Patients, Canada
PDF Version [PDF - 224 KB - 4 pages]
M. R. Mulvey et al.View Abstract
To determine the incidence rate of infections with North American pulsed-field types 7 and 8 (NAP7/NAP8) strains of Clostrodium difficile, ribotype 078, and toxinotype V strains, we examined data collected for the Canadian Nosocomial Infections Surveillance Program (CNISP) CDI surveillance project during 2004–2008. Incidence of human infections increased from 0.5% in 2004/2005 to 1.6% in 2008.
Porcine-Origin Gentamicin-Resistant Enterococcus faecalis in Humans, Denmark
PDF Version [PDF - 176 KB - 3 pages]
J. Larsen et al.View Abstract
During 2001–2002, high-level gentamicin-resistant (HLGR) Enterococcus faecalis isolates were detected in 2 patients in Denmark who had infective endocarditis and in pigs and pork. Our results demonstrate that these isolates belong to the same clonal group, which suggests that pigs are a source of HLGR E. faecalis infection in humans.
Merkel Cell Polyomavirus in Cutaneous Swabs
PDF Version [PDF - 196 KB - 3 pages]
V. Foulongne et al.View Abstract
To assess the usefulness of using cutaneous swabs to detect Merkel cell polyomavirus (MCPyV) DNA, we analyzed swabs from persons with Merkel cell carcinoma (MCC), others with skin diseases, and healthy volunteers. MCPyV was detected in at least 1 sample from virtually all participants. Viral loads were higher in samples from patients with MCC.
Novel Corynebacterium diphtheriae in Domestic Cats
PDF Version [PDF - 254 KB - 4 pages]
A. J. Hall et al.View Abstract
Novel nontoxigenic Corynebacterium diphtheriae was isolated from a domestic cat with severe otitis. Contact investigation and carrier study of human and animal contacts yielded 3 additional, identical isolates from cats, although no evidence of zoonotic transmission was identified. Molecular methods distinguished the feline isolates from known C. diphtheriae.
Sympatric Occurrence of 3 Arenaviruses, Tanzania
PDF Version [PDF - 282 KB - 4 pages]
J. Goüy de Bellocq et al.View Abstract
To determine the specificity of Morogoro virus for its reservoir host, we studied its host range and genetic diversity in Tanzania. We found that 2 rodent species other than Mastomys natalensis mice carry arenaviruses. Analysis of 340 nt of the viral RNA polymerase gene showed sympatric occurrence of 3 distinct arenaviruses.
Evolution of Porcine Kobuvirus Infection, Hungary
PDF Version [PDF - 196 KB - 3 pages]
G. Reuter et al.View Abstract
Porcine kobuvirus was first identified in early 2007 in Hungary. Originally thought to be confined to the intestine, almost 2 years later the virus was found in the blood of clinically healthy pigs on the same farm. Porcine kobuvirus may be widely distributed on pig farms worldwide.
Influenza Virus Transmission from Horses to Dogs, Australia
PDF Version [PDF - 315 KB - 3 pages]
P. D. Kirkland et al.View Abstract
During the 2007 equine influenza outbreak in Australia, respiratory disease in dogs in close contact with infected horses was noted; influenza (H3N8) virus infection was confirmed. Nucleotide sequence of the virus from dogs was identical to that from horses. No evidence of dog-to-dog transmission or virus persistence in dogs was found.
Limited Susceptibility of Chickens, Turkeys, and Mice to Pandemic (H1N1) 2009 Virus
PDF Version [PDF - 192 KB - 3 pages]
D. Kalthoff et al.View Abstract
To determine susceptibility of chickens, turkeys, and mice to pandemic (H1N1) 2009 virus, we conducted contact exposure and inoculation experiments. We demonstrated that chickens were refractory to infection. However, oculo-oronasally inoculated turkeys and intranasally inoculated mice seroconverted without clinical signs of infection.
Pandemic (H1N1) 2009 Infection in Swine Herds, Manitoba, Canada
PDF Version [PDF - 251 KB - 3 pages]
T. Pasma and T. JosephView Abstract
In Manitoba, Canada, several swine herds were infected by pandemic (H1N1) 2009 virus in the summer of 2009. Results of several investigations concluded that outbreaks of infection with this virus are similar in duration to outbreaks of infections with swine influenza viruses A (H1N1) and A (H3N2).
Pandemic (H1N1) 2009 in Breeding Turkeys, Valparaiso, Chile
PDF Version [PDF - 206 KB - 3 pages]
C. Mathieu et al.View Abstract
Pandemic (H1N1) 2009 virus was detected in breeding turkeys on 2 farms in Valparaiso, Chile. Infection was associated with measurable declines in egg production and shell quality. Although the source of infection is not yet known, the outbreak was controlled, and the virus was eliminated from the birds.
16S rRNA Methyltransferase RmtC in Salmonella enterica Serovar Virchow
PDF Version [PDF - 380 KB - 4 pages]
K. L. Hopkins et al.View Abstract
We screened Salmonella and Escherichia coli isolates, collected 2004–2008 in the United Kingdom, for 16S rRNA methyltransferases. rmtC was identified in S. enterica serovar Virchow isolates from clinical samples and food. All isolates were clonally related and bore the rmtC gene on the bacterial chromosome. Surveillance for and research on these resistance determinants are essential.
Reemergence of Dengue in Mauritius
PDF Version [PDF - 348 KB - 3 pages]
M. I. Issack et al.View Abstract
Dengue reemerged in Mauritius in 2009 after an absence of >30 years, and >200 cases were confirmed serologically. Molecular studies showed that the outbreak was caused by dengue virus type 2. Phylogenetic analysis of the envelope gene identified 2 clades of the virus. No case of hemorrhagic fever was recorded.
Pandemic (H1N1) 2009 Risk for Nurses after Trivalent Vaccination
PDF Version [PDF - 78 KB - 2 pages]
M. B. Loeb et al.
Patients with Pandemic (H1N1) 2009 in Intensive Care Units, Israel
PDF Version [PDF - 83 KB - 2 pages]
E. Kopel et al.
Risk for Transmission of Pandemic (H1N1) 2009 Virus by Blood Transfusion
PDF Version [PDF - 97 KB - 2 pages]
C. Matsumoto et al.
Rapid Emergence of Oseltamivir Resistance
PDF Version [PDF - 143 KB - 3 pages]
C. L. Sy et al.
Dual Seasonal Patterns for Influenza, China
PDF Version [PDF - 127 KB - 2 pages]
Y. Shu et al.
Avian Influenza Prevalence in Pigs, Egypt
PDF Version [PDF - 88 KB - 2 pages]
A. El-Sayed et al.
Retraction: Triple Reassortant Swine Influenza A (H3N2) Virus in Waterfowl
PDF Version [PDF - 214 KB - 3 pages]
S. M. Goyal
Ventilator-associated Pneumonia and MRSA ST398, Italy
PDF Version [PDF - 98 KB - 2 pages]
C. Mammina et al.
Clostridium difficile in Ground Meat, France
PDF Version [PDF - 105 KB - 3 pages]
S. Bouttier et al.
WUPyV in Children with Acute Respiratory Tract Infections, China
PDF Version [PDF - 84 KB - 2 pages]
X. Li et al.
Buruli Ulcer Lesions in HIV-Positive Patient
PDF Version [PDF - 79 KB - 2 pages]
K. Kibadi et al.
Hantavirus Pulmonary Syndrome, French Guiana
PDF Version [PDF - 100 KB - 3 pages]
S. Matheus et al.
Fatal Human Case of West Nile Disease, Mexico, 2009
PDF Version [PDF - 100 KB - 3 pages]
C. Rios-Ibarra et al.
Bartonella spp. Infections, Thailand
PDF Version [PDF - 90 KB - 3 pages]
S. Bhengsri et al.
Cholera Outbreak, Laos, 2007
PDF Version [PDF - 118 KB - 2 pages]
N. Sithivong et al.
Buruli Ulcer, Central African Republic
PDF Version [PDF - 206 KB - 3 pages]
F. Minime-Lingoupou et al.
One Flu for One Health
PDF Version [PDF - 75 KB - 1 page]
I. Capua and G. Cattoli
Intestinal Capillariasis, Western Mindanao, the Philippines
PDF Version [PDF - 90 KB - 3 pages]
V. Y. Belizario et al.
Panton-Valentine Leukocidin–Positive MRSA, Shanghai
PDF Version [PDF - 128 KB - 3 pages]
L. Han et al.
Books and Media
Infectious Disease Surveillance
PDF Version [PDF - 83 KB - 1 page]
M. A. Strassburg
Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives
T. C. Smith
About the Cover
Peer Reviewed Report Available Online OnlyFactors Influencing Emerging Infectious Diseases in the Southeastern United States PDF Version [PDF - 25 KB - 3 pages]L. M. Gargano et al.
Peer Reviewed Report Available Online OnlyFindings, Gaps, and Future Direction for Research in Nonpharmaceutical Interventions for Pandemic Influenza PDF Version [PDF - 29 KB - 4 pages]C. J. Vukotich et al.
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- Page last updated: December 07, 2012
- Page last reviewed: December 07, 2012
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