Volume 16, Number 5—May 2010
Volume 16, Number 5—May 2010 PDF Version [PDF - 4.36 MB - 159 pages]
Latent Tuberculosis among Persons at Risk for Infection with HIV, Tijuana, Mexico
PDF Version [PDF - 210 KB - 7 pages]
R. S. Garfein et al.View Abstract
Because there is little routine tuberculosis (TB) screening in Mexico, the prevalence of latent TB infection (LTBI) is unknown. In the context of an increasing HIV epidemic in Tijuana, Mexico, understanding prevalence of LTBI to anticipate emergence of increased LTBI reactivation is critical. Therefore, we recruited injection drug users, noninjection drug users, female sex workers, and homeless persons for a study involving risk assessment, rapid HIV testing, and TB screening. Of 503 participants, the overall prevalences of TB infection, HIV infection, and TB/HIV co-infection were 57%, 4.2%, and 2.2%, respectively; no significant differences by risk group (p>0.05) were observed. Two participants had TB (prevalence 398/100,000). Incarceration in Mexico (odds ratio [OR] 2.28), age (OR 1.03 per year), and years lived in Tijuana (OR 1.02 per year) were independently associated with TB infection (p<0.05). Frequent LTBI in marginalized persons may lead to increases in TB as HIV spreads.
Anaplasma phagocytophilum from Rodents and Sheep, China
PDF Version [PDF - 230 KB - 5 pages]
L. Zhan et al.View Abstract
To characterize the strains of Anaplasma phagocytophilum in wild and domestic animals in China, we isolated the organism from rodents and sheep in northeastern China. We isolated 3 strains (2 from rodents and 1 from sick sheep) through propagation in BALB/c mice and then cell culture in HL60 cells. The 3 isolates were identified by Wright-Giemsa staining, immunofluorescence, and electronic microscopy and were characterized by sequence analyses of the 16S rRNA gene, partial citrate synthase gene, major surface protein 4 gene, and heat shock protein gene. The multiple sequences of the 3 isolates were identical to each other but different from all known strains from other countries. The public health and veterinary relevance of the isolates deserves further investigation.
Spread of Adenovirus to Geographically Dispersed Military Installations, May–October 2007
PDF Version [PDF - 282 KB - 7 pages]
J. S. Trei et al.View Abstract
In mid-May 2007, a respiratory disease outbreak associated with adenovirus, serotype B14 (Ad14), was recognized at a large military basic training facility in Texas. The affected population was highly mobile; after the 6-week basic training course, trainees immediately dispersed to advanced training sites worldwide. Accordingly, enhanced surveillance and control efforts were instituted at sites receiving the most trainees. Specimens from patients with pneumonia or febrile respiratory illness were tested for respiratory pathogens by using cultures and reverse transcription–PCR. During May through October 2007, a total of 959 specimens were collected from 21 sites; 43.1% were adenovirus positive; the Ad14 serotype accounted for 95.3% of adenovirus isolates. Ad14 was identified at 8 sites in California, Florida, Mississippi, Texas, and South Korea. Ad14 spread readily to secondary sites after the initial outbreak. Military and civilian planners must consider how best to control the spread of infectious respiratory diseases in highly mobile populations traveling between diverse geographic locations.
Medscape CME Activity
Tropheryma whipplei in Children with Gastroenteritis PDF Version [PDF - 340 KB - 7 pages]D. Raoult et al.View Abstract
Tropheryma whipplei, which causes Whipple disease, is found in human feces and may cause gastroenteritis. To show that T. whipplei causes gastroenteritis, PCRs for T. whipplei were conducted with feces from children 2–4 years of age. Western blotting was performed for samples from children with diarrhea who had positive or negative results for T. whipplei. T. whipplei was found in samples from 36 (15%) of 241 children with gastroenteritis and associated with other diarrheal pathogens in 13 (33%) of 36. No positive specimen was detected for controls of the same age (0/47; p = 0.008). Bacterial loads in case-patients were as high as those in patients with Whipple disease and significantly higher than those in adult asymptomatic carriers (p = 0.002). High incidence in patients and evidence of clonal circulation suggests that some cases of gastroenteritis are caused or exacerbated by T. whipplei, which may be co-transmitted with other intestinal pathogens.
Contagious Period for Pandemic (H1N1) 2009
PDF Version [PDF - 262 KB - 6 pages]
G. De Serres et al.View Abstract
We estimated the proportion of persons with pandemic (H1N1) 2009 who were shedding infectious virus at diagnosis and on day 8 of illness. In households with confirmed cases, nasopharyngeal swabs were collected on all members and tested by PCR and virus culture. Of 47 cases confirmed by PCR at <7 days of illness, virus culture was positive in 92% (11/12) of febrile and 63% (22/35) of afebrile persons. Of 43 persons with PCR-confirmed pandemic (H1N1) 2009 from whom a second specimen was collected on day 8, 74% remained PCR positive and 19% were culture positive. If the 73 symptomatic household members without PCR-confirmed illness are assumed to have pandemic (H1N1) 2009, a minimum of 8% (6/73) of case-patients shed replicating virus on day 8. Self-isolation only until fever abates appears insufficient to limit transmission. Self-isolation for a week may be more effective, although some case-patients still would shed infectious virus.
Historical Distribution and Molecular Diversity of Bacillus anthracis, Kazakhstan
PDF Version [PDF - 374 KB - 8 pages]
A. M. Aikembayev et al.View Abstract
To map the distribution of anthrax outbreaks and strain subtypes in Kazakhstan during 1937–2005, we combined geographic information system technology and genetic analysis by using archived cultures and data. Biochemical and genetic tests confirmed the identity of 93 archived cultures in the Kazakhstan National Culture Collection as Bacillus anthracis. Multilocus variable number tandem repeat analysis genotyping identified 12 genotypes. Cluster analysis comparing these genotypes with previously published genotypes indicated that most (n = 78) isolates belonged to the previously described A1.a genetic cluster, 6 isolates belonged to the A3.b cluster, and 2 belonged to the A4 cluster. Two genotypes in the collection appeared to represent novel genetic sublineages; 1 of these isolates was from Krygystan. Our data provide a description of the historical, geographic, and genetic diversity of B. anthracis in this Central Asian region.
Methicillin-Resistant Staphylococcus aureus Carriage and Risk Factors for Skin Infections, Southwestern Alaska, USA
PDF Version [PDF - 226 KB - 7 pages]
A. M. Stevens et al.View Abstract
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are common in southwestern Alaska. Outbreak strains have been shown to carry the genes for Panton-Valentine leukocidin (PVL). To determine if carriage of PVL-positive CA-MRSA increased the risk for subsequent soft tissue infection, we conducted a retrospective cohort study by reviewing the medical records of 316 persons for 3.6 years after their participation in a MRSA nasal colonization survey. Demographic, nasal carriage, and antimicrobial drug use data were analyzed for association with skin infection risk. Skin infections were more likely to develop in MRSA carriers than in methicillin-susceptible S. aureus carriers or noncarriers of S. aureus during the first follow-up year, but not in subsequent years. Repeated skin infections were more common among MRSA carriers. In an area where PVL-containing MRSA is prevalent, skin infection risk was increased among MRSA nasal carriers compared with methicillin-susceptible S. aureus carriers and noncarriers, but risk differential diminished over time.
Capacity of Public Health Surveillance to Comply with Revised International Health Regulations, USA
PDF Version [PDF - 125 KB - 5 pages]
K. E. Armstrong et al.View Abstract
Public health surveillance is essential for detecting and responding to infectious diseases and necessary for compliance with the revised International Health Regulations (IHR) 2005. To assess reporting capacities and compliance with IHR of all 50 states and Washington, DC, we sent a questionnaire to respective epidemiologists; 47 of 51 responded. Overall reporting capacity was high. Eighty-one percent of respondents reported being able to transmit notifications about unknown or unexpected events to the Centers for Disease Control and Prevention (CDC) daily. Additionally, 80% of respondents reported use of a risk assessment tool to determine whether CDC should be notified of possible public health emergencies. These findings suggest that most states have systems in place to ensure compliance with IHR. However, full state-level compliance will require additional efforts.
Influenza Outbreaks during World Youth Day 2008 Mass Gathering
PDF Version [PDF - 304 KB - 7 pages]
C. C. Blyth et al.View Abstract
Influenza outbreaks during mass gatherings have been rarely described, and detailed virologic assessment is lacking. An influenza outbreak occurred during World Youth Day in Sydney, Australia, July 2008 (WYD2008). We assessed epidemiologic data and respiratory samples collected from attendees who sought treatment for influenza-like illness at emergency clinics in Sydney during this outbreak. Isolated influenza viruses were compared with seasonal influenza viruses from the 2008 influenza season. From 100 infected attendees, numerous strains were identified: oseltamivir-resistant influenza A (H1N1) viruses, oseltamivir-sensitive influenza A (H1N1) viruses, influenza A (H3N2) viruses, and strains from both influenza B lineages (B/Florida/4/2006-like and B/Malaysia/2506/2004-like). Novel viruses were introduced, and pre-WYD2008 seasonal viruses were amplified. Viruses isolated at mass gatherings can have substantial, complex, and unpredictable effects on community influenza activity. Greater flexibility by public health authorities and hospitals is required to appropriately manage and contain these outbreaks.
Effects of Pneumococcal Conjugate Vaccine 2 Years after Its Introduction, the Netherlands
PDF Version [PDF - 272 KB - 8 pages]
G. D. Rodenburg et al.View Abstract
In the Netherlands, the 7-valent pneumococcal conjugate vaccine (PCV-7) was implemented in a 3+1-dose schedule in the national immunization program for infants born after April 1, 2006. To assess the vaccine’s effectiveness, we compared disease incidence before and after vaccine implementation (June 2004–June 2006 and June 2006–June 2008, respectively). We serotyped 2,552 invasive pneumococcal isolates from throughout the Netherlands, covering 25% of the country’s population. Clinical characteristics were extracted from hospital records. After June 2006, vaccine-serotype invasive pneumococcal disease (IPD) decreased 90% (95% confidence interval [CI] 68%–97%) in children age eligible for PCV-7; simultaneously, however, non–vaccine-serotype IPD increased by 71% (not significant), resulting in a 44% total net IPD reduction (95% CI 7%–66%). IPD rates did not change for other age groups. In the Netherlands, PCV-7 offered high protection against vaccine-serotype IPD in vaccinated children, but increases of non–vaccine-serotype IPD reduced net vaccine benefits.
Rapid Influenza Antigen Test for Diagnosis of Pandemic (H1N1) 2009
PDF Version [PDF - 153 KB - 3 pages]
J. K. Louie et al.View Abstract
We compared the QuickVue Influenza test with PCR for diagnosing pandemic (H1N1) 2009 in 404 persons with influenza-like illness. Overall sensitivity, specificity, and positive and negative predictive values were 66%, 84%, 84%, and 64%, respectively. Rapid test results should be interpreted cautiously when pandemic (H1N1) 2009 virus is suspected.
Multihospital Outbreak of Clostridium difficile Infection, Cleveland, Ohio, USA
PDF Version [PDF - 145 KB - 3 pages]
R. L. Jump et al.View Abstract
To determine whether a multihospital Clostridium difficile outbreak was associated with epidemic strains and whether use of particular fluoroquinolones was associated with increased infection rates, we cultured feces from C. difficile–infected patients. Use of fluoroquionolones with enhanced antianaerobic activity was not associated with increased infection rates.
Rickettsiae in Gulf Coast Ticks, Arkansas, USA
PDF Version [PDF - 195 KB - 3 pages]
R. Trout et al.View Abstract
To determine the cause of spotted fever cases in the southern United States, we screened Gulf Coast ticks (Amblyomma maculatum) collected in Arkansas for rickettsiae. Of the screened ticks, 30% had PCR amplicons consistent with Rickettsia parkeri or Candidatus Rickettsia amblyommii.
Bluetongue Virus in Wild Deer, Belgium, 2005–2008
PDF Version [PDF - 328 KB - 4 pages]
A. Linden et al.View Abstract
To investigate bluetongue virus serotype 8 infection in Belgium, we conducted a virologic and serologic survey on 2,416 free-ranging cervids during 2005–2008. Infection emerged in 2006 and spread over the study area in red deer, but not in roe deer.
Nosocomial Outbreak of Crimean-Congo Hemorrhagic Fever, Sudan
PDF Version [PDF - 174 KB - 3 pages]
I. E. Aradaib et al.View Abstract
To confirm the presence of Crimean-Congo hemorrhagic fever in Sudan, we tested serum of 8 patients with hemorrhagic fever in a rural hospital in 2008. Reverse transcription–PCR identified Crimean-Congo hemorrhagic fever virus. Its identification as group III lineage indicated links to virus strains from South Africa, Mauritania, and Nigeria.
Extensively Drug-Resistant Tuberculosis, Burkina Faso
PDF Version [PDF - 206 KB - 3 pages]
N. Saleri et al.View Abstract
Because data from countries in Africa are limited, we measured the proportion of extensively drug-resistant (XDR) tuberculosis (TB) cases among TB patients in Burkina Faso for whom retreatment was failing. Of 34 patients with multidrug-resistant TB, 2 had an XDR TB strain. Second-line TB drugs should be strictly controlled to prevent further XDR TB increase.
Streptococcus dysgalactiae subsp. equisimilis Bacteremia, Finland, 1995–2004
PDF Version [PDF - 337 KB - 4 pages]
S. Rantala et al.View Abstract
We conducted a retrospective population-based study of 140 episodes of Streptococcus dysgalactiae subsp. equisimilis bacteremia occurring in Finland during 1995–2004. Rare emm types were associated with more severe disease and increased mortality rates. Skin and soft tissue infections were more frequent clinical signs among cases caused by common emm types.
Dengue Virus Surveillance for Early Warning, Singapore
PDF Version [PDF - 258 KB - 3 pages]
K. Lee et al.View Abstract
In Singapore, after a major outbreak of dengue in 2005, another outbreak occurred in 2007. Laboratory-based surveillance detected a switch from dengue virus serotype 1 (DENV-1) to DENV-2. Phylogenetic analysis showed a clade replacement within DENV-2 cosmopolitan genotype, which accompanied the predominant serotype switch, and cocirculation of multiple genotypes of DENV-3.
Adenovirus 36 DNA in Adipose Tissue of Patient with Unusual Visceral Obesity
PDF Version [PDF - 220 KB - 3 pages]
B. Salehian et al.View Abstract
Massive adipose tissue depositions in the abdomen and thorax sufficient to interfere with respiration developed in a patient with multiple medical problems. Biopsy of adipose tissue identified human adenovirus 36 (Adv 36) DNA. Adv 36 causes adipogenesis in animals and humans. Development of massive lipomatosis may be caused by Adv 36.
Vitamin D Deficiency and Tuberculosis Progression
PDF Version [PDF - 179 KB - 3 pages]
N. Talat et al.View Abstract
To assess the association between vitamin D deficiency and tuberculosis disease progression, we studied vitamin D levels in a cohort of tuberculosis patients and their contacts (N = 129) in Pakistan. Most (79%) persons showed deficiency. Low vitamin D levels were associated with a 5-fold increased risk for progression to tuberculosis.
La Crosse Virus in Aedes albopictus Mosquitoes, Texas, USA, 2009
PDF Version [PDF - 181 KB - 3 pages]
A. J. Lambert et al.View Abstract
We report the arthropod-borne pediatric encephalitic agent La Crosse virus in Aedes albopictus mosquitoes collected in Dallas County, Texas, USA, in August 2009. The presence of this virus in an invasive vector species within a region that lies outside the virus’s historically recognized geographic range is of public health concern.
Unusual Assortment of Segments in 2 Rare Human Rotavirus Genomes
PDF Version [PDF - 257 KB - 4 pages]
S. De Grazia et al.View Abstract
Using full-length genome sequence analysis, we investigated 2 rare G3P human rotavirus strains isolated from children with diarrhea. The genomes were recognized as assortments of genes closely related to rotaviruses originating from cats, ruminants, and humans. Results suggest multiple transmissions of genes from animal to human strains of rotaviruses.
Transmission of Hemagglutinin D222G Mutant Strain of Pandemic (H1N1) 2009 Virus
PDF Version [PDF - 173 KB - 3 pages]
S. Puzelli et al.View Abstract
A pandemic (H1N1) 2009 virus strain carrying the D222G mutation was identified in a severely ill man and was transmitted to a household contact. Only mild illness developed in the contact, despite his obesity and diabetes. The isolated virus reacted fully with an antiserum against the pandemic vaccine strain.
Schistosomiasis among Recreational Users of Upper Nile River, Uganda, 2007
PDF Version [PDF - 146 KB - 3 pages]
O. W. Morgan et al.View Abstract
After recreational exposure to river water in Uganda, 12 (17%) of 69 persons had evidence of schistosome infection. Eighteen percent self-medicated with praziquantel prophylaxis immediately after exposure, which was not appropriate. Travelers to schistosomiasis-endemic areas should consult a travel medicine physician.
Sticky Decisions: Peanut Butter in a Time of Salmonella
PDF Version [PDF - 245 KB - 5 pages]
G. Kaptan and B. FischhoffView Abstract
We present a consumer-focused perspective on creating communications regarding potentially contaminated foods. It is illustrated with decisions that might have faced US consumers during the 2009 recalls of peanut and pistachio products. The example shows how knowledge about test results and regulatory processes might be made more useful to consumers.
Kobuvirus in Domestic Sheep, Hungary
PDF Version [PDF - 174 KB - 2 pages]
G. Reuter et al.
Physician Awareness of Chagas Disease, USA
PDF Version [PDF - 151 KB - 2 pages]
K. K. Stimpert and S. P. Montgomery
Possible Transmission of Pandemic (HIN1) 2009 Virus with Oseltamivir Resistance
PDF Version [PDF - 146 KB - 2 pages]
M. Mandelboim et al.
Cross-Reactive Antibodies to Pandemic (H1N1) 2009 Virus, Singapore
PDF Version [PDF - 148 KB - 3 pages]
J. W. Tang et al.
Molecular Epidemiology of Japanese Encephalitis Virus, Taiwan
PDF Version [PDF - 245 KB - 3 pages]
J. Huang et al.
Fluoroquinolone-Resistant Typhoid, South Africa
K. H. Keddy et al.
Sorbitol-fermenting Escherichia coli O157, Scotland
PDF Version [PDF - 148 KB - 2 pages]
K. Pollock et al.
Co-infection with Dengue Virus and Pandemic (H1N1) 2009 Virus
PDF Version [PDF - 154 KB - 3 pages]
E. L. Rodriguez et al.
Bovine Tuberculosis in Buffaloes, Southern Africa
PDF Version [PDF - 147 KB - 2 pages]
M. de Garine-Wichatitsky et al.
No Resistance Plasmid in Yersinia pestis, North America
PDF Version [PDF - 165 KB - 3 pages]
D. M. Wagner et al.
Triatoma infestans Bugs in Southern Patagonia, Argentina
PDF Version [PDF - 199 KB - 3 pages]
R. V. Piccinali et al.
Serologic Survey of Hantavirus Infection, Brazilian Amazon
PDF Version [PDF - 152 KB - 3 pages]
W. S. Mendes et al.
Body Lice, Yersinia pestis Orientalis, and Black Death
PDF Version [PDF - 160 KB - 2 pages]
S. Ayyadurai et al.
Salmonella Senftenberg Infections and Fennel Seed Tea, Serbia
PDF Version [PDF - 232 KB - 3 pages]
S. Ilić et al.
Cryptosporidiosis Associated with Wildlife Center, Scotland
PDF Version [PDF - 181 KB - 2 pages]
C. C. McGuigan et al.
Increase in Pneumococcus Macrolide Resistance, USA
PDF Version [PDF - 150 KB - 2 pages]
L. A. Hicks et al.
Rapid Antigen Test for Pandemic (H1N1) 2009 Virus
PDF Version [PDF - 147 KB - 2 pages]
B. M. Diederen et al.
Books and Media
About the Cover
Peer Reviewed Report Available Online OnlyNational Summit on Neglected Infections of Poverty in the United States PDF Version [PDF - 23 KB - 1 page]P. Hotez et al.
- Page created: May 29, 2012
- Page last updated: May 29, 2012
- Page last reviewed: May 29, 2012
- Centers for Disease Control and Prevention,
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Office of the Director (OD)