Volume 19, Number 1—January 2013
Volume 19, Number 1—January 2013 PDF Version [PDF - 25.05 MB - 195 pages]
Medscape CME Activity
Listeriosis Outbreaks and Associated Food Vehicles, United States, 1998–2008 PDF Version [PDF - 1.08 MB - 10 pages]E. J. Cartwright et al.View SummaryView Abstract
Outbreak investigations can identify industrial gaps and regulatory measures to protect food.
Listeria monocytogenes, a bacterial foodborne pathogen, can cause meningitis, bacteremia, and complications during pregnancy. This report summarizes listeriosis outbreaks reported to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention during 1998–2008. The study period includes the advent of PulseNet (a national molecular subtyping network for outbreak detection) in 1998 and the Listeria Initiative (enhanced surveillance for outbreak investigation) in 2004. Twenty-four confirmed listeriosis outbreaks were reported during 1998–2008, resulting in 359 illnesses, 215 hospitalizations, and 38 deaths. Outbreaks earlier in the study period were generally larger and longer. Serotype 4b caused the largest number of outbreaks and outbreak-associated cases. Ready-to-eat meats caused more early outbreaks, and novel vehicles (i.e., sprouts, taco/nacho salad) were associated with outbreaks later in the study period. These changes may reflect the effect of PulseNet and the Listeria Initiative and regulatory initiatives designed to prevent contamination in ready-to-eat meat and poultry products.
Medscape CME Activity
Staphylococcal Infections in Children, California, USA, 1985–2009 PDF Version [PDF - 136 KB - 3 pages]K. Gutierrez et al.View SummaryView Abstract
Young children, Black children, and those without private insurance were at higher risk for hospitalization.
We conducted a retrospective, observational, population-based study to investigate the effect of staphylococcal infections on the hospitalization of children in California during 1985–2009. Hospitalized children with staphylococcal infections were identified through the California Office of Statewide Health Planning and Development discharge database. Infections were categorized as community onset, community onset health care–associated, or hospital onset. Infection incidence was calculated relative to all children and to those hospitalized in acute-care facilities. A total of 140,265 records were analyzed. Overall incidence increased from 49/100,000 population in 1985 to a peak of 83/100,000 in 2006 and dropped to 73/100,000 in 2009. Staphylococcal infections were associated with longer hospital stays and higher risk for death relative to all-cause hospitalizations of children. The number of methicillin-resistant Staphylococcus aureus infections increased, and the number of methicillin-susceptible S. aureus infections remained unchanged. Children <3 years of age, Blacks, and those without private insurance were at higher risk for hospitalization.
Medscape CME Activity
Pneumocystis jirovecii Genotype Associated with Increased Death Rate of HIV-infected Patients with Pneumonia PDF Version [PDF - 869 KB - 9 pages]M. Rabodonirina et al.View SummaryView Abstract
Comorbidities might predict presence of specific fungal genotypes.
Pneumocystis jirovecii dihydropteroate synthase (DHPS) mutations have been associated with failure of sulfa prophylaxis; their effect on the outcome of patients with P. jirovecii pneumonia (PCP) remains controversial. P. jirovecii DHPS polymorphisms and genotypes were identified in 112 cases of PCP in 110 HIV-infected patients by using PCR single-strand conformation polymorphism. Of the 110 patients observed, 21 died; 18 of those deaths were attributed to PCP. Thirty-three percent of the PCP cases involved a P. jirovecii strain that had 1 or both DHPS mutations. The presence or absence of DHPS mutations had no effect on the PCP mortality rate within 1 month, whereas P.jirovecii type 7 and mechanical ventilation at PCP diagnosis were associated with an increased risk of death caused by PCP. Mechanical ventilation at PCP diagnosis was also associated with an increased risk of sulfa treatment failure at 5 days.
Infections with Spore-forming Bacteria in Persons Who Inject Drugs, 2000–2009
PDF Version [PDF - 496 KB - 6 pages]
N. E. Palmateer et al.View SummaryView Abstract
Clusters of almost 300 cases in time and location might be the result of contamination of specific heroin batches.
Since 2000 in the United Kingdom, infections caused by spore-forming bacteria have been associated with increasing illness and death among persons who inject drugs (PWID). To assess temporal and geographic trends in these illnesses (botulism, tetanus, Clostridium novyi infection, and anthrax), we compared rates across England and Scotland for 2000–2009. Overall, 295 infections were reported: 1.45 per 1,000 PWID in England and 4.01 per 1,000 PWID in Scotland. The higher rate in Scotland was mainly attributable to C. novyi infection and anthrax; rates of botulism and tetanus were comparable in both countries. The temporal and geographic clustering of cases of C. novyi and anthrax into outbreaks suggests possible contamination of specific heroin batches; in contrast, the more sporadic nature of tetanus and botulism cases suggests that these spores might more commonly exist in the drug supply or local environment although at varying levels. PWID should be advised about treatment programs, injecting hygiene, risks, and vaccinations.
Automated Biosurveillance Data from England and Wales, 1991–2011
PDF Version [PDF - 829 KB - 8 pages]
D. G. Enki et al.View SummaryView Abstract
Twenty years of data provide valuable insights for the design of large automated outbreak detection systems.
Outbreak detection systems for use with very large multiple surveillance databases must be suited both to the data available and to the requirements of full automation. To inform the development of more effective outbreak detection algorithms, we analyzed 20 years of data (1991–2011) from a large laboratory surveillance database used for outbreak detection in England and Wales. The data relate to 3,303 distinct types of infectious pathogens, with a frequency range spanning 6 orders of magnitude. Several hundred organism types were reported each week. We describe the diversity of seasonal patterns, trends, artifacts, and extra-Poisson variability to which an effective multiple laboratory-based outbreak detection system must adjust. We provide empirical information to guide the selection of simple statistical models for automated surveillance of multiple organisms, in the light of the key requirements of such outbreak detection systems, namely, robustness, flexibility, and sensitivity.
Microevolution of Highly Pathogenic Avian Influenza A(H5N1) Viruses Isolated from Humans, Egypt, 2007–2011
PDF Version [PDF - 610 KB - 8 pages]
M. Younan et al.View SummaryView Abstract
Viruses originated from poultry and evolved from a single genotype introduced into the country during 2005–2006.
We analyzed highly pathogenic avian influenza A(H5N1) viruses isolated from humans infected in Egypt during 2007–2011. All analyzed viruses evolved from the lineage of subtype H5N1 viruses introduced into Egypt in 2006; we found minimal evidence of reassortment and no exotic introductions. The hemagglutinin genes of the viruses from 2011 formed a monophyletic group within clade 2.2.1 that also included human viruses from 2009 and 2010 and contemporary viruses from poultry; this finding is consistent with zoonotic transmission. Although molecular markers suggestive of decreased susceptibility to antiviral drugs were detected sporadically in the neuraminidase and matrix 2 proteins, functional neuraminidase inhibition assays did not identify resistant viruses. No other mutations suggesting a change in the threat to public health were detected in the viral proteomes. However, a comparison of representative subtype H5N1 viruses from 2011 with older subtype H5N1 viruses from Egypt revealed substantial antigenic drift.
Risk Factors for Nipah Virus Infection among Pteropid Bats, Peninsular Malaysia
PDF Version [PDF - 819 KB - 10 pages]
S. A. Rahman et al.View SummaryView Abstract
Infection rates may be higher during pregnancy and lactation.
We conducted cross-sectional and longitudinal studies to determine the distribution of and risk factors for seropositivity to Nipah virus (NiV) among Pteropus vampyrus and P. hypomelanus bats in Peninsular Malaysia. Neutralizing antibodies against NiV were detected at most locations surveyed. We observed a consistently higher NiV risk (odds ratio 3.9) and seroprevalence (32.8%) for P. vampyrus than P. hypomelanus (11.1%) bats. A 3-year longitudinal study of P. hypomelanus bats indicated nonseasonal temporal variation in seroprevalence, evidence for viral circulation within the study period, and an overall NiV seroprevalence of 9.8%. The seroprevalence fluctuated over the study duration between 1% and 20% and generally decreased during 2004–2006. Adult bats, particularly pregnant, with dependent pup and lactating bats, had a higher prevalence of NiV antibodies than juveniles. Antibodies in juveniles 6 months–2 years of age suggested viral circulation within the study period.
Invasive Pneumococcal Disease after Routine Pneumococcal Conjugate Vaccination in Children, England and Wales
PDF Version [PDF - 536 KB - 8 pages]
S. N. Ladhani et al.View SummaryView Abstract
Nonvaccine serotypes occur more often among children with comorbid conditions.
We assessed known risk factors, clinical presentation, and outcome of invasive pneumococcal disease (IPD) in children 3–59 months of age after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in England and Wales. During September 2006–March 2010, a total of 1,342 IPD episodes occurred in 1,332 children; 14.9% (198/1,332) had comorbidities. Compared with IPD caused by PCV7 serotypes (44/248; 17.7%), comorbidities were less common for the extra 3 serotypes in the 10-valent vaccine (15/299; 5.0%) but similar to the 3 additional PCV13 serotypes (45/336; 13.4%) and increased for the 11 extra serotypes in 23-valent polysaccharide vaccine (PPV23) (39/186; 21.0%) and non-PPV23 serotypes (38/138; 27.5%). Fifty-two (3.9%) cases resulted from PCV7 failure; 9 (0.7%) case-patients had recurrent IPD. Case-fatality rate was 4.4% (58/1,332) but higher for meningitis (11.0%) and children with comorbidities (9.1%). Thus, comorbidities were more prevalent in children with IPD caused by non-PCV13 serotypes and were associated with increased case fatality.
Vaccination and Tick-borne Encephalitis, Central Europe
PDF Version [PDF - 2.62 MB - 8 pages]
F. X. Heinz et al.View SummaryView Abstract
Tick-borne encephalitis is a disease of the brain caused by a virus found in many parts of Europe as well as central and eastern Asia. As the name indicates, the virus is spread by tick bites. The number of people infected each year varies according to complex interactions involving the ticks’environment, the weather, and human socioeconomic and vaccination status. To determine how well vaccine protects against the disease, researchers compared the number of cases in 3 neighboring countries in which vaccination coverage differs but many other factors remain the same: Austria (where more than three quarters of the population are vaccinated) and Slovenia and the Czech Republic (where less than one quarter of the population are vaccinated). They found far fewer cases in Austria, indicating that vaccination is an excellent way to prevent this disease.
Tick-borne encephalitis (TBE) is a substantial public health problem in many parts of Europe and Asia. To assess the effect of increasing TBE vaccination coverage in Austria, we compared incidence rates over 40 years for highly TBE-endemic countries of central Europe (Czech Republic, Slovenia, and Austria). For all 3 countries we found extensive annual and longer range fluctuations and shifts in distribution of patient ages, suggesting major variations in the complex interplay of factors influencing risk for exposure to TBE virus. The most distinctive effect was found for Austria, where mass vaccination decreased incidence to ≈16% of that of the prevaccination era. Incidence rates remained high for the nonvaccinated population. The vaccine was effective for persons in all age groups. During 2000–2011 in Austria, ≈4,000 cases of TBE were prevented by vaccination.
Novel Polyomavirus associated with Brain Tumors in Free-Ranging Raccoons, Western United States
PDF Version [PDF - 1.10 MB - 8 pages]
F. N. Dela Cruz et al.View SummaryView Abstract
A geographic cluster of malignant brain tumors in California raccoons is associated with a novel polyomavirus.
Tumors of any type are exceedingly rare in raccoons. High-grade brain tumors, consistently located in the frontal lobes and olfactory tracts, were detected in 10 raccoons during March 2010–May 2012 in California and Oregon, suggesting an emerging, infectious origin. We have identified a candidate etiologic agent, dubbed raccoon polyomavirus, that was present in the tumor tissue of all affected animals but not in tissues from 20 unaffected animals. Southern blot hybridization and rolling circle amplification showed the episomal viral genome in the tumors. The multifunctional nuclear protein large T-antigen was detectable by immunohistochemical analyses in a subset of neoplastic cells. Raccoon polyomavirus may contribute to the development of malignant brain tumors of raccoons.
Novel Framework for Assessing Epidemiologic Effects of Influenza Epidemics and Pandemics
PDF Version [PDF - 604 KB - 7 pages]
C. Reed et al.View SummaryView Abstract
Organizing and prioritizing data collection may lead to informed assessment and guide decision making.
The effects of influenza on a population are attributable to the clinical severity of illness and the number of persons infected, which can vary greatly between seasons or pandemics. To create a systematic framework for assessing the public health effects of an emerging pandemic, we reviewed data from past influenza seasons and pandemics to characterize severity and transmissibility (based on ranges of these measures in the United States) and outlined a formal assessment of the potential effects of a novel virus. The assessment was divided into 2 periods. Because early in a pandemic, measurement of severity and transmissibility is uncertain, we used a broad dichotomous scale in the initial assessment to divide the range of historic values. In the refined assessment, as more data became available, we categorized those values more precisely. By organizing and prioritizing data collection, this approach may inform an evidence-based assessment of pandemic effects and guide decision making.
Seroepidemiologic Effects of Influenza A(H1N1)pdm09 in Australia, New Zealand, and Singapore
PDF Version [PDF - 623 KB - 10 pages]
J. M. Trauer et al.View SummaryView Abstract
Temperate regions, school-aged children, and native peoples were particularly susceptible to the first wave of a novel influenza strain.
To estimate population attack rates of influenza A(H1N1)pdm2009 in the Southern Hemisphere during June–August 2009, we conducted several serologic studies. We pooled individual-level data from studies using hemagglutination inhibition assays performed in Australia, New Zealand, and Singapore. We determined seropositive proportions (titer >40) for each study region by age-group and sex in pre- and postpandemic phases, as defined by jurisdictional notification data. After exclusions, the pooled database consisted of, 4,414 prepandemic assays and 7,715 postpandemic assays. In the prepandemic phase, older age groups showed greater seropositive proportions, with age-standardized, community-based proportions ranging from 3.5% in Singapore to 11.9% in New Zealand. In the postpandemic phase, seropositive proportions ranged from 17.5% in Singapore to 30.8% in New Zealand, with highest proportions seen in school-aged children. Pregnancy and residential care were associated with lower postpandemic seropositivity, whereas Aboriginal and Torres Strait Islander Australians and Pacific Peoples of New Zealand had greater postpandemic seropositivity.
Sheep-to-Human Transmission of Orf Virus during Eid al-Adha Religious Practices, France
PDF Version [PDF - 616 KB - 4 pages]
A. Nougairede et al.View Abstract
Five persons in France were infected with Orf virus after skin wounds were exposed to infected sheep tissues during Eid al-Adha, the Muslim Feast of Sacrifice. Infections were confirmed by electron microscopy, PCR, and sequence analysis. Prevention and control of this underdiagnosed disease can be achieved by educating physicians, slaughterhouse workers, and persons participating in Eid al-Adha.
Schmallenberg Virus in Culicoides spp. Biting Midges, the Netherlands, 2011
PDF Version [PDF - 743 KB - 4 pages]
A. Elbers et al.View Abstract
To determine which species of Culicoides biting midges carry Schmallenberg virus (SBV), we assayed midges collected in the Netherlands during autumn 2011. SBV RNA was found in C. scoticus, C. obsoletus sensu stricto, and C. chiopterus. The high proportion of infected midges might explain the rapid spread of SBV throughout Europe.
Hepatitis E Virus Genotype 4 Outbreak, Italy, 2011
PDF Version [PDF - 897 KB - 5 pages]
A. R. Garbuglia et al.View Abstract
During 2011, 5 persons in the area of Lazio, Italy were infected with a monophyletic strain of hepatitis E virus that showed high sequence homology with isolates from swine in China. Detection of this genotype in Italy parallels findings in other countries in Europe, signaling the possible spread of strains new to Western countries.
Characterization of Full Genome of Rat Hepatitis E Virus Strain from Vietnam
PDF Version [PDF - 1.02 MB - 4 pages]
T. Li et al.View Abstract
We amplified the complete genome of the rat hepatitis E virus (HEV) Vietnam strain (V-105) and analyzed the nucleotide and amino acid sequences. The entire genome of V-105 shared only 76.8%–76.9% nucleotide sequence identities with rat HEV strains from Germany, which suggests that V-105 is a new genotype of rat HEV.
Adenovirus Serotype 14 Infection, New Brunswick, Canada, 2011
PDF Version [PDF - 1.55 MB - 4 pages]
G. Girouard et al.View Abstract
We describe 3 culture-proven cases of adenovirus serotype 14 infection in New Brunswick, Canada, during the summer of 2011. Strains isolated from severely ill patients were closely related to strains of a genomic variant, adenovirus 14p1, circulating in the United States and Ireland. Physicians in Canada should be aware of this emerging adenovirus.
Staphylococcus aureus Causing Tropical Pyomyositis, Amazon Basin, Peru
PDF Version [PDF - 340 KB - 3 pages]
C. García et al.View Abstract
We studied 12 Staphylococcus aureus isolates causing tropical pyomyositis in the Amazon Basin of Peru. All isolates were methicillin-susceptible; 11 carried Panton-Valentine leukocidin–encoding genes, and 5 belonged to multilocus sequence type 25 and possessed an extensive set of enterotoxins. Our findings suggest sequence type 25 is circulating in tropical areas of South America.
Puumala Virus Infections Associated with Cardiovascular Causes of Death
PDF Version [PDF - 235 KB - 3 pages]
A. Connolly-Andersen et al.View Abstract
We studied the causes of death of patients in Sweden with diagnoses of hemorrhagic fever with renal syndrome (HFRS) during 1997–2009. Cardiovascular disorders were a common cause of death during acute-phase HFRS and were the cause of death for >50% of those who died during the first year after HFRS.
Linezolid Dependence in Staphylococcus epidermidis Bloodstream Isolates
PDF Version [PDF - 533 KB - 4 pages]
S. Pournaras et al.View Abstract
We document linezolid dependence among 5 highly linezolid-resistant (LRSE) Staphylococcus epidermidis bloodstream isolates that grew substantially faster at 32 µg/mL linezolid presence. These isolates carried the mutations T2504A and C2534T in multiple 23S rRNA copies and 2 mutations leading to relevant amino acid substitutions in L3 protein. Linezolid dependence could account for increasing LRSE emergence.
Klebsiella pneumoniae Antimicrobial Drug Resistance, United States, 1998–2010
PDF Version [PDF - 918 KB - 4 pages]
G. V. Sanchez et al.View Abstract
We studied antimicrobial-resistant Klebsiella pneumoniae for 1998–2010 by using data from The Surveillance Network. Susceptibility results (n = 3,132,354) demonstrated significant increases in resistance to all antimicrobial drugs studied, except tetracycline. Cross-resistance among carbapenem-resistant K. pneumoniae was lower for tetracycline and amikacin.
West Nile Virus Infection among Humans, Texas, USA, 2002–2011
PDF Version [PDF - 422 KB - 3 pages]
M. S. Nolan et al.View Abstract
We conducted an epidemiologic analysis to document West Nile virus infections among humans in Texas, USA, during 2002–2011. West Nile virus has become endemic to Texas; the number of reported cases increased every 3 years. Risk for infection was greatest in rural northwestern Texas, where Culex tarsalis mosquitoes are the predominant mosquito species.
Seropositivity for Influenza A(H1N1)pdm09 Virus among Frontline Health Care Personnel
PDF Version [PDF - 421 KB - 4 pages]
K. Alagappan et al.View Abstract
Seroprevalence of antibodies to influenza A(H1N1)pdm09 virus among 193 emergency department health care personnel was similar among 147 non–health care personnel (odds ratio 1.4, 95% CI 0.8–2.4). Working in an acute care setting did not substantially increase risk for virus infection above risk conferred by community-based exposures.
Human Gastroenteritis Outbreak Associated with Escherichia albertii, Japan
PDF Version [PDF - 680 KB - 3 pages]
T. Ooka et al.View Abstract
Although Escherichia albertii is an emerging intestinal pathogen, it has been associated only with sporadic human infections. In this study, we determined that a human gastroenteritis outbreak at a restaurant in Japan had E. albertii as the major causative agent.
Novel Epidemic Clones of Listeria monocytogenes, United States, 2011
PDF Version [PDF - 489 KB - 4 pages]
S. Lomonaco et al.View Abstract
We identified a novel serotype 1/2a outbreak strain and 2 novel epidemic clones of Listeria monocytogenes while investigating a foodborne outbreak of listeriosis associated with consumption of cantaloupe during 2011 in the United States. Comparative analyses of strains worldwide are essential to identification of novel outbreak strains and epidemic clones.
Rinderpest Virus Sequestration and Use in Posteradication Era
PDF Version [PDF - 699 KB - 3 pages]
G. Fournié et al.View Abstract
After the 2011 declaration of rinderpest disease eradication, we surveyed 150 countries about rinderpest virus stocks. Forty-four laboratories in 35 countries held laboratory-attenuated strains, field strains, or diagnostic samples. Vaccine and reagent production and laboratory experiments continued. Rigorous standards are necessary to ensure that stocks are kept under safe conditions.
Schmallenberg Virus in Central Nervous System of Ruminants
PDF Version [PDF - 753 KB - 2 pages]
K. Hahn et al.
Polyomavirus in Saliva of HIV-infected Children, Brazil
PDF Version [PDF - 889 KB - 3 pages]
T. F. Robaina et al.
Carbapenem-hydrolyzing Oxacillinase-48 and Oxacillinase-181 in Canada, 2011
PDF Version [PDF - 353 KB - 4 pages]
L. F. Mataseje et al.
Characterization of Peste des Petits Ruminants Virus, Eritrea, 2002–2011
PDF Version [PDF - 264 KB - 2 pages]
G. Cosseddu et al.
A Case of Endemic Syphilis, Iran
PDF Version [PDF - 317 KB - 2 pages]
A. Abdolrasouli et al.
Antiretroviral Therapy–associated Coccidioidal Meningitis
PDF Version [PDF - 380 KB - 3 pages]
R. Trible et al.
Concurrent Tuberculosis and Influenza, South Korea
PDF Version [PDF - 265 KB - 3 pages]
J. Noh et al.
Cronobacter Infections Not from Infant Formula, Taiwan
PDF Version [PDF - 265 KB - 3 pages]
H. Tsai et al.
Methicillin-Resistant Staphylococcus pseudintermedius in Rats
PDF Version [PDF - 266 KB - 2 pages]
C. Himsworth et al.
Subcutaneous Infection with Dirofilaria immitis Nematode in Human, France
PDF Version [PDF - 198 KB - 2 pages]
M. Foissac et al.
Neurocysticercosis on the Arabian Peninsula, 2003–2011
PDF Version [PDF - 330 KB - 3 pages]
O. H. Del Brutto
Sapovirus Gastroenteritis in Preschool Center, Puerto Rico, 2011
PDF Version [PDF - 258 KB - 2 pages]
E. Hassan-Ríos et al.
Cronobacter sakazakii ST4 Strains and Neonatal Meningitis, United States
PDF Version [PDF - 332 KB - 3 pages]
S. Hariri et al.
Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus, Bulgaria
PDF Version [PDF - 263 KB - 3 pages]
I. Christova et al.
Primary Multidrug-Resistant Leprosy, United States
PDF Version [PDF - 688 KB - 3 pages]
D. Williams et al.
About the Cover
Retraction: Triple Reassortant Swine Influenza A (H3N2) Virus in Waterfowl
PDF Version [PDF - 323 KB - 1 page]
S. M. Goyal
News and Notes
- Page created: January 04, 2013
- Page last updated: January 04, 2013
- Page last reviewed: January 04, 2013
- Centers for Disease Control and Prevention,
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Office of the Director (OD)