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Volume 19, Number 4—April 2013
Volume 19, Number 4—April 2013 PDF Version [PDF - 4.91 MB - 178 pages]
Discrepancies in Data Reporting for Rabies, Africa
PDF Version [PDF - 364 KB - 5 pages]
L. H. NelView SummaryView Abstract
Synchronized, shared, or unified data reporting is necessary and feasible.
Human rabies is an ancient disease but in modern times has primarily been associated with dog rabies–endemic countries of Asia and Africa. From an African perspective, the inevitable and tragic consequences of rabies require serious reflection of the factors that continue to drive its neglect. Established as a major disease only after multiple introductions during the colonial era, rabies continues to spread into new reservoirs and territories in Africa. However, analysis of reported data identified major discrepancies that are indicators of poor surveillance, reporting, and cooperation among national, international, and global authorities. Ultimately, the absence of reliable and sustained data compromises the priority given to the control of rabies. Appropriate actions and changes, in accordance to the One Health philosophy and including aspects such as synchronized, shared, and unified global rabies data reporting, will not only be necessary, but also should be feasible.
Circovirus in Tissues of Dogs with Vasculitis and Hemorrhage
PDF Version [PDF - 469 KB - 8 pages]
L. Li et al.View SummaryView Abstract
Results indicate a likely association between circovirus infection in dogs and canine vascular disease.
We characterized the complete genome of a novel dog circovirus (DogCV) from the liver of a dog with severe hemorrhagic gastroenteritis, vasculitis, and granulomatous lymphadenitis. DogCV was detected by PCR in fecal samples from 19/168 (11.3%) dogs with diarrhea and 14/204 (6.9%) healthy dogs and in blood from 19/409 (3.3%) of dogs with thrombocytopenia and neutropenia, fever of unknown origin, or past tick bite. Co-infection with other canine pathogens was detected for 13/19 (68%) DogCV-positive dogs with diarrhea. DogCV capsid proteins from different dogs varied by up to 8%. In situ hybridization and transmission electron microscopy detected DogCV in the lymph nodes and spleens of 4 dogs with vascular compromise and histiocytic inflammation. The detection of a circovirus in tissues of dogs expands the known tropism of these viruses to a second mammalian host. Our results indicate that circovirus, alone or in co-infection with other pathogens, might contribute to illness and death in dogs.
Cost-effectiveness of Novel System of Mosquito Surveillance and Control, Brazil
PDF Version [PDF - 498 KB - 9 pages]
K. M. Pepin et al.View SummaryView Abstract
Results are relevant to public health budgets and societal concerns.
Of all countries in the Western Hemisphere, Brazil has the highest economic losses caused by dengue fever. We evaluated the cost-effectiveness of a novel system of vector surveillance and control, Monitoramento Inteligente da Dengue (Intelligent Dengue Monitoring System [MID]), which was implemented in 21 cities in Minas Gerais, Brazil. Traps for adult female mosquitoes were spaced at 300-m intervals throughout each city. In cities that used MID, vector control was conducted specifically at high-risk sites (indicated through daily updates by MID). In control cities, vector control proceeded according to guidelines of the Brazilian government. We estimated that MID prevented 27,191 cases of dengue fever and saved an average of $227 (median $58) per case prevented, which saved approximately $364,517 in direct costs (health care and vector control) and $7,138,940 in lost wages (societal effect) annually. MID was more effective in cities with stronger economies and more cost-effective in cities with higher levels of mosquito infestation.
Medscape CME Activity
Serotype IV and Invasive Group B Streptococcus Disease in Neonates, Minnesota, USA, 2000–2010 PDF Version [PDF - 533 KB - 8 pages]P. Ferrieri et al.View SummaryView Abstract
Serotype predominance has shifted, and drug resistance is emerging.
Group B Streptococcus (GBS) is a major cause of invasive disease in neonates in the United States. Surveillance of invasive GBS disease in Minnesota, USA, during 2000–2010 yielded 449 isolates from 449 infants; 257 had early-onset (EO) disease (by age 6 days) and 192 late-onset (LO) disease (180 at age 7–89 days, 12 at age 90–180 days). Isolates were characterized by capsular polysaccharide serotype and surface-protein profile; types III and Ia predominated. However, because previously uncommon serotype IV constitutes 5/31 EO isolates in 2010, twelve type IV isolates collected during 2000–2010 were studied further. By pulsed-field gel electrophoresis, they were classified into 3 profiles; by multilocus sequence typing, representative isolates included new sequence type 468. Resistance to clindamycin or erythromycin was detected in 4/5 serotype IV isolates. Emergence of serotype IV GBS in Minnesota highlights the need for serotype prevalence monitoring to detect trends that could affect prevention strategies.
Transmission of Hepatitis E Virus from Rabbits to Cynomolgus Macaques
PDF Version [PDF - 405 KB - 7 pages]
P. Liu et al.View SummaryView Abstract
Cross-species transmission indicates that this virus may also infect humans.
The recent discovery of hepatitis E virus (HEV) strains in rabbits in the People’s Republic of China and the United States revealed that rabbits are another noteworthy reservoir of HEV. However, whether HEV from rabbits can infect humans is unclear. To study the zoonotic potential for and pathogenesis of rabbit HEV, we infected 2 cynomolgus macaques and 2 rabbits with an HEV strain from rabbits in China. Typical hepatitis developed in both monkeys; they exhibited elevated liver enzymes, viremia, virus shedding in fecal specimens, and seroconversion. Comparison of the complete genome sequence of HEV passed in the macaques with that of the inoculum showed 99.8% nucleotide identity. Rabbit HEV RNA (positive- and negative-stranded) was detectable in various tissues from the experimentally infected rabbits, indicating that extrahepatic replication may be common. Thus, HEV is transmissible from rabbits to cynomolgus macaques, which suggests that rabbits may be a new source of human HEV infection.
Detection of Spliced mRNA from Human Bocavirus 1 in Clinical Samples from Children with Respiratory Tract Infections
PDF Version [PDF - 405 KB - 7 pages]
A. Christensen et al.View Abstract
Human bocavirus 1 (HBoV1) is a parvovirus associated with respiratory tract infections (RTIs) in children, but a causal relation has not yet been confirmed. To develop a qualitative reverse transcription PCR to detect spliced mRNA from HBoV1 and to determine whether HBoV1 mRNA correlated better with RTIs than did HBoV1 DNA, we used samples from HBoV1 DNA–positive children, with and without RTIs, to evaluate the test. A real-time reverse transcription PCR, targeting 2 alternatively spliced mRNAs, was developed. HBoV1 mRNA was detected in nasopharyngeal aspirates from 33 (25%) of 133 children with RTIs but in none of 28 controls (p<0.001). The analytical sensitivity and specificity of the test were good. Our data support the hypothesis that HBoV1 may cause RTIs, and we propose that HBoV1 mRNA could be used with benefit, instead of HBoV1 DNA, as a diagnostic target.
Predicting Hotspots for Influenza Virus Reassortment
PDF Version [PDF - 498 KB - 8 pages]
T. L. Fuller et al.View SummaryView Abstract
Reassortment is most likely to occur in eastern China, central China, or the Nile Delta in Egypt.
The 1957 and 1968 influenza pandemics, each of which killed ≈1 million persons, arose through reassortment events. Influenza virus in humans and domestic animals could reassort and cause another pandemic. To identify geographic areas where agricultural production systems are conducive to reassortment, we fitted multivariate regression models to surveillance data on influenza A virus subtype H5N1 among poultry in China and Egypt and subtype H3N2 among humans. We then applied the models across Asia and Egypt to predict where subtype H3N2 from humans and subtype H5N1 from birds overlap; this overlap serves as a proxy for co-infection and in vivo reassortment. For Asia, we refined the prioritization by identifying areas that also have high swine density. Potential geographic foci of reassortment include the northern plains of India, coastal and central provinces of China, the western Korean Peninsula and southwestern Japan in Asia, and the Nile Delta in Egypt.
Effect of 10-Valent Pneumococcal Vaccine on Pneumonia among Children, Brazil
PDF Version [PDF - 714 KB - 9 pages]
E. Afonso et al.View SummaryView Abstract
Vaccination rapidly reduced hospitalizations for pneumonia among children.
Pneumonia is most problematic for children in developing countries. In 2010, Brazil introduced a 10-valent pneumococcal conjugate vaccine (PCV10) to its National Immunization Program. To assess the vaccine’s effectiveness for preventing pneumonia, we analyzed rates of hospitalization among children 2–24 months of age who had pneumonia from all causes from January 2005 through August 2011. We used data from the National Hospitalization Information System to conduct an interrupted time-series analysis for 5 cities in Brazil that had good data quality and high PCV10 vaccination coverage. Of the 197,975 hospitalizations analyzed, 30% were for pneumonia. Significant declines in hospitalizations for pneumonia were noted in Belo Horizonte (28.7%), Curitiba (23.3%), and Recife (27.4%) but not in São Paulo and Porto Alegre. However, in the latter 2 cities, vaccination coverage was less than that in the former 3. Overall, 1 year after introduction of PCV10, hospitalizations of children for pneumonia were reduced.
Occult Hepatitis B Virus Infection in Chacma Baboons, South Africa
PDF Version [PDF - 589 KB - 8 pages]
C. Dickens et al.View SummaryView Abstract
Whether baboons were infected with HBV by humans or vice versa is unclear.
During previous studies of susceptibility to hepatitis B virus (HBV) infection, HBV DNA was detected in 2/6 wild-caught baboons. In the present study, HBV DNA was amplified from 15/69 wild-caught baboons. All animals were negative for HBV surface antigen and antibody against HBV core antigen. Liver tissue from 1 baboon was immunohistochemically negative for HBV surface antigen but positive for HBV core antigen. The complete HBV genome of an isolate from this liver clustered with subgenotype A2. Reverse transcription PCR of liver RNA amplified virus precore and surface protein genes, indicating replication of virus in baboon liver tissue. Four experimentally naive baboons were injected with serum from HBV DNA–positive baboons. These 4 baboons showed transient seroconversion, and HBV DNA was amplified from serum at various times after infection. The presence of HBV DNA at relatively low levels and in the absence of serologic markers in the baboon, a nonhuman primate, indicates an occult infection.
Medscape CME Activity
Risk Factors for Influenza among Health Care Workers during 2009 Pandemic, Toronto, Ontario, Canada PDF Version [PDF - 687 KB - 10 pages]S. P. Kuster et al.View SummaryView Abstract
Influenza was associated with household exposure, aerosol-generating procedures, and lower adherence to hand hygiene recommendations.
This prospective cohort study, performed during the 2009 influenza A(H1N1) pandemic, was aimed to determine whether adults working in acute care hospitals were at higher risk than other working adults for influenza and to assess risk factors for influenza among health care workers (HCWs). We assessed the risk for influenza among 563 HCWs and 169 non-HCWs using PCR to test nasal swab samples collected during acute respiratory illness; results for 13 (2.2%) HCWs and 7 (4.1%) non-HCWs were positive for influenza. Influenza infection was associated with contact with family members who had acute respiratory illnesses (adjusted odds ratio [AOR]: 6.9, 95% CI 2.2–21.8); performing aerosol-generating medical procedures (AOR 2.0, 95% CI 1.1–3.5); and low self-reported adherence to hand hygiene recommendations (AOR 0.9, 95% CI 0.7–1.0). Contact with persons with acute respiratory illness, rather than workplace, was associated with influenza infection. Adherence to infection control recommendations may prevent influenza among HCWs.
Deaths Associated with Influenza Pandemic of 1918–19, Japan
PDF Version [PDF - 514 KB - 7 pages]
S. ChandraView SummaryView Abstract
Contrary to popular belief, Japan’s experience of the 1918 influenza pandemic was typical of that of Asian countries.
Current estimates of deaths from the influenza pandemic of 1918–19 in Japan are based on vital records and range from 257,000 to 481,000. The resulting crude death rate range of 0.47%–0.88% is considerably lower than parallel and conservative worldwide estimates of 1.66%–2.77%. Because the accuracy of vital registration records for early 20th century Asia is questionable, to calculate the percentage of the population who died from the pandemic, we used alternative prefecture-level population count data for Japan in combination with estimation methods for panel data that were not available to earlier demographers. Our population loss estimates of 1.97–2.02 million are appreciably higher than the standing estimates, and they yield a crude rate of population loss of 3.62%–3.71%. This rate resolves a major puzzle about the pandemic by indicating that the experience of Japan was similar to that of other parts of Asia.
Methicillin-Resistant Staphylococcus aureus Colonization of the Groin and Risk for Clinical Infection among HIV-infected Adults
PDF Version [PDF - 620 KB - 7 pages]
P. J. Peters et al.View Abstract
Data on the interaction between methicillin-resistant Staphylococcus aureus (MRSA) colonization and clinical infection are limited. During 2007–2008, we enrolled HIV-infected adults in Atlanta, Georgia, USA, in a prospective cohort study. Nares and groin swab specimens were cultured for S. aureus at enrollment and after 6 and 12 months. MRSA colonization was detected in 13%–15% of HIV-infected participants (n = 600, 98% male) at baseline, 6 months, and 12 months. MRSA colonization was detected in the nares only (41%), groin only (21%), and at both sites (38%). Over a median of 2.1 years of follow-up, 29 MRSA clinical infections occurred in 25 participants. In multivariate analysis, MRSA clinical infection was significantly associated with MRSA colonization of the groin (adjusted risk ratio 4.8) and a history of MRSA infection (adjusted risk ratio 3.1). MRSA prevention strategies that can effectively prevent or eliminate groin colonization are likely necessary to reduce clinical infections in this population.
Description and Nomenclature of Neisseria meningitidis Capsule Locus
PDF Version [PDF - 500 KB - 4 pages]
O. B. Harrison et al.View SummaryView Abstract
Revised nomenclature for serogroups and capsule biosynthesis genes is proposed.
Pathogenic Neisseria meningitidis isolates contain a polysaccharide capsule that is the main virulence determinant for this bacterium. Thirteen capsular polysaccharides have been described, and nuclear magnetic resonance spectroscopy has enabled determination of the structure of capsular polysaccharides responsible for serogroup specificity. Molecular mechanisms involved in N. meningitidis capsule biosynthesis have also been identified, and genes involved in this process and in cell surface translocation are clustered at a single chromosomal locus termed cps. The use of multiple names for some of the genes involved in capsule synthesis, combined with the need for rapid diagnosis of serogroups commonly associated with invasive meningococcal disease, prompted a requirement for a consistent approach to the nomenclature of capsule genes. In this report, a comprehensive description of all N. meningitidis serogroups is provided, along with a proposed nomenclature, which was presented at the 2012 XVIIIth International Pathogenic Neisseria Conference.
Feline Origin of Rotavirus Strain, Tunisia, 2008
PDF Version [PDF - 1.08 MB - 5 pages]
M. Fredj et al.View Abstract
In Tunisia in 2008, an unusual G6P rotavirus, RVA/human-wt/TUN/17237/2008/G6P, rarely found in humans, was detected in a child. To determine the origin of this strain, we conducted phylogenetic analyses and found a unique genotype constellation resembling rotaviruses belonging to the feline BA222-like genotype constellation. The strain probably resulted from direct cat-to-human transmission.
Tick-borne Encephalitis Virus in Horses, Austria, 2011
PDF Version [PDF - 810 KB - 3 pages]
J. O. Rushton et al.View Abstract
An unexpectedly high infection rate (26.1%) of tick-borne encephalitis virus (TBEV) was identified in a herd of 257 horses of the same breed distributed among 3 federal states in Austria. Young age (p<0.001) and male sex (p = 0.001) were positively associated with infection.
Hepatitis Virus in Long-Fingered Bats, Myanmar
B. He et al.View Abstract
During an analysis of the virome of bats from Myanmar, a large number of reads were annotated to orthohepadnaviruses. We present the full genome sequence and a morphological analysis of an orthohepadnavirus circulating in bats. This virus is substantially different from currently known members of the genus Orthohepadnavirus and represents a new species.
Hand, Foot and Mouth Disease Caused by Coxsackievirus A6, Thailand, 2012
PDF Version [PDF - 319 KB - 3 pages]
J. Puenpa et al.View SummaryView Abstract
Coxsackievirus A6, Thailand
In Thailand, hand, foot, and mouth disease (HFMD) is usually caused by enterovirus 71 or coxsackievirus A16. To determine the cause of a large outbreak of HFMD in Thailand during June–August 2012, we examined patient specimens. Coxsackievirus A6 was the causative agent. To improve prevention and control, causes of HFMD should be monitored.
Early Introduction and Delayed Dissemination of Pandemic Influenza, Gabon
PDF Version [PDF - 425 KB - 4 pages]
S. Lekana-Douki et al.View Abstract
Active surveillance in health care centers in Gabon during 2009–2011 detected 72 clinical cases of pandemic (H1N1) 2009 (pH1N1). We found that pH1N1 virus was introduced in mid-2009 but spread throughout the country in 2010. Thus, Gabon was also affected by pH1N1.
Response to a Rabies Epidemic, Bali, Indonesia, 2008–2011
PDF Version [PDF - 480 KB - 4 pages]
A. Putra et al.View Abstract
Emergency vaccinations and culling failed to contain an outbreak of rabies in Bali, Indonesia, during 2008–2009. Subsequent island-wide mass vaccination (reaching 70% coverage, >200,000 dogs) led to substantial declines in rabies incidence and spread. However, the incidence of dog bites remains high, and repeat campaigns are necessary to eliminate rabies in Bali.
Genetic Relatedness of Dengue Viruses in Key West, Florida, USA, 2009–2010
PDF Version [PDF - 371 KB - 3 pages]
J. L. Jordan et al.View Abstract
Sequencing of dengue virus type 1 (DENV-1) strains isolated in Key West/Monroe County, Florida, indicate endemic transmission for >2 years of a distinct and predominant sublineage of the American–African genotype. DENV-1 strains isolated elsewhere in Florida grouped within a separate Central American lineage. Findings indicate endemic transmission of DENV into the continental United States.
Control of Foot-and-Mouth Disease during 2010–2011 Epidemic, South Korea
PDF Version [PDF - 620 KB - 5 pages]
J. Park et al.View Abstract
An outbreak of foot-and-mouth disease caused by serotype O virus occurred in cattle and pigs in South Korea during November 2010–April 2011. The highest rates of case and virus detection were observed 44 days after the first case was detected. Detection rates declined rapidly after culling and completion of a national vaccination program.
Novel Serotype of Bluetongue Virus, Western North America
PDF Version [PDF - 274 KB - 2 pages]
N. Maclachlan et al.
Novel Respiratory Syncytial Virus Subtype ON1 among Children, Cape Town, South Africa, 2012
PDF Version [PDF - 626 KB - 3 pages]
Z. Valley-Omar et al.
Henipaviruses and Fruit Bats, Papua New Guinea
PDF Version [PDF - 287 KB - 2 pages]
H. Field et al.
High Incidence of Japanese Encephalitis, Southern China
PDF Version [PDF - 269 KB - 2 pages]
Y. Feng et al.
Novel Hantavirus in Wildlife, United Kingdom
PDF Version [PDF - 340 KB - 3 pages]
K. C. Pounder et al.
Hand, Foot and Mouth Disease Outbreak and Coxsackievirus A6, Northern Spain, 2011
PDF Version [PDF - 310 KB - 3 pages]
M. Montes et al.
Rabies Update for Latin America and the Caribbean
PDF Version [PDF - 283 KB - 2 pages]
M. Vigilato et al.
Serosurvey of Dogs for Human, Livestock, and Wildlife Pathogens, Uganda
PDF Version [PDF - 303 KB - 3 pages]
J. Millán et al.
Iatrogenic Creutzfeldt-Jakob Disease from Commercial Cadaveric Human Growth Hormone
PDF Version [PDF - 317 KB - 3 pages]
B. S. Appleby et al.
West Nile Virus Infection in Belgian Traveler Returning from Greece
PDF Version [PDF - 294 KB - 2 pages]
L. Cnops et al.
Hepatitis E Virus Genotype 3 Strains in Domestic Pigs, Cameroon
PDF Version [PDF - 338 KB - 3 pages]
V. de Paula et al.
Human Enterovirus Genotype C104, China
PDF Version [PDF - 293 KB - 3 pages]
Z. Xiang et al.
Monkey Bites among US Military Members, Afghanistan, 2011
PDF Version [PDF - 248 KB - 1 page]
G. A. Engel et al.
Powassan Virus Encephalitis, Minnesota, USA
PDF Version [PDF - 285 KB - 1 page]
D. F. Neitzel et al.
Hepatitis E Virus and Porcine-derived Heparin
PDF Version [PDF - 326 KB - 3 pages]
C. Crossan et al.
Books and Media
The Foundations of Virology: Discoverers and Discoveries, Inventors and Inventions, Developers and Technologies
PDF Version [PDF - 275 KB - 1 page]
About the Cover
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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- Page created: August 13, 2013
- Page last updated: August 13, 2013
- Page last reviewed: August 13, 2013
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