Volume 20, Number 6—June 2014
Volume 20, Number 6—June 2014 PDF Version [PDF - 20.90 MB - 179 pages]
Medscape CME Activity
Adverse Pregnancy Outcomes and Coxiella burnetii Antibodies in Pregnant Women, Denmark PDF Version [PDF - 417 KB - 7 pages]S. Nielsen et al.View SummaryView Abstract
Complications were identified in only 9 pregnancies during 2007–2011.
A high risk for obstetric complications has been reported among women infected with Coxiella burnetii, the causative agent of Q fever, but recent studies have failed to confirm these findings. We reviewed national data collected in Denmark during 2007–2011 and found 19 pregnancies in 12 women during which the mother had a positive or equivocal test for antibodies to C. burnetii (IgM phase I and II titers >64, IgG phase I and II titers >128). Of these 12 women, 4 experienced obstetric complications (miscarriage, preterm delivery, infant small for gestational age, oligohydramnion, fetal growth restriction, or perinatal death); these complications occurred in 9 pregnancies (47% of the 19 total pregnancies identified). Our findings suggest an association between Q fever and adverse pregnancy outcomes, but complications were identified in only 9 pregnancies during the study’s 5-year period, indicating that the overall risk is low.
Short-Term Malaria Reduction by Single-Dose Azithromycin during Mass Drug Administration for Trachoma, Tanzania
PDF Version [PDF - 542 KB - 9 pages]
S. E. Schachterle et al.View SummaryView Abstract
This drug might be beneficial in areas to which malaria and trachoma are endemic.
Single-dose mass drug administration of azithromycin (AZT) is underway to eliminate trachoma worldwide. Studies in Ethiopia showed a reduction in all-cause childhood deaths after administration. To examine the effect of single-dose AZ MDA on prevalent malaria infections in a large prospective cohort of children and parents in Dodoma Province, Tanzania, we quantified the temporal prevalence of malaria parasitemia by real-time PCR for 6 months after single-dose AZT. In the first month after treatment but not in subsequent months, Plasmodium falciparum infections were reduced by 73% (95% CI 43%–89%) in treatment versus control villages and differences remained significant (p = 0.00497) in multivariate models with village-level random effects. Genetic sequencing of P. falciparum ribosomal L4 protein showed no mutations associated with AZT resistance. AZT mass drug administration caused a transient, 1-month antimalarial effect without selecting for P. falciparum ribosomal L4 resistance mutations in a region with a 10-year history of treating trachoma with this drug.
Human Polyomavirus 9 Infection in Kidney Transplant Patients
PDF Version [PDF - 2.46 MB - 9 pages]
E. van der Meijden et al.View SummaryView Abstract
This virus is frequently found within the first year after transplantation and in association with BK polyomavirus infection.
Several human polyomaviruses of unknown prevalence and pathogenicity have been identified, including human polyomavirus 9 (HPyV9). To determine rates of HPyV9 infection among immunosuppressed patients, we screened serum samples from 101 kidney transplant patients in the Netherlands for HPyV9 DNA and seroreactivity. A total of 21 patients had positive results for HPyV9 DNA; positivity rates peaked at 3 months after transplantation, but the highest viral loads were measured just after transplantation. During 18 months of follow-up, HPyV9 seroprevalence increased from 33% to 46% among transplant patients; seroprevalence remained stable at ≈30% in a control group of healthy blood donors in whom no HPyV9 DNA was detected. Further analysis revealed an association between detection of HPyV9 and detection of BK polyomavirus but not of cytomegalovirus. Our data indicate that HPyV9 infection is frequent in kidney transplant patients, but the nature of infection—endogenous or donor-derived—and pathogenic potential of this virus remain unknown.
Oral Fluid Testing for Pertussis, England and Wales, June 2007–August 2009
PDF Version [PDF - 531 KB - 8 pages]
H. Campbell et al.View SummaryView Abstract
Follow-up testing of reported cases resulted in a 32% increase in confirmed cases, especially among young children, adolescents, and those with milder disease.
Existing pertussis surveillance systems tend to underidentify less severe cases among older children and adults. For routine follow-up of notified, nonconfirmed, clinically diagnosed pertussis cases, use of an oral fluid test was pilot tested in England and Wales during June 2007–August 2009. During that period, 1,852 cases of pertussis were confirmed by established laboratory methods and another 591 by oral fluid testing only. Although introduction of serologic testing in 2002 led to the greatest increase in ascertainment of pertussis, oral fluid testing increased laboratory ascertainment by 32% overall; maximal increase (124%) occurred among children 5–9 years of age. Patients whose pertussis was confirmed by oral fluid testing were least likely to be hospitalized, suggesting that milder community cases were being confirmed by this method. Oral fluid testing is an easily administered, noninvasive surveillance tool that could further our understanding of pertussis epidemiology and thereby contribute to decisions on vaccination strategies.
Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo
PDF Version [PDF - 660 KB - 9 pages]
J. C. Patel et al.View SummaryView Abstract
Molecular markers and population genetics were effective tracking tools.
Imported malaria threatens control and elimination efforts in countries that have low rates of transmission. In 2010, an outbreak of Plasmodium falciparum malaria was reported among United Nations peacekeeping soldiers from Guatemala who had recently returned from the Democratic Republic of the Congo (DRC). Epidemiologic evidence suggested that the soldiers were infected in the DRC, but local transmission could not be ruled out in all cases. We used population genetic analyses of neutral microsatellites to determine the outbreak source. Genetic relatedness was compared among parasites found in samples from the soldiers and parasite populations collected in the DRC and Guatemala; parasites identified in the soldiers were more closely related to those from the DRC. A phylogenetic clustering analysis confirms this identification with >99.9% confidence. Thus, results support the hypothesis that the soldiers likely imported malaria from the DRC. This study demonstrates the utility of molecular genotyping in outbreak investigations.
Characteristics of Patients with Mild to Moderate Primary Pulmonary Coccidioidomycosis
PDF Version [PDF - 474 KB - 8 pages]
J. E. Blair et al.View SummaryView Abstract
Convalescence is prolonged, regardless of whether the patient receives treatment.
In Arizona, USA, primary pulmonary coccidioidomycosis accounts for 15%–29% of community-acquired pneumonia. To determine the evolution of symptoms and changes in laboratory values for patients with mild to moderate coccidioidomycosis during 2010–2012, we conducted a prospective 24-week study of patients with primary pulmonary coccidioidomycosis. Of the 36 patients, 16 (44%) were men and 33 (92%) were White. Median age was 53 years, and 20 (56%) had received antifungal treatment at baseline. Symptom scores were higher for patients who received treatment than for those who did not. Median times from symptom onset to 50% reduction and to complete resolution for patients in treatment and nontreatment groups were 9.9 and 9.1 weeks, and 18.7 and 17.8 weeks, respectively. Median times to full return to work were 8.4 and 5.7 weeks, respectively. One patient who received treatment experienced disseminated infection. For otherwise healthy adults with acute coccidioidomycosis, convalescence was prolonged, regardless of whether they received antifungal treatment.
High Prevalence of Ancylostoma ceylanicum Hookworm Infections in Humans, Cambodia, 2012
PDF Version [PDF - 660 KB - 7 pages]
T. Inpankaew et al.View SummaryView Abstract
Preventative chemotherapy without community hygiene and animal health programs may be leading to emergence of this zoonosis.
Ancylostoma ceylanicum, a hookworm of canids and felids in Asia, is becoming the second most common hookworm infecting humans. In 2012, we investigated the prevalence and infection dynamics of and risk factors for hookworm infections in humans and dogs in a rural Cambodian village. Over 57% of the population was infected with hookworms; of those, 52% harbored A. ceylanicum hookworms. The greatest intensities of A. ceylanicum eggs were in persons 21-30 years of age. Over 90% of dogs also harbored A. ceylanicum hookworms. Characterization of the cytochrome oxidase-1 gene divided isolates of A. ceylanicum hookworms into 2 groups, 1 containing isolates from humans only and the other a mix of isolates from humans and animals. We hypothesize that preventative chemotherapy in the absence of concurrent hygiene and animal health programs may be a factor leading to emergence of A. ceylanicum infections; thus, we advocate for a One Health approach to control this zoonosis.
Rapid Spread and Diversification of Respiratory Syncytial Virus Genotype ON1, Kenya
PDF Version [PDF - 882 KB - 10 pages]
C. N. Agoti et al.View SummaryView Abstract
Surveillance of this new genotype helps clarify the mechanisms of rapid emergence of respiratory viruses.
Respiratory syncytial virus genotype ON1, which is characterized by a 72-nt duplication in the attachment protein gene, has been detected in >10 countries since first identified in Ontario, Canada, in 2010. We describe 2 waves of genotype ON1 infections among children admitted to a rural hospital in Kenya during 2012. Phylogenetic analysis of attachment protein gene sequences showed multiple introductions of genotype ON1; variants distinct from the original Canadian viruses predominated in both infection waves. The genotype ON1 dominated over the other group A genotypes during the second wave, and some first wave ON1 variants reappeared in the second wave. An analysis of global genotype ON1 sequences determined that this genotype has become considerably diversified and has acquired signature coding mutations within immunogenic regions, and its most recent common ancestor dates to ≈2008–2009. Surveillance of genotype ON1 contributes to an understanding of the mechanisms of rapid emergence of respiratory viruses.
Bats as Reservoir Hosts of Human Bacterial Pathogen, Bartonella mayotimonensis
PDF Version [PDF - 818 KB - 8 pages]
V. Veikkolainen et al.View SummaryView Abstract
Bats can be potent reservoirs of human bacterial pathogens.
A plethora of pathogenic viruses colonize bats. However, bat bacterial flora and its zoonotic threat remain ill defined. In a study initially conducted as a quantitative metagenomic analysis of the fecal bacterial flora of the Daubenton’s bat in Finland, we unexpectedly detected DNA of several hemotrophic and ectoparasite-transmitted bacterial genera, including Bartonella. Bartonella spp. also were either detected or isolated from the peripheral blood of Daubenton's, northern, and whiskered bats and were detected in the ectoparasites of Daubenton's, northern, and Brandt's bats. The blood isolates belong to the Candidatus-status species B. mayotimonensis, a recently identified etiologic agent of endocarditis in humans, and a new Bartonella species (B. naantaliensis sp. nov.). Phylogenetic analysis of bat-colonizing Bartonella spp. throughout the world demonstrates a distinct B. mayotimonensis cluster in the Northern Hemisphere. The findings of this field study highlight bats as potent reservoirs of human bacterial pathogens.
Dengue Virus Type 3, South Pacific Islands, 2013
PDF Version [PDF - 371 KB - 3 pages]
V. Cao-Lormeau et al.View Abstract
After an 18-year absence, dengue virus serotype 3 reemerged in the South Pacific Islands in 2013. Outbreaks in western (Solomon Islands) and eastern (French Polynesia) regions were caused by different genotypes. This finding suggested that immunity against dengue virus serotype, rather than virus genotype, was the principal determinant of reemergence.
Identification of Possible Virulence Marker from Campylobacter jejuni Isolates
PDF Version [PDF - 511 KB - 4 pages]
J. W. Harrison et al.View Abstract
A novel protein translocation system, the type-6 secretion system (T6SS), may play a role in virulence of Campylobacter jejuni. We investigated 181 C. jejuni isolates from humans, chickens, and environmental sources in Vietnam, Thailand, Pakistan, and the United Kingdom for T6SS. The marker was most prevalent in human and chicken isolates from Vietnam.
MERS Coronaviruses in Dromedary Camels, Egypt
PDF Version [PDF - 568 KB - 5 pages]
D. Chu et al.View Abstract
We identified the near-full-genome sequence (29,908 nt, >99%) of Middle East respiratory syndrome coronavirus (MERS-CoV) from a nasal swab specimen from a dromedary camel in Egypt. We found that viruses genetically very similar to human MERS-CoV are infecting dromedaries beyond the Arabian Peninsula, where human MERS-CoV infections have not yet been detected.
Timeliness of Yellow Fever Surveillance, Central African Republic
PDF Version [PDF - 583 KB - 5 pages]
A. Rachas et al.View Abstract
During January 2007–July 2012, a total of 3,220 suspected yellow fever cases were reported in the Central African Republic; 55 were confirmed and 11 case-patients died. Mean delay between onset of jaundice and case confirmation was 16.6 days. Delay between disease onset and blood collection could be reduced by increasing awareness of the population.
Sequential Gastroenteritis Episodes Caused by 2 Norovirus Genotypes
PDF Version [PDF - 389 KB - 3 pages]
G. I. Parra and K. Y. GreenView Abstract
We investigated sequential episodes of acute norovirus gastroenteritis in a young child within an 11-month period. The infections were caused by 2 distinct genotypes (GII.4 and GII.6). Failure to achieve cross-protective immunity was linked to absence of an enduring and cross-reactive mucosal immune response, a critical consideration for vaccine design.
New Hepatitis E Virus Genotype in Camels, the Middle East
PDF Version [PDF - 1.09 MB - 5 pages]
P. Woo et al.View Abstract
In a molecular epidemiology study of hepatitis E virus (HEV) in dromedaries in Dubai, United Arab Emirates, HEV was detected in fecal samples from 3 camels. Complete genome sequencing of 2 strains showed >20% overall nucleotide difference to known HEVs. Comparative genomic and phylogenetic analyses revealed a previously unrecognized HEV genotype.
Infection with Mansonella perstans Nematodes in Buruli Ulcer Patients, Ghana
PDF Version [PDF - 369 KB - 4 pages]
R. O. Phillips et al.View Abstract
During August 2010–December 2012, we conducted a study of patients in Ghana who had Buruli ulcer, caused by Mycobacterium ulcerans, and found that 23% were co-infected with Mansonella perstans nematodes; 13% of controls also had M. perstans infection. M. perstans co-infection should be considered in the diagnosis and treatment of Buruli ulcer.
Human Infection with MERS Coronavirus after Exposure to Infected Camels, Saudi Arabia, 2013
PDF Version [PDF - 776 KB - 4 pages]
Z. A. Memish et al.View Abstract
We investigated a case of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV) after exposure to infected camels. Analysis of the whole human-derived virus and 15% of the camel-derived virus sequence yielded nucleotide polymorphism signatures suggestive of cross-species transmission. Camels may act as a direct source of human MERS-CoV infection.
Novel Phlebovirus with Zoonotic Potential Isolated from Ticks, Australia
PDF Version [PDF - 679 KB - 4 pages]
J. Wang et al.View Abstract
Recently discovered tick-borne phleboviruses have been associated with severe disease and death among persons in Asia and the United States. We report the discovery of a novel tick phlebovirus in Tasmania State, Australia, that is closely related to those zoonotic viruses found in Asia and North America.
Novel Human Bufavirus Genotype 3 in Children with Severe Diarrhea, Bhutan
PDF Version [PDF - 359 KB - 3 pages]
T. Yahiro et al.View Abstract
We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs.
Fatal Monkeypox in Wild-Living Sooty Mangabey, Côte d’Ivoire, 2012
PDF Version [PDF - 396 KB - 3 pages]
A. Radonić et al.View Abstract
We isolated a monkeypox virus from a wild-living monkey, a sooty mangabey, found dead in Taï National Park, Côte d’Ivoire, in March 2012. The whole-genome sequence obtained from this isolate and directly from clinical specimens showed its close relationship to monkeypox viruses from Western Africa.
Gastroenteritis Outbreaks Caused by a DS-1–like G1P Rotavirus Strain, Japan, 2012–2013
PDF Version [PDF - 425 KB - 4 pages]
S. P. Yamamoto et al.View Abstract
Rotavirus A (RVA) genotype G1P, a hallmark of the Wa-like strain, typically contains only genotype 1 genes. However, an unusual RVA G1P with genotype 2 genes was recently detected in Japan. We determined the complete genomic constellation of this RVA. Our findings suggest that mixed RVAs may be more competitive than once thought.
Iatrogenic Meningitis Caused by Neisseria sicca/subflava after Intrathecal Contrast Injection, Australia
PDF Version [PDF - 1.56 MB - 3 pages]
D. Entesari-Tatafi et al.View Abstract
We report a case of invasive Neisseria sicca/subflava meningitis after a spinal injection procedure during which a face mask was not worn by the proceduralist. The report highlights the importance of awareness of, and adherence to, guidelines for protective face mask use during procedures that require sterile conditions.
Species H Rotavirus Detected in Piglets with Diarrhea, Brazil, 2012
PDF Version [PDF - 2.47 MB - 4 pages]
B. Molinari et al.View Abstract
We determined nucleotide and deduced amino acid sequences of the rotavirus gene encoding viral protein 6 from 3 fecal samples collected from piglets with diarrhea in Brazil, 2012. The analyses showed that the porcine rotavirus strains in Brazil are closely related to the novel species H rotavirus.
Unraveling the Mysteries of Middle East Respiratory Syndrome Coronavirus
PDF Version [PDF - 2.22 MB - 3 pages]
J. T. Watson et al.
Genetic Relatedness of Dolphin Rhabdovirus with Fish Rhabdoviruses
PDF Version [PDF - 261 KB - 2 pages]
J. Y. Siegers et al.
Schmallenberg Virus Circulation in High Mountain Ecosystem, Spain
PDF Version [PDF - 708 KB - 3 pages]
X. Fernández-Aguilar et al.
Bartonella spp. and Yersinia pestis Reservoirs, Cusco, Peru
PDF Version [PDF - 268 KB - 2 pages]
A. Martin-Alonso et al.
Diagnosis of Trombiculosis by Videodermatoscopy
PDF Version [PDF - 638 KB - 2 pages]
M. R. Nasca et al.
Novel Henipa-like Virus, Mojiang Paramyxovirus, in Rats, China, 2012
PDF Version [PDF - 409 KB - 3 pages]
Z. Wu et al.
Streptococcus suis Infection and Malignancy in Man, Spain
PDF Version [PDF - 277 KB - 2 pages]
S. Gómez-Zorrilla et al.
Human Granulocytic Anaplasmosis Acquired in Scotland, 2013
PDF Version [PDF - 281 KB - 3 pages]
P. Hagedorn et al.
Novel Reassortant Influenza A(H5N8) Viruses, South Korea, 2014
PDF Version [PDF - 485 KB - 3 pages]
Y. Lee et al.
Zika Virus, French Polynesia, South Pacific, 2013
PDF Version [PDF - 317 KB - 2 pages]
V. Cao-Lormeau et al.
Bufavirus in Feces of Patients with Gastroenteritis, Finland
PDF Version [PDF - 421 KB - 3 pages]
E. Väisänen et al.
Respiratory Infection with Enterovirus Genotype C117, China and Mongolia
PDF Version [PDF - 404 KB - 3 pages]
Z. Xiang et al.
Rapid Metagenomic Diagnostics for Suspected Outbreak of Severe Pneumonia
PDF Version [PDF - 853 KB - 4 pages]
N. Fischer et al.
Buruli Ulcer Disease in Republic of the Congo
PDF Version [PDF - 644 KB - 3 pages]
E. Marion et al.
Genetic and Ecologic Variability among Anaplasma phagocytophilum Strains, Northern Italy
PDF Version [PDF - 449 KB - 4 pages]
I. Baráková et al.
Hepatitis E Virus Infection, Papua New Guinea, Fiji, and Kiribati, 2003–2005
PDF Version [PDF - 267 KB - 2 pages]
J. S. Halliday et al.
Possible Misidentification of Mycobacterium yongonense
PDF Version [PDF - 319 KB - 2 pages]
S. Hong and E. Kim
Distinguishing Nontuberculous Mycobacteria from Multidrug-Resistant Mycobacterium tuberculosis, China
PDF Version [PDF - 301 KB - 3 pages]
K. Xu et al.
About the Cover
- Page created: May 19, 2014
- Page last updated: May 19, 2014
- Page last reviewed: May 19, 2014
- Centers for Disease Control and Prevention,
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