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Issue Cover for Volume 5, Number 5—October 1999

Volume 5, Number 5—October 1999

[PDF - 3.60 MB - 137 pages]

Perspective

Using a Spatial Filter and a Geographic Information System to Improve Rabies Surveillance Data [PDF - 938 KB - 4 pages]
A. J. Curtis

The design and coordination of antirabies measures (e.g., oral vaccine and disease awareness campaigns) often depend on surveillance data. In Kentucky, health officials are concerned that the raccoon rabies epizootic that has spread throughout the east coast since the late 1970s could enter the state. The quality of surveillance data from Kentucky's 120 counties, however, may not be consistent. This article presents a geographic model that can be used with a geographic information system (GIS) to assess whether a county has a lower number of animals submitted for rabies testing than surrounding counties. This technique can be used as a first step in identifying areas needing improvement in their surveillance scheme. This model is a variant of a spatial filter that uses points within an area of analysis (usually a circle) to estimate the value of a central point. The spatial filter is an easy-to-use method of identifying point patterns, such as clusters or holes, at various geographic scales (county, intraurban), by using the traditional circle as an area of analysis or a GIS to incorporate a political shape (county boundary).

EID Curtis AJ. Using a Spatial Filter and a Geographic Information System to Improve Rabies Surveillance Data. Emerg Infect Dis. 1999;5(5):603-606. https://doi.org/10.3201/eid0505.990501
AMA Curtis AJ. Using a Spatial Filter and a Geographic Information System to Improve Rabies Surveillance Data. Emerging Infectious Diseases. 1999;5(5):603-606. doi:10.3201/eid0505.990501.
APA Curtis, A. J. (1999). Using a Spatial Filter and a Geographic Information System to Improve Rabies Surveillance Data. Emerging Infectious Diseases, 5(5), 603-606. https://doi.org/10.3201/eid0505.990501.
Synopses

Food-Related Illness and Death in the United States [PDF - 168 KB - 19 pages]
P. S. Mead et al.

To better quantify the impact of foodborne diseases on health in the United States, we compiled and analyzed information from multiple surveillance systems and other sources. We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60,000 hospitalizations, and 1,800 deaths. Three pathogens, Salmonella, Listeria, and Toxoplasma, are responsible for 1,500 deaths each year, more than 75% of those caused by known pathogens, while unknown agents account for the remaining 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.

EID Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, et al. Food-Related Illness and Death in the United States. Emerg Infect Dis. 1999;5(5):607-625. https://doi.org/10.3201/eid0505.990502
AMA Mead PS, Slutsker L, Dietz V, et al. Food-Related Illness and Death in the United States. Emerging Infectious Diseases. 1999;5(5):607-625. doi:10.3201/eid0505.990502.
APA Mead, P. S., Slutsker, L., Dietz, V., McCaig, L. F., Bresee, J. S., Shapiro, C....Tauxe, R. V. (1999). Food-Related Illness and Death in the United States. Emerging Infectious Diseases, 5(5), 607-625. https://doi.org/10.3201/eid0505.990502.

Infections Associated with Eating Seed Sprouts: An International Concern [PDF - 89 KB - 9 pages]
P. J. Taormina et al.

Recent outbreaks of Salmonella and Escherichia coli O157:H7 infections associated with raw seed sprouts have occurred in several countries. Subjective evaluations indicate that pathogens can exceed 107 per gram of sprouts produced from inoculated seeds during sprout production without adversely affecting appearance. Treating seeds and sprouts with chlorinated water or other disinfectants fails to eliminate the pathogens. A comprehensive approach based on good manufacturing practices and principles of hazard analysis and critical control points can reduce the risk of sprout-associated disease. Until effective measures to prevent sprout-associated illness are identified, persons who wish to reduce their risk of foodborne illness from raw sprouts are advised not to eat them; in particular, persons at high risk for severe complications of infections with Salmonella or E. coli O157:H7, such as the elderly, children, and those with compromised immune systems, should not eat raw sprouts.

EID Taormina PJ, Beuchat LR, Slutsker L. Infections Associated with Eating Seed Sprouts: An International Concern. Emerg Infect Dis. 1999;5(5):626-634. https://doi.org/10.3201/eid0505.990503
AMA Taormina PJ, Beuchat LR, Slutsker L. Infections Associated with Eating Seed Sprouts: An International Concern. Emerging Infectious Diseases. 1999;5(5):626-634. doi:10.3201/eid0505.990503.
APA Taormina, P. J., Beuchat, L. R., & Slutsker, L. (1999). Infections Associated with Eating Seed Sprouts: An International Concern. Emerging Infectious Diseases, 5(5), 626-634. https://doi.org/10.3201/eid0505.990503.

The Human Ehrlichioses in the United States [PDF - 338 KB - 8 pages]
J. H. McQuiston et al.

The emerging tick-borne zoonoses human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) are underreported in the United States. From 1986 through 1997, 1,223 cases (742 HME, 449 HGE, and 32 not ascribed to a specific ehrlichial agent) were reported by state health departments. HME was most commonly reported from southeastern and southcentral states, while HGE was most often reported from northeastern and upper midwestern states. The annual number of reported cases increased sharply, from 69 in 1994 to 364 in 1997, coincident with an increase in the number of states making these conditions notifiable. From 1986 through 1997, 827 probable and confirmed cases were diagnosed by serologic testing at the Centers for Disease Control and Prevention, although how many of these cases were also reported by states is not known. Improved national surveillance would provide a better assessment of the public health importance of ehrlichiosis.

EID McQuiston JH, Paddock CD, Holman RC, Childs JE. The Human Ehrlichioses in the United States. Emerg Infect Dis. 1999;5(5):635-642. https://doi.org/10.3201/eid0505.990504
AMA McQuiston JH, Paddock CD, Holman RC, et al. The Human Ehrlichioses in the United States. Emerging Infectious Diseases. 1999;5(5):635-642. doi:10.3201/eid0505.990504.
APA McQuiston, J. H., Paddock, C. D., Holman, R. C., & Childs, J. E. (1999). The Human Ehrlichioses in the United States. Emerging Infectious Diseases, 5(5), 635-642. https://doi.org/10.3201/eid0505.990504.

West Nile Fever–a Reemerging Mosquito-Borne Viral Disease in Europe [PDF - 100 KB - 8 pages]
Z. Hubálek and J. Halouzka

West Nile virus causes sporadic cases and outbreaks of human and equine disease in Europe (western Mediterranean and southern Russia in 1962-64, Belarus and Ukraine in the 1970s and 1980s, Romania in 1996-97, Czechland in 1997, and Italy in 1998). Environmental factors, including human activities, that enhance population densities of vector mosquitoes (heavy rains followed by floods, irrigation, higher than usual temperature, or formation of ecologic niches that enable mass breeding of mosquitoes) could increase the incidence of West Nile fever.

EID Hubálek Z, Halouzka J. West Nile Fever–a Reemerging Mosquito-Borne Viral Disease in Europe. Emerg Infect Dis. 1999;5(5):643-650. https://doi.org/10.3201/eid0505.990505
AMA Hubálek Z, Halouzka J. West Nile Fever–a Reemerging Mosquito-Borne Viral Disease in Europe. Emerging Infectious Diseases. 1999;5(5):643-650. doi:10.3201/eid0505.990505.
APA Hubálek, Z., & Halouzka, J. (1999). West Nile Fever–a Reemerging Mosquito-Borne Viral Disease in Europe. Emerging Infectious Diseases, 5(5), 643-650. https://doi.org/10.3201/eid0505.990505.

Morphologic and Molecular Characterization of New Cyclospora Species from Ethiopian Monkeys: C. cercopitheci sp.n., C. colobi sp.n., and C. papionis sp.n. [PDF - 448 KB - 8 pages]
M. L. Eberhard et al.

In recent years, human cyclosporiasis has emerged as an important infection, with large outbreaks in the United States and Canada. Understanding the biology and epidemiology of Cyclospora has been difficult and slow and has been complicated by not knowing the pathogen's origins, animal reservoirs (if any), and relationship to other coccidian parasites. This report provides morphologic and molecular characterization of three parasites isolated from primates and names each isolate: Cyclospora cercopitheci sp.n. for a species recovered from green monkeys, C. colobi sp.n. for a parasite from colobus monkeys, and C. papionis sp.n. for a species infecting baboons. These species, plus C. cayetanensis, which infects humans, increase to four the recognized species of Cyclospora infecting primates. These four species group homogeneously as a single branch intermediate between avian and mammalian Eimeria. Results of our analysis contribute toward clarification of the taxonomic position of Cyclospora and its relationship to other coccidian parasites.

EID Eberhard ML, da Silva AJ, Lilley BG, Pieniazek NJ. Morphologic and Molecular Characterization of New Cyclospora Species from Ethiopian Monkeys: C. cercopitheci sp.n., C. colobi sp.n., and C. papionis sp.n.. Emerg Infect Dis. 1999;5(5):651-658. https://doi.org/10.3201/eid0505.990506
AMA Eberhard ML, da Silva AJ, Lilley BG, et al. Morphologic and Molecular Characterization of New Cyclospora Species from Ethiopian Monkeys: C. cercopitheci sp.n., C. colobi sp.n., and C. papionis sp.n.. Emerging Infectious Diseases. 1999;5(5):651-658. doi:10.3201/eid0505.990506.
APA Eberhard, M. L., da Silva, A. J., Lilley, B. G., & Pieniazek, N. J. (1999). Morphologic and Molecular Characterization of New Cyclospora Species from Ethiopian Monkeys: C. cercopitheci sp.n., C. colobi sp.n., and C. papionis sp.n.. Emerging Infectious Diseases, 5(5), 651-658. https://doi.org/10.3201/eid0505.990506.
Research

The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention [PDF - 198 KB - 13 pages]
M. I. Meltzer et al.

We estimated the possible effects of the next influenza pandemic in the United States and analyzed the economic impact of vaccine-based interventions. Using death rates, hospitalization data, and outpatient visits, we estimated 89,000 to 207,000 deaths; 314,000 to 734,000 hospitalizations; 18 to 42 million outpatient visits; and 20 to 47 million additional illnesses. Patients at high risk (15% of the population) would account for approximately 84% of all deaths. The estimated economic impact would be US$71.3 to $166.5 billion, excluding disruptions to commerce and society. At $21 per vaccinee, we project a net savings to society if persons in all age groups are vaccinated. At $62 per vaccinee and at gross attack rates of 25%, we project net losses if persons not at high risk for complications are vaccinated. Vaccinating 60% of the population would generate the highest economic returns but may not be possible within the time required for vaccine effectiveness, especially if two doses of vaccine are required.

EID Meltzer MI, Cox NJ, Fukuda K. The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention. Emerg Infect Dis. 1999;5(5):659-671. https://doi.org/10.3201/eid0505.990507
AMA Meltzer MI, Cox NJ, Fukuda K. The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention. Emerging Infectious Diseases. 1999;5(5):659-671. doi:10.3201/eid0505.990507.
APA Meltzer, M. I., Cox, N. J., & Fukuda, K. (1999). The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention. Emerging Infectious Diseases, 5(5), 659-671. https://doi.org/10.3201/eid0505.990507.

Influence of Host Genetics on the Severity of Coccidioidomycosis [PDF - 82 KB - 9 pages]
L. Louie et al.

Coccidioidomycosis, a mild flulike illness in approximately 40% of infected persons, progresses to severe pulmonary or disseminated disease in 1% to 10% of symptomatic cases. We examined host genetic influences on disease severity among class II HLA loci and the ABO blood group. Participants included African-American, Caucasian, and Hispanic persons with mild or severe disseminated coccidioidomycosis from Kern County, California. Among Hispanics, predisposition to symptomatic disease and severe disseminated disease is associated with blood types A and B, respectively. The HLA class II DRB1*1301 allele marks a pre-disposition to severe disseminated disease in each of the three groups. Reduced risk for severe disease is associated with DRB1*0301-DQB1*0201 among Caucasians and Hispanics and with DRB1*1501-DQB1*0602 among African-Americans. These data support the hypothesis that host genes, in particular HLA class II and the ABO blood group, influence susceptibility to severe coccidioidomycosis.

EID Louie L, Ng S, Hajjeh R, Johnson R, Vugia D, Werner SB, et al. Influence of Host Genetics on the Severity of Coccidioidomycosis. Emerg Infect Dis. 1999;5(5):672-680. https://doi.org/10.3201/eid0505.990508
AMA Louie L, Ng S, Hajjeh R, et al. Influence of Host Genetics on the Severity of Coccidioidomycosis. Emerging Infectious Diseases. 1999;5(5):672-680. doi:10.3201/eid0505.990508.
APA Louie, L., Ng, S., Hajjeh, R., Johnson, R., Vugia, D., Werner, S. B....Klitz, W. (1999). Influence of Host Genetics on the Severity of Coccidioidomycosis. Emerging Infectious Diseases, 5(5), 672-680. https://doi.org/10.3201/eid0505.990508.

Abscesses due to Mycobacterium abscessus Linked to Injection of Unapproved Alternative Medication [PDF - 199 KB - 7 pages]
K. Galil et al.

An unlicensed injectable medicine sold as adrenal cortex extract (ACE*) and distributed in the alternative medicine community led to the largest outbreak of Mycobacterium abscessus infections reported in the United States. Records from the implicated distributor from January 1, 1995, to August 18, 1996, were used to identify purchasers; purchasers and public health alerts were used to identify patients. Purchasers and patients were interviewed, and available medical records were reviewed. Vials of ACE* were tested for mycobacterial contamination, and the product was recalled by the U.S. Food and Drug Administration. ACE* had been distributed to 148 purchasers in 30 states; 87 persons with postinjection abscesses attributable to the product were identified. Patient and vial cultures contained M. abscessus identical by enzymatic and molecular typing methods. Unusual infectious agents and alternative health practices should be considered in the diagnosis of infections that do not respond to routine treatment.

EID Galil K, Miller LA, Yakrus MA, Wallace RJ, Mosley DG, England B, et al. Abscesses due to Mycobacterium abscessus Linked to Injection of Unapproved Alternative Medication. Emerg Infect Dis. 1999;5(5):681-687. https://doi.org/10.3201/eid0505.990509
AMA Galil K, Miller LA, Yakrus MA, et al. Abscesses due to Mycobacterium abscessus Linked to Injection of Unapproved Alternative Medication. Emerging Infectious Diseases. 1999;5(5):681-687. doi:10.3201/eid0505.990509.
APA Galil, K., Miller, L. A., Yakrus, M. A., Wallace, R. J., Mosley, D. G., England, B....Perkins, B. A. (1999). Abscesses due to Mycobacterium abscessus Linked to Injection of Unapproved Alternative Medication. Emerging Infectious Diseases, 5(5), 681-687. https://doi.org/10.3201/eid0505.990509.

Tracking Drug-Resistant Streptococcus pneumoniae in Oregon: An Alternative Surveillance Method [PDF - 141 KB - 6 pages]
A. E. Chin et al.

With the emergence of drug-resistant Streptococcus pneumoniae, community-specific antimicrobial susceptibility patterns have become valuable determinants of empiric therapy for S. pneumoniae infections. Traditionally, these patterns are tracked by active surveillance for invasive disease, collection of isolates, and centralized susceptibility testing. We investigated whether a simpler and less expensive method— aggregating existing hospital antibiogramscould provide community-specific antimicrobial susceptibility data. We compared 1996 active surveillance data with antibiogram data from hospital laboratories in Portland, Oregon. Of the 178 S. pneumoniae active surveillance isolates, 153 (86% [95% confidence interval (CI) = 80% to 91%]) were susceptible to penicillin. Of the 1,092 aggregated isolates used by hospitals to generate antibiograms, 921 (84% [95% CI = 82%-87%]) were susceptible to penicillin. With the exception of one hospital's erythromycin susceptibility results, hospital-specific S. pneumoniae susceptibilities to penicillin, cefotaxime, trimethoprim-sulfamethoxazole, and erythromycin from the two methods were statistically comparable. Although yielding fewer data than active surveillance, antibiograms provided accurate, community-specific drug-resistant S. pneumoniae data in Oregon.

EID Chin AE, Hedberg K, Cieslak PR, Cassidy M, Stefonek KR, Fleming DW. Tracking Drug-Resistant Streptococcus pneumoniae in Oregon: An Alternative Surveillance Method. Emerg Infect Dis. 1999;5(5):688-693. https://doi.org/10.3201/eid0505.990510
AMA Chin AE, Hedberg K, Cieslak PR, et al. Tracking Drug-Resistant Streptococcus pneumoniae in Oregon: An Alternative Surveillance Method. Emerging Infectious Diseases. 1999;5(5):688-693. doi:10.3201/eid0505.990510.
APA Chin, A. E., Hedberg, K., Cieslak, P. R., Cassidy, M., Stefonek, K. R., & Fleming, D. W. (1999). Tracking Drug-Resistant Streptococcus pneumoniae in Oregon: An Alternative Surveillance Method. Emerging Infectious Diseases, 5(5), 688-693. https://doi.org/10.3201/eid0505.990510.
Dispatches

Diphtheria Antitoxin Levels in the Netherlands: a Population-Based Study [PDF - 124 KB - 7 pages]
H. E. de Melker et al.

In a population-based study in the Netherlands, diphtheria antitoxin antibodies were measured with a toxin-binding inhibition assay in 9,134 sera from the general population and religious communities refusing vaccination. The Dutch immunization program appears to induce long-term protection against diphtheria. However, a substantial number of adults born before the program was introduced had no protective diphtheria antibody levels. Although herd immunity seems adequate, long-term population protection cannot be assured. As more than 60% of orthodox reformed persons have antibody levels lower than 0.01 IU/ml, introduction of diphtheria into religious communities refusing vaccination may constitute a danger of spread of the bacterium.

EID de Melker HE, Berbers G, Nagelkerke N, Conyn-van Spaendonck M. Diphtheria Antitoxin Levels in the Netherlands: a Population-Based Study. Emerg Infect Dis. 1999;5(5):694-700. https://doi.org/10.3201/eid0505.990511
AMA de Melker HE, Berbers G, Nagelkerke N, et al. Diphtheria Antitoxin Levels in the Netherlands: a Population-Based Study. Emerging Infectious Diseases. 1999;5(5):694-700. doi:10.3201/eid0505.990511.
APA de Melker, H. E., Berbers, G., Nagelkerke, N., & Conyn-van Spaendonck, M. (1999). Diphtheria Antitoxin Levels in the Netherlands: a Population-Based Study. Emerging Infectious Diseases, 5(5), 694-700. https://doi.org/10.3201/eid0505.990511.

Acute Sin Nombre Hantavirus Infection without Pulmonary Syndrome, United States [PDF - 68 KB - 5 pages]
P. T. Kitsutani et al.

Hantavirus pulmonary syndrome (HPS) occurs in most infections with Sin Nombre virus and other North American hantaviruses. We report five cases of acute hantavirus infection that did not fit the HPS case definition. The patients had characteristic prodromal symptoms without severe pulmonary involvement. These cases suggest that surveillance for HPS may need to be expanded.

EID Kitsutani PT, Denton RW, Fritz CL, Murray RA, Todd RL, Pape WJ, et al. Acute Sin Nombre Hantavirus Infection without Pulmonary Syndrome, United States. Emerg Infect Dis. 1999;5(5):701-705. https://doi.org/10.3201/eid0505.990512
AMA Kitsutani PT, Denton RW, Fritz CL, et al. Acute Sin Nombre Hantavirus Infection without Pulmonary Syndrome, United States. Emerging Infectious Diseases. 1999;5(5):701-705. doi:10.3201/eid0505.990512.
APA Kitsutani, P. T., Denton, R. W., Fritz, C. L., Murray, R. A., Todd, R. L., Pape, W. J....Ksiazek, T. G. (1999). Acute Sin Nombre Hantavirus Infection without Pulmonary Syndrome, United States. Emerging Infectious Diseases, 5(5), 701-705. https://doi.org/10.3201/eid0505.990512.

Cryptosporidium parvum in Oysters from Commercial Harvesting Sites in the Chesapeake Bay [PDF - 160 KB - 5 pages]
R. Fayer et al.

Oocysts of Cryptosporidium parvum, a zoonotic waterborne pathogen, can be removed by bivalve molluscs from contaminated water and retained on gills and in hemolymph. We identified oocysts of C. parvum in oysters from seven sites in the Chesapeake Bay area. These findings document the presence of C. parvum infectious for humans in oysters intended for human consumption.

EID Fayer R, Lewis EJ, Trout JM, Graczyk TK, Jenkins MC, Higgins J, et al. Cryptosporidium parvum in Oysters from Commercial Harvesting Sites in the Chesapeake Bay. Emerg Infect Dis. 1999;5(5):706-710. https://doi.org/10.3201/eid0505.990513
AMA Fayer R, Lewis EJ, Trout JM, et al. Cryptosporidium parvum in Oysters from Commercial Harvesting Sites in the Chesapeake Bay. Emerging Infectious Diseases. 1999;5(5):706-710. doi:10.3201/eid0505.990513.
APA Fayer, R., Lewis, E. J., Trout, J. M., Graczyk, T. K., Jenkins, M. C., Higgins, J....Lal, A. A. (1999). Cryptosporidium parvum in Oysters from Commercial Harvesting Sites in the Chesapeake Bay. Emerging Infectious Diseases, 5(5), 706-710. https://doi.org/10.3201/eid0505.990513.

Seroepidemiology of Bartonella vinsonii subsp. berkhoffii Infection in California Coyotes, 1994-1998 [PDF - 113 KB - 5 pages]
C. Chang et al.

The prevalence of antibodies to Bartonella vinsonii subsp. berkhoffii in coyotes (Canis latrans) in California ranged from 51% in central to 34% in southern and 7% in northern California. Seropositive coyotes were more likely to be from coastal than inland counties (p < 0.05). The clustered distribution of Bartonella seropositivity in coyotes suggests that B. vinsonii subsp. berkhoffii infection is vectorborne. Further investigation is warranted to evaluate which arthropods are vectors and what the mode of transmission is from wildlife to domestic dogs and possibly humans.

EID Chang C, Yamamoto K, Chomel BB, Kasten RW, Simpson DC, Smith CR, et al. Seroepidemiology of Bartonella vinsonii subsp. berkhoffii Infection in California Coyotes, 1994-1998. Emerg Infect Dis. 1999;5(5):711-715. https://doi.org/10.3201/eid0505.990514
AMA Chang C, Yamamoto K, Chomel BB, et al. Seroepidemiology of Bartonella vinsonii subsp. berkhoffii Infection in California Coyotes, 1994-1998. Emerging Infectious Diseases. 1999;5(5):711-715. doi:10.3201/eid0505.990514.
APA Chang, C., Yamamoto, K., Chomel, B. B., Kasten, R. W., Simpson, D. C., Smith, C. R....Kramer, V. L. (1999). Seroepidemiology of Bartonella vinsonii subsp. berkhoffii Infection in California Coyotes, 1994-1998. Emerging Infectious Diseases, 5(5), 711-715. https://doi.org/10.3201/eid0505.990514.

Epidemic Typhus Imported from Algeria [PDF - 213 KB - 3 pages]
M. Niang et al.

We report epidemic typhus in a French patient returning from Algeria. The diagnosis was confirmed by serologic testing and the isolation of Rickettsia prowazekii in blood. Initially the patient was thought to have typhoid fever. Because body lice are prevalent in industrialized regions, the introduction of typhus to pediculosis-endemic areas poses a serious public health risk.

EID Niang M, Brouqui P, Raoult D. Epidemic Typhus Imported from Algeria. Emerg Infect Dis. 1999;5(5):716-718. https://doi.org/10.3201/eid0505.990515
AMA Niang M, Brouqui P, Raoult D. Epidemic Typhus Imported from Algeria. Emerging Infectious Diseases. 1999;5(5):716-718. doi:10.3201/eid0505.990515.
APA Niang, M., Brouqui, P., & Raoult, D. (1999). Epidemic Typhus Imported from Algeria. Emerging Infectious Diseases, 5(5), 716-718. https://doi.org/10.3201/eid0505.990515.

Human and Animal Epidemic of Yersinia enterocolitica O:9, 1989–1997, Auvergne, France [PDF - 100 KB - 3 pages]
F. Gourdon et al.

Yersinia enterocolitica O:9 infections were reported in Auvergne in 1988 to 1989, while brucellosis due to Brucella abortus was almost eliminated. The serologic cross-reactions between the two bacteria complicated the diagnosis of brucellosis cases. In 1996, human cases of Yersinia enterocolitica O:9 infection were detected, with a peak incidence of 12 cases. Veterinary surveillance could have predicted the emergence of this disease in humans.

EID Gourdon F, Beytout J, Reynaud A, Romaszko J, Perre D, Theodore P, et al. Human and Animal Epidemic of Yersinia enterocolitica O:9, 1989–1997, Auvergne, France. Emerg Infect Dis. 1999;5(5):719-721. https://doi.org/10.3201/eid0505.990516
AMA Gourdon F, Beytout J, Reynaud A, et al. Human and Animal Epidemic of Yersinia enterocolitica O:9, 1989–1997, Auvergne, France. Emerging Infectious Diseases. 1999;5(5):719-721. doi:10.3201/eid0505.990516.
APA Gourdon, F., Beytout, J., Reynaud, A., Romaszko, J., Perre, D., Theodore, P....Sirot, J. (1999). Human and Animal Epidemic of Yersinia enterocolitica O:9, 1989–1997, Auvergne, France. Emerging Infectious Diseases, 5(5), 719-721. https://doi.org/10.3201/eid0505.990516.
Letters

A Case of Corynebacterium pseudodiphtheriticum Nosocomial Pneumonia [PDF - 55 KB - 2 pages]
C. Martaresche et al.
EID Martaresche C, Fournier P, Jacomo V, Gainnier M, Boussuge A, Drancourt M. A Case of Corynebacterium pseudodiphtheriticum Nosocomial Pneumonia. Emerg Infect Dis. 1999;5(5):722-723. https://doi.org/10.3201/eid0505.990517
AMA Martaresche C, Fournier P, Jacomo V, et al. A Case of Corynebacterium pseudodiphtheriticum Nosocomial Pneumonia. Emerging Infectious Diseases. 1999;5(5):722-723. doi:10.3201/eid0505.990517.
APA Martaresche, C., Fournier, P., Jacomo, V., Gainnier, M., Boussuge, A., & Drancourt, M. (1999). A Case of Corynebacterium pseudodiphtheriticum Nosocomial Pneumonia. Emerging Infectious Diseases, 5(5), 722-723. https://doi.org/10.3201/eid0505.990517.

Family Outbreak of Rickettsia conorii Infection [PDF - 54 KB - 2 pages]
G. Shazberg et al.
EID Shazberg G, Moise J, Terespolsky N, Hurvitz H. Family Outbreak of Rickettsia conorii Infection. Emerg Infect Dis. 1999;5(5):723-724. https://doi.org/10.3201/eid0505.990518
AMA Shazberg G, Moise J, Terespolsky N, et al. Family Outbreak of Rickettsia conorii Infection. Emerging Infectious Diseases. 1999;5(5):723-724. doi:10.3201/eid0505.990518.
APA Shazberg, G., Moise, J., Terespolsky, N., & Hurvitz, H. (1999). Family Outbreak of Rickettsia conorii Infection. Emerging Infectious Diseases, 5(5), 723-724. https://doi.org/10.3201/eid0505.990518.

Iron and the Role of Chlamydia pneumoniae in Heart Disease [PDF - 58 KB - 3 pages]
J. L. Sullivan and E. D. Weinberg
EID Sullivan JL, Weinberg ED. Iron and the Role of Chlamydia pneumoniae in Heart Disease. Emerg Infect Dis. 1999;5(5):724-726. https://doi.org/10.3201/eid0505.990519
AMA Sullivan JL, Weinberg ED. Iron and the Role of Chlamydia pneumoniae in Heart Disease. Emerging Infectious Diseases. 1999;5(5):724-726. doi:10.3201/eid0505.990519.
APA Sullivan, J. L., & Weinberg, E. D. (1999). Iron and the Role of Chlamydia pneumoniae in Heart Disease. Emerging Infectious Diseases, 5(5), 724-726. https://doi.org/10.3201/eid0505.990519.

Filth Flies Are Transport Hosts of Cryptosporidium parvum
T. K. Graczyk et al.
EID Graczyk TK, Fayer R, Cranfield MR, Mhangami-Ruwende B, Knight R, Trout JM, et al. Filth Flies Are Transport Hosts of Cryptosporidium parvum. Emerg Infect Dis. 1999;5(5):726-727. https://doi.org/10.3201/eid0505.990520
AMA Graczyk TK, Fayer R, Cranfield MR, et al. Filth Flies Are Transport Hosts of Cryptosporidium parvum. Emerging Infectious Diseases. 1999;5(5):726-727. doi:10.3201/eid0505.990520.
APA Graczyk, T. K., Fayer, R., Cranfield, M. R., Mhangami-Ruwende, B., Knight, R., Trout, J. M....Bixler, H. (1999). Filth Flies Are Transport Hosts of Cryptosporidium parvum. Emerging Infectious Diseases, 5(5), 726-727. https://doi.org/10.3201/eid0505.990520.

The Cost-Effectiveness of Vaccinating against Lyme Disease [PDF - 52 KB - 2 pages]
D. Prybylski
EID Prybylski D. The Cost-Effectiveness of Vaccinating against Lyme Disease. Emerg Infect Dis. 1999;5(5):727-728. https://doi.org/10.3201/eid0505.990521
AMA Prybylski D. The Cost-Effectiveness of Vaccinating against Lyme Disease. Emerging Infectious Diseases. 1999;5(5):727-728. doi:10.3201/eid0505.990521.
APA Prybylski, D. (1999). The Cost-Effectiveness of Vaccinating against Lyme Disease. Emerging Infectious Diseases, 5(5), 727-728. https://doi.org/10.3201/eid0505.990521.
Books and Media

The Elusive Magic Bullet: The Search for the Perfect Drug [PDF - 52 KB - 1 page]
A. Zuger
EID Zuger A. The Elusive Magic Bullet: The Search for the Perfect Drug. Emerg Infect Dis. 1999;5(5):729. https://doi.org/10.3201/eid0505.990522
AMA Zuger A. The Elusive Magic Bullet: The Search for the Perfect Drug. Emerging Infectious Diseases. 1999;5(5):729. doi:10.3201/eid0505.990522.
APA Zuger, A. (1999). The Elusive Magic Bullet: The Search for the Perfect Drug. Emerging Infectious Diseases, 5(5), 729. https://doi.org/10.3201/eid0505.990522.
About the Cover

Girl Eating Oysters (c.1658/1660)
Conference Summaries

The 2nd International Symposium of the European Study Group on Enterohemorrhagic Escherichia coli (EHEC)
R. D. Hess et al.
EID Hess RD, Lieske R, Weber B. The 2nd International Symposium of the European Study Group on Enterohemorrhagic Escherichia coli (EHEC). Emerg Infect Dis. 1999;5(5):730-733. https://doi.org/10.3201/eid0505.990523
AMA Hess RD, Lieske R, Weber B. The 2nd International Symposium of the European Study Group on Enterohemorrhagic Escherichia coli (EHEC). Emerging Infectious Diseases. 1999;5(5):730-733. doi:10.3201/eid0505.990523.
APA Hess, R. D., Lieske, R., & Weber, B. (1999). The 2nd International Symposium of the European Study Group on Enterohemorrhagic Escherichia coli (EHEC). Emerging Infectious Diseases, 5(5), 730-733. https://doi.org/10.3201/eid0505.990523.
Corrections

Erratum Vol. 5, No. 3 [PDF - 90 KB - 1 page]
EID Erratum Vol. 5, No. 3. Emerg Infect Dis. 1999;5(5):734. https://doi.org/10.3201/eid0505.990524
AMA Erratum Vol. 5, No. 3. Emerging Infectious Diseases. 1999;5(5):734. doi:10.3201/eid0505.990524.
APA (1999). Erratum Vol. 5, No. 3. Emerging Infectious Diseases, 5(5), 734. https://doi.org/10.3201/eid0505.990524.
Page created: January 23, 2012
Page updated: January 23, 2012
Page reviewed: January 23, 2012
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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