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Articles from Emerging Infectious Diseases

Synopses

Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018 [PDF - 1.02 MB - 8 pages]
E. Kisaakye et al.

On April 20, 2018, the Kween District Health Office in Kween District, Uganda reported 7 suspected cases of human anthrax. A team from the Uganda Ministry of Health and partners investigated and identified 49 cases, 3 confirmed and 46 suspected; no deaths were reported. Multiple exposures from handling the carcass of a cow that had died suddenly were significantly associated with cutaneous anthrax, whereas eating meat from that cow was associated with gastrointestinal anthrax. Eating undercooked meat was significantly associated with gastrointestinal anthrax, but boiling the meat for >60 minutes was protective. We recommended providing postexposure antimicrobial prophylaxis for all exposed persons, vaccinating healthy livestock in the area, educating farmers to safely dispose of animal carcasses, and avoiding handling or eating meat from livestock that died of unknown causes.

EID Kisaakye E, Ario A, Bainomugisha K, Cossaboom CM, Lowe D, Bulage L, et al. Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018. Emerg Infect Dis. 2020;26(12):2799-2806. https://dx.doi.org/10.3201/eid2612.191373
AMA Kisaakye E, Ario A, Bainomugisha K, et al. Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018. Emerging Infectious Diseases. 2020;26(12):2799-2806. doi:10.3201/eid2612.191373.
APA Kisaakye, E., Ario, A., Bainomugisha, K., Cossaboom, C. M., Lowe, D., Bulage, L....Zhu, B. (2020). Outbreak of Anthrax Associated with Handling and Eating Meat from a Cow, Uganda, 2018. Emerging Infectious Diseases, 26(12), 2799-2806. https://dx.doi.org/10.3201/eid2612.191373.

Mycoplasma bovis Infections in Free-Ranging Pronghorn, Wyoming, USA [PDF - 2.89 MB - 8 pages]
J. L. Malmberg et al.

Mycoplasma bovis is 1 of several bacterial pathogens associated with pneumonia in cattle. Its role in pneumonia of free-ranging ungulates has not been established. Over a 3-month period in early 2019, »60 free-ranging pronghorn with signs of respiratory disease died in northeast Wyoming, USA. A consistent finding in submitted carcasses was severe fibrinosuppurative pleuropneumonia and detection of M. bovis by PCR and immunohistochemical analysis. Multilocus sequence typing of isolates from 4 animals revealed that all have a deletion in 1 of the target genes, adh-1. A retrospective survey by PCR and immunohistochemical analysis of paraffin-embedded lung from 20 pronghorn that died with and without pneumonia during 2007–2018 yielded negative results. These findings indicate that a distinct strain of M. bovis was associated with fatal pneumonia in this group of pronghorn.

EID Malmberg JL, O’Toole D, Creekmore T, Peckham E, Killion H, Vance M, et al. Mycoplasma bovis Infections in Free-Ranging Pronghorn, Wyoming, USA. Emerg Infect Dis. 2020;26(12):2807-2814. https://dx.doi.org/10.3201/eid2612.191375
AMA Malmberg JL, O’Toole D, Creekmore T, et al. Mycoplasma bovis Infections in Free-Ranging Pronghorn, Wyoming, USA. Emerging Infectious Diseases. 2020;26(12):2807-2814. doi:10.3201/eid2612.191375.
APA Malmberg, J. L., O’Toole, D., Creekmore, T., Peckham, E., Killion, H., Vance, M....Sondgeroth, K. S. (2020). Mycoplasma bovis Infections in Free-Ranging Pronghorn, Wyoming, USA. Emerging Infectious Diseases, 26(12), 2807-2814. https://dx.doi.org/10.3201/eid2612.191375.

Control and Prevention of Anthrax, Texas, USA, 2019 [PDF - 2.30 MB - 10 pages]
T. Sidwa et al.

The zoonotic disease anthrax is endemic to most continents. It is a disease of herbivores that incidentally infects humans through contact with animals that are ill or have died from anthrax or through contact with Bacillus anthracis–contaminated byproducts. In the United States, human risk is primarily associated with handling carcasses of hoofstock that have died of anthrax; the primary risk for herbivores is ingestion of B. anthracis spores, which can persist in suitable alkaline soils in a corridor from Texas through Montana. The last known naturally occurring human case of cutaneous anthrax associated with livestock exposure in the United States was reported from South Dakota in 2002. Texas experienced an increase of animal cases in 2019 and consequently higher than usual human risk. We describe the animal outbreak that occurred in southwest Texas beginning in June 2019 and an associated human case. Primary prevention in humans is achieved through control of animal anthrax.

EID Sidwa T, Salzer JS, Traxler R, Swaney E, Sims ML, Bradshaw P, et al. Control and Prevention of Anthrax, Texas, USA, 2019. Emerg Infect Dis. 2020;26(12):2815-2824. https://dx.doi.org/10.3201/eid2612.200470
AMA Sidwa T, Salzer JS, Traxler R, et al. Control and Prevention of Anthrax, Texas, USA, 2019. Emerging Infectious Diseases. 2020;26(12):2815-2824. doi:10.3201/eid2612.200470.
APA Sidwa, T., Salzer, J. S., Traxler, R., Swaney, E., Sims, M. L., Bradshaw, P....Hendricks, K. (2020). Control and Prevention of Anthrax, Texas, USA, 2019. Emerging Infectious Diseases, 26(12), 2815-2824. https://dx.doi.org/10.3201/eid2612.200470.

Animal Rabies Surveillance, China, 2004–2018 [PDF - 3.98 MB - 10 pages]
Y. Feng et al.

Rabies is a severe zoonotic disease in China, but the circulation and distribution of rabies virus (RABV) within animal reservoirs is not well understood. We report the results of 15 years of surveillance of the first Chinese Rabies Surveillance Plan in animal populations, in which animal brain tissues collected during 2004–2018 were tested for RABV and phylogenetic and spatial–temporal evolutionary analyses performed using obtained RABV sequences. The results have provided the most comprehensive dataset to date on the infected animal species, geographic distribution, transmission sources, and genetic diversity of RABVs in China. In particular, the transboundary transmission of emerging RABV subclades between China and neighboring countries was confirmed. The study highlights the importance of continuous animal rabies surveillance in monitoring the transmission dynamics, and provides updated information for improving current control and prevention strategies at the source.

EID Feng Y, Wang Y, Xu W, Tu Z, Liu T, Huo M, et al. Animal Rabies Surveillance, China, 2004–2018. Emerg Infect Dis. 2020;26(12):2825-2834. https://dx.doi.org/10.3201/eid2612.200303
AMA Feng Y, Wang Y, Xu W, et al. Animal Rabies Surveillance, China, 2004–2018. Emerging Infectious Diseases. 2020;26(12):2825-2834. doi:10.3201/eid2612.200303.
APA Feng, Y., Wang, Y., Xu, W., Tu, Z., Liu, T., Huo, M....Tu, C. (2020). Animal Rabies Surveillance, China, 2004–2018. Emerging Infectious Diseases, 26(12), 2825-2834. https://dx.doi.org/10.3201/eid2612.200303.
Research

Small Particle Aerosol Exposure of African Green Monkeys to MERS-CoV as a Model for Highly Pathogenic Coronavirus Infection [PDF - 1.68 MB - 9 pages]
A. Totura et al.

Emerging coronaviruses are a global public health threat because of the potential for person-to-person transmission and high mortality rates. Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012, causing lethal respiratory disease in »35% of cases. Primate models of coronavirus disease are needed to support development of therapeutics, but few models exist that recapitulate severe disease. For initial development of a MERS-CoV primate model, 12 African green monkeys were exposed to 103, 104, or 105 PFU target doses of aerosolized MERS-CoV. We observed a dose-dependent increase of respiratory disease signs, although all 12 monkeys survived for the 28-day duration of the study. This study describes dose-dependent effects of MERS-CoV infection of primates and uses a route of infection with potential relevance to MERS-CoV transmission. Aerosol exposure of African green monkeys might provide a platform approach for the development of primate models of novel coronavirus diseases.

EID Totura A, Livingston V, Frick O, Dyer D, Nichols D, Nalca A. Small Particle Aerosol Exposure of African Green Monkeys to MERS-CoV as a Model for Highly Pathogenic Coronavirus Infection. Emerg Infect Dis. 2020;26(12):2835-2843. https://dx.doi.org/10.3201/eid2612.201664
AMA Totura A, Livingston V, Frick O, et al. Small Particle Aerosol Exposure of African Green Monkeys to MERS-CoV as a Model for Highly Pathogenic Coronavirus Infection. Emerging Infectious Diseases. 2020;26(12):2835-2843. doi:10.3201/eid2612.201664.
APA Totura, A., Livingston, V., Frick, O., Dyer, D., Nichols, D., & Nalca, A. (2020). Small Particle Aerosol Exposure of African Green Monkeys to MERS-CoV as a Model for Highly Pathogenic Coronavirus Infection. Emerging Infectious Diseases, 26(12), 2835-2843. https://dx.doi.org/10.3201/eid2612.201664.

Coronavirus Disease Model to Inform Transmission-Reducing Measures and Health System Preparedness, Australia [PDF - 2.79 MB - 10 pages]
R. Moss et al.

The ability of health systems to cope with coronavirus disease (COVID-19) cases is of major concern. In preparation, we used clinical pathway models to estimate healthcare requirements for COVID-19 patients in the context of broader public health measures in Australia. An age- and risk-stratified transmission model of COVID-19 demonstrated that an unmitigated epidemic would dramatically exceed the capacity of the health system of Australia over a prolonged period. Case isolation and contact quarantine alone are insufficient to constrain healthcare needs within feasible levels of expansion of health sector capacity. Overlaid social restrictions must be applied over the course of the epidemic to ensure systems do not become overwhelmed and essential health sector functions, including care of COVID-19 patients, can be maintained. Attention to the full pathway of clinical care is needed, along with ongoing strengthening of capacity.

EID Moss R, Wood J, Brown D, Shearer FM, Black AJ, Glass K, et al. Coronavirus Disease Model to Inform Transmission-Reducing Measures and Health System Preparedness, Australia. Emerg Infect Dis. 2020;26(12):2844-2853. https://dx.doi.org/10.3201/eid2612.202530
AMA Moss R, Wood J, Brown D, et al. Coronavirus Disease Model to Inform Transmission-Reducing Measures and Health System Preparedness, Australia. Emerging Infectious Diseases. 2020;26(12):2844-2853. doi:10.3201/eid2612.202530.
APA Moss, R., Wood, J., Brown, D., Shearer, F. M., Black, A. J., Glass, K....McVernon, J. (2020). Coronavirus Disease Model to Inform Transmission-Reducing Measures and Health System Preparedness, Australia. Emerging Infectious Diseases, 26(12), 2844-2853. https://dx.doi.org/10.3201/eid2612.202530.

Genomic Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2, Colombia [PDF - 2.17 MB - 9 pages]
K. Laiton-Donato et al.

Coronavirus disease (COVID-19) in Colombia was first diagnosed in a traveler arriving from Italy on February 26, 2020. However, limited data are available on the origins and number of introductions of COVID-19 into the country. We sequenced the causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from 43 clinical samples we collected, along with another 79 genome sequences available from Colombia. We investigated the emergence and importation routes for SARS-CoV-2 into Colombia by using epidemiologic, historical air travel, and phylogenetic observations. Our study provides evidence of multiple introductions, mostly from Europe, and documents >12 lineages. Phylogenetic findings validate the lineage diversity, support multiple importation events, and demonstrate the evolutionary relationship of epidemiologically linked transmission chains. Our results reconstruct the early evolutionary history of SARS-CoV-2 in Colombia and highlight the advantages of genome sequencing to complement COVID-19 outbreak investigations.

EID Laiton-Donato K, Villabona-Arenas C, Usme-Ciro JA, Franco-Muñoz C, Álvarez-Díaz DA, Villabona-Arenas L, et al. Genomic Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2, Colombia. Emerg Infect Dis. 2020;26(12):2854-2862. https://dx.doi.org/10.3201/eid2612.202969
AMA Laiton-Donato K, Villabona-Arenas C, Usme-Ciro JA, et al. Genomic Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2, Colombia. Emerging Infectious Diseases. 2020;26(12):2854-2862. doi:10.3201/eid2612.202969.
APA Laiton-Donato, K., Villabona-Arenas, C., Usme-Ciro, J. A., Franco-Muñoz, C., Álvarez-Díaz, D. A., Villabona-Arenas, L....Mercado-Reyes, M. (2020). Genomic Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2, Colombia. Emerging Infectious Diseases, 26(12), 2854-2862. https://dx.doi.org/10.3201/eid2612.202969.

SARS-CoV-2 Seroprevalence among Healthcare, First Response, and Public Safety Personnel, Detroit Metropolitan Area, Michigan, USA, May–June 2020 [PDF - 1.37 MB - 9 pages]
L. J. Akinbami et al.

To estimate seroprevalence of severe acute respiratory syndrome 2 (SARS-CoV-2) among healthcare, first response, and public safety personnel, antibody testing was conducted in emergency medical service agencies and 27 hospitals in the Detroit, Michigan, USA, metropolitan area during May–June 2020. Of 16,403 participants, 6.9% had SARS-CoV-2 antibodies. In adjusted analyses, seropositivity was associated with exposure to SARS-CoV-2–positive household members (adjusted odds ratio [aOR] 6.18, 95% CI 4.81–7.93) and working within 15 km of Detroit (aOR 5.60, 95% CI 3.98–7.89). Nurse assistants (aOR 1.88, 95% CI 1.24–2.83) and nurses (aOR 1.52, 95% CI 1.18–1.95) had higher likelihood of seropositivity than physicians. Working in a hospital emergency department increased the likelihood of seropositivity (aOR 1.16, 95% CI 1.002–1.35). Consistently using N95 respirators (aOR 0.83, 95% CI 0.72–0.95) and surgical facemasks (aOR 0.86, 95% CI 0.75–0.98) decreased the likelihood of seropositivity.

EID Akinbami LJ, Vuong N, Petersen LR, Sami S, Patel A, Lukacs SL, et al. SARS-CoV-2 Seroprevalence among Healthcare, First Response, and Public Safety Personnel, Detroit Metropolitan Area, Michigan, USA, May–June 2020. Emerg Infect Dis. 2020;26(12):2863-2871. https://dx.doi.org/10.3201/eid2612.203764
AMA Akinbami LJ, Vuong N, Petersen LR, et al. SARS-CoV-2 Seroprevalence among Healthcare, First Response, and Public Safety Personnel, Detroit Metropolitan Area, Michigan, USA, May–June 2020. Emerging Infectious Diseases. 2020;26(12):2863-2871. doi:10.3201/eid2612.203764.
APA Akinbami, L. J., Vuong, N., Petersen, L. R., Sami, S., Patel, A., Lukacs, S. L....Atas, J. (2020). SARS-CoV-2 Seroprevalence among Healthcare, First Response, and Public Safety Personnel, Detroit Metropolitan Area, Michigan, USA, May–June 2020. Emerging Infectious Diseases, 26(12), 2863-2871. https://dx.doi.org/10.3201/eid2612.203764.

Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing [PDF - 1.65 MB - 9 pages]
H. Speake et al.

To investigate potential transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during a domestic flight within Australia, we performed epidemiologic analyses with whole-genome sequencing. Eleven passengers with PCR-confirmed SARS-CoV-2 infection and symptom onset within 48 hours of the flight were considered infectious during travel; 9 had recently disembarked from a cruise ship with a retrospectively identified SARS-CoV-2 outbreak. The virus strain of those on the cruise and the flight was linked (A2-RP) and had not been previously identified in Australia. For 11 passengers, none of whom had traveled on the cruise ship, PCR-confirmed SARS-CoV-2 illness developed between 48 hours and 14 days after the flight. Eight cases were considered flight associated with the distinct SARS-CoV-2 A2-RP strain; the remaining 3 cases (1 with A2-RP) were possibly flight associated. All 11 passengers had been in the same cabin with symptomatic persons who had culture-positive A2-RP virus strain. This investigation provides evidence of flight-associated SARS-CoV-2 transmission.

EID Speake H, Phillips A, Chong T, Sikazwe C, Levy A, Lang J, et al. Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing. Emerg Infect Dis. 2020;26(12):2872-2880. https://dx.doi.org/10.3201/eid2612.203910
AMA Speake H, Phillips A, Chong T, et al. Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing. Emerging Infectious Diseases. 2020;26(12):2872-2880. doi:10.3201/eid2612.203910.
APA Speake, H., Phillips, A., Chong, T., Sikazwe, C., Levy, A., Lang, J....McEvoy, S. P. (2020). Flight-Associated Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Corroborated by Whole-Genome Sequencing. Emerging Infectious Diseases, 26(12), 2872-2880. https://dx.doi.org/10.3201/eid2612.203910.

Risk for Hepatitis E Virus Transmission by Solvent/Detergent–Treated Plasma [PDF - 1.32 MB - 6 pages]
P. Gallian et al.

Hepatitis E has emerged as a major transfusion-transmitted infectious risk. Two recipients of plasma from 2 lots (A and B) of pooled solvent/detergent–treated plasma were found to be infected by hepatitis E virus (HEV) that was determined to have been transmitted by the solvent/detergent–treated plasma. HEV RNA viral loads were 433 IU in lot A and 55 IU in lot B. Retrospective studies found that 100% (13/13) of evaluable lot A recipients versus 18% (3/17) of evaluable lot B recipients had been infected by HEV (p<0.001), albeit not necessarily at time of transfusion. Among evaluable recipients, 86% with a transfused HEV RNA load >50,000 IU were infected, most likely by the HEV-containing solvent/detergent–treated plasma, versus only 7% with a transfused HEV RNA load <50,000 IU (p<0.001). Overall, solvent/detergent–treated plasma might harbor HEV. Such an occurrence might result in a dose-dependent risk for transfusion-transmitted hepatitis E.

EID Gallian P, Lhomme S, Morel P, Gross S, Mantovani C, Hauser L, et al. Risk for Hepatitis E Virus Transmission by Solvent/Detergent–Treated Plasma. Emerg Infect Dis. 2020;26(12):2881-2886. https://dx.doi.org/10.3201/eid2612.191482
AMA Gallian P, Lhomme S, Morel P, et al. Risk for Hepatitis E Virus Transmission by Solvent/Detergent–Treated Plasma. Emerging Infectious Diseases. 2020;26(12):2881-2886. doi:10.3201/eid2612.191482.
APA Gallian, P., Lhomme, S., Morel, P., Gross, S., Mantovani, C., Hauser, L....Tiberghien, P. (2020). Risk for Hepatitis E Virus Transmission by Solvent/Detergent–Treated Plasma. Emerging Infectious Diseases, 26(12), 2881-2886. https://dx.doi.org/10.3201/eid2612.191482.

Equine-Like H3 Avian Influenza Viruses in Wild Birds, Chile [PDF - 4.11 MB - 12 pages]
N. Bravo-Vasquez et al.

Since their discovery in the United States in 1963, outbreaks of infection with equine influenza virus (H3N8) have been associated with serious respiratory disease in horses worldwide. Genomic analysis suggests that equine H3 viruses are of an avian lineage, likely originating in wild birds. Equine-like internal genes have been identified in avian influenza viruses isolated from wild birds in the Southern Cone of South America. However, an equine-like H3 hemagglutinin has not been identified. We isolated 6 distinct H3 viruses from wild birds in Chile that have hemagglutinin, nucleoprotein, nonstructural protein 1, and polymerase acidic genes with high nucleotide homology to the 1963 H3N8 equine influenza virus lineage. Despite the nucleotide similarity, viruses from Chile were antigenically more closely related to avian viruses and transmitted effectively in chickens, suggesting adaptation to the avian host. These studies provide the initial demonstration that equine-like H3 hemagglutinin continues to circulate in a wild bird reservoir.

EID Bravo-Vasquez N, Yao J, Jimenez-Bluhm P, Meliopoulos V, Freiden P, Sharp B, et al. Equine-Like H3 Avian Influenza Viruses in Wild Birds, Chile. Emerg Infect Dis. 2020;26(12):2887-2898. https://dx.doi.org/10.3201/eid2612.202063
AMA Bravo-Vasquez N, Yao J, Jimenez-Bluhm P, et al. Equine-Like H3 Avian Influenza Viruses in Wild Birds, Chile. Emerging Infectious Diseases. 2020;26(12):2887-2898. doi:10.3201/eid2612.202063.
APA Bravo-Vasquez, N., Yao, J., Jimenez-Bluhm, P., Meliopoulos, V., Freiden, P., Sharp, B....Hamilton-West, C. (2020). Equine-Like H3 Avian Influenza Viruses in Wild Birds, Chile. Emerging Infectious Diseases, 26(12), 2887-2898. https://dx.doi.org/10.3201/eid2612.202063.

Game Animal Density, Climate, and Tick-Borne Encephalitis in Finland, 2007–2017 [PDF - 1.84 MB - 8 pages]
T. Dub et al.

Tick-borne encephalitis (TBE) is an endemic infection of public health importance in Finland. We investigated the effect of ecologic factors on 2007–2017 TBE trends. We obtained domestic TBE case data from the National Infectious Diseases Register, weather data from the US National Oceanic and Atmospheric Administration, and data from the Natural Resources Institute in Finland on mammals killed by hunters yearly in game management areas. We performed a mixed-effects time-series analysis with time lags on weather and animal parameters, adding a random effect to game management areas. During 2007–2017, a total of 395/460 (86%) domestic TBE cases were reported with known place of exposure and date of sampling. Overall, TBE incidence increased yearly by 15%. After adjusting for the density of other animals and minimum temperatures, we found thatTBE incidence was positively associated with white-tailed deer density. Variation in host animal density should be considered when assessing TBE risks and designing interventions.

EID Dub T, Ollgren J, Huusko S, Uusitalo R, Siljander M, Vapalahti O, et al. Game Animal Density, Climate, and Tick-Borne Encephalitis in Finland, 2007–2017. Emerg Infect Dis. 2020;26(12):2899-2906. https://dx.doi.org/10.3201/eid2612.191282
AMA Dub T, Ollgren J, Huusko S, et al. Game Animal Density, Climate, and Tick-Borne Encephalitis in Finland, 2007–2017. Emerging Infectious Diseases. 2020;26(12):2899-2906. doi:10.3201/eid2612.191282.
APA Dub, T., Ollgren, J., Huusko, S., Uusitalo, R., Siljander, M., Vapalahti, O....Sane, J. (2020). Game Animal Density, Climate, and Tick-Borne Encephalitis in Finland, 2007–2017. Emerging Infectious Diseases, 26(12), 2899-2906. https://dx.doi.org/10.3201/eid2612.191282.

Trends in Population Dynamics of Escherichia coli Sequence Type 131, Calgary, Alberta, Canada, 2006–2016 [PDF - 710 KB - 9 pages]
G. Peirano et al.

Global expansion of antimicrobial drug–resistant Escherichia coli sequence type (ST) 131 is unrivaled among human bacteria. Understanding trends among ST131 clades will help with designing prevention strategies. We screened E. coli from blood samples (n = 1,784) obtained in Calgary, Alberta, Canada, during 2006, 2012, and 2016 by PCR for ST131 and positive samples (n = 344) underwent whole-genome sequencing. The incidence rate per 100,000 residents increased from 4.91 during 2006 to 12.35 during 2012 and 10.12 during 2016. ST131 belonged to clades A (10%), B (9%), and C (81%). Clades C1-nonM27 and B were common during 2006, and C2 containing blaCTX-M-15, C1-M27 containing blaCTX-M-27, and A were responsible for the increase of ST131 during 2012 and 2016. C2 was the most antimicrobial drug–resistant subclade and increased exponentially over time. Eradicating ST131, more specifically the C2 subclade, will lead to considerable public health benefits for persons in Calgary.

EID Peirano G, Lynch T, Matsumara Y, Nobrega D, Finn TJ, DeVinney R, et al. Trends in Population Dynamics of Escherichia coli Sequence Type 131, Calgary, Alberta, Canada, 2006–2016. Emerg Infect Dis. 2020;26(12):2907-2915. https://dx.doi.org/10.3201/eid2612.201221
AMA Peirano G, Lynch T, Matsumara Y, et al. Trends in Population Dynamics of Escherichia coli Sequence Type 131, Calgary, Alberta, Canada, 2006–2016. Emerging Infectious Diseases. 2020;26(12):2907-2915. doi:10.3201/eid2612.201221.
APA Peirano, G., Lynch, T., Matsumara, Y., Nobrega, D., Finn, T. J., DeVinney, R....Pitout, J. (2020). Trends in Population Dynamics of Escherichia coli Sequence Type 131, Calgary, Alberta, Canada, 2006–2016. Emerging Infectious Diseases, 26(12), 2907-2915. https://dx.doi.org/10.3201/eid2612.201221.

Outbreak of Haff Disease along the Yangtze River, Anhui Province, China, 2016 [PDF - 699 KB - 6 pages]
H. Ma et al.

We investigated a large outbreak of Haff disease that occurred along the Yangtze River in Anhui Province, China, in 2016. Of the 672 cases identified during the outbreak, 83.3% (560/672) occurred in Wuhu and Ma’anshan. Patients experienced myalgia (100%) and muscle weakness (54.7%). The mean value of myoglobin was 330 + 121.2 ng/mL and of serum creatine kinase 5,439.2 + 4,765.1 U/L. Eating crayfish was the only common exposure among all cases; 96.8% (240/248) of implicated crayfish were caught on the shores of the Yangtze River or its connected ditches. Mean incubation period was 6.2 + 3.8 hours. This case–control study demonstrated that eating the liver of crayfish and eating a large quantity of crayfish were associated with an increased risk for Haff disease. The seasonal increases in crayfish population along the Yangtze River might explain the seasonal outbreaks of Haff disease.

EID Ma H, Wu J, Qin W, Lin C, Li D, Zha B, et al. Outbreak of Haff Disease along the Yangtze River, Anhui Province, China, 2016. Emerg Infect Dis. 2020;26(12):2916-2921. https://dx.doi.org/10.3201/eid2612.191186
AMA Ma H, Wu J, Qin W, et al. Outbreak of Haff Disease along the Yangtze River, Anhui Province, China, 2016. Emerging Infectious Diseases. 2020;26(12):2916-2921. doi:10.3201/eid2612.191186.
APA Ma, H., Wu, J., Qin, W., Lin, C., Li, D., Zha, B....Li, Q. (2020). Outbreak of Haff Disease along the Yangtze River, Anhui Province, China, 2016. Emerging Infectious Diseases, 26(12), 2916-2921. https://dx.doi.org/10.3201/eid2612.191186.

Medscape CME Activity
Clinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil [PDF - 2.48 MB - 11 pages]
C. Brandão-de-Resende et al.

In 2015, an outbreak of presumed waterborne toxoplasmosis occurred in Gouveia, Brazil. We conducted a 3-year prospective study on a cohort of 52 patients from this outbreak, collected clinical and multimodal imaging findings, and determined risk factors for ocular involvement. At baseline examination, 12 (23%) patients had retinochoroiditis; 4 patients had bilateral and 2 had macular lesions. Multimodal imaging revealed 2 distinct retinochoroiditis patterns: necrotizing focal retinochoroiditis and punctate retinochoroiditis. Older age, worse visual acuity, self-reported recent reduction of visual acuity, and presence of floaters were associated with retinochoroiditis. Among patients, persons >40 years of age had 5 times the risk for ocular involvement. Five patients had recurrences during follow-up, a rate of 22% per person-year. Recurrences were associated with binocular involvement. Two patients had late ocular involvement that occurred >34 months after initial diagnosis. Patients with acquired toxoplasmosis should have long-term ophthalmic follow-up, regardless of initial ocular involvement.

EID Brandão-de-Resende C, Santos H, Rojas Lagos A, Lara C, Arruda J, Marino A, et al. Clinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil. Emerg Infect Dis. 2020;26(12):2922-2932. https://dx.doi.org/10.3201/eid2612.200227
AMA Brandão-de-Resende C, Santos H, Rojas Lagos A, et al. Clinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil. Emerging Infectious Diseases. 2020;26(12):2922-2932. doi:10.3201/eid2612.200227.
APA Brandão-de-Resende, C., Santos, H., Rojas Lagos, A., Lara, C., Arruda, J., Marino, A....Vasconcelos-Santos, D. (2020). Clinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil. Emerging Infectious Diseases, 26(12), 2922-2932. https://dx.doi.org/10.3201/eid2612.200227.

Human-Pathogenic Kasokero Virus in Field-Collected Ticks [PDF - 703 KB - 7 pages]
A. J. Schuh et al.

Kasokero virus (KASV; genus Orthonairovirus) was first isolated in 1977 at Uganda Virus Research Institute from serum collected from Rousettus aegyptiacus bats captured at Kasokero Cave, Uganda. During virus characterization studies at the institute, 4 laboratory-associated infections resulted in mild to severe disease. Although orthonairoviruses are typically associated with vertebrate and tick hosts, a tick vector of KASV never has been reported. We tested 786 Ornithodoros (Reticulinasus) faini tick pools (3,930 ticks) for KASV. The ticks were collected from a large R. aegyptiacus bat roosting site in western Uganda. We detected KASV RNA in 43 tick pools and recovered 2 infectious isolates, 1 of which was derived from host blood–depleted ticks. Our findings suggest that KASV is maintained in an enzootic transmission cycle involving O. (R.) faini ticks and R. aegyptiacus bats and has the potential for incidental virus spillover to humans.

EID Schuh AJ, Amman BR, Patel K, Sealy TK, Swanepoel R, Towner JS. Human-Pathogenic Kasokero Virus in Field-Collected Ticks. Emerg Infect Dis. 2020;26(12):2944-2950. https://dx.doi.org/10.3201/eid2612.202411
AMA Schuh AJ, Amman BR, Patel K, et al. Human-Pathogenic Kasokero Virus in Field-Collected Ticks. Emerging Infectious Diseases. 2020;26(12):2944-2950. doi:10.3201/eid2612.202411.
APA Schuh, A. J., Amman, B. R., Patel, K., Sealy, T. K., Swanepoel, R., & Towner, J. S. (2020). Human-Pathogenic Kasokero Virus in Field-Collected Ticks. Emerging Infectious Diseases, 26(12), 2944-2950. https://dx.doi.org/10.3201/eid2612.202411.

Medscape CME Activity
Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa [PDF - 2.13 MB - 11 pages]
A. M. Mandalakas et al.

HIV-infected children and adolescents are at increased risk for tuberculosis (TB). Antiretroviral therapy (ART) reduces TB risk in HIV-infected adults, but its effectiveness in HIV-infected children and adolescents is unknown. We analyzed data from 7 integrated pediatric HIV/TB centers in 6 countries in sub-Saharan Africa. We used a Bayesian mixed-effect model to assess association between ART and TB prevalence and used adaptive lasso regression to analyze risk factors for adverse TB outcomes. The study period encompassed 57,525 patient-years and 1,160 TB cases (2,017 cases/100,000 patient-years). Every 10% increase in ART uptake resulted in a 2.33% reduction in TB prevalence. Favorable TB outcomes were associated with increased time in care and early ART initiation, whereas severe immunosuppression was associated with death. These findings support integrated HIV/TB services for HIV-infected children and adults and demonstrate the association of ART uptake with decreased TB incidence in high HIV/TB settings.

EID Mandalakas AM, Kay AW, Bacha JM, Devezin T, Golin R, Simon KR, et al. Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa. Emerg Infect Dis. 2020;26(12):2933-2943. https://dx.doi.org/10.3201/eid2612.202245
AMA Mandalakas AM, Kay AW, Bacha JM, et al. Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa. Emerging Infectious Diseases. 2020;26(12):2933-2943. doi:10.3201/eid2612.202245.
APA Mandalakas, A. M., Kay, A. W., Bacha, J. M., Devezin, T., Golin, R., Simon, K. R....Schutze, G. E. (2020). Tuberculosis among Children and Adolescents at HIV Treatment Centers in Sub-Saharan Africa. Emerging Infectious Diseases, 26(12), 2933-2943. https://dx.doi.org/10.3201/eid2612.202245.
Dispatches

Characterization and Source Investigation of Multidrug-Resistant Salmonella Anatum from a Sustained Outbreak, Taiwan [PDF - 1.45 MB - 5 pages]
Y. Feng et al.

An ongoing outbreak of multidrug-resistant Salmonella enterica serovar Anatum began in Taiwan in 2015. Pork and poultry were identified as vehicles for transmission. Contaminated meat contributed to the high rate of infections among children. Nearly identical Salmonella Anatum strains have been identified in the United Kingdom, the United States, and the Philippines.

EID Feng Y, Chang Y, Pan S, Su L, Li H, Yang H, et al. Characterization and Source Investigation of Multidrug-Resistant Salmonella Anatum from a Sustained Outbreak, Taiwan. Emerg Infect Dis. 2020;26(12):2951-2955. https://dx.doi.org/10.3201/eid2612.200147
AMA Feng Y, Chang Y, Pan S, et al. Characterization and Source Investigation of Multidrug-Resistant Salmonella Anatum from a Sustained Outbreak, Taiwan. Emerging Infectious Diseases. 2020;26(12):2951-2955. doi:10.3201/eid2612.200147.
APA Feng, Y., Chang, Y., Pan, S., Su, L., Li, H., Yang, H....Chiu, C. (2020). Characterization and Source Investigation of Multidrug-Resistant Salmonella Anatum from a Sustained Outbreak, Taiwan. Emerging Infectious Diseases, 26(12), 2951-2955. https://dx.doi.org/10.3201/eid2612.200147.

Outbreaks of Highly Pathogenic Avian Influenza (H5N6) Virus Subclade 2.3.4.4h in Swans, Xinjiang, Western China, 2020 [PDF - 1.96 MB - 5 pages]
Y. Li et al.

In January 2020, the subclade 2.3.4.4h of highly pathogenic avian influenza (H5N6) virus infected migratory whooper swans and mute swans in Xinjiang, western China. The virus is lethal to chickens and ducks but has low pathogenicity in mice. Antigenically, this subclade is similar to the H5N1 vaccine seed virus Re-11.

EID Li Y, Li M, Li Y, Tian J, Bai X, Yang C, et al. Outbreaks of Highly Pathogenic Avian Influenza (H5N6) Virus Subclade 2.3.4.4h in Swans, Xinjiang, Western China, 2020. Emerg Infect Dis. 2020;26(12):2956-2960. https://dx.doi.org/10.3201/eid2612.201201
AMA Li Y, Li M, Li Y, et al. Outbreaks of Highly Pathogenic Avian Influenza (H5N6) Virus Subclade 2.3.4.4h in Swans, Xinjiang, Western China, 2020. Emerging Infectious Diseases. 2020;26(12):2956-2960. doi:10.3201/eid2612.201201.
APA Li, Y., Li, M., Li, Y., Tian, J., Bai, X., Yang, C....Chen, H. (2020). Outbreaks of Highly Pathogenic Avian Influenza (H5N6) Virus Subclade 2.3.4.4h in Swans, Xinjiang, Western China, 2020. Emerging Infectious Diseases, 26(12), 2956-2960. https://dx.doi.org/10.3201/eid2612.201201.

Differential Tropism of SARS-CoV and SARS-CoV-2 in Bat Cells [PDF - 1.87 MB - 5 pages]
S. Lau et al.

Severe acute respiratory syndrome coronavirus 2 did not replicate efficiently in 13 bat cell lines, whereas severe acute respiratory syndrome coronavirus replicated efficiently in kidney cells of its ancestral host, the Rhinolophus sinicus bat, suggesting different evolutionary origins. Structural modeling showed that RBD/RsACE2 binding may contribute to the differential cellular tropism.

EID Lau S, Wong A, Luk H, Li K, Fung J, He Z, et al. Differential Tropism of SARS-CoV and SARS-CoV-2 in Bat Cells. Emerg Infect Dis. 2020;26(12):2961-2965. https://dx.doi.org/10.3201/eid2612.202308
AMA Lau S, Wong A, Luk H, et al. Differential Tropism of SARS-CoV and SARS-CoV-2 in Bat Cells. Emerging Infectious Diseases. 2020;26(12):2961-2965. doi:10.3201/eid2612.202308.
APA Lau, S., Wong, A., Luk, H., Li, K., Fung, J., He, Z....Woo, P. (2020). Differential Tropism of SARS-CoV and SARS-CoV-2 in Bat Cells. Emerging Infectious Diseases, 26(12), 2961-2965. https://dx.doi.org/10.3201/eid2612.202308.

Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry, United States, 2020 [PDF - 1.31 MB - 4 pages]
S. Youk et al.

An outbreak of low-pathogenicity avian influenza A(H7N3) virus of North American wild bird lineage occurred on commercial turkey farms in North Carolina and South Carolina, USA, during March–April 2020. The virus mutated to the highly pathogenic form in 1 house on 1 farm via recombination with host 28S rRNA.

EID Youk S, Lee D, Killian ML, Pantin-Jackwood MJ, Swayne DE, Torchetti MK. Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry, United States, 2020. Emerg Infect Dis. 2020;26(12):2966-2969. https://dx.doi.org/10.3201/eid2612.202790
AMA Youk S, Lee D, Killian ML, et al. Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry, United States, 2020. Emerging Infectious Diseases. 2020;26(12):2966-2969. doi:10.3201/eid2612.202790.
APA Youk, S., Lee, D., Killian, M. L., Pantin-Jackwood, M. J., Swayne, D. E., & Torchetti, M. K. (2020). Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry, United States, 2020. Emerging Infectious Diseases, 26(12), 2966-2969. https://dx.doi.org/10.3201/eid2612.202790.

Sensitive Detection of SARS-CoV-2–Specific Antibodies in Dried Blood Spot Samples [PDF - 703 KB - 4 pages]
G. L. Morley et al.

Dried blood spot (DBS) samples can be used for the detection of severe acute respiratory syndrome coronavirus 2 spike antibodies. DBS sampling is comparable to matched serum samples with a relative 98.1% sensitivity and 100% specificity. Thus, DBS sampling offers an alternative for population-wide serologic testing in the coronavirus pandemic.

EID Morley GL, Taylor S, Jossi S, Perez-Toledo M, Faustini SE, Marcial-Juarez E, et al. Sensitive Detection of SARS-CoV-2–Specific Antibodies in Dried Blood Spot Samples. Emerg Infect Dis. 2020;26(12):2970-2973. https://dx.doi.org/10.3201/eid2612.203309
AMA Morley GL, Taylor S, Jossi S, et al. Sensitive Detection of SARS-CoV-2–Specific Antibodies in Dried Blood Spot Samples. Emerging Infectious Diseases. 2020;26(12):2970-2973. doi:10.3201/eid2612.203309.
APA Morley, G. L., Taylor, S., Jossi, S., Perez-Toledo, M., Faustini, S. E., Marcial-Juarez, E....O’Shea, M. K. (2020). Sensitive Detection of SARS-CoV-2–Specific Antibodies in Dried Blood Spot Samples. Emerging Infectious Diseases, 26(12), 2970-2973. https://dx.doi.org/10.3201/eid2612.203309.

Antibody Profiles According to Mild or Severe SARS-CoV-2 Infection, Atlanta, Georgia, USA, 2020 [PDF - 1.05 MB - 5 pages]
W. T. Hu et al.

Among patients with coronavirus disease (COVID-19), IgM levels increased early after symptom onset for those with mild and severe disease, but IgG levels increased early only in those with severe disease. A similar pattern was observed in a separate serosurveillance cohort. Mild COVID-19 should be investigated separately from severe COVID-19.

EID Hu WT, Howell J, Ozturk T, Benameur K, Bassit LC, Ramonell R, et al. Antibody Profiles According to Mild or Severe SARS-CoV-2 Infection, Atlanta, Georgia, USA, 2020. Emerg Infect Dis. 2020;26(12):2974-2978. https://dx.doi.org/10.3201/eid2612.203334
AMA Hu WT, Howell J, Ozturk T, et al. Antibody Profiles According to Mild or Severe SARS-CoV-2 Infection, Atlanta, Georgia, USA, 2020. Emerging Infectious Diseases. 2020;26(12):2974-2978. doi:10.3201/eid2612.203334.
APA Hu, W. T., Howell, J., Ozturk, T., Benameur, K., Bassit, L. C., Ramonell, R....Schinazi, R. F. (2020). Antibody Profiles According to Mild or Severe SARS-CoV-2 Infection, Atlanta, Georgia, USA, 2020. Emerging Infectious Diseases, 26(12), 2974-2978. https://dx.doi.org/10.3201/eid2612.203334.

Experimental Infection of Cattle with SARS-CoV-2 [PDF - 600 KB - 3 pages]
L. Ulrich et al.

We inoculated 6 cattle with severe acute respiratory syndrome coronavirus 2 and kept them together with 3 uninoculated cattle. We observed viral replication and specific seroreactivity in 2 inoculated animals, despite high levels of preexisting antibody titers against a bovine betacoronavirus. The in-contact animals did not become infected.

EID Ulrich L, Wernike K, Hoffmann D, Mettenleiter TC, Beer M. Experimental Infection of Cattle with SARS-CoV-2. Emerg Infect Dis. 2020;26(12):2979-2981. https://dx.doi.org/10.3201/eid2612.203799
AMA Ulrich L, Wernike K, Hoffmann D, et al. Experimental Infection of Cattle with SARS-CoV-2. Emerging Infectious Diseases. 2020;26(12):2979-2981. doi:10.3201/eid2612.203799.
APA Ulrich, L., Wernike, K., Hoffmann, D., Mettenleiter, T. C., & Beer, M. (2020). Experimental Infection of Cattle with SARS-CoV-2. Emerging Infectious Diseases, 26(12), 2979-2981. https://dx.doi.org/10.3201/eid2612.203799.

Susceptibility of Raccoon Dogs for Experimental SARS-CoV-2 Infection [PDF - 1.30 MB - 4 pages]
C. M. Freuling et al.

Raccoon dogs might have been intermediate hosts for severe acute respiratory syndrome–associated coronavirus in 2002–2004. We demonstrated susceptibility of raccoon dogs to severe acute respiratory syndrome coronavirus 2 infection and transmission to in-contact animals. Infected animals had no signs of illness. Virus replication and tissue lesions occurred in the nasal conchae.

EID Freuling CM, Breithaupt A, Müller T, Sehl J, Balkema-Buschmann A, Rissmann M, et al. Susceptibility of Raccoon Dogs for Experimental SARS-CoV-2 Infection. Emerg Infect Dis. 2020;26(12):2982-2985. https://dx.doi.org/10.3201/eid2612.203733
AMA Freuling CM, Breithaupt A, Müller T, et al. Susceptibility of Raccoon Dogs for Experimental SARS-CoV-2 Infection. Emerging Infectious Diseases. 2020;26(12):2982-2985. doi:10.3201/eid2612.203733.
APA Freuling, C. M., Breithaupt, A., Müller, T., Sehl, J., Balkema-Buschmann, A., Rissmann, M....Mettenleiter, T. C. (2020). Susceptibility of Raccoon Dogs for Experimental SARS-CoV-2 Infection. Emerging Infectious Diseases, 26(12), 2982-2985. https://dx.doi.org/10.3201/eid2612.203733.

Zoonotic Pathogens in Ticks from Migratory Birds, Italy [PDF - 323 KB - 3 pages]
E. Battisti et al.

Migratory birds can transport infected ticks across continents. We evaluated pathogens in ticks collected from migratory birds in Italy. We found DNA from Rickettsia aeschlimannii, R. africae, and R. raoultii bacteria, all of which can cause disease in humans. Bird migrations might facilitate the spread of these pathogens into new areas.

EID Battisti E, Urach K, Hodžić A, Fusani L, Hufnagl P, Felsberger G, et al. Zoonotic Pathogens in Ticks from Migratory Birds, Italy. Emerg Infect Dis. 2020;26(12):2986-2988. https://dx.doi.org/10.3201/eid2612.181686
AMA Battisti E, Urach K, Hodžić A, et al. Zoonotic Pathogens in Ticks from Migratory Birds, Italy. Emerging Infectious Diseases. 2020;26(12):2986-2988. doi:10.3201/eid2612.181686.
APA Battisti, E., Urach, K., Hodžić, A., Fusani, L., Hufnagl, P., Felsberger, G....Duscher, G. (2020). Zoonotic Pathogens in Ticks from Migratory Birds, Italy. Emerging Infectious Diseases, 26(12), 2986-2988. https://dx.doi.org/10.3201/eid2612.181686.

Coyotes as Reservoirs for Onchocerca lupi, United States, 2015–2018 [PDF - 1.97 MB - 5 pages]
C. C. Roe et al.

The Onchocerca lupi nematode infects dogs, cats, and humans, but whether it can be spread by coyotes has been unknown. We conducted surveillance for O. lupi nematode infection in coyotes in the southwestern United States. We identified multiple coyote populations in Arizona and New Mexico as probable reservoirs for this species.

EID Roe CC, Yaglom H, Howard A, Urbanz J, Verocai GG, Andrews L, et al. Coyotes as Reservoirs for Onchocerca lupi, United States, 2015–2018. Emerg Infect Dis. 2020;26(12):2989-2993. https://dx.doi.org/10.3201/eid2612.190136
AMA Roe CC, Yaglom H, Howard A, et al. Coyotes as Reservoirs for Onchocerca lupi, United States, 2015–2018. Emerging Infectious Diseases. 2020;26(12):2989-2993. doi:10.3201/eid2612.190136.
APA Roe, C. C., Yaglom, H., Howard, A., Urbanz, J., Verocai, G. G., Andrews, L....Engelthaler, D. M. (2020). Coyotes as Reservoirs for Onchocerca lupi, United States, 2015–2018. Emerging Infectious Diseases, 26(12), 2989-2993. https://dx.doi.org/10.3201/eid2612.190136.

Direct Transmission of Severe Fever with Thrombocytopenia Syndrome Virus from Domestic Cat to Veterinary Personnel [PDF - 1.73 MB - 5 pages]
A. Yamanaka et al.

Two veterinary personnel in Japan were infected with severe fever with thrombocytopenia syndrome virus (SFTSV) while handling a sick cat. Whole-genome sequences of SFTSV isolated from the personnel and the cat were 100% identical. These results identified a nosocomial outbreak of SFTSV infection in an animal hospital without a tick as a vector.

EID Yamanaka A, Kirino Y, Fujimoto S, Ueda N, Himeji D, Miura M, et al. Direct Transmission of Severe Fever with Thrombocytopenia Syndrome Virus from Domestic Cat to Veterinary Personnel. Emerg Infect Dis. 2020;26(12):2994-2998. https://dx.doi.org/10.3201/eid2612.191513
AMA Yamanaka A, Kirino Y, Fujimoto S, et al. Direct Transmission of Severe Fever with Thrombocytopenia Syndrome Virus from Domestic Cat to Veterinary Personnel. Emerging Infectious Diseases. 2020;26(12):2994-2998. doi:10.3201/eid2612.191513.
APA Yamanaka, A., Kirino, Y., Fujimoto, S., Ueda, N., Himeji, D., Miura, M....Okabayashi, T. (2020). Direct Transmission of Severe Fever with Thrombocytopenia Syndrome Virus from Domestic Cat to Veterinary Personnel. Emerging Infectious Diseases, 26(12), 2994-2998. https://dx.doi.org/10.3201/eid2612.191513.

Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient [PDF - 897 KB - 3 pages]
M. Mustafa-Hellou et al.

We report a case of Kingella kingae endovascular infection in an immunocompromised elderly patient in Israel who had culture-negative septic arthritis. This case highlights potential sources of metastatic infection other than infective endocarditis, and emphasizes the need for molecular diagnostic methods in detection of pathogens in culture-negative septic arthritis in immunocompromised patients.

EID Mustafa-Hellou M, Sagi N, Ofran Y, Geffen Y, Ghanem-Zoubi N. Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient. Emerg Infect Dis. 2020;26(12):2999-3001. https://dx.doi.org/10.3201/eid2612.191665
AMA Mustafa-Hellou M, Sagi N, Ofran Y, et al. Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient. Emerging Infectious Diseases. 2020;26(12):2999-3001. doi:10.3201/eid2612.191665.
APA Mustafa-Hellou, M., Sagi, N., Ofran, Y., Geffen, Y., & Ghanem-Zoubi, N. (2020). Endovascular Infection with Kingella kingae Complicated by Septic Arthritis in Immunocompromised Adult Patient. Emerging Infectious Diseases, 26(12), 2999-3001. https://dx.doi.org/10.3201/eid2612.191665.

Lymphocytic Choriomeningitis Virus Infections and Seroprevalence, Southern Iraq [PDF - 2.40 MB - 5 pages]
H. Alburkat et al.

Acute febrile neurological infection cases in southern Iraq (N = 212) were screened for lymphocytic choriomeningitis virus (LCMV). Two LCMV IgM–positive serum samples and 2 cerebrospinal fluid samples with phylogenetically distinct LCMV strains were found. The overall LCMV seroprevalence was 8.8%. LCMV infections are common and associated with acute neurological disease in Iraq.

EID Alburkat H, Jääskeläinen AJ, Barakat AM, Hasony HJ, Sironen T, Al-hello H, et al. Lymphocytic Choriomeningitis Virus Infections and Seroprevalence, Southern Iraq. Emerg Infect Dis. 2020;26(12):3002-3006. https://dx.doi.org/10.3201/eid2612.201792
AMA Alburkat H, Jääskeläinen AJ, Barakat AM, et al. Lymphocytic Choriomeningitis Virus Infections and Seroprevalence, Southern Iraq. Emerging Infectious Diseases. 2020;26(12):3002-3006. doi:10.3201/eid2612.201792.
APA Alburkat, H., Jääskeläinen, A. J., Barakat, A. M., Hasony, H. J., Sironen, T., Al-hello, H....Vapalahti, O. (2020). Lymphocytic Choriomeningitis Virus Infections and Seroprevalence, Southern Iraq. Emerging Infectious Diseases, 26(12), 3002-3006. https://dx.doi.org/10.3201/eid2612.201792.

Range Expansion of Bombali Virus in Mops condylurus Bats, Kenya, 2019 [PDF - 787 KB - 4 pages]
L. Kareinen et al.

Previously identified only in Sierra Leone, Guinea, and southeastern Kenya, Bombali virus–infected Mops condylurus bats were recently found »750 km away in western Kenya. This finding supports the role of M. condylurus bats as hosts and the potential for Bombali virus circulation across the bats’ range in sub-Saharan Africa.

EID Kareinen L, Ogola J, Kivistö I, Smura T, Aaltonen K, Jääskeläinen AJ, et al. Range Expansion of Bombali Virus in Mops condylurus Bats, Kenya, 2019. Emerg Infect Dis. 2020;26(12):3007-3010. https://dx.doi.org/10.3201/eid2612.202925
AMA Kareinen L, Ogola J, Kivistö I, et al. Range Expansion of Bombali Virus in Mops condylurus Bats, Kenya, 2019. Emerging Infectious Diseases. 2020;26(12):3007-3010. doi:10.3201/eid2612.202925.
APA Kareinen, L., Ogola, J., Kivistö, I., Smura, T., Aaltonen, K., Jääskeläinen, A. J....Sironen, T. (2020). Range Expansion of Bombali Virus in Mops condylurus Bats, Kenya, 2019. Emerging Infectious Diseases, 26(12), 3007-3010. https://dx.doi.org/10.3201/eid2612.202925.

Novel Rickettsia Species Infecting Dogs, United States [PDF - 824 KB - 5 pages]
J. M. Wilson et al.

In 2018 and 2019, spotted fever was suspected in 3 dogs in 3 US states. The dogs had fever and hematological abnormalities; blood samples were Rickettsia seroreactive. Identical Rickettsia DNA sequences were amplified from the samples. Multilocus phylogenetic analysis showed the dogs were infected with a novel Rickettsia species related to human Rickettsia pathogens.

EID Wilson JM, Breitschwerdt EB, Juhasz NB, Marr HS, de Brito Galvão J, Pratt CL, et al. Novel Rickettsia Species Infecting Dogs, United States. Emerg Infect Dis. 2020;26(12):3011-3015. https://dx.doi.org/10.3201/eid2612.200272
AMA Wilson JM, Breitschwerdt EB, Juhasz NB, et al. Novel Rickettsia Species Infecting Dogs, United States. Emerging Infectious Diseases. 2020;26(12):3011-3015. doi:10.3201/eid2612.200272.
APA Wilson, J. M., Breitschwerdt, E. B., Juhasz, N. B., Marr, H. S., de Brito Galvão, J., Pratt, C. L....Qurollo, B. A. (2020). Novel Rickettsia Species Infecting Dogs, United States. Emerging Infectious Diseases, 26(12), 3011-3015. https://dx.doi.org/10.3201/eid2612.200272.

Human Monocytic Ehrlichiosis, Mexico City, Mexico [PDF - 902 KB - 4 pages]
V. E. Alcántara-Rodríguez et al.

Little information is available about human infections by the members of the genus Ehrlichia in Mexico. Only 2 species, Ehrlichia canis and E. chaffensis, are known to cause disease in this country. We report a fatal case of human monocytic ehrlichiosis in Mexico City in a man who was homeless.

EID Alcántara-Rodríguez VE, Sánchez-Montes S, Contreras H, Colunga-Salas P, Fierro-Flores L, Avalos S, et al. Human Monocytic Ehrlichiosis, Mexico City, Mexico. Emerg Infect Dis. 2020;26(12):3016-3019. https://dx.doi.org/10.3201/eid2612.200520
AMA Alcántara-Rodríguez VE, Sánchez-Montes S, Contreras H, et al. Human Monocytic Ehrlichiosis, Mexico City, Mexico. Emerging Infectious Diseases. 2020;26(12):3016-3019. doi:10.3201/eid2612.200520.
APA Alcántara-Rodríguez, V. E., Sánchez-Montes, S., Contreras, H., Colunga-Salas, P., Fierro-Flores, L., Avalos, S....Walker, D. H. (2020). Human Monocytic Ehrlichiosis, Mexico City, Mexico. Emerging Infectious Diseases, 26(12), 3016-3019. https://dx.doi.org/10.3201/eid2612.200520.

Hantavirus Cardiopulmonary Syndrome in Canada [PDF - 1.74 MB - 5 pages]
B. M. Warner et al.

Hantavirus cardiopulmonary syndrome (HCPS) is a severe respiratory disease caused by Sin Nombre virus in North America (SNV). As of January 1, 2020, SNV has caused 143 laboratory-confirmed cases of HCPS in Canada. We review critical aspects of SNV virus epidemiology and the ecology, biology, and genetics of HCPS in Canada.

EID Warner BM, Dowhanik S, Audet J, Grolla A, Dick D, Strong JE, et al. Hantavirus Cardiopulmonary Syndrome in Canada. Emerg Infect Dis. 2020;26(12):3020-3024. https://dx.doi.org/10.3201/eid2612.202808
AMA Warner BM, Dowhanik S, Audet J, et al. Hantavirus Cardiopulmonary Syndrome in Canada. Emerging Infectious Diseases. 2020;26(12):3020-3024. doi:10.3201/eid2612.202808.
APA Warner, B. M., Dowhanik, S., Audet, J., Grolla, A., Dick, D., Strong, J. E....Safronetz, D. (2020). Hantavirus Cardiopulmonary Syndrome in Canada. Emerging Infectious Diseases, 26(12), 3020-3024. https://dx.doi.org/10.3201/eid2612.202808.

Detection and Characterization of Bat Sarbecovirus Phylogenetically Related to SARS-CoV-2, Japan [PDF - 3.18 MB - 5 pages]
S. Murakami et al.

Epidemiology of bat Betacoronavirus, subgenus Sarbecovirus is largely unknown, especially outside China. We detected a sarbecovirus phylogenetically related to severe acute respiratory syndrome coronavirus 2 from Rhinolophus cornutus bats in Japan. The sarbecovirus’ spike protein specifically recognizes angiotensin-converting enzyme 2 of R. cornutus, but not humans, as an entry receptor.

EID Murakami S, Kitamura T, Suzuki J, Sato R, Aoi T, Fujii M, et al. Detection and Characterization of Bat Sarbecovirus Phylogenetically Related to SARS-CoV-2, Japan. Emerg Infect Dis. 2020;26(12):3025-3029. https://dx.doi.org/10.3201/eid2612.203386
AMA Murakami S, Kitamura T, Suzuki J, et al. Detection and Characterization of Bat Sarbecovirus Phylogenetically Related to SARS-CoV-2, Japan. Emerging Infectious Diseases. 2020;26(12):3025-3029. doi:10.3201/eid2612.203386.
APA Murakami, S., Kitamura, T., Suzuki, J., Sato, R., Aoi, T., Fujii, M....Horimoto, T. (2020). Detection and Characterization of Bat Sarbecovirus Phylogenetically Related to SARS-CoV-2, Japan. Emerging Infectious Diseases, 26(12), 3025-3029. https://dx.doi.org/10.3201/eid2612.203386.

Unique Outbreak of Rift Valley Fever in Sudan, 2019 [PDF - 1016 KB - 4 pages]
A. Ahmed et al.

We report a unique outbreak of Rift Valley fever in the Eldamar area, Sudan, May–July 2019, that resulted in 1,129 case-patients and 19 (1.7%) deaths. Patients exhibited clinical signs including fever (100%), headache (79%), and bleeding (4%). Most (98%) patients also reported death and abortions among their livestock.

EID Ahmed A, Ali Y, Elduma A, Eldigail M, Mhmoud R, Mohamed N, et al. Unique Outbreak of Rift Valley Fever in Sudan, 2019. Emerg Infect Dis. 2020;26(12):3030-3033. https://dx.doi.org/10.3201/eid2612.201599
AMA Ahmed A, Ali Y, Elduma A, et al. Unique Outbreak of Rift Valley Fever in Sudan, 2019. Emerging Infectious Diseases. 2020;26(12):3030-3033. doi:10.3201/eid2612.201599.
APA Ahmed, A., Ali, Y., Elduma, A., Eldigail, M., Mhmoud, R., Mohamed, N....Weaver, S. C. (2020). Unique Outbreak of Rift Valley Fever in Sudan, 2019. Emerging Infectious Diseases, 26(12), 3030-3033. https://dx.doi.org/10.3201/eid2612.201599.

Transmission of Multidrug-Resistant Salmonella enterica Subspecies enterica 4,[5],12:i:- Sequence Type 34 between Europe and the United States [PDF - 2.07 MB - 5 pages]
E. Elnekave et al.

Multidrug-resistant Salmonella enterica subspecies enterica 4,[5],12:i:- sequence type 34 represents a worldwide public health risk. To determine its origin in the United States, we reconstructed a time-scaled phylogeny with a discrete trait geospatial model. The clone in the United States was introduced from Europe on multiple occasions in the early 2000s.

EID Elnekave E, Hong SL, Lim S, Boxrud D, Rovira A, Mather AE, et al. Transmission of Multidrug-Resistant Salmonella enterica Subspecies enterica 4,[5],12:i:- Sequence Type 34 between Europe and the United States. Emerg Infect Dis. 2020;26(12):3034-3038. https://dx.doi.org/10.3201/eid2612.200336
AMA Elnekave E, Hong SL, Lim S, et al. Transmission of Multidrug-Resistant Salmonella enterica Subspecies enterica 4,[5],12:i:- Sequence Type 34 between Europe and the United States. Emerging Infectious Diseases. 2020;26(12):3034-3038. doi:10.3201/eid2612.200336.
APA Elnekave, E., Hong, S. L., Lim, S., Boxrud, D., Rovira, A., Mather, A. E....Alvarez, J. (2020). Transmission of Multidrug-Resistant Salmonella enterica Subspecies enterica 4,[5],12:i:- Sequence Type 34 between Europe and the United States. Emerging Infectious Diseases, 26(12), 3034-3038. https://dx.doi.org/10.3201/eid2612.200336.

Hypervirulent Klebsiella pneumoniae as Unexpected Cause of Fatal Outbreak in Captive Marmosets, Brazil [PDF - 2.58 MB - 5 pages]
J. Guerra et al.

After the sudden death of captive marmosets in São Paulo, Brazil, we conducted a histologic and microbiologic study. We found hyperacute septicemia caused by hypermucoviscous sequence type 86 K2 Klebsiella pneumoniae. We implemented prophylactic antimicrobial therapy, selected dedicated staff for marmoset interactions, and sanitized the animals’ fruit to successfully control this outbreak.

EID Guerra J, Fernandes NA, Morales dos Santos A, Barrel J, Petri B, Milanelo L, et al. Hypervirulent Klebsiella pneumoniae as Unexpected Cause of Fatal Outbreak in Captive Marmosets, Brazil. Emerg Infect Dis. 2020;26(12):3039-3043. https://dx.doi.org/10.3201/eid2612.191562
AMA Guerra J, Fernandes NA, Morales dos Santos A, et al. Hypervirulent Klebsiella pneumoniae as Unexpected Cause of Fatal Outbreak in Captive Marmosets, Brazil. Emerging Infectious Diseases. 2020;26(12):3039-3043. doi:10.3201/eid2612.191562.
APA Guerra, J., Fernandes, N. A., Morales dos Santos, A., Barrel, J., Petri, B., Milanelo, L....Camargo, C. (2020). Hypervirulent Klebsiella pneumoniae as Unexpected Cause of Fatal Outbreak in Captive Marmosets, Brazil. Emerging Infectious Diseases, 26(12), 3039-3043. https://dx.doi.org/10.3201/eid2612.191562.

Identification of a Novel α-herpesvirus Associated with Ulcerative Stomatitis in Donkeys [PDF - 1.78 MB - 4 pages]
V. Martella et al.

An outbreak of ulcerative stomatitis was observed in a donkey (Equus asinus) dairy herd. Similar lesions were also observed on the dams’ udders and, sporadically, in genital areas. The lesions typically resolved in 1–3 weeks. An α-herpesvirus, Varicellovirus, genetically related to equid herpesvirus type 3, was identified.

EID Martella V, Lanave G, Camero M, Larocca V, Lorusso E, Catella C, et al. Identification of a Novel α-herpesvirus Associated with Ulcerative Stomatitis in Donkeys. Emerg Infect Dis. 2020;26(12):3044-3047. https://dx.doi.org/10.3201/eid2612.200201
AMA Martella V, Lanave G, Camero M, et al. Identification of a Novel α-herpesvirus Associated with Ulcerative Stomatitis in Donkeys. Emerging Infectious Diseases. 2020;26(12):3044-3047. doi:10.3201/eid2612.200201.
APA Martella, V., Lanave, G., Camero, M., Larocca, V., Lorusso, E., Catella, C....Buonavoglia, C. (2020). Identification of a Novel α-herpesvirus Associated with Ulcerative Stomatitis in Donkeys. Emerging Infectious Diseases, 26(12), 3044-3047. https://dx.doi.org/10.3201/eid2612.200201.

Human Rickettsiosis Caused by Rickettsia parkeri Strain Atlantic Rainforest, Urabá, Colombia [PDF - 794 KB - 3 pages]
M. Arboleda et al.

We describe the clinical, serologic, and molecular findings of a new human rickettsiosis in Colombia. Antibodies against Rickettsia spp. were detected. PCR showed amplification of genes for R. parkeri strain Atlantic Rainforest. This new rickettsiosis of minor virulence could explain some of the undifferentiated acute febrile diseases in Colombia.

EID Arboleda M, Acevedo-Gutiérrez LY, Ávila A, Ospina D, Díaz FJ, Walker DH, et al. Human Rickettsiosis Caused by Rickettsia parkeri Strain Atlantic Rainforest, Urabá, Colombia. Emerg Infect Dis. 2020;26(12):3048-3050. https://dx.doi.org/10.3201/eid2612.200388
AMA Arboleda M, Acevedo-Gutiérrez LY, Ávila A, et al. Human Rickettsiosis Caused by Rickettsia parkeri Strain Atlantic Rainforest, Urabá, Colombia. Emerging Infectious Diseases. 2020;26(12):3048-3050. doi:10.3201/eid2612.200388.
APA Arboleda, M., Acevedo-Gutiérrez, L. Y., Ávila, A., Ospina, D., Díaz, F. J., Walker, D. H....Rodas, J. D. (2020). Human Rickettsiosis Caused by Rickettsia parkeri Strain Atlantic Rainforest, Urabá, Colombia. Emerging Infectious Diseases, 26(12), 3048-3050. https://dx.doi.org/10.3201/eid2612.200388.

Shedding of Marburg Virus in Naturally Infected Egyptian Rousette Bats, South Africa, 2017 [PDF - 927 KB - 5 pages]
J. T. Pawęska et al.

We detected Marburg virus RNA in rectal swab samples from Egyptian rousette bats in South Africa in 2017. This finding signifies that fecal contamination of natural bat habitats is a potential source of infection for humans. Identified genetic sequences are closely related to Ravn virus, implying wider distribution of Marburg virus in Africa.

EID Pawęska JT, Storm N, Markotter W, Di Paola N, Wiley MR, Palacios G, et al. Shedding of Marburg Virus in Naturally Infected Egyptian Rousette Bats, South Africa, 2017. Emerg Infect Dis. 2020;26(12):3051-3055. https://dx.doi.org/10.3201/eid2612.202108
AMA Pawęska JT, Storm N, Markotter W, et al. Shedding of Marburg Virus in Naturally Infected Egyptian Rousette Bats, South Africa, 2017. Emerging Infectious Diseases. 2020;26(12):3051-3055. doi:10.3201/eid2612.202108.
APA Pawęska, J. T., Storm, N., Markotter, W., Di Paola, N., Wiley, M. R., Palacios, G....Jansen van Vuren, P. (2020). Shedding of Marburg Virus in Naturally Infected Egyptian Rousette Bats, South Africa, 2017. Emerging Infectious Diseases, 26(12), 3051-3055. https://dx.doi.org/10.3201/eid2612.202108.

Lyssaviruses in Insectivorous Bats, South Africa, 2003–2018 [PDF - 1.07 MB - 5 pages]
J. Coertse et al.

We detected 3 lyssaviruses in insectivorous bats sampled in South Africa during 2003–2018. We used phylogenetic analysis to identify Duvenhage lyssavirus and a potentially new lyssavirus, provisionally named Matlo bat lyssavirus, that is related to West Caucasian bat virus. These new detections highlight that much about lyssaviruses remains unknown.

EID Coertse J, Grobler CS, Sabeta CT, Seamark E, Kearney T, Paweska JT, et al. Lyssaviruses in Insectivorous Bats, South Africa, 2003–2018. Emerg Infect Dis. 2020;26(12):3056-3060. https://dx.doi.org/10.3201/eid2612.203592
AMA Coertse J, Grobler CS, Sabeta CT, et al. Lyssaviruses in Insectivorous Bats, South Africa, 2003–2018. Emerging Infectious Diseases. 2020;26(12):3056-3060. doi:10.3201/eid2612.203592.
APA Coertse, J., Grobler, C. S., Sabeta, C. T., Seamark, E., Kearney, T., Paweska, J. T....Markotter, W. (2020). Lyssaviruses in Insectivorous Bats, South Africa, 2003–2018. Emerging Infectious Diseases, 26(12), 3056-3060. https://dx.doi.org/10.3201/eid2612.203592.

Circulation of 2 Barmah Forest Virus Lineages in Military Training Areas, Australia [PDF - 1.00 MB - 5 pages]
W. Liu et al.

During 2017–2018, Barmah Forest virus was recovered from mosquitoes trapped in military training areas in Australia and from a soldier infected at 1 of these areas. Phylogenies of the nucleotide sequences of the envelope glycoprotein gene E2 and the 3′ untranslated region suggest that 2 lineages are circulating in eastern Australia.

EID Liu W, Kizu JR, Matley DR, Grant R, McCallum FJ, Moller CG, et al. Circulation of 2 Barmah Forest Virus Lineages in Military Training Areas, Australia. Emerg Infect Dis. 2020;26(12):3061-3065. https://dx.doi.org/10.3201/eid2612.191747
AMA Liu W, Kizu JR, Matley DR, et al. Circulation of 2 Barmah Forest Virus Lineages in Military Training Areas, Australia. Emerging Infectious Diseases. 2020;26(12):3061-3065. doi:10.3201/eid2612.191747.
APA Liu, W., Kizu, J. R., Matley, D. R., Grant, R., McCallum, F. J., Moller, C. G....Aaskov, J. G. (2020). Circulation of 2 Barmah Forest Virus Lineages in Military Training Areas, Australia. Emerging Infectious Diseases, 26(12), 3061-3065. https://dx.doi.org/10.3201/eid2612.191747.
Research Letters

Effects of Cocooning on Coronavirus Disease Rates after Relaxing Social Distancing [PDF - 493 KB - 3 pages]
X. Wang et al.

As coronavirus disease spreads throughout the United States, policymakers are contemplating reinstatement and relaxation of shelter-in-place orders. By using a model capturing high-risk populations and transmission rates estimated from hospitalization data, we found that postponing relaxation will only delay future disease waves. Cocooning vulnerable populations can prevent overwhelming medical surges.

EID Wang X, Du Z, Huang G, Pasco RF, Fox SJ, Galvani AP, et al. Effects of Cocooning on Coronavirus Disease Rates after Relaxing Social Distancing. Emerg Infect Dis. 2020;26(12):3066-3068. https://dx.doi.org/10.3201/eid2612.201930
AMA Wang X, Du Z, Huang G, et al. Effects of Cocooning on Coronavirus Disease Rates after Relaxing Social Distancing. Emerging Infectious Diseases. 2020;26(12):3066-3068. doi:10.3201/eid2612.201930.
APA Wang, X., Du, Z., Huang, G., Pasco, R. F., Fox, S. J., Galvani, A. P....Meyers, L. (2020). Effects of Cocooning on Coronavirus Disease Rates after Relaxing Social Distancing. Emerging Infectious Diseases, 26(12), 3066-3068. https://dx.doi.org/10.3201/eid2612.201930.

SARS-CoV-2 Natural Transmission from Human to Cat, Belgium, March 2020 [PDF - 1.15 MB - 3 pages]
M. Garigliany et al.

In March 2020, a severe respiratory syndrome developed in a cat, 1 week after its owner received positive test results for severe acute respiratory syndrome coronavirus 2. Viral RNA was detected in the cat’s nasopharyngeal swab samples and vomitus or feces; immunoglobulin against the virus was found in convalescent-phase serum. Human-to-cat transmission is suspected.

EID Garigliany M, Van Laere A, Clercx C, Giet D, Escriou N, Huon C, et al. SARS-CoV-2 Natural Transmission from Human to Cat, Belgium, March 2020. Emerg Infect Dis. 2020;26(12):3069-3071. https://dx.doi.org/10.3201/eid2612.202223
AMA Garigliany M, Van Laere A, Clercx C, et al. SARS-CoV-2 Natural Transmission from Human to Cat, Belgium, March 2020. Emerging Infectious Diseases. 2020;26(12):3069-3071. doi:10.3201/eid2612.202223.
APA Garigliany, M., Van Laere, A., Clercx, C., Giet, D., Escriou, N., Huon, C....Desmecht, D. (2020). SARS-CoV-2 Natural Transmission from Human to Cat, Belgium, March 2020. Emerging Infectious Diseases, 26(12), 3069-3071. https://dx.doi.org/10.3201/eid2612.202223.

SARS-CoV-2 in Quarantined Domestic Cats from COVID-19 Households or Close Contacts, Hong Kong, China [PDF - 1.02 MB - 4 pages]
V. R. Barrs et al.

We tested 50 cats from coronavirus disease households or close contacts in Hong Kong, China, for severe acute respiratory syndrome coronavirus 2 RNA in respiratory and fecal samples. We found 6 cases of apparent human-to-feline transmission involving healthy cats. Virus genomes sequenced from 1 cat and its owner were identical.

EID Barrs VR, Peiris M, Tam K, Law P, Brackman CJ, To E, et al. SARS-CoV-2 in Quarantined Domestic Cats from COVID-19 Households or Close Contacts, Hong Kong, China. Emerg Infect Dis. 2020;26(12):3071-3074. https://dx.doi.org/10.3201/eid2612.202786
AMA Barrs VR, Peiris M, Tam K, et al. SARS-CoV-2 in Quarantined Domestic Cats from COVID-19 Households or Close Contacts, Hong Kong, China. Emerging Infectious Diseases. 2020;26(12):3071-3074. doi:10.3201/eid2612.202786.
APA Barrs, V. R., Peiris, M., Tam, K., Law, P., Brackman, C. J., To, E....Sit, T. (2020). SARS-CoV-2 in Quarantined Domestic Cats from COVID-19 Households or Close Contacts, Hong Kong, China. Emerging Infectious Diseases, 26(12), 3071-3074. https://dx.doi.org/10.3201/eid2612.202786.

Lack of Susceptibility to SARS-CoV-2 and MERS-CoV in Poultry [PDF - 290 KB - 3 pages]
D. L. Suarez et al.

We challenged chickens, turkeys, ducks, quail, and geese with severe acute respiratory syndrome coronavirus 2 or Middle East respiratory syndrome coronavirus. We observed no disease and detected no virus replication and no serum antibodies. We concluded that poultry are unlikely to serve a role in maintenance of either virus.

EID Suarez DL, Pantin-Jackwood MJ, Swayne DE, Lee SA, DeBlois SM, Spackman E. Lack of Susceptibility to SARS-CoV-2 and MERS-CoV in Poultry. Emerg Infect Dis. 2020;26(12):3074-3076. https://dx.doi.org/10.3201/eid2612.202989
AMA Suarez DL, Pantin-Jackwood MJ, Swayne DE, et al. Lack of Susceptibility to SARS-CoV-2 and MERS-CoV in Poultry. Emerging Infectious Diseases. 2020;26(12):3074-3076. doi:10.3201/eid2612.202989.
APA Suarez, D. L., Pantin-Jackwood, M. J., Swayne, D. E., Lee, S. A., DeBlois, S. M., & Spackman, E. (2020). Lack of Susceptibility to SARS-CoV-2 and MERS-CoV in Poultry. Emerging Infectious Diseases, 26(12), 3074-3076. https://dx.doi.org/10.3201/eid2612.202989.

Serologic Responses in Healthy Adult with SARS-CoV-2 Reinfection, Hong Kong, August 2020 [PDF - 448 KB - 3 pages]
P. Chan et al.

In March 2020, mild signs and symptoms of coronavirus disease developed in a healthy 33-year-old man in Hong Kong. His first infection did not produce virus neutralizing antibodies. In August, he had asymptomatic reinfection, suggesting that persons without a robust neutralizing antibody response might be at risk for reinfection.

EID Chan P, Lui G, Hachim A, Ko R, Boon SS, Li T, et al. Serologic Responses in Healthy Adult with SARS-CoV-2 Reinfection, Hong Kong, August 2020. Emerg Infect Dis. 2020;26(12):3076-3078. https://dx.doi.org/10.3201/eid2612.203833
AMA Chan P, Lui G, Hachim A, et al. Serologic Responses in Healthy Adult with SARS-CoV-2 Reinfection, Hong Kong, August 2020. Emerging Infectious Diseases. 2020;26(12):3076-3078. doi:10.3201/eid2612.203833.
APA Chan, P., Lui, G., Hachim, A., Ko, R., Boon, S. S., Li, T....Peiris, M. (2020). Serologic Responses in Healthy Adult with SARS-CoV-2 Reinfection, Hong Kong, August 2020. Emerging Infectious Diseases, 26(12), 3076-3078. https://dx.doi.org/10.3201/eid2612.203833.

Brucella canis in Commercial Dog Breeding Kennels, Ontario, Canada [PDF - 303 KB - 2 pages]
J. Weese et al.

We evaluated the prevalence of Brucella canis seropositivity in a convenience sample of dogs from commercial breeding kennels in Ontario, Canada. Overall, 127/1,080 (11.8%) dogs from 23/63 (37%) kennels were seropositive. The prevalence of positive dogs within kennels with >1 positive dog ranged from 3.9% to 100% (median 33%).

EID Weese J, Hrinivich K, Anderson M. Brucella canis in Commercial Dog Breeding Kennels, Ontario, Canada. Emerg Infect Dis. 2020;26(12):3079-3080. https://dx.doi.org/10.3201/eid2612.201144
AMA Weese J, Hrinivich K, Anderson M. Brucella canis in Commercial Dog Breeding Kennels, Ontario, Canada. Emerging Infectious Diseases. 2020;26(12):3079-3080. doi:10.3201/eid2612.201144.
APA Weese, J., Hrinivich, K., & Anderson, M. (2020). Brucella canis in Commercial Dog Breeding Kennels, Ontario, Canada. Emerging Infectious Diseases, 26(12), 3079-3080. https://dx.doi.org/10.3201/eid2612.201144.

Novel Serotype of Epizootic Hemorrhagic Disease Virus, China [PDF - 612 KB - 3 pages]
H. Yang et al.

In 2018, a strain of epizootic hemorrhagic disease virus (EHDV), named YNDH/V079/2018, was isolated from a sentinel calf in Mangshi County, Yunnan Province, China. Nucleotide sequencing and neutralization tests indicated that the virus belongs to a novel serotype of EHDV that had not been reported previously.

EID Yang H, Li Z, Wang J, Li Z, Yang Z, Liao D, et al. Novel Serotype of Epizootic Hemorrhagic Disease Virus, China. Emerg Infect Dis. 2020;26(12):3081-3083. https://dx.doi.org/10.3201/eid2612.191301
AMA Yang H, Li Z, Wang J, et al. Novel Serotype of Epizootic Hemorrhagic Disease Virus, China. Emerging Infectious Diseases. 2020;26(12):3081-3083. doi:10.3201/eid2612.191301.
APA Yang, H., Li, Z., Wang, J., Li, Z., Yang, Z., Liao, D....Li, H. (2020). Novel Serotype of Epizootic Hemorrhagic Disease Virus, China. Emerging Infectious Diseases, 26(12), 3081-3083. https://dx.doi.org/10.3201/eid2612.191301.

Pathogenic New World Relapsing Fever Borrelia in a Myotis Bat, Eastern China, 2015 [PDF - 405 KB - 3 pages]
H. Han et al.

We identified Candidatus Borrelia fainii, a human pathogenic bacterium causing New World relapsing fever in a Myotis bat in eastern China. This finding expands knowledge about the geographic distribution of Borrelia spp. and the potential for infection with New World relapsing fever in China.

EID Han H, Liu J, Wen H, Li Z, Lei S, Qin X, et al. Pathogenic New World Relapsing Fever Borrelia in a Myotis Bat, Eastern China, 2015. Emerg Infect Dis. 2020;26(12):3083-3085. https://dx.doi.org/10.3201/eid2612.191450
AMA Han H, Liu J, Wen H, et al. Pathogenic New World Relapsing Fever Borrelia in a Myotis Bat, Eastern China, 2015. Emerging Infectious Diseases. 2020;26(12):3083-3085. doi:10.3201/eid2612.191450.
APA Han, H., Liu, J., Wen, H., Li, Z., Lei, S., Qin, X....Yu, X. (2020). Pathogenic New World Relapsing Fever Borrelia in a Myotis Bat, Eastern China, 2015. Emerging Infectious Diseases, 26(12), 3083-3085. https://dx.doi.org/10.3201/eid2612.191450.

High Coxiella burnetii Seroconversion Rate in Veterinary Students, the Netherlands, 2006–2010 [PDF - 372 KB - 3 pages]
M. de Lange et al.

We examined Coxiella burnetii seroconversion rates by measuring C. burnetii IgG among 2 cohorts of veterinary students. During follow-up of 118 seronegative veterinary students, 23 students seroconverted. Although the clinical importance of the presence of antibodies is unknown, veterinary students should be informed about the potential risks for Q fever.

EID de Lange M, van der Hoek W, Schneeberger PM, Swart A, Heederik D, Schimmer B, et al. High Coxiella burnetii Seroconversion Rate in Veterinary Students, the Netherlands, 2006–2010. Emerg Infect Dis. 2020;26(12):3086-3088. https://dx.doi.org/10.3201/eid2612.200063
AMA de Lange M, van der Hoek W, Schneeberger PM, et al. High Coxiella burnetii Seroconversion Rate in Veterinary Students, the Netherlands, 2006–2010. Emerging Infectious Diseases. 2020;26(12):3086-3088. doi:10.3201/eid2612.200063.
APA de Lange, M., van der Hoek, W., Schneeberger, P. M., Swart, A., Heederik, D., Schimmer, B....Wouters, I. M. (2020). High Coxiella burnetii Seroconversion Rate in Veterinary Students, the Netherlands, 2006–2010. Emerging Infectious Diseases, 26(12), 3086-3088. https://dx.doi.org/10.3201/eid2612.200063.

Phylogenetic Analysis of MERS-CoV in a Camel Abattoir, Saudi Arabia, 2016–2018 [PDF - 1.16 MB - 3 pages]
M. Hemida et al.

We detected Middle East respiratory syndrome coronavirus (MERS-CoV) RNA in 305/1,131 (27%) camels tested at an abattoir in Al Hasa, Eastern Province, Saudi Arabia, during January 2016–March 2018. We characterized 48 full-length MERS-CoV genomes and noted the viruses clustered in MERS-CoV lineage 5 clade B.

EID Hemida M, Chu D, Chor YY, Cheng S, Poon L, Alnaeem A, et al. Phylogenetic Analysis of MERS-CoV in a Camel Abattoir, Saudi Arabia, 2016–2018. Emerg Infect Dis. 2020;26(12):3089-3091. https://dx.doi.org/10.3201/eid2612.191094
AMA Hemida M, Chu D, Chor YY, et al. Phylogenetic Analysis of MERS-CoV in a Camel Abattoir, Saudi Arabia, 2016–2018. Emerging Infectious Diseases. 2020;26(12):3089-3091. doi:10.3201/eid2612.191094.
APA Hemida, M., Chu, D., Chor, Y. Y., Cheng, S., Poon, L., Alnaeem, A....Peiris, M. (2020). Phylogenetic Analysis of MERS-CoV in a Camel Abattoir, Saudi Arabia, 2016–2018. Emerging Infectious Diseases, 26(12), 3089-3091. https://dx.doi.org/10.3201/eid2612.191094.

One-Year Retrospective Review of Psychiatric Consultations in Lassa Fever, Southern Nigeria [PDF - 269 KB - 3 pages]
E. O. Okogbenin et al.

We conducted a retrospective review of psychiatric consultations for hospitalized patients with Lassa fever in southern Nigeria. Ten (8.8%) of 113 patients had psychiatric consultations. Delirium was the most common psychiatric manifestation complicating Lassa fever. Findings suggest that psychiatric intervention could improve overall outcomes of Lassa fever.

EID Okogbenin EO, Obagaye MO, Aweh BE, Eriyo WO, Okogbenin SA, Okokhere PO. One-Year Retrospective Review of Psychiatric Consultations in Lassa Fever, Southern Nigeria. Emerg Infect Dis. 2020;26(12):3091-3093. https://dx.doi.org/10.3201/eid2612.200084
AMA Okogbenin EO, Obagaye MO, Aweh BE, et al. One-Year Retrospective Review of Psychiatric Consultations in Lassa Fever, Southern Nigeria. Emerging Infectious Diseases. 2020;26(12):3091-3093. doi:10.3201/eid2612.200084.
APA Okogbenin, E. O., Obagaye, M. O., Aweh, B. E., Eriyo, W. O., Okogbenin, S. A., & Okokhere, P. O. (2020). One-Year Retrospective Review of Psychiatric Consultations in Lassa Fever, Southern Nigeria. Emerging Infectious Diseases, 26(12), 3091-3093. https://dx.doi.org/10.3201/eid2612.200084.

Low Pathogenicity Avian Influenza (H5N2) Viruses, Dominican Republic [PDF - 1.20 MB - 3 pages]
D. H. Chung et al.

Low pathogenicity avian influenza (H5N2) virus was detected in poultry in the Dominican Republic in 2007 and re-emerged in 2017. Whole-genome sequencing and phylogenetic analysis show introduction of an H5N2 virus lineage from Mexico into poultry in the Dominican Republic, then divergence into 3 distinct genetic subgroups during 2007–2019.

EID Chung DH, Gomez DR, Vargas JM, Amador BL, Torchetti MK, Killian ML, et al. Low Pathogenicity Avian Influenza (H5N2) Viruses, Dominican Republic. Emerg Infect Dis. 2020;26(12):3094-3096. https://dx.doi.org/10.3201/eid2612.200268
AMA Chung DH, Gomez DR, Vargas JM, et al. Low Pathogenicity Avian Influenza (H5N2) Viruses, Dominican Republic. Emerging Infectious Diseases. 2020;26(12):3094-3096. doi:10.3201/eid2612.200268.
APA Chung, D. H., Gomez, D. R., Vargas, J. M., Amador, B. L., Torchetti, M. K., Killian, M. L....Lee, D. (2020). Low Pathogenicity Avian Influenza (H5N2) Viruses, Dominican Republic. Emerging Infectious Diseases, 26(12), 3094-3096. https://dx.doi.org/10.3201/eid2612.200268.

Autochthonous Ratborne Seoul Virus Infection in Woman with Acute Kidney Injury [PDF - 519 KB - 4 pages]
J. Hofmann et al.

Outside Asia, Seoul virus (SEOV) is an underestimated pathogen. In Germany, autochthonous SEOV-associated hantavirus disease has not been unequivocally diagnosed. We found clinical and molecular evidence for SEOV infection in a young woman; her pet rat was the source of infection.

EID Hofmann J, Heuser E, Weiss S, Tenner B, Schoppmeyer K, Esser J, et al. Autochthonous Ratborne Seoul Virus Infection in Woman with Acute Kidney Injury. Emerg Infect Dis. 2020;26(12):3096-3099. https://dx.doi.org/10.3201/eid2612.200708
AMA Hofmann J, Heuser E, Weiss S, et al. Autochthonous Ratborne Seoul Virus Infection in Woman with Acute Kidney Injury. Emerging Infectious Diseases. 2020;26(12):3096-3099. doi:10.3201/eid2612.200708.
APA Hofmann, J., Heuser, E., Weiss, S., Tenner, B., Schoppmeyer, K., Esser, J....Kruger, D. H. (2020). Autochthonous Ratborne Seoul Virus Infection in Woman with Acute Kidney Injury. Emerging Infectious Diseases, 26(12), 3096-3099. https://dx.doi.org/10.3201/eid2612.200708.

Pediatric Lyme Disease Biobank, United States, 2015–2020 [PDF - 289 KB - 3 pages]
L. E. Nigrovic et al.

In 2015, we founded Pedi Lyme Net, a pediatric Lyme disease research network comprising 8 emergency departments in the United States. Of 2,497 children evaluated at 1 of these sites for Lyme disease, 515 (20.6%) were infected. This network is a unique resource for evaluating new approaches for diagnosing Lyme disease in children.

EID Nigrovic LE, Neville DN, Balamuth F, Levas MN, Bennett JE, Kharbanda AB, et al. Pediatric Lyme Disease Biobank, United States, 2015–2020. Emerg Infect Dis. 2020;26(12):3099-3101. https://dx.doi.org/10.3201/eid2612.200920
AMA Nigrovic LE, Neville DN, Balamuth F, et al. Pediatric Lyme Disease Biobank, United States, 2015–2020. Emerging Infectious Diseases. 2020;26(12):3099-3101. doi:10.3201/eid2612.200920.
APA Nigrovic, L. E., Neville, D. N., Balamuth, F., Levas, M. N., Bennett, J. E., Kharbanda, A. B....Garro, A. C. (2020). Pediatric Lyme Disease Biobank, United States, 2015–2020. Emerging Infectious Diseases, 26(12), 3099-3101. https://dx.doi.org/10.3201/eid2612.200920.

Transmission Electron Microscopy Confirmation of Orientia tsutsugamushi in Human Bile [PDF - 1.22 MB - 3 pages]
Y. Lee et al.

Scrub typhus, the third most frequently reported infectious disease in South Korea, causes serious public health problems. In 2019, we collected a bile specimen from a patient with scrub typhus through percutaneous transhepatic gallbladder drainage and performed transmission electron microscopy to confirm the ultrastructure of Orientia tsutsugamushi.

EID Lee Y, Kim SI, Yi Y, Lee H, Hwang J, Park E, et al. Transmission Electron Microscopy Confirmation of Orientia tsutsugamushi in Human Bile. Emerg Infect Dis. 2020;26(12):3101-3103. https://dx.doi.org/10.3201/eid2612.202188
AMA Lee Y, Kim SI, Yi Y, et al. Transmission Electron Microscopy Confirmation of Orientia tsutsugamushi in Human Bile. Emerging Infectious Diseases. 2020;26(12):3101-3103. doi:10.3201/eid2612.202188.
APA Lee, Y., Kim, S. I., Yi, Y., Lee, H., Hwang, J., Park, E....Lee, C. (2020). Transmission Electron Microscopy Confirmation of Orientia tsutsugamushi in Human Bile. Emerging Infectious Diseases, 26(12), 3101-3103. https://dx.doi.org/10.3201/eid2612.202188.
Letters

Arthritis Caused by MRSA CC398 in a Patient without Animal Contact, Japan [PDF - 218 KB - 1 page]
H. Nakaminami
EID Nakaminami H. Arthritis Caused by MRSA CC398 in a Patient without Animal Contact, Japan. Emerg Infect Dis. 2020;26(12):3015-3105. https://dx.doi.org/10.3201/eid2612.203738
AMA Nakaminami H. Arthritis Caused by MRSA CC398 in a Patient without Animal Contact, Japan. Emerging Infectious Diseases. 2020;26(12):3015-3105. doi:10.3201/eid2612.203738.
APA Nakaminami, H. (2020). Arthritis Caused by MRSA CC398 in a Patient without Animal Contact, Japan. Emerging Infectious Diseases, 26(12), 3015-3105. https://dx.doi.org/10.3201/eid2612.203738.

Arthritis Caused by MRSA CC398 in Patient without Animal Contact, Japan [PDF - 242 KB - 2 pages]
A. R. Larsen and J. Larsen
EID Larsen AR, Larsen J. Arthritis Caused by MRSA CC398 in Patient without Animal Contact, Japan. Emerg Infect Dis. 2020;26(12):3104-3105. https://dx.doi.org/10.3201/eid2612.202780
AMA Larsen AR, Larsen J. Arthritis Caused by MRSA CC398 in Patient without Animal Contact, Japan. Emerging Infectious Diseases. 2020;26(12):3104-3105. doi:10.3201/eid2612.202780.
APA Larsen, A. R., & Larsen, J. (2020). Arthritis Caused by MRSA CC398 in Patient without Animal Contact, Japan. Emerging Infectious Diseases, 26(12), 3104-3105. https://dx.doi.org/10.3201/eid2612.202780.

Etymologia: Buruli Ulcer [PDF - 233 KB - 1 page]
T. M. Korman et al.
EID Korman TM, Johnson P, Hayman J. Etymologia: Buruli Ulcer. Emerg Infect Dis. 2020;26(12):3104. https://dx.doi.org/10.3201/eid2612.200744
AMA Korman TM, Johnson P, Hayman J. Etymologia: Buruli Ulcer. Emerging Infectious Diseases. 2020;26(12):3104. doi:10.3201/eid2612.200744.
APA Korman, T. M., Johnson, P., & Hayman, J. (2020). Etymologia: Buruli Ulcer. Emerging Infectious Diseases, 26(12), 3104. https://dx.doi.org/10.3201/eid2612.200744.

Interpreting Transmissibility of COVID-19 in Children [PDF - 238 KB - 2 pages]
E. Cho et al.
EID Cho E, Choi E, Kim J. Interpreting Transmissibility of COVID-19 in Children. Emerg Infect Dis. 2020;26(12):3106-3107. https://dx.doi.org/10.3201/eid2612.203452
AMA Cho E, Choi E, Kim J. Interpreting Transmissibility of COVID-19 in Children. Emerging Infectious Diseases. 2020;26(12):3106-3107. doi:10.3201/eid2612.203452.
APA Cho, E., Choi, E., & Kim, J. (2020). Interpreting Transmissibility of COVID-19 in Children. Emerging Infectious Diseases, 26(12), 3106-3107. https://dx.doi.org/10.3201/eid2612.203452.

Large SARS-CoV-2 Outbreak Caused by Asymptomatic Traveler, China [PDF - 232 KB - 1 page]
A. R. Akhmetzhanov
EID Akhmetzhanov AR. Large SARS-CoV-2 Outbreak Caused by Asymptomatic Traveler, China. Emerg Infect Dis. 2020;26(12):3106. https://dx.doi.org/10.3201/eid2612.203437
AMA Akhmetzhanov AR. Large SARS-CoV-2 Outbreak Caused by Asymptomatic Traveler, China. Emerging Infectious Diseases. 2020;26(12):3106. doi:10.3201/eid2612.203437.
APA Akhmetzhanov, A. R. (2020). Large SARS-CoV-2 Outbreak Caused by Asymptomatic Traveler, China. Emerging Infectious Diseases, 26(12), 3106. https://dx.doi.org/10.3201/eid2612.203437.
About the Cover

In Consideration of Our Mutual Relationship with Cats [PDF - 1018 KB - 2 pages]
B. Breedlove and J. Igunma
EID Breedlove B, Igunma J. In Consideration of Our Mutual Relationship with Cats. Emerg Infect Dis. 2020;26(12):3108-3109. https://dx.doi.org/10.3201/eid2612.ac2612
AMA Breedlove B, Igunma J. In Consideration of Our Mutual Relationship with Cats. Emerging Infectious Diseases. 2020;26(12):3108-3109. doi:10.3201/eid2612.ac2612.
APA Breedlove, B., & Igunma, J. (2020). In Consideration of Our Mutual Relationship with Cats. Emerging Infectious Diseases, 26(12), 3108-3109. https://dx.doi.org/10.3201/eid2612.ac2612.
Etymologia

Salmonella [PDF - 520 KB - 1 page]
D. M. Monte and F. P. Sellera
EID Monte DM, Sellera FP. Salmonella. Emerg Infect Dis. 2020;26(12):2955. https://dx.doi.org/10.3201/eid2612.et2612
AMA Monte DM, Sellera FP. Salmonella. Emerging Infectious Diseases. 2020;26(12):2955. doi:10.3201/eid2612.et2612.
APA Monte, D. M., & Sellera, F. P. (2020). Salmonella. Emerging Infectious Diseases, 26(12), 2955. https://dx.doi.org/10.3201/eid2612.et2612.
Online Reports

Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths [PDF - 2.40 MB - 9 pages]
R. M. Wallace et al.

Domestic dogs are responsible for nearly all the »59,000 global human rabies deaths that occur annually. Numerous control measures have been successful at eliminating dog-mediated human rabies deaths in upper-income countries, including dog population management, parenteral dog vaccination programs, access to human rabies vaccines, and education programs for bite prevention and wound treatment. Implementing these techniques in resource-poor settings can be challenging; perhaps the greatest challenge is maintaining adequate herd immunity in free-roaming dog populations. Oral rabies vaccines have been a cornerstone in rabies virus elimination from wildlife populations; however, oral vaccines have never been effectively used to control dog-mediated rabies. Here, we convey the perspectives of the World Organisation for Animal Health Rabies Reference Laboratory Directors, the World Organisation for Animal Health expert committee on dog rabies control, and World Health Organization regarding the role of oral vaccines for dogs. We also issue recommendations for overcoming hesitations to expedited field use of appropriate oral vaccines.

EID Wallace RM, Cliquet F, Fehlner-Gardiner C, Fooks AR, Sabeta CT, Setién A, et al. Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths. Emerg Infect Dis. 2020;26(12):1-9. https://dx.doi.org/10.3201/eid2612.201266
AMA Wallace RM, Cliquet F, Fehlner-Gardiner C, et al. Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths. Emerging Infectious Diseases. 2020;26(12):1-9. doi:10.3201/eid2612.201266.
APA Wallace, R. M., Cliquet, F., Fehlner-Gardiner, C., Fooks, A. R., Sabeta, C. T., Setién, A....Müller, T. (2020). Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths. Emerging Infectious Diseases, 26(12), 1-9. https://dx.doi.org/10.3201/eid2612.201266.
Page created: November 18, 2020
Page updated: November 25, 2020
Page reviewed: November 25, 2020
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