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Articles from Emerging Infectious Diseases

Synopses

Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity [PDF - 1.05 MB - 9 pages]
R. Mandage et al.

Plasmodium infections are co-endemic with infections caused by other agents of acute febrile illnesses, such as dengue virus (DENV), chikungunya virus, Leptospira spp., and Orientia tsutsugamushi. However, co-infections may influence disease severity, treatment outcomes, and development of drug resistance. When we analyzed cases of acute febrile illness at the All India Institute of Medical Sciences, New Delhi, India, from July 2017 through September 2018, we found that most patients with malaria harbored co-infections (Plasmodium mixed species and other pathogens). DENV was the most common malaria co-infection (44% of total infections). DENV serotype 4 was associated with mild malaria, and Leptospira was associated with severe malaria. We also found the presence of P. knowlesi in our study population. Therefore, in areas with a large number of severe malaria cases, diagnostic screening for all 4 DENV serotypes, Leptospira, and all Plasmodium species should be performed.

EID Mandage R, Kaur C, Pramanik A, Kumar V, Kodan P, Singh A, et al. Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity. Emerg Infect Dis. 2020;26(8):1645-1653. https://dx.doi.org/10.3201/eid2608.191214
AMA Mandage R, Kaur C, Pramanik A, et al. Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity. Emerging Infectious Diseases. 2020;26(8):1645-1653. doi:10.3201/eid2608.191214.
APA Mandage, R., Kaur, C., Pramanik, A., Kumar, V., Kodan, P., Singh, A....Acharya, P. (2020). Association of Dengue Virus and Leptospira Co-Infections with Malaria Severity. Emerging Infectious Diseases, 26(8), 1645-1653. https://dx.doi.org/10.3201/eid2608.191214.

US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 [PDF - 1.38 MB - 12 pages]
X. Lu et al.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the etiologic agent associated with coronavirus disease, which emerged in late 2019. In response, we developed a diagnostic panel consisting of 3 real-time reverse transcription PCR assays targeting the nucleocapsid gene and evaluated use of these assays for detecting SARS-CoV-2 infection. All assays demonstrated a linear dynamic range of 8 orders of magnitude and an analytical limit of detection of 5 copies/reaction of quantified RNA transcripts and 1 x 10−1.5 50% tissue culture infectious dose/mL of cell-cultured SARS-CoV-2. All assays performed comparably with nasopharyngeal and oropharyngeal secretions, serum, and fecal specimens spiked with cultured virus. We obtained no false-positive amplifications with other human coronaviruses or common respiratory pathogens. Results from all 3 assays were highly correlated during clinical specimen testing. On February 4, 2020, the Food and Drug Administration issued an Emergency Use Authorization to enable emergency use of this panel.

EID Lu X, Wang L, Sakthivel SK, Whitaker B, Murray J, Kamili S, et al. US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis. 2020;26(8):1654-1665. https://dx.doi.org/10.3201/eid2608.201246
AMA Lu X, Wang L, Sakthivel SK, et al. US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2. Emerging Infectious Diseases. 2020;26(8):1654-1665. doi:10.3201/eid2608.201246.
APA Lu, X., Wang, L., Sakthivel, S. K., Whitaker, B., Murray, J., Kamili, S....Lindstrom, S. (2020). US CDC Real-Time Reverse Transcription PCR Panel for Detection of Severe Acute Respiratory Syndrome Coronavirus 2. Emerging Infectious Diseases, 26(8), 1654-1665. https://dx.doi.org/10.3201/eid2608.201246.

Coronavirus Disease Outbreak in Call Center, South Korea [PDF - 2.82 MB - 5 pages]
S. Park et al.

We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%–10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%–50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%– 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.

EID Park S, Kim Y, Yi S, Lee S, Na B, Kim C, et al. Coronavirus Disease Outbreak in Call Center, South Korea. Emerg Infect Dis. 2020;26(8):1666-1670. https://dx.doi.org/10.3201/eid2608.201274
AMA Park S, Kim Y, Yi S, et al. Coronavirus Disease Outbreak in Call Center, South Korea. Emerging Infectious Diseases. 2020;26(8):1666-1670. doi:10.3201/eid2608.201274.
APA Park, S., Kim, Y., Yi, S., Lee, S., Na, B., Kim, C....Jeong, E. (2020). Coronavirus Disease Outbreak in Call Center, South Korea. Emerging Infectious Diseases, 26(8), 1666-1670. https://dx.doi.org/10.3201/eid2608.201274.

Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA [PDF - 983 KB - 8 pages]
V. T. Chu et al.

We describe the contact investigation for an early confirmed case of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the United States. Contacts of the case-patient were identified, actively monitored for symptoms, interviewed for a detailed exposure history, and tested for SARS-CoV-2 infection by real-time reverse transcription PCR (rRT-PCR) and ELISA. Fifty contacts were identified and 38 (76%) were interviewed, of whom 11 (29%) reported unprotected face-to-face interaction with the case-patient. Thirty-seven (74%) had respiratory specimens tested by rRT-PCR, and all tested negative. Twenty-three (46%) had ELISA performed on serum samples collected ≈6 weeks after exposure, and none had detectable antibodies to SARS-CoV-2. Among contacts who were tested, no secondary transmission was identified in this investigation, despite unprotected close interactions with the infectious case-patient.

EID Chu VT, Freeman-Ponder B, Lindquist S, Spitters C, Kawakami V, Dyal JW, et al. Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA. Emerg Infect Dis. 2020;26(8):1671-1678. https://dx.doi.org/10.3201/eid2608.201423
AMA Chu VT, Freeman-Ponder B, Lindquist S, et al. Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA. Emerging Infectious Diseases. 2020;26(8):1671-1678. doi:10.3201/eid2608.201423.
APA Chu, V. T., Freeman-Ponder, B., Lindquist, S., Spitters, C., Kawakami, V., Dyal, J. W....Biggs, H. M. (2020). Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA. Emerging Infectious Diseases, 26(8), 1671-1678. https://dx.doi.org/10.3201/eid2608.201423.

Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020 [PDF - 676 KB - 7 pages]
J. Ferguson et al.

Limited data are available on the clinical presentation and outcomes of coronavirus disease (COVID-19) patients in the United States hospitalized under normal-caseload or nonsurge conditions. We retrospectively studied 72 consecutive adult patients hospitalized with COVID-19 in 2 hospitals in the San Francisco Bay area, California, USA, during March 13–April 11, 2020. The death rate for all hospitalized COVID-19 patients was 8.3%, and median length of hospitalization was 7.5 days. Of the 21 (29% of total) intensive care unit patients, 3 (14.3% died); median length of intensive care unit stay was 12 days. Of the 72 patients, 43 (59.7%) had underlying cardiovascular disease and 19 (26.4%) had underlying pulmonary disease. In this study, death rates were lower than those reported from regions of the United States experiencing a high volume of COVID-19 patients.

EID Ferguson J, Rosser JI, Quintero O, Scott J, Subramanian A, Gumma M, et al. Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020. Emerg Infect Dis. 2020;26(8):1679-1685. https://dx.doi.org/10.3201/eid2608.201776
AMA Ferguson J, Rosser JI, Quintero O, et al. Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020. Emerging Infectious Diseases. 2020;26(8):1679-1685. doi:10.3201/eid2608.201776.
APA Ferguson, J., Rosser, J. I., Quintero, O., Scott, J., Subramanian, A., Gumma, M....Kappagoda, S. (2020). Characteristics and Outcomes of Coronavirus Disease Patients under Nonsurge Conditions, Northern California, USA, March–April 2020. Emerging Infectious Diseases, 26(8), 1679-1685. https://dx.doi.org/10.3201/eid2608.201776.

Medscape CME Activity
Tuberculosis in Internationally Displaced Children Resettling in Harris County, Texas, USA, 2010–2015 [PDF - 692 KB - 9 pages]
G. S. Lamb et al.

US guidelines have recommended testing children emigrating from high tuberculosis-incidence countries with interferon-gamma release assays (IGRAs) or tuberculin skin tests (TSTs). We describe the Harris County (Texas) Public Health Refugee Health Screening Program’s testing results during 2010–2015 for children <18 years of age: 5,990 were evaluated, and 5,870 (98%) were tested. Overall, 364 (6.2%) children had >1 positive test: 143/1,842 (7.8%) were tested with TST alone, 129/3,730 (3.5%) with IGRA alone, and 92/298 (30.9%) with both TST and IGRA. Region of origin and younger age were associated with positive TST or IGRA results. All children were more likely to have positive results for TST than for IGRA (OR 2.92, 95% CI 2.37–3.59). Discordant test results were common (20%) and most often were TST+/IGRA– (95.0%), likely because of bacillus Calmette-Guérin vaccination. Finding fewer false positives supports the 2018 change in US immigration guidelines that recommends using IGRAs for recently immigrated children.

EID Lamb GS, Cruz AT, Camp EA, Javier M, Montour J, Piper T, et al. Tuberculosis in Internationally Displaced Children Resettling in Harris County, Texas, USA, 2010–2015. Emerg Infect Dis. 2020;26(8):1686-1694. https://dx.doi.org/10.3201/eid2608.190793
AMA Lamb GS, Cruz AT, Camp EA, et al. Tuberculosis in Internationally Displaced Children Resettling in Harris County, Texas, USA, 2010–2015. Emerging Infectious Diseases. 2020;26(8):1686-1694. doi:10.3201/eid2608.190793.
APA Lamb, G. S., Cruz, A. T., Camp, E. A., Javier, M., Montour, J., Piper, T....Starke, J. R. (2020). Tuberculosis in Internationally Displaced Children Resettling in Harris County, Texas, USA, 2010–2015. Emerging Infectious Diseases, 26(8), 1686-1694. https://dx.doi.org/10.3201/eid2608.190793.

Epidemiology of Legionnaires’ Disease, Hong Kong, China, 2005−2015 [PDF - 1.40 MB - 8 pages]
Y. Leung et al.

We reviewed findings of clinical, epidemiologic, and environmental investigations for 288 confirmed case-patients with Legionnaires’ disease reported in Hong Kong, China, during January 2005−December 2015. We found that chronic renal failure/impairment (adjusted odds ratio [aOR] 4.09), chronic pulmonary diseases (aOR 3.22), malignancy (aOR 3.04), and heart diseases (aOR 2.15) were independently associated with a higher risk for severe Legionnaires’ disease. However, patients with hyperlipidemia had a lower risk for severe outcome (aOR 0.17). Legionella positivity rate was 22% for 1,904 water samples collected. We found a higher positivity rate in summer months (28%−30%), which corroborated with months of highest rainfalls. Our novel finding that Legionnaires’ disease patients with hyperlipidemia had a lower risk for severe outcome deserves further study to confirm the observation and ascertain the underlying reason.

EID Leung Y, Lam C, Cheung Y, Chan C, Chuang S. Epidemiology of Legionnaires’ Disease, Hong Kong, China, 2005−2015. Emerg Infect Dis. 2020;26(8):1695-1702. https://dx.doi.org/10.3201/eid2608.191244
AMA Leung Y, Lam C, Cheung Y, et al. Epidemiology of Legionnaires’ Disease, Hong Kong, China, 2005−2015. Emerging Infectious Diseases. 2020;26(8):1695-1702. doi:10.3201/eid2608.191244.
APA Leung, Y., Lam, C., Cheung, Y., Chan, C., & Chuang, S. (2020). Epidemiology of Legionnaires’ Disease, Hong Kong, China, 2005−2015. Emerging Infectious Diseases, 26(8), 1695-1702. https://dx.doi.org/10.3201/eid2608.191244.

Rise in Babesiosis Cases, Pennsylvania, USA, 2005–2018 [PDF - 1.98 MB - 7 pages]
D. Ingram and T. Crook

Babesiosis is an emerging infection in the state of Pennsylvania, and clinicians need to be made aware of its clinical manifestations as well as the risk factors associated with severe disease. Before 2010, our tertiary academic center in central Pennsylvania previously saw zero cases of babesiosis. We saw our first confirmed case of Babesia infection acquired in Pennsylvania in 2011; we recorded 2 confirmed cases in 2017 and 4 confirmed cases in 2018. All 4 cases from 2018 were thought to be acquired in southcentral Pennsylvania counties, whereas prior reports of cases were predominately in the southeast and northeast counties of the state.

EID Ingram D, Crook T. Rise in Babesiosis Cases, Pennsylvania, USA, 2005–2018. Emerg Infect Dis. 2020;26(8):1703-1709. https://dx.doi.org/10.3201/eid2608.191293
AMA Ingram D, Crook T. Rise in Babesiosis Cases, Pennsylvania, USA, 2005–2018. Emerging Infectious Diseases. 2020;26(8):1703-1709. doi:10.3201/eid2608.191293.
APA Ingram, D., & Crook, T. (2020). Rise in Babesiosis Cases, Pennsylvania, USA, 2005–2018. Emerging Infectious Diseases, 26(8), 1703-1709. https://dx.doi.org/10.3201/eid2608.191293.
Research

Medscape CME Activity
Sporadic Creutzfeldt-Jakob Disease among Physicians, Germany, 1993–2018 [PDF - 2.79 MB - 10 pages]
P. Hermann et al.

We investigated sporadic Creutzfeldt-Jakob disease (sCJD) among physicians in Germany by analyzing occupational information of patients with sCJD recorded by the German CJD Surveillance Unit (1993–2005; 1,250 patients, of whom 4 [0.32%] were physicians) and the National Reference Center for Human Spongiform Encephalopathies (2006–2016; 1,491 patients, of whom 13 [0.87%] were physicians). Among the physicians, we did not identify any neurologists, neurosurgeons, psychiatrists, or pathologists. A cumulative sum test showed an increase in reported physicians over time. Data for 2017–2018 indicated an increased rate of physicians among all notified sCJD cases (5/239 [2.1%]) when we used the total population of Germany as control group. Our data suggest the possibility of an increased risk for sCJD among physicians in Germany. However, we can only speculate about the reasons, and larger multinational studies are needed to replicate the finding and to clarify whether this finding is a general or a country-specific phenomenon.

EID Hermann P, Treig J, Unkel S, Goebel S, Bunck T, Jünemann M, et al. Sporadic Creutzfeldt-Jakob Disease among Physicians, Germany, 1993–2018. Emerg Infect Dis. 2020;26(8):1710-1719. https://dx.doi.org/10.3201/eid2608.191159
AMA Hermann P, Treig J, Unkel S, et al. Sporadic Creutzfeldt-Jakob Disease among Physicians, Germany, 1993–2018. Emerging Infectious Diseases. 2020;26(8):1710-1719. doi:10.3201/eid2608.191159.
APA Hermann, P., Treig, J., Unkel, S., Goebel, S., Bunck, T., Jünemann, M....Zerr, I. (2020). Sporadic Creutzfeldt-Jakob Disease among Physicians, Germany, 1993–2018. Emerging Infectious Diseases, 26(8), 1710-1719. https://dx.doi.org/10.3201/eid2608.191159.

Analysis of MarketScan Data for Immunosuppressive Conditions and Hospitalizations for Acute Respiratory Illness, United States [PDF - 1002 KB - 11 pages]
M. Patel et al.

Increasing use of immunosuppressive biologic therapies poses a challenge for infectious diseases. Immunosuppressed patients have a high risk for influenza complications and an impaired immune response to vaccines. The total burden of immunosuppressive conditions in the United States, including those receiving emerging biologic therapies, remains unknown. We used the national claims database MarketScan to estimate the prevalence of immunosuppressive conditions and risk for acute respiratory illnesses (ARIs). We studied 47.2 million unique enrollees, representing 115 million person-years of observation during 2012–2017, and identified immunosuppressive conditions in 6.2% adults 18–64 years of age and 2.6% of children <18 years of age. Among 542,105 ARI hospitalizations, 32% of patients had immunosuppressive conditions. The risk for ARI hospitalizations was higher among enrollees with immunosuppression than among nonimmunosuppressed enrollees. Future efforts should focus on developing improved strategies, including vaccines, for preventing influenza in immunosuppressed patients, who are an increasing population in the United States.

EID Patel M, Chen J, Kim S, Garg S, Flannery B, Haddadin Z, et al. Analysis of MarketScan Data for Immunosuppressive Conditions and Hospitalizations for Acute Respiratory Illness, United States. Emerg Infect Dis. 2020;26(8):1720-1730. https://dx.doi.org/10.3201/eid2608.191493
AMA Patel M, Chen J, Kim S, et al. Analysis of MarketScan Data for Immunosuppressive Conditions and Hospitalizations for Acute Respiratory Illness, United States. Emerging Infectious Diseases. 2020;26(8):1720-1730. doi:10.3201/eid2608.191493.
APA Patel, M., Chen, J., Kim, S., Garg, S., Flannery, B., Haddadin, Z....Reed, C. (2020). Analysis of MarketScan Data for Immunosuppressive Conditions and Hospitalizations for Acute Respiratory Illness, United States. Emerging Infectious Diseases, 26(8), 1720-1730. https://dx.doi.org/10.3201/eid2608.191493.

CrAssphage as a Novel Tool to Detect Human Fecal Contamination on Environmental Surfaces and Hands [PDF - 2.95 MB - 9 pages]
G. Park et al.

CrAssphage is a recently discovered human gut–associated bacteriophage. To validate the potential use of crAssphage for detecting human fecal contamination on environmental surfaces and hands, we tested stool samples (n = 60), hand samples (n = 30), and environmental swab samples (n = 201) from 17 norovirus outbreaks for crAssphage by real-time PCR. In addition, we tested stool samples from healthy persons (n = 173), respiratory samples (n = 113), and animal fecal specimens (n = 68) and further sequenced positive samples. Overall, we detected crAssphage in 71.4% of outbreak stool samples, 48%–68.5% of stool samples from healthy persons, 56.2% of environmental swabs, and 60% of hand rinse samples, but not in human respiratory samples or animal fecal samples. CrAssphage sequences could be grouped into 2 major genetic clusters. Our data suggest that crAssphage could be used to detect human fecal contamination on environmental surfaces and hands.

EID Park G, Ng T, Freeland AL, Marconi VC, Boom JA, Staat MA, et al. CrAssphage as a Novel Tool to Detect Human Fecal Contamination on Environmental Surfaces and Hands. Emerg Infect Dis. 2020;26(8):1731-1739. https://dx.doi.org/10.3201/eid2608.200346
AMA Park G, Ng T, Freeland AL, et al. CrAssphage as a Novel Tool to Detect Human Fecal Contamination on Environmental Surfaces and Hands. Emerging Infectious Diseases. 2020;26(8):1731-1739. doi:10.3201/eid2608.200346.
APA Park, G., Ng, T., Freeland, A. L., Marconi, V. C., Boom, J. A., Staat, M. A....Vinjé, J. (2020). CrAssphage as a Novel Tool to Detect Human Fecal Contamination on Environmental Surfaces and Hands. Emerging Infectious Diseases, 26(8), 1731-1739. https://dx.doi.org/10.3201/eid2608.200346.

Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease [PDF - 2.48 MB - 9 pages]
L. Matrajt and T. Leung

By April 2, 2020, >1 million persons worldwide were infected with severe acute respiratory syndrome coronavirus 2. We used a mathematical model to investigate the effectiveness of social distancing interventions in a mid-sized city. Interventions reduced contacts of adults >60 years of age, adults 20–59 years of age, and children <19 years of age for 6 weeks. Our results suggest interventions started earlier in the epidemic delay the epidemic curve and interventions started later flatten the epidemic curve. We noted that, while social distancing interventions were in place, most new cases, hospitalizations, and deaths were averted, even with modest reductions in contact among adults. However, when interventions ended, the epidemic rebounded. Our models suggest that social distancing can provide crucial time to increase healthcare capacity but must occur in conjunction with testing and contact tracing of all suspected cases to mitigate virus transmission.

EID Matrajt L, Leung T. Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease. Emerg Infect Dis. 2020;26(8):1740-1748. https://dx.doi.org/10.3201/eid2608.201093
AMA Matrajt L, Leung T. Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease. Emerging Infectious Diseases. 2020;26(8):1740-1748. doi:10.3201/eid2608.201093.
APA Matrajt, L., & Leung, T. (2020). Evaluating the Effectiveness of Social Distancing Interventions to Delay or Flatten the Epidemic Curve of Coronavirus Disease. Emerging Infectious Diseases, 26(8), 1740-1748. https://dx.doi.org/10.3201/eid2608.201093.

Population Genomic Structure and Recent Evolution of Plasmodium knowlesi, Peninsular Malaysia [PDF - 3.23 MB - 10 pages]
S. E. Hocking et al.

Most malaria in Malaysia is caused by Plasmodium knowlesi parasites through zoonotic infection from macaque reservoir hosts. We obtained genome sequences from 28 clinical infections in Peninsular Malaysia to clarify the emerging parasite population structure and test for evidence of recent adaptation. The parasites all belonged to a major genetic population of P. knowlesi (cluster 3) with high genomewide divergence from populations occurring in Borneo (clusters 1 and 2). We also observed unexpected local genetic subdivision; most parasites belonged to 2 subpopulations sharing a high level of diversity except at particular genomic regions, the largest being a region of chromosome 12, which showed evidence of recent directional selection. Surprisingly, we observed a third subpopulation comprising P. knowlesi infections that were almost identical to each other throughout much of the genome, indicating separately maintained transmission and recent genetic isolation. Each subpopulation could evolve and present a broader health challenge in Asia.

EID Hocking SE, Divis P, Kadir KA, Singh B, Conway DJ. Population Genomic Structure and Recent Evolution of Plasmodium knowlesi, Peninsular Malaysia. Emerg Infect Dis. 2020;26(8):1749-1758. https://dx.doi.org/10.3201/eid2608.190864
AMA Hocking SE, Divis P, Kadir KA, et al. Population Genomic Structure and Recent Evolution of Plasmodium knowlesi, Peninsular Malaysia. Emerging Infectious Diseases. 2020;26(8):1749-1758. doi:10.3201/eid2608.190864.
APA Hocking, S. E., Divis, P., Kadir, K. A., Singh, B., & Conway, D. J. (2020). Population Genomic Structure and Recent Evolution of Plasmodium knowlesi, Peninsular Malaysia. Emerging Infectious Diseases, 26(8), 1749-1758. https://dx.doi.org/10.3201/eid2608.190864.

Human Outbreak of Trichinellosis Caused by Trichinella papuae Nematodes, Central Kampong Thom Province, Cambodia [PDF - 1.12 MB - 8 pages]
Y. Caron et al.

In September 2017, a severe trichinellosis outbreak occurred in Cambodia after persons consumed raw wild pig meat; 33 persons were infected and 8 died. We collected and analyzed the medical records for 25 patients. Clinical signs and symptoms included myalgia, facial or peripheral edema, asthenia, and fever. We observed increased levels of creatine phosphokinase and aspartate aminotransferase­, as well as eosinophilia. Histopathologic examination of muscle biopsy specimens showed nonencapsulated Trichinella larvae. A Trichinella excretory/secretory antigen ELISA identified Trichinella IgM and IgG. Biopsy samples were digested and larvae were isolated and counted. PCR for the 5S rDNA intergenic spacer region and a multiplex PCR, followed by sequencing identified the parasite as Trichinella papuae. This species was identified in Papua New Guinea during 1999 and in several outbreaks in humans in Thailand. Thus, we identified T. papuae nematodes in humans in Cambodia.

EID Caron Y, Bory S, Pluot M, Nheb M, Chan S, Prum S, et al. Human Outbreak of Trichinellosis Caused by Trichinella papuae Nematodes, Central Kampong Thom Province, Cambodia. Emerg Infect Dis. 2020;26(8):1759-1766. https://dx.doi.org/10.3201/eid2608.191497
AMA Caron Y, Bory S, Pluot M, et al. Human Outbreak of Trichinellosis Caused by Trichinella papuae Nematodes, Central Kampong Thom Province, Cambodia. Emerging Infectious Diseases. 2020;26(8):1759-1766. doi:10.3201/eid2608.191497.
APA Caron, Y., Bory, S., Pluot, M., Nheb, M., Chan, S., Prum, S....Yera, H. (2020). Human Outbreak of Trichinellosis Caused by Trichinella papuae Nematodes, Central Kampong Thom Province, Cambodia. Emerging Infectious Diseases, 26(8), 1759-1766. https://dx.doi.org/10.3201/eid2608.191497.

Increased Sensitivity of Plasmodium falciparum to Artesunate/Amodiaquine Despite 14 Years as First-Line Malaria Treatment, Zanzibar [PDF - 1.98 MB - 11 pages]
M. Msellem et al.

Artemisinin-based combination therapies (ACTs) are first-line treatments for uncomplicated Plasmodium falciparum malaria. ACT resistance is spreading in Asia but not yet in Africa. Reduced effects of ACT partner drugs have been reported but with little information regarding widely used artesunate/amodiaquine (ASAQ). We studied its efficacy in Zanzibar after 14 years as first-line treatment directly by an in vivo, single-armed trial and indirectly by prevalences of different genotypes in the P. falciparum chloroquine-resistance transporter, multidrug-resistance 1, and Kelch 13 propeller domain genes. In vivo efficacy was higher during 2017 (100%; 95% CI 97.4%–100%) than during 2002–2005 (94.7%; 95% CI 91.9%–96.7%) (p = 0.003). Molecular findings showed no artemisinin resistance–associated genotypes and major increases in genotypes associated with high sensitivity/efficacy for amodiaquine than before ASAQ was introduced. Thus, the efficacy of ASAQ is maintained and appears to be increased after long-term use in contrast to what is observed for other ACTs used in Africa.

EID Msellem M, Morris U, Soe A, Abbas FB, Ali A, Barnes R, et al. Increased Sensitivity of Plasmodium falciparum to Artesunate/Amodiaquine Despite 14 Years as First-Line Malaria Treatment, Zanzibar. Emerg Infect Dis. 2020;26(8):1767-1777. https://dx.doi.org/10.3201/eid2608.191547
AMA Msellem M, Morris U, Soe A, et al. Increased Sensitivity of Plasmodium falciparum to Artesunate/Amodiaquine Despite 14 Years as First-Line Malaria Treatment, Zanzibar. Emerging Infectious Diseases. 2020;26(8):1767-1777. doi:10.3201/eid2608.191547.
APA Msellem, M., Morris, U., Soe, A., Abbas, F. B., Ali, A., Barnes, R....Björkman, A. (2020). Increased Sensitivity of Plasmodium falciparum to Artesunate/Amodiaquine Despite 14 Years as First-Line Malaria Treatment, Zanzibar. Emerging Infectious Diseases, 26(8), 1767-1777. https://dx.doi.org/10.3201/eid2608.191547.

Factors Associated with Prescription of Antimicrobial Drugs for Dogs and Cats, United Kingdom, 2014–2016 [PDF - 1.21 MB - 14 pages]
D. A. Singleton et al.

Antimicrobial stewardship is a cornerstone of efforts to curtail antimicrobial resistance. To determine factors potentially influencing likelihood of prescribing antimicrobials for animals, we analyzed electronic health records for unwell dogs (n = 155,732 unique dogs, 281,543 consultations) and cats (n = 69,236 unique cats, 111,139 consultations) voluntarily contributed by 173 UK veterinary practices. Using multivariable mixed effects logistic regression, we found that factors associated with decreased odds of systemic antimicrobial prescription were client decisions focused on preventive health: vaccination (dogs, odds ratio [OR] 0.93, 95% CI, 0.90–0.95; cats, OR 0.92, 95% CI 0.89–0.95), insurance (dogs, OR 0.87, 95% CI 0.84–0.90; cats, OR 0.82, 95% CI 0.79–0.86), neutering of dogs (OR 0.90, 95% CI 0.88–0.92), and practices accredited by the Royal College of Veterinary Surgeons (OR 0.79, 95% 95% CI 0.68–0.92). This large multicenter companion animal study demonstrates the potential of preventive healthcare and client engagement to encourage responsible antimicrobial drug use.

EID Singleton DA, Pinchbeck GL, Radford AD, Arsevska E, Dawson S, Jones PH, et al. Factors Associated with Prescription of Antimicrobial Drugs for Dogs and Cats, United Kingdom, 2014–2016. Emerg Infect Dis. 2020;26(8):1778-1791. https://dx.doi.org/10.3201/eid2608.191786
AMA Singleton DA, Pinchbeck GL, Radford AD, et al. Factors Associated with Prescription of Antimicrobial Drugs for Dogs and Cats, United Kingdom, 2014–2016. Emerging Infectious Diseases. 2020;26(8):1778-1791. doi:10.3201/eid2608.191786.
APA Singleton, D. A., Pinchbeck, G. L., Radford, A. D., Arsevska, E., Dawson, S., Jones, P. H....Sánchez-Vizcaíno, F. (2020). Factors Associated with Prescription of Antimicrobial Drugs for Dogs and Cats, United Kingdom, 2014–2016. Emerging Infectious Diseases, 26(8), 1778-1791. https://dx.doi.org/10.3201/eid2608.191786.

Linezolid-Associated Neurologic Adverse Events in Patients with Multidrug-Resistant Tuberculosis, France [PDF - 590 KB - 9 pages]
M. Jaspard et al.

Linezolid is one of the most effective drugs for treating multidrug-resistant tuberculosis (MDR TB), but adverse effects remain problematic. We evaluated 57 MDR TB patients who had received >1 dose of linezolid during 2011–2016. Overall, patients received 600 mg/day of linezolid for a median of 13 months. In 33 (58%) patients, neurologic or ophthalmologic signs developed, and 18 (32%) had confirmed peripheral neuropathy, which for 78% was irreversible at 12 months after the end of TB treatment despite linezolid withdrawal. Among the 19 patients who underwent ophthalmologic evaluation, 14 patients had optic neuropathy that fully reversed for 2. A total of 16 (33%) of 49 patients had a linezolid trough concentration >2 mg/L, and among these, 14 (88%) experienced adverse effects. No significant association was found between trough concentration and neurologic toxicity. These findings suggest the need to closely monitor patients for neurologic signs and discuss optimal duration of linezolid treatment.

EID Jaspard M, Butel N, El Helali N, Marigot-Outtandy D, Guillot H, Peytavin G, et al. Linezolid-Associated Neurologic Adverse Events in Patients with Multidrug-Resistant Tuberculosis, France. Emerg Infect Dis. 2020;26(8):1792-1800. https://dx.doi.org/10.3201/eid2608.191499
AMA Jaspard M, Butel N, El Helali N, et al. Linezolid-Associated Neurologic Adverse Events in Patients with Multidrug-Resistant Tuberculosis, France. Emerging Infectious Diseases. 2020;26(8):1792-1800. doi:10.3201/eid2608.191499.
APA Jaspard, M., Butel, N., El Helali, N., Marigot-Outtandy, D., Guillot, H., Peytavin, G....Pourcher, V. (2020). Linezolid-Associated Neurologic Adverse Events in Patients with Multidrug-Resistant Tuberculosis, France. Emerging Infectious Diseases, 26(8), 1792-1800. https://dx.doi.org/10.3201/eid2608.191499.

Naturally Acquired Human Plasmodium cynomolgi and P. knowlesi Infections, Malaysian Borneo [PDF - 2.19 MB - 9 pages]
T. Raja et al.

To monitor the incidence of Plasmodium knowlesi infections and determine whether other simian malaria parasites are being transmitted to humans, we examined 1,047 blood samples from patients with malaria at Kapit Hospital in Kapit, Malaysia, during June 24, 2013–December 31, 2017. Using nested PCR assays, we found 845 (80.6%) patients had either P. knowlesi monoinfection (n = 815) or co-infection with other Plasmodium species (n = 30). We noted the annual number of these zoonotic infections increased greatly in 2017 (n = 284). We identified 6 patients, 17–65 years of age, with P. cynomolgi and P. knowlesi co-infections, confirmed by phylogenetic analyses of the Plasmodium cytochrome c oxidase subunit 1 gene sequences. P. knowlesi continues to be a public health concern in the Kapit Division of Sarawak, Malaysian Borneo. In addition, another simian malaria parasite, P. cynomolgi, also is an emerging cause of malaria in humans.

EID Raja T, Hu T, Kadir K, Mohamad D, Rosli N, Wong L, et al. Naturally Acquired Human Plasmodium cynomolgi and P. knowlesi Infections, Malaysian Borneo. Emerg Infect Dis. 2020;26(8):1801-1809. https://dx.doi.org/10.3201/eid2608.200343
AMA Raja T, Hu T, Kadir K, et al. Naturally Acquired Human Plasmodium cynomolgi and P. knowlesi Infections, Malaysian Borneo. Emerging Infectious Diseases. 2020;26(8):1801-1809. doi:10.3201/eid2608.200343.
APA Raja, T., Hu, T., Kadir, K., Mohamad, D., Rosli, N., Wong, L....Singh, B. (2020). Naturally Acquired Human Plasmodium cynomolgi and P. knowlesi Infections, Malaysian Borneo. Emerging Infectious Diseases, 26(8), 1801-1809. https://dx.doi.org/10.3201/eid2608.200343.

Presence of Segmented Flavivirus Infections in North America [PDF - 1.51 MB - 8 pages]
K. J. Vandegrift et al.

Identifying viruses in synanthropic animals is necessary for understanding the origin of many viruses that can infect human hosts and developing strategies to prevent new zoonotic infections. The white-footed mouse, Peromyscus leucopus, is one of the most abundant rodent species in the northeastern United States. We characterized the serum virome of 978 free-ranging P. leucopus mice caught in Pennsylvania. We identified many new viruses belonging to 26 different virus families. Among these viruses was a highly divergent segmented flavivirus whose genetic relatives were recently identified in ticks, mosquitoes, and vertebrates, including febrile humans. This novel flavi-like segmented virus was found in rodents and shares ˂70% aa identity with known viruses in the highly conserved region of the viral polymerase. Our data will enable researchers to develop molecular reagents to further characterize this virus and its relatives infecting other hosts and to curtail their spread, if necessary.

EID Vandegrift KJ, Kumar A, Sharma H, Murthy S, Kramer LD, Ostfeld R, et al. Presence of Segmented Flavivirus Infections in North America. Emerg Infect Dis. 2020;26(8):1810-1817. https://dx.doi.org/10.3201/eid2608.190986
AMA Vandegrift KJ, Kumar A, Sharma H, et al. Presence of Segmented Flavivirus Infections in North America. Emerging Infectious Diseases. 2020;26(8):1810-1817. doi:10.3201/eid2608.190986.
APA Vandegrift, K. J., Kumar, A., Sharma, H., Murthy, S., Kramer, L. D., Ostfeld, R....Kapoor, A. (2020). Presence of Segmented Flavivirus Infections in North America. Emerging Infectious Diseases, 26(8), 1810-1817. https://dx.doi.org/10.3201/eid2608.190986.

Characterizing Norovirus Transmission from Outbreak Data, United States [PDF - 746 KB - 8 pages]
M. K. Steele et al.

Norovirus is the leading cause of acute gastroenteritis outbreaks in the United States. We estimated the basic (R0) and effective (Re) reproduction numbers for 7,094 norovirus outbreaks reported to the National Outbreak Reporting System (NORS) during 2009–2017 and used regression models to assess whether transmission varied by outbreak setting. The median R0 was 2.75 (interquartile range [IQR] 2.38–3.65), and median Re was 1.29 (IQR 1.12–1.74). Long-term care and assisted living facilities had an R0 of 3.35 (95% CI 3.26–3.45), but R0 did not differ substantially for outbreaks in other settings, except for outbreaks in schools, colleges, and universities, which had an R0 of 2.92 (95% CI 2.82–3.03). Seasonally, R0 was lowest (3.11 [95% CI 2.97–3.25]) in summer and peaked in fall and winter. Overall, we saw little variability in transmission across different outbreaks settings in the United States.

EID Steele MK, Wikswo ME, Hall AJ, Koelle K, Handel A, Levy K, et al. Characterizing Norovirus Transmission from Outbreak Data, United States. Emerg Infect Dis. 2020;26(8):1818-1825. https://dx.doi.org/10.3201/eid2608.191537
AMA Steele MK, Wikswo ME, Hall AJ, et al. Characterizing Norovirus Transmission from Outbreak Data, United States. Emerging Infectious Diseases. 2020;26(8):1818-1825. doi:10.3201/eid2608.191537.
APA Steele, M. K., Wikswo, M. E., Hall, A. J., Koelle, K., Handel, A., Levy, K....Lopman, B. A. (2020). Characterizing Norovirus Transmission from Outbreak Data, United States. Emerging Infectious Diseases, 26(8), 1818-1825. https://dx.doi.org/10.3201/eid2608.191537.
Dispatches

Imported Monkeypox, Singapore [PDF - 3.38 MB - 5 pages]
S. Yong et al.

In May 2019, we investigated monkeypox in a traveler from Nigeria to Singapore. The public health response included rapid identification of contacts, use of quarantine, and postexposure smallpox vaccination. No secondary cases were identified. Countries should develop surveillance systems to detect emerging infectious diseases globally.

EID Yong S, Ng O, Ho Z, Mak T, Marimuthu K, Vasoo S, et al. Imported Monkeypox, Singapore. Emerg Infect Dis. 2020;26(8):1826-1830. https://dx.doi.org/10.3201/eid2608.191387
AMA Yong S, Ng O, Ho Z, et al. Imported Monkeypox, Singapore. Emerging Infectious Diseases. 2020;26(8):1826-1830. doi:10.3201/eid2608.191387.
APA Yong, S., Ng, O., Ho, Z., Mak, T., Marimuthu, K., Vasoo, S....Leo, Y. (2020). Imported Monkeypox, Singapore. Emerging Infectious Diseases, 26(8), 1826-1830. https://dx.doi.org/10.3201/eid2608.191387.

Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States [PDF - 282 KB - 3 pages]
M. L. Adams et al.

We estimated that 45.4% of US adults are at increased risk for complications from coronavirus disease because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. Rates increased by age, from 19.8% for persons 18–29 years of age to 80.7% for persons >80 years of age, and varied by state, race/ethnicity, health insurance status, and employment.

EID Adams ML, Katz DL, Grandpre J. Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States. Emerg Infect Dis. 2020;26(8):1831-1833. https://dx.doi.org/10.3201/eid2608.200679
AMA Adams ML, Katz DL, Grandpre J. Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States. Emerging Infectious Diseases. 2020;26(8):1831-1833. doi:10.3201/eid2608.200679.
APA Adams, M. L., Katz, D. L., & Grandpre, J. (2020). Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States. Emerging Infectious Diseases, 26(8), 1831-1833. https://dx.doi.org/10.3201/eid2608.200679.

Prolonged Persistence of SARS-CoV-2 RNA in Body Fluids [PDF - 1.48 MB - 5 pages]
J. Sun et al.

We prospectively assessed 49 coronavirus disease cases in Guangdong, China, to estimate the frequency and duration of detectable severe acute respiratory syndrome coronavirus 2 RNA in human body fluids. The prolonged persistence of virus RNA in various body fluids may guide the clinical diagnosis and prevention of onward virus transmission.

EID Sun J, Xiao J, Sun R, Tang X, Liang C, Lin H, et al. Prolonged Persistence of SARS-CoV-2 RNA in Body Fluids. Emerg Infect Dis. 2020;26(8):1834-1838. https://dx.doi.org/10.3201/eid2608.201097
AMA Sun J, Xiao J, Sun R, et al. Prolonged Persistence of SARS-CoV-2 RNA in Body Fluids. Emerging Infectious Diseases. 2020;26(8):1834-1838. doi:10.3201/eid2608.201097.
APA Sun, J., Xiao, J., Sun, R., Tang, X., Liang, C., Lin, H....Ke, C. (2020). Prolonged Persistence of SARS-CoV-2 RNA in Body Fluids. Emerging Infectious Diseases, 26(8), 1834-1838. https://dx.doi.org/10.3201/eid2608.201097.

Prognostic Value of Leukocytosis and Lymphopenia for Coronavirus Disease Severity [PDF - 977 KB - 3 pages]
G. Huang et al.

To evaluate lymphopenia as a marker for coronavirus disease severity, we conducted a meta-analysis of 10 studies. Severe illness was associated with lower lymphocyte and higher leukocyte counts. Using these markers for early identification of patients with severe disease may help healthcare providers prioritize the need to obtain therapy.

EID Huang G, Kovalic AJ, Graber CJ. Prognostic Value of Leukocytosis and Lymphopenia for Coronavirus Disease Severity. Emerg Infect Dis. 2020;26(8):1839-1841. https://dx.doi.org/10.3201/eid2608.201160
AMA Huang G, Kovalic AJ, Graber CJ. Prognostic Value of Leukocytosis and Lymphopenia for Coronavirus Disease Severity. Emerging Infectious Diseases. 2020;26(8):1839-1841. doi:10.3201/eid2608.201160.
APA Huang, G., Kovalic, A. J., & Graber, C. J. (2020). Prognostic Value of Leukocytosis and Lymphopenia for Coronavirus Disease Severity. Emerging Infectious Diseases, 26(8), 1839-1841. https://dx.doi.org/10.3201/eid2608.201160.

SARS-CoV-2 Phylogenetic Analysis, Lazio Region, Italy, February–March 2020 [PDF - 1.01 MB - 4 pages]
B. Bartolini et al.

We report phylogenetic and mutational analysis of severe acute respiratory syndrome coronavirus 2 virus strains from the Lazio region of Italy and provide information about the dynamics of virus spread. Data suggest effective containment of clade V strains, but subsequently, multiple waves of clade G strains were circulating widely in Europe.

EID Bartolini B, Rueca M, Gruber C, Messina F, Carletti F, Giombini E, et al. SARS-CoV-2 Phylogenetic Analysis, Lazio Region, Italy, February–March 2020. Emerg Infect Dis. 2020;26(8):1842-1845. https://dx.doi.org/10.3201/eid2608.201525
AMA Bartolini B, Rueca M, Gruber C, et al. SARS-CoV-2 Phylogenetic Analysis, Lazio Region, Italy, February–March 2020. Emerging Infectious Diseases. 2020;26(8):1842-1845. doi:10.3201/eid2608.201525.
APA Bartolini, B., Rueca, M., Gruber, C., Messina, F., Carletti, F., Giombini, E....Di Caro, A. (2020). SARS-CoV-2 Phylogenetic Analysis, Lazio Region, Italy, February–March 2020. Emerging Infectious Diseases, 26(8), 1842-1845. https://dx.doi.org/10.3201/eid2608.201525.

Plasma-Derived Extracellular Vesicles as Potential Biomarkers in Heart Transplant Patient with Chronic Chagas Disease [PDF - 1.35 MB - 6 pages]
N. Cortes-Serra et al.

Chagas disease is emerging in countries to which it is not endemic. Biomarkers for earlier therapeutic response assessment in patients with chronic Chagas disease are needed. We profiled plasma-derived extracellular vesicles from a heart transplant patient with chronic Chagas disease and showed the potential of this approach for discovering such biomarkers.

EID Cortes-Serra N, Mendes M, Mazagatos C, Segui-Barber J, Ellis CC, Ballart C, et al. Plasma-Derived Extracellular Vesicles as Potential Biomarkers in Heart Transplant Patient with Chronic Chagas Disease. Emerg Infect Dis. 2020;26(8):1846-1851. https://dx.doi.org/10.3201/eid2608.191042
AMA Cortes-Serra N, Mendes M, Mazagatos C, et al. Plasma-Derived Extracellular Vesicles as Potential Biomarkers in Heart Transplant Patient with Chronic Chagas Disease. Emerging Infectious Diseases. 2020;26(8):1846-1851. doi:10.3201/eid2608.191042.
APA Cortes-Serra, N., Mendes, M., Mazagatos, C., Segui-Barber, J., Ellis, C. C., Ballart, C....Fernandez-Becerra, C. (2020). Plasma-Derived Extracellular Vesicles as Potential Biomarkers in Heart Transplant Patient with Chronic Chagas Disease. Emerging Infectious Diseases, 26(8), 1846-1851. https://dx.doi.org/10.3201/eid2608.191042.

Increasing Malaria Parasite Clearance Time after Chloroquine Therapy, South Korea, 2000–2016 [PDF - 474 KB - 4 pages]
S. Park et al.

We reviewed the clinical efficacy of chloroquine for Plasmodium vivax malaria, the changing trend of parasite clearance time, and fever clearance time during 2000–2016 in South Korea. Median parasite clearance time and fever clearance time increased significantly over the study period. Chloroquine was mostly underdosed when used to treat P. vivax malaria.

EID Park S, Park Y, Park Y, Kwak Y, Song J, Lee K, et al. Increasing Malaria Parasite Clearance Time after Chloroquine Therapy, South Korea, 2000–2016. Emerg Infect Dis. 2020;26(8):1852-1855. https://dx.doi.org/10.3201/eid2608.190687
AMA Park S, Park Y, Park Y, et al. Increasing Malaria Parasite Clearance Time after Chloroquine Therapy, South Korea, 2000–2016. Emerging Infectious Diseases. 2020;26(8):1852-1855. doi:10.3201/eid2608.190687.
APA Park, S., Park, Y., Park, Y., Kwak, Y., Song, J., Lee, K....Yeom, J. (2020). Increasing Malaria Parasite Clearance Time after Chloroquine Therapy, South Korea, 2000–2016. Emerging Infectious Diseases, 26(8), 1852-1855. https://dx.doi.org/10.3201/eid2608.190687.

Disseminated Echinococcus multilocularis Infection without Liver Involvement in Child, Canada, 2018 [PDF - 909 KB - 4 pages]
J. Joyce et al.

An immunocompetent child in Canada received a diagnosis of disseminated alveolar Echinococcus multilocularis infection. The case lacked typical features of liver involvement and was possibly related to a rare congenital portosystemic shunt. We summarize the rapidly evolving epidemiology of E. multilocularis parasites in Canada.

EID Joyce J, He X, Rozovsky K, Stefanovici C, Fanella S. Disseminated Echinococcus multilocularis Infection without Liver Involvement in Child, Canada, 2018. Emerg Infect Dis. 2020;26(8):1856-1859. https://dx.doi.org/10.3201/eid2608.191644
AMA Joyce J, He X, Rozovsky K, et al. Disseminated Echinococcus multilocularis Infection without Liver Involvement in Child, Canada, 2018. Emerging Infectious Diseases. 2020;26(8):1856-1859. doi:10.3201/eid2608.191644.
APA Joyce, J., He, X., Rozovsky, K., Stefanovici, C., & Fanella, S. (2020). Disseminated Echinococcus multilocularis Infection without Liver Involvement in Child, Canada, 2018. Emerging Infectious Diseases, 26(8), 1856-1859. https://dx.doi.org/10.3201/eid2608.191644.

Canine Dracunculus Nematode Infection, Toledo, Spain [PDF - 1.10 MB - 4 pages]
I. Diekmann et al.

A fragment of a Dracunculus-like worm was extracted from the hind limb of a 2-year-old dog from Toledo, Spain. Cytochrome oxidase I and rRNA sequences confirmed an autochthonous mammalian Dracunculus worm infection in Europe. Sequence analyses suggest close relation to a parasite obtained from a North American opossum.

EID Diekmann I, Alnassan A, Globokar M, Pantchev N, Kurzrock L, Hernandez L, et al. Canine Dracunculus Nematode Infection, Toledo, Spain. Emerg Infect Dis. 2020;26(8):1860-1863. https://dx.doi.org/10.3201/eid2608.201661
AMA Diekmann I, Alnassan A, Globokar M, et al. Canine Dracunculus Nematode Infection, Toledo, Spain. Emerging Infectious Diseases. 2020;26(8):1860-1863. doi:10.3201/eid2608.201661.
APA Diekmann, I., Alnassan, A., Globokar, M., Pantchev, N., Kurzrock, L., Hernandez, L....Krücken, J. (2020). Canine Dracunculus Nematode Infection, Toledo, Spain. Emerging Infectious Diseases, 26(8), 1860-1863. https://dx.doi.org/10.3201/eid2608.201661.

Leishmania donovani Infection with Atypical Cutaneous Manifestations, Himachal Pradesh, India, 2014–2018 [PDF - 1.36 MB - 6 pages]
L. Thakur et al.

We conducted a molecular study of parasite sequences from a cohort of cutaneous leishmaniasis patients in Himachal Pradesh, India. Results revealed atypical cutaneous disease caused by Leishmania donovani parasites. L. donovani variants causing cutaneous manifestations in this region are different from those causing visceral leishmaniasis in northeastern India.

EID Thakur L, Singh KK, Kushwaha HR, Sharma SK, Shankar V, Negi A, et al. Leishmania donovani Infection with Atypical Cutaneous Manifestations, Himachal Pradesh, India, 2014–2018. Emerg Infect Dis. 2020;26(8):1864-1869. https://dx.doi.org/10.3201/eid2608.191761
AMA Thakur L, Singh KK, Kushwaha HR, et al. Leishmania donovani Infection with Atypical Cutaneous Manifestations, Himachal Pradesh, India, 2014–2018. Emerging Infectious Diseases. 2020;26(8):1864-1869. doi:10.3201/eid2608.191761.
APA Thakur, L., Singh, K. K., Kushwaha, H. R., Sharma, S. K., Shankar, V., Negi, A....Jain, M. (2020). Leishmania donovani Infection with Atypical Cutaneous Manifestations, Himachal Pradesh, India, 2014–2018. Emerging Infectious Diseases, 26(8), 1864-1869. https://dx.doi.org/10.3201/eid2608.191761.

Doxycycline and Sitafloxacin Combination Therapy for Treating Highly Resistant Mycoplasma genitalium [PDF - 1.94 MB - 5 pages]
D. Durukan et al.

Antimicrobial-resistant Mycoplasma genitalium is becoming increasingly common and creating major treatment challenges. We present early data on combination therapy with doxycycline and sitafloxacin to treat highly resistant M. genitalium. We found the regimen was well tolerated and cured 11/12 infections that had failed prior regimens with moxifloxacin and pristinamycin.

EID Durukan D, Doyle M, Murray G, Bodiyabadu K, Vodstrcil L, Chow E, et al. Doxycycline and Sitafloxacin Combination Therapy for Treating Highly Resistant Mycoplasma genitalium. Emerg Infect Dis. 2020;26(8):1870-1874. https://dx.doi.org/10.3201/eid2608.191806
AMA Durukan D, Doyle M, Murray G, et al. Doxycycline and Sitafloxacin Combination Therapy for Treating Highly Resistant Mycoplasma genitalium. Emerging Infectious Diseases. 2020;26(8):1870-1874. doi:10.3201/eid2608.191806.
APA Durukan, D., Doyle, M., Murray, G., Bodiyabadu, K., Vodstrcil, L., Chow, E....Bradshaw, C. S. (2020). Doxycycline and Sitafloxacin Combination Therapy for Treating Highly Resistant Mycoplasma genitalium. Emerging Infectious Diseases, 26(8), 1870-1874. https://dx.doi.org/10.3201/eid2608.191806.

Autochthonous Gnathostomiasis in Madagascar [PDF - 858 KB - 3 pages]
A. Raharisoa et al.

We used molecular tools to identify an autochthonous case of gnathostomiasis in Madagascar. This severe ocular infection, caused by Gnathostoma spinigerum nematodes, led to vision loss in the patient’s left eye. Clinicians should be aware of this parasitosis in Madagascar and other countries in Africa.

EID Raharisoa A, Izri A, Andrianjafy R, Rajaona R, Marteau A, Durand R, et al. Autochthonous Gnathostomiasis in Madagascar. Emerg Infect Dis. 2020;26(8):1875-1877. https://dx.doi.org/10.3201/eid2608.200383
AMA Raharisoa A, Izri A, Andrianjafy R, et al. Autochthonous Gnathostomiasis in Madagascar. Emerging Infectious Diseases. 2020;26(8):1875-1877. doi:10.3201/eid2608.200383.
APA Raharisoa, A., Izri, A., Andrianjafy, R., Rajaona, R., Marteau, A., Durand, R....Akhoundi, M. (2020). Autochthonous Gnathostomiasis in Madagascar. Emerging Infectious Diseases, 26(8), 1875-1877. https://dx.doi.org/10.3201/eid2608.200383.

Genotypic Heterogeneity of Orientia tsutsugamushi in Scrub Typhus Patients and Thrombocytopenia Syndrome Co-infection, Myanmar [PDF - 754 KB - 4 pages]
A. Win et al.

Serologic and molecular surveillance of serum collected from 152 suspected scrub typhus patients in Myanmar revealed Orientia tsutsugamushi of genotypic heterogeneity. In addition, potential co-infection with severe fever with thrombocytopenia syndrome virus was observed in 5 (3.3%) patients. Both scrub typhus and severe fever with thrombocytopenia syndrome are endemic in Myanmar.

EID Win A, Nguyen Y, Kim Y, Ha N, Kang J, Kim H, et al. Genotypic Heterogeneity of Orientia tsutsugamushi in Scrub Typhus Patients and Thrombocytopenia Syndrome Co-infection, Myanmar. Emerg Infect Dis. 2020;26(8):1878-1881. https://dx.doi.org/10.3201/eid2608.200135
AMA Win A, Nguyen Y, Kim Y, et al. Genotypic Heterogeneity of Orientia tsutsugamushi in Scrub Typhus Patients and Thrombocytopenia Syndrome Co-infection, Myanmar. Emerging Infectious Diseases. 2020;26(8):1878-1881. doi:10.3201/eid2608.200135.
APA Win, A., Nguyen, Y., Kim, Y., Ha, N., Kang, J., Kim, H....Cho, N. (2020). Genotypic Heterogeneity of Orientia tsutsugamushi in Scrub Typhus Patients and Thrombocytopenia Syndrome Co-infection, Myanmar. Emerging Infectious Diseases, 26(8), 1878-1881. https://dx.doi.org/10.3201/eid2608.200135.

Leishmania infantum in US-Born Dog [PDF - 657 KB - 3 pages]
M. E. de Almeida et al.

Leishmaniasis is a vectorborne disease that can infect humans, dogs, and other mammals. We identified one of its causative agents, Leishmania infantum, in a dog born in California, USA, demonstrating potential for autochthonous infections in this country. Our finding bolsters the need for improved leishmaniasis screening practices in the United States.

EID de Almeida ME, Spann DR, Bradbury RS. Leishmania infantum in US-Born Dog. Emerg Infect Dis. 2020;26(8):1882-1884. https://dx.doi.org/10.3201/eid2608.200149
AMA de Almeida ME, Spann DR, Bradbury RS. Leishmania infantum in US-Born Dog. Emerging Infectious Diseases. 2020;26(8):1882-1884. doi:10.3201/eid2608.200149.
APA de Almeida, M. E., Spann, D. R., & Bradbury, R. S. (2020). Leishmania infantum in US-Born Dog. Emerging Infectious Diseases, 26(8), 1882-1884. https://dx.doi.org/10.3201/eid2608.200149.

Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile [PDF - 1.26 MB - 4 pages]
M. Ferrés et al.

Andes virus (ANDV) is the only hantavirus transmitted between humans through close contact. We detected the genome and proteins of ANDV in breast milk cells from an infected mother in Chile who transmitted the virus to her child, suggesting gastrointestinal infection through breast milk as a route of ANDV person-to-person transmission.

EID Ferrés M, Martínez-Valdebenito C, Angulo J, Henríquez C, Vera-Otárola J, Vergara M, et al. Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile. Emerg Infect Dis. 2020;26(8):1885-1888. https://dx.doi.org/10.3201/eid2608.200204
AMA Ferrés M, Martínez-Valdebenito C, Angulo J, et al. Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile. Emerging Infectious Diseases. 2020;26(8):1885-1888. doi:10.3201/eid2608.200204.
APA Ferrés, M., Martínez-Valdebenito, C., Angulo, J., Henríquez, C., Vera-Otárola, J., Vergara, M....Le Corre, N. (2020). Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile. Emerging Infectious Diseases, 26(8), 1885-1888. https://dx.doi.org/10.3201/eid2608.200204.

Bertiella studeri Infection in Children, Sri Lanka [PDF - 765 KB - 4 pages]
A. Amarasinghe et al.

We provide a detailed molecular and phylogenetic description of Bertiella studeri tapeworms infecting children in Sri Lanka. Our findings can be used to identify multiple species of Bertiella tapeworms that can infect human hosts in the Old World.

EID Amarasinghe A, Le TH, Wickramasinghe S. Bertiella studeri Infection in Children, Sri Lanka. Emerg Infect Dis. 2020;26(8):1889-1892. https://dx.doi.org/10.3201/eid2608.200324
AMA Amarasinghe A, Le TH, Wickramasinghe S. Bertiella studeri Infection in Children, Sri Lanka. Emerging Infectious Diseases. 2020;26(8):1889-1892. doi:10.3201/eid2608.200324.
APA Amarasinghe, A., Le, T. H., & Wickramasinghe, S. (2020). Bertiella studeri Infection in Children, Sri Lanka. Emerging Infectious Diseases, 26(8), 1889-1892. https://dx.doi.org/10.3201/eid2608.200324.

Spread of Multidrug-Resistant Bacteria by Moth Flies from Hospital Waste Water System [PDF - 1.60 MB - 6 pages]
T. Rupprecht et al.

We documented and analyzed moth fly occurrence and spread of multidrug-resistant bacteria in a tertiary care hospital in Germany. The moth flies (Clogmia albipunctata) bred in the sewage system, then moved into the hospital, carrying biofilm and multidrug-resistant bacteria on their feet. Subsequently, the hospital developed a pest control protocol.

EID Rupprecht T, Moter A, Wiessener A, Reutershan J, Lang-Schwarz K, Vieth M, et al. Spread of Multidrug-Resistant Bacteria by Moth Flies from Hospital Waste Water System. Emerg Infect Dis. 2020;26(8):1893-1898. https://dx.doi.org/10.3201/eid2608.190750
AMA Rupprecht T, Moter A, Wiessener A, et al. Spread of Multidrug-Resistant Bacteria by Moth Flies from Hospital Waste Water System. Emerging Infectious Diseases. 2020;26(8):1893-1898. doi:10.3201/eid2608.190750.
APA Rupprecht, T., Moter, A., Wiessener, A., Reutershan, J., Lang-Schwarz, K., Vieth, M....Bollinger, T. (2020). Spread of Multidrug-Resistant Bacteria by Moth Flies from Hospital Waste Water System. Emerging Infectious Diseases, 26(8), 1893-1898. https://dx.doi.org/10.3201/eid2608.190750.

Atypical Pathogenicity of Avian Influenza (H3N1) Virus Involved in Outbreak, Belgium, 2019 [PDF - 1.42 MB - 5 pages]
M. Steensels et al.

In 2019, an outbreak of avian influenza (H3N1) virus infection occurred among commercial poultry in Belgium. Full-genome phylogenetic analysis indicated a wild bird origin rather than recent circulation among poultry. Although classified as a nonnotifiable avian influenza virus, it was associated with reproductive tropism and substantial mortality in the field.

EID Steensels M, Gelaude P, Van Borm S, Van Den Berg T, Cargnel M, Roupie V, et al. Atypical Pathogenicity of Avian Influenza (H3N1) Virus Involved in Outbreak, Belgium, 2019. Emerg Infect Dis. 2020;26(8):1899-1903. https://dx.doi.org/10.3201/eid2608.191338
AMA Steensels M, Gelaude P, Van Borm S, et al. Atypical Pathogenicity of Avian Influenza (H3N1) Virus Involved in Outbreak, Belgium, 2019. Emerging Infectious Diseases. 2020;26(8):1899-1903. doi:10.3201/eid2608.191338.
APA Steensels, M., Gelaude, P., Van Borm, S., Van Den Berg, T., Cargnel, M., Roupie, V....Lambrecht, B. (2020). Atypical Pathogenicity of Avian Influenza (H3N1) Virus Involved in Outbreak, Belgium, 2019. Emerging Infectious Diseases, 26(8), 1899-1903. https://dx.doi.org/10.3201/eid2608.191338.

In Vivo Observation of Trombiculosis with Fluorescence–Advanced Videodermatoscopy [PDF - 877 KB - 2 pages]
A. Ramondetta et al.

Trombiculosis is a skin infestation by larvae of mites of the Trombiculidae family. We used fluorescence–advanced videodermatoscopy to diagnose trombiculosis in a woman in Italy with targetoid patches. This method might be useful for identifying atypical manifestations of trombiculosis.

EID Ramondetta A, Ribero S, Peano A, Quaglino P, Broganelli P. In Vivo Observation of Trombiculosis with Fluorescence–Advanced Videodermatoscopy. Emerg Infect Dis. 2020;26(8):1904-1905. https://dx.doi.org/10.3201/eid2608.200077
AMA Ramondetta A, Ribero S, Peano A, et al. In Vivo Observation of Trombiculosis with Fluorescence–Advanced Videodermatoscopy. Emerging Infectious Diseases. 2020;26(8):1904-1905. doi:10.3201/eid2608.200077.
APA Ramondetta, A., Ribero, S., Peano, A., Quaglino, P., & Broganelli, P. (2020). In Vivo Observation of Trombiculosis with Fluorescence–Advanced Videodermatoscopy. Emerging Infectious Diseases, 26(8), 1904-1905. https://dx.doi.org/10.3201/eid2608.200077.

Evolution and Antigenic Drift of Influenza A (H7N9) Viruses, China, 2017–2019 [PDF - 2.65 MB - 6 pages]
J. Zhang et al.

After a sharp decrease of influenza A(H7N9) virus in China in 2018, highly pathogenic H7N9 viruses re-emerged in 2019. These H7N9 variants exhibited a new predominant subclade and had been cocirculating at a low level in eastern and northeastern China. Several immune escape mutations and antigenic drift were observed in H7N9 variants.

EID Zhang J, Ye H, Li H, Ma K, Qiu W, Chen Y, et al. Evolution and Antigenic Drift of Influenza A (H7N9) Viruses, China, 2017–2019. Emerg Infect Dis. 2020;26(8):1906-1911. https://dx.doi.org/10.3201/eid2608.200244
AMA Zhang J, Ye H, Li H, et al. Evolution and Antigenic Drift of Influenza A (H7N9) Viruses, China, 2017–2019. Emerging Infectious Diseases. 2020;26(8):1906-1911. doi:10.3201/eid2608.200244.
APA Zhang, J., Ye, H., Li, H., Ma, K., Qiu, W., Chen, Y....Qi, W. (2020). Evolution and Antigenic Drift of Influenza A (H7N9) Viruses, China, 2017–2019. Emerging Infectious Diseases, 26(8), 1906-1911. https://dx.doi.org/10.3201/eid2608.200244.
Research Letters

Doubling Time of the COVID-19 Epidemic by Province, China [PDF - 970 KB - 3 pages]
K. Muniz-Rodriguez et al.

In China, the doubling time of the coronavirus disease epidemic by province increased during January 20–February 9, 2020. Doubling time estimates ranged from 1.4 (95% CI 1.2–2.0) days for Hunan Province to 3.1 (95% CI 2.1–4.8) days for Xinjiang Province. The estimate for Hubei Province was 2.5 (95% CI 2.4–2.6) days.

EID Muniz-Rodriguez K, Chowell G, Cheung C, Jia D, Lai P, Lee Y, et al. Doubling Time of the COVID-19 Epidemic by Province, China. Emerg Infect Dis. 2020;26(8):1912-1914. https://dx.doi.org/10.3201/eid2608.200219
AMA Muniz-Rodriguez K, Chowell G, Cheung C, et al. Doubling Time of the COVID-19 Epidemic by Province, China. Emerging Infectious Diseases. 2020;26(8):1912-1914. doi:10.3201/eid2608.200219.
APA Muniz-Rodriguez, K., Chowell, G., Cheung, C., Jia, D., Lai, P., Lee, Y....Fung, I. (2020). Doubling Time of the COVID-19 Epidemic by Province, China. Emerging Infectious Diseases, 26(8), 1912-1914. https://dx.doi.org/10.3201/eid2608.200219.

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020 [PDF - 589 KB - 3 pages]
K. Muniz-Rodriguez et al.

To determine the transmission potential of severe acute respiratory syndrome coronavirus 2 in Iran in 2020, we estimated the reproduction number as 4.4 (95% CI 3.9–4.9) by using a generalized growth model and 3.5 (95% CI 1.3–8.1) by using epidemic doubling time. The reproduction number decreased to 1.55 after social distancing interventions were implemented.

EID Muniz-Rodriguez K, Fung I, Ferdosi SR, Ofori SK, Lee Y, Tariq A, et al. Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020. Emerg Infect Dis. 2020;26(8):1915-1917. https://dx.doi.org/10.3201/eid2608.200536
AMA Muniz-Rodriguez K, Fung I, Ferdosi SR, et al. Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020. Emerging Infectious Diseases. 2020;26(8):1915-1917. doi:10.3201/eid2608.200536.
APA Muniz-Rodriguez, K., Fung, I., Ferdosi, S. R., Ofori, S. K., Lee, Y., Tariq, A....Chowell, G. (2020). Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Potential, Iran, 2020. Emerging Infectious Diseases, 26(8), 1915-1917. https://dx.doi.org/10.3201/eid2608.200536.

Cluster of Coronavirus Disease Associated with Fitness Dance Classes, South Korea [PDF - 903 KB - 4 pages]
S. Jang et al.

During 24 days in Cheonan, South Korea, 112 persons were infected with severe acute respiratory syndrome coronavirus 2 associated with fitness dance classes at 12 sports facilities. Intense physical exercise in densely populated sports facilities could increase risk for infection. Vigorous exercise in confined spaces should be minimized during outbreaks.

EID Jang S, Han S, Rhee J. Cluster of Coronavirus Disease Associated with Fitness Dance Classes, South Korea. Emerg Infect Dis. 2020;26(8):1917-1920. https://dx.doi.org/10.3201/eid2608.200633
AMA Jang S, Han S, Rhee J. Cluster of Coronavirus Disease Associated with Fitness Dance Classes, South Korea. Emerging Infectious Diseases. 2020;26(8):1917-1920. doi:10.3201/eid2608.200633.
APA Jang, S., Han, S., & Rhee, J. (2020). Cluster of Coronavirus Disease Associated with Fitness Dance Classes, South Korea. Emerging Infectious Diseases, 26(8), 1917-1920. https://dx.doi.org/10.3201/eid2608.200633.

Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19 [PDF - 241 KB - 3 pages]
F. Xiao et al.

Severe acute respiratory syndrome coronavirus 2 was isolated from feces of a patient in China with coronavirus disease who died. Confirmation of infectious virus in feces affirms the potential for fecal–oral or fecal–respiratory transmission and warrants further study.

EID Xiao F, Sun J, Xu Y, Li F, Huang X, Li H, et al. Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19. Emerg Infect Dis. 2020;26(8):1920-1922. https://dx.doi.org/10.3201/eid2608.200681
AMA Xiao F, Sun J, Xu Y, et al. Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19. Emerging Infectious Diseases. 2020;26(8):1920-1922. doi:10.3201/eid2608.200681.
APA Xiao, F., Sun, J., Xu, Y., Li, F., Huang, X., Li, H....Zhao, J. (2020). Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19. Emerging Infectious Diseases, 26(8), 1920-1922. https://dx.doi.org/10.3201/eid2608.200681.

Estimation of Coronavirus Disease Case-Fatality Risk in Real Time [PDF - 537 KB - 2 pages]
Y. Ge and S. Sun

We ran a simulation comparing 3 methods to calculate case-fatality risk for coronavirus disease using parameters described in previous studies. Case-fatality risk calculated from these methods all are biased at the early stage of the epidemic. When comparing real-time case-fatality risk, the current trajectory of the epidemic should be considered.

EID Ge Y, Sun S. Estimation of Coronavirus Disease Case-Fatality Risk in Real Time. Emerg Infect Dis. 2020;26(8):1922-1923. https://dx.doi.org/10.3201/eid2608.201096
AMA Ge Y, Sun S. Estimation of Coronavirus Disease Case-Fatality Risk in Real Time. Emerging Infectious Diseases. 2020;26(8):1922-1923. doi:10.3201/eid2608.201096.
APA Ge, Y., & Sun, S. (2020). Estimation of Coronavirus Disease Case-Fatality Risk in Real Time. Emerging Infectious Diseases, 26(8), 1922-1923. https://dx.doi.org/10.3201/eid2608.201096.

Secondary Transmission of Coronavirus Disease from Presymptomatic Persons, China [PDF - 310 KB - 3 pages]
W. Zhang et al.

We explored the secondary attack rate in different types of contact with persons presymptomatic for coronavirus disease (COVID-19). Close contacts who lived with or had frequent contact with an index case-patient had a higher risk for COVID-19. Our findings provide population-based evidence for transmission from persons with presymptomatic COVID-19 infections.

EID Zhang W, Cheng W, Luo L, Ma Y, Xu C, Qin P, et al. Secondary Transmission of Coronavirus Disease from Presymptomatic Persons, China. Emerg Infect Dis. 2020;26(8):1924-1926. https://dx.doi.org/10.3201/eid2608.201142
AMA Zhang W, Cheng W, Luo L, et al. Secondary Transmission of Coronavirus Disease from Presymptomatic Persons, China. Emerging Infectious Diseases. 2020;26(8):1924-1926. doi:10.3201/eid2608.201142.
APA Zhang, W., Cheng, W., Luo, L., Ma, Y., Xu, C., Qin, P....Zhang, Z. (2020). Secondary Transmission of Coronavirus Disease from Presymptomatic Persons, China. Emerging Infectious Diseases, 26(8), 1924-1926. https://dx.doi.org/10.3201/eid2608.201142.

Abdominal Visceral Infarction in 3 Patients with COVID-19 [PDF - 532 KB - 3 pages]
G. Besutti et al.

A high incidence of thrombotic events has been reported in patients with coronavirus disease (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We report 3 clinical cases of patients in Italy with COVID-19 who developed abdominal viscera infarction, demonstrated by computed tomography.

EID Besutti G, Bonacini R, Iotti V, Marini G, Riva N, Dolci G, et al. Abdominal Visceral Infarction in 3 Patients with COVID-19. Emerg Infect Dis. 2020;26(8):1926-1928. https://dx.doi.org/10.3201/eid2608.201161
AMA Besutti G, Bonacini R, Iotti V, et al. Abdominal Visceral Infarction in 3 Patients with COVID-19. Emerging Infectious Diseases. 2020;26(8):1926-1928. doi:10.3201/eid2608.201161.
APA Besutti, G., Bonacini, R., Iotti, V., Marini, G., Riva, N., Dolci, G....Massari, M. (2020). Abdominal Visceral Infarction in 3 Patients with COVID-19. Emerging Infectious Diseases, 26(8), 1926-1928. https://dx.doi.org/10.3201/eid2608.201161.

Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan [PDF - 914 KB - 3 pages]
S. Kuo et al.

Taiwan has strictly followed infection control measures to prevent spread of coronavirus disease. Meanwhile, nationwide surveillance data revealed drastic decreases in influenza diagnoses in outpatient departments, positivity rates of clinical specimens, and confirmed severe cases during the first 12 weeks of 2020 compared with the same period of 2019.

EID Kuo S, Shih S, Chien L, Hsiung CA. Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan. Emerg Infect Dis. 2020;26(8):1928-1930. https://dx.doi.org/10.3201/eid2608.201192
AMA Kuo S, Shih S, Chien L, et al. Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan. Emerging Infectious Diseases. 2020;26(8):1928-1930. doi:10.3201/eid2608.201192.
APA Kuo, S., Shih, S., Chien, L., & Hsiung, C. A. (2020). Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan. Emerging Infectious Diseases, 26(8), 1928-1930. https://dx.doi.org/10.3201/eid2608.201192.

Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China [PDF - 1015 KB - 4 pages]
Y. Luo et al.

We found that all 5 asymptomatic household contacts of a Wuhan, China, physician with coronavirus disease had severe acute respiratory syndrome coronavirus 2 detected by PCR. The index patient and 2 contacts also had abnormal chest computed tomography scans. Asymptomatic infected household contacts of healthcare workers with coronavirus disease might be underrecognized.

EID Luo Y, Trevathan E, Qian Z, Li Y, Li J, Xiao W, et al. Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China. Emerg Infect Dis. 2020;26(8):1930-1933. https://dx.doi.org/10.3201/eid2608.201016
AMA Luo Y, Trevathan E, Qian Z, et al. Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China. Emerging Infectious Diseases. 2020;26(8):1930-1933. doi:10.3201/eid2608.201016.
APA Luo, Y., Trevathan, E., Qian, Z., Li, Y., Li, J., Xiao, W....Ye, G. (2020). Asymptomatic SARS-CoV-2 Infection in Household Contacts of a Healthcare Provider, Wuhan, China. Emerging Infectious Diseases, 26(8), 1930-1933. https://dx.doi.org/10.3201/eid2608.201016.

Decreased Influenza Incidence under COVID-19 Control Measures, Singapore [PDF - 929 KB - 3 pages]
R. Soo et al.

We compared indicators of influenza activity in 2020 before and after public health measures were taken to reduce coronavirus disease (COVID-19) with the corresponding indicators from 3 preceding years. Influenza activity declined substantially, suggesting that the measures taken for COVID-19 were effective in reducing spread of other viral respiratory diseases.

EID Soo R, Chiew CJ, Ma S, Pung R, Lee V. Decreased Influenza Incidence under COVID-19 Control Measures, Singapore. Emerg Infect Dis. 2020;26(8):1933-1935. https://dx.doi.org/10.3201/eid2608.201229
AMA Soo R, Chiew CJ, Ma S, et al. Decreased Influenza Incidence under COVID-19 Control Measures, Singapore. Emerging Infectious Diseases. 2020;26(8):1933-1935. doi:10.3201/eid2608.201229.
APA Soo, R., Chiew, C. J., Ma, S., Pung, R., & Lee, V. (2020). Decreased Influenza Incidence under COVID-19 Control Measures, Singapore. Emerging Infectious Diseases, 26(8), 1933-1935. https://dx.doi.org/10.3201/eid2608.201229.

SARS-CoV-2 Transmission from Presymptomatic Meeting Attendee, Germany [PDF - 243 KB - 3 pages]
D. Hijnen et al.

During a meeting in Munich, Germany, a presymptomatic attendee with severe acute respiratory syndrome coronavirus 2 infected at least 11 of 13 other participants. Although 5 participants had no or mild symptoms, 6 had typical coronavirus disease, without dyspnea. Our findings suggest hand shaking and face-to-face contact as possible modes of transmission.

EID Hijnen D, Marzano A, Eyerich K, GeurtsvanKessel C, Giménez-Arnau A, Joly P, et al. SARS-CoV-2 Transmission from Presymptomatic Meeting Attendee, Germany. Emerg Infect Dis. 2020;26(8):1935-1937. https://dx.doi.org/10.3201/eid2608.201235
AMA Hijnen D, Marzano A, Eyerich K, et al. SARS-CoV-2 Transmission from Presymptomatic Meeting Attendee, Germany. Emerging Infectious Diseases. 2020;26(8):1935-1937. doi:10.3201/eid2608.201235.
APA Hijnen, D., Marzano, A., Eyerich, K., GeurtsvanKessel, C., Giménez-Arnau, A., Joly, P....Schmidt, E. (2020). SARS-CoV-2 Transmission from Presymptomatic Meeting Attendee, Germany. Emerging Infectious Diseases, 26(8), 1935-1937. https://dx.doi.org/10.3201/eid2608.201235.

COVID-19 and Acute Pulmonary Embolism in Postpartum Patient [PDF - 841 KB - 3 pages]
Z. Khodamoradi et al.

We report a 36-year-old woman in Iran who sought care for left shoulder pain and cough 5 days after a scheduled cesarean section. Acute pulmonary embolism and coronavirus disease were diagnosed. Physicians should be aware of the potential for these concurrent conditions in postpartum women.

EID Khodamoradi Z, Boogar S, Shirazi F, Kouhi P. COVID-19 and Acute Pulmonary Embolism in Postpartum Patient. Emerg Infect Dis. 2020;26(8):1937-1939. https://dx.doi.org/10.3201/eid2608.201383
AMA Khodamoradi Z, Boogar S, Shirazi F, et al. COVID-19 and Acute Pulmonary Embolism in Postpartum Patient. Emerging Infectious Diseases. 2020;26(8):1937-1939. doi:10.3201/eid2608.201383.
APA Khodamoradi, Z., Boogar, S., Shirazi, F., & Kouhi, P. (2020). COVID-19 and Acute Pulmonary Embolism in Postpartum Patient. Emerging Infectious Diseases, 26(8), 1937-1939. https://dx.doi.org/10.3201/eid2608.201383.

Panton-Valentine Leukocidin–Secreting Staphylococcus aureus Pneumonia Complicating COVID-19 [PDF - 436 KB - 3 pages]
C. Duployez et al.

Necrotizing pneumonia induced by Panton-Valentine leukocidin–secreting Staphylococcus aureus is a rare but life-threatening infection that has been described in patients after they had influenza. We report a fatal case of this superinfection in a young adult who had coronavirus disease.

EID Duployez C, Le Guern R, Tinez C, Lejeune A, Robriquet L, Six S, et al. Panton-Valentine Leukocidin–Secreting Staphylococcus aureus Pneumonia Complicating COVID-19. Emerg Infect Dis. 2020;26(8):1939-1941. https://dx.doi.org/10.3201/eid2608.201413
AMA Duployez C, Le Guern R, Tinez C, et al. Panton-Valentine Leukocidin–Secreting Staphylococcus aureus Pneumonia Complicating COVID-19. Emerging Infectious Diseases. 2020;26(8):1939-1941. doi:10.3201/eid2608.201413.
APA Duployez, C., Le Guern, R., Tinez, C., Lejeune, A., Robriquet, L., Six, S....Wallet, F. (2020). Panton-Valentine Leukocidin–Secreting Staphylococcus aureus Pneumonia Complicating COVID-19. Emerging Infectious Diseases, 26(8), 1939-1941. https://dx.doi.org/10.3201/eid2608.201413.

Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease [PDF - 298 KB - 3 pages]
D. O. Griffin et al.

We report 3 patients with coronavirus disease who had a decline in respiratory status during their hospital course that responded well to intravenous steroids and interleukin-6 receptor antagonist therapy. These patients later showed development of persistent hypoxia with increased levels of d-dimer levels and were given a diagnosis of pulmonary embolisms.

EID Griffin DO, Jensen A, Khan M, Chin J, Chin K, Saad J, et al. Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease. Emerg Infect Dis. 2020;26(8):1941-1943. https://dx.doi.org/10.3201/eid2608.201477
AMA Griffin DO, Jensen A, Khan M, et al. Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease. Emerging Infectious Diseases. 2020;26(8):1941-1943. doi:10.3201/eid2608.201477.
APA Griffin, D. O., Jensen, A., Khan, M., Chin, J., Chin, K., Saad, J....Patel, D. (2020). Pulmonary Embolism and Increased Levels of d-Dimer in Patients with Coronavirus Disease. Emerging Infectious Diseases, 26(8), 1941-1943. https://dx.doi.org/10.3201/eid2608.201477.

Delayed Laboratory Response to COVID-19 Caused by Molecular Diagnostic Contamination [PDF - 689 KB - 3 pages]
R. Mögling et al.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) created an exceptional situation in which numerous laboratories in Europe simultaneously implemented SARS-CoV-2 diagnostics. These laboratories reported in February 2020 that commercial primer and probe batches for SARS-CoV-2 detection were contaminated with synthetic control material, causing delays of regional testing roll-out in various countries.

EID Mögling R, Meijer A, Berginc N, Bruisten S, Charrel R, Coutard B, et al. Delayed Laboratory Response to COVID-19 Caused by Molecular Diagnostic Contamination. Emerg Infect Dis. 2020;26(8):1944-1946. https://dx.doi.org/10.3201/eid2608.201843
AMA Mögling R, Meijer A, Berginc N, et al. Delayed Laboratory Response to COVID-19 Caused by Molecular Diagnostic Contamination. Emerging Infectious Diseases. 2020;26(8):1944-1946. doi:10.3201/eid2608.201843.
APA Mögling, R., Meijer, A., Berginc, N., Bruisten, S., Charrel, R., Coutard, B....Reusken, C. (2020). Delayed Laboratory Response to COVID-19 Caused by Molecular Diagnostic Contamination. Emerging Infectious Diseases, 26(8), 1944-1946. https://dx.doi.org/10.3201/eid2608.201843.

Dengue Virus Type 1 Infection in Traveler Returning from Benin to France, 2019 [PDF - 654 KB - 4 pages]
T. Fourié et al.

We investigated a case of dengue virus type 1 infection acquired in Benin. Phylogenetic analysis revealed the strain belongs to genotype V but clusters with Asian, rather than with known African, strains. Our finding suggests the introduction of Asian dengue virus in West Africa.

EID Fourié T, Luciani L, Amrane S, Zandotti C, Leparc-Goffart I, Ninove L, et al. Dengue Virus Type 1 Infection in Traveler Returning from Benin to France, 2019. Emerg Infect Dis. 2020;26(8):1946-1949. https://dx.doi.org/10.3201/eid2608.200055
AMA Fourié T, Luciani L, Amrane S, et al. Dengue Virus Type 1 Infection in Traveler Returning from Benin to France, 2019. Emerging Infectious Diseases. 2020;26(8):1946-1949. doi:10.3201/eid2608.200055.
APA Fourié, T., Luciani, L., Amrane, S., Zandotti, C., Leparc-Goffart, I., Ninove, L....Nougairède, A. (2020). Dengue Virus Type 1 Infection in Traveler Returning from Benin to France, 2019. Emerging Infectious Diseases, 26(8), 1946-1949. https://dx.doi.org/10.3201/eid2608.200055.

Outbreak of Human Metapneumovirus Infection in Zoo, Slovenia [PDF - 383 KB - 3 pages]
T. Uršič et al.

We report a case of human metapneumovirus infection that spread from humans to chimpanzees and back to humans. Bronchopneumonia developed in 4 of 6 members of a chimpanzee family, and 2 subsequently died. The chimpanzees’ keeper also became ill. Sequencing showed 100% identity between virus sequences from chimpanzees and the keeper.

EID Uršič T, Lalek N, Kvapil P, Kastelic M, Cociancich V, Košnik IG, et al. Outbreak of Human Metapneumovirus Infection in Zoo, Slovenia. Emerg Infect Dis. 2020;26(8):1949-1951. https://dx.doi.org/10.3201/eid2608.200125
AMA Uršič T, Lalek N, Kvapil P, et al. Outbreak of Human Metapneumovirus Infection in Zoo, Slovenia. Emerging Infectious Diseases. 2020;26(8):1949-1951. doi:10.3201/eid2608.200125.
APA Uršič, T., Lalek, N., Kvapil, P., Kastelic, M., Cociancich, V., Košnik, I. G....Petrovec, M. (2020). Outbreak of Human Metapneumovirus Infection in Zoo, Slovenia. Emerging Infectious Diseases, 26(8), 1949-1951. https://dx.doi.org/10.3201/eid2608.200125.

mcr-Positive Escherichia coli ST131-H22 from Poultry in Brazil [PDF - 1.30 MB - 4 pages]
A. S. Saidenberg et al.

Escherichia coli sequence type (ST) 131 is of concern because it can acquire antimicrobial resistance and cause extraintestinal infections. E. coli ST131-H22 sublineage appears capable of being transmitted to humans through poultry. We report on multidrug-resistant ST131-H22 poultry isolates in Brazil closely related to international human and poultry isolates.

EID Saidenberg AS, Stegger M, Price L, Johannesen T, Aziz M, Cunha M, et al. mcr-Positive Escherichia coli ST131-H22 from Poultry in Brazil. Emerg Infect Dis. 2020;26(8):1951-1954. https://dx.doi.org/10.3201/eid2608.191724
AMA Saidenberg AS, Stegger M, Price L, et al. mcr-Positive Escherichia coli ST131-H22 from Poultry in Brazil. Emerging Infectious Diseases. 2020;26(8):1951-1954. doi:10.3201/eid2608.191724.
APA Saidenberg, A. S., Stegger, M., Price, L., Johannesen, T., Aziz, M., Cunha, M....Knöbl, T. (2020). mcr-Positive Escherichia coli ST131-H22 from Poultry in Brazil. Emerging Infectious Diseases, 26(8), 1951-1954. https://dx.doi.org/10.3201/eid2608.191724.

Heartland Virus in Lone Star Ticks, Alabama, USA [PDF - 972 KB - 3 pages]
B. C. Newman et al.

We detected Heartland virus (HRTV) in lone star nymphs collected in 2018 in northern Alabama, USA. Real-time reverse transcription PCR selective for the small segment of the HRTV genome and confirmatory sequencing of positive samples showed high identity with HRTV strains sequenced from Tennessee and Missouri.

EID Newman BC, Sutton WB, Moncayo AC, Hughes HR, Taheri A, Moore TC, et al. Heartland Virus in Lone Star Ticks, Alabama, USA. Emerg Infect Dis. 2020;26(8):1954-1956. https://dx.doi.org/10.3201/eid2608.200494
AMA Newman BC, Sutton WB, Moncayo AC, et al. Heartland Virus in Lone Star Ticks, Alabama, USA. Emerging Infectious Diseases. 2020;26(8):1954-1956. doi:10.3201/eid2608.200494.
APA Newman, B. C., Sutton, W. B., Moncayo, A. C., Hughes, H. R., Taheri, A., Moore, T. C....Wang, Y. (2020). Heartland Virus in Lone Star Ticks, Alabama, USA. Emerging Infectious Diseases, 26(8), 1954-1956. https://dx.doi.org/10.3201/eid2608.200494.

Visceral Leishmaniasis Caused by Leishmania donovani Zymodeme MON-37, Western Ghats, India [PDF - 817 KB - 3 pages]
P. Saini et al.
EID Saini P, Kumar N, Ajithlal P, Joji A, Rajesh K, Reena K, et al. Visceral Leishmaniasis Caused by Leishmania donovani Zymodeme MON-37, Western Ghats, India. Emerg Infect Dis. 2020;26(8):1956-1958. https://dx.doi.org/10.3201/eid2608.200557
AMA Saini P, Kumar N, Ajithlal P, et al. Visceral Leishmaniasis Caused by Leishmania donovani Zymodeme MON-37, Western Ghats, India. Emerging Infectious Diseases. 2020;26(8):1956-1958. doi:10.3201/eid2608.200557.
APA Saini, P., Kumar, N., Ajithlal, P., Joji, A., Rajesh, K., Reena, K....Kumar, A. (2020). Visceral Leishmaniasis Caused by Leishmania donovani Zymodeme MON-37, Western Ghats, India. Emerging Infectious Diseases, 26(8), 1956-1958. https://dx.doi.org/10.3201/eid2608.200557.

Cryptosporidium baileyi Pulmonary Infection in Immunocompetent Woman with Benign Neoplasm [PDF - 860 KB - 4 pages]
Ż. Kopacz et al.

Cryptosporidium baileyi, a bird-specific parasite, infects gastrointestinal, pulmonary, and urinary tracts of its host. We report on a C. baileyi infection associated with pulmonary hamartoma in an immunocompetent patient in Poland. Further work is needed to investigate the association between Cryptosporidium infections and tumors.

EID Kopacz Ż, Kváč M, Piesiak P, Szydłowicz M, Hendrich AB, Sak B, et al. Cryptosporidium baileyi Pulmonary Infection in Immunocompetent Woman with Benign Neoplasm. Emerg Infect Dis. 2020;26(8):1958-1961. https://dx.doi.org/10.3201/eid2608.201117
AMA Kopacz Ż, Kváč M, Piesiak P, et al. Cryptosporidium baileyi Pulmonary Infection in Immunocompetent Woman with Benign Neoplasm. Emerging Infectious Diseases. 2020;26(8):1958-1961. doi:10.3201/eid2608.201117.
APA Kopacz, Ż., Kváč, M., Piesiak, P., Szydłowicz, M., Hendrich, A. B., Sak, B....Kicia, M. (2020). Cryptosporidium baileyi Pulmonary Infection in Immunocompetent Woman with Benign Neoplasm. Emerging Infectious Diseases, 26(8), 1958-1961. https://dx.doi.org/10.3201/eid2608.201117.
Letters

Intact Mycobacterium leprae Isolated from Placenta of a Pregnant Woman, China [PDF - 250 KB - 1 page]
A. Singh et al.
EID Singh A, Pawar H, Yadav R, Chauhan D. Intact Mycobacterium leprae Isolated from Placenta of a Pregnant Woman, China. Emerg Infect Dis. 2020;26(8):1961. https://dx.doi.org/10.3201/eid2608.191149
AMA Singh A, Pawar H, Yadav R, et al. Intact Mycobacterium leprae Isolated from Placenta of a Pregnant Woman, China. Emerging Infectious Diseases. 2020;26(8):1961. doi:10.3201/eid2608.191149.
APA Singh, A., Pawar, H., Yadav, R., & Chauhan, D. (2020). Intact Mycobacterium leprae Isolated from Placenta of a Pregnant Woman, China. Emerging Infectious Diseases, 26(8), 1961. https://dx.doi.org/10.3201/eid2608.191149.

The Practice of Wearing Surgical Masks during the COVID-19 Pandemic [PDF - 237 KB - 1 page]
C. Chiang et al.
EID Chiang C, Chiang C, Chiang C, Chen Y. The Practice of Wearing Surgical Masks during the COVID-19 Pandemic. Emerg Infect Dis. 2020;26(8):1962. https://dx.doi.org/10.3201/eid2608.201498
AMA Chiang C, Chiang C, Chiang C, et al. The Practice of Wearing Surgical Masks during the COVID-19 Pandemic. Emerging Infectious Diseases. 2020;26(8):1962. doi:10.3201/eid2608.201498.
APA Chiang, C., Chiang, C., Chiang, C., & Chen, Y. (2020). The Practice of Wearing Surgical Masks during the COVID-19 Pandemic. Emerging Infectious Diseases, 26(8), 1962. https://dx.doi.org/10.3201/eid2608.201498.

Infections among Contacts of Patients with Nipah Virus, India [PDF - 241 KB - 1 page]
C. Tan and K. Wong
EID Tan C, Wong K. Infections among Contacts of Patients with Nipah Virus, India. Emerg Infect Dis. 2020;26(8):1963. https://dx.doi.org/10.3201/eid2608.190722
AMA Tan C, Wong K. Infections among Contacts of Patients with Nipah Virus, India. Emerging Infectious Diseases. 2020;26(8):1963. doi:10.3201/eid2608.190722.
APA Tan, C., & Wong, K. (2020). Infections among Contacts of Patients with Nipah Virus, India. Emerging Infectious Diseases, 26(8), 1963. https://dx.doi.org/10.3201/eid2608.190722.
Books and Media

Human Parasitic Diseases: A Diagnostic Atlas [PDF - 162 KB - 1 page]
T. Crook
EID Crook T. Human Parasitic Diseases: A Diagnostic Atlas. Emerg Infect Dis. 2020;26(8):1965. https://dx.doi.org/10.3201/eid2608.200270
AMA Crook T. Human Parasitic Diseases: A Diagnostic Atlas. Emerging Infectious Diseases. 2020;26(8):1965. doi:10.3201/eid2608.200270.
APA Crook, T. (2020). Human Parasitic Diseases: A Diagnostic Atlas. Emerging Infectious Diseases, 26(8), 1965. https://dx.doi.org/10.3201/eid2608.200270.
About the Cover

The Curious Case of the Cephalopod Parasites [PDF - 1.47 MB - 2 pages]
B. Breedlove
EID Breedlove B. The Curious Case of the Cephalopod Parasites. Emerg Infect Dis. 2020;26(8):1966-1967. https://dx.doi.org/10.3201/eid2608.ac2608
AMA Breedlove B. The Curious Case of the Cephalopod Parasites. Emerging Infectious Diseases. 2020;26(8):1966-1967. doi:10.3201/eid2608.ac2608.
APA Breedlove, B. (2020). The Curious Case of the Cephalopod Parasites. Emerging Infectious Diseases, 26(8), 1966-1967. https://dx.doi.org/10.3201/eid2608.ac2608.
Etymologia

Etymologia: Acanthamoeba [PDF - 377 KB - 1 page]
N. Pradhan
EID Pradhan N. Etymologia: Acanthamoeba. Emerg Infect Dis. 2020;26(8):1855. https://dx.doi.org/10.3201/eid2608.et2608
AMA Pradhan N. Etymologia: Acanthamoeba. Emerging Infectious Diseases. 2020;26(8):1855. doi:10.3201/eid2608.et2608.
APA Pradhan, N. (2020). Etymologia: Acanthamoeba. Emerging Infectious Diseases, 26(8), 1855. https://dx.doi.org/10.3201/eid2608.et2608.
Retractions

Retraction: Novel Orthobunyavirus Causing Severe Kidney Disease in Broiler Chickens, Malaysia, 2014–2017 [PDF - 559 KB - 1 page]
V. Palya et al.
EID Palya V, Kovács E, Marton S, Tatár-Kis T, Felföldi B, Forró B, et al. Retraction: Novel Orthobunyavirus Causing Severe Kidney Disease in Broiler Chickens, Malaysia, 2014–2017. Emerg Infect Dis. 2020;26(8):1964. https://dx.doi.org/10.3201/eid2608.202331
AMA Palya V, Kovács E, Marton S, et al. Retraction: Novel Orthobunyavirus Causing Severe Kidney Disease in Broiler Chickens, Malaysia, 2014–2017. Emerging Infectious Diseases. 2020;26(8):1964. doi:10.3201/eid2608.202331.
APA Palya, V., Kovács, E., Marton, S., Tatár-Kis, T., Felföldi, B., Forró, B....Bányai, K. (2020). Retraction: Novel Orthobunyavirus Causing Severe Kidney Disease in Broiler Chickens, Malaysia, 2014–2017. Emerging Infectious Diseases, 26(8), 1964. https://dx.doi.org/10.3201/eid2608.202331.
Page created: July 19, 2020
Page updated: July 21, 2020
Page reviewed: July 21, 2020
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