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Articles from Emerging Infectious Diseases

Perspective

Considerations for Establishing Successful Coronavirus Disease Vaccination Programs in Africa [PDF - 730 KB - 8 pages]
V. Williams et al.

The accelerated development of coronavirus disease (COVID-19) candidate vaccines is intended to achieve worldwide immunity. Ensuring COVID-19 vaccination is crucial to stemming the pandemic, reclaiming everyday life, and helping restore economies. However, challenges exist to deploying these vaccines, especially in resource-limited sub-Saharan Africa. In this article, we highlight lessons learned from previous efforts to scale up vaccine distribution and offer considerations for policymakers and key stakeholders to use for successful COVID-19 vaccination rollout in Africa. These considerations range from improving weak infrastructure for managing data and identifying adverse events after immunization to considering financing options for overcoming the logistical challenges of vaccination campaigns and generating demand for vaccine uptake. In addition, providing COVID-19 vaccination can be used to promote the adoption of universal healthcare, especially in sub-Saharan Africa countries.

EID Williams V, Edem B, Calnan M, Otwombe K, Okeahalam C. Considerations for Establishing Successful Coronavirus Disease Vaccination Programs in Africa. Emerg Infect Dis. 2021;27(8):2009-2016. https://doi.org/10.3201/eid2708.203870
AMA Williams V, Edem B, Calnan M, et al. Considerations for Establishing Successful Coronavirus Disease Vaccination Programs in Africa. Emerging Infectious Diseases. 2021;27(8):2009-2016. doi:10.3201/eid2708.203870.
APA Williams, V., Edem, B., Calnan, M., Otwombe, K., & Okeahalam, C. (2021). Considerations for Establishing Successful Coronavirus Disease Vaccination Programs in Africa. Emerging Infectious Diseases, 27(8), 2009-2016. https://doi.org/10.3201/eid2708.203870.

Comparison of Lyme Disease in the United States and Europe [PDF - 2.04 MB - 8 pages]
A. R. Marques et al.

Lyme disease, or Lyme borreliosis, is the most common tickborne disease in the United States and Europe. In both locations, Ixodes species ticks transmit the Borrelia burgdorferi sensu lato bacteria species responsible for causing the infection. The diversity of Borrelia species that cause human infection is greater in Europe; the 2 B. burgdorferi s.l. species collectively responsible for most infections in Europe, B. afzelii and B. garinii, are not found in the United States, where most infections are caused by B. burgdorferi sensu stricto. Strain differences seem to explain some of the variation in the clinical manifestations of Lyme disease, which are both minor and substantive, between the United States and Europe. Future studies should attempt to delineate the specific virulence factors of the different species of B. burgdorferi s.l. responsible for these variations in clinical features.

EID Marques AR, Strle F, Wormser GP. Comparison of Lyme Disease in the United States and Europe. Emerg Infect Dis. 2021;27(8):2017-2024. https://doi.org/10.3201/eid2708.204763
AMA Marques AR, Strle F, Wormser GP. Comparison of Lyme Disease in the United States and Europe. Emerging Infectious Diseases. 2021;27(8):2017-2024. doi:10.3201/eid2708.204763.
APA Marques, A. R., Strle, F., & Wormser, G. P. (2021). Comparison of Lyme Disease in the United States and Europe. Emerging Infectious Diseases, 27(8), 2017-2024. https://doi.org/10.3201/eid2708.204763.
Synopses

Mycobacterium microti Infections in Free-Ranging Red Deer (Cervus elaphus) [PDF - 3.53 MB - 8 pages]
G. Ghielmetti et al.

Infections with Mycobacterium microti, a member of the M. tuberculosis complex, have been increasingly reported in humans and in domestic and free-ranging wild animals. At postmortem examination, infected animals may display histopathologic lesions indistinguishable from those caused by M. bovis or M. caprae, potentially leading to misidentification of bovine tuberculosis. We report 3 cases of M. microti infections in free-ranging red deer (Cervus elaphus) from western Austria and southern Germany. One diseased animal displayed severe pyogranulomatous pleuropneumonia and multifocal granulomas on the surface of the pericardium. Two other animals showed alterations of the lungs and associated lymph nodes compatible with parasitic infestation. Results of the phylogenetic analysis including multiple animal strains from the study area showed independent infection events, but no host-adapted genotype. Personnel involved in bovine tuberculosis–monitoring programs should be aware of the fastidious nature of M. microti, its pathogenicity in wildlife, and zoonotic potential.

EID Ghielmetti G, Kupca AM, Hanczaruk M, Friedel U, Weinberger H, Revilla-Fernández S, et al. Mycobacterium microti Infections in Free-Ranging Red Deer (Cervus elaphus). Emerg Infect Dis. 2021;27(8):2025-2032. https://doi.org/10.3201/eid2708.210634
AMA Ghielmetti G, Kupca AM, Hanczaruk M, et al. Mycobacterium microti Infections in Free-Ranging Red Deer (Cervus elaphus). Emerging Infectious Diseases. 2021;27(8):2025-2032. doi:10.3201/eid2708.210634.
APA Ghielmetti, G., Kupca, A. M., Hanczaruk, M., Friedel, U., Weinberger, H., Revilla-Fernández, S....Glawischnig, W. (2021). Mycobacterium microti Infections in Free-Ranging Red Deer (Cervus elaphus). Emerging Infectious Diseases, 27(8), 2025-2032. https://doi.org/10.3201/eid2708.210634.

Plague Transmission from Corpses and Carcasses [PDF - 2.03 MB - 9 pages]
S. Jullien et al.

Knowing whether human corpses can transmit plague will inform policies for handling the bodies of those who have died of the disease. We analyzed the literature to evaluate risk for transmission of Yersinia pestis, the causative agent of plague, from human corpses and animal carcasses. Because we could not find direct evidence of transmission, we described a transmission pathway and assessed the potential for transmission at each step. We examined 3 potential sources of infection: body fluids of living plague patients, infected corpses and carcasses, and body fluids of infected corpses. We concluded that pneumonic plague can be transmitted by intensive handling of the corpse or carcass, presumably through the inhalation of respiratory droplets, and that bubonic plague can be transmitted by blood-to-blood contact with the body fluids of a corpse or carcass. These findings should inform precautions taken by those handling the bodies of persons or animals that died of plague.

EID Jullien S, de Silva N, Garner P. Plague Transmission from Corpses and Carcasses. Emerg Infect Dis. 2021;27(8):2033-2041. https://doi.org/10.3201/eid2708.200136
AMA Jullien S, de Silva N, Garner P. Plague Transmission from Corpses and Carcasses. Emerging Infectious Diseases. 2021;27(8):2033-2041. doi:10.3201/eid2708.200136.
APA Jullien, S., de Silva, N., & Garner, P. (2021). Plague Transmission from Corpses and Carcasses. Emerging Infectious Diseases, 27(8), 2033-2041. https://doi.org/10.3201/eid2708.200136.

Medscape CME Activity
Four Human Cases of Eastern Equine Encephalitis in Connecticut, USA, during a Larger Regional Outbreak, 2019 [PDF - 3.33 MB - 10 pages]
S. C. Brown et al.

During 3 weeks in 2019, 4 human cases of Eastern equine encephalitis (EEE) were diagnosed at a single hospital in Connecticut, USA. The cases coincided with notable shifts in vector–host infection patterns in the northeastern United States and signified a striking change in EEE incidence. All 4 cases were geographically clustered, rapidly progressive, and neurologically devastating. Diagnostic tests conducted by a national commercial reference laboratory revealed initial granulocytic cerebrospinal fluid pleocytosis and false-negative antibody results. EEE virus infection was diagnosed only after patient samples were retested by the arbovirus laboratory of the Centers for Disease Control and Prevention in Fort Collins, Colorado, USA. The crucial diagnostic challenges, clinical findings, and epidemiologic patterns revealed in this outbreak can inform future public health and clinical practice.

EID Brown SC, Cormier J, Tuan J, Lier AJ, McGuone D, Armstrong PM, et al. Four Human Cases of Eastern Equine Encephalitis in Connecticut, USA, during a Larger Regional Outbreak, 2019. Emerg Infect Dis. 2021;27(8):2042-2051. https://doi.org/10.3201/eid2708.203730
AMA Brown SC, Cormier J, Tuan J, et al. Four Human Cases of Eastern Equine Encephalitis in Connecticut, USA, during a Larger Regional Outbreak, 2019. Emerging Infectious Diseases. 2021;27(8):2042-2051. doi:10.3201/eid2708.203730.
APA Brown, S. C., Cormier, J., Tuan, J., Lier, A. J., McGuone, D., Armstrong, P. M....Gobeske, K. T. (2021). Four Human Cases of Eastern Equine Encephalitis in Connecticut, USA, during a Larger Regional Outbreak, 2019. Emerging Infectious Diseases, 27(8), 2042-2051. https://doi.org/10.3201/eid2708.203730.
Research

Medscape CME Activity
Fungemia and Other Fungal Infections Associated with Use of Saccharomyces boulardii Probiotic Supplements [PDF - 848 KB - 7 pages]
J. Rannikko et al.

Because of widespread use of probiotics, their safety must be guaranteed. We assessed use of Saccharomyces boulardii probiotic yeast from medical records for patients who had Saccharomyces fungemia or other clinical Saccharomyces culture findings. We evaluated all Saccharomyces sp. findings at 5 university hospitals in Finland during 2009–2018. We found 46 patients who had Saccharomyces fungemia; at least 20 (43%) were using S. boulardii probiotic. Compared with a control group that had bacteremia or candidemia, the odds ratio for use of an S. boulardii probiotic was 14 (95% CI 4–44). Of 1,153 nonblood culture findings, the history for 125 patients was checked; at least 24 (19%) were using the probiotic (odds ratio 10, 95% CI 3–32). This study adds to published fungemia cases linked to use of S. boulardii probiotic and sheds light on the scale of nonblood Saccharomyces culture findings that are also linked to use of this probiotic.

EID Rannikko J, Holmberg V, Karppelin M, Arvola P, Huttunen R, Mattila E, et al. Fungemia and Other Fungal Infections Associated with Use of Saccharomyces boulardii Probiotic Supplements. Emerg Infect Dis. 2021;27(8):2043-2051. https://doi.org/10.3201/eid2708.210018
AMA Rannikko J, Holmberg V, Karppelin M, et al. Fungemia and Other Fungal Infections Associated with Use of Saccharomyces boulardii Probiotic Supplements. Emerging Infectious Diseases. 2021;27(8):2043-2051. doi:10.3201/eid2708.210018.
APA Rannikko, J., Holmberg, V., Karppelin, M., Arvola, P., Huttunen, R., Mattila, E....Hohenthal, U. (2021). Fungemia and Other Fungal Infections Associated with Use of Saccharomyces boulardii Probiotic Supplements. Emerging Infectious Diseases, 27(8), 2043-2051. https://doi.org/10.3201/eid2708.210018.

Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in High-Density Settings, Minnesota, USA, March–June 2020 [PDF - 3.83 MB - 12 pages]
N. B. Lehnertz et al.

Coronavirus disease has disproportionately affected persons in congregate settings and high-density workplaces. To determine more about the transmission patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in these settings, we performed whole-genome sequencing and phylogenetic analysis on 319 (14.4%) samples from 2,222 SARS-CoV-2–positive persons associated with 8 outbreaks in Minnesota, USA, during March–June 2020. Sequencing indicated that virus spread in 3 long-term care facilities and 2 correctional facilities was associated with a single genetic sequence and that in a fourth long-term care facility, outbreak cases were associated with 2 distinct sequences. In contrast, cases associated with outbreaks in 2 meat-processing plants were associated with multiple SARS-CoV-2 sequences. These results suggest that a single introduction of SARS-CoV-2 into a facility can result in a widespread outbreak. Early identification and cohorting (segregating) of virus-positive persons in these settings, along with continued vigilance with infection prevention and control measures, is imperative.

EID Lehnertz NB, Wang X, Garfin J, Taylor J, Zipprich J, VonBank B, et al. Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in High-Density Settings, Minnesota, USA, March–June 2020. Emerg Infect Dis. 2021;27(8):2052-2063. https://doi.org/10.3201/eid2708.204838
AMA Lehnertz NB, Wang X, Garfin J, et al. Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in High-Density Settings, Minnesota, USA, March–June 2020. Emerging Infectious Diseases. 2021;27(8):2052-2063. doi:10.3201/eid2708.204838.
APA Lehnertz, N. B., Wang, X., Garfin, J., Taylor, J., Zipprich, J., VonBank, B....Lynfield, R. (2021). Transmission Dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in High-Density Settings, Minnesota, USA, March–June 2020. Emerging Infectious Diseases, 27(8), 2052-2063. https://doi.org/10.3201/eid2708.204838.

Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia [PDF - 2.20 MB - 9 pages]
B. Abatan et al.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is evolving differently in Africa than in other regions. Africa has lower SARS-CoV-2 transmission rates and milder clinical manifestations. Detailed SARS-CoV-2 epidemiologic data are needed in Africa. We used publicly available data to calculate SARS-CoV-2 infections per 1,000 persons in The Gambia. We evaluated transmission rates among 1,366 employees of the Medical Research Council Unit The Gambia (MRCG), where systematic surveillance of symptomatic cases and contact tracing were implemented. By September 30, 2020, The Gambia had identified 3,579 SARS-CoV-2 cases, including 115 deaths; 67% of cases were identified in August. Among infections, MRCG staff accounted for 191 cases; all were asymptomatic or mild. The cumulative incidence rate among nonclinical MRCG staff was 124 infections/1,000 persons, which is >80-fold higher than estimates of diagnosed cases among the population. Systematic surveillance and seroepidemiologic surveys are needed to clarify the extent of SARS-CoV-2 transmission in Africa.

EID Abatan B, Agboghoroma O, Akemoke F, Antonio M, Awokola B, Bittaye M, et al. Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia. Emerg Infect Dis. 2021;27(8):2064-2072. https://doi.org/10.3201/eid2708.204954
AMA Abatan B, Agboghoroma O, Akemoke F, et al. Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia. Emerging Infectious Diseases. 2021;27(8):2064-2072. doi:10.3201/eid2708.204954.
APA Abatan, B., Agboghoroma, O., Akemoke, F., Antonio, M., Awokola, B., Bittaye, M....Wariri, O. (2021). Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia. Emerging Infectious Diseases, 27(8), 2064-2072. https://doi.org/10.3201/eid2708.204954.

Peridomestic Mammal Susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 Infection [PDF - 2.68 MB - 8 pages]
A. M. Bosco-Lauth et al.

Wild animals have been implicated as the origin of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but it is largely unknown how the virus affects most wildlife species and if wildlife could ultimately serve as a reservoir for maintaining the virus outside the human population. We show that several common peridomestic species, including deer mice, bushy-tailed woodrats, and striped skunks, are susceptible to infection and can shed the virus in respiratory secretions. In contrast, we demonstrate that cottontail rabbits, fox squirrels, Wyoming ground squirrels, black-tailed prairie dogs, house mice, and racoons are not susceptible to SARS-CoV-2 infection. Our results expand the knowledge base of susceptible species and provide evidence that human–wildlife interactions could result in continued transmission of SARS-CoV-2.

EID Bosco-Lauth AM, Root J, Porter SM, Walker AE, Guilbert L, Hawvermale D, et al. Peridomestic Mammal Susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Emerg Infect Dis. 2021;27(8):2073-2080. https://doi.org/10.3201/eid2708.210180
AMA Bosco-Lauth AM, Root J, Porter SM, et al. Peridomestic Mammal Susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Emerging Infectious Diseases. 2021;27(8):2073-2080. doi:10.3201/eid2708.210180.
APA Bosco-Lauth, A. M., Root, J., Porter, S. M., Walker, A. E., Guilbert, L., Hawvermale, D....Bowen, R. A. (2021). Peridomestic Mammal Susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Emerging Infectious Diseases, 27(8), 2073-2080. https://doi.org/10.3201/eid2708.210180.

Effects of Patient Characteristics on Diagnostic Performance of Self-Collected Samples for SARS-CoV-2 Testing [PDF - 1.27 MB - 9 pages]
S. E. Smith-Jeffcoat et al.

We evaluated the performance of self-collected anterior nasal swab (ANS) and saliva samples compared with healthcare worker–collected nasopharyngeal swab specimens used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used the same PCR diagnostic panel to test all self-collected and healthcare worker–collected samples from participants at a public hospital in Atlanta, Georgia, USA. Among 1,076 participants, 51.9% were men, 57.1% were >50 years of age, 81.2% were Black (non-Hispanic), and 74.9% reported >1 chronic medical condition. In total, 8.0% tested positive for SARS-CoV-2. Compared with nasopharyngeal swab samples, ANS samples had a sensitivity of 59% and saliva samples a sensitivity of 68%. Among participants tested 3–7 days after symptom onset, ANS samples had a sensitivity of 80% and saliva samples a sensitivity of 85%. Sensitivity varied by specimen type and patient characteristics. These findings can help physicians interpret PCR results for SARS-CoV-2.

EID Smith-Jeffcoat SE, Koh M, Hoffman A, Rebolledo PA, Schechter MC, Miller HK, et al. Effects of Patient Characteristics on Diagnostic Performance of Self-Collected Samples for SARS-CoV-2 Testing. Emerg Infect Dis. 2021;27(8):2081-2089. https://doi.org/10.3201/eid2708.210667
AMA Smith-Jeffcoat SE, Koh M, Hoffman A, et al. Effects of Patient Characteristics on Diagnostic Performance of Self-Collected Samples for SARS-CoV-2 Testing. Emerging Infectious Diseases. 2021;27(8):2081-2089. doi:10.3201/eid2708.210667.
APA Smith-Jeffcoat, S. E., Koh, M., Hoffman, A., Rebolledo, P. A., Schechter, M. C., Miller, H. K....Kirking, H. L. (2021). Effects of Patient Characteristics on Diagnostic Performance of Self-Collected Samples for SARS-CoV-2 Testing. Emerging Infectious Diseases, 27(8), 2081-2089. https://doi.org/10.3201/eid2708.210667.

Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data, Germany, 2011–2016 [PDF - 1.18 MB - 10 pages]
A. Krings et al.

Toxoplasmosis is a zoonotic infection contracted through Toxoplasma gondii–contaminated food, soil, or water. Seroprevalence in Germany is high, but estimates of disease incidence are scarce. We investigated incidences for various toxoplasmosis manifestations using anonymized healthcare claims data from Germany for 2011–2016. Patients with a toxoplasmosis diagnosis during the annual observational period were considered incident. The estimated incidence was adjusted to the general population age/sex distribution. We estimated an annual average of 8,047 toxoplasmosis patients in Germany. The average incidence of non–pregnancy-associated toxoplasmosis patients was 9.6/100,000 population. The incidence was highest in 2011, at 10.6 (95% CI 9.4–12.6)/100,000 population, and lowest in 2016, at 8.0 (95% CI 7.0–9.4)/100,000 population. The average incidence of toxoplasmosis during pregnancy was 40.3/100,000 pregnancies. We demonstrate a substantial toxoplasmosis disease burden in Germany. Public health and food safety authorities should implement toxoplasmosis-specific prevention programs.

EID Krings A, Jacob J, Seeber F, Pleyer U, Walker J, Stark K, et al. Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data, Germany, 2011–2016. Emerg Infect Dis. 2021;27(8):2097-2106. https://doi.org/10.3201/eid2708.203740
AMA Krings A, Jacob J, Seeber F, et al. Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data, Germany, 2011–2016. Emerging Infectious Diseases. 2021;27(8):2097-2106. doi:10.3201/eid2708.203740.
APA Krings, A., Jacob, J., Seeber, F., Pleyer, U., Walker, J., Stark, K....Wilking, H. (2021). Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data, Germany, 2011–2016. Emerging Infectious Diseases, 27(8), 2097-2106. https://doi.org/10.3201/eid2708.203740.

Modeling Immune Evasion and Vaccine Limitations by Targeted Nasopharyngeal Bordetella pertussis Inoculation in Mice [PDF - 2.58 MB - 10 pages]
I. Soumana et al.

Conventional pertussis animal models deliver hundreds of thousands of Bordetella pertussis bacteria deep into the lungs, rapidly inducing severe pneumonic pathology and a robust immune response. However, human infections usually begin with colonization and growth in the upper respiratory tract. We inoculated only the nasopharynx of mice to explore the course of infection in a more natural exposure model. Nasopharyngeal colonization resulted in robust growth in the upper respiratory tract but elicited little immune response, enabling prolonged and persistent infection. Immunization with human acellular pertussis vaccine, which prevents severe lung infections in the conventional pneumonic infection model, had little effect on nasopharyngeal colonization. Our infection model revealed that B. pertussis can efficiently colonize the mouse nasopharynx, grow and spread within and between respiratory organs, evade robust host immunity, and persist for months. This experimental approach can measure aspects of the infection processes not observed in the conventional pneumonic infection model.

EID Soumana I, Linz B, Dewan KK, Sarr D, Gestal MC, Howard LK, et al. Modeling Immune Evasion and Vaccine Limitations by Targeted Nasopharyngeal Bordetella pertussis Inoculation in Mice. Emerg Infect Dis. 2021;27(8):2107-2116. https://doi.org/10.3201/eid2708.203566
AMA Soumana I, Linz B, Dewan KK, et al. Modeling Immune Evasion and Vaccine Limitations by Targeted Nasopharyngeal Bordetella pertussis Inoculation in Mice. Emerging Infectious Diseases. 2021;27(8):2107-2116. doi:10.3201/eid2708.203566.
APA Soumana, I., Linz, B., Dewan, K. K., Sarr, D., Gestal, M. C., Howard, L. K....Harvill, E. T. (2021). Modeling Immune Evasion and Vaccine Limitations by Targeted Nasopharyngeal Bordetella pertussis Inoculation in Mice. Emerging Infectious Diseases, 27(8), 2107-2116. https://doi.org/10.3201/eid2708.203566.

Spotted Fever Group Rickettsioses in Israel, 2010–2019 [PDF - 2.10 MB - 10 pages]
R. Cohen et al.

In a multicenter, nationwide, retrospective study of patients hospitalized with spotted fever group rickettsiosis in Israel during 2010–2019, we identified 42 cases, of which 36 were autochthonous. The most prevalent species was the Rickettsia conorii Israeli tick typhus strain (n = 33, 79%); infection with this species necessitated intensive care for 52% of patients and was associated with a 30% fatality rate. A history of tick bite was rare, found for only 5% of patients; eschar was found in 12%; and leukocytosis was more common than leukopenia. Most (72%) patients resided along the Mediterranean shoreline. For 3 patients, a new Rickettsia variant was identified and had been acquired in eastern, mountainous parts of Israel. One patient had prolonged fever before admission and clinical signs resembling tickborne lymphadenopathy. Our findings suggest that a broad range of Rickettsia species cause spotted fever group rickettsiosis in Israel.

EID Cohen R, Finn T, Babushkin F, Paran Y, Ben Ami R, Atamna A, et al. Spotted Fever Group Rickettsioses in Israel, 2010–2019. Emerg Infect Dis. 2021;27(8):2117-2126. https://doi.org/10.3201/eid2708.203661
AMA Cohen R, Finn T, Babushkin F, et al. Spotted Fever Group Rickettsioses in Israel, 2010–2019. Emerging Infectious Diseases. 2021;27(8):2117-2126. doi:10.3201/eid2708.203661.
APA Cohen, R., Finn, T., Babushkin, F., Paran, Y., Ben Ami, R., Atamna, A....Atiya-Nasagi, Y. (2021). Spotted Fever Group Rickettsioses in Israel, 2010–2019. Emerging Infectious Diseases, 27(8), 2117-2126. https://doi.org/10.3201/eid2708.203661.

Spatial, Ecologic, and Clinical Epidemiology of Community-Onset, Ceftriaxone-Resistant Enterobacteriaceae, Cook County, Illinois, USA [PDF - 2.33 MB - 8 pages]
V. Sardá et al.

We performed a spatial and mixed ecologic study of community-onset Enterobacteriaceae isolates collected from a public healthcare system in Cook County, Illinois, USA. Individual-level data were collected from the electronic medical record and census tract–level data from the US Census Bureau. Associations between individual- and population-level characteristics and presence of ceftriaxone resistance were determined by logistic regression analysis. Spatial analysis confirmed nonrandom distribution of ceftriaxone resistance across census tracts, which was associated with higher percentages of Hispanic, foreign-born, and uninsured residents. Individual-level analysis showed that ceftriaxone resistance was associated with male sex, an age range of 35–85 years, race or ethnicity other than non-Hispanic Black, inpatient encounter, and percentage of foreign-born residents in the census tract of isolate provenance. Our findings suggest that the likelihood of community-onset ceftriaxone resistance in Enterobacteriaceae is influenced by geographic and population-level variables. The development of effective mitigation strategies might depend on better accounting for these factors.

EID Sardá V, Trick WE, Zhang H, Schwartz DN. Spatial, Ecologic, and Clinical Epidemiology of Community-Onset, Ceftriaxone-Resistant Enterobacteriaceae, Cook County, Illinois, USA. Emerg Infect Dis. 2021;27(8):2127-2134. https://doi.org/10.3201/eid2708.204235
AMA Sardá V, Trick WE, Zhang H, et al. Spatial, Ecologic, and Clinical Epidemiology of Community-Onset, Ceftriaxone-Resistant Enterobacteriaceae, Cook County, Illinois, USA. Emerging Infectious Diseases. 2021;27(8):2127-2134. doi:10.3201/eid2708.204235.
APA Sardá, V., Trick, W. E., Zhang, H., & Schwartz, D. N. (2021). Spatial, Ecologic, and Clinical Epidemiology of Community-Onset, Ceftriaxone-Resistant Enterobacteriaceae, Cook County, Illinois, USA. Emerging Infectious Diseases, 27(8), 2127-2134. https://doi.org/10.3201/eid2708.204235.

Social Distancing, Mask Use, and Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Brazil, April–June 2020 [PDF - 1.35 MB - 9 pages]
M. Gonçalves et al.

We assessed the associations of social distancing and mask use with symptomatic, laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in Porto Alegre, Brazil. We conducted a population-based case-control study during April–June 2020. Municipal authorities furnished case-patients, and controls were taken from representative household surveys. In adjusted logistic regression analyses of 271 case-patients and 1,396 controls, those reporting moderate to greatest adherence to social distancing had 59% (odds ratio [OR] 0.41, 95% CI 0.24–0.70) to 75% (OR 0.25, 95% CI 0.15–0.42) lower odds of infection. Lesser out-of-household exposure (vs. going out every day all day) reduced odds from 52% (OR 0.48, 95% CI 0.29–0.77) to 75% (OR 0.25, 95% CI 0.18–0.36). Mask use reduced odds of infection by 87% (OR 0.13, 95% CI 0.04–0.36). In conclusion, social distancing and mask use while outside the house provided major protection against symptomatic infection.

EID Gonçalves M, dos Reis R, Tólio R, Pellanda L, Schmidt M, Katz N, et al. Social Distancing, Mask Use, and Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Brazil, April–June 2020. Emerg Infect Dis. 2021;27(8):2135-2143. https://doi.org/10.3201/eid2708.204757
AMA Gonçalves M, dos Reis R, Tólio R, et al. Social Distancing, Mask Use, and Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Brazil, April–June 2020. Emerging Infectious Diseases. 2021;27(8):2135-2143. doi:10.3201/eid2708.204757.
APA Gonçalves, M., dos Reis, R., Tólio, R., Pellanda, L., Schmidt, M., Katz, N....Duncan, B. B. (2021). Social Distancing, Mask Use, and Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Brazil, April–June 2020. Emerging Infectious Diseases, 27(8), 2135-2143. https://doi.org/10.3201/eid2708.204757.

Costs and Outcomes of Integrated Human African Trypanosomiasis Surveillance System Using Rapid Diagnostic Tests, Democratic Republic of the Congo [PDF - 2.49 MB - 10 pages]
R. Snijders et al.

We integrated sleeping sickness case detection into the primary healthcare system in 2 health districts in the Democratic Republic of the Congo. We replaced a less field-friendly serologic test with a rapid diagnostic test, which was followed up by human African trypanosomiasis microscopic testing, and used a mixed costing methodology to estimate costs from a healthcare provider perspective. We screened a total of 18,225 persons and identified 27 new cases. Average financial cost (i.e., actual expenditures) was US $6.70/person screened and $4,464/case diagnosed and treated. Average economic cost (i.e., value of resources foregone that could have been used for other purposes) was $9.40/person screened and $6,138/case diagnosed and treated. Our study shows that integrating sleeping sickness surveillance into the primary healthcare system is feasible and highlights challenges in completing the diagnostic referral process and developing a context-adapted diagnostic algorithm for the large-scale implementation of this strategy in a sustainable and low-cost manner.

EID Snijders R, Fukinsia A, Claeys Y, Hasker E, Mpanya A, Miaka E, et al. Costs and Outcomes of Integrated Human African Trypanosomiasis Surveillance System Using Rapid Diagnostic Tests, Democratic Republic of the Congo. Emerg Infect Dis. 2021;27(8):2144-2153. https://doi.org/10.3201/eid2708.202399
AMA Snijders R, Fukinsia A, Claeys Y, et al. Costs and Outcomes of Integrated Human African Trypanosomiasis Surveillance System Using Rapid Diagnostic Tests, Democratic Republic of the Congo. Emerging Infectious Diseases. 2021;27(8):2144-2153. doi:10.3201/eid2708.202399.
APA Snijders, R., Fukinsia, A., Claeys, Y., Hasker, E., Mpanya, A., Miaka, E....Boelaert, M. (2021). Costs and Outcomes of Integrated Human African Trypanosomiasis Surveillance System Using Rapid Diagnostic Tests, Democratic Republic of the Congo. Emerging Infectious Diseases, 27(8), 2144-2153. https://doi.org/10.3201/eid2708.202399.

Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018 [PDF - 2.69 MB - 9 pages]
A. Russell et al.

Human granulocytic anaplasmosis, a tickborne disease caused by the bacterium Anaplasma phagocytophilum, was first identified during 1994 and is now an emerging public health threat in the United States. New York state (NYS) has experienced a recent increase in the incidence of anaplasmosis. We analyzed human case surveillance and tick surveillance data collected by the NYS Department of Health for spatiotemporal patterns of disease emergence. We describe the epidemiology and growing incidence of anaplasmosis cases reported during 2010–2018. Spatial analysis showed an expanding hot spot of anaplasmosis in the Capital Region, where incidence increased >8-fold. The prevalence of A. phagocytophilum increased greatly within tick populations in the Capital Region over the same period, and entomologic risk factors were correlated with disease incidence at a local level. These results indicate that anaplasmosis is rapidly emerging in a geographically focused area of NYS, likely driven by localized changes in exposure risk.

EID Russell A, Prusinski M, Sommer J, O’Connor C, White J, Falco R, et al. Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018. Emerg Infect Dis. 2021;27(8):2154-2162. https://doi.org/10.3201/eid2708.210133
AMA Russell A, Prusinski M, Sommer J, et al. Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018. Emerging Infectious Diseases. 2021;27(8):2154-2162. doi:10.3201/eid2708.210133.
APA Russell, A., Prusinski, M., Sommer, J., O’Connor, C., White, J., Falco, R....Backenson, P. (2021). Epidemiology and Spatial Emergence of Anaplasmosis, New York, USA, 2010‒2018. Emerging Infectious Diseases, 27(8), 2154-2162. https://doi.org/10.3201/eid2708.210133.
Dispatches

Zoonotic Soil-Transmitted Helminths in Free-Roaming Dogs, Kiribati [PDF - 1.20 MB - 3 pages]
P. A. Zendejas-Heredia et al.

Soil-transmitted helminths are highly prevalent in the Asia–Pacific region. We report a 96.5% prevalence of zoonotic soil-transmitted helminths in dogs in Kiribati. We advocate for urgent implementation of treatment and prevention programs for these zoonotic pathogens, in line with the Kiribati–World Health Organization Cooperation Strategy 2018–2022.

EID Zendejas-Heredia PA, Crawley A, Byrnes H, Traub RJ, Colella V. Zoonotic Soil-Transmitted Helminths in Free-Roaming Dogs, Kiribati. Emerg Infect Dis. 2021;27(8):2163-2165. https://doi.org/10.3201/eid2708.204900
AMA Zendejas-Heredia PA, Crawley A, Byrnes H, et al. Zoonotic Soil-Transmitted Helminths in Free-Roaming Dogs, Kiribati. Emerging Infectious Diseases. 2021;27(8):2163-2165. doi:10.3201/eid2708.204900.
APA Zendejas-Heredia, P. A., Crawley, A., Byrnes, H., Traub, R. J., & Colella, V. (2021). Zoonotic Soil-Transmitted Helminths in Free-Roaming Dogs, Kiribati. Emerging Infectious Diseases, 27(8), 2163-2165. https://doi.org/10.3201/eid2708.204900.

SARS-CoV-2 Prevalence among Outpatients during Community Transmission, Zambia, July 2020 [PDF - 668 KB - 3 pages]
J. Z. Hines et al.

During the July 2020 first wave of severe acute respiratory syndrome coronavirus 2 in Zambia, PCR-measured prevalence was 13.4% among outpatients at health facilities, an absolute difference of 5.7% compared with prevalence among community members. This finding suggests that facility testing might be an effective strategy during high community transmission.

EID Hines JZ, Fwoloshi S, Kampamba D, Barradas DT, Banda D, Zulu JE, et al. SARS-CoV-2 Prevalence among Outpatients during Community Transmission, Zambia, July 2020. Emerg Infect Dis. 2021;27(8):2166-2168. https://doi.org/10.3201/eid2708.210502
AMA Hines JZ, Fwoloshi S, Kampamba D, et al. SARS-CoV-2 Prevalence among Outpatients during Community Transmission, Zambia, July 2020. Emerging Infectious Diseases. 2021;27(8):2166-2168. doi:10.3201/eid2708.210502.
APA Hines, J. Z., Fwoloshi, S., Kampamba, D., Barradas, D. T., Banda, D., Zulu, J. E....Agolory, S. (2021). SARS-CoV-2 Prevalence among Outpatients during Community Transmission, Zambia, July 2020. Emerging Infectious Diseases, 27(8), 2166-2168. https://doi.org/10.3201/eid2708.210502.

Outbreak of SARS-CoV-2 B.1.1.7 Lineage after Vaccination in Long-Term Care Facility, Germany, February–March 2021 [PDF - 1.84 MB - 5 pages]
P. Tober-Lau et al.

One week after second vaccinations were administered, an outbreak of B.1.1.7 lineage severe acute respiratory syndrome coronavirus 2 infections occurred in a long-term care facility in Berlin, Germany, affecting 16/20 vaccinated and 4/4 unvaccinated residents. Despite considerable viral loads, vaccinated residents experienced mild symptoms and faster time to negative test results.

EID Tober-Lau P, Schwarz T, Hillus D, Spieckermann J, Helbig ET, Lippert LJ, et al. Outbreak of SARS-CoV-2 B.1.1.7 Lineage after Vaccination in Long-Term Care Facility, Germany, February–March 2021. Emerg Infect Dis. 2021;27(8):2169-2173. https://doi.org/10.3201/eid2708.210887
AMA Tober-Lau P, Schwarz T, Hillus D, et al. Outbreak of SARS-CoV-2 B.1.1.7 Lineage after Vaccination in Long-Term Care Facility, Germany, February–March 2021. Emerging Infectious Diseases. 2021;27(8):2169-2173. doi:10.3201/eid2708.210887.
APA Tober-Lau, P., Schwarz, T., Hillus, D., Spieckermann, J., Helbig, E. T., Lippert, L. J....Corman, V. M. (2021). Outbreak of SARS-CoV-2 B.1.1.7 Lineage after Vaccination in Long-Term Care Facility, Germany, February–March 2021. Emerging Infectious Diseases, 27(8), 2169-2173. https://doi.org/10.3201/eid2708.210887.

Delayed Antibody and T-Cell Response to BNT162b2 Vaccination in the Elderly, Germany [PDF - 1.73 MB - 5 pages]
T. Schwarz et al.

We detected delayed and reduced antibody and T-cell responses after BNT162b2 vaccination in 71 elderly persons (median age 81 years) compared with 123 healthcare workers (median age 34 years) in Germany. These data emphasize that nonpharmaceutical interventions for coronavirus disease remain crucial and that additional immunizations for the elderly might become necessary.

EID Schwarz T, Tober-Lau P, Hillus D, Helbig ET, Lippert LJ, Thibeault C, et al. Delayed Antibody and T-Cell Response to BNT162b2 Vaccination in the Elderly, Germany. Emerg Infect Dis. 2021;27(8):2174-2178. https://doi.org/10.3201/eid2708.211145
AMA Schwarz T, Tober-Lau P, Hillus D, et al. Delayed Antibody and T-Cell Response to BNT162b2 Vaccination in the Elderly, Germany. Emerging Infectious Diseases. 2021;27(8):2174-2178. doi:10.3201/eid2708.211145.
APA Schwarz, T., Tober-Lau, P., Hillus, D., Helbig, E. T., Lippert, L. J., Thibeault, C....Kurth, F. (2021). Delayed Antibody and T-Cell Response to BNT162b2 Vaccination in the Elderly, Germany. Emerging Infectious Diseases, 27(8), 2174-2178. https://doi.org/10.3201/eid2708.211145.

Autochthonous Cases of Tick-Borne Encephalitis, Belgium, 2020 [PDF - 1.10 MB - 4 pages]
A. Stoefs et al.

We report 3 confirmed autochthonous tick-borne encephalitis cases in Belgium diagnosed during summer 2020. Clinicians should include this viral infection in the differential diagnosis for patients with etiologically unexplained neurologic manifestations, even for persons without recent travel history.

EID Stoefs A, Heyndrickx L, De Winter J, Coeckelbergh E, Willekens B, Alonso-Jiménez A, et al. Autochthonous Cases of Tick-Borne Encephalitis, Belgium, 2020. Emerg Infect Dis. 2021;27(8):2179-2182. https://doi.org/10.3201/eid2708.211175
AMA Stoefs A, Heyndrickx L, De Winter J, et al. Autochthonous Cases of Tick-Borne Encephalitis, Belgium, 2020. Emerging Infectious Diseases. 2021;27(8):2179-2182. doi:10.3201/eid2708.211175.
APA Stoefs, A., Heyndrickx, L., De Winter, J., Coeckelbergh, E., Willekens, B., Alonso-Jiménez, A....Van Esbroeck, M. (2021). Autochthonous Cases of Tick-Borne Encephalitis, Belgium, 2020. Emerging Infectious Diseases, 27(8), 2179-2182. https://doi.org/10.3201/eid2708.211175.

Epidemiology of COVID-19 in Prisons, England, 2020 [PDF - 1.21 MB - 4 pages]
W. M. Rice et al.

Using laboratory data and a novel address matching methodology, we identified 734 cases of coronavirus disease in 88 prisons in England during March 16–October 12, 2020. An additional 412 cases were identified in prison staff and household members. We identified 84 prison outbreaks involving 86% of all prison-associated cases.

EID Rice WM, Chudasama DY, Lewis J, Senyah F, Florence I, Thelwall S, et al. Epidemiology of COVID-19 in Prisons, England, 2020. Emerg Infect Dis. 2021;27(8):2183-2186. https://doi.org/10.3201/eid2708.204920
AMA Rice WM, Chudasama DY, Lewis J, et al. Epidemiology of COVID-19 in Prisons, England, 2020. Emerging Infectious Diseases. 2021;27(8):2183-2186. doi:10.3201/eid2708.204920.
APA Rice, W. M., Chudasama, D. Y., Lewis, J., Senyah, F., Florence, I., Thelwall, S....Lamagni, T. (2021). Epidemiology of COVID-19 in Prisons, England, 2020. Emerging Infectious Diseases, 27(8), 2183-2186. https://doi.org/10.3201/eid2708.204920.

Natural Human Infections with Plasmodium cynomolgi, P. inui, and 4 other Simian Malaria Parasites, Malaysia [PDF - 1.19 MB - 5 pages]
N. Yap et al.

We detected the simian malaria parasites Plasmodium knowlesi, P. cynomolgi, P. inui, P. coatneyi, P. inui–like, and P. simiovale among forest fringe–living indigenous communities from various locations in Malaysia. Our findings underscore the importance of using molecular tools to identify newly emergent malaria parasites in humans.

EID Yap N, Hossain H, Nada-Raja T, Ngui R, Muslim A, Hoh B, et al. Natural Human Infections with Plasmodium cynomolgi, P. inui, and 4 other Simian Malaria Parasites, Malaysia. Emerg Infect Dis. 2021;27(8):2187-2191. https://doi.org/10.3201/eid2708.204502
AMA Yap N, Hossain H, Nada-Raja T, et al. Natural Human Infections with Plasmodium cynomolgi, P. inui, and 4 other Simian Malaria Parasites, Malaysia. Emerging Infectious Diseases. 2021;27(8):2187-2191. doi:10.3201/eid2708.204502.
APA Yap, N., Hossain, H., Nada-Raja, T., Ngui, R., Muslim, A., Hoh, B....Lim, Y. (2021). Natural Human Infections with Plasmodium cynomolgi, P. inui, and 4 other Simian Malaria Parasites, Malaysia. Emerging Infectious Diseases, 27(8), 2187-2191. https://doi.org/10.3201/eid2708.204502.

Weekly SARS-CoV-2 Sentinel Surveillance in Primary Schools, Kindergartens, and Nurseries, Germany, June‒November 2020 [PDF - 1.44 MB - 5 pages]
M. Hoch et al.

We investigated severe acute respiratory syndrome coronavirus 2 infections in primary schools, kindergartens, and nurseries in Germany. Of 3,169 oropharyngeal swab specimens, only 2 were positive by real-time reverse transcription PCR. Asymptomatic children attending these institutions do not appear to be driving the pandemic when appropriate infection control measures are used.

EID Hoch M, Vogel S, Kolberg L, Dick E, Fingerle V, Eberle U, et al. Weekly SARS-CoV-2 Sentinel Surveillance in Primary Schools, Kindergartens, and Nurseries, Germany, June‒November 2020. Emerg Infect Dis. 2021;27(8):2192-2196. https://doi.org/10.3201/eid2708.204859
AMA Hoch M, Vogel S, Kolberg L, et al. Weekly SARS-CoV-2 Sentinel Surveillance in Primary Schools, Kindergartens, and Nurseries, Germany, June‒November 2020. Emerging Infectious Diseases. 2021;27(8):2192-2196. doi:10.3201/eid2708.204859.
APA Hoch, M., Vogel, S., Kolberg, L., Dick, E., Fingerle, V., Eberle, U....von Both, U. (2021). Weekly SARS-CoV-2 Sentinel Surveillance in Primary Schools, Kindergartens, and Nurseries, Germany, June‒November 2020. Emerging Infectious Diseases, 27(8), 2192-2196. https://doi.org/10.3201/eid2708.204859.

Genomic Detection of Schmallenberg Virus, Israel [PDF - 1.08 MB - 4 pages]
A. Behar et al.

We discuss genomic detection of Schmallenberg virus in both Culicoides midges and affected ruminants during June 2018–December 2019, demonstrating its circulation in Israel. This region is a geographic bridge between 3 continents and may serve as an epidemiologic bridge for potential Schmallenberg virus spread into Asia.

EID Behar A, Izhaki O, Rot A, Benor T, Yankilevich M, Leszkowicz-Mazuz M, et al. Genomic Detection of Schmallenberg Virus, Israel. Emerg Infect Dis. 2021;27(8):2197-2200. https://doi.org/10.3201/eid2708.203705
AMA Behar A, Izhaki O, Rot A, et al. Genomic Detection of Schmallenberg Virus, Israel. Emerging Infectious Diseases. 2021;27(8):2197-2200. doi:10.3201/eid2708.203705.
APA Behar, A., Izhaki, O., Rot, A., Benor, T., Yankilevich, M., Leszkowicz-Mazuz, M....Brenner, J. (2021). Genomic Detection of Schmallenberg Virus, Israel. Emerging Infectious Diseases, 27(8), 2197-2200. https://doi.org/10.3201/eid2708.203705.

Parasitic Disease Surveillance, Mississippi, USA [PDF - 2.22 MB - 4 pages]
R. S. Bradbury et al.

Surveillance for soil-transmitted helminths, strongyloidiasis, cryptosporidiosis, and giardiasis was conducted in Mississippi, USA. PCR performed on 224 fecal samples for all soil-transmitted helminths and on 370 samples for only Necator americanus and Strongyloides stercoralis identified 1 S. stercoralis infection. Seroprevalences were 8.8% for Toxocara, 27.4% for Cryptosporidium, 5.7% for Giardia, and 0.2% for Strongyloides parasites.

EID Bradbury RS, Lane M, Arguello I, Handali S, Cooley G, Pilotte N, et al. Parasitic Disease Surveillance, Mississippi, USA. Emerg Infect Dis. 2021;27(8):2201-2204. https://doi.org/10.3201/eid2708.204318
AMA Bradbury RS, Lane M, Arguello I, et al. Parasitic Disease Surveillance, Mississippi, USA. Emerging Infectious Diseases. 2021;27(8):2201-2204. doi:10.3201/eid2708.204318.
APA Bradbury, R. S., Lane, M., Arguello, I., Handali, S., Cooley, G., Pilotte, N....Hobbs, C. V. (2021). Parasitic Disease Surveillance, Mississippi, USA. Emerging Infectious Diseases, 27(8), 2201-2204. https://doi.org/10.3201/eid2708.204318.

Screening for Q Fever in Patients Undergoing Transcatheter Aortic Valve Implantation, Israel, June 2018–May 2020 [PDF - 658 KB - 3 pages]
N. Ghanem-Zoubi et al.

Q fever infective endocarditis frequently mimics degenerative valvular disease. We tested for Coxiella burnettii antibodies in 155 patients in Israel who underwent transcatheter aortic valve implantation. Q fever infective endocarditis was diagnosed and treated in 4 (2.6%) patients; follow-up at a median 12 months after valve implantation indicated preserved prosthetic valvular function.

EID Ghanem-Zoubi N, Paul M, Szwarcwort M, Agmon Y, Kerner A. Screening for Q Fever in Patients Undergoing Transcatheter Aortic Valve Implantation, Israel, June 2018–May 2020. Emerg Infect Dis. 2021;27(8):2205-2207. https://doi.org/10.3201/eid2708.204963
AMA Ghanem-Zoubi N, Paul M, Szwarcwort M, et al. Screening for Q Fever in Patients Undergoing Transcatheter Aortic Valve Implantation, Israel, June 2018–May 2020. Emerging Infectious Diseases. 2021;27(8):2205-2207. doi:10.3201/eid2708.204963.
APA Ghanem-Zoubi, N., Paul, M., Szwarcwort, M., Agmon, Y., & Kerner, A. (2021). Screening for Q Fever in Patients Undergoing Transcatheter Aortic Valve Implantation, Israel, June 2018–May 2020. Emerging Infectious Diseases, 27(8), 2205-2207. https://doi.org/10.3201/eid2708.204963.

African Horse Sickness Virus Serotype 1 on Horse Farm, Thailand, 2020 [PDF - 3.32 MB - 4 pages]
N. Bunpapong et al.

To investigate an outbreak of African horse sickness (AHS) on a horse farm in northeastern Thailand, we used whole-genome sequencing to detect and characterize the virus. The viruses belonged to serotype 1 and contained unique amino acids (95V,166S, 660I in virus capsid protein 2), suggesting a single virus introduction to Thailand.

EID Bunpapong N, Charoenkul K, Nasamran C, Chamsai E, Udom K, Boonyapisitsopa S, et al. African Horse Sickness Virus Serotype 1 on Horse Farm, Thailand, 2020. Emerg Infect Dis. 2021;27(8):2208-2211. https://doi.org/10.3201/eid2708.210004
AMA Bunpapong N, Charoenkul K, Nasamran C, et al. African Horse Sickness Virus Serotype 1 on Horse Farm, Thailand, 2020. Emerging Infectious Diseases. 2021;27(8):2208-2211. doi:10.3201/eid2708.210004.
APA Bunpapong, N., Charoenkul, K., Nasamran, C., Chamsai, E., Udom, K., Boonyapisitsopa, S....Amonsin, A. (2021). African Horse Sickness Virus Serotype 1 on Horse Farm, Thailand, 2020. Emerging Infectious Diseases, 27(8), 2208-2211. https://doi.org/10.3201/eid2708.210004.

Replication in Human Intestinal Enteroids of Infectious Norovirus from Vomit Samples [PDF - 683 KB - 3 pages]
M. Hagbom et al.

A typical clinical symptom of human norovirus infection is projectile vomiting. Although norovirus RNA and viral particles have been detected in vomitus, infectivity has not yet been reported. We detected replication-competent norovirus in 25% of vomit samples with a 13-fold to 714-fold increase in genomic equivalents, confirming infectious norovirus.

EID Hagbom M, Lin J, Falkeborn T, Serrander L, Albert J, Nordgren J, et al. Replication in Human Intestinal Enteroids of Infectious Norovirus from Vomit Samples. Emerg Infect Dis. 2021;27(8):2212-2214. https://doi.org/10.3201/eid2708.210011
AMA Hagbom M, Lin J, Falkeborn T, et al. Replication in Human Intestinal Enteroids of Infectious Norovirus from Vomit Samples. Emerging Infectious Diseases. 2021;27(8):2212-2214. doi:10.3201/eid2708.210011.
APA Hagbom, M., Lin, J., Falkeborn, T., Serrander, L., Albert, J., Nordgren, J....Sharma, S. (2021). Replication in Human Intestinal Enteroids of Infectious Norovirus from Vomit Samples. Emerging Infectious Diseases, 27(8), 2212-2214. https://doi.org/10.3201/eid2708.210011.

Endogenous Endophthalmitis Caused by ST66-K2 Hypervirulent Klebsiella pneumoniae, United States [PDF - 1.03 MB - 4 pages]
E. Kamau et al.

We describe a case of endogenous endophthalmitis caused by sequence type 66-K2 hypervirulent Klebsiella pneumoniae in a diabetic patient with no travel history outside the United States. Genomic analysis showed the pathogen has remained highly conserved, retaining >98% genetic similarity to the original strain described in Indonesia in 1935.

EID Kamau E, Allyn PR, Beaird OE, Ward KW, Kwan N, Garner OB, et al. Endogenous Endophthalmitis Caused by ST66-K2 Hypervirulent Klebsiella pneumoniae, United States. Emerg Infect Dis. 2021;27(8):2215-2218. https://doi.org/10.3201/eid2708.210234
AMA Kamau E, Allyn PR, Beaird OE, et al. Endogenous Endophthalmitis Caused by ST66-K2 Hypervirulent Klebsiella pneumoniae, United States. Emerging Infectious Diseases. 2021;27(8):2215-2218. doi:10.3201/eid2708.210234.
APA Kamau, E., Allyn, P. R., Beaird, O. E., Ward, K. W., Kwan, N., Garner, O. B....Yang, S. (2021). Endogenous Endophthalmitis Caused by ST66-K2 Hypervirulent Klebsiella pneumoniae, United States. Emerging Infectious Diseases, 27(8), 2215-2218. https://doi.org/10.3201/eid2708.210234.
Research Letters

Whole-Genome Sequencing of SARS-CoV-2 from Quarantine Hotel Outbreak [PDF - 1.44 MB - 3 pages]
L. Leong et al.

Hotel quarantine for international travelers has been used to prevent coronavirus disease spread into Australia. A quarantine hotel–associated community outbreak was detected in South Australia. Real-time genomic sequencing enabled rapid confirmation tracking the outbreak to a recently returned traveler and linked 2 cases of infection in travelers at the same facility.

EID Leong L, Soubrier J, Turra M, Denehy E, Walters L, Kassahn K, et al. Whole-Genome Sequencing of SARS-CoV-2 from Quarantine Hotel Outbreak. Emerg Infect Dis. 2021;27(8):2219-2221. https://doi.org/10.3201/eid2708.204875
AMA Leong L, Soubrier J, Turra M, et al. Whole-Genome Sequencing of SARS-CoV-2 from Quarantine Hotel Outbreak. Emerging Infectious Diseases. 2021;27(8):2219-2221. doi:10.3201/eid2708.204875.
APA Leong, L., Soubrier, J., Turra, M., Denehy, E., Walters, L., Kassahn, K....Lim, C. K. (2021). Whole-Genome Sequencing of SARS-CoV-2 from Quarantine Hotel Outbreak. Emerging Infectious Diseases, 27(8), 2219-2221. https://doi.org/10.3201/eid2708.204875.

Linezolid- and Multidrug-Resistant Enterococci in Raw Commercial Dog Food, Europe, 2019–2020 [PDF - 979 KB - 4 pages]
A. R. Freitas et al.

We describe enterococci in raw-frozen dog food commercialized in Europe as a source of genes encoding resistance to the antibiotic drug linezolid and of strains and plasmids enriched in antibiotic-resistance and virulence genes in hospitalized patients. Whole-genome sequencing was fundamental to linking isolates from dog food to human cases across Europe.

EID Freitas AR, Finisterra L, Tedim AP, Duarte B, Novais C, Peixe L. Linezolid- and Multidrug-Resistant Enterococci in Raw Commercial Dog Food, Europe, 2019–2020. Emerg Infect Dis. 2021;27(8):2221-2224. https://doi.org/10.3201/eid2708.204933
AMA Freitas AR, Finisterra L, Tedim AP, et al. Linezolid- and Multidrug-Resistant Enterococci in Raw Commercial Dog Food, Europe, 2019–2020. Emerging Infectious Diseases. 2021;27(8):2221-2224. doi:10.3201/eid2708.204933.
APA Freitas, A. R., Finisterra, L., Tedim, A. P., Duarte, B., Novais, C., & Peixe, L. (2021). Linezolid- and Multidrug-Resistant Enterococci in Raw Commercial Dog Food, Europe, 2019–2020. Emerging Infectious Diseases, 27(8), 2221-2224. https://doi.org/10.3201/eid2708.204933.

Highly Pathogenic Avian Influenza A(H5N8) Virus Clade 2.3.4.4b, Western Siberia, Russia, 2020 [PDF - 1.86 MB - 4 pages]
I. Sobolev et al.

Two variants of highly pathogenic avian influenza A(H5N8) virus were detected in dead poultry in Western Siberia, Russia, during August and September 2020. One variant was represented by viruses of clade 2.3.4.4b and the other by a novel reassortant between clade 2.3.4.4b and Eurasian low pathogenicity avian influenza viruses circulating in wild birds.

EID Sobolev I, Sharshov K, Dubovitskiy N, Kurskaya O, Alekseev A, Leonov S, et al. Highly Pathogenic Avian Influenza A(H5N8) Virus Clade 2.3.4.4b, Western Siberia, Russia, 2020. Emerg Infect Dis. 2021;27(8):2224-2227. https://doi.org/10.3201/eid2708.204969
AMA Sobolev I, Sharshov K, Dubovitskiy N, et al. Highly Pathogenic Avian Influenza A(H5N8) Virus Clade 2.3.4.4b, Western Siberia, Russia, 2020. Emerging Infectious Diseases. 2021;27(8):2224-2227. doi:10.3201/eid2708.204969.
APA Sobolev, I., Sharshov, K., Dubovitskiy, N., Kurskaya, O., Alekseev, A., Leonov, S....Shestopalov, A. (2021). Highly Pathogenic Avian Influenza A(H5N8) Virus Clade 2.3.4.4b, Western Siberia, Russia, 2020. Emerging Infectious Diseases, 27(8), 2224-2227. https://doi.org/10.3201/eid2708.204969.

Tuberculosis-Associated Hospitalizations and Deaths after COVID-19 Shelter-In-Place, San Francisco, California, USA [PDF - 876 KB - 3 pages]
J. K. Louie et al.

A mandated shelter-in-place and other restrictions associated with the coronavirus disease pandemic precipitated a decline in tuberculosis diagnoses in San Francisco, California, USA. Several months into the pandemic, severe illness resulting in hospitalization or death increased compared with prepandemic levels, warranting heightened vigilance for tuberculosis in at-risk populations.

EID Louie JK, Agraz-Lara R, Romo L, Crespin F, Chen L, Graves S. Tuberculosis-Associated Hospitalizations and Deaths after COVID-19 Shelter-In-Place, San Francisco, California, USA. Emerg Infect Dis. 2021;27(8):2227-2229. https://doi.org/10.3201/eid2708.210670
AMA Louie JK, Agraz-Lara R, Romo L, et al. Tuberculosis-Associated Hospitalizations and Deaths after COVID-19 Shelter-In-Place, San Francisco, California, USA. Emerging Infectious Diseases. 2021;27(8):2227-2229. doi:10.3201/eid2708.210670.
APA Louie, J. K., Agraz-Lara, R., Romo, L., Crespin, F., Chen, L., & Graves, S. (2021). Tuberculosis-Associated Hospitalizations and Deaths after COVID-19 Shelter-In-Place, San Francisco, California, USA. Emerging Infectious Diseases, 27(8), 2227-2229. https://doi.org/10.3201/eid2708.210670.

SARS-CoV-2 Superspread in Fitness Center, Hong Kong, China, March 2021 [PDF - 839 KB - 3 pages]
D. Chu et al.

To investigate a superspreading event at a fitness center in Hong Kong, China, we used genomic sequencing to analyze 102 reverse transcription PCR–confirmed cases of severe acute respiratory syndrome coronavirus 2 infection. Our finding highlights the risk for virus transmission in confined spaces with poor ventilation and limited public health interventions.

EID Chu D, Gu H, Chang L, Cheuk S, Gurung S, Krishnan P, et al. SARS-CoV-2 Superspread in Fitness Center, Hong Kong, China, March 2021. Emerg Infect Dis. 2021;27(8):2230-2232. https://doi.org/10.3201/eid2708.210833
AMA Chu D, Gu H, Chang L, et al. SARS-CoV-2 Superspread in Fitness Center, Hong Kong, China, March 2021. Emerging Infectious Diseases. 2021;27(8):2230-2232. doi:10.3201/eid2708.210833.
APA Chu, D., Gu, H., Chang, L., Cheuk, S., Gurung, S., Krishnan, P....Poon, L. (2021). SARS-CoV-2 Superspread in Fitness Center, Hong Kong, China, March 2021. Emerging Infectious Diseases, 27(8), 2230-2232. https://doi.org/10.3201/eid2708.210833.

Persistence of SARS-CoV-2–Specific IgG in Children 6 Months After Infection, Australia [PDF - 1.04 MB - 3 pages]
Z. Toh et al.

The duration of the humoral immune response in children infected with severe acute respiratory syndrome coronavirus 2 is unknown. We detected specific IgG 6 months after infection in children who were asymptomatic or had mild symptoms of coronavirus disease. These findings will inform vaccination strategies and other prevention measures.

EID Toh Z, Higgins RA, Do LH, Rautenbacher K, Mordant FL, Subbarao K, et al. Persistence of SARS-CoV-2–Specific IgG in Children 6 Months After Infection, Australia. Emerg Infect Dis. 2021;27(8):2233-2235. https://doi.org/10.3201/eid2708.210965
AMA Toh Z, Higgins RA, Do LH, et al. Persistence of SARS-CoV-2–Specific IgG in Children 6 Months After Infection, Australia. Emerging Infectious Diseases. 2021;27(8):2233-2235. doi:10.3201/eid2708.210965.
APA Toh, Z., Higgins, R. A., Do, L. H., Rautenbacher, K., Mordant, F. L., Subbarao, K....Licciardi, P. V. (2021). Persistence of SARS-CoV-2–Specific IgG in Children 6 Months After Infection, Australia. Emerging Infectious Diseases, 27(8), 2233-2235. https://doi.org/10.3201/eid2708.210965.

COVID-19 and the Consequences of Anchoring Bias [PDF - 615 KB - 2 pages]
H. W. Horowitz et al.

Suspicion of coronavirus disease in febrile patients might lead to anchoring bias, causing misdiagnosis of other infections for which epidemiologic risks are present. This bias has potentially severe consequences, illustrated by cases of human granulocytic anaplasmosis and Lyme disease in a pregnant woman and human granulocytic anaplasmosis in another person.

EID Horowitz HW, Behar C, Greene J. COVID-19 and the Consequences of Anchoring Bias. Emerg Infect Dis. 2021;27(8):2235-2236. https://doi.org/10.3201/eid2708.211107
AMA Horowitz HW, Behar C, Greene J. COVID-19 and the Consequences of Anchoring Bias. Emerging Infectious Diseases. 2021;27(8):2235-2236. doi:10.3201/eid2708.211107.
APA Horowitz, H. W., Behar, C., & Greene, J. (2021). COVID-19 and the Consequences of Anchoring Bias. Emerging Infectious Diseases, 27(8), 2235-2236. https://doi.org/10.3201/eid2708.211107.

Molecular Detection and Characterization of Rickettsia asembonensis in Human Blood, Zambia [PDF - 931 KB - 3 pages]
L. C. Moonga et al.

Rickettsia asembonensis is a flea-related Rickettsia with unknown pathogenicity to humans. We detected R. asembonensis DNA in 2 of 1,153 human blood samples in Zambia. Our findings suggest the possibility of R. asembonensis infection in humans despite its unknown pathogenicity.

EID Moonga LC, Hayashida K, Mulunda NR, Nakamura Y, Chipeta J, Moonga HB, et al. Molecular Detection and Characterization of Rickettsia asembonensis in Human Blood, Zambia. Emerg Infect Dis. 2021;27(8):2237-2239. https://doi.org/10.3201/eid2708.203467
AMA Moonga LC, Hayashida K, Mulunda NR, et al. Molecular Detection and Characterization of Rickettsia asembonensis in Human Blood, Zambia. Emerging Infectious Diseases. 2021;27(8):2237-2239. doi:10.3201/eid2708.203467.
APA Moonga, L. C., Hayashida, K., Mulunda, N. R., Nakamura, Y., Chipeta, J., Moonga, H. B....Yamagishi, J. (2021). Molecular Detection and Characterization of Rickettsia asembonensis in Human Blood, Zambia. Emerging Infectious Diseases, 27(8), 2237-2239. https://doi.org/10.3201/eid2708.203467.
Letters

Post–13-Valent Pneumococcal Conjugate Vaccine Dynamics in Young Children [PDF - 703 KB - 2 pages]
C. Levy et al.
EID Levy C, Ouldali N, Varon E, Béchet S, Bonacorsi S, Cohen R. Post–13-Valent Pneumococcal Conjugate Vaccine Dynamics in Young Children. Emerg Infect Dis. 2021;27(8):2240-2241. https://doi.org/10.3201/eid2708.210037
AMA Levy C, Ouldali N, Varon E, et al. Post–13-Valent Pneumococcal Conjugate Vaccine Dynamics in Young Children. Emerging Infectious Diseases. 2021;27(8):2240-2241. doi:10.3201/eid2708.210037.
APA Levy, C., Ouldali, N., Varon, E., Béchet, S., Bonacorsi, S., & Cohen, R. (2021). Post–13-Valent Pneumococcal Conjugate Vaccine Dynamics in Young Children. Emerging Infectious Diseases, 27(8), 2240-2241. https://doi.org/10.3201/eid2708.210037.

Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States [PDF - 863 KB - 2 pages]
S. DeFlorio-Barker et al.
EID DeFlorio-Barker S, Shrestha A, Dorevitch S. Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States. Emerg Infect Dis. 2021;27(8):2241-2242. https://doi.org/10.3201/eid2708.210242
AMA DeFlorio-Barker S, Shrestha A, Dorevitch S. Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States. Emerging Infectious Diseases. 2021;27(8):2241-2242. doi:10.3201/eid2708.210242.
APA DeFlorio-Barker, S., Shrestha, A., & Dorevitch, S. (2021). Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States. Emerging Infectious Diseases, 27(8), 2241-2242. https://doi.org/10.3201/eid2708.210242.
Books and Media

The Yellow Flag: Quarantine and the British Mediterranean World, 1780–1860 [PDF - 889 KB - 1 page]
R. Wurtz
EID Wurtz R. The Yellow Flag: Quarantine and the British Mediterranean World, 1780–1860. Emerg Infect Dis. 2021;27(8):2243. https://doi.org/10.3201/eid2708.210997
AMA Wurtz R. The Yellow Flag: Quarantine and the British Mediterranean World, 1780–1860. Emerging Infectious Diseases. 2021;27(8):2243. doi:10.3201/eid2708.210997.
APA Wurtz, R. (2021). The Yellow Flag: Quarantine and the British Mediterranean World, 1780–1860. Emerging Infectious Diseases, 27(8), 2243. https://doi.org/10.3201/eid2708.210997.
About the Cover

Special Wonders of the Canal [PDF - 3.27 MB - 3 pages]
B. Breedlove
EID Breedlove B. Special Wonders of the Canal. Emerg Infect Dis. 2021;27(8):2244-2246. https://doi.org/10.3201/eid2708.ac2708
AMA Breedlove B. Special Wonders of the Canal. Emerging Infectious Diseases. 2021;27(8):2244-2246. doi:10.3201/eid2708.ac2708.
APA Breedlove, B. (2021). Special Wonders of the Canal. Emerging Infectious Diseases, 27(8), 2244-2246. https://doi.org/10.3201/eid2708.ac2708.
Etymologia

Etymologia: Culex quinquefasciatus [PDF - 1.10 MB - 1 page]
S. J. Guagliardo and R. S. Levine
EID Guagliardo SJ, Levine RS. Etymologia: Culex quinquefasciatus. Emerg Infect Dis. 2021;27(8):2041. https://doi.org/10.3201/eid2708.et2708
AMA Guagliardo SJ, Levine RS. Etymologia: Culex quinquefasciatus. Emerging Infectious Diseases. 2021;27(8):2041. doi:10.3201/eid2708.et2708.
APA Guagliardo, S. J., & Levine, R. S. (2021). Etymologia: Culex quinquefasciatus. Emerging Infectious Diseases, 27(8), 2041. https://doi.org/10.3201/eid2708.et2708.
Page created: July 19, 2021
Page updated: July 21, 2021
Page reviewed: July 21, 2021
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