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Articles from Emerging Infectious Diseases

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Vaccine Effectiveness during Outbreak of COVID-19 Alpha (B.1.1.7) Variant in Men’s Correctional Facility, United States [PDF - 549 KB - 6 pages]
R. A. Silverman et al.

In April 2021, a COVID-19 outbreak occurred at a correctional facility in rural Virginia, USA. Eighty-four infections were identified among 854 incarcerated persons by facilitywide testing with reverse transcription quantitative PCR (qRT-PCR). We used whole-genome sequencing to link all infections to 2 employees infected with the B.1.1.7α (UK) variant. The relative risk comparing unvaccinated to fully vaccinated persons (mRNA-1273 [Moderna, https://www.modernatx.com]) was 7.8 (95% CI 4.8–12.7), corresponding to a vaccine effectiveness of 87.1% (95% CI 79.0%–92.1%). Average qRT-PCR cycle threshold values were lower, suggesting higher viral loads, among unvaccinated infected than vaccinated cases for the nucleocapsid, envelope, and spike genes. Vaccination was highly effective at preventing SARS-CoV-2 infection in this high-risk setting. This approach can be applied to similar settings to estimate vaccine effectiveness as variants emerge to guide public health strategies during the ongoing pandemic.

EID Silverman RA, Ceci A, Cohen A, Helmick M, Short E, Bordwine P, et al. Vaccine Effectiveness during Outbreak of COVID-19 Alpha (B.1.1.7) Variant in Men’s Correctional Facility, United States. Emerg Infect Dis. 2022;28(7):1313-1320. https://doi.org/10.3201/eid2807.220091
AMA Silverman RA, Ceci A, Cohen A, et al. Vaccine Effectiveness during Outbreak of COVID-19 Alpha (B.1.1.7) Variant in Men’s Correctional Facility, United States. Emerging Infectious Diseases. 2022;28(7):1313-1320. doi:10.3201/eid2807.220091.
APA Silverman, R. A., Ceci, A., Cohen, A., Helmick, M., Short, E., Bordwine, P....Finkielstein, C. V. (2022). Vaccine Effectiveness during Outbreak of COVID-19 Alpha (B.1.1.7) Variant in Men’s Correctional Facility, United States. Emerging Infectious Diseases, 28(7), 1313-1320. https://doi.org/10.3201/eid2807.220091.

Medscape CME Activity
Updated Estimates and Mapping for Prevalence of Chagas Disease among Adults, United States [PDF - 498 KB - 8 pages]
A. Irish et al.

We combined American Community Survey data with age-specific Trypanosoma cruzi prevalence derived from US surveys and World Health Organization reports to yield estimates of Chagas disease in the United States, which we mapped at the local level. In addition, we used blood donor data to estimate the relative prevalence of autochthonous T. cruzi infection. Our estimates indicate that 288,000 infected persons, including 57,000 Chagas cardiomyopathy patients and 43,000 infected reproductive-age women, currently live in the United States; 22–108 congenital infections occur annually. We estimated ≈10,000 prevalent cases of locally acquired T. cruzi infection. Mapping shows marked geographic heterogeneity of T. cruzi prevalence and illness. Reliable demographic and geographic data are key to guiding prevention and management of Chagas disease. Population-based surveys in high prevalence areas could improve the evidence base for future estimates. Knowledge of the demographics and geographic distribution of affected persons may aid practitioners in recognizing Chagas disease.

EID Irish A, Whitman JD, Clark EH, Marcus R, Bern C. Updated Estimates and Mapping for Prevalence of Chagas Disease among Adults, United States. Emerg Infect Dis. 2022;28(7):1313-1320. https://doi.org/10.3201/eid2807.212221
AMA Irish A, Whitman JD, Clark EH, et al. Updated Estimates and Mapping for Prevalence of Chagas Disease among Adults, United States. Emerging Infectious Diseases. 2022;28(7):1313-1320. doi:10.3201/eid2807.212221.
APA Irish, A., Whitman, J. D., Clark, E. H., Marcus, R., & Bern, C. (2022). Updated Estimates and Mapping for Prevalence of Chagas Disease among Adults, United States. Emerging Infectious Diseases, 28(7), 1313-1320. https://doi.org/10.3201/eid2807.212221.

Enterovirus D68 in Hospitalized Children, Barcelona, Spain, 2014–2021 [PDF - 563 KB - 5 pages]
C. Andrés et al.

To determine molecular epidemiology and clinical features of enterovirus D68 (EV-D68) infections, we reviewed EV-D68–associated respiratory cases at a hospital in Barcelona, Spain, during 2014–2021. Respiratory samples were collected from hospitalized patients or outpatients with symptoms of acute respiratory tract infection or suggestive of enterovirus infection. Enterovirus detection was performed by real-time multiplex reverse transcription PCR and characterization by phylogenetic analysis of the partial viral protein 1 coding region sequences. From 184 patients with EV-D68 infection, circulating subclades were B3 (80%), D1 (17%), B2 (1%), and A (<1%); clade proportions shifted over time. EV-D68 was detected mostly in children (86%) and biennially (2016, 2018, 2021). In patients <16 years of age, the most common sign/symptom was lower respiratory tract infection, for which 11.8% required pediatric intensive care unit admission and 2.3% required invasive mechanical ventilation; neurologic complications developed in 1. The potential neurotropism indicates that enterovirus surveillance should be mandatory.

EID Andrés C, Vila J, Creus-Costa A, Piñana M, González-Sánchez A, Esperalba J, et al. Enterovirus D68 in Hospitalized Children, Barcelona, Spain, 2014–2021. Emerg Infect Dis. 2022;28(7):1327-1331. https://doi.org/10.3201/eid2807.220264
AMA Andrés C, Vila J, Creus-Costa A, et al. Enterovirus D68 in Hospitalized Children, Barcelona, Spain, 2014–2021. Emerging Infectious Diseases. 2022;28(7):1327-1331. doi:10.3201/eid2807.220264.
APA Andrés, C., Vila, J., Creus-Costa, A., Piñana, M., González-Sánchez, A., Esperalba, J....Antón, A. (2022). Enterovirus D68 in Hospitalized Children, Barcelona, Spain, 2014–2021. Emerging Infectious Diseases, 28(7), 1327-1331. https://doi.org/10.3201/eid2807.220264.
Research

Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China [PDF - 4.07 MB - 13 pages]
W. Zhu et al.

The recent rise in the frequency of influenza A(H5N6) infections in China has raised serious concerns about whether the risk for human infection has increased. We surveyed epidemiologic, clinical, and genetic data of human infections with A(H5N6) viruses. Severe disease occurred in 93.8% of cases, and the fatality rate was 55.4%. Median patient age was 51 years. Most H5N6 hemagglutinin (HA) genes in human isolates in 2021 originated from subclade 2.3.4.4b; we estimated the time to most recent common ancestor as June 16, 2020. A total of 13 genotypes with HA genes from multiple subclades in clade 2.3.4.4 were identified in human isolates. Of note, 4 new genotypes detected in 2021 were the major causes of increased H5N6 virus infections. Mammalian-adapted mutations were found in HA and internal genes. Although we found no evidence of human-to-human transmission, continuous evolution of H5N6 viruses may increase the risk for human infections.

EID Zhu W, Li X, Dong J, Bo H, Liu J, Yang J, et al. Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China. Emerg Infect Dis. 2022;28(7):1332-1344. https://doi.org/10.3201/eid2807.212482
AMA Zhu W, Li X, Dong J, et al. Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China. Emerging Infectious Diseases. 2022;28(7):1332-1344. doi:10.3201/eid2807.212482.
APA Zhu, W., Li, X., Dong, J., Bo, H., Liu, J., Yang, J....Wang, D. (2022). Epidemiologic, Clinical, and Genetic Characteristics of Human Infections with Influenza A(H5N6) Viruses, China. Emerging Infectious Diseases, 28(7), 1332-1344. https://doi.org/10.3201/eid2807.212482.

Measuring Basic Reproduction Number to Assess Effects of Nonpharmaceutical Interventions on Nosocomial SARS-CoV-2 Transmission [PDF - 2.57 MB - 10 pages]
G. Shirreff et al.

Outbreaks of SARS-CoV-2 infection frequently occur in hospitals. Preventing nosocomial infection requires insight into hospital transmission. However, estimates of the basic reproduction number (R0) in care facilities are lacking. Analyzing a closely monitored SARS-CoV-2 outbreak in a hospital in early 2020, we estimated the patient-to-patient transmission rate and R0. We developed a model for SARS-CoV-2 nosocomial transmission that accounts for stochastic effects and undetected infections and fit it to patient test results. The model formalizes changes in testing capacity over time, and accounts for evolving PCR sensitivity at different stages of infection. R0 estimates varied considerably across wards, ranging from 3 to 15 in different wards. During the outbreak, the hospital introduced a contact precautions policy. Our results strongly support a reduction in the hospital-level R0 after this policy was implemented, from 8.7 to 1.3, corresponding to a policy efficacy of 85% and demonstrating the effectiveness of nonpharmaceutical interventions.

EID Shirreff G, Zahar J, Cauchemez S, Temime L, Opatowski L. Measuring Basic Reproduction Number to Assess Effects of Nonpharmaceutical Interventions on Nosocomial SARS-CoV-2 Transmission. Emerg Infect Dis. 2022;28(7):1345-1354. https://doi.org/10.3201/eid2807.212339
AMA Shirreff G, Zahar J, Cauchemez S, et al. Measuring Basic Reproduction Number to Assess Effects of Nonpharmaceutical Interventions on Nosocomial SARS-CoV-2 Transmission. Emerging Infectious Diseases. 2022;28(7):1345-1354. doi:10.3201/eid2807.212339.
APA Shirreff, G., Zahar, J., Cauchemez, S., Temime, L., & Opatowski, L. (2022). Measuring Basic Reproduction Number to Assess Effects of Nonpharmaceutical Interventions on Nosocomial SARS-CoV-2 Transmission. Emerging Infectious Diseases, 28(7), 1345-1354. https://doi.org/10.3201/eid2807.212339.

Analyzing and Modeling the Spread of SARS-CoV-2 Omicron Lineages BA.1 and BA.2, France, September 2021–February 2022 [PDF - 2.75 MB - 11 pages]
M. T. Sofonea et al.

We analyzed 324,734 SARS-CoV-2 variant screening tests from France enriched with 16,973 whole-genome sequences sampled during September 1, 2021–February 28, 2022. Results showed the estimated growth advantage of the Omicron variant over the Delta variant to be 105% (95% CI 96%–114%) and that of the BA.2 lineage over the BA.1 lineage to be 49% (95% CI 44%–52%). Quantitative PCR cycle threshold values were consistent with an increased ability of Omicron to generate breakthrough infections. Epidemiologic modeling shows that, in spite of its decreased virulence, the Omicron variant can generate important critical COVID-19 activity in hospitals in France. The magnitude of the BA.2 wave in hospitals depends on the level of relaxing of control measures but remains lower than that of BA.1 in median scenarios.

EID Sofonea MT, Roquebert B, Foulongne V, Morquin D, Verdurme L, Trombert-Paolantoni S, et al. Analyzing and Modeling the Spread of SARS-CoV-2 Omicron Lineages BA.1 and BA.2, France, September 2021–February 2022. Emerg Infect Dis. 2022;28(7):1355-1365. https://doi.org/10.3201/eid2807.220033
AMA Sofonea MT, Roquebert B, Foulongne V, et al. Analyzing and Modeling the Spread of SARS-CoV-2 Omicron Lineages BA.1 and BA.2, France, September 2021–February 2022. Emerging Infectious Diseases. 2022;28(7):1355-1365. doi:10.3201/eid2807.220033.
APA Sofonea, M. T., Roquebert, B., Foulongne, V., Morquin, D., Verdurme, L., Trombert-Paolantoni, S....Alizon, S. (2022). Analyzing and Modeling the Spread of SARS-CoV-2 Omicron Lineages BA.1 and BA.2, France, September 2021–February 2022. Emerging Infectious Diseases, 28(7), 1355-1365. https://doi.org/10.3201/eid2807.220033.

Effect of Returning University Students on COVID-19 Infections in England, 2020 [PDF - 2.30 MB - 9 pages]
D. Leeman et al.

Each September in England, ≈1 million students relocate to study at universities. To determine COVID-19 cases and outbreaks among university students after their return to university during the COVID pandemic in September 2020, we identified students with COVID-19 (student case-patients) by reviewing contact tracing records identifying attendance at university and residence in student accommodations identified by matching case-patients’ residential addresses with national property databases. We determined COVID-19 rates in towns/cities with and without a university campus. We identified 53,430 student case-patients during September 1–December 31, 2020, which accounted for 2.7% of all cases during this period. Student case-patients increased rapidly after the start of the term, driven initially by cases and outbreaks in student accommodations. Case rates among students 18–23 years of age doubled at the start of term in towns with universities. Our findings highlight the need for face-to-face and control measures to reduce virus transmission.

EID Leeman D, Flannagan J, Chudasama D, Dack K, Anderson C, Dabrera G, et al. Effect of Returning University Students on COVID-19 Infections in England, 2020. Emerg Infect Dis. 2022;28(7):1366-1374. https://doi.org/10.3201/eid2807.212332
AMA Leeman D, Flannagan J, Chudasama D, et al. Effect of Returning University Students on COVID-19 Infections in England, 2020. Emerging Infectious Diseases. 2022;28(7):1366-1374. doi:10.3201/eid2807.212332.
APA Leeman, D., Flannagan, J., Chudasama, D., Dack, K., Anderson, C., Dabrera, G....Lamagni, T. (2022). Effect of Returning University Students on COVID-19 Infections in England, 2020. Emerging Infectious Diseases, 28(7), 1366-1374. https://doi.org/10.3201/eid2807.212332.

Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose [PDF - 1.94 MB - 9 pages]
M. Mofaz et al.

Despite extensive technological advances in recent years, objective and continuous assessment of physiologic measures after vaccination is rarely performed. We conducted a prospective observational study to evaluate short-term self-reported and physiologic reactions to the booster BNT162b2 mRNA (Pfizer-BioNTech, https://www.pfizer.com) vaccine dose. A total of 1,609 participants were equipped with smartwatches and completed daily questionnaires through a dedicated mobile application. The extent of systemic reactions reported after the booster dose was similar to that of the second dose and considerably greater than that of the first dose. Analyses of objective heart rate and heart rate variability measures recorded by smartwatches further supported this finding. Subjective and objective reactions after the booster dose were more apparent in younger participants and in participants who did not have underlying medical conditions. Our findings further support the safety of the booster dose from subjective and objective perspectives and underscore the need for integrating wearables in clinical trials.

EID Mofaz M, Yechezkel M, Guan G, Brandeau ML, Patalon T, Gazit S, et al. Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose. Emerg Infect Dis. 2022;28(7):1375-1383. https://doi.org/10.3201/eid2807.212330
AMA Mofaz M, Yechezkel M, Guan G, et al. Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose. Emerging Infectious Diseases. 2022;28(7):1375-1383. doi:10.3201/eid2807.212330.
APA Mofaz, M., Yechezkel, M., Guan, G., Brandeau, M. L., Patalon, T., Gazit, S....Shmueli, E. (2022). Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose. Emerging Infectious Diseases, 28(7), 1375-1383. https://doi.org/10.3201/eid2807.212330.

Nipah Virus Detection at Bat Roosts after Spillover Events, Bangladesh, 2012–2019 [PDF - 1.16 MB - 9 pages]
C. D. McKee et al.

Knowledge of the dynamics and genetic diversity of Nipah virus circulating in bats and at the human-animal interface is limited by current sampling efforts, which produce few detections of viral RNA. We report a series of investigations at Pteropus medius bat roosts identified near the locations of human Nipah cases in Bangladesh during 2012–2019. Pooled bat urine was collected from 23 roosts; 7 roosts (30%) had >1 sample in which Nipah RNA was detected from the first visit. In subsequent visits to these 7 roosts, RNA was detected in bat urine up to 52 days after the presumed exposure of the human case-patient, although the probability of detection declined rapidly with time. These results suggest that rapidly deployed investigations of Nipah virus shedding from bat roosts near human cases could increase the success of viral sequencing compared with background surveillance and could enhance understanding of Nipah virus ecology and evolution.

EID McKee CD, Islam A, Rahman M, Khan S, Rahman M, Satter SM, et al. Nipah Virus Detection at Bat Roosts after Spillover Events, Bangladesh, 2012–2019. Emerg Infect Dis. 2022;28(7):1384-1392. https://doi.org/10.3201/eid2807.212614
AMA McKee CD, Islam A, Rahman M, et al. Nipah Virus Detection at Bat Roosts after Spillover Events, Bangladesh, 2012–2019. Emerging Infectious Diseases. 2022;28(7):1384-1392. doi:10.3201/eid2807.212614.
APA McKee, C. D., Islam, A., Rahman, M., Khan, S., Rahman, M., Satter, S. M....Gurley, E. S. (2022). Nipah Virus Detection at Bat Roosts after Spillover Events, Bangladesh, 2012–2019. Emerging Infectious Diseases, 28(7), 1384-1392. https://doi.org/10.3201/eid2807.212614.

Effect of Agroecosystems on Seroprevalence of St. Louis Encephalitis and West Nile Viruses in Birds, La Pampa, Argentina, 2017–2019 [PDF - 1.46 MB - 10 pages]
A. P. Mansilla et al.

In Argentina, the Pampa ecoregion has been almost completely transformed into agroecosystems. To evaluate the environmental (agricultural area, tree coverage, distance to the nearest water body and urban site) and biological (dove, cowbird, and sparrow abundance) effects on free-ranging bird exposure to St. Louis encephalitis virus (SLEV) and West Nile virus (WNV), we used generalized linear mixed models. For 1,019 birds sampled during 2017–2019, neutralizing antibodies were found against SLEV in samples from 60 (5.8%) birds and against WNV for 21 (2.1%). The best variable for explaining SLEV seroprevalence was agricultural area, which had a positive effect; however, for WNV, no model was conclusive. Our results suggest that agroecosystems in the La Pampa ecoregion increase the exposure of avian hosts to SLEV, thus potentially increasing virus activity.

EID Mansilla AP, Grande JM, Diaz A. Effect of Agroecosystems on Seroprevalence of St. Louis Encephalitis and West Nile Viruses in Birds, La Pampa, Argentina, 2017–2019. Emerg Infect Dis. 2022;28(7):1393-1402. https://doi.org/10.3201/eid2807.211485
AMA Mansilla AP, Grande JM, Diaz A. Effect of Agroecosystems on Seroprevalence of St. Louis Encephalitis and West Nile Viruses in Birds, La Pampa, Argentina, 2017–2019. Emerging Infectious Diseases. 2022;28(7):1393-1402. doi:10.3201/eid2807.211485.
APA Mansilla, A. P., Grande, J. M., & Diaz, A. (2022). Effect of Agroecosystems on Seroprevalence of St. Louis Encephalitis and West Nile Viruses in Birds, La Pampa, Argentina, 2017–2019. Emerging Infectious Diseases, 28(7), 1393-1402. https://doi.org/10.3201/eid2807.211485.

Targeted Screening for Chronic Q Fever, the Netherlands [PDF - 1.10 MB - 7 pages]
D. Reukers et al.

Early detection of and treatment for chronic Q fever might prevent potentially life-threatening complications. We performed a chronic Q fever screening program in general practitioner practices in the Netherlands 10 years after a large Q fever outbreak. Thirteen general practitioner practices located in outbreak areas selected 3,419 patients who had specific underlying medical conditions, of whom 1,642 (48%) participated. Immunofluorescence assay of serum showed that 289 (18%) of 1,642 participants had a previous Coxiella burnetii infection (IgG II titer >1:64), and 9 patients were suspected of having chronic Q fever (IgG I y titer >1:512). After medical evaluation, 4 of those patients received a chronic Q fever diagnosis. The cost of screening was higher than estimated earlier, but the program was still cost-effective in certain high risk groups. Years after a large Q fever outbreak, targeted screening still detected patients with chronic Q fever and is estimated to be cost-effective.

EID Reukers D, de Boer PT, Loohuis AO, Wever PC, Bleeker-Rovers CP, van Gageldonk-Lafeber AB, et al. Targeted Screening for Chronic Q Fever, the Netherlands. Emerg Infect Dis. 2022;28(7):1403-1409. https://doi.org/10.3201/eid2807.212273
AMA Reukers D, de Boer PT, Loohuis AO, et al. Targeted Screening for Chronic Q Fever, the Netherlands. Emerging Infectious Diseases. 2022;28(7):1403-1409. doi:10.3201/eid2807.212273.
APA Reukers, D., de Boer, P. T., Loohuis, A. O., Wever, P. C., Bleeker-Rovers, C. P., van Gageldonk-Lafeber, A. B....Timen, A. (2022). Targeted Screening for Chronic Q Fever, the Netherlands. Emerging Infectious Diseases, 28(7), 1403-1409. https://doi.org/10.3201/eid2807.212273.

One Health Genomic Analysis of Extended-Spectrum β-Lactamase‒Producing Salmonella enterica, Canada, 2012‒2016 [PDF - 2.56 MB - 11 pages]
A. Bharat et al.

Extended-spectrum β-lactamases (ESBLs) confer resistance to extended-spectrum cephalosporins, a major class of clinical antimicrobial drugs. We used genomic analysis to investigate whether domestic food animals, retail meat, and pets were reservoirs of ESBL-producing Salmonella for human infection in Canada. Of 30,303 Salmonella isolates tested during 2012–2016, we detected 95 ESBL producers. ESBL serotypes and alleles were mostly different between humans (n = 54) and animals/meat (n = 41). Two exceptions were blaSHV-2 and blaCTX-M-1 IncI1 plasmids, which were found in both sources. A subclade of S. enterica serovar Heidelberg isolates carrying the same IncI1-blaSHV-2 plasmid differed by only 1–7 single nucleotide variants. The most common ESBL producer in humans was Salmonella Infantis carrying blaCTX-M-65, which has since emerged in poultry in other countries. There were few instances of similar isolates and plasmids, suggesting that domestic animals and retail meat might have been minor reservoirs of ESBL-producing Salmonella for human infection.

EID Bharat A, Mataseje L, Parmley E, Avery BP, Cox G, Carson CA, et al. One Health Genomic Analysis of Extended-Spectrum β-Lactamase‒Producing Salmonella enterica, Canada, 2012‒2016. Emerg Infect Dis. 2022;28(7):1410-1420. https://doi.org/10.3201/eid2807.211528
AMA Bharat A, Mataseje L, Parmley E, et al. One Health Genomic Analysis of Extended-Spectrum β-Lactamase‒Producing Salmonella enterica, Canada, 2012‒2016. Emerging Infectious Diseases. 2022;28(7):1410-1420. doi:10.3201/eid2807.211528.
APA Bharat, A., Mataseje, L., Parmley, E., Avery, B. P., Cox, G., Carson, C. A....Mulvey, M. R. (2022). One Health Genomic Analysis of Extended-Spectrum β-Lactamase‒Producing Salmonella enterica, Canada, 2012‒2016. Emerging Infectious Diseases, 28(7), 1410-1420. https://doi.org/10.3201/eid2807.211528.

Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China [PDF - 2.95 MB - 10 pages]
L. Chen et al.

Carbapenem-resistant Enterobacterales (CRE) infection is highly endemic in China; Klebsiella pneumoniae carbapenemase (KPC) 2–producing CRE is the most common, whereas KPC-3–producing CRE is rare. We report an outbreak of KPC-3–producing Enterobacterales infection in China. During August 2020–June 2021, 25 blaKPC-3–positive Enterobacteriale isolates were detected from 24 patients in China. Whole-genome sequencing analysis revealed that the blaKPC-3 genes were harbored by IncX8 plasmids. The outbreak involved clonal expansion of KPC-3–producing Serratia marcescens and transmission of blaKPC-3 plasmids across different species. The blaKPC-3 plasmids demonstrated high conjugation frequencies (10−3 to 10−4). A Galleria mellonella infection model showed that 2 sequence type 65 K2 K. pneumoniae strains containing blaKPC-3 plasmids were highly virulent. A ceftazidime/avibactam in vitro selection assay indicated that the KPC-3–producing strains can readily develop resistance. The spread of blaKPC-3–harboring IncX8 plasmids and these KPC-3 strains should be closely monitored in China and globally.

EID Chen L, Ai W, Zhou Y, Wu C, Guo Y, Wu X, et al. Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China. Emerg Infect Dis. 2022;28(7):1421-1430. https://doi.org/10.3201/eid2807.212181
AMA Chen L, Ai W, Zhou Y, et al. Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China. Emerging Infectious Diseases. 2022;28(7):1421-1430. doi:10.3201/eid2807.212181.
APA Chen, L., Ai, W., Zhou, Y., Wu, C., Guo, Y., Wu, X....Yu, F. (2022). Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China. Emerging Infectious Diseases, 28(7), 1421-1430. https://doi.org/10.3201/eid2807.212181.

Novel Mycobacterium tuberculosis Complex Genotype Related to M. caprae [PDF - 1.42 MB - 6 pages]
J. Shea et al.

We report the unusual genotypic characterization of a bacterium isolated from a clinical sample of a patient who grew up in Bangladesh and lives in the United States. Using whole-genome sequencing, we identified the bacterium as a member of the Mycobacterium tuberculosis complex (MTBC). Phylogenetic placement of this strain suggests a new MTBC genotype. Even though it had the same spoligotype as M. caprae strains, single-nucleotide polymorphism–based phylogenetic analysis placed the isolate as a sister lineage distinct from M. caprae, most closely related to 5 previously sequenced genomes isolated from primates and elephants in Asia. We propose a new animal-associated lineage, La4, within MTBC.

EID Shea J, Smith C, Halse TA, Kohlerschmidt D, Rourke AK, Musser KA, et al. Novel Mycobacterium tuberculosis Complex Genotype Related to M. caprae. Emerg Infect Dis. 2022;28(7):1431-1436. https://doi.org/10.3201/eid2807.212353
AMA Shea J, Smith C, Halse TA, et al. Novel Mycobacterium tuberculosis Complex Genotype Related to M. caprae. Emerging Infectious Diseases. 2022;28(7):1431-1436. doi:10.3201/eid2807.212353.
APA Shea, J., Smith, C., Halse, T. A., Kohlerschmidt, D., Rourke, A. K., Musser, K. A....Lapierre, P. (2022). Novel Mycobacterium tuberculosis Complex Genotype Related to M. caprae. Emerging Infectious Diseases, 28(7), 1431-1436. https://doi.org/10.3201/eid2807.212353.
Dispatches

Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense [PDF - 948 KB - 5 pages]
T. Kuge et al.

Unidentified Mycobacterium species are sometimes detected in respiratory specimens. We identified a novel Tsukamurella species (Tsukamurella sp. TY48, RIMD 2001001, CIP 111916T), Tsukamurella toyonakaense, from a patient given a misdiagnosis of nontuberculous mycobacterial pulmonary disease caused by unidentified mycobacteria. Genomic identification of this Tsukamurella species helped clarify its clinical characteristics and epidemiology.

EID Kuge T, Fukushima K, Matsumoto Y, Saito H, Abe Y, Akiba E, et al. Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense. Emerg Infect Dis. 2022;28(7):1437-1441. https://doi.org/10.3201/eid2807.212320
AMA Kuge T, Fukushima K, Matsumoto Y, et al. Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense. Emerging Infectious Diseases. 2022;28(7):1437-1441. doi:10.3201/eid2807.212320.
APA Kuge, T., Fukushima, K., Matsumoto, Y., Saito, H., Abe, Y., Akiba, E....Kida, H. (2022). Chronic Pulmonary Disease Caused by Tsukamurella toyonakaense. Emerging Infectious Diseases, 28(7), 1437-1441. https://doi.org/10.3201/eid2807.212320.

SARS-CoV-2 Delta–Omicron Recombinant Viruses, United States [PDF - 406 KB - 4 pages]
K. A. Lacek et al.

To detect new and changing SARS-CoV-2 variants, we investigated candidate Delta–Omicron recombinant genomes from Centers for Disease Control and Prevention national genomic surveillance. Laboratory and bioinformatic investigations identified and validated 9 genetically related SARS-CoV-2 viruses with a hybrid Delta–Omicron spike protein.

EID Lacek KA, Rambo-Martin BL, Batra D, Zheng X, Hassell N, Sakaguchi H, et al. SARS-CoV-2 Delta–Omicron Recombinant Viruses, United States. Emerg Infect Dis. 2022;28(7):1442-1445. https://doi.org/10.3201/eid2807.220526
AMA Lacek KA, Rambo-Martin BL, Batra D, et al. SARS-CoV-2 Delta–Omicron Recombinant Viruses, United States. Emerging Infectious Diseases. 2022;28(7):1442-1445. doi:10.3201/eid2807.220526.
APA Lacek, K. A., Rambo-Martin, B. L., Batra, D., Zheng, X., Hassell, N., Sakaguchi, H....Paden, C. R. (2022). SARS-CoV-2 Delta–Omicron Recombinant Viruses, United States. Emerging Infectious Diseases, 28(7), 1442-1445. https://doi.org/10.3201/eid2807.220526.

Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Virus in Dust Samples from Poultry Farms, France, 2021 [PDF - 811 KB - 5 pages]
F. Filaire et al.

Avian influenza A(H5N8) virus has caused major epizootics in Europe since 2016. We conducted virologic analysis of aerosol and dust collected on poultry farms in France during 2020–2021. Our results suggest dust contributes to viral dispersal, even early in an outbreak, and could be a valuable surveillance tool.

EID Filaire F, Lebre L, Foret-Lucas C, Vergne T, Daniel P, Lelièvre A, et al. Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Virus in Dust Samples from Poultry Farms, France, 2021. Emerg Infect Dis. 2022;28(7):1446-1450. https://doi.org/10.3201/eid2807.212247
AMA Filaire F, Lebre L, Foret-Lucas C, et al. Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Virus in Dust Samples from Poultry Farms, France, 2021. Emerging Infectious Diseases. 2022;28(7):1446-1450. doi:10.3201/eid2807.212247.
APA Filaire, F., Lebre, L., Foret-Lucas, C., Vergne, T., Daniel, P., Lelièvre, A....Guérin, J. (2022). Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Virus in Dust Samples from Poultry Farms, France, 2021. Emerging Infectious Diseases, 28(7), 1446-1450. https://doi.org/10.3201/eid2807.212247.

Genetically Diverse Highly Pathogenic Avian Influenza A(H5N1/H5N8) Viruses among Wild Waterfowl and Domestic Poultry, Japan, 2021 [PDF - 945 KB - 5 pages]
K. Okuya et al.

Genetic analyses of highly pathogenic avian influenza H5 subtype viruses isolated from the Izumi Plain, Japan, revealed cocirculation of 2 genetic groups of clade 2.3.4.4b viruses among migratory waterfowl. Our findings demonstrate that both continuous surveillance and timely information sharing of avian influenza viruses are valuable for rapid risk assessment.

EID Okuya K, Mine J, Tokorozaki K, Kojima I, Esaki M, Miyazawa K, et al. Genetically Diverse Highly Pathogenic Avian Influenza A(H5N1/H5N8) Viruses among Wild Waterfowl and Domestic Poultry, Japan, 2021. Emerg Infect Dis. 2022;28(7):1451-1455. https://doi.org/10.3201/eid2807.212586
AMA Okuya K, Mine J, Tokorozaki K, et al. Genetically Diverse Highly Pathogenic Avian Influenza A(H5N1/H5N8) Viruses among Wild Waterfowl and Domestic Poultry, Japan, 2021. Emerging Infectious Diseases. 2022;28(7):1451-1455. doi:10.3201/eid2807.212586.
APA Okuya, K., Mine, J., Tokorozaki, K., Kojima, I., Esaki, M., Miyazawa, K....Ozawa, M. (2022). Genetically Diverse Highly Pathogenic Avian Influenza A(H5N1/H5N8) Viruses among Wild Waterfowl and Domestic Poultry, Japan, 2021. Emerging Infectious Diseases, 28(7), 1451-1455. https://doi.org/10.3201/eid2807.212586.

Multisystem Inflammatory Syndrome after Breakthrough SARS-CoV-2 Infection in 2 Immunized Adolescents, United States [PDF - 595 KB - 4 pages]
L. D. Cole et al.

Eight weeks after having laboratory-confirmed SARS-CoV-2 breakthrough infections, 2 otherwise healthy, fully immunized adolescent patients in the United States who were experiencing related signs and symptoms were diagnosed with multisystem inflammatory syndrome in children. Our findings indicate that COVID-19 vaccination does not completely protect adolescents against multisystem inflammatory syndrome.

EID Cole LD, Slate M, Minneman S, Bozzella MJ. Multisystem Inflammatory Syndrome after Breakthrough SARS-CoV-2 Infection in 2 Immunized Adolescents, United States. Emerg Infect Dis. 2022;28(7):1456-1459. https://doi.org/10.3201/eid2807.220560
AMA Cole LD, Slate M, Minneman S, et al. Multisystem Inflammatory Syndrome after Breakthrough SARS-CoV-2 Infection in 2 Immunized Adolescents, United States. Emerging Infectious Diseases. 2022;28(7):1456-1459. doi:10.3201/eid2807.220560.
APA Cole, L. D., Slate, M., Minneman, S., & Bozzella, M. J. (2022). Multisystem Inflammatory Syndrome after Breakthrough SARS-CoV-2 Infection in 2 Immunized Adolescents, United States. Emerging Infectious Diseases, 28(7), 1456-1459. https://doi.org/10.3201/eid2807.220560.

Medscape CME Activity
Natural History of and Dynamic Changes in Clinical Manifestation, Serology, and Treatment of Brucellosis, China [PDF - 1.63 MB - 6 pages]
H. Wang et al.

Serum agglutination test plus exposure history were used to diagnose most cases of human brucellosis in 2 China provinces. After appropriate treatment, 13.3% of acute brucellosis cases progressed to chronic disease; arthritis was an early predictor. Seropositivity can persist after symptoms disappear, which might cause physicians to subjectively extend therapeutic regimens.

EID Wang H, Liu H, Zhang Q, Lu X, Li D, Zhang H, et al. Natural History of and Dynamic Changes in Clinical Manifestation, Serology, and Treatment of Brucellosis, China. Emerg Infect Dis. 2022;28(7):1460-1465. https://doi.org/10.3201/eid2807.211766
AMA Wang H, Liu H, Zhang Q, et al. Natural History of and Dynamic Changes in Clinical Manifestation, Serology, and Treatment of Brucellosis, China. Emerging Infectious Diseases. 2022;28(7):1460-1465. doi:10.3201/eid2807.211766.
APA Wang, H., Liu, H., Zhang, Q., Lu, X., Li, D., Zhang, H....Zhang, W. (2022). Natural History of and Dynamic Changes in Clinical Manifestation, Serology, and Treatment of Brucellosis, China. Emerging Infectious Diseases, 28(7), 1460-1465. https://doi.org/10.3201/eid2807.211766.

Anncaliia algerae Microsporidiosis Diagnosed by Metagenomic Next-Generation Sequencing, China [PDF - 2.12 MB - 5 pages]
C. Liu et al.

We report a case of Anncaliia algerae microsporidia infection in an immunosuppressed kidney transplant recipient in China. Light microscopy and transmission electron microscopy initially failed to identify A. algerae, which eventually was detected by metagenomic next-generation sequencing. Our case highlights the supporting role of metagenomic sequencing in early identification of uncommon pathogens.

EID Liu C, Chen Q, Fu P, Shi Y. Anncaliia algerae Microsporidiosis Diagnosed by Metagenomic Next-Generation Sequencing, China. Emerg Infect Dis. 2022;28(7):1466-1470. https://doi.org/10.3201/eid2807.212315
AMA Liu C, Chen Q, Fu P, et al. Anncaliia algerae Microsporidiosis Diagnosed by Metagenomic Next-Generation Sequencing, China. Emerging Infectious Diseases. 2022;28(7):1466-1470. doi:10.3201/eid2807.212315.
APA Liu, C., Chen, Q., Fu, P., & Shi, Y. (2022). Anncaliia algerae Microsporidiosis Diagnosed by Metagenomic Next-Generation Sequencing, China. Emerging Infectious Diseases, 28(7), 1466-1470. https://doi.org/10.3201/eid2807.212315.

Deaths from Tick-Borne Encephalitis, Sweden [PDF - 766 KB - 4 pages]
R. Varnaitė et al.

We assessed standardized mortality ratio in tick-borne encephalitis (TBE) in Sweden, 2004–2017. Standardized mortality ratio for TBE was 3.96 (95% CI 2.55–5.90); no cases in patients <40 years of age were fatal. These results underscore the need for further vaccination efforts in populations at risk for TBE.

EID Varnaitė R, Gredmark-Russ S, Klingström J. Deaths from Tick-Borne Encephalitis, Sweden. Emerg Infect Dis. 2022;28(7):1471-1474. https://doi.org/10.3201/eid2807.220010
AMA Varnaitė R, Gredmark-Russ S, Klingström J. Deaths from Tick-Borne Encephalitis, Sweden. Emerging Infectious Diseases. 2022;28(7):1471-1474. doi:10.3201/eid2807.220010.
APA Varnaitė, R., Gredmark-Russ, S., & Klingström, J. (2022). Deaths from Tick-Borne Encephalitis, Sweden. Emerging Infectious Diseases, 28(7), 1471-1474. https://doi.org/10.3201/eid2807.220010.

Use of Human Intestinal Enteroids to Evaluate Persistence of Infectious Human Norovirus in Seawater [PDF - 2.41 MB - 5 pages]
M. Desdouits et al.

Little data on the persistence of human norovirus infectivity are available to predict its transmissibility. Using human intestinal enteroids, we demonstrate that 2 human norovirus strains can remain infectious for several weeks in seawater. Such experiments can improve understanding of factors associated with norovirus survival in coastal waters and shellfish.

EID Desdouits M, Polo D, Le Mennec C, Strubbia S, Zeng X, Ettayebi K, et al. Use of Human Intestinal Enteroids to Evaluate Persistence of Infectious Human Norovirus in Seawater. Emerg Infect Dis. 2022;28(7):1475-1479. https://doi.org/10.3201/eid2807.220219
AMA Desdouits M, Polo D, Le Mennec C, et al. Use of Human Intestinal Enteroids to Evaluate Persistence of Infectious Human Norovirus in Seawater. Emerging Infectious Diseases. 2022;28(7):1475-1479. doi:10.3201/eid2807.220219.
APA Desdouits, M., Polo, D., Le Mennec, C., Strubbia, S., Zeng, X., Ettayebi, K....Le Guyader, F. S. (2022). Use of Human Intestinal Enteroids to Evaluate Persistence of Infectious Human Norovirus in Seawater. Emerging Infectious Diseases, 28(7), 1475-1479. https://doi.org/10.3201/eid2807.220219.

Isolation and Characterization of Novel Reassortant Influenza A(H10N7) Virus in a Harbor Seal, British Columbia, Canada [PDF - 2.46 MB - 5 pages]
Y. Berhane et al.

We isolated a novel reassortant influenza A(H10N7) virus from a harbor seal in British Columbia, Canada, that died from bronchointerstitial pneumonia. The virus had unique genome constellations involving lineages from North America and Eurasia and polymerase basic 2 segment D701N mutation, associated with adaptation to mammals.

EID Berhane Y, Joseph T, Lung O, Embury-Hyatt C, Xu W, Cottrell P, et al. Isolation and Characterization of Novel Reassortant Influenza A(H10N7) Virus in a Harbor Seal, British Columbia, Canada. Emerg Infect Dis. 2022;28(7):1480-1484. https://doi.org/10.3201/eid2807.212302
AMA Berhane Y, Joseph T, Lung O, et al. Isolation and Characterization of Novel Reassortant Influenza A(H10N7) Virus in a Harbor Seal, British Columbia, Canada. Emerging Infectious Diseases. 2022;28(7):1480-1484. doi:10.3201/eid2807.212302.
APA Berhane, Y., Joseph, T., Lung, O., Embury-Hyatt, C., Xu, W., Cottrell, P....Raverty, S. (2022). Isolation and Characterization of Novel Reassortant Influenza A(H10N7) Virus in a Harbor Seal, British Columbia, Canada. Emerging Infectious Diseases, 28(7), 1480-1484. https://doi.org/10.3201/eid2807.212302.

Suspected Cat-to-Human Transmission of SARS-CoV-2, Thailand, July–September 2021 [PDF - 1.09 MB - 4 pages]
T. Sila et al.

A veterinarian in Thailand was diagnosed with COVID-19 after being sneezed on by an infected cat owned by an infected patient. Genetic study supported the hypothesis of SARS-CoV-2 transmission from the owner to the cat, and then from the cat to the veterinarian.

EID Sila T, Sunghan J, Laochareonsuk W, Surasombatpattana S, Kongkamol C, Ingviya T, et al. Suspected Cat-to-Human Transmission of SARS-CoV-2, Thailand, July–September 2021. Emerg Infect Dis. 2022;28(7):1485-1488. https://doi.org/10.3201/eid2807.212605
AMA Sila T, Sunghan J, Laochareonsuk W, et al. Suspected Cat-to-Human Transmission of SARS-CoV-2, Thailand, July–September 2021. Emerging Infectious Diseases. 2022;28(7):1485-1488. doi:10.3201/eid2807.212605.
APA Sila, T., Sunghan, J., Laochareonsuk, W., Surasombatpattana, S., Kongkamol, C., Ingviya, T....Chusri, S. (2022). Suspected Cat-to-Human Transmission of SARS-CoV-2, Thailand, July–September 2021. Emerging Infectious Diseases, 28(7), 1485-1488. https://doi.org/10.3201/eid2807.212605.

Potential Threats to Human Health from Eurasian Avian-Like Swine Influenza A(H1N1) Virus and Its Reassortants [PDF - 1.59 MB - 5 pages]
S. Wang et al.

During 2018–2020, we isolated 32 Eurasian avian-like swine influenza A(H1N1) viruses and their reassortant viruses from pigs in China. Genomic testing identified a novel reassortant H3N1 virus, which emerged in late 2020. Derived from G4 Eurasian H1N1 and H3N2 swine influenza viruses. This virus poses a risk for zoonotic infection.

EID Wang S, Wen F, Yu L, Wang J, Wang M, Yan J, et al. Potential Threats to Human Health from Eurasian Avian-Like Swine Influenza A(H1N1) Virus and Its Reassortants. Emerg Infect Dis. 2022;28(7):1489-1493. https://doi.org/10.3201/eid2807.211822
AMA Wang S, Wen F, Yu L, et al. Potential Threats to Human Health from Eurasian Avian-Like Swine Influenza A(H1N1) Virus and Its Reassortants. Emerging Infectious Diseases. 2022;28(7):1489-1493. doi:10.3201/eid2807.211822.
APA Wang, S., Wen, F., Yu, L., Wang, J., Wang, M., Yan, J....Yu, H. (2022). Potential Threats to Human Health from Eurasian Avian-Like Swine Influenza A(H1N1) Virus and Its Reassortants. Emerging Infectious Diseases, 28(7), 1489-1493. https://doi.org/10.3201/eid2807.211822.

Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi [PDF - 1.57 MB - 5 pages]
S. Jien et al.

We detected Helicobacter cinaedi in 4 of 10 patients with infected aortic aneurysms diagnosed using blood or tissue culture in Aichi, Japan, during September 2017–January 2021. Infected aortic aneurysms caused by H. cinaedi had a higher detection rate and better results after treatment than previously reported, without recurrent infection.

EID Jien S, Emiko R, Shingo I, Chihiro H, Shinji K, Akihiro M, et al. Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi. Emerg Infect Dis. 2022;28(7):1494-1498. https://doi.org/10.3201/eid2807.212505
AMA Jien S, Emiko R, Shingo I, et al. Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi. Emerging Infectious Diseases. 2022;28(7):1494-1498. doi:10.3201/eid2807.212505.
APA Jien, S., Emiko, R., Shingo, I., Chihiro, H., Shinji, K., Akihiro, M....Miki, A. (2022). Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi. Emerging Infectious Diseases, 28(7), 1494-1498. https://doi.org/10.3201/eid2807.212505.
Photo Quizzes

Photo Quiz [PDF - 859 KB - 4 pages]
J. Crainey et al.
EID Crainey J, Suwa U, Bessa Luz S. The Scientist Who Described the Filarial Parasite Mansonella ozzardi in 1897. Emerg Infect Dis. 2022;28(7):1499-1502. https://doi.org/10.3201/eid2807.210818
AMA Crainey J, Suwa U, Bessa Luz S. The Scientist Who Described the Filarial Parasite Mansonella ozzardi in 1897. Emerging Infectious Diseases. 2022;28(7):1499-1502. doi:10.3201/eid2807.210818.
APA Crainey, J., Suwa, U., & Bessa Luz, S. (2022). The Scientist Who Described the Filarial Parasite Mansonella ozzardi in 1897. Emerging Infectious Diseases, 28(7), 1499-1502. https://doi.org/10.3201/eid2807.210818.
Research Letters

Bagaza Virus in Wild Birds, Portugal, 2021 [PDF - 1.19 MB - 3 pages]
J. Queirós et al.

Bagaza virus emerged in Spain in 2010 and was not reported in other countries in Europe until 2021, when the virus was detected by molecular methods in a corn bunting and several red-legged partridges in Portugal. Sequencing revealed high similarity between the 2021 strains from Portugal and the 2010 strains from Spain.

EID Queirós J, Barros SC, Sánchez-Cano A, Henriques A, Fagulha T, dos Santos F, et al. Bagaza Virus in Wild Birds, Portugal, 2021. Emerg Infect Dis. 2022;28(7):1504-1506. https://doi.org/10.3201/eid2807.212408
AMA Queirós J, Barros SC, Sánchez-Cano A, et al. Bagaza Virus in Wild Birds, Portugal, 2021. Emerging Infectious Diseases. 2022;28(7):1504-1506. doi:10.3201/eid2807.212408.
APA Queirós, J., Barros, S. C., Sánchez-Cano, A., Henriques, A., Fagulha, T., dos Santos, F....Alves, P. (2022). Bagaza Virus in Wild Birds, Portugal, 2021. Emerging Infectious Diseases, 28(7), 1504-1506. https://doi.org/10.3201/eid2807.212408.

Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany [PDF - 691 KB - 4 pages]
J. Trauth et al.

Mycobacterium genavense infection, a rare nontuberculous mycobacteria infection, occurs in heavily immunocompromised patients (i.e., those with advanced HIV disease, genetic disorders, or acquired immunologic disorders and those undergoing immunosuppressive therapy). We report a case of disseminated M. genavense infection preceding Hodgkin lymphoma in a patient without obvious risk factors for this infection.

EID Trauth J, Discher T, Fritzenwanker M, Imirzalioglu C, Arnold T, Steiner D, et al. Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany. Emerg Infect Dis. 2022;28(7):1506-1509. https://doi.org/10.3201/eid2807.220425
AMA Trauth J, Discher T, Fritzenwanker M, et al. Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany. Emerging Infectious Diseases. 2022;28(7):1506-1509. doi:10.3201/eid2807.220425.
APA Trauth, J., Discher, T., Fritzenwanker, M., Imirzalioglu, C., Arnold, T., Steiner, D....Herold, S. (2022). Hodgkin Lymphoma after Disseminated Mycobacterium genavense Infection, Germany. Emerging Infectious Diseases, 28(7), 1506-1509. https://doi.org/10.3201/eid2807.220425.

Natural Reassortment of Eurasian Avian-Like Swine H1N1 and Avian H9N2 Influenza Viruses in Pigs, China [PDF - 705 KB - 4 pages]
W. Sun et al.

Several zoonotic influenza A viruses detected in humans contain genes derived from avian H9N2 subtypes. We uncovered a Eurasian avian-like H1N1 swine influenza virus with polymerase basic 1 and matrix gene segments derived from the H9N2 subtype, suggesting that H9N2 viruses are infecting pigs and reassorting with swine influenza viruses in China.

EID Sun W, Cheng S, Lam K, Kwan TC, Wong R, Lau L, et al. Natural Reassortment of Eurasian Avian-Like Swine H1N1 and Avian H9N2 Influenza Viruses in Pigs, China. Emerg Infect Dis. 2022;28(7):1509-1512. https://doi.org/10.3201/eid2807.220642
AMA Sun W, Cheng S, Lam K, et al. Natural Reassortment of Eurasian Avian-Like Swine H1N1 and Avian H9N2 Influenza Viruses in Pigs, China. Emerging Infectious Diseases. 2022;28(7):1509-1512. doi:10.3201/eid2807.220642.
APA Sun, W., Cheng, S., Lam, K., Kwan, T. C., Wong, R., Lau, L....Poon, L. (2022). Natural Reassortment of Eurasian Avian-Like Swine H1N1 and Avian H9N2 Influenza Viruses in Pigs, China. Emerging Infectious Diseases, 28(7), 1509-1512. https://doi.org/10.3201/eid2807.220642.

Persistent SARS-CoV-2 Alpha Variant Infection in Immunosuppressed Patient, France, February 2022 [PDF - 884 KB - 4 pages]
S. Fourati et al.

We describe persistent circulation of SARS-CoV-2 Alpha variant in an immunosuppressed patient in France during February 2022. The virus had a new pattern of mutation accumulation. The ongoing circulation of previous variants of concern could lead to reemergence of variants with the potential to propagate future waves of infection.

EID Fourati S, Gautier G, Chovelon M, Soulier A, N’Debi M, Demontant V, et al. Persistent SARS-CoV-2 Alpha Variant Infection in Immunosuppressed Patient, France, February 2022. Emerg Infect Dis. 2022;28(7):1512-1515. https://doi.org/10.3201/eid2807.220467
AMA Fourati S, Gautier G, Chovelon M, et al. Persistent SARS-CoV-2 Alpha Variant Infection in Immunosuppressed Patient, France, February 2022. Emerging Infectious Diseases. 2022;28(7):1512-1515. doi:10.3201/eid2807.220467.
APA Fourati, S., Gautier, G., Chovelon, M., Soulier, A., N’Debi, M., Demontant, V....Pawlotsky, J. (2022). Persistent SARS-CoV-2 Alpha Variant Infection in Immunosuppressed Patient, France, February 2022. Emerging Infectious Diseases, 28(7), 1512-1515. https://doi.org/10.3201/eid2807.220467.

Increased Stability of SARS-CoV-2 Omicron Variant over Ancestral Strain [PDF - 300 KB - 3 pages]
A. Chin et al.

As of April 2022, the Omicron BA.1 variant of concern of SARS-CoV-2 was spreading quickly around the world and outcompeting other circulating strains. We examined its stability on various surfaces and found that this Omicron variant is more stable than its ancestral strain on smooth and porous surfaces.

EID Chin A, Lai A, Peiris M, Man Poon L. Increased Stability of SARS-CoV-2 Omicron Variant over Ancestral Strain. Emerg Infect Dis. 2022;28(7):1515-1517. https://doi.org/10.3201/eid2807.220428
AMA Chin A, Lai A, Peiris M, et al. Increased Stability of SARS-CoV-2 Omicron Variant over Ancestral Strain. Emerging Infectious Diseases. 2022;28(7):1515-1517. doi:10.3201/eid2807.220428.
APA Chin, A., Lai, A., Peiris, M., & Man Poon, L. (2022). Increased Stability of SARS-CoV-2 Omicron Variant over Ancestral Strain. Emerging Infectious Diseases, 28(7), 1515-1517. https://doi.org/10.3201/eid2807.220428.

Type 1 Diabetes Mellitus Associated with Nivolumab after Second SARS-CoV-2 Vaccination, Japan [PDF - 328 KB - 3 pages]
T. Sato et al.

Recently, along with increasing use of immune checkpoint inhibitors such as nivolumab, the incidence of immune-related adverse events, including type 1 diabetes mellitus, has become a serious problem. We report a patient who had immune checkpoint inhibitor‒associated type 1 diabetes mellitus that developed after a second mRNA-based SARS-CoV-2 vaccination.

EID Sato T, Kodama S, Kaneko K, Imai J, Katagiri H. Type 1 Diabetes Mellitus Associated with Nivolumab after Second SARS-CoV-2 Vaccination, Japan. Emerg Infect Dis. 2022;28(7):1518-1520. https://doi.org/10.3201/eid2807.220127
AMA Sato T, Kodama S, Kaneko K, et al. Type 1 Diabetes Mellitus Associated with Nivolumab after Second SARS-CoV-2 Vaccination, Japan. Emerging Infectious Diseases. 2022;28(7):1518-1520. doi:10.3201/eid2807.220127.
APA Sato, T., Kodama, S., Kaneko, K., Imai, J., & Katagiri, H. (2022). Type 1 Diabetes Mellitus Associated with Nivolumab after Second SARS-CoV-2 Vaccination, Japan. Emerging Infectious Diseases, 28(7), 1518-1520. https://doi.org/10.3201/eid2807.220127.

University-Associated SARS-CoV-2 Omicron BA.2 Infections, Maricopa County, Arizona, USA, 2022 [PDF - 271 KB - 3 pages]
N. Fowle et al.

We investigated a university-affiliated cohort of SARS-CoV-2 Omicron BA.2 infections in Arizona, USA. Of 44 cases, 43 were among students; 26 persons were symptomatic, 8 sought medical care, but none were hospitalized. Most (55%) persons had completed a primary vaccine series; 8 received booster vaccines. BA.2 infection was mild in this young cohort.

EID Fowle N, Garrett B, Floyd OL, Collins J, Krasnow AD, Islas M, et al. University-Associated SARS-CoV-2 Omicron BA.2 Infections, Maricopa County, Arizona, USA, 2022. Emerg Infect Dis. 2022;28(7):1520-1522. https://doi.org/10.3201/eid2807.220470
AMA Fowle N, Garrett B, Floyd OL, et al. University-Associated SARS-CoV-2 Omicron BA.2 Infections, Maricopa County, Arizona, USA, 2022. Emerging Infectious Diseases. 2022;28(7):1520-1522. doi:10.3201/eid2807.220470.
APA Fowle, N., Garrett, B., Floyd, O. L., Collins, J., Krasnow, A. D., Islas, M....Scott, S. E. (2022). University-Associated SARS-CoV-2 Omicron BA.2 Infections, Maricopa County, Arizona, USA, 2022. Emerging Infectious Diseases, 28(7), 1520-1522. https://doi.org/10.3201/eid2807.220470.

Zoster Meningitis in an Immunocompetent Child after COVID-19 Vaccination, California, USA [PDF - 690 KB - 2 pages]
S. K. Daouk et al.

Varicella zoster virus reactivation after COVID-19 vaccination has been reported in older or immunocompromised adults. We report zoster meningitis from live-attenuated varicella vaccine reactivation in an immunocompetent child after COVID-19 vaccination. This type of case is rare; COVID-19 and varicella vaccines remain safe and effective for appropriate recipients in the pediatric population.

EID Daouk SK, Kamau E, Adachi K, Aldrovandi GM. Zoster Meningitis in an Immunocompetent Child after COVID-19 Vaccination, California, USA. Emerg Infect Dis. 2022;28(7):1523-1524. https://doi.org/10.3201/eid2807.220600
AMA Daouk SK, Kamau E, Adachi K, et al. Zoster Meningitis in an Immunocompetent Child after COVID-19 Vaccination, California, USA. Emerging Infectious Diseases. 2022;28(7):1523-1524. doi:10.3201/eid2807.220600.
APA Daouk, S. K., Kamau, E., Adachi, K., & Aldrovandi, G. M. (2022). Zoster Meningitis in an Immunocompetent Child after COVID-19 Vaccination, California, USA. Emerging Infectious Diseases, 28(7), 1523-1524. https://doi.org/10.3201/eid2807.220600.

Circulation of Enterovirus D68 during Period of Increased Influenza-Like Illness, Maryland, USA, 2021 [PDF - 360 KB - 3 pages]
A. Fall et al.

We report enterovirus D68 circulation in Maryland, USA, during September–October 2021, which was associated with a spike in influenza-like illness. The characterized enterovirus D68 genomes clustered within the B3 subclade that circulated in 2018 in Europe and the United States.

EID Fall A, Gallagher N, Morris C, Norton JM, Pekosz A, Klein E, et al. Circulation of Enterovirus D68 during Period of Increased Influenza-Like Illness, Maryland, USA, 2021. Emerg Infect Dis. 2022;28(7):1525-1527. https://doi.org/10.3201/eid2807.212603
AMA Fall A, Gallagher N, Morris C, et al. Circulation of Enterovirus D68 during Period of Increased Influenza-Like Illness, Maryland, USA, 2021. Emerging Infectious Diseases. 2022;28(7):1525-1527. doi:10.3201/eid2807.212603.
APA Fall, A., Gallagher, N., Morris, C., Norton, J. M., Pekosz, A., Klein, E....Mostafa, H. H. (2022). Circulation of Enterovirus D68 during Period of Increased Influenza-Like Illness, Maryland, USA, 2021. Emerging Infectious Diseases, 28(7), 1525-1527. https://doi.org/10.3201/eid2807.212603.

Genomic Evidence of In-Flight SARS-CoV-2 Transmission, India to Australia, April 2021 [PDF - 716 KB - 4 pages]
F. Hogarth et al.

Epidemiologic and genomic investigation of SARS-CoV-2 infections associated with 2 repatriation flights from India to Australia in April 2021 indicated that 4 passengers transmitted SARS-CoV-2 to >11 other passengers. Results suggest transmission despite mandatory mask use and predeparture testing. For subsequent flights, predeparture quarantine and expanded predeparture testing were implemented.

EID Hogarth F, Coffey P, Goddard L, Lewis S, Labib S, Wilmot M, et al. Genomic Evidence of In-Flight SARS-CoV-2 Transmission, India to Australia, April 2021. Emerg Infect Dis. 2022;28(7):1527-1530. https://doi.org/10.3201/eid2807.212466
AMA Hogarth F, Coffey P, Goddard L, et al. Genomic Evidence of In-Flight SARS-CoV-2 Transmission, India to Australia, April 2021. Emerging Infectious Diseases. 2022;28(7):1527-1530. doi:10.3201/eid2807.212466.
APA Hogarth, F., Coffey, P., Goddard, L., Lewis, S., Labib, S., Wilmot, M....Meumann, E. M. (2022). Genomic Evidence of In-Flight SARS-CoV-2 Transmission, India to Australia, April 2021. Emerging Infectious Diseases, 28(7), 1527-1530. https://doi.org/10.3201/eid2807.212466.

Strongyloides Hyperinfection Syndrome among COVID-19 Patients Treated with Corticosteroids [PDF - 503 KB - 4 pages]
J. M. Kim and G. Sivasubramanian

Widespread use of corticosteroids for COVID-19 treatment has led to Strongyloides reactivation and severe disease in patients from endemic areas. We describe a US patient with COVID-19 and Strongyloides hyperinfection syndrome and review other reported cases. Our findings highlight the need for Strongyloides screening and treatment in high-risk populations.

EID Kim JM, Sivasubramanian G. Strongyloides Hyperinfection Syndrome among COVID-19 Patients Treated with Corticosteroids. Emerg Infect Dis. 2022;28(7):1531-1533. https://doi.org/10.3201/eid2807.220198
AMA Kim JM, Sivasubramanian G. Strongyloides Hyperinfection Syndrome among COVID-19 Patients Treated with Corticosteroids. Emerging Infectious Diseases. 2022;28(7):1531-1533. doi:10.3201/eid2807.220198.
APA Kim, J. M., & Sivasubramanian, G. (2022). Strongyloides Hyperinfection Syndrome among COVID-19 Patients Treated with Corticosteroids. Emerging Infectious Diseases, 28(7), 1531-1533. https://doi.org/10.3201/eid2807.220198.

Mental Health Conditions and Severe COVID-19 Outcomes after Hospitalization, United States [PDF - 382 KB - 4 pages]
A. K. Koyama et al.

Among 664,956 hospitalized COVID-19 patients during March 2020–July 2021 in the United States, select mental health conditions (i.e., anxiety, depression, bipolar, schizophrenia) were associated with increased risk for same-hospital readmission and longer length of stay. Anxiety was also associated with increased risk for intensive care unit admission, invasive mechanical ventilation, and death.

EID Koyama AK, Koumans EH, Sircar K, Lavery AM, Ko JY, Hsu J, et al. Mental Health Conditions and Severe COVID-19 Outcomes after Hospitalization, United States. Emerg Infect Dis. 2022;28(7):1533-1536. https://doi.org/10.3201/eid2807.212208
AMA Koyama AK, Koumans EH, Sircar K, et al. Mental Health Conditions and Severe COVID-19 Outcomes after Hospitalization, United States. Emerging Infectious Diseases. 2022;28(7):1533-1536. doi:10.3201/eid2807.212208.
APA Koyama, A. K., Koumans, E. H., Sircar, K., Lavery, A. M., Ko, J. Y., Hsu, J....Siegel, D. A. (2022). Mental Health Conditions and Severe COVID-19 Outcomes after Hospitalization, United States. Emerging Infectious Diseases, 28(7), 1533-1536. https://doi.org/10.3201/eid2807.212208.
Another Dimension

Emerging from an Isolation Cocoon, 2022 [PDF - 194 KB - 1 page]
R. Louie
EID Louie R. Emerging from an Isolation Cocoon, 2022. Emerg Infect Dis. 2022;28(7):1503. https://doi.org/10.3201/eid2807.220488
AMA Louie R. Emerging from an Isolation Cocoon, 2022. Emerging Infectious Diseases. 2022;28(7):1503. doi:10.3201/eid2807.220488.
APA Louie, R. (2022). Emerging from an Isolation Cocoon, 2022. Emerging Infectious Diseases, 28(7), 1503. https://doi.org/10.3201/eid2807.220488.
About the Cover

Of Those We Have Lost and Those Who Have Saved So Many Others [PDF - 588 KB - 3 pages]
T. Chorba
EID Chorba T. Of Those We Have Lost and Those Who Have Saved So Many Others. Emerg Infect Dis. 2022;28(7):1537-1539. https://doi.org/10.3201/eid2807.ac2807
AMA Chorba T. Of Those We Have Lost and Those Who Have Saved So Many Others. Emerging Infectious Diseases. 2022;28(7):1537-1539. doi:10.3201/eid2807.ac2807.
APA Chorba, T. (2022). Of Those We Have Lost and Those Who Have Saved So Many Others. Emerging Infectious Diseases, 28(7), 1537-1539. https://doi.org/10.3201/eid2807.ac2807.
Page created: June 18, 2022
Page updated: June 21, 2022
Page reviewed: June 21, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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