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Articles from Emerging Infectious Diseases

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Medscape CME Activity
Clinical Characteristics of Corynebacterium Bacteremia Caused by Different Species, Japan, 2014–2020 [PDF - 998 KB - 7 pages]
R. Yamamuro et al.

To determine differences in clinical characteristics of patients with bacteremia caused by Corynebacterium striatum, C. jeikeium, and other species of Corynebacterium, we retrospectively reviewed medical records of patients in Japan who had Corynebacterium bacteremia during January 2014–May 2020. Of the 115 records evaluated, 60 (52%) were cases of true bacteremia and 55 (48%) were cases of contamination. Proportions of true bacteremia cases caused by C. striatum (70%) and by C. jeikeium (71%) were significantly higher than those caused by other species of Corynebacterium (9%). These 2 organisms were commonly detected in blood cultures of patients with hematologic malignancies and neutropenia. The mortality rates at 90 days were 34% (C. striatum), 30% (C. jeikeium), and 0 (other species). Given the high mortality rates, assessing true bacteremia when C. striatum or C. jeikeium is detected in blood cultures, especially in patients with hematologic malignancy, is warranted.

EID Yamamuro R, Hosokawa N, Otsuka Y, Osawa R. Clinical Characteristics of Corynebacterium Bacteremia Caused by Different Species, Japan, 2014–2020. Emerg Infect Dis. 2021;27(12):2981-2987. https://doi.org/10.3201/eid2712.210473
AMA Yamamuro R, Hosokawa N, Otsuka Y, et al. Clinical Characteristics of Corynebacterium Bacteremia Caused by Different Species, Japan, 2014–2020. Emerging Infectious Diseases. 2021;27(12):2981-2987. doi:10.3201/eid2712.210473.
APA Yamamuro, R., Hosokawa, N., Otsuka, Y., & Osawa, R. (2021). Clinical Characteristics of Corynebacterium Bacteremia Caused by Different Species, Japan, 2014–2020. Emerging Infectious Diseases, 27(12), 2981-2987. https://doi.org/10.3201/eid2712.210473.

Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020 [PDF - 1.99 MB - 11 pages]
M. Keita et al.

The 10th and largest Ebola virus disease epidemic in the Democratic Republic of the Congo (DRC) was declared in North Kivu Province in August 2018 and ended in June 2020. We describe and evaluate an Early Warning, Alert and Response System (EWARS) implemented in the Beni health zone of DRC during August 5, 2018–June 30, 2020. During this period, 194,768 alerts were received, of which 30,728 (15.8%) were validated as suspected cases. From these, 801 confirmed and 3 probable cases were detected. EWARS showed an overall good performance: sensitivity and specificity >80%, nearly all (97%) of alerts investigated within 2 hours of notification, and good demographic representativeness. The average cost of the system was US $438/case detected and US $1.8/alert received. The system was stable, despite occasional disruptions caused by political insecurity. Our results demonstrate that EWARS was a cost-effective component of the Ebola surveillance strategy in this setting.

EID Keita M, Lucaccioni H, Ilumbulumbu M, Polonsky J, Nsio-Mbeta J, Panda G, et al. Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020. Emerg Infect Dis. 2021;27(12):2988-2998. https://doi.org/10.3201/eid2712.210290
AMA Keita M, Lucaccioni H, Ilumbulumbu M, et al. Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020. Emerging Infectious Diseases. 2021;27(12):2988-2998. doi:10.3201/eid2712.210290.
APA Keita, M., Lucaccioni, H., Ilumbulumbu, M., Polonsky, J., Nsio-Mbeta, J., Panda, G....Ahuka-Mundeke, S. (2021). Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018–2020. Emerging Infectious Diseases, 27(12), 2988-2998. https://doi.org/10.3201/eid2712.210290.
Research

Coronavirus Disease Contact Tracing Outcomes and Cost, Salt Lake County, Utah, USA, March–May 2020 [PDF - 2.51 MB - 10 pages]
V. L. Fields et al.

Outcomes and costs of coronavirus disease (COVID-19) contact tracing are limited. During March–May 2020, we constructed transmission chains from 184 index cases and 1,499 contacts in Salt Lake County, Utah, USA, to assess outcomes and estimate staff time and salaries. We estimated 1,102 staff hours and $29,234 spent investigating index cases and contacts. Among contacts, 374 (25%) had COVID-19; secondary case detection rate was ≈31% among first-generation contacts, ≈16% among second- and third-generation contacts, and ≈12% among fourth-, fifth-, and sixth-generation contacts. At initial interview, 51% (187/370) of contacts were COVID-19–positive; 35% (98/277) became positive during 14-day quarantine. Median time from symptom onset to investigation was 7 days for index cases and 4 days for first-generation contacts. Contact tracing reduced the number of cases between contact generations and time between symptom onset and investigation but required substantial resources. Our findings can help jurisdictions allocate resources for contact tracing.

EID Fields VL, Kracalik IT, Carthel C, Lopez A, Schwartz A, Lewis NM, et al. Coronavirus Disease Contact Tracing Outcomes and Cost, Salt Lake County, Utah, USA, March–May 2020. Emerg Infect Dis. 2021;27(12):2999-3008. https://doi.org/10.3201/eid2712.210505
AMA Fields VL, Kracalik IT, Carthel C, et al. Coronavirus Disease Contact Tracing Outcomes and Cost, Salt Lake County, Utah, USA, March–May 2020. Emerging Infectious Diseases. 2021;27(12):2999-3008. doi:10.3201/eid2712.210505.
APA Fields, V. L., Kracalik, I. T., Carthel, C., Lopez, A., Schwartz, A., Lewis, N. M....Tran, C. H. (2021). Coronavirus Disease Contact Tracing Outcomes and Cost, Salt Lake County, Utah, USA, March–May 2020. Emerging Infectious Diseases, 27(12), 2999-3008. https://doi.org/10.3201/eid2712.210505.

Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Households with Children, Southwest Germany, May–August 2020 [PDF - 1.65 MB - 11 pages]
M. Stich et al.

Resolving the role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in households with members from different generations is crucial for containing the current pandemic. We conducted a large-scale, multicenter, cross-sectional seroepidemiologic household transmission study in southwest Germany during May 11–August 1, 2020. We included 1,625 study participants from 405 households that each had ≥1 child and 1 reverse transcription PCR–confirmed SARS-CoV-2–infected index case-patient. The overall secondary attack rate was 31.6% and was significantly higher in exposed adults (37.5%) than in children (24.6%–29.2%; p = <0.015); the rate was also significantly higher when the index case-patient was >60 years of age (72.9%; p = 0.039). Other risk factors for infectiousness of the index case-patient were SARS-CoV-2–seropositivity (odds ratio [OR] 27.8, 95% CI 8.26–93.5), fever (OR 1.93, 95% CI 1.14–3.31), and cough (OR 2.07, 95% CI 1.21–3.53). Secondary infections in household contacts generate a substantial disease burden.

EID Stich M, Elling R, Renk H, Janda A, Garbade SF, Müller B, et al. Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Households with Children, Southwest Germany, May–August 2020. Emerg Infect Dis. 2021;27(12):3009-3019. https://doi.org/10.3201/eid2712.210978
AMA Stich M, Elling R, Renk H, et al. Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Households with Children, Southwest Germany, May–August 2020. Emerging Infectious Diseases. 2021;27(12):3009-3019. doi:10.3201/eid2712.210978.
APA Stich, M., Elling, R., Renk, H., Janda, A., Garbade, S. F., Müller, B....Henneke, P. (2021). Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Households with Children, Southwest Germany, May–August 2020. Emerging Infectious Diseases, 27(12), 3009-3019. https://doi.org/10.3201/eid2712.210978.

SARS-CoV-2 Seroprevalence in a Rural and Urban Household Cohort during First and Second Waves of Infections, South Africa, July 2020–March 2021 [PDF - 2.61 MB - 10 pages]
J. Kleynhans et al.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections may be underestimated because of limited access to testing. We measured SARS-CoV-2 seroprevalence in South Africa every 2 months during July 2020–March 2021 in randomly selected household cohorts in 2 communities. We compared seroprevalence to reported laboratory-confirmed infections, hospitalizations, and deaths to calculate infection–case, infection–hospitalization, and infection–fatality ratios in 2 waves of infection. Post–second wave seroprevalence ranged from 18% in the rural community children <5 years of age, to 59% in urban community adults 35–59 years of age. The second wave saw a shift in age distribution of case-patients in the urban community (from persons 35–59 years of age to persons at the extremes of age), higher attack rates in the rural community, and a higher infection–fatality ratio in the urban community. Approximately 95% of SARS-CoV-2 infections were not reported to national surveillance.

EID Kleynhans J, Tempia S, Wolter N, von Gottberg A, Bhiman JN, Buys A, et al. SARS-CoV-2 Seroprevalence in a Rural and Urban Household Cohort during First and Second Waves of Infections, South Africa, July 2020–March 2021. Emerg Infect Dis. 2021;27(12):3020-3029. https://doi.org/10.3201/eid2712.211465
AMA Kleynhans J, Tempia S, Wolter N, et al. SARS-CoV-2 Seroprevalence in a Rural and Urban Household Cohort during First and Second Waves of Infections, South Africa, July 2020–March 2021. Emerging Infectious Diseases. 2021;27(12):3020-3029. doi:10.3201/eid2712.211465.
APA Kleynhans, J., Tempia, S., Wolter, N., von Gottberg, A., Bhiman, J. N., Buys, A....Cohen, C. (2021). SARS-CoV-2 Seroprevalence in a Rural and Urban Household Cohort during First and Second Waves of Infections, South Africa, July 2020–March 2021. Emerging Infectious Diseases, 27(12), 3020-3029. https://doi.org/10.3201/eid2712.211465.

Human Melioidosis Caused by Novel Transmission of Burkholderia pseudomallei from Freshwater Home Aquarium, United States [PDF - 1.20 MB - 6 pages]
P. Dawson et al.

Nearly all cases of melioidosis in the continental United States are related to international travel to areas to which Burkholderia pseudomallei, the bacterium that causes melioidosis, is endemic. We report the diagnosis and clinical course of melioidosis in a patient from the United States who had no international travel history and the public health investigation to determine the source of exposure. We tested environmental samples collected from the patient’s home for B. pseudomallei by PCR and culture. Whole-genome sequencing was conducted on PCR-positive environmental samples, and results were compared with sequences from the patient’s clinical specimen. Three PCR-positive environmental samples, all collected from a freshwater home aquarium that had contained imported tropical fish, were a genetic match to the clinical isolate from the patient. This finding suggests a novel route of exposure and a potential for importation of B. pseudomallei, a select agent, into the United States from disease-endemic areas.

EID Dawson P, Duwell MM, Elrod MG, Thompson RJ, Crum DA, Jacobs RM, et al. Human Melioidosis Caused by Novel Transmission of Burkholderia pseudomallei from Freshwater Home Aquarium, United States. Emerg Infect Dis. 2021;27(12):3030-3035. https://doi.org/10.3201/eid2712.211756
AMA Dawson P, Duwell MM, Elrod MG, et al. Human Melioidosis Caused by Novel Transmission of Burkholderia pseudomallei from Freshwater Home Aquarium, United States. Emerging Infectious Diseases. 2021;27(12):3030-3035. doi:10.3201/eid2712.211756.
APA Dawson, P., Duwell, M. M., Elrod, M. G., Thompson, R. J., Crum, D. A., Jacobs, R. M....Salzer, J. S. (2021). Human Melioidosis Caused by Novel Transmission of Burkholderia pseudomallei from Freshwater Home Aquarium, United States. Emerging Infectious Diseases, 27(12), 3030-3035. https://doi.org/10.3201/eid2712.211756.

Medscape CME Activity
Trends in Incidence and Clinical Outcomes of Clostridioides difficile Infection, Hong Kong [PDF - 1.31 MB - 9 pages]
C. Guo et al.

We conducted a territorywide survey to investigate the epidemiology, risk factors, and clinical outcomes of Clostridioides difficile infection (CDI) among hospitalized patients in Hong Kong. A total of 17,105 cases of CDI were identified, of which 15,717 (91.9%) were healthcare-associated and 1,025 (6.0%) were community-associated. Although CDI incidence increased substantially from 2006 to 2017, it plateaued in 2018 and 2019. The 30-day mortality rates decreased from 20.1% in 2015 to 16.8% in 2019, whereas the 60-day recurrence rates remained constant at ≈11% during the study period. Cross-correlation statistic showed significant correlations between incidence trend and overall antimicrobial drug use (r = 0.865, p<0.001), which has decreased as a result of an antibiotic stewardship program initiated in 2017. Our data suggest a turning point in C. difficile epidemiology that could be related to the changing pattern of antimicrobial drug use.

EID Guo C, Kwong T, Mak J, Zhang L, Lui G, Wong G, et al. Trends in Incidence and Clinical Outcomes of Clostridioides difficile Infection, Hong Kong. Emerg Infect Dis. 2021;27(12):3036-3044. https://doi.org/10.3201/eid2712.203769
AMA Guo C, Kwong T, Mak J, et al. Trends in Incidence and Clinical Outcomes of Clostridioides difficile Infection, Hong Kong. Emerging Infectious Diseases. 2021;27(12):3036-3044. doi:10.3201/eid2712.203769.
APA Guo, C., Kwong, T., Mak, J., Zhang, L., Lui, G., Wong, G....Wong, S. H. (2021). Trends in Incidence and Clinical Outcomes of Clostridioides difficile Infection, Hong Kong. Emerging Infectious Diseases, 27(12), 3036-3044. https://doi.org/10.3201/eid2712.203769.

Characterization of Swine Influenza A(H1N2) Variant, Alberta, Canada, 2020 [PDF - 1.13 MB - 7 pages]
J. N. Kanji et al.

Influenza strains circulating among swine populations can cause outbreaks in humans. In October 2020, we detected a variant influenza A subtype H1N2 of swine origin in a person in Alberta, Canada. We initiated a public health, veterinary, and laboratory investigation to identify the source of the infection and determine whether it had spread. We identified the probable source as a local pig farm where a household contact of the index patient worked. Phylogenetic analysis revealed that the isolate closely resembled strains found at that farm in 2017. Retrospective and prospective surveillance using molecular testing did not identify any secondary cases among 1,532 persons tested in the surrounding area. Quick collaboration between human and veterinary public health practitioners in this case enabled a rapid response to a potential outbreak.

EID Kanji JN, Pabbaraju K, Croxen M, Detmer S, Bastien N, Li Y, et al. Characterization of Swine Influenza A(H1N2) Variant, Alberta, Canada, 2020. Emerg Infect Dis. 2021;27(12):3045-3051. https://doi.org/10.3201/eid2712.210298
AMA Kanji JN, Pabbaraju K, Croxen M, et al. Characterization of Swine Influenza A(H1N2) Variant, Alberta, Canada, 2020. Emerging Infectious Diseases. 2021;27(12):3045-3051. doi:10.3201/eid2712.210298.
APA Kanji, J. N., Pabbaraju, K., Croxen, M., Detmer, S., Bastien, N., Li, Y....Tipples, G. (2021). Characterization of Swine Influenza A(H1N2) Variant, Alberta, Canada, 2020. Emerging Infectious Diseases, 27(12), 3045-3051. https://doi.org/10.3201/eid2712.210298.

Surface‒Aerosol Stability and Pathogenicity of Diverse Middle East Respiratory Syndrome Coronavirus Strains, 2012‒2018 [PDF - 3.49 MB - 11 pages]
N. van Doremalen et al.

Middle East respiratory syndrome coronavirus (MERS-CoV) infects humans and dromedary camels and is responsible for an ongoing outbreak of severe respiratory illness in humans in the Middle East. Although some mutations found in camel-derived MERS-CoV strains have been characterized, most natural variation found across MERS-CoV isolates remains unstudied. We report on the environmental stability, replication kinetics, and pathogenicity of several diverse isolates of MERS-CoV, as well as isolates of severe acute respiratory syndrome coronavirus 2, to serve as a basis of comparison with other stability studies. Although most MERS-CoV isolates had similar stability and pathogenicity in our experiments, the camel-derived isolate C/KSA/13 had reduced surface stability, and another camel isolate, C/BF/15, had reduced pathogenicity in a small animal model. These results suggest that although betacoronaviruses might have similar environmental stability profiles, individual variation can influence this phenotype, underscoring the need for continual global viral surveillance.

EID van Doremalen N, Letko M, Fischer RJ, Bushmaker T, Schulz J, Yinda CK, et al. Surface‒Aerosol Stability and Pathogenicity of Diverse Middle East Respiratory Syndrome Coronavirus Strains, 2012‒2018. Emerg Infect Dis. 2021;27(12):3052-3062. https://doi.org/10.3201/eid2712.210344
AMA van Doremalen N, Letko M, Fischer RJ, et al. Surface‒Aerosol Stability and Pathogenicity of Diverse Middle East Respiratory Syndrome Coronavirus Strains, 2012‒2018. Emerging Infectious Diseases. 2021;27(12):3052-3062. doi:10.3201/eid2712.210344.
APA van Doremalen, N., Letko, M., Fischer, R. J., Bushmaker, T., Schulz, J., Yinda, C. K....Munster, V. J. (2021). Surface‒Aerosol Stability and Pathogenicity of Diverse Middle East Respiratory Syndrome Coronavirus Strains, 2012‒2018. Emerging Infectious Diseases, 27(12), 3052-3062. https://doi.org/10.3201/eid2712.210344.

Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018–2020 [PDF - 2.09 MB - 10 pages]
J. A. Polonsky et al.

Despite its critical role in containing outbreaks, the efficacy of contact tracing, measured as the sensitivity of case detection, remains an elusive metric. We estimated the sensitivity of contact tracing by applying unilist capture-recapture methods on data from the 2018–2020 outbreak of Ebola virus disease in the Democratic Republic of the Congo. To compute sensitivity, we applied different distributional assumptions to the zero-truncated count data to estimate the number of unobserved case-patients with any contacts and infected contacts. Geometric distributions were the best-fitting models. Our results indicate that contact tracing efforts identified almost all (n = 792, 99%) of case-patients with any contacts but only half (n = 207, 48%) of case-patients with infected contacts, suggesting that contact tracing efforts performed well at identifying contacts during the listing stage but performed poorly during the contact follow-up stage. We discuss extensions to our work and potential applications for the ongoing coronavirus pandemic.

EID Polonsky JA, Böhning D, Keita M, Ahuka-Mundeke S, Nsio-Mbeta J, Abedi A, et al. Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018–2020. Emerg Infect Dis. 2021;27(12):3063-3072. https://doi.org/10.3201/eid2712.204958
AMA Polonsky JA, Böhning D, Keita M, et al. Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018–2020. Emerging Infectious Diseases. 2021;27(12):3063-3072. doi:10.3201/eid2712.204958.
APA Polonsky, J. A., Böhning, D., Keita, M., Ahuka-Mundeke, S., Nsio-Mbeta, J., Abedi, A....Vilas, V. (2021). Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing during an Ebola Outbreak, Democratic Republic of the Congo, 2018–2020. Emerging Infectious Diseases, 27(12), 3063-3072. https://doi.org/10.3201/eid2712.204958.

Novel Assay to Measure Seroprevalence of Zika Virus in the Philippines [PDF - 1.35 MB - 9 pages]
C. Adams et al.

Zika virus (ZIKV) is a member of the Flaviviridae family, which includes other clinically notable viruses such as the 4 dengue virus serotypes (DENV-1–4). Distinguishing DENVs from ZIKV using the established serologic assays widely used for monitoring DENV transmission is difficult because of antibody cross-reactivity between these closely related flaviviruses. We describe a modified and improved recombinant envelope domain III–based serologic assay for detecting ZIKV type-specific antibodies in regions with endemic DENV transmission. When the assay was used to measure ZIKV seroprevalence in 2017 among children 9–14 years of age living in a region of the Philippines with endemic DENV transmission, we observed a ZIKV seroprevalence of 18%. Investigators should consider using the ZIKV envelope domain III–based assay, which is simple and readily adaptable for use in standard clinical and public health laboratories, to assess ZIKV seroprevalence in areas with endemic DENV transmission.

EID Adams C, Jadi R, Segovia-Chumbez B, Daag J, Ylade M, Medina FA, et al. Novel Assay to Measure Seroprevalence of Zika Virus in the Philippines. Emerg Infect Dis. 2021;27(12):3073-3081. https://doi.org/10.3201/eid2712.211150
AMA Adams C, Jadi R, Segovia-Chumbez B, et al. Novel Assay to Measure Seroprevalence of Zika Virus in the Philippines. Emerging Infectious Diseases. 2021;27(12):3073-3081. doi:10.3201/eid2712.211150.
APA Adams, C., Jadi, R., Segovia-Chumbez, B., Daag, J., Ylade, M., Medina, F. A....Premkumar, L. (2021). Novel Assay to Measure Seroprevalence of Zika Virus in the Philippines. Emerging Infectious Diseases, 27(12), 3073-3081. https://doi.org/10.3201/eid2712.211150.

Novel Filoviruses, Hantavirus, and Rhabdovirus in Freshwater Fish, Switzerland, 2017 [PDF - 4.07 MB - 10 pages]
M. M. Hierweger et al.

European perch (Perca fluviatilis) are increasingly farmed as a human food source. Viral infections of European perch remain largely unexplored, thereby putting farm populations at incalculable risk for devastating fish epizootics and presenting a potential hazard to consumers. To address these concerns, we applied metatranscriptomics to identify disease-associated viruses in European perch farmed in Switzerland. Unexpectedly, in clinically diseased fish we detected novel freshwater fish filoviruses, a novel freshwater fish hantavirus, and a previously unknown rhabdovirus. Hantavirus titers were high, and we demonstrated virus in macrophages and gill endothelial cells by using in situ hybridization. Rhabdovirus titers in organ samples were low, but virus could be isolated on cell culture. Our data add to the hypothesis that filoviruses, hantaviruses, and rhabdoviruses are globally distributed common fish commensals, pathogens, or both. Our findings shed new light on negative-sense RNA virus diversity and evolution.

EID Hierweger MM, Koch MC, Rupp M, Maes P, Di Paola N, Bruggmann R, et al. Novel Filoviruses, Hantavirus, and Rhabdovirus in Freshwater Fish, Switzerland, 2017. Emerg Infect Dis. 2021;27(12):3082-3091. https://doi.org/10.3201/eid2712.210491
AMA Hierweger MM, Koch MC, Rupp M, et al. Novel Filoviruses, Hantavirus, and Rhabdovirus in Freshwater Fish, Switzerland, 2017. Emerging Infectious Diseases. 2021;27(12):3082-3091. doi:10.3201/eid2712.210491.
APA Hierweger, M. M., Koch, M. C., Rupp, M., Maes, P., Di Paola, N., Bruggmann, R....Seuberlich, T. (2021). Novel Filoviruses, Hantavirus, and Rhabdovirus in Freshwater Fish, Switzerland, 2017. Emerging Infectious Diseases, 27(12), 3082-3091. https://doi.org/10.3201/eid2712.210491.

Mammarenaviruses of Rodents, South Africa and Zimbabwe [PDF - 2.49 MB - 11 pages]
A. A. Grobbelaar et al.

We conducted a survey for group-specific indirect immunofluorescence antibody to mammarenaviruses by using Lassa fever and Mopeia virus antigens on serum specimens of 5,363 rodents of 33 species collected in South Africa and Zimbabwe during 1964–1994. Rodents were collected for unrelated purposes or for this study and stored at −70°C. We found antibody to be widely distributed in the 2 countries; antibody was detected in serum specimens of 1.2%–31.8% of 14 species of myomorph rodents, whereas 19 mammarenavirus isolates were obtained from serum specimens and viscera of 4 seropositive species. Phylogenetic analysis on the basis of partial nucleoprotein sequences indicates that 14 isolates from Mastomys natalensis, the Natal multimammate mouse, were Mopeia virus, whereas Merino Walk virus was characterized as a novel virus in a separate study. The remaining 4 isolates from 3 rodent species potentially constitute novel viruses pending full characterization.

EID Grobbelaar AA, Jardine J, Burt FJ, Shepherd AJ, Shepherd SP, Leman PA, et al. Mammarenaviruses of Rodents, South Africa and Zimbabwe. Emerg Infect Dis. 2021;27(12):3092-3102. https://doi.org/10.3201/eid2712.211088
AMA Grobbelaar AA, Jardine J, Burt FJ, et al. Mammarenaviruses of Rodents, South Africa and Zimbabwe. Emerging Infectious Diseases. 2021;27(12):3092-3102. doi:10.3201/eid2712.211088.
APA Grobbelaar, A. A., Jardine, J., Burt, F. J., Shepherd, A. J., Shepherd, S. P., Leman, P. A....Swanepoel, R. (2021). Mammarenaviruses of Rodents, South Africa and Zimbabwe. Emerging Infectious Diseases, 27(12), 3092-3102. https://doi.org/10.3201/eid2712.211088.

Potential Use for Serosurveillance of Feral Swine to Map Risk for Anthrax Exposure, Texas, USA [PDF - 1.30 MB - 8 pages]
R. M. Maison et al.

Anthrax is a disease of concern in many mammals, including humans. Management primarily consists of prevention through vaccination and tracking clinical-level observations because environmental isolation is laborious and bacterial distribution across large geographic areas difficult to confirm. Feral swine (Sus scrofa) are an invasive species with an extensive range in the southern United States that rarely succumbs to anthrax. We present evidence that feral swine might serve as biosentinels based on comparative seroprevalence in swine from historically defined anthrax-endemic and non–anthrax-endemic regions of Texas. Overall seropositivity was 43.7% (n = 478), and logistic regression revealed county endemicity status, age-class, sex, latitude, and longitude were informative for predicting antibody status. However, of these covariates, only latitude was statistically significant (β = –0.153, p = 0.047). These results suggests anthrax exposure in swine, when paired with continuous location data, could serve as a proxy for bacterial presence in specific areas.

EID Maison RM, Pierce CF, Ragan IK, Brown VR, Bodenchuk MJ, Bowen RA, et al. Potential Use for Serosurveillance of Feral Swine to Map Risk for Anthrax Exposure, Texas, USA. Emerg Infect Dis. 2021;27(12):3103-3110. https://doi.org/10.3201/eid2712.211482
AMA Maison RM, Pierce CF, Ragan IK, et al. Potential Use for Serosurveillance of Feral Swine to Map Risk for Anthrax Exposure, Texas, USA. Emerging Infectious Diseases. 2021;27(12):3103-3110. doi:10.3201/eid2712.211482.
APA Maison, R. M., Pierce, C. F., Ragan, I. K., Brown, V. R., Bodenchuk, M. J., Bowen, R. A....Bosco-Lauth, A. M. (2021). Potential Use for Serosurveillance of Feral Swine to Map Risk for Anthrax Exposure, Texas, USA. Emerging Infectious Diseases, 27(12), 3103-3110. https://doi.org/10.3201/eid2712.211482.
Dispatches

Detection of SARS-CoV-2 in Wastewater at Residential College, Maine, USA, August–November 2020 [PDF - 1.42 MB - 4 pages]
Y. M. Brooks et al.

We used wastewater surveillance to identify 2 coronavirus disease outbreaks at a college in Maine, USA. Cumulative increases of >1 log10 severe acute respiratory syndrome coronavirus 2 RNA in consecutive 24-hour composite samples preceded the outbreaks. For 76% of cases, RNA was identified in grab samples from residence halls <7 days before case discovery.

EID Brooks YM, Gryskwicz B, Sheehan S, Piers S, Mahale P, McNeil S, et al. Detection of SARS-CoV-2 in Wastewater at Residential College, Maine, USA, August–November 2020. Emerg Infect Dis. 2021;27(12):3111-3114. https://doi.org/10.3201/eid2712.211199
AMA Brooks YM, Gryskwicz B, Sheehan S, et al. Detection of SARS-CoV-2 in Wastewater at Residential College, Maine, USA, August–November 2020. Emerging Infectious Diseases. 2021;27(12):3111-3114. doi:10.3201/eid2712.211199.
APA Brooks, Y. M., Gryskwicz, B., Sheehan, S., Piers, S., Mahale, P., McNeil, S....Pardales, M. (2021). Detection of SARS-CoV-2 in Wastewater at Residential College, Maine, USA, August–November 2020. Emerging Infectious Diseases, 27(12), 3111-3114. https://doi.org/10.3201/eid2712.211199.

SARS-CoV-2–Specific Antibodies in Domestic Cats during First COVID-19 Wave, Europe [PDF - 1.37 MB - 4 pages]
C. Schulz et al.

We conducted a severe acute respiratory syndrome coronavirus 2 antibody seroprevalence study among >2,000 domestic cats from 4 countries during the first coronavirus disease wave in Europe. We found 4.4% seroprevalence using a virus neutralization test and 4.3% using a receptor-binding domain ELISA, demonstrating probable human-to-cat transmission.

EID Schulz C, Martina B, Mirolo M, Müller E, Klein R, Volk H, et al. SARS-CoV-2–Specific Antibodies in Domestic Cats during First COVID-19 Wave, Europe. Emerg Infect Dis. 2021;27(12):3115-3118. https://doi.org/10.3201/eid2712.211252
AMA Schulz C, Martina B, Mirolo M, et al. SARS-CoV-2–Specific Antibodies in Domestic Cats during First COVID-19 Wave, Europe. Emerging Infectious Diseases. 2021;27(12):3115-3118. doi:10.3201/eid2712.211252.
APA Schulz, C., Martina, B., Mirolo, M., Müller, E., Klein, R., Volk, H....Osterhaus, A. (2021). SARS-CoV-2–Specific Antibodies in Domestic Cats during First COVID-19 Wave, Europe. Emerging Infectious Diseases, 27(12), 3115-3118. https://doi.org/10.3201/eid2712.211252.

Increased Incidence of Melioidosis in Far North Queensland, Queensland, Australia, 1998–2019 [PDF - 1.96 MB - 5 pages]
S. Smith et al.

During January 1998–December 2019, the annual incidence of melioidosis in Far North Queensland, Queensland, Australia, more than doubled. Because climate and prevalence of predisposing medical conditions remained stable during that time, we hypothesize that the increased incidence was caused by urban expansion and increased construction, resulting in greater exposure to Burkholderia pseudomallei.

EID Smith S, Horne P, Rubenach S, Gair R, Stewart J, Fairhead L, et al. Increased Incidence of Melioidosis in Far North Queensland, Queensland, Australia, 1998–2019. Emerg Infect Dis. 2021;27(12):3119-3123. https://doi.org/10.3201/eid2712.211302
AMA Smith S, Horne P, Rubenach S, et al. Increased Incidence of Melioidosis in Far North Queensland, Queensland, Australia, 1998–2019. Emerging Infectious Diseases. 2021;27(12):3119-3123. doi:10.3201/eid2712.211302.
APA Smith, S., Horne, P., Rubenach, S., Gair, R., Stewart, J., Fairhead, L....Hanson, J. (2021). Increased Incidence of Melioidosis in Far North Queensland, Queensland, Australia, 1998–2019. Emerging Infectious Diseases, 27(12), 3119-3123. https://doi.org/10.3201/eid2712.211302.

Large-Scale Screening of Asymptomatic Persons for SARS-CoV-2 Variants of Concern and Gamma Takeover, Brazil [PDF - 1.60 MB - 4 pages]
D. Adamoski et al.

We performed a large-scale severe acute respiratory syndrome coronavirus 2 screening campaign using 2 PCR-based approaches, coupled with variant genotyping, aiming to provide a safer environment for employees of Federal University in Curitiba, Brazil. We observed the rapid spread of the Gamma variant of concern, which replaced other variants in <3 months.

EID Adamoski D, de Oliveira J, Bonatto A, Wassem R, Nogueira M, Raboni S, et al. Large-Scale Screening of Asymptomatic Persons for SARS-CoV-2 Variants of Concern and Gamma Takeover, Brazil. Emerg Infect Dis. 2021;27(12):3124-3127. https://doi.org/10.3201/eid2712.211326
AMA Adamoski D, de Oliveira J, Bonatto A, et al. Large-Scale Screening of Asymptomatic Persons for SARS-CoV-2 Variants of Concern and Gamma Takeover, Brazil. Emerging Infectious Diseases. 2021;27(12):3124-3127. doi:10.3201/eid2712.211326.
APA Adamoski, D., de Oliveira, J., Bonatto, A., Wassem, R., Nogueira, M., Raboni, S....Gradia, D. (2021). Large-Scale Screening of Asymptomatic Persons for SARS-CoV-2 Variants of Concern and Gamma Takeover, Brazil. Emerging Infectious Diseases, 27(12), 3124-3127. https://doi.org/10.3201/eid2712.211326.

Heartland Virus Transmission, Suffolk County, New York, USA [PDF - 1.40 MB - 5 pages]
A. P. Dupuis et al.

During 2018, Heartland virus RNA was detected in an Amblyomma americanum tick removed from a resident of Suffolk County, New York, USA. The person showed seroconversion. Tick surveillance and white-tailed deer (Odocoileus virginianus) serosurveys showed widespread distribution in Suffolk County, emphasizing a need for disease surveillance anywhere A. americanum ticks are established or emerging.

EID Dupuis AP, Prusinski MA, O’Connor C, Maffei JG, Ngo KA, Koetzner CA, et al. Heartland Virus Transmission, Suffolk County, New York, USA. Emerg Infect Dis. 2021;27(12):3128-3132. https://doi.org/10.3201/eid2712.211426
AMA Dupuis AP, Prusinski MA, O’Connor C, et al. Heartland Virus Transmission, Suffolk County, New York, USA. Emerging Infectious Diseases. 2021;27(12):3128-3132. doi:10.3201/eid2712.211426.
APA Dupuis, A. P., Prusinski, M. A., O’Connor, C., Maffei, J. G., Ngo, K. A., Koetzner, C. A....Ciota, A. T. (2021). Heartland Virus Transmission, Suffolk County, New York, USA. Emerging Infectious Diseases, 27(12), 3128-3132. https://doi.org/10.3201/eid2712.211426.

SARS-CoV-2 Variants, South Sudan, January–March 2021 [PDF - 2.72 MB - 4 pages]
D. Bugembe et al.

As the coronavirus pandemic continues, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequence data are required to inform vaccine efforts. We provide SARS-CoV-2 sequence data from South Sudan and document the dominance of SARS-CoV-2 lineage B.1.525 (Eta variant) during the country's second wave of infection.

EID Bugembe D, Phan M, Abias AG, Ayei J, Deng L, Lako R, et al. SARS-CoV-2 Variants, South Sudan, January–March 2021. Emerg Infect Dis. 2021;27(12):3133-3136. https://doi.org/10.3201/eid2712.211488
AMA Bugembe D, Phan M, Abias AG, et al. SARS-CoV-2 Variants, South Sudan, January–March 2021. Emerging Infectious Diseases. 2021;27(12):3133-3136. doi:10.3201/eid2712.211488.
APA Bugembe, D., Phan, M., Abias, A. G., Ayei, J., Deng, L., Lako, R....Cotten, M. (2021). SARS-CoV-2 Variants, South Sudan, January–March 2021. Emerging Infectious Diseases, 27(12), 3133-3136. https://doi.org/10.3201/eid2712.211488.

Incidence Trends for SARS-CoV-2 Alpha and Beta Variants, Finland, Spring 2021 [PDF - 1.45 MB - 5 pages]
R. Kant et al.

Severe acute respiratory syndrome coronavirus 2 Alpha and Beta variants became dominant in Finland in spring 2021 but had diminished by summer. We used phylogenetic clustering to identify sources of spreading. We found that outbreaks were mostly seeded by a few introductions, highlighting the importance of surveillance and prevention policies.

EID Kant R, Nguyen P, Blomqvist S, Erdin M, Alburkat H, Suvanto M, et al. Incidence Trends for SARS-CoV-2 Alpha and Beta Variants, Finland, Spring 2021. Emerg Infect Dis. 2021;27(12):3137-3141. https://doi.org/10.3201/eid2712.211631
AMA Kant R, Nguyen P, Blomqvist S, et al. Incidence Trends for SARS-CoV-2 Alpha and Beta Variants, Finland, Spring 2021. Emerging Infectious Diseases. 2021;27(12):3137-3141. doi:10.3201/eid2712.211631.
APA Kant, R., Nguyen, P., Blomqvist, S., Erdin, M., Alburkat, H., Suvanto, M....Vapalahti, O. (2021). Incidence Trends for SARS-CoV-2 Alpha and Beta Variants, Finland, Spring 2021. Emerging Infectious Diseases, 27(12), 3137-3141. https://doi.org/10.3201/eid2712.211631.

Potential Mosquito Vectors for Shuni Virus, South Africa, 2014–2018 [PDF - 2.41 MB - 5 pages]
M. Guarido et al.

Shuni virus is associated with neurologic and febrile illness in animals and humans. To determine potential vectors, we collected mosquitoes in South Africa and detected the virus in species of the genera Mansonia, Culex, Aedes, and Anopheles. These mosquitoes may be associated with Shuni virus outbreaks in Africa and emergence in other regions.

EID Guarido M, Motlou T, Riddin MA, MacIntyre C, Manyana S, Johnson T, et al. Potential Mosquito Vectors for Shuni Virus, South Africa, 2014–2018. Emerg Infect Dis. 2021;27(12):3142-3146. https://doi.org/10.3201/eid2712.203426
AMA Guarido M, Motlou T, Riddin MA, et al. Potential Mosquito Vectors for Shuni Virus, South Africa, 2014–2018. Emerging Infectious Diseases. 2021;27(12):3142-3146. doi:10.3201/eid2712.203426.
APA Guarido, M., Motlou, T., Riddin, M. A., MacIntyre, C., Manyana, S., Johnson, T....Venter, M. (2021). Potential Mosquito Vectors for Shuni Virus, South Africa, 2014–2018. Emerging Infectious Diseases, 27(12), 3142-3146. https://doi.org/10.3201/eid2712.203426.

Incubation Period for Neuroinvasive Toscana Virus Infections [PDF - 1.08 MB - 4 pages]
L. Laroche et al.

Toscana virus (TOSV) is an emerging pathogen in the Mediterranean area and is neuroinvasive in its most severe form. Basic knowledge on TOSV biology is limited. We conducted a systematic review on travel-related infections to estimate the TOSV incubation period. We estimated the incubation period at 12.1 days.

EID Laroche L, Jourdain F, Ayhan N, Bañuls A, Charrel R, Prudhomme J. Incubation Period for Neuroinvasive Toscana Virus Infections. Emerg Infect Dis. 2021;27(12):3147-3150. https://doi.org/10.3201/eid2712.203172
AMA Laroche L, Jourdain F, Ayhan N, et al. Incubation Period for Neuroinvasive Toscana Virus Infections. Emerging Infectious Diseases. 2021;27(12):3147-3150. doi:10.3201/eid2712.203172.
APA Laroche, L., Jourdain, F., Ayhan, N., Bañuls, A., Charrel, R., & Prudhomme, J. (2021). Incubation Period for Neuroinvasive Toscana Virus Infections. Emerging Infectious Diseases, 27(12), 3147-3150. https://doi.org/10.3201/eid2712.203172.

Uptake, Retention, and Excretion of Infectious Prions by Experimentally Exposed Earthworms [PDF - 1.64 MB - 4 pages]
S. Pritzkow et al.

Prions are proteinaceous infectious agents that can be transmitted through various components of the environment, including soil particles. We found that earthworms exposed to prion-contaminated soil can bind, retain, and excrete prions, which remain highly infectious. Our results suggest that earthworms potentially contribute to prion disease spread in the environment.

EID Pritzkow S, Morales R, Camacho M, Soto C. Uptake, Retention, and Excretion of Infectious Prions by Experimentally Exposed Earthworms. Emerg Infect Dis. 2021;27(12):3151-3154. https://doi.org/10.3201/eid2712.204236
AMA Pritzkow S, Morales R, Camacho M, et al. Uptake, Retention, and Excretion of Infectious Prions by Experimentally Exposed Earthworms. Emerging Infectious Diseases. 2021;27(12):3151-3154. doi:10.3201/eid2712.204236.
APA Pritzkow, S., Morales, R., Camacho, M., & Soto, C. (2021). Uptake, Retention, and Excretion of Infectious Prions by Experimentally Exposed Earthworms. Emerging Infectious Diseases, 27(12), 3151-3154. https://doi.org/10.3201/eid2712.204236.

Experimental Oronasal Transmission of Chronic Wasting Disease Agent from White-Tailed Deer to Suffolk Sheep [PDF - 1.28 MB - 3 pages]
E. D. Cassmann et al.

Chronic wasting disease (CWD) is a fatal prion disease of cervids. We examined host range of CWD by oronasally inoculating Suffolk sheep with brain homogenate from a CWD-positive white-tailed deer. Sixty months after inoculation, 1/7 sheep had immunoreactivity against the misfolded form of prion protein in lymphoid tissue. Results were confirmed by mouse bioassay.

EID Cassmann ED, Moore SJ, Greenlee JJ. Experimental Oronasal Transmission of Chronic Wasting Disease Agent from White-Tailed Deer to Suffolk Sheep. Emerg Infect Dis. 2021;27(12):3156-3158. https://doi.org/10.3201/eid2712.204978
AMA Cassmann ED, Moore SJ, Greenlee JJ. Experimental Oronasal Transmission of Chronic Wasting Disease Agent from White-Tailed Deer to Suffolk Sheep. Emerging Infectious Diseases. 2021;27(12):3156-3158. doi:10.3201/eid2712.204978.
APA Cassmann, E. D., Moore, S. J., & Greenlee, J. J. (2021). Experimental Oronasal Transmission of Chronic Wasting Disease Agent from White-Tailed Deer to Suffolk Sheep. Emerging Infectious Diseases, 27(12), 3156-3158. https://doi.org/10.3201/eid2712.204978.

Rift Valley Fever Virus Seroprevalence among Humans, Northern KwaZulu-Natal Province, South Africa, 2018–2019 [PDF - 1.26 MB - 4 pages]
J. T. Pawęska et al.

We detected Rift Valley fever virus (RVFV) IgM and IgG in human serum samples collected during 2018–2019 in northern KwaZulu-Natal Province, South Africa. Our results show recent RVFV circulation and likely RVFV endemicity in this tropical coastal plain region of South Africa in the absence of apparent clinical disease.

EID Pawęska JT, Msimang V, Kgaladi J, Hellferscee O, Weyer J, Jansen van Vuren P. Rift Valley Fever Virus Seroprevalence among Humans, Northern KwaZulu-Natal Province, South Africa, 2018–2019. Emerg Infect Dis. 2021;27(12):3159-3162. https://doi.org/10.3201/eid2712.210643
AMA Pawęska JT, Msimang V, Kgaladi J, et al. Rift Valley Fever Virus Seroprevalence among Humans, Northern KwaZulu-Natal Province, South Africa, 2018–2019. Emerging Infectious Diseases. 2021;27(12):3159-3162. doi:10.3201/eid2712.210643.
APA Pawęska, J. T., Msimang, V., Kgaladi, J., Hellferscee, O., Weyer, J., & Jansen van Vuren, P. (2021). Rift Valley Fever Virus Seroprevalence among Humans, Northern KwaZulu-Natal Province, South Africa, 2018–2019. Emerging Infectious Diseases, 27(12), 3159-3162. https://doi.org/10.3201/eid2712.210643.

Surge of Typhoid Intestinal Perforations as Possible Result of COVID-19–Associated Delays in Seeking Care, Madagascar [PDF - 855 KB - 3 pages]
H. Jeon et al.

During the coronavirus disease pandemic, we observed a 6.4-fold increase in typhoid intestinal perforation incidence in Antananarivo, Madagascar. Thirteen perforations occurred within 6 months (February 2020–July 2020), compared with 13 perforations during the previous 41 months (August 2016–January 2020). The increase may be attributable to delayed healthcare seeking during the pandemic.

EID Jeon H, Marks F, Sugimoto J, Im J, Kang S, Haselbeck A, et al. Surge of Typhoid Intestinal Perforations as Possible Result of COVID-19–Associated Delays in Seeking Care, Madagascar. Emerg Infect Dis. 2021;27(12):3163-3165. https://doi.org/10.3201/eid2712.210516
AMA Jeon H, Marks F, Sugimoto J, et al. Surge of Typhoid Intestinal Perforations as Possible Result of COVID-19–Associated Delays in Seeking Care, Madagascar. Emerging Infectious Diseases. 2021;27(12):3163-3165. doi:10.3201/eid2712.210516.
APA Jeon, H., Marks, F., Sugimoto, J., Im, J., Kang, S., Haselbeck, A....Rakotozandrindrainy, R. (2021). Surge of Typhoid Intestinal Perforations as Possible Result of COVID-19–Associated Delays in Seeking Care, Madagascar. Emerging Infectious Diseases, 27(12), 3163-3165. https://doi.org/10.3201/eid2712.210516.

Evidence of Human Exposure to Tamdy Virus, Northwest China [PDF - 1.90 MB - 5 pages]
A. Moming et al.

We report the isolation of Tamdy virus from Hyalomma asiaticum ticks in northwest China and serologic evidence of human Tamdy virus infection in the same region. These findings highlight the need to further investigate a potential causal relationship between Tamdy virus and febrile illnesses of unknown etiology in that region.

EID Moming A, Shen S, Fang Y, Zhang J, Zhang Y, Tang S, et al. Evidence of Human Exposure to Tamdy Virus, Northwest China. Emerg Infect Dis. 2021;27(12):3166-3170. https://doi.org/10.3201/eid2712.203532
AMA Moming A, Shen S, Fang Y, et al. Evidence of Human Exposure to Tamdy Virus, Northwest China. Emerging Infectious Diseases. 2021;27(12):3166-3170. doi:10.3201/eid2712.203532.
APA Moming, A., Shen, S., Fang, Y., Zhang, J., Zhang, Y., Tang, S....Deng, F. (2021). Evidence of Human Exposure to Tamdy Virus, Northwest China. Emerging Infectious Diseases, 27(12), 3166-3170. https://doi.org/10.3201/eid2712.203532.
Research Letters

SARS-CoV-2 B.1.1.7 Variant Infection in Malayan Tigers, Virginia, USA [PDF - 676 KB - 3 pages]
P. K. Mitchell et al.

We report infection of 3 Malayan tigers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.7 (Alpha) variant at a zoologic park in Virginia, USA. All tigers exhibited respiratory signs consistent with SARS-CoV-2 infection. These findings show that tigers are susceptible to infection with the SARS-CoV-2 B.1.1.7 variant.

EID Mitchell PK, Martins M, Reilly T, Caserta LC, Anderson RR, Cronk BD, et al. SARS-CoV-2 B.1.1.7 Variant Infection in Malayan Tigers, Virginia, USA. Emerg Infect Dis. 2021;27(12):3171-3173. https://doi.org/10.3201/eid2712.211234
AMA Mitchell PK, Martins M, Reilly T, et al. SARS-CoV-2 B.1.1.7 Variant Infection in Malayan Tigers, Virginia, USA. Emerging Infectious Diseases. 2021;27(12):3171-3173. doi:10.3201/eid2712.211234.
APA Mitchell, P. K., Martins, M., Reilly, T., Caserta, L. C., Anderson, R. R., Cronk, B. D....Diel, D. G. (2021). SARS-CoV-2 B.1.1.7 Variant Infection in Malayan Tigers, Virginia, USA. Emerging Infectious Diseases, 27(12), 3171-3173. https://doi.org/10.3201/eid2712.211234.

Postmortem Stability of SARS-CoV-2 in Mouse Lung Tissue [PDF - 1.06 MB - 3 pages]
S. A. Valkenburg et al.

The infectivity of severe acute respiratory syndrome coronavirus 2 in deceased persons and organisms remains unclear. We studied transgenic K18 hACE2 mice to determine the kinetics of virus infectivity after host death. Five days after death, virus infectivity in the lung declined by >96% and RNA copies declined by 48.2%.

EID Valkenburg SA, Cheng S, Hachim A, Peiris M, Nicholls J. Postmortem Stability of SARS-CoV-2 in Mouse Lung Tissue. Emerg Infect Dis. 2021;27(12):3173-3175. https://doi.org/10.3201/eid2712.211621
AMA Valkenburg SA, Cheng S, Hachim A, et al. Postmortem Stability of SARS-CoV-2 in Mouse Lung Tissue. Emerging Infectious Diseases. 2021;27(12):3173-3175. doi:10.3201/eid2712.211621.
APA Valkenburg, S. A., Cheng, S., Hachim, A., Peiris, M., & Nicholls, J. (2021). Postmortem Stability of SARS-CoV-2 in Mouse Lung Tissue. Emerging Infectious Diseases, 27(12), 3173-3175. https://doi.org/10.3201/eid2712.211621.

Guillain-​Barré Syndrome Associated with COVID-19 Vaccination [PDF - 975 KB - 4 pages]
S. Shao et al.

We conducted a multi-institutional study in Taiwan and a systematic review of the literature for reports of Guillain-​Barré syndrome after coronavirus disease vaccination. This condition, mostly the classic form and the acute inflammatory demyelinating polyneuropathy subtype, has been reported in 39 cases and has occurred within 2 weeks of vaccine administration.

EID Shao S, Wang C, Chang K, Hung M, Chen H, Liao S. Guillain-​Barré Syndrome Associated with COVID-19 Vaccination. Emerg Infect Dis. 2021;27(12):3175-3178. https://doi.org/10.3201/eid2712.211634
AMA Shao S, Wang C, Chang K, et al. Guillain-​Barré Syndrome Associated with COVID-19 Vaccination. Emerging Infectious Diseases. 2021;27(12):3175-3178. doi:10.3201/eid2712.211634.
APA Shao, S., Wang, C., Chang, K., Hung, M., Chen, H., & Liao, S. (2021). Guillain-​Barré Syndrome Associated with COVID-19 Vaccination. Emerging Infectious Diseases, 27(12), 3175-3178. https://doi.org/10.3201/eid2712.211634.

Limited and Short-Lasting Virus Neutralizing Titers Induced by Inactivated SARS-CoV-2 Vaccine [PDF - 1.03 MB - 3 pages]
T. Hunsawong et al.

In vitro determination of severe acute respiratory syndrome coronavirus 2 neutralizing antibodies induced in serum samples from recipients of the CoronaVac vaccine showed a short protection period against the original virus strain and limited protection against variants of concern. These data provide support for vaccine boosters, especially variants of concern circulate.

EID Hunsawong T, Fernandez S, Buathong R, Khadthasrima N, Rungrojchareonkit K, Lohachanakul J, et al. Limited and Short-Lasting Virus Neutralizing Titers Induced by Inactivated SARS-CoV-2 Vaccine. Emerg Infect Dis. 2021;27(12):3178-3180. https://doi.org/10.3201/eid2712.211772
AMA Hunsawong T, Fernandez S, Buathong R, et al. Limited and Short-Lasting Virus Neutralizing Titers Induced by Inactivated SARS-CoV-2 Vaccine. Emerging Infectious Diseases. 2021;27(12):3178-3180. doi:10.3201/eid2712.211772.
APA Hunsawong, T., Fernandez, S., Buathong, R., Khadthasrima, N., Rungrojchareonkit, K., Lohachanakul, J....Putcharoen, O. (2021). Limited and Short-Lasting Virus Neutralizing Titers Induced by Inactivated SARS-CoV-2 Vaccine. Emerging Infectious Diseases, 27(12), 3178-3180. https://doi.org/10.3201/eid2712.211772.

Breakthrough Infections of E484K-Harboring SARS-CoV-2 Delta Variant, Lombardy, Italy [PDF - 671 KB - 3 pages]
A. Baj et al.

The Delta variant of concern of severe acute respiratory syndrome coronavirus 2 is dominant worldwide. We report a case cluster caused by Delta sublineage B.1.617.2 harboring the mutation E484K in Italy during July 11–July 29, 2021. This mutation appears to affect immune response and vaccine efficacy; monitoring its appearance is urgent.

EID Baj A, Novazzi F, Pasciuta R, Genoni A, Ferrante F, Valli M, et al. Breakthrough Infections of E484K-Harboring SARS-CoV-2 Delta Variant, Lombardy, Italy. Emerg Infect Dis. 2021;27(12):3180-3182. https://doi.org/10.3201/eid2712.211792
AMA Baj A, Novazzi F, Pasciuta R, et al. Breakthrough Infections of E484K-Harboring SARS-CoV-2 Delta Variant, Lombardy, Italy. Emerging Infectious Diseases. 2021;27(12):3180-3182. doi:10.3201/eid2712.211792.
APA Baj, A., Novazzi, F., Pasciuta, R., Genoni, A., Ferrante, F., Valli, M....Maggi, F. (2021). Breakthrough Infections of E484K-Harboring SARS-CoV-2 Delta Variant, Lombardy, Italy. Emerging Infectious Diseases, 27(12), 3180-3182. https://doi.org/10.3201/eid2712.211792.

Subclinical Burkholderia pseudomallei Infection Associated with Travel to the British Virgin Islands [PDF - 1.30 MB - 3 pages]
C. M. Dewart et al.

Phylogenetic analysis of a clinical isolate associated with subclinical Burkholderia pseudomallei infection revealed probable exposure in the British Virgin Islands, where reported infections are limited. Clinicians should consider this geographic distribution when evaluating possible infection among persons with compatible travel history.

EID Dewart CM, Almeida FA, Koval C, Nowicki S, Gee JE, Elrod M, et al. Subclinical Burkholderia pseudomallei Infection Associated with Travel to the British Virgin Islands. Emerg Infect Dis. 2021;27(12):3182-3184. https://doi.org/10.3201/eid2712.211816
AMA Dewart CM, Almeida FA, Koval C, et al. Subclinical Burkholderia pseudomallei Infection Associated with Travel to the British Virgin Islands. Emerging Infectious Diseases. 2021;27(12):3182-3184. doi:10.3201/eid2712.211816.
APA Dewart, C. M., Almeida, F. A., Koval, C., Nowicki, S., Gee, J. E., Elrod, M....Liu, L. (2021). Subclinical Burkholderia pseudomallei Infection Associated with Travel to the British Virgin Islands. Emerging Infectious Diseases, 27(12), 3182-3184. https://doi.org/10.3201/eid2712.211816.

SARS-CoV-2 Sequence Analysis during COVID-19 Case Surge, Liberia, 2021 [PDF - 1.52 MB - 4 pages]
B. Shobayo et al.

In June 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases surged in Liberia. SARS-CoV-2 sequences from patients hospitalized during March–July 2021 revealed the Delta variant was in Liberia in early March and was dominant in June, irrespective of geography. Mutations and deletions suggest multiple SARS-CoV-2 Delta variant introductions.

EID Shobayo B, Mishra M, Sameroff S, Petrosov A, Ng J, Gokden A, et al. SARS-CoV-2 Sequence Analysis during COVID-19 Case Surge, Liberia, 2021. Emerg Infect Dis. 2021;27(12):3185-3188. https://doi.org/10.3201/eid2712.211818
AMA Shobayo B, Mishra M, Sameroff S, et al. SARS-CoV-2 Sequence Analysis during COVID-19 Case Surge, Liberia, 2021. Emerging Infectious Diseases. 2021;27(12):3185-3188. doi:10.3201/eid2712.211818.
APA Shobayo, B., Mishra, M., Sameroff, S., Petrosov, A., Ng, J., Gokden, A....Mishra, N. (2021). SARS-CoV-2 Sequence Analysis during COVID-19 Case Surge, Liberia, 2021. Emerging Infectious Diseases, 27(12), 3185-3188. https://doi.org/10.3201/eid2712.211818.

Real-Time Projections of SARS-CoV-2 B.1.1.7 Variant in a University Setting, Texas, USA [PDF - 1.05 MB - 3 pages]
K. E. Johnson et al.

We used the incidence of spike gene target failures identified during PCR testing to provide an early projection of the prevalence of severe acute respiratory syndrome coronavirus 2 variant B.1.1.7 in a university setting in Texas, USA, before sequencing results were available. Findings from a more recent evaluation validated those early projections.

EID Johnson KE, Woody S, Lachmann M, Fox SJ, Klima J, Hines TS, et al. Real-Time Projections of SARS-CoV-2 B.1.1.7 Variant in a University Setting, Texas, USA. Emerg Infect Dis. 2021;27(12):3188-3190. https://doi.org/10.3201/eid2712.210652
AMA Johnson KE, Woody S, Lachmann M, et al. Real-Time Projections of SARS-CoV-2 B.1.1.7 Variant in a University Setting, Texas, USA. Emerging Infectious Diseases. 2021;27(12):3188-3190. doi:10.3201/eid2712.210652.
APA Johnson, K. E., Woody, S., Lachmann, M., Fox, S. J., Klima, J., Hines, T. S....Meyers, L. (2021). Real-Time Projections of SARS-CoV-2 B.1.1.7 Variant in a University Setting, Texas, USA. Emerging Infectious Diseases, 27(12), 3188-3190. https://doi.org/10.3201/eid2712.210652.

Correlation between Buruli Ulcer Incidence and Vectorborne Diseases, Southeastern Australia, 2000–2020 [PDF - 874 KB - 2 pages]
J. Linke et al.

Researchers have hypothesized that mosquitoes are vectors involved in Mycobacterium ulcerans transmission. Previous findings of a correlation between incidence of M. ulcerans, which causes Buruli ulcer, and locally acquired vectorborne diseases in southeastern Australia further strengthened this argument. However, our updated data indicate that this correlation has not continued beyond 2008.

EID Linke J, Athan E, Friedman N. Correlation between Buruli Ulcer Incidence and Vectorborne Diseases, Southeastern Australia, 2000–2020. Emerg Infect Dis. 2021;27(12):3191-3192. https://doi.org/10.3201/eid2712.203182
AMA Linke J, Athan E, Friedman N. Correlation between Buruli Ulcer Incidence and Vectorborne Diseases, Southeastern Australia, 2000–2020. Emerging Infectious Diseases. 2021;27(12):3191-3192. doi:10.3201/eid2712.203182.
APA Linke, J., Athan, E., & Friedman, N. (2021). Correlation between Buruli Ulcer Incidence and Vectorborne Diseases, Southeastern Australia, 2000–2020. Emerging Infectious Diseases, 27(12), 3191-3192. https://doi.org/10.3201/eid2712.203182.

Borrelia miyamotoi in Human-Biting Ticks, United States, 2013–2019 [PDF - 1.03 MB - 3 pages]
G. Xu et al.

During 2013–2019, Borrelia miyamotoi infection was detected in 19 US states. Infection rate was 0.5%–3.2%; of B. miyamotoi–positive ticks, 59.09% had concurrent infections. B. miyamotoi is homogeneous with 1 genotype from Ixodes scapularis ticks in northeastern and midwestern states and 1 from I. pacificus in western states.

EID Xu G, Luo C, Ribbe F, Pearson P, Ledizet M, Rich SM. Borrelia miyamotoi in Human-Biting Ticks, United States, 2013–2019. Emerg Infect Dis. 2021;27(12):3193-3195. https://doi.org/10.3201/eid2712.204646
AMA Xu G, Luo C, Ribbe F, et al. Borrelia miyamotoi in Human-Biting Ticks, United States, 2013–2019. Emerging Infectious Diseases. 2021;27(12):3193-3195. doi:10.3201/eid2712.204646.
APA Xu, G., Luo, C., Ribbe, F., Pearson, P., Ledizet, M., & Rich, S. M. (2021). Borrelia miyamotoi in Human-Biting Ticks, United States, 2013–2019. Emerging Infectious Diseases, 27(12), 3193-3195. https://doi.org/10.3201/eid2712.204646.

Wohlfahrtiimonas chitiniclastica Monomicrobial Bacteremia in a Homeless Man [PDF - 700 KB - 3 pages]
O. Harfouch et al.

We report a case of septic shock attributable to monomicrobial bloodstream infection secondary to Wohlfahrtiimonas chitiniclastica infection. This case suggests that W. chitiniclastica likely possesses the virulence to cause severe disease. Culture-independent techniques were essential in the identification of this organism, which enabled selection of appropriate therapy.

EID Harfouch O, Luethy PM, Noval M, Baghdadi JD. Wohlfahrtiimonas chitiniclastica Monomicrobial Bacteremia in a Homeless Man. Emerg Infect Dis. 2021;27(12):3195-3197. https://doi.org/10.3201/eid2712.210327
AMA Harfouch O, Luethy PM, Noval M, et al. Wohlfahrtiimonas chitiniclastica Monomicrobial Bacteremia in a Homeless Man. Emerging Infectious Diseases. 2021;27(12):3195-3197. doi:10.3201/eid2712.210327.
APA Harfouch, O., Luethy, P. M., Noval, M., & Baghdadi, J. D. (2021). Wohlfahrtiimonas chitiniclastica Monomicrobial Bacteremia in a Homeless Man. Emerging Infectious Diseases, 27(12), 3195-3197. https://doi.org/10.3201/eid2712.210327.

Septic Polyarthritis Caused by Streptobacillus moniliformis [PDF - 1.08 MB - 2 pages]
A. Uddin et al.

Streptobacillus moniliformis is a pleomorphic, fastidious gram-negative bacillus that colonizes rodent respiratory tracts and causes rat-bite fever in humans. Rat-bite fever is associated with septic arthritis, usually monoarticular or pauciarticular. We report a rare case of polyarticular septic arthritis caused by S. moniliformis; the disease was initially misdiagnosed as inflammatory arthritis.

EID Uddin A, Phan T, Yassin M. Septic Polyarthritis Caused by Streptobacillus moniliformis. Emerg Infect Dis. 2021;27(12):3198-3199. https://doi.org/10.3201/eid2712.210649
AMA Uddin A, Phan T, Yassin M. Septic Polyarthritis Caused by Streptobacillus moniliformis. Emerging Infectious Diseases. 2021;27(12):3198-3199. doi:10.3201/eid2712.210649.
APA Uddin, A., Phan, T., & Yassin, M. (2021). Septic Polyarthritis Caused by Streptobacillus moniliformis. Emerging Infectious Diseases, 27(12), 3198-3199. https://doi.org/10.3201/eid2712.210649.

Coxiella burnetii in 3 Species of Turtles in the Upper Midwest, United States [PDF - 914 KB - 4 pages]
W. E. Sander et al.

Coxiella burnetii, the causative bacterium of the zoonotic disease Q fever, has been documented in many different species. We describe documented turtles that were PCR positive for C. burnetii from multiple locations in Illinois and Wisconsin, USA. Assessing the conservation implications, reservoir potential, and zoonotic risk requires further research.

EID Sander WE, King R, Graser W, Kapfer JM, Engel AI, Adamovicz L, et al. Coxiella burnetii in 3 Species of Turtles in the Upper Midwest, United States. Emerg Infect Dis. 2021;27(12):3199-3202. https://doi.org/10.3201/eid2712.211278
AMA Sander WE, King R, Graser W, et al. Coxiella burnetii in 3 Species of Turtles in the Upper Midwest, United States. Emerging Infectious Diseases. 2021;27(12):3199-3202. doi:10.3201/eid2712.211278.
APA Sander, W. E., King, R., Graser, W., Kapfer, J. M., Engel, A. I., Adamovicz, L....Allender, M. C. (2021). Coxiella burnetii in 3 Species of Turtles in the Upper Midwest, United States. Emerging Infectious Diseases, 27(12), 3199-3202. https://doi.org/10.3201/eid2712.211278.

Reassortant Influenza A(H1N1)pdm09 Virus in Elderly Woman, Denmark, January 2021 [PDF - 1.22 MB - 4 pages]
J. N. Nissen et al.

A case of human infection with influenza A(H1N1)pdm09 virus containing a nonstructural gene highly similar to Eurasian avian-like H1Nx swine influenza virus was detected in Denmark in January 2021. We describe the clinical case and report testing results of the genetic and antigenic characterizations of the virus.

EID Nissen JN, George SJ, Hjulsager CK, Krog JS, Nielsen XC, Madsen TV, et al. Reassortant Influenza A(H1N1)pdm09 Virus in Elderly Woman, Denmark, January 2021. Emerg Infect Dis. 2021;27(12):3202-3205. https://doi.org/10.3201/eid2712.211361
AMA Nissen JN, George SJ, Hjulsager CK, et al. Reassortant Influenza A(H1N1)pdm09 Virus in Elderly Woman, Denmark, January 2021. Emerging Infectious Diseases. 2021;27(12):3202-3205. doi:10.3201/eid2712.211361.
APA Nissen, J. N., George, S. J., Hjulsager, C. K., Krog, J. S., Nielsen, X. C., Madsen, T. V....Trebbien, R. (2021). Reassortant Influenza A(H1N1)pdm09 Virus in Elderly Woman, Denmark, January 2021. Emerging Infectious Diseases, 27(12), 3202-3205. https://doi.org/10.3201/eid2712.211361.
Books and Media

Modern Epidemics: From the Spanish Flu to COVID-19 [PDF - 669 KB - 1 page]
M. A. Greischar
EID Greischar MA. Modern Epidemics: From the Spanish Flu to COVID-19. Emerg Infect Dis. 2021;27(12):3206. https://doi.org/10.3201/eid2712.211312
AMA Greischar MA. Modern Epidemics: From the Spanish Flu to COVID-19. Emerging Infectious Diseases. 2021;27(12):3206. doi:10.3201/eid2712.211312.
APA Greischar, M. A. (2021). Modern Epidemics: From the Spanish Flu to COVID-19. Emerging Infectious Diseases, 27(12), 3206. https://doi.org/10.3201/eid2712.211312.

Prepare and Protect: Safer Behaviors in Laboratories and Clinical Containment Settings [PDF - 823 KB - 1 page]
K. Jennings and C. E. Carr
EID Jennings K, Carr CE. Prepare and Protect: Safer Behaviors in Laboratories and Clinical Containment Settings. Emerg Infect Dis. 2021;27(12):3207. https://doi.org/10.3201/eid2712.211866
AMA Jennings K, Carr CE. Prepare and Protect: Safer Behaviors in Laboratories and Clinical Containment Settings. Emerging Infectious Diseases. 2021;27(12):3207. doi:10.3201/eid2712.211866.
APA Jennings, K., & Carr, C. E. (2021). Prepare and Protect: Safer Behaviors in Laboratories and Clinical Containment Settings. Emerging Infectious Diseases, 27(12), 3207. https://doi.org/10.3201/eid2712.211866.
About the Cover

“It Is a Tiger That Devours Me, But I Am the Tiger” [PDF - 3.25 MB - 2 pages]
B. Breedlove
EID Breedlove B. “It Is a Tiger That Devours Me, But I Am the Tiger”. Emerg Infect Dis. 2021;27(12):3208-3209. https://doi.org/10.3201/eid2712.ac2712
AMA Breedlove B. “It Is a Tiger That Devours Me, But I Am the Tiger”. Emerging Infectious Diseases. 2021;27(12):3208-3209. doi:10.3201/eid2712.ac2712.
APA Breedlove, B. (2021). “It Is a Tiger That Devours Me, But I Am the Tiger”. Emerging Infectious Diseases, 27(12), 3208-3209. https://doi.org/10.3201/eid2712.ac2712.
Etymologia

Trichinella spiralis [PDF - 1.37 MB - 1 page]
M. Mahajan
EID Mahajan M. Trichinella spiralis. Emerg Infect Dis. 2021;27(12):3155. https://doi.org/10.3201/eid2712.211230
AMA Mahajan M. Trichinella spiralis. Emerging Infectious Diseases. 2021;27(12):3155. doi:10.3201/eid2712.211230.
APA Mahajan, M. (2021). Trichinella spiralis. Emerging Infectious Diseases, 27(12), 3155. https://doi.org/10.3201/eid2712.211230.
Corrections

Correction: Vol. 27, No. 10 [PDF - 612 KB - 1 page]
EID Correction: Vol. 27, No. 10. Emerg Infect Dis. 2021;27(12):3205. https://doi.org/10.3201/eid2712.c12712
AMA Correction: Vol. 27, No. 10. Emerging Infectious Diseases. 2021;27(12):3205. doi:10.3201/eid2712.c12712.
APA (2021). Correction: Vol. 27, No. 10. Emerging Infectious Diseases, 27(12), 3205. https://doi.org/10.3201/eid2712.c12712.
Page created: November 18, 2021
Page updated: November 22, 2021
Page reviewed: November 22, 2021
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