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Ahead of Print / In Press

Disclaimer: Ahead of print articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Issues Available

Volume 23, Number 4—April 2017


  • Zika Disease Enhancement by Dengue Antibodies
    S. B. Halstead


  • Neurologic Complications of Influenza B Virus Infection, Romania
    C. P. Popescu et al.
    View Summary

    Infection with this virus should be considered as an etiologic factor for encephalitis.

  • Implementation and Initial Analysis of a Laboratory-Based Weekly Biosurveillance System, Provence-Alpes-Côte d’Azur, France
    M. Huart et al.
  • Transmission of Hepatitis A Virus through Combined Liver–Small Intestine–Pancreas Transplantation
    M. A. Foster et al.
    View Summary

    Vaccination of the donor might have prevented infection in the recipient and subsequent transmission to healthcare workers.



  • Presence and Persistence of Zika Virus RNA in Semen, United Kingdom, 2016
    B. Atkinson et al.
        View Abstract

    Zika virus RNA has been detected in semen collected several months after onset of symptoms of infection. Given the potential for sexual transmission of Zika virus and for serious fetal abnormalities resulting from infection during pregnancy, information regarding the persistence of Zika virus in semen is critical for advancing our understanding of potential risks. We tested serial semen samples from symptomatic male patients in the United Kingdom who had a diagnosis of imported Zika virus infection. Among the initial semen samples from 23 patients, Zika virus RNA was detected at high levels in 13 (56.5%) and was not detected in 9 (39.1%); detection was indeterminate in 1 sample (4.4%). After symptomatic infection, a substantial proportion of men have detectable Zika virus RNA at high copy numbers in semen during early convalescence, suggesting high risk for sexual transmission. Viral RNA clearance times are not consistent and can be prolonged.

  • Plasmodium malariae Prevalence and csp Gene Diversity, Kenya, 2014 and 2015
    E. Lo et al.
        View Abstract

    In Africa, control programs that target primarily Plasmodium falciparum are inadequate for eliminating malaria. To learn more about prevalence and genetic variability of P. malariae in Africa, we examined blood samples from 663 asymptomatic and 245 symptomatic persons from western Kenya during June–August of 2014 and 2015. P. malariae accounted for 5.3% (35/663) of asymptomatic infections and 3.3% (8/245) of clinical cases. Among asymptomatic persons, 71% (32/45) of P. malariae infections detected by PCR were undetected by microscopy. The low sensitivity of microscopy probably results from the significantly lower parasitemia of P. malariae. Analyses of P. malariae circumsporozoite protein gene sequences revealed high genetic diversity among P. malariae in Africa, but no clear differentiation among geographic populations was observed. Our findings suggest that P. malariae should be included in the malaria elimination strategy in Africa and highlight the need for sensitive and field-applicable methods to identify P. malariae in malaria-endemic areas.

  • Influence of Referral Pathway on Ebola Virus Disease Case-Fatality Rate and Effect of Survival Selection Bias
    F. Rudolf et al.
        View Abstract

    Case-fatality rates in Ebola treatment centers (ETCs) varied widely during the Ebola virus disease (EVD) outbreak in West Africa. We assessed the influence of referral pathway on ETC case-fatality rates with a retrospective cohort of 126 patients treated at the Mathaska ETC in Port Loko, Sierra Leone. The patients consisted of persons who had confirmed EVD when transferred to the ETC or who had been diagnosed onsite. The case-fatality rate for transferred patients was 46% versus 67% for patients diagnosed onsite (p = 0.02). The difference was mediated by Ebola viral load at diagnosis, suggesting a survival selection bias. Comparisons of case-fatality rates across ETCs and clinical management strategies should account for potential survival selection bias.

  • Variation in Aedes aegypti Competence for Zika Virus Transmission
    C. M. Roundy et al.


  • Severe Thrombocytopenia after Zika Virus Infection, Guadeloupe, 2016
    T. Boyer Chammard et al.
        View Abstract

    Severe thrombocytopenia during or after the course of Zika virus infection has been rarely reported. We report 7 cases of severe thrombocytopenia and hemorrhagic signs and symptoms in Guadeloupe after infection with this virus. Clinical course and laboratory findings strongly suggest a causal link between Zika virus infection and immune-mediated thrombocytopenia.

  • Outbreaks among Wild Birds and Domestic Poultry Caused by Reassorted Influenza A(H5N8) Clade Viruses, Germany, 2016
    A. Pohlmann et al.
        View Abstract

    In November 2016, an influenza A(H5N8) outbreak caused deaths of wild birds and domestic poultry in Germany. Clade virus was closely related to viruses at the Russia–Mongolia border in 2016 but had new polymerase acidic and nucleoprotein segments. These new strains may be more efficiently transmitted to and shed by birds.

  • Detection of Zika Virus in Desiccated Mosquitoes by Real-Time Reverse Transcription PCR and Plaque Assay
    K. L. Burkhalter and H. M. Savage
        View Abstract

    We assayed Zika virus–infected mosquitoes stored at room temperature for <30 days for live virus by using plaque assay and virus RNA by using real-time reverse transcription PCR. Viable virus was detected in samples stored <10 days, and virus RNA was detected in samples held for 30 days.

  • Increasing Incidence and Characteristics of Scarlet Fever, South Korea, 2008–2015
    D. Park et al.
  • Zika Virus Seroprevalence, French Polynesia, 2014–2015
    M. Aubry et al.
        View Abstract

    During 2013–2014, French Polynesia experienced an outbreak of Zika virus infection. Serosurveys conducted at the end of the outbreak and 18 months later showed lower than expected disease prevalence rates (49%) and asymptomatic:symptomatic case ratios (1:1) in the general population but significantly different prevalence rates (66%) and asymptomatic:symptomatic ratios (1:2) in schoolchildren.

  • Assessing Sensitivity and Specificity of Surveillance Case Definitions for Zika Virus Disease
    A. Chow et al.
        View Abstract

    We evaluated performance of 5 case definitions for Zika virus disease surveillance in a human cohort during an outbreak in Singapore, August 26–September 5, 2016. Because laboratory tests are largely inaccessible, use of case definitions that include rash as a required clinical feature are useful in identifying this disease.

  • Rapid Reassortment of High and Low Pathogenic Avian Influenza A Virus in Wild Birds in Alaska before H5 Clade Outbreaks
    N. J. Hill et al.
  • Molecular Identification of Spirometra erinaceieuropaei in Cases of Human Sparganosis, Hong Kong
    T. Tang et al.
  • Persistent Arthralgia Associated with Chikungunya Virus Outbreak, US Virgin Islands, December 2014–February 2016
    L. R. Feldstein et al.
        View Abstract

    After the 2014–2015 outbreak of chikungunya virus in the US Virgin Islands, we compared the prevalence of persistent arthralgia among case-patients and controls. Prevalence was higher in case-patients than controls 6 and 12 months after disease onset. Continued vaccine research to prevent acute illness and long-term sequelae is essential.

  • Antiviral Drug–Resistant Influenza B Viruses Carrying H134N Substitution in Neuraminidase, Laos, February 2016
  • Detection and Molecular Characterization of Zoonotic Poxviruses Circulating in the Amazon Region of Colombia, 2014
    J. A. Usme-Ciro et al.
  • Surveillance and Testing for Middle East Respiratory Syndrome Coronavirus, Saudi Arabia, April 2015–February 2016
    A. Saeed et al.
  • Highly Pathogenic Avian Influenza A(H5N8) Virus in Wild Migratory Birds, Qinghai Lake, China
    M. Li et al.
        View Abstract

    In May 2016, a highly pathogenic avian influenza A(H5N8) virus strain caused deaths among 3 species of wild migratory birds in Qinghai Lake, China. Genetic analysis showed that the novel reassortant virus belongs to group B H5N8 viruses and that the reassortment events likely occurred in early 2016.

  • Typhus Group Rickettsiosis, Texas, USA, 2003–2013
    K. O. Murray et al.
  • Characterization of Highly Pathogenic Avian Influenza Virus A(H5N6), Japan, November 2016
    M. Okamatsu et al.

Research Letters

  • Novel Reassortant Highly Pathogenic Avian Influenza (H5N8) Virus in Zoos, India
    S. Nagarajan et al.
        View Abstract

    Highly pathogenic avian influenza (H5N8) viruses were detected in waterfowl at 2 zoos in India in October 2016. Both viruses were different 7:1 reassortants of H5N8 viruses isolated in May 2016 from wild birds in the Russian Federation and China, suggesting virus spread during southward winter migration of birds.

  • mcr-1 in Enterobacteriaceae from Companion Animals, Beijing, China, 2012–2016
    L. Lei et al.
        View Abstract

    To investigate the prevalence of the recently emerging colistin resistance gene mcr-1 in Enterobacteriaceae among companion animals, we examined 566 isolates collected from cats and dogs in Beijing, China, during 2012–2016. Of these isolates, 49 (8.7%) were mcr-1–positive.

  • Acute Tetraplegia Caused by Rat Bite Fever in Snake Keeper and Transmission of Streptobacillus moniliformis
    T. Eisenberg et al.
        View Abstract

    We report acute tetraplegia caused by rat bite fever in a 59-year old man (snake keeper) and transmission of Streptobacillus moniliformis. We found an identical characteristic bacterial pattern in rat and human samples, which validated genotyping-based evidence for infection with the same strain, and identified diagnostic difficulties concerning infection with this microorganism.

  • Ebola Virus RNA in Semen from an HIV-Positive Survivor of Ebola
    L. J. Purpura et al.
        View Abstract

    Ebola virus is known to persist in semen of male survivors of Ebola virus disease (EVD). However, maximum duration of, or risk factors for, virus persistence are unknown. We report an EVD survivor with preexisting HIV infection, whose semen was positive for Ebola virus RNA 565 days after recovery from EVD.

  • Treatment Failure of Dihydroartemisinin-Piperaquine for Plasmodium falciparum Malaria, Vietnam
    B. Phuc et al.
  • West Nile Virus Seroprevalence, Connecticut, USA, 2000–2014
    M. E. Cahill et al.
        View Abstract

    West Nile virus (WNV) infection is mainly asymptomatic but can be severe in elderly persons. As part of studies on immunity and aging in Connecticut, USA, we detected WNV seroconversion in 8.5% of nonimmunosuppressed and 16.8% of immunosuppressed persons. Age was not a significant seroconversion factor. Our findings suggest that immune factors affect seroconversion.

  • Bartonella-Associated Transverse Myelitis
    P. Sendi et al.
        View Abstract

    Each year in the United States, 500 patients are hospitalized for cat-scratch disease, caused by Bartonella henselae infection. We report a case of rare but serious neurologic B. henselae infection. When typical features of cat-scratch disease occur with neurologic findings, Bartonella infection should be suspected and diagnostic testing should be performed.

  • Peste des Petits Ruminants Virus in Vulnerable Wild Small Ruminants, Iran, 2014–2016
    M. Marashi et al.
  • Discussion of Average versus Extreme Case Severity in Pandemic Risk Communications
    B. J. Zikmund-Fisher et al.
        View Abstract

    To assess the public’s understanding of disease threat, in 2015 we conducted a randomized survey experiment in the Netherlands. Adults who read a mock news article describing average and/or extreme outcomes from a hypothetical influenza pandemic were more influenced by average than by extreme case information. Presenting both types of information simultaneously appeared counterproductive.


Books and Media

Volume 23, Number 5—May 2017


  • Risk for Hantavirus Pulmonary Syndrome, United States, 1993–2015


  • Control of Malaria Mosquito Vectors by Insecticide-Treated Combinations of Window Screens and Eave Baffles
    G. F. Killeen et al.
  • Insecticide-Treated Nets in the Protection Against Insecticide-Resistant Mosquito Vectors of Malaria, Western Kenya
    E. Ochomo et al.
  • Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China
    F. Cui et al.
        View Abstract

    China’s hepatitis B virus (HBV) prevention policy has been evaluated through nationally representative serologic surveys conducted in 1992 and 2006. We report results of a 2014 serologic survey and reanalysis of the 1992 and 2006 surveys in the context of program policy. The 2014 survey used a 2-stage sample strategy in which townships were selected from 160 longstanding, nationally representative, county-level disease surveillance points, and persons 1–29 years of age were invited to participate. The 2014 sample size was 31,713; the response rate was 83.3%. Compared with the 1992 pre–recombinant vaccine survey, HBV surface antigen prevalence declined 46% by 2006 and by 52% by 2014. Among children <5 years of age, the decline was 97%. China’s HBV prevention program, targeted toward interrupting perinatal transmission, has been highly successful and increasingly effective. However, this progress must be sustained for decades to come, and elimination of HBV transmission will require augmented strategies.

  • Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia
    J. L. Morris et al.
    View Summary

    These strains have heightened pathogenic potential for rapid dissemination to multiple tissues, including the central nervous system.



  • Exposure Risk for Infection and Lack of Human-to-Human Transmission of Mycobacterium ulcerans Disease, Australia
    D. P. O’Brien et al.
  • Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis
    Y. Katanami et al.
  • Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium
    G. L. Murray et al.
  • Reassortant Clade Avian Influenza A(H5N6) Virus in a Wild Mandarin Duck, South Korea, 2016
    J. Kwon et al.

Research Letters

  • Management of 2 Cases of Bartonella Prosthetic Valve Endocarditis without Cardiac Surgery
    A. Carroll et al.
  • Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy
    J. R. Sotelo et al.
        View Abstract

    We detected Zika virus in breast milk of a woman in Brazil infected with the virus during the 36th week of pregnancy. Virus was detected 33 days after onset of signs and symptoms and 9 days after delivery. No abnormalities were found during fetal assessment or after birth of the infant.

  • Colistin Resistance in ESBL-Producing Klebsiella pneumoniae, France
    Y. Caspar et al.
  • Borrelia turicatae Infection in Febrile Soldier, Texas, USA
    A. M. Christensen et al.


  • CTX-M-27–Producing Escherichia coli of Sequence Type 131 and Clade C1-M27 in France
    A. Birgy et al.
  • Antimicrobial Drug Resistance Among Refugees from Syria, Jordan
    A. Abbara et al.

Online Report

  • Translating Real-Time Infectious Disease Modeling into Routine Public Health Practice
    D. J. Muscatello et al.

Volume 23, Number 6—June 2017


  • Distribution and Quantitative Estimates of Variant Creutzfeldt–Jakob Disease Prions in Tissues of Clinical and Asymptomatic Patients
    J. Y. Douet et al.


  • Autochthonous Case of Eosinophilic Meningitis Caused by Angiostrongylus cantonensis, France, 2016
    Y. Nguyen et al.
  • Congenital Malformations of Calves Infected with Shamonda Virus, Southern Japan
    Y. Hirashima et al.