Ahead of Print / In Press
Volume 24, Number 1—January 2018
Increased Severity and Spread of Mycobacterium ulcerans, Southeastern Australia
A. Tai et al.View AbstractEmail this Article
Reported cases of Mycobacterium ulcerans disease (Buruli ulcer) have been increasing in southeastern Australia and spreading into new geographic areas. We analyzed 426 cases of M. ulcerans disease during January 1998–May 2017 in the established disease-endemic region of the Bellarine Peninsula and the emerging endemic region of the Mornington Peninsula. A total of 20.4% of cases-patients had severe disease. Over time, there has been an increase in the number of cases managed per year and the proportion associated with severe disease. Risk factors associated with severe disease included age, time period (range of years of diagnosis), and location of lesions over a joint. We highlight the changing epidemiology and pathogenicity of M. ulcerans disease in Australia. Further research, including genomic studies of emergent strains with increased pathogenicity, are urgently needed to improve the understanding of disease to facilitate implementation of effective public health measures to halt its spread.
Japanese Encephalitis Virus Transmitted Via Blood Transfusion, Hong Kong, China
V. Cheng et al.View AbstractEmail this Article
Japanese encephalitis virus (JEV) is a mosquitoborne virus endemic to China and Southeast Asia that causes severe encephalitis in <1% of infected persons. Transmission of JEV via blood transfusion has not been reported. We report transmission of JEV via blood donation products from an asymptomatic viremic donor to 2 immunocompromised recipients. One recipient on high-dose immunosuppressive drugs received JEV-positive packed red blood cells after a double lung transplant; severe encephalitis and a poor clinical outcome resulted. JEV RNA was detected in serum, cerebrospinal fluid, and bronchoalveolar lavage fluid specimens. The second recipient had leukemia and received platelets after undergoing chemotherapy. This patient was asymptomatic; JEV infection was confirmed in this person by IgM seroconversion. This study illustrates that, consistent with other pathogenic flaviviruses, JEV can be transmitted via blood products. Targeted donor screening and pathogen reduction technologies could be used to prevent transfusion-transmitted JEV infection in highly JEV-endemic areas.
Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic
C. H. Hsu et al.View AbstractEmail this Article
Rapid early detection and control of Ebola virus disease (EVD) is contingent on accurate case definitions. Using an epidemic surveillance dataset from Guinea, we analyzed an EVD case definition developed by the World Health Organization (WHO) and used in Guinea. We used the surveillance dataset (March–October 2014; n = 2,847 persons) to identify patients that satisfied or did not satisfy case definition criteria. Laboratory confirmation determined cases from noncases, and we calculates sensitivity, specificity and predictive values. The sensitivity of the defintion was 68.9%, and the specificity of the definition was 49.6%. The presence of epidemiologic risk factors (i.e., recent contact with a known or suspected EVD case-patient) had the highest sensitivity (74.7%), and unexplained deaths had the highest specificity (92.8%). Results for case definition analyses were statistically significant (p<0.05 by χ2 test). Multiple components of the EVD case definition used in Guinea contributed to improved overall sensitivity and specificity.
Drug-Resistant Polymorphisms and Copy Numbers in Plasmodium falciparum, Mozambique, 2015
H. Gupta et al.View AbstractEmail this Article
One of the fundamental steps toward malaria control is the use of antimalarial drugs. The success of antimalarial treatment can be affected by the presence of drug-resistant populations of Plasmodium falciparum. To assess resistance, we used molecular methods to examine 351 P. falciparum isolates collected from 4 sentinel sites in Mozambique for K13, pfmdr1, pfcrt, and pfdhps polymorphisms and for plasmepsin2 (pfpm2) and pfmdr1 copy numbers. We found multiple copies of pfpm2 in 1.1% of isolates. All isolates carried K13 wild-type alleles (3D7-like), except 4 novel polymorphisms (Leu619Leu, Phe656Ile, Val666Val, Gly690Gly). Prevalence of isolates with pfcrt mutant (K76T) allele was low (2.3%). Prevalence of isolates with pfdhps mutant alleles (A437G and K540E) was >80%, indicating persistence of sulfadoxine/pyrimethamine resistance; however, markers of artemisinin were absent, and markers of piperaquine resistance were low. Piperaquine resistance isolates may spread in Mozambique as dihydroartemisinin/piperaquine drug pressure increases.
Emergence of Vaccine-Derived Polioviruses during Ebola Virus Disease Outbreak, Guinea, 2014–2015
M. Fernandez-Garcia et al.
Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013–2014
M. Hassan et al.View AbstractEmail this Article
Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. We aimed to detect whether NiV-infected patients contaminate hospital surfaces with the virus. During December 2013–April 2014, we collected 1 swab sample from 5 surfaces near NiV-infected patients and tested surface and oral swab samples by real-time reverse transcription PCR for NiV RNA. We identified 16 Nipah patients; 12 cases were laboratory-confirmed and 4 probable. Of the 12 laboratory-confirmed cases, 10 showed NiV RNA in oral swab specimens. We obtained surface swab samples for 6 Nipah patients; 5 had evidence of NiV RNA on >1 surface: 4 patients contaminated towels, 3 bed sheets, and 1 the bed rail. Patients with NiV RNA in oral swab samples were significantly more likely than other Nipah patients to die. To reduce the risk for fomite transmission of NiV, infection control should target hospital surfaces.
Detection and Circulation of a Novel Rabbit Hemorrhagic Disease Virus in Australia
J. E. Mahar et al.View AbstractEmail this Article
The highly virulent rabbit hemorrhagic disease virus (RHDV) has been widely used in Australia and New Zealand since the mid-1990s to control wild rabbits, an invasive vertebrate pest in these countries. In January 2014, an exotic RHDV was detected in Australia, and 8 additional outbreaks were reported in both domestic and wild rabbits in the 15 months following its detection. Full-length genomic analysis revealed that this virus is a recombinant containing an RHDVa capsid gene and nonstructural genes most closely related to nonpathogenic rabbit caliciviruses. Nationwide monitoring efforts need to be expanded to assess if the increasing number of different RHDV variants circulating in the Australian environment will affect biological control of rabbits. At the same time, updated vaccines and vaccination protocols are urgently needed to protect pet and farmed rabbits from these novel rabbit caliciviruses.
Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China
J. Artois et al.View AbstractEmail this Article
The fifth epidemic wave of avian influenza A(H7N9) virus in China during 2016–2017 demonstrated a geographic range expansion and caused more human cases than any previous wave. The factors that may explain the recent range expansion and surge in incidence remain unknown. We investigated the effect of anthropogenic, poultry, and wetland variables on all epidemic waves. Poultry predictor variables became much more important in the last 2 epidemic waves than they were previously, supporting the assumption of much wider H7N9 transmission in the chicken reservoir. We show that the future range expansion of H7N9 to northern China may increase the risk of H7N9 epidemic peaks coinciding in time and space with those of seasonal influenza, leading to a higher risk of reassortments than before, although the risk is still low so far.
Dangers of Noncritical Use of Historical Plague Data
J. Roosen and D. R. CurtisView AbstractEmail this Article
Researchers have published several articles using historical data sets on plague epidemics using impressive digital databases that contain thousands of recorded outbreaks across Europe over the past several centuries. Through the digitization of preexisting data sets, scholars have unprecedented access to the historical record of plague occurrences. However, although these databases offer new research opportunities, noncritical use and reproduction of preexisting data sets can also limit our understanding of how infectious diseases evolved. Many scholars have performed investigations using Jean-Noël Biraben’s data, which contains information on mentions of plague from various kinds of sources, many of which were not cited. When scholars fail to apply source criticism or do not reflect on the content of the data they use, the reliability of their results becomes highly questionable. Researchers using these databases going forward need to verify and restrict content spatially and temporally, and historians should be encouraged to compile the work.
Pneumonic Plague in Johannesburg, South Africa, 1904
C. M. Evans et al.View AbstractEmail this Article
Plague is a potentially dangerous reemerging disease. Because modern outbreaks are relatively infrequent, data for epidemiologic study are best found in historical accounts. In 1905, the Rand Plague Committee published a report describing an explosive outbreak of 113 cases of pneumonic plague that occurred in Johannesburg, South Africa, in 1904. Using these data, we investigated social, spatial, and temporal dynamics and quantified transmissibility as measured by the time-varying reproduction number. Risk for transmission was highest when friends, family members, and caregivers approached the sick. Reproduction numbers were 2–4. Transmission rates rapidly diminished after implementation of control measures, including isolation and safer burial practices. A contemporaneous smaller bubonic plague outbreak associated with a low-key epizootic of rats also occurred. Clusters of cases of pneumonic plague were mostly limited to the Indian community; cases of bubonic plague were mostly associated with white communities and their black African servants.
Mammalian Pathogenesis and Transmission of Avian Influenza A(H7N9) Viruses, Tennessee, USA, 2017
J. Belser et al.View AbstractEmail this Article
Infections with low pathogenicity and highly pathogenic avian influenza A(H7N9) viruses affected poultry in 4 states in the southeastern United States in 2017. We evaluated pathogenicity and transmission of representative viruses in mouse and ferret models and examined replication kinetics in human respiratory tract cells. These viruses can cause respiratory infections in mammalian models.
Expected Duration of Adverse Pregnancy Outcomes after Zika Epidemic
R. M. Eggo and A. J. KucharskiView AbstractEmail this Article
Evidence is increasing that Zika virus–related adverse outcomes can occur throughout pregnancy. Mathematical modeling analysis using reported outcome data suggests that surveillance for these outcomes should begin as soon as an outbreak is detected and should continue for 40 weeks after the outbreak ends.
Rodent Abundance and Hantavirus Infection in Protected Area, East-Central Argentina
M. Maroli et al.View AbstractEmail this Article
We captured 3 hantavirus rodent hosts in Otamendi Natural Reserve, Argentina, during 2007–2012. Hantavirus antibodies were found only in Akodon azarae grass mice, mainly in males and old animals. Higher abundance of this species was associated with warm and rainy weather and high water levels, which peaked after a strong El Niño event.
High Seroprevalence of Jamestown Canyon Virus among Deer and Humans, Nova Scotia, Canada
G. Patriquin et al.View AbstractEmail this Article
Using residual serum samples from Nova Scotia, Canada, we found that 87.8% of tested deer and an estimated 20.6% of the human population were infected with Jamestown Canyon virus. Human seropositivity reached 48.2% in 1 region. This virus may be an underrecognized cause of disease in Nova Scotia.
Recognition of Azole-Resistant Aspergillosis by Physicians Specializing in Infectious Disease, United States
T. A. Walker et al.View Summary
Of 709 surveyed infectious disease physicians in the US, 348 were familiar with azole-resistant A. fumigatus; of those treating case-patients, 21% lacked access to susceptibility testing.
Melioidosis, Singapore, 2003–2014
L. Pang et al.View AbstractEmail this Article
In contrast with northern Australia and Thailand, in Singapore the incidence of melioidosis and co-incidence of melioidosis and pneumonia have declined. Burkholderia pseudomallei deep abscesses increased 20.4% during 2003–2014. These trends could not be explained by the environmental and climatic factors conventionally ascribed to melioidosis.
Serologic Evidence of Fruit Bat Exposure to Filoviruses, Singapore, 2011–2016
E. D. Laing et al.View AbstractEmail this Article
To determine whether fruit bats in Singapore have been exposed to filoviruses, we screened 409 serum samples from bats of 3 species by using a multiplex assay that detects antibodies against filoviruses. Positive samples reacted with glycoproteins from Bundibugyo, Ebola, and Sudan viruses, indicating filovirus circulation among bats in Southeast Asia.
Two-Center Evaluation of Disinfectant Efficacy against Ebola Virus in Clinical and Laboratory Matrices
S. J. Smither et al.View AbstractEmail this Article
Ebola virus (EBOV) in body fluids poses risk for virus transmission. However, there are limited experimental data for such matrices on the disinfectant efficacy against EBOV. We evaluated the effectiveness of disinfectants against EBOV in blood on surfaces. Only 5% peracetic acid consistently reduced EBOV titers in dried blood to the assay limit of quantification.
Phylogeny and Immunoreactivity of Norovirus GII.P16-GII.2, Japan, Winter 2016–17
K. Nagasawa et al.View AbstractEmail this Article
During the 2016–17 winter season in Japan, human norovirus GII.P16-GII.2 strains (2016 strains) caused large outbreaks of acute gastroenteritis. Phylogenetic analyses suggested that the 2016 strains derived from the GII.2 strains detected during 2010–12. Immunochromatography between 2016 strains and the pre-2016 GII.2 strains showed similar reactivity.
Postmortem Findings in Patient with Guillain-Barré Syndrome and Zika Virus Infection
E. Dirlikov et al.View AbstractEmail this Article
Postmortem examination results of a patient with Guillain-Barré syndrome and confirmed Zika virus infection revealed demyelination of the sciatic and cranial IV nerves, providing evidence of the acute demyelinating inflammatory polyneuropathy Guillain-Barré syndrome variant. Lack of evidence of Zika virus in nervous tissue suggests that pathophysiology was antibody mediated without neurotropism.
Dengue Fever in Burkina Faso, 2016
Z. Tarnagda et al.View AbstractEmail this Article
We report 1,327 probable cases of dengue in Burkina Faso in 2016. Of 35 serum samples tested by a trioplex test, 19 were confirmed dengue virus (DENV)‒positive: 11 DENV-2, 6 DENV-3, 2 nontypeable, and 1 DENV-2/DENV-3 co-infection. Molecular testing should be conducted to correctly identify causative agents in this complex infectious disease landscape.
Yellow Fever Virus RNA in Urine and Semen of Convalescent Patient, Brazil
C. M. Barbosa et al.View AbstractEmail this Article
Yellow fever virus RNA is usually detected in blood of infected humans. We detected virus RNA in urine and semen samples from a convalescent patient. A complete virus genome was sequenced for an isolate from a urine sample. This virus had a South American I genotype and unique synapomorphic changes.
Investigation of Canine-Mediated Human Rabies Death, Haiti, 2015
C. H. Tran et al.View AbstractEmail this Article
In Haiti, an investigation occurred after the death of a 4-year-old girl with suspected rabies. With tips provided by community members, the investigation led to the identification of 2 probable rabies-related deaths and 16 persons bitten by rabid dogs, 75% of which chose postexposure prophylaxis. Community engagement can bolster rabies control.
Increasing Number of Scarlet Fever Cases, South Korea, 2011–2016
J. Kim and H. CheongView AbstractEmail this Article
The increasing number of reported scarlet fever cases during 2011‒2016 in the National Notifiable Infectious Disease database in South Korea occurred because of increased overall reporting and expanded reporting criteria rather than because of increasing scarlet fever incidence. Further increases are anticipated because of other expansions in reporting requirements.
Molecular Characterization of Autochthonous Chikungunya Cluster in Latium Region, Italy
L. Bordi et al.View AbstractEmail this Article
We report partial molecular characterization of isolates from an autochthonous chikungunya virus cluster in Latium Region. E1 sequences from 3 patients differ substantially from sequences from the 2007 outbreak in Italy and lack the A226V substitution associated with increased viral fitness in the Aedes albopictus mosquito vector.
Estimation of Undiagnosed Naegleria fowleri Primary Amebic Meningoencephalitis, United States
A. Matanock et al.View AbstractEmail this Article
Primary amebic meningoencephalitis (PAM) is an acute, rare, typically fatal disease. We used epidemiologic risk factors and multiple cause-of-death mortality data to estimate the number of deaths that fit the typical pattern for PAM; we estimated an annual average of 16 deaths (8 male, 8 female) in the United States.
Whole-Genome Analysis of Recurrent Staphylococcus aureus t571/ST398 Infection in Farmer, Iowa, USA
S. E. Wardyn et al.View AbstractEmail this Article
Staphylococcus aureus strain sequence type (ST) 398 has emerged during the last decade, largely among persons who have contact with swine or other livestock. Although colonization with ST398 is common in livestock workers, infections are not frequently documented. We report recurrent ST398-IIa infection in an Iowa farmer in contact with swine and cattle.
Visceral Leishmaniasis in Traveler to Guyana Caused by Leishmania siamensis, London
S. D. Polley et al.View AbstractEmail this Article
The parasite, Leishmania siamensis, is a zoonotic agent of leishmaniasis; infection among humans has been documented in Europe and the United States. Reported authochthonous human infections have been limited to Thailand. We report a case of human visceral Leishmania siamensis infection acquired in Guyana, suggesting colonization in South America.
Costs of Conjunctivitis Outbreak, Réunion Island, France
L. Filleul et al.View AbstractEmail this Article
During January–April 2015, a major outbreak of conjunctivitis on Réunion Island caused a large public health impact. On the basis of general practitioner consultations, emergency department visits, and eye medication sales during the 13-week epidemic, we estimated a total healthcare cost of €3,341,191 from the outbreak.
Leprosy in Nonimmigrant Canadian Man without Travel outside North America, 2014
P. E. Bonnar et al.View AbstractEmail this Article
In Canada, Hansen disease (leprosy) is rare and not considered in diagnoses for nonimmigrant patients. We report Mycobacterium leprae infection in a Canadian man whose sole travel was to Florida, USA. The M. leprae isolate was identified as armadillo-associated genotype 3I-2-v1. Travelers to the southern United States should avoid contact with armadillos.
Epidemiology of Cutaneous Leishmaniasis Outbreak, Waziristan, Pakistan
M. Hussain et al.View AbstractEmail this Article
During 2013–2015, prevalence of cutaneous leishmaniasis in war-affected Waziristan areas was 3.61% by PCR. Youths (1–15 years of age) were more susceptible. Internal transcribed spacer 1 PCR followed by restriction fragment length polymorphism analysis identified Leishmania tropica in 215 samples and Leishmania major in 6 samples.
Ocular Vaccinia Infection in Dairy Worker, Brazil
M. Lima et al.
Emmonsia helica Infection in HIV-Infected Man, California, USA
M. Rofael et al.
Inonotosis in Patient with Hematologic Malignancy
A. Fernández-Cruz et al.View AbstractEmail this Article
We report a lung-invasive fungal disease with possible cutaneous needle tract seeding in a patient with a febrile neutropenia caused by the Basidiomycetes mold Inonotus spp. Although rare, Inonotus spp. should be added to the list of microorganisms causing invasive fungal disease in neutropenic patients with hematologic malignancies.
Antimicrobial Drug Resistance in Blood Culture Isolates at a Tertiary Hospital, Uganda
H. Kajumbula et al.View AbstractEmail this Article
We summarize antimicrobial drug resistance (AMR) patterns from blood cultures at a tertiary hospital in Uganda. High rates of resistance to first-line antibiotic drugs were observed among Staphylococcus aureus and gram-negative organisms. Microbiology services with susceptibility testing should be strengthened to support standardized reporting of AMR data in sub-Saharan Africa.
Investigation of Pneumonic Plague, Madagascar
M. Drancourt and D. Raoult
Increasing Virulence in Leprosy Indicated by Global Mycobacterium spp.
W. Levis et al.
Books and Media
About the Cover
Volume 24, Number 2—February 2018
Hypervirulent Klebsiella pneumoniae in Cryptogenic Liver Abscesses, Paris, France
B. Rossi et al.View Summary
France and Europe might have an epidemic of this bacteria as did Asia in the early 2000s.
Adenovirus Type 4 Respiratory Infections among Civilians, Northeastern United States, 2011–2015
A. E. Kajon et al.
Increase in Ocular Syphilis Cases at an Ophthalmologic Reference Center, France, 2012–2015
Ecologic Features of Plague Outbreak Areas, Democratic Republic of the Congo, 2004–2014
A. Abedi et al.
Environmental Risk Factors for and Spatial Distribution of Typhoid Fever in Fiji
R. de Alwis et al.
Trends in Infectious Disease Deaths, South Korea, 1983–2015
Y. Choe et al.
Lethal Respiratory Disease Associated with Human Rhinovirus C in Wild Chimpanzees, Uganda, 2013
E. J. Scully et al.
Multiplex PCR−Based Next-Generation Sequencing and Global Diversity of Seoul Virus in Humans and Rats
W. Kim et al.
Spread of Meropenem-Resistant Streptococcus pneumoniae Serotype 15A-ST63 Clone in Japan, 2012–2014
S. Nakano et al.
Borrelia miyamotoi Infections in Humans and Ticks, Northeastern China
B. Jiang et al.
Use of Pristinamycin for Macrolide-Resistant Mycoplasma genitalium Infection
T. Read et al.
New Parvovirus Associated with Serum Hepatitis in Horses After inoculation of Common Biological Product
T. J. Divers et al.
Potential Reservoir for Yersinia pestis Survival and Replication in Phagocytic Amebae Colonies
D. W. Markman et al.
Ceftriaxone-Resistant Neisseria gonorrhoeae, Canada, 2017
B. Lefebvre et al.View AbstractEmail this Article
We identified a ceftriaxone-resistant Neisseria gonorrhoeae isolate in a patient in Canada. This isolate carried the penA-60 allele, which differs substantially from its closest relative, mosaic penA XXVII (80% nucleotide identity). Epidemiologic and genomic data suggest spread from Asia. Antimicrobial susceptibility surveillance helps prevent spread of highly resistant N. gonorrhoeae strains.
Containment of Highly Pathogenic Avian Influenza A(H5N1) Virus, Lebanon, 2016
Z. E. Farah et al.
Clusters of Human Infection and Human-to-Human Transmission of Avian Influenza A(H7N9) Virus, 2013–2017
L. Zhou et al.View AbstractEmail this Article
To detect changes in human-to-human transmission of influenza A(H7N9) virus, we analyzed characteristics of 40 clusters of case-patients during 5 epidemics in China in 2013–2017. Similarities in number and size of clusters and proportion of clusters with probable human-to-human transmission across all epidemics suggest no change in human-to-human transmission risk.
Co-circulation of Influenza A/H5N1, H7, and H9 Viruses and Evidence of Co-infected Poultry in Live Bird Markets, Cambodia
P. F. Horwood et al.
Effects of Culling on Leptospira interrogans Carriage by Rats
M. J. Lee et al.
Epidemic Varicella Zoster Virus among University Students, India
J. Meyers et al.
Emergomyces africanus in Soil, South Africa
I. S. Schwartz et al.
Novel Sequence Type ST834 Streptococcus suis among Humans on Pig Farms, Madagascar
M. Raberahona et al.
Influenza D Virus in Cattle, Ireland
O. Flynn et al.
Human African Trypanosomiasis in a Chinese Emigrant Returning from Gabon in 2017
X. Wang et al.
Cronobacter sakazakii Infection from Expressed Breast Milk, Australia
R. McMullan et al.
Dengue-Associated Posterior Reversible Encephalopathy Syndrome, Vietnam
N. Mai et al.
Cerebral Syphilitic Gumma in Immunocompetent Man, Japan
T. Kodama et al.
Books and Media
In the Company of Microbes: Ten Years of Small Things Considered
Volume 24, Number 3—March 2018
Epidemiology of Recurrent Hand, Foot and Mouth Disease, China, 2008–2015
J. Huang et al.
Major Threat to Malaria Control Programs by Plasmodium falciparum Lacking Histidine-Rich Protein 2, Eritrea
A. Berhane et al.
Incidence and Preventable Burden of Childhood Tuberculosis, Kenya
A. J. Brent et al.
Molecular and Epidemiologic Analysis of Reemergent Salmonella enterica Serovar Napoli, Italy, 2011–2015
M. Sabbatucci et al.
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.