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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.

Volume 23, Number 12—December 2017


  • Fatal Outbreak in Tonkean Macaques Caused by Possibly Novel Orthopoxvirus, Italy, January 2015
    G. Cardeti et al.
        View Abstract

    In January 2015, during a 3-week period, 12 captive Tonkean macacques at a sanctuary in Italy died. An orthopoxvirus infection was suspected because of negative-staining electron microscopy results. The diagnosis was confirmed by histology, virus isolation, and molecular analysis performed on different organs from all animals. An epidemiologic investigation was unable to define the infection source in the surrounding area. Trapped rodents were negative by virologic testing, but specific IgG was detected in 27.27% of small rodents and 14.28% of rats. An attenuated live vaccine was administered to the susceptible monkey population, and no adverse reactions were observed; a detectable humoral immune response was induced in most of the vaccinated animals. We performed molecular characterization of the orthopoxvirus isolate by next-generation sequencing. According to the phylogenetic analysis of the 9 conserved genes, the virus could be part of a novel clade, lying between cowpox and ectromelia viruses.

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  • Spread of Canine Influenza A(H3N2) Virus, United States
    I. Voorhees et al.
        View Abstract

    A canine influenza A(H3N2) virus emerged in the United States in February–March 2015, causing respiratory disease in dogs. The virus had previously been circulating among dogs in Asia, where it originated through the transfer of an avian-origin influenza virus around 2005 and continues to circulate. Sequence analysis suggests the US outbreak was initiated by a single introduction, in Chicago, of an H3N2 canine influenza virus circulating among dogs in South Korea in 2015. Despite local control measures, the virus has continued circulating among dogs in and around Chicago and has spread to several other areas of the country, particularly Georgia and North Carolina, although these secondary outbreaks appear to have ended within a few months. Some genetic variation has accumulated among the US viruses, with the appearance of regional-temporal lineages. The potential for interspecies transmission and zoonotic events involving this newly emerged influenza A virus is currently unknown.

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  • Group B Streptococcus Infections Caused by Handling and Consumption of Raw Fish, Singapore, 2015–2016
    M. L. Chau et al.
  • Experimental Infection of Common Eider Ducklings with Wellfleet Bay Virus, a Newly Characterized Orthomyxovirus
    V. Shearn-Bochsler et al.
        View Abstract

    Wellfleet Bay virus (WFBV), a novel orthomyxovirus in the genus Quaranjavirus, was first isolated in 2006 from carcasses of common eider (Somateria mollissima) during a mortality event in Wellfleet Bay (Barnstable County, Massachusetts, USA) and has since been repeatedly isolated during recurrent mortality events in this location. Hepatic, pancreatic, splenic, and intestinal necrosis were observed in dead eiders. We inoculated 6-week-old common eider ducklings with WFBV in an attempt to recreate the naturally occurring disease. Approximately 25% of inoculated eiders had onset of clinical disease and required euthanasia; an additional 18.75% were adversely affected based on net weight loss during the trial. Control ducklings did not become infected and did not have clinical disease. Infected ducklings with clinical disease had pathologic lesions consistent with those observed during natural mortality events. WFBV was re-isolated from 37.5% of the inoculated ducklings. Ducklings surviving to 5 days postinoculation developed serum antibody titers to WFBV.

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  • Genomic Analysis of Non–Sorbitol-Fermenting Shiga Toxin–Producing Escherichia coli O55:H7
    K. Schutz et al.
  • High Rate of MCR-1–Producing Escherichia coli and Klebsiella pneumoniae among Pigs, Portugal
    N. Kieffer et al.
  • Bourbon Virus in Field-Collected Ticks, Missouri, USA
    H. M. Savage et al.
        View Abstract

    Bourbon virus (BRBV) was first isolated in 2014 from a resident of Bourbon County, Kansas, USA, who died of the infection. In 2015, an ill Payne County, Oklahoma, resident tested positive for antibodies to BRBV, before fully recovering. We retrospectively tested for BRBV in 39,096 ticks from northwestern Missouri, located 240 km from Bourbon County, Kansas. We detected BRBV in 3 pools of Amblyomma americanum (L.) ticks: 1 pool of male adults and 2 pools of nymphs. Detection of BRBV in A. americanum, a species that is aggressive, feeds on humans, and is abundant in Kansas and Oklahoma, supports the premise that A. americanum is a vector of BRBV to humans. BRBV has not been detected in nonhuman vertebrates, and its natural history remains largely unknown.

  • Multiple Reassorted Viruses as Cause of a Highly Pathogenic Avian Influenza A(H5N8) Virus Epidemic, Netherlands, 2016
    N. Beerens et al.

Historical Review

  • History of Taenia saginata Tapeworms in Northern Russia
    S. V. Konyaev et al.


  • Mycobacterium ulcerans DNA in Bandicoot Excreta in Buruli Ulcer–Endemic Area, Far Northern Queensland, Australia
    K. Röltgen et al.
  • Tick-borne encephalitis in sheep, Romania
    J. Salat et al.
  • West Nile Virus Lineage 2 in Horses and Other Animals with Neurologic Disease, South Africa, 2008–2015
    M. Venter et al.
  • Lack of Secondary Transmission of Ebola Virus Disease from Healthcare Worker to 238 Contacts, United Kingdom, December 2014
    P. Crook et al.
  • Genome and Phylogenetic Characterization of Crimean-Congo Hemorrhagic Fever Virus, Spain
    E. Ramírez de Arellano et al.
  • Diagnostic Accuracy of Parameters for Zika and Dengue Virus Infections, Singapore
  • Outbreak of Yellow Fever among Nonhuman Primates, Espirito Santo, Brazil, 2017
    N. Fernandes et al.
  • Deaths among Wild Birds during a Highly Pathogenic Avian Influenza A(H5N8) Virus Outbreak, Netherlands
    E. Kleyheeg et al.
  • Identification of Dermacentor reticulatus Ticks Carrying Rickettsia raoultii on Migrating Jackal, Denmark
    K. Klitgaard et al.

Research Letters

  • O80:H2 Enteropathogenic Escherichia coli in Young Diarrheic Calves, Belgium
    D. Thiry et al.
  • Detection of Zika Virus in April 2013 Patient Samples, Rio de Janeiro, Brazil
    S. R. Passos et al.
        View Abstract

    We tested 210 dengue virus‒negative samples collected from febrile patients during a dengue virus type 4 outbreak in Rio de Janeiro in April 2013 and found 3 samples positive for Zika virus. Our findings support previously published entomological data suggesting Zika virus was introduced into Brazil during October 2012–May 2013.

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  • Influenza A(H9N2) Virus, Burkina Faso
    B. Zecchin et al.
        View Abstract

    We identified influenza A(H9N2) virus G1 lineage in poultry in Burkina Faso. Urgent actions are needed to raise awareness about the risk associated with spread of this zoonotic virus subtype in the area and to construct a strategy for effective prevention and control of influenza caused by this virus.

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  • Angiostrongylus cantonensis DNA in Cerebrospinal Fluid of Persons with Eosinophilic Meningitis, Laos
    D. Ming et al.
  • Unexpected Infection with Armillifer Parasites
    I. Potters et al.
  • H7N9 Avian Influenza Viruses Cocirculating Among Chickens in Southern China, 2016–2017
    N. Wang et al.
  • New Avian Hepadnavirus in Palaeognathous Bird, Germany
    W. K. Jo et al.
  • Tickborne Acute Myopericarditis Associated with Rickettsia sibirica mongolitimonae
    P. Revilla-Martí et al.
  • Tool for Eliminating Dog-Mediated Human Rabies through Mass Dog Vaccination Campaigns
    E. A. Undurraga et al.
  • Porcine Astrovirus Type 3 in Central Nervous System of Swine with Polioencephalomyelitis
    B. Arruda et al.
  • Streptococcus suis Disease in a Human, Ontario, Canada
    J. Gomez-Torres et al.
  • Incentives for Bushmeat Consumption and Importation among West African Immigrants, Minnesota, USA
    E. Walz et al.

Global Health Security Supplement


  • US Centers for Disease Control and Prevention and Its Partners’ Contributions to Global Health Security
    J. W. Tappero et al.
        View Abstract

    To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.

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  • Establishment of CDC Global Rapid Response Team to Ensure Global Health Security
    T. Stehling-Ariza et al.
        View Abstract

    The 2014–2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise. Team members are offered emergency response training, technical training, foreign language training, and responder readiness support. Recent response missions illustrate the breadth of support the team provides. GRRT serves as a model for other countries and is committed to strengthening emergency response capacity to respond to outbreaks and emergencies worldwide, thereby enhancing global health security.

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  • Joint External Evaluation—Development and Scale-Up of Global Multisectoral Health Capacity Evaluation Process
    E. Bell et al.
        View Abstract

    The Joint External Evaluation (JEE), a consolidation of the World Health Organization (WHO) International Health Regulations 2005 (IHR 2005) Monitoring and Evaluation Framework and the Global Health Security Agenda country assessment tool, is an objective, voluntary, independent peer-to-peer multisectoral assessment of a country’s health security preparedness and response capacity across 19 IHR technical areas. WHO approved the standardized JEE tool in February 2016. The JEE process is wholly transparent; countries request a JEE and are encouraged to make its findings public. Donors (e.g., member states, public and private partners, and other public health institutions) can support countries in addressing JEE gaps identified, and implementing country-led national action plans for health security. Through July 2017, 52 JEEs were completed, and 25 more countries were scheduled across WHO’s 6 regions. JEEs facilitate progress toward IHR 2005 implementation, thereby building trust and mutual accountability between countries to detect and respond to public health threats.

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  • Enhancing Laboratory Response Network Capacity in South Korea
    J. Parker et al.
        View Abstract

    Laboratory Response Network (LRN) laboratories help protect populations from biological and chemical public health threats. We examined the role of LRN biological laboratories in enhancing capacity to detect and respond to public health infectious disease emergencies in South Korea. The model for responding to infectious disease emergencies leverages standardized laboratory testing procedures, a repository of standardized testing reagents, laboratory testing cooperation among hospital sentinel laboratories and reference laboratories, and maintenance of a trained workforce through traditional and on-demand training. Cooperation among all network stakeholders helps ensure that laboratory response is an integrated part of the national response. The added laboratory testing capacity provided by the US Centers for Disease Control and Prevention LRN assets helps protect persons who reside in South Korea, US military personnel and civilians in South Korea, and those who reside in the continental United States.

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  • Capacity Development through the US President’s Malaria Initiative–Supported Antimalarial Resistance Monitoring in Africa Network
    E. S. Halsey et al.
        View Abstract

    Antimalarial drug resistance is an evolving global health security threat to malaria control. Early detection of Plasmodium falciparum resistance through therapeutic efficacy studies and associated genetic analyses may facilitate timely implementation of intervention strategies. The US President’s Malaria Initiative–supported Antimalarial Resistance Monitoring in Africa (PARMA) Network has assisted numerous laboratories in partner countries in acquiring the knowledge and capability to independently monitor for molecular markers of antimalarial drug resistance.

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  • Assessment of National Public Health and Reference Laboratory, Accra, Ghana, within Framework of Global Health Security
    A. Ogee-Nwankwo et al.
        View Abstract

    The Second Year of Life project of the Global Health Security Agenda aims to improve immunization systems and strengthen measles and rubella surveillance, including building laboratory capacity. A new laboratory assessment tool was developed by the Centers for Disease Control and Prevention to assess the national laboratory in Ghana to improve molecular surveillance for measles and rubella. Results for the tool showed that the laboratory is well organized, has a good capacity for handling specimens, has a good biosafety system, and is proficient for diagnosis of measles and rubella by serologic analysis. However, there was little knowledge about molecular biology and virology activities (i.e., virus isolation on tissue culture was not available). Recommendations included training of technical personnel for molecular techniques and advocacy for funding for laboratory equipment, reagents, and supplies.

  • Strengthening Global Surveillance for Antimicrobial-Resistant Neisseria gonorrhoeae through the Enhanced Gonococcal Antimicrobial Surveillance Program (EGASP)
    E. J. Weston et al.
        View Abstract

    Monitoring trends in antimicrobial-resistant Neisseria gonorrhoeae is a critical public health and global health security activity because the number of antimicrobial drugs available to treat gonorrhea effectively is rapidly diminishing. Current global surveillance methods for antimicrobial drug–resistant N. gonorrhoeae have many limitations, especially in countries with the greatest burden of disease. The Enhanced Gonococcal Antimicrobial Surveillance Program is a collaboration between the World Health Organization and the Centers for Disease Control and Prevention. The program aims to monitor trends in antimicrobial drug susceptibilities in N. gonorrhoeae by using standardized sampling and laboratory protocols; to improve the quality, comparability, and timeliness of gonococcal antimicrobial drug resistance data across multiple countries; and to assess resistance patterns in key populations at highest risk for antimicrobial drug–resistant gonorrhea so country-specific treatment guidelines can be informed.

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  • Global Health Security—An Unfinished Journey
    M. T. Osterholm
        View Abstract

    This supplement is a timely, comprehensive compendium of the critical work being done by the Centers for Disease Control and Prevention and various partners to enhance and expand the Global Health Security Agenda. This perspective provides a review of, and comments regarding, our past, current, and future challenges in supporting the Global Health Security Agenda.

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Volume 24, Number 1—January 2018


  • Increased Severity and Spread of Mycobacterium ulcerans, Southeastern Australia
    A. Tai et al.
        View Abstract

    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.

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  • Japanese Encephalitis Virus Transmitted Via Blood Transfusion, Hong Kong, China
    V. Cheng et al.
        View Abstract

    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.

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  • Mammalian Pathogenesis and Transmission of Avian Influenza A(H7N9), Viruses, Tennessee, USA, 2017
    J. A. Belser et al.

Research Letters

  • Dengue Fever in Burkina Faso, 2016
    Z. Tarnagda et al.
  • Yellow Fever Virus in Urine and Semen of Convalescent Patient, Brazil
    C. M. Barbosa et al.

Books and Media

  • Deadliest Enemy: Our War against Germs
    A. A. Adalja

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.



  • 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.