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Volume 12, Number 3—March 2006

Volume 12, Number 3—March 2006   PDF Version [PDF - 6.02 MB - 179 pages]

Perspective

  • Possibilities for Relapsing Fever Reemergence PDF Version [PDF - 199 KB - 6 pages]
    S. J. Cutler
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    Increasing globalization may pave the way for reemergence of relapsing fever.

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    Relapsing fever Borrelia infections have attracted little attention in recent years; however, where endemic, these infections still result in considerable illness and death. Despite the marked antimicrobial drug susceptibility of these organisms, therapy is often delayed through lack of clinical suspicion. With increasing travel, infections may be imported, through exotic relapsing fever infection or through resurgence of infected disease vectors. Although louseborne relapsing fever is now geographically limited, it was once of global importance. The possibility for reemergence was recently highlighted by the probable reemergence of louseborne relapsing fever in homeless persons from France. Host limitations enforced through louseborne transmission are less applicable for the tickborne forms of relapsing fever. Although the latter have reduced potential for epidemic spread, they have the ability to infect diverse hosts, thus establishing reservoirs of infection and presenting greater challenges for their control.

        Cite This Article
    EID Cutler SJ. Possibilities for Relapsing Fever Reemergence. Emerg Infect Dis. 2006;12(3):369-374. https://dx.doi.org/10.3201/eid1203.050899
    AMA Cutler SJ. Possibilities for Relapsing Fever Reemergence. Emerging Infectious Diseases. 2006;12(3):369-374. doi:10.3201/eid1203.050899.
    APA Cutler, S. J. (2006). Possibilities for Relapsing Fever Reemergence. Emerging Infectious Diseases, 12(3), 369-374. https://dx.doi.org/10.3201/eid1203.050899.
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  • Cost-effectiveness of West Nile Virus Vaccination PDF Version [PDF - 101 KB - 6 pages]
    A. Zohrabian et al.
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    Vaccination is unlikely to result in societal monetary savings.

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    West Nile virus (WNV) was first detected in the Western Hemisphere in 1999 in New York City. From 1999 through 2004, >16,600 cases of WNV-related illnesses were reported in the United States, of which >7,000 were neuroinvasive disease and >600 were fatal. Several approaches are under way to develop a human vaccine. Through simulations and sensitivity analysis that incorporated uncertainties regarding future transmission patterns of WNV and costs of health outcomes, we estimated that the range of values for the cost per case of WNV illness prevented by vaccination was US $20,000–$59,000 (mean $36,000). Cost-effectiveness was most sensitive to changes in the risk for infection, probability of symptomatic illness, and vaccination cost. Analysis indicated that universal vaccination against WNV disease would be unlikely to result in societal monetary savings unless disease incidence increases substantially over what has been seen in the past 6 years.

        Cite This Article
    EID Zohrabian A, Hayes EB, Petersen LR. Cost-effectiveness of West Nile Virus Vaccination. Emerg Infect Dis. 2006;12(3):375-380. https://dx.doi.org/10.3201/eid1203.050782
    AMA Zohrabian A, Hayes EB, Petersen LR. Cost-effectiveness of West Nile Virus Vaccination. Emerging Infectious Diseases. 2006;12(3):375-380. doi:10.3201/eid1203.050782.
    APA Zohrabian, A., Hayes, E. B., & Petersen, L. R. (2006). Cost-effectiveness of West Nile Virus Vaccination. Emerging Infectious Diseases, 12(3), 375-380. https://dx.doi.org/10.3201/eid1203.050782.
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Synopses

  • Web-based Surveillance and Global Salmonella Distribution, 2000–2002 PDF Version [PDF - 296 KB - 8 pages]
    E. Galanis et al.
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    Surveillance improves control of Salmonella infections.

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    Salmonellae are a common cause of foodborne disease worldwide. The World Health Organization (WHO) supports international foodborne disease surveillance through WHO Global Salm-Surv and other activities. WHO Global Salm-Surv members annually report the 15 most frequently isolated Salmonella serotypes to a Web-based country databank. We describe the global distribution of reported Salmonella serotypes from human and nonhuman sources from 2000 to 2002. Among human isolates, S. Enteritidis was the most common serotype, accounting for 65% of all isolates. Among nonhuman isolates, although no serotype predominated, Salmonella enterica serovar Typhimurium was reported most frequently. Several serotypes were reported from only 1 region of the world. The WHO Global Salm-Surv country databank is a valuable public health resource; it is a publicly accessible, Web-based tool that can be used by health professionals to explore hypotheses related to the sources and distribution of salmonellae worldwide.

        Cite This Article
    EID Galanis E, Wong D, Patrick ME, Binsztein N, Cieslik A, Chalermchaikit T, et al. Web-based Surveillance and Global Salmonella Distribution, 2000–2002. Emerg Infect Dis. 2006;12(3):381-388. https://dx.doi.org/10.3201/eid1203.050854
    AMA Galanis E, Wong D, Patrick ME, et al. Web-based Surveillance and Global Salmonella Distribution, 2000–2002. Emerging Infectious Diseases. 2006;12(3):381-388. doi:10.3201/eid1203.050854.
    APA Galanis, E., Wong, D., Patrick, M. E., Binsztein, N., Cieslik, A., Chalermchaikit, T....Wegener, H. C. (2006). Web-based Surveillance and Global Salmonella Distribution, 2000–2002. Emerging Infectious Diseases, 12(3), 381-388. https://dx.doi.org/10.3201/eid1203.050854.
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  • Bartonella Spp. in Pets and Effect on Human Health PDF Version [PDF - 98 KB - 5 pages]
    B. B. Chomel et al.
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    Pets represent a large reservoir for human infection.

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    Among the many mammals infected with Bartonella spp., pets represent a large reservoir for human infection because most Bartonella spp. infecting them are zoonotic. Cats are the main reservoir for Bartonella henselae, B. clarridgeiae, and B. koehlerae. Dogs can be infected with B. vinsonii subsp. berkhoffii, B. henselae, B. clarridgeiae, B. washoensis, B. elizabethae, and B. quintana. The role of dogs as an important reservoir of Bartonella spp. is less clear than for cats because domestic dogs are more likely to be accidental hosts, at least in nontropical regions. Nevertheless, dogs are excellent sentinels for human infections because a similar disease spectrum develops in dogs. Transmission of B. henselae by cat fleas is better understood, although new potential vectors (ticks and biting flies) have been identified. We review current knowledge on the etiologic agents, clinical features, and epidemiologic characteristics of these emerging zoonoses.

        Cite This Article
    EID Chomel BB, Boulouis H, Maruyama S, Breitschwerdt EB. Bartonella Spp. in Pets and Effect on Human Health. Emerg Infect Dis. 2006;12(3):389-394. https://dx.doi.org/10.3201/eid1203.050931
    AMA Chomel BB, Boulouis H, Maruyama S, et al. Bartonella Spp. in Pets and Effect on Human Health. Emerging Infectious Diseases. 2006;12(3):389-394. doi:10.3201/eid1203.050931.
    APA Chomel, B. B., Boulouis, H., Maruyama, S., & Breitschwerdt, E. B. (2006). Bartonella Spp. in Pets and Effect on Human Health. Emerging Infectious Diseases, 12(3), 389-394. https://dx.doi.org/10.3201/eid1203.050931.
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Research

  • West Nile Virus Infections Projected from Blood Donor Screening Data, United States, 2003 PDF Version [PDF - 200 KB - 8 pages]
    E. L. Murphy et al.
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    Routine donor nucleic acid amplification testing is a valuable surveillance screening tool.

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    National blood donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. We compiled national NAT yield data and performed WNV immunoglobulin M (IgM) testing in 1 WNV-epidemic region (North Dakota). State-specific MP-NAT yield, antibody seroprevalence, and the average time RNA is detectable by MP-NAT were used to estimate incident infections in 2003. WNV donor screening yielded 944 confirmed viremic donors. MP-NAT yield peaked in August with >0.5% of donations positive for WNV RNA in 4 states. Peak IgM seroprevalence for North Dakota was 5.2% in late September. The average time viremia is detectable by MP-NAT was 6.9 days (95% confidence interval [CI] 3.0–10.7). An estimated 735,000 (95% CI 322,000–1,147,000) infections occurred in 2003, with 256 (95% CI 112–401) infections per neuroinvasive case. In addition to preventing transfusion-transmitted WNV infection, donor screening can serve as a tool to monitor seasonal incidence in the general population.

        Cite This Article
    EID Murphy EL, Wright DJ, Custer BS, Tobler LH, Stramer SL, Kleinman SH, et al. West Nile Virus Infections Projected from Blood Donor Screening Data, United States, 2003. Emerg Infect Dis. 2006;12(3):395-402. https://dx.doi.org/10.3201/eid1203.051287
    AMA Murphy EL, Wright DJ, Custer BS, et al. West Nile Virus Infections Projected from Blood Donor Screening Data, United States, 2003. Emerging Infectious Diseases. 2006;12(3):395-402. doi:10.3201/eid1203.051287.
    APA Murphy, E. L., Wright, D. J., Custer, B. S., Tobler, L. H., Stramer, S. L., Kleinman, S. H....Glynn, S. A. (2006). West Nile Virus Infections Projected from Blood Donor Screening Data, United States, 2003. Emerging Infectious Diseases, 12(3), 395-402. https://dx.doi.org/10.3201/eid1203.051287.
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  • Aspergillus ustus Infections among Transplant Recipients PDF Version [PDF - 166 KB - 6 pages]
    A. A. Panackal et al.
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    This is the first report of clustered Aspergillus ustus causing systemic disease in transplant patients.

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    Aspergillus ustus is a mold that rarely infects humans; only 15 systemic cases have been reported. We report the first outbreak of invasive infection caused by A. ustus among hematopoietic stem cell transplant (HSCT) recipients. Six patients with infections were identified; 3 infections each occurred in both 2001 and 2003. Molecular typing by using randomly amplified polymorphic DNA (RAPD) and antifungal drug susceptibility testing were performed on clinical and environmental isolates recovered from our hospital from 1999 to 2003. The highest overall attack rate in HSCT patients was 1.6%. The overall death rate was 50%, and death occurred within 8 days after diagnostic culture collection. Clinical isolates exhibited decreased susceptibility to antifungal drugs, especially azoles. RAPD and phylogenetic analysis showed genetic similarity between isolates from different patients. Based on the clustering of cases in space and time and molecular data, common-source acquisition of this unusual drug-resistant species is possible.

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    EID Panackal AA, Imhof A, Hanley EW, Marr KA. Aspergillus ustus Infections among Transplant Recipients. Emerg Infect Dis. 2006;12(3):403-408. https://dx.doi.org/10.3201/eid1203.050670
    AMA Panackal AA, Imhof A, Hanley EW, et al. Aspergillus ustus Infections among Transplant Recipients. Emerging Infectious Diseases. 2006;12(3):403-408. doi:10.3201/eid1203.050670.
    APA Panackal, A. A., Imhof, A., Hanley, E. W., & Marr, K. A. (2006). Aspergillus ustus Infections among Transplant Recipients. Emerging Infectious Diseases, 12(3), 403-408. https://dx.doi.org/10.3201/eid1203.050670.
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  • Clostridium difficile Infection in Patients Discharged from US Short-stay Hospitals, 1996–2003 PDF Version [PDF - 153 KB - 7 pages]
    L. McDonald et al.
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    Clinicians should be aware of the increasing risk of C. difficile–associated disease and make efforts to control its transmission.

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    US hospital discharges for which Clostridium difficile–associated disease (CDAD) was listed as any diagnosis doubled from 82,000 (95% confidence interval [CI] 71,000–94,000) or 31/100,000 population in 1996 to 178,000 (95% CI 151,000–205,000) or 61/100,000 in 2003; this increase was significant between 2000 and 2003 (slope of linear trend 9.48; 95% CI 6.16–12.80, p = 0.01). The overall rate during this period was severalfold higher in persons >65 years of age (228/100,000) than in the age group with the next highest rate, 45–64 years (40/100,000; p<0.001). CDAD appears to be increasing rapidly in the United States and is disproportionately affecting older persons. Clinicians should be aware of the increasing risk for CDAD and make efforts to control transmission of C. difficile and prevent disease.

        Cite This Article
    EID McDonald L, Owings M, Jernigan DB. Clostridium difficile Infection in Patients Discharged from US Short-stay Hospitals, 1996–2003. Emerg Infect Dis. 2006;12(3):409-415. https://dx.doi.org/10.3201/eid1203.051064
    AMA McDonald L, Owings M, Jernigan DB. Clostridium difficile Infection in Patients Discharged from US Short-stay Hospitals, 1996–2003. Emerging Infectious Diseases. 2006;12(3):409-415. doi:10.3201/eid1203.051064.
    APA McDonald, L., Owings, M., & Jernigan, D. B. (2006). Clostridium difficile Infection in Patients Discharged from US Short-stay Hospitals, 1996–2003. Emerging Infectious Diseases, 12(3), 409-415. https://dx.doi.org/10.3201/eid1203.051064.
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  • Medication Sales and Syndromic Surveillance, France PDF Version [PDF - 175 KB - 6 pages]
    E. Vergu et al.
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    Real-time over-the-counter drug sales provide an additional tool for disease surveillance.

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    Although syndromic surveillance systems using nonclinical data have been implemented in the United States, the approach has yet to be tested in France. We present the results of the first model based on drug sales that detects the onset of influenza season and forecasts its trend. Using weekly lagged sales of a selected set of medications, we forecast influenzalike illness (ILI) incidence at the national and regional level for 3 epidemic seasons (2000-01, 2001-02, and 2002-03) and validate the model with real-time updating on the fourth (2003-04). For national forecasts 1–3 weeks ahead, the correlation between observed ILI incidence and forecast was 0.85–0.96, an improvement over the current surveillance method in France. Our findings indicate that drug sales are a useful additional tool to syndromic surveillance, a complementary and independent source of information, and a potential improvement for early warning systems for both epidemic and pandemic planning.

        Cite This Article
    EID Vergu E, Grais RF, Sarter H, Fagot J, Lambert B, Valleron A, et al. Medication Sales and Syndromic Surveillance, France. Emerg Infect Dis. 2006;12(3):416-421. https://dx.doi.org/10.3201/eid1203.050573
    AMA Vergu E, Grais RF, Sarter H, et al. Medication Sales and Syndromic Surveillance, France. Emerging Infectious Diseases. 2006;12(3):416-421. doi:10.3201/eid1203.050573.
    APA Vergu, E., Grais, R. F., Sarter, H., Fagot, J., Lambert, B., Valleron, A....Flahault, A. (2006). Medication Sales and Syndromic Surveillance, France. Emerging Infectious Diseases, 12(3), 416-421. https://dx.doi.org/10.3201/eid1203.050573.
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  • Personal Hygiene and Methicillin-resistant Staphylococcus aureus Infection PDF Version [PDF - 127 KB - 6 pages]
    G. Turabelidze et al.
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    Improving personal hygienic practices may prevent and control MRSA outbreaks.

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    Methicillin-resistant Staphylococcus aureus (MRSA) infections outside the healthcare setting are an increasing concern. We conducted a case-control study to investigate an MRSA outbreak during 2002–2003 in a Missouri prison and focused on hygiene factors. Information on sociodemographic characteristics, medical history, and hygiene practices of study participants was collected by interview and medical record review. Logistic regression was used to evaluate MRSA infection in relation to hygiene factors individually and as a composite hygiene score; potential confounding factors were controlled. Selected MRSA isolates were analyzed by pulsed-field gel electrophoresis (PFGE). MRSA infection was significantly associated with a low composite hygiene score. Transmission among prison inmates appeared to be responsible for this outbreak. PFGE analysis showed that isolates were indistinguishable and associated with community-onset MRSA infections in other US prisons. Improving hygiene practices and environmental conditions may help prevent and interrupt future MRSA outbreaks in prison settings.

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    EID Turabelidze G, Lin M, Wolkoff B, Dodson D, Gladbach S, Zhu B, et al. Personal Hygiene and Methicillin-resistant Staphylococcus aureus Infection. Emerg Infect Dis. 2006;12(3):422-427. https://dx.doi.org/10.3201/eid1203.050625
    AMA Turabelidze G, Lin M, Wolkoff B, et al. Personal Hygiene and Methicillin-resistant Staphylococcus aureus Infection. Emerging Infectious Diseases. 2006;12(3):422-427. doi:10.3201/eid1203.050625.
    APA Turabelidze, G., Lin, M., Wolkoff, B., Dodson, D., Gladbach, S., & Zhu, B. (2006). Personal Hygiene and Methicillin-resistant Staphylococcus aureus Infection. Emerging Infectious Diseases, 12(3), 422-427. https://dx.doi.org/10.3201/eid1203.050625.
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  • Rickettsia prowazekii and Real-time Polymerase Chain Reaction PDF Version [PDF - 150 KB - 5 pages]
    S. Svraka et al.
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    This highly standardized and adaptable assay could improve epidemic typhus surveillance.

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    Rickettsia prowazekii is the causative agent of epidemic typhus and a potential bioterrorism agent. Sensitive and specific rapid assays are needed to complement existing methods of detecting this organism. We developed a real-time quantitative polymerase chain reaction assay by using a species-specific probe targeting the gltA gene. This assay, which was rapid, specific for R. prowazekii only, and sensitive (cutoff detection of 1 to 5 copies per sample), detected and directly identified R. prowazekii in blood of 12 experimentally infected mice sampled at day 3 and 6 postinfection or in naturally or experimentally infected lice. Because our assay is highly standardized and easily adaptable, it could improve epidemic typhus surveillance in public health programs, especially for countries with underdiagnosed or unrecognized human cases.

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    EID Svraka S, Rolain J, Bechah Y, Gatabazi J, Raoult D. Rickettsia prowazekii and Real-time Polymerase Chain Reaction. Emerg Infect Dis. 2006;12(3):428-432. https://dx.doi.org/10.3201/eid1203.050888
    AMA Svraka S, Rolain J, Bechah Y, et al. Rickettsia prowazekii and Real-time Polymerase Chain Reaction. Emerging Infectious Diseases. 2006;12(3):428-432. doi:10.3201/eid1203.050888.
    APA Svraka, S., Rolain, J., Bechah, Y., Gatabazi, J., & Raoult, D. (2006). Rickettsia prowazekii and Real-time Polymerase Chain Reaction. Emerging Infectious Diseases, 12(3), 428-432. https://dx.doi.org/10.3201/eid1203.050888.
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  • Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients PDF Version [PDF - 147 KB - 7 pages]
    M. Borchert et al.
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    Asymptomatic secondary infections are rare.

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    The first major outbreak of Marburg hemorrhagic fever (MHF) outside a laboratory environment occurred in the subdistrict of Watsa, Democratic Republic of Congo, from October 1998 to August 2000. We performed a serosurvey of household contacts of MHF patients to identify undetected cases, ascertain the frequency of asymptomatic Marburg infection, and estimate secondary attack risk and postintervention reproduction number. Contacts were interviewed about their exposure and symptoms consistent with MHF. Blood samples were tested for anti–Marburg immunoglobulin G (IgG). One hundred twenty-one (51%) of 237 identified contacts participated; 72 (60%) were not known to the health authorities. Two participating contacts were seropositive and reported becoming ill after the contact; no serologic evidence for asymptomatic or mild Marburg infection was found. The secondary attack risk was 21%; the postintervention reproduction number was 0.9, consistent with an outbreak sustained by repeated primary transmission, rather than large-scale secondary transmission.

        Cite This Article
    EID Borchert M, Mulangu S, Swanepoel R, Libande M, Tshomba A, Kulidri A, et al. Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients. Emerg Infect Dis. 2006;12(3):433-439. https://dx.doi.org/10.3201/eid1203.050622
    AMA Borchert M, Mulangu S, Swanepoel R, et al. Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients. Emerging Infectious Diseases. 2006;12(3):433-439. doi:10.3201/eid1203.050622.
    APA Borchert, M., Mulangu, S., Swanepoel, R., Libande, M., Tshomba, A., Kulidri, A....Van der Stuyft, P. (2006). Serosurvey on Household Contacts of Marburg Hemorrhagic Fever Patients. Emerging Infectious Diseases, 12(3), 433-439. https://dx.doi.org/10.3201/eid1203.050622.
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  • Canine Visceral Leishmaniasis, United States and Canada, 2000–2003 PDF Version [PDF - 142 KB - 7 pages]
    Z. H. Duprey et al.
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    Foxhounds infected with Leishmania spp. were found in 18 states and 2 Canadian provinces.

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    Visceral leishmaniasis, caused by protozoa of the genus Leishmania donovani complex, is a vectorborne zoonotic infection that infects humans, dogs, and other mammals. In 2000, this infection was implicated as causing high rates of illness and death among foxhounds in a kennel in New York. A serosurvey of >12,000 foxhounds and other canids and 185 persons in 35 states and 4 Canadian provinces was performed to determine geographic extent, prevalence, host range, and modes of transmission within foxhounds, other dogs, and wild canids and to assess possible infections in humans. Foxhounds infected with Leishmania spp. were found in 18 states and 2 Canadian provinces. No evidence of infection was found in humans. The infection in North America appears to be widespread in foxhounds and limited to dog-to-dog mechanisms of transmission; however, if the organism becomes adapted for vector transmission by indigenous phlebotomines, the probability of human exposure will be greatly increased.

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    EID Duprey ZH, Steurer FJ, Rooney JA, Kirchhoff LV, Jackson JE, Rowton ED, et al. Canine Visceral Leishmaniasis, United States and Canada, 2000–2003. Emerg Infect Dis. 2006;12(3):440-446. https://dx.doi.org/10.3201/eid1203.050811
    AMA Duprey ZH, Steurer FJ, Rooney JA, et al. Canine Visceral Leishmaniasis, United States and Canada, 2000–2003. Emerging Infectious Diseases. 2006;12(3):440-446. doi:10.3201/eid1203.050811.
    APA Duprey, Z. H., Steurer, F. J., Rooney, J. A., Kirchhoff, L. V., Jackson, J. E., Rowton, E. D....Schantz, P. M. (2006). Canine Visceral Leishmaniasis, United States and Canada, 2000–2003. Emerging Infectious Diseases, 12(3), 440-446. https://dx.doi.org/10.3201/eid1203.050811.
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  • Chemoprophylaxis and Malaria Death Rates PDF Version [PDF - 137 KB - 5 pages]
    G. Krause et al.
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    Malaria chemoprophylaxis increases the survival of nonimmune travelers.

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    To determine the effect of chemoprophylaxis on the case-fatality rate of malaria, we analyzed all cases of Plasmodium falciparum malaria in nonimmune persons reported from 1993 to 2004 in Germany. In univariate and multivariate logistic regression analysis, we determined the effect of age, sex, chemoprophylaxis, chemoprophylactic regimen, compliance for chemoprophylactic regimen, exposure prophylaxis, country of infection, and year of reporting on the outcome. Of 3,935 case-patients, 116 (3%) died of malaria. Univariate analysis showed significant associations with death for chemoprophylaxis with chloroquine plus proguanil compared to no chemoprophylaxis. The multivariate model showed that patients who had taken chemoprophylaxis were less likely to die compared to those who had not taken chemoprophylaxis, adjusted for patient age and reporting year. The study demonstrated that chemoprophylaxis significantly reduced fatality rates among nonimmune malaria patients and supports the importance of existing guidelines for malaria prevention.

        Cite This Article
    EID Krause G, Schöneberg I, Altmann D, Stark K. Chemoprophylaxis and Malaria Death Rates. Emerg Infect Dis. 2006;12(3):447-451. https://dx.doi.org/10.3201/eid1203.050736
    AMA Krause G, Schöneberg I, Altmann D, et al. Chemoprophylaxis and Malaria Death Rates. Emerging Infectious Diseases. 2006;12(3):447-451. doi:10.3201/eid1203.050736.
    APA Krause, G., Schöneberg, I., Altmann, D., & Stark, K. (2006). Chemoprophylaxis and Malaria Death Rates. Emerging Infectious Diseases, 12(3), 447-451. https://dx.doi.org/10.3201/eid1203.050736.
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  • Self-medication with Antimicrobial Drugs in Europe PDF Version [PDF - 270 KB - 8 pages]
    L. Grigoryan et al.
    View Summary

    Antimicrobial drug self-medication occurs most often in eastern and southern Europe and least often in northern and western Europe.

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    We surveyed the populations of 19 European countries to compare the prevalence of antimicrobial drug self-medication in the previous 12 months and intended self-medication and storage and to identify the associated demographic characteristics. By using a multistage sampling design, 1,000–3,000 adults in each country were randomly selected. The prevalence of actual self-medication varied from 1 to 210 per 1,000 and intended self-medication from 73 to 449 per 1,000; both rates were high in eastern and southern Europe and low in northern and western Europe. The most common reasons for self-medication were throat symptoms (e.g., dry, inflamed, red, or sore throat, inflamed tonsils, tonsil pain). The main medication sources were pharmacies and medication leftover from previous prescriptions. Younger age, higher education, and presence of a chronic disease were associated with higher rates of self-medication. Attempts to reduce inappropriate self-medication should target prescribers, pharmacists, and the general public.

        Cite This Article
    EID Grigoryan L, Haaijer-Ruskamp FM, Burgerhof J, Mechtler R, Deschepper R, Tambic-Andrasevic A, et al. Self-medication with Antimicrobial Drugs in Europe. Emerg Infect Dis. 2006;12(3):452-459. https://dx.doi.org/10.3201/eid1203.050992
    AMA Grigoryan L, Haaijer-Ruskamp FM, Burgerhof J, et al. Self-medication with Antimicrobial Drugs in Europe. Emerging Infectious Diseases. 2006;12(3):452-459. doi:10.3201/eid1203.050992.
    APA Grigoryan, L., Haaijer-Ruskamp, F. M., Burgerhof, J., Mechtler, R., Deschepper, R., Tambic-Andrasevic, A....Birkin, J. (2006). Self-medication with Antimicrobial Drugs in Europe. Emerging Infectious Diseases, 12(3), 452-459. https://dx.doi.org/10.3201/eid1203.050992.
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  • Pneumonic Plague Cluster, Uganda, 2004 PDF Version [PDF - 271 KB - 8 pages]
    E. M. Begier et al.
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    In a case cluster, pneumonic plague transmission was compatible with respiratory droplet rather than aerosol transmission.

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    The public and clinicians have long-held beliefs that pneumonic plague is highly contagious; inappropriate alarm and panic have occurred during outbreaks. We investigated communicability in a naturally occurring pneumonic plague cluster. We defined a probable pneumonic plague case as an acute-onset respiratory illness with bloody sputum during December 2004 in Kango Subcounty, Uganda. A definite case was a probable case with laboratory evidence of Yersinia pestis infection. The cluster (1 definite and 3 probable cases) consisted of 2 concurrent index patient–caregiver pairs. Direct fluorescent antibody microscopy and polymerase chain reaction testing on the only surviving patient's sputum verified plague infection. Both index patients transmitted pneumonic plague to only 1 caregiver each, despite 23 additional untreated close contacts (attack rate 8%). Person-to-person transmission was compatible with transmission by respiratory droplets, rather than aerosols, and only a few close contacts, all within droplet range, became ill.

        Cite This Article
    EID Begier EM, Asiki G, Anywaine Z, Yockey B, Schriefer M, Aleti P, et al. Pneumonic Plague Cluster, Uganda, 2004. Emerg Infect Dis. 2006;12(3):460-467. https://dx.doi.org/10.3201/eid1203.051051
    AMA Begier EM, Asiki G, Anywaine Z, et al. Pneumonic Plague Cluster, Uganda, 2004. Emerging Infectious Diseases. 2006;12(3):460-467. doi:10.3201/eid1203.051051.
    APA Begier, E. M., Asiki, G., Anywaine, Z., Yockey, B., Schriefer, M., Aleti, P....Kool, J. L. (2006). Pneumonic Plague Cluster, Uganda, 2004. Emerging Infectious Diseases, 12(3), 460-467. https://dx.doi.org/10.3201/eid1203.051051.
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  • Host Feeding Patterns of Culex Mosquitoes and West Nile Virus Transmission, Northeastern United States PDF Version [PDF - 192 KB - 7 pages]
    G. Molaei et al.
    View Summary

    Culex salinarius is a bridge vector to humans, while Cx. pipiens and Cx. restuans are more efficient enzootic vectors.

        View Abstract

    To evaluate the role of Culex mosquitoes as enzootic and epidemic vectors for WNV, we identified the source of vertebrate blood by polymerase chain reaction amplification and sequencing portions of the cytochrome b gene of mitochondrial DNA. All Cx. restuans and 93% of Cx. pipiens acquired blood from avian hosts; Cx. salinarius fed frequently on both mammals (53%) and birds (36%). Mixed-blood meals were detected in 11% and 4% of Cx. salinarius and Cx. pipiens, respectively. American robin was the most common source of vertebrate blood for Cx. pipiens (38%) and Cx. restuans (37%). American crow represented <1% of the blood meals in Cx. pipiens and none in Cx. restuans. Human-derived blood meals were identified from 2 Cx. salinarius and 1 Cx. pipiens. Results suggest that Cx. salinarius is an important bridge vector to humans, while Cx. pipiens and Cx. restuans are more efficient enzootic vectors in the northeastern United States.

        Cite This Article
    EID Molaei G, Andreadis TG, Armstrong PM, Anderson JF, Vossbrinck CR. Host Feeding Patterns of Culex Mosquitoes and West Nile Virus Transmission, Northeastern United States. Emerg Infect Dis. 2006;12(3):468-474. https://dx.doi.org/10.3201/eid1203.051004
    AMA Molaei G, Andreadis TG, Armstrong PM, et al. Host Feeding Patterns of Culex Mosquitoes and West Nile Virus Transmission, Northeastern United States. Emerging Infectious Diseases. 2006;12(3):468-474. doi:10.3201/eid1203.051004.
    APA Molaei, G., Andreadis, T. G., Armstrong, P. M., Anderson, J. F., & Vossbrinck, C. R. (2006). Host Feeding Patterns of Culex Mosquitoes and West Nile Virus Transmission, Northeastern United States. Emerging Infectious Diseases, 12(3), 468-474. https://dx.doi.org/10.3201/eid1203.051004.
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  • Identifying and Quantifying Genotypes in Polyclonal Infections due to Single Species PDF Version [PDF - 321 KB - 8 pages]
    J. M. Colborn et al.
    View Summary

    The combination of real-time PCR and capillary electrophoresis permits the rapid identification and quantification of pathogen genotypes.

        View Abstract

    Simultaneous infection with multiple pathogens of the same species occurs with HIV, hepatitis C, Epstein-Barr virus, dengue, tuberculosis, and malaria. However, available methods do not distinguish among or quantify pathogen genotypes in individual patients; they also cannot test for novel insertions and deletions in genetically modified organisms. The strategy reported here accomplishes these goals with real-time polymerase chain reaction (PCR) and capillary electrophoresis. Real-time PCR with allotype-specific primers defines the allotypes (strains) present and the intensity of infection (copy number). Capillary electrophoresis defines the number of genotypes within each allotype and the intensity of infection by genotype. This strategy can be used to study the epidemiology of emerging infectious diseases with simultaneous infection by multiple genotypes, as demonstrated here with malaria. It also permits testing for insertions or deletions in genetically modified organisms that may be used for bioterrorism.

        Cite This Article
    EID Colborn JM, Koita OA, Cissé O, Bagayoko MW, Guthrie EJ, Krogstad DJ, et al. Identifying and Quantifying Genotypes in Polyclonal Infections due to Single Species. Emerg Infect Dis. 2006;12(3):475-482. https://dx.doi.org/10.3201/eid1203.050572
    AMA Colborn JM, Koita OA, Cissé O, et al. Identifying and Quantifying Genotypes in Polyclonal Infections due to Single Species. Emerging Infectious Diseases. 2006;12(3):475-482. doi:10.3201/eid1203.050572.
    APA Colborn, J. M., Koita, O. A., Cissé, O., Bagayoko, M. W., Guthrie, E. J., & Krogstad, D. J. (2006). Identifying and Quantifying Genotypes in Polyclonal Infections due to Single Species. Emerging Infectious Diseases, 12(3), 475-482. https://dx.doi.org/10.3201/eid1203.050572.
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Dispatches

  • "Candidatus Rickettsia kellyi," India PDF Version [PDF - 160 KB - 3 pages]
    J. Rolain et al.
        View Abstract

    We report the first laboratory-confirmed human infection due to a new rickettsial genotype in India, "Candidatus Rickettsia kellyi," in a 1-year-old boy with fever and maculopapular rash. The diagnosis was made by serologic testing, polymerase chain reaction detection, and immunohistochemical testing of the organism from a skin biopsy specimen.

        Cite This Article
    EID Rolain J, Mathai E, Lepidi H, Somashekar HR, Mathew LG, Prakash J, et al. "Candidatus Rickettsia kellyi," India. Emerg Infect Dis. 2006;12(3):483-485. https://dx.doi.org/10.3201/eid1203.050853
    AMA Rolain J, Mathai E, Lepidi H, et al. "Candidatus Rickettsia kellyi," India. Emerging Infectious Diseases. 2006;12(3):483-485. doi:10.3201/eid1203.050853.
    APA Rolain, J., Mathai, E., Lepidi, H., Somashekar, H. R., Mathew, L. G., Prakash, J....Raoult, D. (2006). "Candidatus Rickettsia kellyi," India. Emerging Infectious Diseases, 12(3), 483-485. https://dx.doi.org/10.3201/eid1203.050853.
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  • Lyssavirus Surveillance in Bats, Bangladesh PDF Version [PDF - 204 KB - 3 pages]
    I. V. Kuzmin et al.
        View Abstract

    Lyssavirus surveillance in bats was performed in Bangladesh during 2003 and 2004. No virus isolates were obtained. Three serum samples (all from Pteropus giganteus, n = 127) of 288 total serum samples, obtained from bats in 9 different taxa, neutralized lyssaviruses Aravan and Khujand. The infection occurs in bats in Bangladesh, but virus prevalence appears low.

        Cite This Article
    EID Kuzmin IV, Niezgoda M, Carroll DS, Keeler N, Hossain M, Breiman RF, et al. Lyssavirus Surveillance in Bats, Bangladesh. Emerg Infect Dis. 2006;12(3):486-488. https://dx.doi.org/10.3201/eid1203.050333
    AMA Kuzmin IV, Niezgoda M, Carroll DS, et al. Lyssavirus Surveillance in Bats, Bangladesh. Emerging Infectious Diseases. 2006;12(3):486-488. doi:10.3201/eid1203.050333.
    APA Kuzmin, I. V., Niezgoda, M., Carroll, D. S., Keeler, N., Hossain, M., Breiman, R. F....Rupprecht, C. E. (2006). Lyssavirus Surveillance in Bats, Bangladesh. Emerging Infectious Diseases, 12(3), 486-488. https://dx.doi.org/10.3201/eid1203.050333.
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  • Molecular Analysis of Fluoroquinolone-resistant Salmonella Paratyphi A Isolate, India PDF Version [PDF - 82 KB - 3 pages]
    S. Nair et al.
        View Abstract

    Salmonella enterica serovar Paratyphi A is increasingly a cause of enteric fever. Sequence analysis of an Indian isolate showed a unique strain with high-level resistance to ciprofloxacin associated with double mutations in the DNA gyrase subunit gyrA (Ser83→Phe and Asp87→Gly) and a mutation in topoisomerase IV subunit parC (Ser80→Arg).

        Cite This Article
    EID Nair S, Unnikrishnan M, Turner K, Parija S, Churcher C, Wain J, et al. Molecular Analysis of Fluoroquinolone-resistant Salmonella Paratyphi A Isolate, India. Emerg Infect Dis. 2006;12(3):489-491. https://dx.doi.org/10.3201/eid1203.050560
    AMA Nair S, Unnikrishnan M, Turner K, et al. Molecular Analysis of Fluoroquinolone-resistant Salmonella Paratyphi A Isolate, India. Emerging Infectious Diseases. 2006;12(3):489-491. doi:10.3201/eid1203.050560.
    APA Nair, S., Unnikrishnan, M., Turner, K., Parija, S., Churcher, C., Wain, J....Harish, B. (2006). Molecular Analysis of Fluoroquinolone-resistant Salmonella Paratyphi A Isolate, India. Emerging Infectious Diseases, 12(3), 489-491. https://dx.doi.org/10.3201/eid1203.050560.
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  • Canine Coronavirus Highly Pathogenic for Dogs PDF Version [PDF - 107 KB - 3 pages]
    C. Buonavoglia et al.
        View Abstract

    Canine coronavirus (CCoV) is usually responsible for mild, self-limiting infections restricted to the enteric tract. We report an outbreak of fatal disease in puppies caused by a pathogenic variant of CCoV that was isolated from organs with severe lesions.

        Cite This Article
    EID Buonavoglia C, Decaro N, Martella V, Elia G, Campolo M, Desario C, et al. Canine Coronavirus Highly Pathogenic for Dogs. Emerg Infect Dis. 2006;12(3):492-494. https://dx.doi.org/10.3201/eid1203.050839
    AMA Buonavoglia C, Decaro N, Martella V, et al. Canine Coronavirus Highly Pathogenic for Dogs. Emerging Infectious Diseases. 2006;12(3):492-494. doi:10.3201/eid1203.050839.
    APA Buonavoglia, C., Decaro, N., Martella, V., Elia, G., Campolo, M., Desario, C....Tempesta, M. (2006). Canine Coronavirus Highly Pathogenic for Dogs. Emerging Infectious Diseases, 12(3), 492-494. https://dx.doi.org/10.3201/eid1203.050839.
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  • Acute Hemorrhagic Conjunctivitis and Coxsackievirus A24v, Rio de Janeiro, Brazil, 2004 PDF Version [PDF - 114 KB - 3 pages]
    F. N. Tavares et al.
        View Abstract

    An outbreak of acute hemorrhagic conjunctivitis (AHC) occurred in Rio de Janeiro in 2004. Coxsackievirus A24v (CA24v) was identified as the etiologic agent, and partial sequences from the VP1 gene show that the isolates are closely related to CA24v viruses that previously caused AHC epidemics in South Korea and French Guiana.

        Cite This Article
    EID Tavares FN, Costa EV, Oliveira SS, Nicolai C, Baran M, da Silva EE, et al. Acute Hemorrhagic Conjunctivitis and Coxsackievirus A24v, Rio de Janeiro, Brazil, 2004. Emerg Infect Dis. 2006;12(3):495-497. https://dx.doi.org/10.3201/eid1203.051173
    AMA Tavares FN, Costa EV, Oliveira SS, et al. Acute Hemorrhagic Conjunctivitis and Coxsackievirus A24v, Rio de Janeiro, Brazil, 2004. Emerging Infectious Diseases. 2006;12(3):495-497. doi:10.3201/eid1203.051173.
    APA Tavares, F. N., Costa, E. V., Oliveira, S. S., Nicolai, C., Baran, M., & da Silva, E. E. (2006). Acute Hemorrhagic Conjunctivitis and Coxsackievirus A24v, Rio de Janeiro, Brazil, 2004. Emerging Infectious Diseases, 12(3), 495-497. https://dx.doi.org/10.3201/eid1203.051173.
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  • Pneumonia and New Methicillin-resistant Staphylococcus aureus Clone PDF Version [PDF - 93 KB - 3 pages]
    F. Garnier et al.
        View Abstract

    Necrotizing pneumonia caused by Staphylococcus aureus strains carrying the Panton-Valentin leukocidin gene is a newly described disease entity. We report a new fatal case of necrotizing pneumonia. An S. aureus strain with an agr1 allele and of a new sequence type 377 was recovered, representing a new, emerging, community-acquired methicillin-resistant clone.

        Cite This Article
    EID Garnier F, Tristan A, François B, Etienne J, Delage-Corre M, Martin C, et al. Pneumonia and New Methicillin-resistant Staphylococcus aureus Clone. Emerg Infect Dis. 2006;12(3):498-500. https://dx.doi.org/10.3201/eid1203.051040
    AMA Garnier F, Tristan A, François B, et al. Pneumonia and New Methicillin-resistant Staphylococcus aureus Clone. Emerging Infectious Diseases. 2006;12(3):498-500. doi:10.3201/eid1203.051040.
    APA Garnier, F., Tristan, A., François, B., Etienne, J., Delage-Corre, M., Martin, C....Ploy, M. (2006). Pneumonia and New Methicillin-resistant Staphylococcus aureus Clone. Emerging Infectious Diseases, 12(3), 498-500. https://dx.doi.org/10.3201/eid1203.051040.
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  • Canine Leptospirosis, United States, 2002–2004 PDF Version [PDF - 108 KB - 3 pages]
    G. E. Moore et al.
        View Abstract

    The proportion of positive Leptospira microscopic agglutination tests for 23,005 dogs significantly increased from 2002 to 2004 (p<0.002) regardless of the positive cutoff titer used and was highest (p<0.05) for serovars Autumnalis and Grippotyphosa. The strongest positive serologic correlation (r = 0.72) was between serovars Autumnalis and Pomona.

        Cite This Article
    EID Moore GE, Guptill LF, Glickman NW, Caldanaro RJ, AuCoin D, Glickman LT, et al. Canine Leptospirosis, United States, 2002–2004. Emerg Infect Dis. 2006;12(3):501-503. https://dx.doi.org/10.3201/eid1203.050809
    AMA Moore GE, Guptill LF, Glickman NW, et al. Canine Leptospirosis, United States, 2002–2004. Emerging Infectious Diseases. 2006;12(3):501-503. doi:10.3201/eid1203.050809.
    APA Moore, G. E., Guptill, L. F., Glickman, N. W., Caldanaro, R. J., AuCoin, D., & Glickman, L. T. (2006). Canine Leptospirosis, United States, 2002–2004. Emerging Infectious Diseases, 12(3), 501-503. https://dx.doi.org/10.3201/eid1203.050809.
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  • Lagos Bat Virus, South Africa PDF Version [PDF - 72 KB - 3 pages]
    W. Markotter et al.
        View Abstract

    Three more isolates of Lagos bat virus were recently recovered from fruit bats in South Africa after an apparent absence of this virus for 13 years. The sporadic occurrence of cases is likely due to inadequate surveillance programs for lyssavirus infections among bat populations in Africa.

        Cite This Article
    EID Markotter W, Randles J, Rupprecht CE, Sabeta CT, Taylor PJ, Wandeler AI, et al. Lagos Bat Virus, South Africa. Emerg Infect Dis. 2006;12(3):504-506. https://dx.doi.org/10.3201/eid1203.051306
    AMA Markotter W, Randles J, Rupprecht CE, et al. Lagos Bat Virus, South Africa. Emerging Infectious Diseases. 2006;12(3):504-506. doi:10.3201/eid1203.051306.
    APA Markotter, W., Randles, J., Rupprecht, C. E., Sabeta, C. T., Taylor, P. J., Wandeler, A. I....Nel, L. H. (2006). Lagos Bat Virus, South Africa. Emerging Infectious Diseases, 12(3), 504-506. https://dx.doi.org/10.3201/eid1203.051306.
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  • Aquariums as Reservoirs for Multidrug-resistant Salmonella Paratyphi B PDF Version [PDF - 205 KB - 4 pages]
    R. S. Levings et al.
        View Abstract

    Multidrug-resistant Salmonella enterica serovar Paratyphi B dT+ isolates from patients with gastroenteritis were identical with isolates from their home aquariums. Matched isolates had identical phage types, XbaI and IS200 profiles, and Salmonella genomic island 1 (SGI1). Ornamental fish tanks are reservoirs for SGI1-containing S. Paratyphi B dT+.

        Cite This Article
    EID Levings RS, Lightfoot D, Hall RM, Djordjevic SP. Aquariums as Reservoirs for Multidrug-resistant Salmonella Paratyphi B. Emerg Infect Dis. 2006;12(3):507-510. https://dx.doi.org/10.3201/eid1203.051085
    AMA Levings RS, Lightfoot D, Hall RM, et al. Aquariums as Reservoirs for Multidrug-resistant Salmonella Paratyphi B. Emerging Infectious Diseases. 2006;12(3):507-510. doi:10.3201/eid1203.051085.
    APA Levings, R. S., Lightfoot, D., Hall, R. M., & Djordjevic, S. P. (2006). Aquariums as Reservoirs for Multidrug-resistant Salmonella Paratyphi B. Emerging Infectious Diseases, 12(3), 507-510. https://dx.doi.org/10.3201/eid1203.051085.
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  • Protease-resistant Prion Protein in Lymphoreticular Tumors of Variant Creutzfeldt-Jakob Disease Mice PDF Version [PDF - 83 KB - 3 pages]
    L. Cervenakova et al.
        View Abstract

    We report protease-resistant prion protein (PrPres) in spontaneous lymphoreticular tumors of mice infected with the agent of variant Creutzfeldt-Jakob disease (vCJD). PrPres may accumulate in lymphoreticular system tumors of asymptomatic persons with vCJD. The statistical power of estimates of vCJD prevalence might be increased by expanding screening to include samples of lymphoreticular neoplasms.

        Cite This Article
    EID Cervenakova L, Yakovleva O, McKenzie C. Protease-resistant Prion Protein in Lymphoreticular Tumors of Variant Creutzfeldt-Jakob Disease Mice. Emerg Infect Dis. 2006;12(3):511-513. https://dx.doi.org/10.3201/eid1203.051348
    AMA Cervenakova L, Yakovleva O, McKenzie C. Protease-resistant Prion Protein in Lymphoreticular Tumors of Variant Creutzfeldt-Jakob Disease Mice. Emerging Infectious Diseases. 2006;12(3):511-513. doi:10.3201/eid1203.051348.
    APA Cervenakova, L., Yakovleva, O., & McKenzie, C. (2006). Protease-resistant Prion Protein in Lymphoreticular Tumors of Variant Creutzfeldt-Jakob Disease Mice. Emerging Infectious Diseases, 12(3), 511-513. https://dx.doi.org/10.3201/eid1203.051348.
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  • West Nile Virus–associated Flaccid Paralysis Outcome PDF Version [PDF - 68 KB - 3 pages]
    J. J. Sejvar et al.
        View Abstract

    We report 1-year follow-up data from a longitudinal prospective cohort study of patients with West Nile virus–associated paralysis. As in the 4-month follow-up, a variety of recovery patterns were observed, but persistent weakness was frequent. Respiratory involvement was associated with considerable illness and death.

        Cite This Article
    EID Sejvar JJ, Bode AV, Marfin AA, Campbell GL, Pape J, Biggerstaff BJ, et al. West Nile Virus–associated Flaccid Paralysis Outcome. Emerg Infect Dis. 2006;12(3):514-516. https://dx.doi.org/10.3201/eid1203.050643
    AMA Sejvar JJ, Bode AV, Marfin AA, et al. West Nile Virus–associated Flaccid Paralysis Outcome. Emerging Infectious Diseases. 2006;12(3):514-516. doi:10.3201/eid1203.050643.
    APA Sejvar, J. J., Bode, A. V., Marfin, A. A., Campbell, G. L., Pape, J., Biggerstaff, B. J....Petersen, L. R. (2006). West Nile Virus–associated Flaccid Paralysis Outcome. Emerging Infectious Diseases, 12(3), 514-516. https://dx.doi.org/10.3201/eid1203.050643.
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  • Screening and Toxigenic Corynebacteria Spread PDF Version [PDF - 52 KB - 2 pages]
    N. S. Crowcroft et al.
            Cite This Article
    EID Crowcroft NS, White JM, Efstratiou A, George R. Screening and Toxigenic Corynebacteria Spread. Emerg Infect Dis. 2006;12(3):520-521. https://dx.doi.org/10.3201/eid1203.050601
    AMA Crowcroft NS, White JM, Efstratiou A, et al. Screening and Toxigenic Corynebacteria Spread. Emerging Infectious Diseases. 2006;12(3):520-521. doi:10.3201/eid1203.050601.
    APA Crowcroft, N. S., White, J. M., Efstratiou, A., & George, R. (2006). Screening and Toxigenic Corynebacteria Spread. Emerging Infectious Diseases, 12(3), 520-521. https://dx.doi.org/10.3201/eid1203.050601.
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Letters

  • Human Pythiosis PDF Version [PDF - 40 KB - 2 pages]
    J. Pupaibool et al.
            Cite This Article
    EID Pupaibool J, Chindamporn A, Patarakul K, Suankratay C, Sindhuphak W, Kulwichit W, et al. Human Pythiosis. Emerg Infect Dis. 2006;12(3):517-518. https://dx.doi.org/10.3201/eid1203.051044
    AMA Pupaibool J, Chindamporn A, Patarakul K, et al. Human Pythiosis. Emerging Infectious Diseases. 2006;12(3):517-518. doi:10.3201/eid1203.051044.
    APA Pupaibool, J., Chindamporn, A., Patarakul, K., Suankratay, C., Sindhuphak, W., & Kulwichit, W. (2006). Human Pythiosis. Emerging Infectious Diseases, 12(3), 517-518. https://dx.doi.org/10.3201/eid1203.051044.
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  • Rift Valley Fever Potential, Arabian Peninsula PDF Version [PDF - 46 KB - 3 pages]
    A. Anyamba et al.
            Cite This Article
    EID Anyamba A, Chretien J, Formenty P, Small J, Tucker CJ, Malone JL, et al. Rift Valley Fever Potential, Arabian Peninsula. Emerg Infect Dis. 2006;12(3):518-520. https://dx.doi.org/10.3201/eid1203.050973
    AMA Anyamba A, Chretien J, Formenty P, et al. Rift Valley Fever Potential, Arabian Peninsula. Emerging Infectious Diseases. 2006;12(3):518-520. doi:10.3201/eid1203.050973.
    APA Anyamba, A., Chretien, J., Formenty, P., Small, J., Tucker, C. J., Malone, J. L....Linthicum, K. J. (2006). Rift Valley Fever Potential, Arabian Peninsula. Emerging Infectious Diseases, 12(3), 518-520. https://dx.doi.org/10.3201/eid1203.050973.
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  • Rickettsia slovaca Infection, France PDF Version [PDF - 70 KB - 3 pages]
    F. Gouriet et al.
            Cite This Article
    EID Gouriet F, Rolain J, Raoult D. Rickettsia slovaca Infection, France. Emerg Infect Dis. 2006;12(3):521-523. https://dx.doi.org/10.3201/eid1203.050911
    AMA Gouriet F, Rolain J, Raoult D. Rickettsia slovaca Infection, France. Emerging Infectious Diseases. 2006;12(3):521-523. doi:10.3201/eid1203.050911.
    APA Gouriet, F., Rolain, J., & Raoult, D. (2006). Rickettsia slovaca Infection, France. Emerging Infectious Diseases, 12(3), 521-523. https://dx.doi.org/10.3201/eid1203.050911.
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  • Cutaneous Anthrax, Belgian Traveler PDF Version [PDF - 71 KB - 3 pages]
    E. Van den Enden et al.
            Cite This Article
    EID Van den Enden E, Van Gompel A, Van Esbroeck M. Cutaneous Anthrax, Belgian Traveler. Emerg Infect Dis. 2006;12(3):523-525. https://dx.doi.org/10.3201/eid1203.051407
    AMA Van den Enden E, Van Gompel A, Van Esbroeck M. Cutaneous Anthrax, Belgian Traveler. Emerging Infectious Diseases. 2006;12(3):523-525. doi:10.3201/eid1203.051407.
    APA Van den Enden, E., Van Gompel, A., & Van Esbroeck, M. (2006). Cutaneous Anthrax, Belgian Traveler. Emerging Infectious Diseases, 12(3), 523-525. https://dx.doi.org/10.3201/eid1203.051407.
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  • Japanese Encephalitis, Singapore PDF Version [PDF - 25 KB - 2 pages]
    Y. Koh et al.
            Cite This Article
    EID Koh Y, Tan B, Loh J, Ooi E, Su S, Hsu L, et al. Japanese Encephalitis, Singapore. Emerg Infect Dis. 2006;12(3):525-526. https://dx.doi.org/10.3201/eid1203.051251
    AMA Koh Y, Tan B, Loh J, et al. Japanese Encephalitis, Singapore. Emerging Infectious Diseases. 2006;12(3):525-526. doi:10.3201/eid1203.051251.
    APA Koh, Y., Tan, B., Loh, J., Ooi, E., Su, S., & Hsu, L. (2006). Japanese Encephalitis, Singapore. Emerging Infectious Diseases, 12(3), 525-526. https://dx.doi.org/10.3201/eid1203.051251.
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  • HIV and Lacaziosis, Brazil PDF Version [PDF - 42 KB - 2 pages]
    M. B. Xavier et al.
            Cite This Article
    EID Xavier MB, Ferreira M, Quaresma J, de Brito AC. HIV and Lacaziosis, Brazil. Emerg Infect Dis. 2006;12(3):526-527. https://dx.doi.org/10.3201/eid1203.051426
    AMA Xavier MB, Ferreira M, Quaresma J, et al. HIV and Lacaziosis, Brazil. Emerging Infectious Diseases. 2006;12(3):526-527. doi:10.3201/eid1203.051426.
    APA Xavier, M. B., Ferreira, M., Quaresma, J., & de Brito, A. C. (2006). HIV and Lacaziosis, Brazil. Emerging Infectious Diseases, 12(3), 526-527. https://dx.doi.org/10.3201/eid1203.051426.
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  • Hand Sanitizer Alert PDF Version [PDF - 55 KB - 3 pages]
    S. A. Reynolds et al.
            Cite This Article
    EID Reynolds SA, Levy F, Walker ES. Hand Sanitizer Alert. Emerg Infect Dis. 2006;12(3):527-529. https://dx.doi.org/10.3201/eid1203.050955
    AMA Reynolds SA, Levy F, Walker ES. Hand Sanitizer Alert. Emerging Infectious Diseases. 2006;12(3):527-529. doi:10.3201/eid1203.050955.
    APA Reynolds, S. A., Levy, F., & Walker, E. S. (2006). Hand Sanitizer Alert. Emerging Infectious Diseases, 12(3), 527-529. https://dx.doi.org/10.3201/eid1203.050955.
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  • Spleen Abscess as Malaria Complication PDF Version [PDF - 68 KB - 3 pages]
    S. Contini and H. Lewis
            Cite This Article
    EID Contini S, Lewis H. Spleen Abscess as Malaria Complication. Emerg Infect Dis. 2006;12(3):529-531. https://dx.doi.org/10.3201/eid1203.050311
    AMA Contini S, Lewis H. Spleen Abscess as Malaria Complication. Emerging Infectious Diseases. 2006;12(3):529-531. doi:10.3201/eid1203.050311.
    APA Contini, S., & Lewis, H. (2006). Spleen Abscess as Malaria Complication. Emerging Infectious Diseases, 12(3), 529-531. https://dx.doi.org/10.3201/eid1203.050311.
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  • Rickettsioses in South Korea, Materials and Methods PDF Version [PDF - 20 KB - 1 page]
    P. Fournier et al.
            Cite This Article
    EID Fournier P, Rolain J, Raoult D. Rickettsioses in South Korea, Materials and Methods. Emerg Infect Dis. 2006;12(3):531. https://dx.doi.org/10.3201/eid1203.050334
    AMA Fournier P, Rolain J, Raoult D. Rickettsioses in South Korea, Materials and Methods. Emerging Infectious Diseases. 2006;12(3):531. doi:10.3201/eid1203.050334.
    APA Fournier, P., Rolain, J., & Raoult, D. (2006). Rickettsioses in South Korea, Materials and Methods. Emerging Infectious Diseases, 12(3), 531. https://dx.doi.org/10.3201/eid1203.050334.
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  • Rickettsioses in South Korea, Data Analysis
    J. Ma
            Cite This Article
    EID Ma J. Rickettsioses in South Korea, Data Analysis. Emerg Infect Dis. 2006;12(3):531-532. https://dx.doi.org/10.3201/eid1203.050957
    AMA Ma J. Rickettsioses in South Korea, Data Analysis. Emerging Infectious Diseases. 2006;12(3):531-532. doi:10.3201/eid1203.050957.
    APA Ma, J. (2006). Rickettsioses in South Korea, Data Analysis. Emerging Infectious Diseases, 12(3), 531-532. https://dx.doi.org/10.3201/eid1203.050957.
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  • "Mycobacterium tilburgii" Infections PDF Version [PDF - 126 KB - 3 pages]
    D. Wagner et al.
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    EID Wagner D, Vos MC, Buiting A, Serr A, Bergmans A, Kern W, et al. "Mycobacterium tilburgii" Infections. Emerg Infect Dis. 2006;12(3):532-534. https://dx.doi.org/10.3201/eid1203.051139
    AMA Wagner D, Vos MC, Buiting A, et al. "Mycobacterium tilburgii" Infections. Emerging Infectious Diseases. 2006;12(3):532-534. doi:10.3201/eid1203.051139.
    APA Wagner, D., Vos, M. C., Buiting, A., Serr, A., Bergmans, A., Kern, W....Schouls, L. M. (2006). "Mycobacterium tilburgii" Infections. Emerging Infectious Diseases, 12(3), 532-534. https://dx.doi.org/10.3201/eid1203.051139.
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Books and Media

  • Infection and Autoimmunity PDF Version [PDF - 15 KB - 1 page]
    J. S. McDougal
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    EID McDougal JS. Infection and Autoimmunity. Emerg Infect Dis. 2006;12(3):535. https://dx.doi.org/10.3201/eid1203.051409
    AMA McDougal JS. Infection and Autoimmunity. Emerging Infectious Diseases. 2006;12(3):535. doi:10.3201/eid1203.051409.
    APA McDougal, J. S. (2006). Infection and Autoimmunity. Emerging Infectious Diseases, 12(3), 535. https://dx.doi.org/10.3201/eid1203.051409.
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  • World Class Parasites: Vol. X, Schistosomiasis PDF Version [PDF - 220 KB - 1 page]
    J. McKerrow
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    EID McKerrow J. World Class Parasites: Vol. X, Schistosomiasis. Emerg Infect Dis. 2006;12(3):535. https://dx.doi.org/10.3201/eid1203.051537
    AMA McKerrow J. World Class Parasites: Vol. X, Schistosomiasis. Emerging Infectious Diseases. 2006;12(3):535. doi:10.3201/eid1203.051537.
    APA McKerrow, J. (2006). World Class Parasites: Vol. X, Schistosomiasis. Emerging Infectious Diseases, 12(3), 535. https://dx.doi.org/10.3201/eid1203.051537.
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  • Rembrandt van Rijn, Scholar in His Study PDF Version [PDF - 41 KB - 2 pages]
    P. Potter
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    EID Potter P. Rembrandt van Rijn, Scholar in His Study. Emerg Infect Dis. 2006;12(3):537-538. https://dx.doi.org/10.3201/eid1203.AC1203
    AMA Potter P. Rembrandt van Rijn, Scholar in His Study. Emerging Infectious Diseases. 2006;12(3):537-538. doi:10.3201/eid1203.AC1203.
    APA Potter, P. (2006). Rembrandt van Rijn, Scholar in His Study. Emerging Infectious Diseases, 12(3), 537-538. https://dx.doi.org/10.3201/eid1203.AC1203.
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