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Issue Cover for Volume 12, Number 8—August 2006

Volume 12, Number 8—August 2006

[PDF - 5.37 MB - 131 pages]

Synopses

Invasive Enterobacter sakazakii Disease in Infants [PDF - 87 KB - 5 pages]
A. Bowen and C. R. Braden

Enterobacter sakazakii kills 40%–80% of infected infants and has been associated with powdered formula. We analyzed 46 cases of invasive infant E. sakazakii infection to define risk factors and guide prevention and treatment. Twelve infants had bacteremia, 33 had meningitis, and 1 had a urinary tract infection. Compared with infants with isolated bacteremia, infants with meningitis had greater birthweight (2,454 g vs. 850 g, p = 0.002) and gestational age (37 weeks vs. 27.8 weeks, p = 0.02), and infection developed at a younger age (6 days vs. 35 days, p<0.001). Among meningitis patients, 11 (33%) had seizures, 7 (21%) had brain abscess, and 14 (42%) died. Twenty-four (92%) of 26 infants with feeding patterns specified were fed powdered formula. Formula samples associated with 15 (68%) of 22 cases yielded E. sakazakii; in 13 cases, clinical and formula strains were indistinguishable. Further clarification of clinical risk factors and improved powdered formula safety is needed.

EID Bowen A, Braden CR. Invasive Enterobacter sakazakii Disease in Infants. Emerg Infect Dis. 2006;12(8):1185-1189. https://doi.org/10.3201/eid1208.051509
AMA Bowen A, Braden CR. Invasive Enterobacter sakazakii Disease in Infants. Emerging Infectious Diseases. 2006;12(8):1185-1189. doi:10.3201/eid1208.051509.
APA Bowen, A., & Braden, C. R. (2006). Invasive Enterobacter sakazakii Disease in Infants. Emerging Infectious Diseases, 12(8), 1185-1189. https://doi.org/10.3201/eid1208.051509.
Research

Venezuelan Equine Encephalitis Virus Transmission and Effect on Pathogenesis [PDF - 233 KB - 7 pages]
D. R. Smith et al.

Quantifying the dose of an arbovirus transmitted by mosquitoes is essential for designing pathogenesis studies simulating natural infection of vertebrates. Titration of saliva collected in vitro from infected mosquitoes may not accurately estimate titers transmitted during blood feeding, and infection by needle injection may affect vertebrate pathogenesis. We compared the amount of Venezuelan equine encephalitis virus collected from the saliva of Aedes taeniorhynchus to the amount injected into a mouse during blood feeding. Less virus was transmitted by mosquitoes in vivo (geometric mean 11 PFU) than was found for comparable times of salivation in vitro (mean saliva titer 74 PFU). We also observed slightly lower early and late viremia titers in mice that were needle injected with 8 PFU, which represents the low end of the in vivo transmission range. No differences in survival were detected, regardless of the dose or infection route.

EID Smith DR, Aguilar PV, Coffey LL, Gromowski GD, Wang E, Vasilakis N. Venezuelan Equine Encephalitis Virus Transmission and Effect on Pathogenesis. Emerg Infect Dis. 2006;12(8):1190-1196. https://doi.org/10.3201/eid1208.050841
AMA Smith DR, Aguilar PV, Coffey LL, et al. Venezuelan Equine Encephalitis Virus Transmission and Effect on Pathogenesis. Emerging Infectious Diseases. 2006;12(8):1190-1196. doi:10.3201/eid1208.050841.
APA Smith, D. R., Aguilar, P. V., Coffey, L. L., Gromowski, G. D., Wang, E., & Vasilakis, N. (2006). Venezuelan Equine Encephalitis Virus Transmission and Effect on Pathogenesis. Emerging Infectious Diseases, 12(8), 1190-1196. https://doi.org/10.3201/eid1208.050841.

Bat-transmitted Human Rabies Outbreaks, Brazilian Amazon
E. da Rosa et al.

We describe 2 bat-transmitted outbreaks in remote, rural areas of Portel and Viseu Municipalities, Pará State, northern Brazil. Central nervous system specimens were taken after patients' deaths and underwent immunofluorescent assay and histopathologic examination for rabies antigens; also, specimens were injected intracerebrally into suckling mice in an attempt to isolate the virus. Strains obtained were antigenically and genetically characterized. Twenty-one persons died due to paralytic rabies in the 2 municipalities. Ten rabies virus strains were isolated from human specimens; 2 other cases were diagnosed by histopathologic examination. Isolates were antigenically characterized as Desmodus rotundus variant 3 (AgV3). DNA sequencing of 6 strains showed that they were genetically close to D. rotundus–related strains isolated in Brazil. The genetic results were similar to those obtained by using monoclonal antibodies and support the conclusion that the isolates studied belong to the same rabies cycle, the virus variants found in the vampire bat D. rotundus.

EID da Rosa E, Kotait I, Barbosa T, Carrieri ML, Brandão PE, Pinheiro AS, et al. Bat-transmitted Human Rabies Outbreaks, Brazilian Amazon. Emerg Infect Dis. 2006;12(8):1197-1202. https://doi.org/10.3201/eid1208.050929
AMA da Rosa E, Kotait I, Barbosa T, et al. Bat-transmitted Human Rabies Outbreaks, Brazilian Amazon. Emerging Infectious Diseases. 2006;12(8):1197-1202. doi:10.3201/eid1208.050929.
APA da Rosa, E., Kotait, I., Barbosa, T., Carrieri, M. L., Brandão, P. E., Pinheiro, A. S....Vasconcelos, P. (2006). Bat-transmitted Human Rabies Outbreaks, Brazilian Amazon. Emerging Infectious Diseases, 12(8), 1197-1202. https://doi.org/10.3201/eid1208.050929.

Streptococcus suis Sequence Type 7 Outbreak, Sichuan, China [PDF - 192 KB - 6 pages]
C. Ye et al.

An outbreak of Streptococcus suis serotype 2 emerged in the summer of 2005 in Sichuan Province, and sporadic infections occurred in 4 additional provinces of China. In total, 99 S. suis strains were isolated and analyzed in this study: 88 isolates from human patients and 11 from diseased pigs. We defined 98 of 99 isolates as pulse type I by using pulsed-field gel electrophoresis analysis of SmaI-digested chromosomal DNA. Furthermore, multilocus sequence typing classified 97 of 98 members of the pulse type I in the same sequence type (ST), ST-7. Isolates of ST-7 were more toxic to peripheral blood mononuclear cells than ST-1 strains. S. suis ST-7, the causative agent, was a single-locus variant of ST-1 with increased virulence. These findings strongly suggest that ST-7 is an emerging, highly virulent S. suis clone that caused the largest S. suis outbreak ever described.

EID Ye C, Zhu X, Jing H, Du H, Segura M, Zheng H, et al. Streptococcus suis Sequence Type 7 Outbreak, Sichuan, China. Emerg Infect Dis. 2006;12(8):1203-1208. https://doi.org/10.3201/eid1208.060232
AMA Ye C, Zhu X, Jing H, et al. Streptococcus suis Sequence Type 7 Outbreak, Sichuan, China. Emerging Infectious Diseases. 2006;12(8):1203-1208. doi:10.3201/eid1208.060232.
APA Ye, C., Zhu, X., Jing, H., Du, H., Segura, M., Zheng, H....Xu, J. (2006). Streptococcus suis Sequence Type 7 Outbreak, Sichuan, China. Emerging Infectious Diseases, 12(8), 1203-1208. https://doi.org/10.3201/eid1208.060232.

Carbapenem Resistance in Klebsiella pneumoniae Not Detected by Automated Susceptibility Testing [PDF - 105 KB - 5 pages]
F. C. Tenover et al.

Detecting β-lactamase–mediated carbapenem resistance among Klebsiella pneumoniae isolates and other Enterobacteriaceae is an emerging problem. In this study, 15 blaKPC-positive Klebsiella pneumoniae that showed discrepant results for imipenem and meropenem from 4 New York City hospitals were characterized by isoelectric focusing; broth microdilution (BMD); disk diffusion (DD); and MicroScan, Phoenix, Sensititre, VITEK, and VITEK 2 automated systems. All 15 isolates were either intermediate or resistant to imipenem and meropenem by BMD; 1 was susceptible to imipenem by DD. MicroScan and Phoenix reported 1 (6.7%) and 2 (13.3%) isolates, respectively, as imipenem susceptible. VITEK and VITEK 2 reported 10 (67%) and 5 (33%) isolates, respectively, as imipenem susceptible. By Sensititre, 13 (87%) isolates were susceptible to imipenem, and 12 (80%) were susceptible to meropenem. The VITEK 2 Advanced Expert System changed 2 imipenem MIC results from >16 μg/mL to <2 μg/mL but kept the interpretation as resistant. The recognition of carbapenem-resistant K. pneumoniae continues to challenge automated susceptibility systems.

EID Tenover FC, Kalsi RK, Williams PP, Carey RB, Stocker S, Lonsway DR, et al. Carbapenem Resistance in Klebsiella pneumoniae Not Detected by Automated Susceptibility Testing. Emerg Infect Dis. 2006;12(8):1209-1213. https://doi.org/10.3201/eid1208.060291
AMA Tenover FC, Kalsi RK, Williams PP, et al. Carbapenem Resistance in Klebsiella pneumoniae Not Detected by Automated Susceptibility Testing. Emerging Infectious Diseases. 2006;12(8):1209-1213. doi:10.3201/eid1208.060291.
APA Tenover, F. C., Kalsi, R. K., Williams, P. P., Carey, R. B., Stocker, S., Lonsway, D. R....Hanna, B. (2006). Carbapenem Resistance in Klebsiella pneumoniae Not Detected by Automated Susceptibility Testing. Emerging Infectious Diseases, 12(8), 1209-1213. https://doi.org/10.3201/eid1208.060291.

VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France [PDF - 394 KB - 9 pages]
T. Naas et al.

VEB-1 extended-spectrum β-lactamase–producing Acinetobacter baumannii was responsible for an outbreak in hospitals in France. A national alert was triggered in September 2003 when 4 hospitals reported clusters of A. baumannii infection with similar susceptibility profiles. Case definitions and laboratory guidelines were disseminated, and prospective surveillance was implemented; strains were sent to a single laboratory for characterization and typing. From April 2003 through June 2004, 53 hospitals reported 290 cases of A. baumannii infection or colonization; 275 isolates were blaVEB-1-positive and clonally related. Cases were first reported in 5 districts of northern France, then in 10 other districts in 4 regions. Within a region, interhospital spread was associated with patient transfer. In northern France, investigation and control measures led to a reduction of reported cases after January 2004. The national alert enabled early control of new clusters, demonstrating the usefulness of early warning about antimicrobial drug resistance.

EID Naas T, Coignard B, Carbonne A, Blanckaert K, Bajolet O, Bernet C, et al. VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France. Emerg Infect Dis. 2006;12(8):1214-1222. https://doi.org/10.3201/eid1208.051547
AMA Naas T, Coignard B, Carbonne A, et al. VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France. Emerging Infectious Diseases. 2006;12(8):1214-1222. doi:10.3201/eid1208.051547.
APA Naas, T., Coignard, B., Carbonne, A., Blanckaert, K., Bajolet, O., Bernet, C....Nordmann, P. (2006). VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France. Emerging Infectious Diseases, 12(8), 1214-1222. https://doi.org/10.3201/eid1208.051547.

Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia [PDF - 177 KB - 8 pages]
J. P. Metlay et al.

We conducted a case-control study of adults with bacteremic pneumococcal pneumonia to identify factors associated with macrolide resistance. Study participants were identified through population-based surveillance in a 5-county region surrounding Philadelphia. Forty-three hospitals contributed 444 patients, who were interviewed by telephone regarding potential risk factors. In multivariable analyses, prior exposure to a macrolide antimicrobial agent (odds ratio [OR] 2.8), prior flu vaccination (OR 2.0), and Hispanic ethnicity (OR 4.1) were independently associated with an increased probability of macrolide resistance, and a history of stroke was independently associated with a decreased probability of macrolide resistance (OR 0.2). Fifty-five percent of patients with macrolide-resistant infections reported no antimicrobial drug exposure in the preceding 6 months. Among patients who reported taking antimicrobial agents in the 6 months preceding infection, failure to complete the course of prescribed drugs was associated with an increased probability of macrolide resistance (OR 3.4).

EID Metlay JP, Fishman NO, Joffe MM, Kallan MJ, Chittams JL, Edelstein PH. Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia. Emerg Infect Dis. 2006;12(8):1223-1230. https://doi.org/10.3201/eid1208.060017
AMA Metlay JP, Fishman NO, Joffe MM, et al. Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia. Emerging Infectious Diseases. 2006;12(8):1223-1230. doi:10.3201/eid1208.060017.
APA Metlay, J. P., Fishman, N. O., Joffe, M. M., Kallan, M. J., Chittams, J. L., & Edelstein, P. H. (2006). Macrolide Resistance in Adults with Bacteremic Pneumococcal Pneumonia. Emerging Infectious Diseases, 12(8), 1223-1230. https://doi.org/10.3201/eid1208.060017.

Antibody Response to Pneumocystis jirovecii [PDF - 228 KB - 8 pages]
K. R. Daly et al.

We conducted a prospective pilot study of the serologic responses to overlapping recombinant fragments of the Pneumocystis jirovecii major surface glycoprotein (Msg) in HIV-infected patients with pneumonia due to P. jirovecii and other causes. Similar baseline geometric mean antibody levels to the fragments measured by an ELISA were found in both groups. Serum antibodies to MsgC in P. jirovecii patients rose to a peak level 3–4 weeks (p<0.001) after recovery from pneumocystosis; baseline CD4+ count >50 cells/μL and first episode of pneumocystosis were the principal host factors associated with this rise (both p<0.001). Thus, MsgC shows promise as a serologic reagent and should be tested further in clinical and epidemiologic studies.

EID Daly KR, Huang L, Morris A, Koch J, Crothers K, Levin L, et al. Antibody Response to Pneumocystis jirovecii. Emerg Infect Dis. 2006;12(8):1231-1237. https://doi.org/10.3201/eid1208.060230
AMA Daly KR, Huang L, Morris A, et al. Antibody Response to Pneumocystis jirovecii. Emerging Infectious Diseases. 2006;12(8):1231-1237. doi:10.3201/eid1208.060230.
APA Daly, K. R., Huang, L., Morris, A., Koch, J., Crothers, K., Levin, L....Walzer, P. D. (2006). Antibody Response to Pneumocystis jirovecii. Emerging Infectious Diseases, 12(8), 1231-1237. https://doi.org/10.3201/eid1208.060230.
Policy Review

Virulent Epidemics and Scope of Healthcare Workers' Duty of Care [PDF - 132 KB - 4 pages]
D. K. Sokol

The phrase "duty of care" is, at best, too vague and, at worst, ethically dangerous. The nature and scope of the duty need to be determined, and conflicting duties must be recognized and acknowledged. Duty of care is neither fixed nor absolute but heavily dependent on context. The normal risk level of the working environment, the healthcare worker's specialty, the likely harm and benefits of treatment, and the competing obligations deriving from the worker's multiple roles will all influence the limits of the duty of care. As experts anticipate the arrival of an avian influenza pandemic in humans, discussion of this matter is urgently needed.

EID Sokol DK. Virulent Epidemics and Scope of Healthcare Workers' Duty of Care. Emerg Infect Dis. 2006;12(8):1238-1241. https://doi.org/10.3201/eid1208.060360
AMA Sokol DK. Virulent Epidemics and Scope of Healthcare Workers' Duty of Care. Emerging Infectious Diseases. 2006;12(8):1238-1241. doi:10.3201/eid1208.060360.
APA Sokol, D. K. (2006). Virulent Epidemics and Scope of Healthcare Workers' Duty of Care. Emerging Infectious Diseases, 12(8), 1238-1241. https://doi.org/10.3201/eid1208.060360.
Dispatches

Human and Canine Pulmonary Blastomycosis, North Carolina, 2001–2002 [PDF - 182 KB - 3 pages]
P. MacDonald et al.

We investigated a cluster of blastomycosis in 8 humans and 4 dogs in a rural North Carolina community. Delayed diagnosis, difficulty isolating Blastomyces dermatitidis in nature, and lack of a sensitive and specific test to assess exposure make outbreaks of this disease difficult to study.

EID MacDonald P, Langley RL, Gerkin SR, Torok MR, MacCormack J. Human and Canine Pulmonary Blastomycosis, North Carolina, 2001–2002. Emerg Infect Dis. 2006;12(8):1242-1244. https://doi.org/10.3201/eid1208.050781
AMA MacDonald P, Langley RL, Gerkin SR, et al. Human and Canine Pulmonary Blastomycosis, North Carolina, 2001–2002. Emerging Infectious Diseases. 2006;12(8):1242-1244. doi:10.3201/eid1208.050781.
APA MacDonald, P., Langley, R. L., Gerkin, S. R., Torok, M. R., & MacCormack, J. (2006). Human and Canine Pulmonary Blastomycosis, North Carolina, 2001–2002. Emerging Infectious Diseases, 12(8), 1242-1244. https://doi.org/10.3201/eid1208.050781.

West Nile Virus Epizootiology, Central Red River Valley, North Dakota and Minnesota, 2002–2005 [PDF - 74 KB - 3 pages]
J. A. Bell et al.

West Nile virus (WNV) epizootiology was monitored from 2002 through 2005 in the area surrounding Grand Forks, North Dakota. Mosquitoes were tested for infection, and birds were surveyed for antibodies. In 2003, WNV was epidemic; in 2004, cool temperatures precluded WNV amplification; and in 2005, immunity in passerines decreased, but did not preclude, WNV amplification.

EID Bell JA, Brewer CM, Mickelson NJ, Garman GW, Vaughan JA. West Nile Virus Epizootiology, Central Red River Valley, North Dakota and Minnesota, 2002–2005. Emerg Infect Dis. 2006;12(8):1245-1247. https://doi.org/10.3201/eid1208.060129
AMA Bell JA, Brewer CM, Mickelson NJ, et al. West Nile Virus Epizootiology, Central Red River Valley, North Dakota and Minnesota, 2002–2005. Emerging Infectious Diseases. 2006;12(8):1245-1247. doi:10.3201/eid1208.060129.
APA Bell, J. A., Brewer, C. M., Mickelson, N. J., Garman, G. W., & Vaughan, J. A. (2006). West Nile Virus Epizootiology, Central Red River Valley, North Dakota and Minnesota, 2002–2005. Emerging Infectious Diseases, 12(8), 1245-1247. https://doi.org/10.3201/eid1208.060129.

O'nyong-nyong Virus, Chad [PDF - 125 KB - 3 pages]
M. Bessaud et al.

We report the first laboratory-confirmed human infection with O'nyong-nyong virus in Chad. This virus was isolated from peripheral blood mononuclear cells of a patient with evidence of a seroconversion to a virus related to Chikungunya virus. Genome sequence was partly determined, and phylogenetic studies were conducted.

EID Bessaud M, Peyrefitte CN, Pastorino B, Gravier P, Tock F, Boete F, et al. O'nyong-nyong Virus, Chad. Emerg Infect Dis. 2006;12(8):1248-1250. https://doi.org/10.3201/eid1208.060199
AMA Bessaud M, Peyrefitte CN, Pastorino B, et al. O'nyong-nyong Virus, Chad. Emerging Infectious Diseases. 2006;12(8):1248-1250. doi:10.3201/eid1208.060199.
APA Bessaud, M., Peyrefitte, C. N., Pastorino, B., Gravier, P., Tock, F., Boete, F....Grandadam, M. (2006). O'nyong-nyong Virus, Chad. Emerging Infectious Diseases, 12(8), 1248-1250. https://doi.org/10.3201/eid1208.060199.

Human Bocavirus in French Children [PDF - 86 KB - 3 pages]
V. Foulongne et al.

Human bocavirus (HBoV), a new member of the genus Bocavirus in the family Parvoviridae, has been recently associated with respiratory tract infections. We report the epidemiologic and clinical features observed from a 1-year retrospective study of HBoV infection in young children hospitalized with a respiratory tract infection.

EID Foulongne V, Olejnik Y, Perez V, Elaerts S, Rodière M, Segondy M. Human Bocavirus in French Children. Emerg Infect Dis. 2006;12(8):1251-1253. https://doi.org/10.3201/eid1208.060213
AMA Foulongne V, Olejnik Y, Perez V, et al. Human Bocavirus in French Children. Emerging Infectious Diseases. 2006;12(8):1251-1253. doi:10.3201/eid1208.060213.
APA Foulongne, V., Olejnik, Y., Perez, V., Elaerts, S., Rodière, M., & Segondy, M. (2006). Human Bocavirus in French Children. Emerging Infectious Diseases, 12(8), 1251-1253. https://doi.org/10.3201/eid1208.060213.

Bocavirus Infection in Hospitalized Children, South Korea [PDF - 207 KB - 3 pages]
J. Chung et al.

This study presents the first evidence of human bocavirus infection in South Korean children. The virus was detected in 27 (8.0%) of 336 tested specimens, including 17 (7.5%) of 225 virus-negative specimens, collected from children with acute lower respiratory tract infection.

EID Chung J, Han T, Kim C, Kim S. Bocavirus Infection in Hospitalized Children, South Korea. Emerg Infect Dis. 2006;12(8):1254-1256. https://doi.org/10.3201/eid1208.060261
AMA Chung J, Han T, Kim C, et al. Bocavirus Infection in Hospitalized Children, South Korea. Emerging Infectious Diseases. 2006;12(8):1254-1256. doi:10.3201/eid1208.060261.
APA Chung, J., Han, T., Kim, C., & Kim, S. (2006). Bocavirus Infection in Hospitalized Children, South Korea. Emerging Infectious Diseases, 12(8), 1254-1256. https://doi.org/10.3201/eid1208.060261.

Changing Pattern of Visceral Leishmaniasis, United Kingdom, 1985-2004 [PDF - 95 KB - 3 pages]
A. Malik et al.

A 20-year (1985–2004) retrospective review of 39 patients with imported visceral leishmaniasis found that tourism to Mediterranean countries and HIV infection were associated with visceral leishmaniasis. Diagnosis was often delayed. Treatment with liposomal amphotericin B has improved prognosis. Visceral leishmaniasis should be made a reportable disease.

EID Malik A, John L, Bryceson A, Lockwood D. Changing Pattern of Visceral Leishmaniasis, United Kingdom, 1985-2004. Emerg Infect Dis. 2006;12(8):1257-1259. https://doi.org/10.3201/eid1208.050486
AMA Malik A, John L, Bryceson A, et al. Changing Pattern of Visceral Leishmaniasis, United Kingdom, 1985-2004. Emerging Infectious Diseases. 2006;12(8):1257-1259. doi:10.3201/eid1208.050486.
APA Malik, A., John, L., Bryceson, A., & Lockwood, D. (2006). Changing Pattern of Visceral Leishmaniasis, United Kingdom, 1985-2004. Emerging Infectious Diseases, 12(8), 1257-1259. https://doi.org/10.3201/eid1208.050486.

Mental Status after West Nile Virus Infection [PDF - 121 KB - 3 pages]
K. Y. Haaland et al.

Mental status after acute West Nile virus infection has not been examined objectively. We compared Telephone Interview for Cognitive Status scores of 116 patients with West Nile fever or West Nile neuroinvasive disease. Mental status was poorer and cognitive complaints more frequent with West Nile neuroinvasive disease (p = 0.005).

EID Haaland KY, Sadek J, Pergam SA, Echevarria LA, Davis LE, Goade D, et al. Mental Status after West Nile Virus Infection. Emerg Infect Dis. 2006;12(8):1260-1262. https://doi.org/10.3201/eid1208.060097
AMA Haaland KY, Sadek J, Pergam SA, et al. Mental Status after West Nile Virus Infection. Emerging Infectious Diseases. 2006;12(8):1260-1262. doi:10.3201/eid1208.060097.
APA Haaland, K. Y., Sadek, J., Pergam, S. A., Echevarria, L. A., Davis, L. E., Goade, D....Ettestad, P. (2006). Mental Status after West Nile Virus Infection. Emerging Infectious Diseases, 12(8), 1260-1262. https://doi.org/10.3201/eid1208.060097.

Human Metapneumovirus, Australia, 2001–2004 [PDF - 212 KB - 4 pages]
T. P. Sloots et al.

We examined 10,025 respiratory samples collected for 4 years (2001–2004) and found a 7.1% average annual incidence of human metapneumovirus. The epidemic peak of infection was late winter to spring, and genotyping showed a change in predominant viral genotype in 3 of the 4 years.

EID Sloots TP, Mackay IM, Bialasiewicz S, Jacob KC, McQueen E, Harnett GB, et al. Human Metapneumovirus, Australia, 2001–2004. Emerg Infect Dis. 2006;12(8):1263-1266. https://doi.org/10.3201/eid1208.051239
AMA Sloots TP, Mackay IM, Bialasiewicz S, et al. Human Metapneumovirus, Australia, 2001–2004. Emerging Infectious Diseases. 2006;12(8):1263-1266. doi:10.3201/eid1208.051239.
APA Sloots, T. P., Mackay, I. M., Bialasiewicz, S., Jacob, K. C., McQueen, E., Harnett, G. B....Nissen, M. D. (2006). Human Metapneumovirus, Australia, 2001–2004. Emerging Infectious Diseases, 12(8), 1263-1266. https://doi.org/10.3201/eid1208.051239.

Community-acquired Methicillin-resistant Staphylococcus aureus in Children, Taiwan [PDF - 115 KB - 4 pages]
W. Lo et al.

Highly virulent community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) with Panton-Valentine leukocidin (PVL) is common worldwide. Using antimicrobial drug susceptibility testing, staphylococcal cassette chromosome mec typing, exotoxin profiling, and pulsed-field gel electrophoresis typing, we provide evidence that supports the relationship between nasal strains of PVL-positive MRSA and community-acquired disease.

EID Lo W, Lin W, Tseng M, Wang S, Chu M, Wang C. Community-acquired Methicillin-resistant Staphylococcus aureus in Children, Taiwan. Emerg Infect Dis. 2006;12(8):1267-1270. https://doi.org/10.3201/eid1208.051570
AMA Lo W, Lin W, Tseng M, et al. Community-acquired Methicillin-resistant Staphylococcus aureus in Children, Taiwan. Emerging Infectious Diseases. 2006;12(8):1267-1270. doi:10.3201/eid1208.051570.
APA Lo, W., Lin, W., Tseng, M., Wang, S., Chu, M., & Wang, C. (2006). Community-acquired Methicillin-resistant Staphylococcus aureus in Children, Taiwan. Emerging Infectious Diseases, 12(8), 1267-1270. https://doi.org/10.3201/eid1208.051570.

Incubation Period of Hantavirus Cardiopulmonary Syndrome [PDF - 184 KB - 3 pages]
P. Vial et al.

The potential incubation period from exposure to onset of symptoms was 7–39 days (median 18 days) in 20 patients with a defined period of exposure to Andes virus in a high-risk area. This period was 14–32 days (median 18 days) in 11 patients with exposure for <48 hours.

EID Vial P, Valdivieso F, Mertz G, Castillo C, Belmar E, Delgado I, et al. Incubation Period of Hantavirus Cardiopulmonary Syndrome. Emerg Infect Dis. 2006;12(8):1271-1273. https://doi.org/10.3201/eid1208.051127
AMA Vial P, Valdivieso F, Mertz G, et al. Incubation Period of Hantavirus Cardiopulmonary Syndrome. Emerging Infectious Diseases. 2006;12(8):1271-1273. doi:10.3201/eid1208.051127.
APA Vial, P., Valdivieso, F., Mertz, G., Castillo, C., Belmar, E., Delgado, I....Ferrés, M. (2006). Incubation Period of Hantavirus Cardiopulmonary Syndrome. Emerging Infectious Diseases, 12(8), 1271-1273. https://doi.org/10.3201/eid1208.051127.

Bat-associated Rabies Virus in Skunks [PDF - 187 KB - 4 pages]
M. J. Leslie et al.

Rabies was undetected in terrestrial wildlife of northern Arizona until 2001, when rabies was diagnosed in 19 rabid skunks in Flagstaff. Laboratory analyses showed causative rabies viruses associated with bats, which indicated cross-species transmission of unprecedented magnitude. Public health infrastructure must be maintained to address emerging zoonotic diseases.

EID Leslie MJ, Messenger S, Rohde RE, Smith J, Cheshier R, Hanlon C, et al. Bat-associated Rabies Virus in Skunks. Emerg Infect Dis. 2006;12(8):1274-1277. https://doi.org/10.3201/eid1208.051526
AMA Leslie MJ, Messenger S, Rohde RE, et al. Bat-associated Rabies Virus in Skunks. Emerging Infectious Diseases. 2006;12(8):1274-1277. doi:10.3201/eid1208.051526.
APA Leslie, M. J., Messenger, S., Rohde, R. E., Smith, J., Cheshier, R., Hanlon, C....Rupprecht, C. E. (2006). Bat-associated Rabies Virus in Skunks. Emerging Infectious Diseases, 12(8), 1274-1277. https://doi.org/10.3201/eid1208.051526.

Fecal Viral Load and Norovirus-associated Gastroenteritis [PDF - 88 KB - 3 pages]
M. Chan et al.

We report the median cDNA viral load of norovirus genogroup II is >100-fold higher than that of genogroup I in the fecal specimens of patients with norovirus-associated gastroenteritis. We speculate that increased cDNA viral load accounts for the higher transmissibility of genogroup II strains through the fecal-oral route.

EID Chan M, Sung J, Lam R, Chan P, Lee N, Lai R, et al. Fecal Viral Load and Norovirus-associated Gastroenteritis. Emerg Infect Dis. 2006;12(8):1278-1280. https://doi.org/10.3201/eid1208.060081
AMA Chan M, Sung J, Lam R, et al. Fecal Viral Load and Norovirus-associated Gastroenteritis. Emerging Infectious Diseases. 2006;12(8):1278-1280. doi:10.3201/eid1208.060081.
APA Chan, M., Sung, J., Lam, R., Chan, P., Lee, N., Lai, R....Leung, W. K. (2006). Fecal Viral Load and Norovirus-associated Gastroenteritis. Emerging Infectious Diseases, 12(8), 1278-1280. https://doi.org/10.3201/eid1208.060081.

Rickettsia felis in Xenopsylla cheopis, Java, Indonesia [PDF - 74 KB - 3 pages]
J. Jiang et al.

Rickettsia typhi and R. felis, etiologic agents of murine typhus and fleaborne spotted fever, respectively, were detected in Oriental rat fleas (Xenopsylla cheopis) collected from rodents and shrews in Java, Indonesia. We describe the first evidence of R. felis in Indonesia and naturally occurring R. felis in Oriental rat fleas.

EID Jiang J, Soeatmadji DW, Henry KM, Ratiwayanto S, Bangs MJ, Richards AL. Rickettsia felis in Xenopsylla cheopis, Java, Indonesia. Emerg Infect Dis. 2006;12(8):1281-1283. https://doi.org/10.3201/eid1208.060327
AMA Jiang J, Soeatmadji DW, Henry KM, et al. Rickettsia felis in Xenopsylla cheopis, Java, Indonesia. Emerging Infectious Diseases. 2006;12(8):1281-1283. doi:10.3201/eid1208.060327.
APA Jiang, J., Soeatmadji, D. W., Henry, K. M., Ratiwayanto, S., Bangs, M. J., & Richards, A. L. (2006). Rickettsia felis in Xenopsylla cheopis, Java, Indonesia. Emerging Infectious Diseases, 12(8), 1281-1283. https://doi.org/10.3201/eid1208.060327.

Avian Influenza among Waterfowl Hunters and Wildlife Professionals [PDF - 92 KB - 3 pages]
J. S. Gill et al.

We report serologic evidence of avian influenza infection in 1 duck hunter and 2 wildlife professionals with extensive histories of wild waterfowl and game bird exposure. Two laboratory methods showed evidence of past infection with influenza A/H11N9, a less common virus strain in wild ducks, in these 3 persons.

EID Gill JS, Webby R, Gilchrist M, Gray GC. Avian Influenza among Waterfowl Hunters and Wildlife Professionals. Emerg Infect Dis. 2006;12(8):1284-1286. https://doi.org/10.3201/eid1208.060492
AMA Gill JS, Webby R, Gilchrist M, et al. Avian Influenza among Waterfowl Hunters and Wildlife Professionals. Emerging Infectious Diseases. 2006;12(8):1284-1286. doi:10.3201/eid1208.060492.
APA Gill, J. S., Webby, R., Gilchrist, M., & Gray, G. C. (2006). Avian Influenza among Waterfowl Hunters and Wildlife Professionals. Emerging Infectious Diseases, 12(8), 1284-1286. https://doi.org/10.3201/eid1208.060492.

OFFLU Network on Avian Influenza [PDF - 112 KB - 2 pages]
S. Edwards

OFFLU is the name of the network of avian influenza expertise inaugurated jointly in 2005 by the Food and Agriculture Organization of the United Nations and the World Organisation for Animal Health. Achievements and constraints to date and plans for the future are described.

EID Edwards S. OFFLU Network on Avian Influenza. Emerg Infect Dis. 2006;12(8):1287-1288. https://doi.org/10.3201/eid1208.060380
AMA Edwards S. OFFLU Network on Avian Influenza. Emerging Infectious Diseases. 2006;12(8):1287-1288. doi:10.3201/eid1208.060380.
APA Edwards, S. (2006). OFFLU Network on Avian Influenza. Emerging Infectious Diseases, 12(8), 1287-1288. https://doi.org/10.3201/eid1208.060380.
Letters

Salmonella Typhimurium DT104, Italy [PDF - 22 KB - 1 page]
A. Cawthorne et al.
EID Cawthorne A, Galetta P, Massari M, Dionisi A, Filetici E, Luzzi I. Salmonella Typhimurium DT104, Italy. Emerg Infect Dis. 2006;12(8):1289. https://doi.org/10.3201/eid1208.050968
AMA Cawthorne A, Galetta P, Massari M, et al. Salmonella Typhimurium DT104, Italy. Emerging Infectious Diseases. 2006;12(8):1289. doi:10.3201/eid1208.050968.
APA Cawthorne, A., Galetta, P., Massari, M., Dionisi, A., Filetici, E., & Luzzi, I. (2006). Salmonella Typhimurium DT104, Italy. Emerging Infectious Diseases, 12(8), 1289. https://doi.org/10.3201/eid1208.050968.

Echovirus 13 Aseptic Meningitis, Brazil [PDF - 32 KB - 3 pages]
C. I. Kmetzsch et al.
EID Kmetzsch CI, Balkie E, Monteiro A, Costa EV, dos Santos G, da Silva EE. Echovirus 13 Aseptic Meningitis, Brazil. Emerg Infect Dis. 2006;12(8):1289-1291. https://doi.org/10.3201/eid1208.051317
AMA Kmetzsch CI, Balkie E, Monteiro A, et al. Echovirus 13 Aseptic Meningitis, Brazil. Emerging Infectious Diseases. 2006;12(8):1289-1291. doi:10.3201/eid1208.051317.
APA Kmetzsch, C. I., Balkie, E., Monteiro, A., Costa, E. V., dos Santos, G., & da Silva, E. E. (2006). Echovirus 13 Aseptic Meningitis, Brazil. Emerging Infectious Diseases, 12(8), 1289-1291. https://doi.org/10.3201/eid1208.051317.

Nonsteroidal Antiinflammatory Drugs and Group A Streptococcal Infection [PDF - 17 KB - 1 page]
D. M. Aronoff and Z. D. Mulla
EID Aronoff DM, Mulla ZD. Nonsteroidal Antiinflammatory Drugs and Group A Streptococcal Infection. Emerg Infect Dis. 2006;12(8):1291-129. https://doi.org/10.3201/eid1208.051067
AMA Aronoff DM, Mulla ZD. Nonsteroidal Antiinflammatory Drugs and Group A Streptococcal Infection. Emerging Infectious Diseases. 2006;12(8):1291-129. doi:10.3201/eid1208.051067.
APA Aronoff, D. M., & Mulla, Z. D. (2006). Nonsteroidal Antiinflammatory Drugs and Group A Streptococcal Infection. Emerging Infectious Diseases, 12(8), 1291-129. https://doi.org/10.3201/eid1208.051067.

Detecting Clostridium botulinum [PDF - 18 KB - 1 page]
J. Karner and F. Allerberger
EID Karner J, Allerberger F. Detecting Clostridium botulinum. Emerg Infect Dis. 2006;12(8):1292. https://doi.org/10.3201/eid1208.051364
AMA Karner J, Allerberger F. Detecting Clostridium botulinum. Emerging Infectious Diseases. 2006;12(8):1292. doi:10.3201/eid1208.051364.
APA Karner, J., & Allerberger, F. (2006). Detecting Clostridium botulinum. Emerging Infectious Diseases, 12(8), 1292. https://doi.org/10.3201/eid1208.051364.

Echinococcus multilocularis in Dogs, Japan [PDF - 47 KB - 3 pages]
Y. Morishima et al.
EID Morishima Y, Sugiyama H, Arakawa K, Kawanaka M. Echinococcus multilocularis in Dogs, Japan. Emerg Infect Dis. 2006;12(8):1292-1294. https://doi.org/10.3201/eid1208.051241
AMA Morishima Y, Sugiyama H, Arakawa K, et al. Echinococcus multilocularis in Dogs, Japan. Emerging Infectious Diseases. 2006;12(8):1292-1294. doi:10.3201/eid1208.051241.
APA Morishima, Y., Sugiyama, H., Arakawa, K., & Kawanaka, M. (2006). Echinococcus multilocularis in Dogs, Japan. Emerging Infectious Diseases, 12(8), 1292-1294. https://doi.org/10.3201/eid1208.051241.

New World Hantavirus in Humans, French Guiana [PDF - 36 KB - 2 pages]
S. Matheus et al.
EID Matheus S, Meynard J, Rollin PE, Maubert B, Morvan J. New World Hantavirus in Humans, French Guiana. Emerg Infect Dis. 2006;12(8):1294-1295. https://doi.org/10.3201/eid1208.051619
AMA Matheus S, Meynard J, Rollin PE, et al. New World Hantavirus in Humans, French Guiana. Emerging Infectious Diseases. 2006;12(8):1294-1295. doi:10.3201/eid1208.051619.
APA Matheus, S., Meynard, J., Rollin, P. E., Maubert, B., & Morvan, J. (2006). New World Hantavirus in Humans, French Guiana. Emerging Infectious Diseases, 12(8), 1294-1295. https://doi.org/10.3201/eid1208.051619.

Qinghai-like H5N1 from Domestic Cats, Northern Iraq [PDF - 53 KB - 3 pages]
S. L. Yingst et al.
EID Yingst SL, Saad MD, Felt SA. Qinghai-like H5N1 from Domestic Cats, Northern Iraq. Emerg Infect Dis. 2006;12(8):1295-1297. https://doi.org/10.3201/eid1208.060264
AMA Yingst SL, Saad MD, Felt SA. Qinghai-like H5N1 from Domestic Cats, Northern Iraq. Emerging Infectious Diseases. 2006;12(8):1295-1297. doi:10.3201/eid1208.060264.
APA Yingst, S. L., Saad, M. D., & Felt, S. A. (2006). Qinghai-like H5N1 from Domestic Cats, Northern Iraq. Emerging Infectious Diseases, 12(8), 1295-1297. https://doi.org/10.3201/eid1208.060264.

Classifying Escherichia coli [PDF - 50 KB - 3 pages]
D. M. Girão et al.
EID Girão DM, Girão V, Irino K, Gomes TA. Classifying Escherichia coli. Emerg Infect Dis. 2006;12(8):1297-1299. https://doi.org/10.3201/eid1208.051654
AMA Girão DM, Girão V, Irino K, et al. Classifying Escherichia coli. Emerging Infectious Diseases. 2006;12(8):1297-1299. doi:10.3201/eid1208.051654.
APA Girão, D. M., Girão, V., Irino, K., & Gomes, T. A. (2006). Classifying Escherichia coli. Emerging Infectious Diseases, 12(8), 1297-1299. https://doi.org/10.3201/eid1208.051654.

Toscana Virus RNA in Sergentomyia minuta Flies [PDF - 79 KB - 2 pages]
R. N. Charrel et al.
EID Charrel RN, Izri A, Temmam S, de Lamballerie X, Parola P. Toscana Virus RNA in Sergentomyia minuta Flies. Emerg Infect Dis. 2006;12(8):1299-1300. https://doi.org/10.3201/eid1208.060345
AMA Charrel RN, Izri A, Temmam S, et al. Toscana Virus RNA in Sergentomyia minuta Flies. Emerging Infectious Diseases. 2006;12(8):1299-1300. doi:10.3201/eid1208.060345.
APA Charrel, R. N., Izri, A., Temmam, S., de Lamballerie, X., & Parola, P. (2006). Toscana Virus RNA in Sergentomyia minuta Flies. Emerging Infectious Diseases, 12(8), 1299-1300. https://doi.org/10.3201/eid1208.060345.

Rat-bite Fever, Canada [PDF - 27 KB - 2 pages]
M. E. Schachter et al.
EID Schachter ME, Wilcox L, Rau N, Yamamura D, Brown S, Lee CH. Rat-bite Fever, Canada. Emerg Infect Dis. 2006;12(8):1301-1302. https://doi.org/10.3201/eid1208.060044
AMA Schachter ME, Wilcox L, Rau N, et al. Rat-bite Fever, Canada. Emerging Infectious Diseases. 2006;12(8):1301-1302. doi:10.3201/eid1208.060044.
APA Schachter, M. E., Wilcox, L., Rau, N., Yamamura, D., Brown, S., & Lee, C. H. (2006). Rat-bite Fever, Canada. Emerging Infectious Diseases, 12(8), 1301-1302. https://doi.org/10.3201/eid1208.060044.

Cutaneous Injury and Vibrio vulnificus Infection [PDF - 28 KB - 2 pages]
P. Chung et al.
EID Chung P, Chuang S, Tsang T, Wai-man L, Yung R, Lo J. Cutaneous Injury and Vibrio vulnificus Infection. Emerg Infect Dis. 2006;12(8):1302-1303. https://doi.org/10.3201/eid1208.051495
AMA Chung P, Chuang S, Tsang T, et al. Cutaneous Injury and Vibrio vulnificus Infection. Emerging Infectious Diseases. 2006;12(8):1302-1303. doi:10.3201/eid1208.051495.
APA Chung, P., Chuang, S., Tsang, T., Wai-man, L., Yung, R., & Lo, J. (2006). Cutaneous Injury and Vibrio vulnificus Infection. Emerging Infectious Diseases, 12(8), 1302-1303. https://doi.org/10.3201/eid1208.051495.

Neorickettsia helminthoeca in Dog, Brazil [PDF - 89 KB - 3 pages]
S. A. Headley et al.
EID Headley SA, Scorpio DG, Barat NC, Vidotto O, Dumler J. Neorickettsia helminthoeca in Dog, Brazil. Emerg Infect Dis. 2006;12(8):1303-1305. https://doi.org/10.3201/eid1208.060130
AMA Headley SA, Scorpio DG, Barat NC, et al. Neorickettsia helminthoeca in Dog, Brazil. Emerging Infectious Diseases. 2006;12(8):1303-1305. doi:10.3201/eid1208.060130.
APA Headley, S. A., Scorpio, D. G., Barat, N. C., Vidotto, O., & Dumler, J. (2006). Neorickettsia helminthoeca in Dog, Brazil. Emerging Infectious Diseases, 12(8), 1303-1305. https://doi.org/10.3201/eid1208.060130.
Another Dimension

Grandmother Speaks of the Old Country [PDF - 11 KB - 1 page]
L. Haskins
EID Haskins L. Grandmother Speaks of the Old Country. Emerg Infect Dis. 2006;12(8):1202. https://doi.org/10.3201/eid1208.ad1208
AMA Haskins L. Grandmother Speaks of the Old Country. Emerging Infectious Diseases. 2006;12(8):1202. doi:10.3201/eid1208.ad1208.
APA Haskins, L. (2006). Grandmother Speaks of the Old Country. Emerging Infectious Diseases, 12(8), 1202. https://doi.org/10.3201/eid1208.ad1208.
Books and Media

Mycobacterium bovis Infection in Animals and Humans, 2nd Edition [PDF - 16 KB - 1 page]
M. V. Palmer
EID Palmer MV. Mycobacterium bovis Infection in Animals and Humans, 2nd Edition. Emerg Infect Dis. 2006;12(8):1306. https://doi.org/10.3201/eid1208.060526
AMA Palmer MV. Mycobacterium bovis Infection in Animals and Humans, 2nd Edition. Emerging Infectious Diseases. 2006;12(8):1306. doi:10.3201/eid1208.060526.
APA Palmer, M. V. (2006). Mycobacterium bovis Infection in Animals and Humans, 2nd Edition. Emerging Infectious Diseases, 12(8), 1306. https://doi.org/10.3201/eid1208.060526.

Evolution of Microbial Pathogens [PDF - 21 KB - 2 pages]
J. Xu
EID Xu J. Evolution of Microbial Pathogens. Emerg Infect Dis. 2006;12(8):1306-1307. https://doi.org/10.3201/eid1208.060579
AMA Xu J. Evolution of Microbial Pathogens. Emerging Infectious Diseases. 2006;12(8):1306-1307. doi:10.3201/eid1208.060579.
APA Xu, J. (2006). Evolution of Microbial Pathogens. Emerging Infectious Diseases, 12(8), 1306-1307. https://doi.org/10.3201/eid1208.060579.
Etymologia

Etymologia: O’nyong-nyong virus [PDF - 64 KB - 1 page]
EID Etymologia: O’nyong-nyong virus. Emerg Infect Dis. 2006;12(8):1250. https://doi.org/10.3201/eid1208.et1208
AMA Etymologia: O’nyong-nyong virus. Emerging Infectious Diseases. 2006;12(8):1250. doi:10.3201/eid1208.et1208.
APA (2006). Etymologia: O’nyong-nyong virus. Emerging Infectious Diseases, 12(8), 1250. https://doi.org/10.3201/eid1208.et1208.
Conference Summaries

Pathogenesis of Verocytotoxin/Shiga Toxin–producing Escherichia coli Infection
A. Caprioli et al.
Corrections

Correction, Vol. 12, No. 4 [PDF - 16 KB - 1 page]
EID Correction, Vol. 12, No. 4. Emerg Infect Dis. 2006;12(8):1305. https://doi.org/10.3201/eid1208.c11208
AMA Correction, Vol. 12, No. 4. Emerging Infectious Diseases. 2006;12(8):1305. doi:10.3201/eid1208.c11208.
APA (2006). Correction, Vol. 12, No. 4. Emerging Infectious Diseases, 12(8), 1305. https://doi.org/10.3201/eid1208.c11208.

Correction: Vol. 12, No. 6 [PDF - 12 KB - 1 page]
EID Correction: Vol. 12, No. 6. Emerg Infect Dis. 2006;12(8):1307. https://doi.org/10.3201/eid1208.c21208
AMA Correction: Vol. 12, No. 6. Emerging Infectious Diseases. 2006;12(8):1307. doi:10.3201/eid1208.c21208.
APA (2006). Correction: Vol. 12, No. 6. Emerging Infectious Diseases, 12(8), 1307. https://doi.org/10.3201/eid1208.c21208.

Correction: Vol. 12 No. 7 [PDF - 12 KB - 1 page]
EID Correction: Vol. 12 No. 7. Emerg Infect Dis. 2006;12(8):1307. https://doi.org/10.3201/eid1208.c31208
AMA Correction: Vol. 12 No. 7. Emerging Infectious Diseases. 2006;12(8):1307. doi:10.3201/eid1208.c31208.
APA (2006). Correction: Vol. 12 No. 7. Emerging Infectious Diseases, 12(8), 1307. https://doi.org/10.3201/eid1208.c31208.

Correction: Vol. 12, No. 7 [PDF - 12 KB - 1 page]
EID Correction: Vol. 12, No. 7. Emerg Infect Dis. 2006;12(8):1307. https://doi.org/10.3201/eid1208.c41208
AMA Correction: Vol. 12, No. 7. Emerging Infectious Diseases. 2006;12(8):1307. doi:10.3201/eid1208.c41208.
APA (2006). Correction: Vol. 12, No. 7. Emerging Infectious Diseases, 12(8), 1307. https://doi.org/10.3201/eid1208.c41208.
About the Cover

Art, Science, and Life’s Enigmas [PDF - 60 KB - 2 pages]
P. Potter
EID Potter P. Art, Science, and Life’s Enigmas. Emerg Infect Dis. 2006;12(8):1308-1309. https://doi.org/10.3201/eid1208.ac1208
AMA Potter P. Art, Science, and Life’s Enigmas. Emerging Infectious Diseases. 2006;12(8):1308-1309. doi:10.3201/eid1208.ac1208.
APA Potter, P. (2006). Art, Science, and Life’s Enigmas. Emerging Infectious Diseases, 12(8), 1308-1309. https://doi.org/10.3201/eid1208.ac1208.
Page created: December 09, 2011
Page updated: December 09, 2011
Page reviewed: December 09, 2011
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.
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