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Issue Cover for Volume 15, Number 4—April 2009

Volume 15, Number 4—April 2009

[PDF - 7.33 MB - 175 pages]

THEME ISSUE
The Amazon Region
Commentary

The Status of Infectious Disease in the Amazon Region [PDF - 70 KB - 1 page]
P. L. Tauil
EID Tauil PL. The Status of Infectious Disease in the Amazon Region. Emerg Infect Dis. 2009;15(4):625. https://dx.doi.org/10.3201/eid1504.090169
AMA Tauil PL. The Status of Infectious Disease in the Amazon Region. Emerging Infectious Diseases. 2009;15(4):625. doi:10.3201/eid1504.090169.
APA Tauil, P. L. (2009). The Status of Infectious Disease in the Amazon Region. Emerging Infectious Diseases, 15(4), 625. https://dx.doi.org/10.3201/eid1504.090169.
Synopsis

High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006 [PDF - 413 KB - 7 pages]
G. Penna et al.

In Brazil, reportable diseases are the responsibility of the Secretariat of Health Surveillance of the Brazilian Federal Ministry of Health. During 2001–2006, to determine incidence and hospitalization rates, we analyzed 5 diseases (malaria, leishmaniasis [cutaneous and visceral], dengue fever, leprosy, and tuberculosis) that are endemic to the Amazon region of Brazil. Data were obtained from 773 municipalities in 3 regions. Although incidence rates of malaria, leishmaniasis, tuberculosis, and leprosy are decreasing, persons in lower socioeconomic classes with insufficient formal education are affected more by these diseases and other health inequalities than are other population groups in the region.

EID Penna G, Pinto LF, Soranz D, Glatt R. High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006. Emerg Infect Dis. 2009;15(4):626-632. https://dx.doi.org/10.3201/eid1504.081329
AMA Penna G, Pinto LF, Soranz D, et al. High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006. Emerging Infectious Diseases. 2009;15(4):626-632. doi:10.3201/eid1504.081329.
APA Penna, G., Pinto, L. F., Soranz, D., & Glatt, R. (2009). High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006. Emerging Infectious Diseases, 15(4), 626-632. https://dx.doi.org/10.3201/eid1504.081329.
Research

Human Febrile Illness Caused by Encephalomyocarditis Virus Infection, Peru [PDF - 356 KB - 7 pages]
M. Oberste et al.

Etiologic studies of acute febrile disease were conducted in sites across South America, including Cusco and Iquitos, Peru. Patients’ clinical signs and symptoms were recorded, and acute- and convalescent-phase serum samples were obtained for serologic examination and virus isolation in Vero E6 and C6/36 cells. Virus isolated in Vero E6 cells was identified as encephalomyocarditis virus (EMCV) by electron microscopy and by subsequent molecular diagnostic testing of samples from 2 febrile patients with nausea, headache, and dyspnea. The virus was recovered from acute-phase serum samples from both case-patients and identified with cardiovirus-specific reverse transcription–PCR and sequencing. Serum samples from case-patient 1 showed cardiovirus antibody by immunoglobulin M ELISA (acute phase <8, convalescent phase >1,024) and by neutralization assay (acute phase <10, convalescent phase >1,280). Serum samples from case-patient 2 did not contain antibodies detectable by either assay. Detection of virus in serum strongly supports a role for EMCV in human infection and febrile illness.

EID Oberste M, Gotuzzo E, Blair P, Nix W, Ksiazek TG, Comer JA, et al. Human Febrile Illness Caused by Encephalomyocarditis Virus Infection, Peru. Emerg Infect Dis. 2009;15(4):640-646. https://dx.doi.org/10.3201/eid1504.081428
AMA Oberste M, Gotuzzo E, Blair P, et al. Human Febrile Illness Caused by Encephalomyocarditis Virus Infection, Peru. Emerging Infectious Diseases. 2009;15(4):640-646. doi:10.3201/eid1504.081428.
APA Oberste, M., Gotuzzo, E., Blair, P., Nix, W., Ksiazek, T. G., Comer, J. A....Kochel, T. J. (2009). Human Febrile Illness Caused by Encephalomyocarditis Virus Infection, Peru. Emerging Infectious Diseases, 15(4), 640-646. https://dx.doi.org/10.3201/eid1504.081428.

Medscape CME Activity
Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005 [PDF - 350 KB - 7 pages]
M. O. Mendes et al.

We conducted an epidemiologic investigation of an outbreak of ocular disease among children to determine whether the disease was linked to Emmonsia sp., a rarely-reported fungus and an agent of adiaspiromycosis. Using an unmatched case–control study design, we compared case-patients with asymptomatic controls randomly selected from the population. Scleral biopsies were analyzed microscopically. Of 5,084 children examined, 99 case-patients were identified; mean age (+1 SD) was 11.0 ± 4.4 years. Symptoms included photophobia (57%), ocular pain (42%), and blurred vision (40%). In the multivariate analysis, risk factors included diving in the Araguaia River (odds ratio 5.2; 95% confidence interval 2.4–12.0). Microscopy identified foreign bodies consistent with adiaconidia. This outbreak probably resulted from foreign-body–type reactions to adiaspiromycosis conidia after initial irritation caused by conjunctival contact with spicules of sponges in the river. Symptomatic children responded to corticosteroid treatment. Adiaspiromycosis is a preventable cause of ocular disease in the Amazon region.

EID Mendes MO, Moraes MA, Renoiner EI, Dantas MH, Lanzieri TM, Fonseca CF, et al. Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005. Emerg Infect Dis. 2009;15(4):633-639. https://dx.doi.org/10.3201/eid1504.081281
AMA Mendes MO, Moraes MA, Renoiner EI, et al. Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005. Emerging Infectious Diseases. 2009;15(4):633-639. doi:10.3201/eid1504.081281.
APA Mendes, M. O., Moraes, M. A., Renoiner, E. I., Dantas, M. H., Lanzieri, T. M., Fonseca, C. F....Hatch, D. L. (2009). Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005. Emerging Infectious Diseases, 15(4), 633-639. https://dx.doi.org/10.3201/eid1504.081281.
Dispatch

Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil [PDF - 235 KB - 3 pages]
M. Sabidó et al.

We assessed the acceptability and operational suitability of a rapid point-of-care syphilis test and identified barriers to testing among high-risk groups and healthcare professionals in a sexually transmitted infections clinic in Manaus, Brazil. Use of this test could considerably alleviate the impact of syphilis in hard-to-reach populations in the Amazon region of Brazil.

EID Sabidó M, Benzaken AS, Rodrigues ỆJ, Mayaud P. Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil. Emerg Infect Dis. 2009;15(4):647-649. https://dx.doi.org/10.3201/eid1504.081293
AMA Sabidó M, Benzaken AS, Rodrigues ỆJ, et al. Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil. Emerging Infectious Diseases. 2009;15(4):647-649. doi:10.3201/eid1504.081293.
APA Sabidó, M., Benzaken, A. S., Rodrigues, Ệ. J., & Mayaud, P. (2009). Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil. Emerging Infectious Diseases, 15(4), 647-649. https://dx.doi.org/10.3201/eid1504.081293.

Spatial Distribution of Leprosy in the Amazon Region of Brazil [PDF - 250 KB - 3 pages]
M. L. Penna et al.

To detect areas with increased case-detection rates, we used spatial scan statistics to identify 5 of 10 clusters of leprosy in the Amazon region of Brazil. Despite increasing economic development, population growth, and road infrastructure, leprosy is endemic to this region, which is a source of case exportation to other parts of Brazil.

EID Penna ML, Wand-del-Rey de Oliveira ML, Penna G. Spatial Distribution of Leprosy in the Amazon Region of Brazil. Emerg Infect Dis. 2009;15(4):650-652. https://dx.doi.org/10.3201/eid1504.081378
AMA Penna ML, Wand-del-Rey de Oliveira ML, Penna G. Spatial Distribution of Leprosy in the Amazon Region of Brazil. Emerging Infectious Diseases. 2009;15(4):650-652. doi:10.3201/eid1504.081378.
APA Penna, M. L., Wand-del-Rey de Oliveira, M. L., & Penna, G. (2009). Spatial Distribution of Leprosy in the Amazon Region of Brazil. Emerging Infectious Diseases, 15(4), 650-652. https://dx.doi.org/10.3201/eid1504.081378.

Oral Transmission of Chagas Disease by Consumption of Açaí Palm Fruit, Brazil [PDF - 230 KB - 3 pages]
A. A. Nóbrega et al.

In 2006, a total of 178 cases of acute Chagas disease were reported from the Amazonian state of Pará, Brazil. Eleven occurred in Barcarena and were confirmed by visualization of parasites on blood smears. Using cohort and case–control studies, we implicated oral transmission by consumption of açaí palm fruit.

EID Nóbrega AA, Garcia MH, Tatto E, Obara MT, Costa E, Sobel J, et al. Oral Transmission of Chagas Disease by Consumption of Açaí Palm Fruit, Brazil. Emerg Infect Dis. 2009;15(4):653-655. https://dx.doi.org/10.3201/eid1504.081450
AMA Nóbrega AA, Garcia MH, Tatto E, et al. Oral Transmission of Chagas Disease by Consumption of Açaí Palm Fruit, Brazil. Emerging Infectious Diseases. 2009;15(4):653-655. doi:10.3201/eid1504.081450.
APA Nóbrega, A. A., Garcia, M. H., Tatto, E., Obara, M. T., Costa, E., Sobel, J....Araujo, W. N. (2009). Oral Transmission of Chagas Disease by Consumption of Açaí Palm Fruit, Brazil. Emerging Infectious Diseases, 15(4), 653-655. https://dx.doi.org/10.3201/eid1504.081450.

Severe Acquired Toxoplasmosis Caused by Wild Cycle of Toxoplasma gondii, French Guiana [PDF - 224 KB - 3 pages]
B. Carme et al.

From 1998 through 2006, 44 cases of severe primary toxoplasmosis were observed in French Guiana in immunocompetent adults. Toxoplasma gondii isolates exhibited an atypical multilocus genotype. Severe disease in humans may result from poor host adaptation to neotropical zoonotic strains of T. gondii circulating in a forest-based cycle.

EID Carme B, Demar M, Ajzenberg D, Dardé ML. Severe Acquired Toxoplasmosis Caused by Wild Cycle of Toxoplasma gondii, French Guiana. Emerg Infect Dis. 2009;15(4):656-658. https://dx.doi.org/10.3201/eid1504.081306
AMA Carme B, Demar M, Ajzenberg D, et al. Severe Acquired Toxoplasmosis Caused by Wild Cycle of Toxoplasma gondii, French Guiana. Emerging Infectious Diseases. 2009;15(4):656-658. doi:10.3201/eid1504.081306.
APA Carme, B., Demar, M., Ajzenberg, D., & Dardé, M. L. (2009). Severe Acquired Toxoplasmosis Caused by Wild Cycle of Toxoplasma gondii, French Guiana. Emerging Infectious Diseases, 15(4), 656-658. https://dx.doi.org/10.3201/eid1504.081306.

Links between Climate, Malaria, and Wetlands in the Amazon Basin [PDF - 696 KB - 4 pages]
S. H. Olson et al.

Climate changes are altering patterns of temperature and precipitation, potentially affecting regions of malaria transmission. We show that areas of the Amazon Basin with few wetlands show a variable relationship between precipitation and malaria, while areas with extensive wetlands show a negative relationship with malaria incidence.

EID Olson SH, Gangnon R, Elguero E, Durieux L, Guégan J, Foley JA, et al. Links between Climate, Malaria, and Wetlands in the Amazon Basin. Emerg Infect Dis. 2009;15(4):659-662. https://dx.doi.org/10.3201/eid1504.080822
AMA Olson SH, Gangnon R, Elguero E, et al. Links between Climate, Malaria, and Wetlands in the Amazon Basin. Emerging Infectious Diseases. 2009;15(4):659-662. doi:10.3201/eid1504.080822.
APA Olson, S. H., Gangnon, R., Elguero, E., Durieux, L., Guégan, J., Foley, J. A....Patz, J. A. (2009). Links between Climate, Malaria, and Wetlands in the Amazon Basin. Emerging Infectious Diseases, 15(4), 659-662. https://dx.doi.org/10.3201/eid1504.080822.

Seroprevalence of Kaposi Sarcoma–associated Herpesvirus and Other Serologic Markers in the Brazilian Amazon [PDF - 377 KB - 5 pages]
M. C. Nascimento et al.

To determine the presence of Kaposi sarcoma–associated herpesvirus (KSHV) and other serologic markers, we tested serum specimens of 339 Amerindians, 181 rural non-Amerindians, and 1,133 urban blood donors (13 Amerindians) in the Brazilian Amazon. High KSHV seroprevalence in children and inverse association with herpes simplex virus type 2 indicates predominant nonsexual transmission among Amerindians.

EID Nascimento MC, Sumita LM, Souza VU, Weiss HA, Oliveira J, Mascheretti M, et al. Seroprevalence of Kaposi Sarcoma–associated Herpesvirus and Other Serologic Markers in the Brazilian Amazon. Emerg Infect Dis. 2009;15(4):663-667. https://dx.doi.org/10.3201/eid1504.081488
AMA Nascimento MC, Sumita LM, Souza VU, et al. Seroprevalence of Kaposi Sarcoma–associated Herpesvirus and Other Serologic Markers in the Brazilian Amazon. Emerging Infectious Diseases. 2009;15(4):663-667. doi:10.3201/eid1504.081488.
APA Nascimento, M. C., Sumita, L. M., Souza, V. U., Weiss, H. A., Oliveira, J., Mascheretti, M....Mayaud, P. (2009). Seroprevalence of Kaposi Sarcoma–associated Herpesvirus and Other Serologic Markers in the Brazilian Amazon. Emerging Infectious Diseases, 15(4), 663-667. https://dx.doi.org/10.3201/eid1504.081488.

Concurrent Dengue and Malaria in Cayenne Hospital, French Guiana [PDF - 310 KB - 4 pages]
B. Carme et al.

Dengue–malaria co-infection reports are scarce. Of 1,723 consecutive febrile patients in Cayenne Hospital, 238 had dengue (174 early dengue fever cases) and 393 had malaria (371 acute malaria); 17 had both. Diagnosis of 1 of these 2 infections should not rule out testing for the other infection.

EID Carme B, Matheus S, Donutil G, Raulin O, Adenis A, Morvan J. Concurrent Dengue and Malaria in Cayenne Hospital, French Guiana. Emerg Infect Dis. 2009;15(4):668-671. https://dx.doi.org/10.3201/eid1504.080891
AMA Carme B, Matheus S, Donutil G, et al. Concurrent Dengue and Malaria in Cayenne Hospital, French Guiana. Emerging Infectious Diseases. 2009;15(4):668-671. doi:10.3201/eid1504.080891.
APA Carme, B., Matheus, S., Donutil, G., Raulin, O., Adenis, A., & Morvan, J. (2009). Concurrent Dengue and Malaria in Cayenne Hospital, French Guiana. Emerging Infectious Diseases, 15(4), 668-671. https://dx.doi.org/10.3201/eid1504.080891.
Letters

Lobomycosis in Inshore and Estuarine Dolphins [PDF - 167 KB - 2 pages]
A. E. Paniz-Mondolfi and L. Sander-Hoffmann
EID Paniz-Mondolfi AE, Sander-Hoffmann L. Lobomycosis in Inshore and Estuarine Dolphins. Emerg Infect Dis. 2009;15(4):672-673. https://dx.doi.org/10.3201/eid1504.080955
AMA Paniz-Mondolfi AE, Sander-Hoffmann L. Lobomycosis in Inshore and Estuarine Dolphins. Emerging Infectious Diseases. 2009;15(4):672-673. doi:10.3201/eid1504.080955.
APA Paniz-Mondolfi, A. E., & Sander-Hoffmann, L. (2009). Lobomycosis in Inshore and Estuarine Dolphins. Emerging Infectious Diseases, 15(4), 672-673. https://dx.doi.org/10.3201/eid1504.080955.

Variations in Leprosy Manifestations among HIV-Positive Patients, Manaus, Brazil [PDF - 166 KB - 2 pages]
C. Talhari et al.
EID Talhari C, Matsuo C, Chrusciak-Talhari A, Ferreira LC, Mira M, Talhari S. Variations in Leprosy Manifestations among HIV-Positive Patients, Manaus, Brazil. Emerg Infect Dis. 2009;15(4):673-674. https://dx.doi.org/10.3201/eid1504.081300
AMA Talhari C, Matsuo C, Chrusciak-Talhari A, et al. Variations in Leprosy Manifestations among HIV-Positive Patients, Manaus, Brazil. Emerging Infectious Diseases. 2009;15(4):673-674. doi:10.3201/eid1504.081300.
APA Talhari, C., Matsuo, C., Chrusciak-Talhari, A., Ferreira, L. C., Mira, M., & Talhari, S. (2009). Variations in Leprosy Manifestations among HIV-Positive Patients, Manaus, Brazil. Emerging Infectious Diseases, 15(4), 673-674. https://dx.doi.org/10.3201/eid1504.081300.

Suspected Brazilian Purpuric Fever, Brazilian Amazon Region [PDF - 132 KB - 2 pages]
E. A. Santana-Porto et al.
EID Santana-Porto EA, Oliveira AA, da Costa MR, Pinheiro AS, Oliveira C, Lopes ML, et al. Suspected Brazilian Purpuric Fever, Brazilian Amazon Region. Emerg Infect Dis. 2009;15(4):675-676. https://dx.doi.org/10.3201/eid1504.090014
AMA Santana-Porto EA, Oliveira AA, da Costa MR, et al. Suspected Brazilian Purpuric Fever, Brazilian Amazon Region. Emerging Infectious Diseases. 2009;15(4):675-676. doi:10.3201/eid1504.090014.
APA Santana-Porto, E. A., Oliveira, A. A., da Costa, M. R., Pinheiro, A. S., Oliveira, C., Lopes, M. L....Sobel, J. (2009). Suspected Brazilian Purpuric Fever, Brazilian Amazon Region. Emerging Infectious Diseases, 15(4), 675-676. https://dx.doi.org/10.3201/eid1504.090014.

Hepatitis C Virus in Blood Donors, Brazil [PDF - 157 KB - 3 pages]
K. L. Torres et al.
EID Torres KL, Malheiro A, Tateno A, Amabile de Lima T, Maia LP, Pimentel JP, et al. Hepatitis C Virus in Blood Donors, Brazil. Emerg Infect Dis. 2009;15(4):676-678. https://dx.doi.org/10.3201/eid1504.081288
AMA Torres KL, Malheiro A, Tateno A, et al. Hepatitis C Virus in Blood Donors, Brazil. Emerging Infectious Diseases. 2009;15(4):676-678. doi:10.3201/eid1504.081288.
APA Torres, K. L., Malheiro, A., Tateno, A., Amabile de Lima, T., Maia, L. P., Pimentel, J. P....Levi, J. (2009). Hepatitis C Virus in Blood Donors, Brazil. Emerging Infectious Diseases, 15(4), 676-678. https://dx.doi.org/10.3201/eid1504.081288.

Leishmaniasis in Chaparé, Bolivia [PDF - 189 KB - 3 pages]
E. Rojas et al.
EID Rojas E, Parrado R, Delgado R, Reithinger R, Garcia AL. Leishmaniasis in Chaparé, Bolivia. Emerg Infect Dis. 2009;15(4):678-680. https://dx.doi.org/10.3201/eid1504.081257
AMA Rojas E, Parrado R, Delgado R, et al. Leishmaniasis in Chaparé, Bolivia. Emerging Infectious Diseases. 2009;15(4):678-680. doi:10.3201/eid1504.081257.
APA Rojas, E., Parrado, R., Delgado, R., Reithinger, R., & Garcia, A. L. (2009). Leishmaniasis in Chaparé, Bolivia. Emerging Infectious Diseases, 15(4), 678-680. https://dx.doi.org/10.3201/eid1504.081257.
Volume 15, Number 4—April 2009 - Continued

Research

Experimental Infection of Potential Reservoir Hosts with Venezuelan Equine Encephalitis Virus, Mexico [PDF - 348 KB - 7 pages]
E. R. Deardorff et al.

In 1993, an outbreak of encephalitis among 125 affected equids in coastal Chiapas, Mexico, resulted in a 50% case-fatality rate. The outbreak was attributed to Venezuelan equine encephalitis virus (VEEV) subtype IE, not previously associated with equine disease and death. To better understand the ecology of this VEEV strain in Chiapas, we experimentally infected 5 species of wild rodents and evaluated their competence as reservoir and amplifying hosts. Rodents from 1 species (Baiomys musculus) showed signs of disease and died by day 8 postinoculation. Rodents from the 4 other species (Liomys salvini, Oligoryzomys fulvescens, Oryzomys couesi, and Sigmodon hispidus) became viremic but survived and developed neutralizing antibodies, indicating that multiple species may contribute to VEEV maintenance. By infecting numerous rodent species and producing adequate viremia, VEEV may increase its chances of long-term persistence in nature and could increase risk for establishment in disease-endemic areas and amplification outside the disease-endemic range.

EID Deardorff ER, Forrester NL, Travassos da Rosa AP, Estrada-Franco JG, Navarro-Lopez R, Tesh RB, et al. Experimental Infection of Potential Reservoir Hosts with Venezuelan Equine Encephalitis Virus, Mexico. Emerg Infect Dis. 2009;15(4):519-525. https://dx.doi.org/10.3201/eid1504.081008
AMA Deardorff ER, Forrester NL, Travassos da Rosa AP, et al. Experimental Infection of Potential Reservoir Hosts with Venezuelan Equine Encephalitis Virus, Mexico. Emerging Infectious Diseases. 2009;15(4):519-525. doi:10.3201/eid1504.081008.
APA Deardorff, E. R., Forrester, N. L., Travassos da Rosa, A. P., Estrada-Franco, J. G., Navarro-Lopez, R., Tesh, R. B....Vasilakis, N. (2009). Experimental Infection of Potential Reservoir Hosts with Venezuelan Equine Encephalitis Virus, Mexico. Emerging Infectious Diseases, 15(4), 519-525. https://dx.doi.org/10.3201/eid1504.081008.

Exotic Small Mammals as Potential Reservoirs of Zoonotic Bartonella spp. [PDF - 267 KB - 7 pages]
K. Inoue et al.

To evaluate the risk for emerging human infections caused by zoonotic Bartonella spp. from exotic small mammals, we investigated the prevalence of Bartonella spp. in 546 small mammals (28 species) that had been imported into Japan as pets from Asia, North America, Europe, and the Middle and Near East. We obtained 407 Bartonella isolates and characterized them by molecular phylogenetic analysis of the citrate synthase gene, gltA. The animals examined carried 4 zoonotic Bartonella spp. that cause human endocarditis and neuroretinitis and 6 novel Bartonella spp. at a high prevalence (26.0%, 142/546). We conclude that exotic small mammals potentially serve as reservoirs of several zoonotic Bartonella spp.

EID Inoue K, Maruyama S, Kabeya H, Hagiya K, Izumi Y, Une Y, et al. Exotic Small Mammals as Potential Reservoirs of Zoonotic Bartonella spp.. Emerg Infect Dis. 2009;15(4):526-532. https://dx.doi.org/10.3201/eid1504.081223
AMA Inoue K, Maruyama S, Kabeya H, et al. Exotic Small Mammals as Potential Reservoirs of Zoonotic Bartonella spp.. Emerging Infectious Diseases. 2009;15(4):526-532. doi:10.3201/eid1504.081223.
APA Inoue, K., Maruyama, S., Kabeya, H., Hagiya, K., Izumi, Y., Une, Y....Yoshikawa, Y. (2009). Exotic Small Mammals as Potential Reservoirs of Zoonotic Bartonella spp.. Emerging Infectious Diseases, 15(4), 526-532. https://dx.doi.org/10.3201/eid1504.081223.

Enhancing Time-Series Detection Algorithms for Automated Biosurveillance [PDF - 287 KB - 7 pages]
J. I. Tokars et al.

BioSense is a US national system that uses data from health information systems for automated disease surveillance. We studied 4 time-series algorithm modifications designed to improve sensitivity for detecting artificially added data. To test these modified algorithms, we used reports of daily syndrome visits from 308 Department of Defense (DoD) facilities and 340 hospital emergency departments (EDs). At a constant alert rate of 1%, sensitivity was improved for both datasets by using a minimum standard deviation (SD) of 1.0, a 14–28 day baseline duration for calculating mean and SD, and an adjustment for total clinic visits as a surrogate denominator. Stratifying baseline days into weekdays versus weekends to account for day-of-week effects increased sensitivity for the DoD data but not for the ED data. These enhanced methods may increase sensitivity without increasing the alert rate and may improve the ability to detect outbreaks by using automated surveillance system data.

EID Tokars JI, Burkom H, Xing J, English R, Bloom S, Cox K, et al. Enhancing Time-Series Detection Algorithms for Automated Biosurveillance. Emerg Infect Dis. 2009;15(4):533-539. https://dx.doi.org/10.3201/eid1504.080616
AMA Tokars JI, Burkom H, Xing J, et al. Enhancing Time-Series Detection Algorithms for Automated Biosurveillance. Emerging Infectious Diseases. 2009;15(4):533-539. doi:10.3201/eid1504.080616.
APA Tokars, J. I., Burkom, H., Xing, J., English, R., Bloom, S., Cox, K....Pavlin, J. A. (2009). Enhancing Time-Series Detection Algorithms for Automated Biosurveillance. Emerging Infectious Diseases, 15(4), 533-539. https://dx.doi.org/10.3201/eid1504.080616.

Animal Reservoir Hosts and Fish-borne Zoonotic Trematode Infections on Fish Farms, Vietnam [PDF - 1.32 MB - 7 pages]
N. T. Anh et al.

Fish-borne zoonotic trematodes (FZT) pose a risk to human food safety and health and may cause substantial economic losses in the aquaculture industry. In Nghe An Province, Vietnam, low prevalence of FZT for fish farmers but high prevalence for fish indicate that reservoir hosts other than humans may play a role in sustaining transmission. To determine whether domestic animals may be reservoir hosts, we assessed prevalence and species composition of FZT infections in dogs, cats, and pigs in a fish-farming community in Vietnam. Feces from 35 cats, 80 dogs, and 114 pigs contained small trematode eggs at 48.6%, 35.0%, and 14.4%, respectively; 7 species of adult FZT were recovered from these hosts. These results, combined with data from previous investigations in this community, imply that domestic animals serve as reservoir hosts for FZT and therefore must be included in any control programs to prevent FZT infection in humans.

EID Anh NT, Phuong NT, Murrell KD, Johansen MV, Dalsgaard A, Thu LT, et al. Animal Reservoir Hosts and Fish-borne Zoonotic Trematode Infections on Fish Farms, Vietnam. Emerg Infect Dis. 2009;15(4):540-546. https://dx.doi.org/10.3201/eid1504.081147
AMA Anh NT, Phuong NT, Murrell KD, et al. Animal Reservoir Hosts and Fish-borne Zoonotic Trematode Infections on Fish Farms, Vietnam. Emerging Infectious Diseases. 2009;15(4):540-546. doi:10.3201/eid1504.081147.
APA Anh, N. T., Phuong, N. T., Murrell, K. D., Johansen, M. V., Dalsgaard, A., Thu, L. T....Thamsborg, S. M. (2009). Animal Reservoir Hosts and Fish-borne Zoonotic Trematode Infections on Fish Farms, Vietnam. Emerging Infectious Diseases, 15(4), 540-546. https://dx.doi.org/10.3201/eid1504.081147.

Novel Type of Streptococcus pneumoniae Causing Multidrug-Resistant Acute Otitis Media in Children [PDF - 210 KB - 5 pages]
Q. Xu et al.

After our recent discovery of a Streptococcus pneumoniae 19A “superbug” (Legacy strain) that is resistant to all Food and Drug Administration–approved antimicrobial drugs for treatment of acute otitis media (AOM) in children, other S. pneumoniae isolates from children with AOM were characterized by multilocus sequence typing (MLST). Among 40 isolates studied, 16 (40%) were serotype 19A, and 9 (23%) were resistant to multiple antimicrobial drugs. Two others had unreported sequence types (STs) that expressed the 19A capsule, and 8 (88%) of the 9 multidrug-resistant strains were serotype 19A, including the Legacy strain with the new ST-2722. In genetic relatedness, ST-2722 belonged to a cluster of reported strains of S. pneumoniae in which all strains had 6 of the same alleles as ST-156. The multidrug-resistant strains related to ST-156 expressed different capsular serotypes: 9V, 14, 11A, 15C, and 19F.

EID Xu Q, Pichichero ME, Casey JR, Zeng M. Novel Type of Streptococcus pneumoniae Causing Multidrug-Resistant Acute Otitis Media in Children. Emerg Infect Dis. 2009;15(4):547-551. https://dx.doi.org/10.3201/eid1504.071704
AMA Xu Q, Pichichero ME, Casey JR, et al. Novel Type of Streptococcus pneumoniae Causing Multidrug-Resistant Acute Otitis Media in Children. Emerging Infectious Diseases. 2009;15(4):547-551. doi:10.3201/eid1504.071704.
APA Xu, Q., Pichichero, M. E., Casey, J. R., & Zeng, M. (2009). Novel Type of Streptococcus pneumoniae Causing Multidrug-Resistant Acute Otitis Media in Children. Emerging Infectious Diseases, 15(4), 547-551. https://dx.doi.org/10.3201/eid1504.071704.

Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007–08 Season [PDF - 396 KB - 9 pages]
A. Meijer et al.

In Europe, the 2007–08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant influenza viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of 2007 to 56% in week 19 of 2008 (mean 20%). Neuraminidase genes of ORVs possessing the H275Y substitution formed a homogeneous subgroup closely related to, but distinguishable from, those of oseltamivir-sensitive influenza viruses A (H1N1). Minor variants of ORVs emerged independently, indicating multiclonal ORVs. Overall, the clinical effect of ORVs in Europe, measured by influenza-like illness or acute respiratory infection, was unremarkable and consistent with normal seasonal activity.

EID Meijer A, Lackenby A, Hungnes O, Lina B, van der Werf S, Schweiger B, et al. Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007–08 Season. Emerg Infect Dis. 2009;15(4):552-560. https://dx.doi.org/10.3201/eid1504.081280
AMA Meijer A, Lackenby A, Hungnes O, et al. Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007–08 Season. Emerging Infectious Diseases. 2009;15(4):552-560. doi:10.3201/eid1504.081280.
APA Meijer, A., Lackenby, A., Hungnes, O., Lina, B., van der Werf, S., Schweiger, B....Zambon, M. (2009). Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007–08 Season. Emerging Infectious Diseases, 15(4), 552-560. https://dx.doi.org/10.3201/eid1504.081280.

Hantavirus Pulmonary Syndrome, Central Plateau, Southeastern, and Southern Brazil [PDF - 190 KB - 7 pages]
L. T. Figueiredo et al.

Hantavirus pulmonary syndrome (HPS) is an increasing health problem in Brazil because of encroachment of sprawling urban, agricultural, and cattle-raising areas into habitats of subfamily Sigmodontinae rodents, which serve as hantavirus reservoirs. From 1993 through June 2007, a total of 884 cases of HPS were reported in Brazil (case-fatality rate 39%). To better understand this emerging disease, we collected 89 human serum samples and 68 rodent lung samples containing antibodies to hantavirus from a 2,500-km-wide area in Brazil. RNA was isolated from human samples and rodent tissues and subjected to reverse transcription–PCR. Partial sequences of nucleocapsid protein and glycoprotein genes from 22 human and 16 rodent sources indicated only Araraquara virus and Juquitiba virus lineages. The case-fatality rate of HPS was higher in the area with Araraquara virus. This virus, which may be the most virulent hantavirus in Brazil, was associated with areas that have had greater anthropogenic changes.

EID Figueiredo LT, Moreli ML, de Sousa RL, Borges AA, de Figueiredo GG, Machado AM, et al. Hantavirus Pulmonary Syndrome, Central Plateau, Southeastern, and Southern Brazil. Emerg Infect Dis. 2009;15(4):561-567. https://dx.doi.org/10.3201/eid1504.080289
AMA Figueiredo LT, Moreli ML, de Sousa RL, et al. Hantavirus Pulmonary Syndrome, Central Plateau, Southeastern, and Southern Brazil. Emerging Infectious Diseases. 2009;15(4):561-567. doi:10.3201/eid1504.080289.
APA Figueiredo, L. T., Moreli, M. L., de Sousa, R. L., Borges, A. A., de Figueiredo, G. G., Machado, A. M....Zanotto, P. M. (2009). Hantavirus Pulmonary Syndrome, Central Plateau, Southeastern, and Southern Brazil. Emerging Infectious Diseases, 15(4), 561-567. https://dx.doi.org/10.3201/eid1504.080289.
Dispatches

Rift Valley Fever, Mayotte, 2007–2008 [PDF - 139 KB - 3 pages]
D. Sissoko et al.

After the 2006–2007 epidemic wave of Rift Valley fever (RVF) in East Africa and its circulation in the Comoros, laboratory case-finding of RVF was conducted in Mayotte from September 2007 through May 2008. Ten recent human RVF cases were detected, which confirms the indigenous transmission of RFV virus in Mayotte.

EID Sissoko D, Giry C, Gabrie P, Tarantola A, Pettinelli F, Collet L, et al. Rift Valley Fever, Mayotte, 2007–2008. Emerg Infect Dis. 2009;15(4):568-570. https://dx.doi.org/10.3201/eid1504.081045
AMA Sissoko D, Giry C, Gabrie P, et al. Rift Valley Fever, Mayotte, 2007–2008. Emerging Infectious Diseases. 2009;15(4):568-570. doi:10.3201/eid1504.081045.
APA Sissoko, D., Giry, C., Gabrie, P., Tarantola, A., Pettinelli, F., Collet, L....Pierre, V. (2009). Rift Valley Fever, Mayotte, 2007–2008. Emerging Infectious Diseases, 15(4), 568-570. https://dx.doi.org/10.3201/eid1504.081045.

High Prevalence of Spirochetosis in Cholera Patients, Bangladesh [PDF - 197 KB - 3 pages]
E. J. Nelson et al.

The microbes that accompany the etiologic agent of cholera, Vibrio cholerae, are only now being defined. In this study, spirochetes from the genus Brachyspira were identified at high titers in more than one third of cholera patients in Bangladesh. Spirochetosis should now be tracked in the setting of cholera outbreaks.

EID Nelson EJ, Tanudra A, Chowdhury A, Kane AV, Qadri F, Calderwood SB, et al. High Prevalence of Spirochetosis in Cholera Patients, Bangladesh. Emerg Infect Dis. 2009;15(4):571-573. https://dx.doi.org/10.3201/eid1504.081214
AMA Nelson EJ, Tanudra A, Chowdhury A, et al. High Prevalence of Spirochetosis in Cholera Patients, Bangladesh. Emerging Infectious Diseases. 2009;15(4):571-573. doi:10.3201/eid1504.081214.
APA Nelson, E. J., Tanudra, A., Chowdhury, A., Kane, A. V., Qadri, F., Calderwood, S. B....Camilli, A. (2009). High Prevalence of Spirochetosis in Cholera Patients, Bangladesh. Emerging Infectious Diseases, 15(4), 571-573. https://dx.doi.org/10.3201/eid1504.081214.

Genetic Diversity of Toscana Virus [PDF - 356 KB - 4 pages]
X. Collao et al.

Distribution of Toscana virus (TOSV) is evolving with climate change, and pathogenicity may be higher in nonexposed populations outside areas of current prevalence (Mediterranean Basin). To characterize genetic diversity of TOSV, we determined the coding sequences of isolates from Spain and France. TOSV is more diverse than other well-studied phleboviruses (e.g.,Rift Valley fever virus).

EID Collao X, Palacios G, Sanbonmatsu-Gámez S, Pérez-Ruiz M, Negredo AI, Navarro-Marí J, et al. Genetic Diversity of Toscana Virus. Emerg Infect Dis. 2009;15(4):574-577. https://dx.doi.org/10.3201/eid1504.081111
AMA Collao X, Palacios G, Sanbonmatsu-Gámez S, et al. Genetic Diversity of Toscana Virus. Emerging Infectious Diseases. 2009;15(4):574-577. doi:10.3201/eid1504.081111.
APA Collao, X., Palacios, G., Sanbonmatsu-Gámez, S., Pérez-Ruiz, M., Negredo, A. I., Navarro-Marí, J....Sánchez-Seco, M. (2009). Genetic Diversity of Toscana Virus. Emerging Infectious Diseases, 15(4), 574-577. https://dx.doi.org/10.3201/eid1504.081111.

Co-infection with Pansensitive and Multidrug-Resistant Strains of Mycobacterium tuberculosis [PDF - 190 KB - 3 pages]
M. P. Mendez et al.

We report a case of a 23-year-old HIV-negative man with multidrug-resistant Mycobacterium tuberculosis that became evident while he was being treated for M. tuberculosis that was sensitive to all first-line drugs. This case should alert clinicians to consider co-infection as a possible cause of recrudescent disease.

EID Mendez MP, Landon ME, McCloud MK, Davidson P, Christensen PJ. Co-infection with Pansensitive and Multidrug-Resistant Strains of Mycobacterium tuberculosis. Emerg Infect Dis. 2009;15(4):578-580. https://dx.doi.org/10.3201/eid1504.080592
AMA Mendez MP, Landon ME, McCloud MK, et al. Co-infection with Pansensitive and Multidrug-Resistant Strains of Mycobacterium tuberculosis. Emerging Infectious Diseases. 2009;15(4):578-580. doi:10.3201/eid1504.080592.
APA Mendez, M. P., Landon, M. E., McCloud, M. K., Davidson, P., & Christensen, P. J. (2009). Co-infection with Pansensitive and Multidrug-Resistant Strains of Mycobacterium tuberculosis. Emerging Infectious Diseases, 15(4), 578-580. https://dx.doi.org/10.3201/eid1504.080592.

Enterovirus 71 Maternal Antibodies in Infants, Taiwan [PDF - 251 KB - 4 pages]
S. Luo et al.

Enterovirus 71 (EV71) causes life-threatening disease outbreaks in young children in Asia. This cohort study was conducted to understand the dynamics of maternal EV71 antibodies in Taiwanese young infants. Approximately 50% of neonates had detectable EV71 neutralizing antibodies, which declined to almost undetectable levels by 6 months of age.

EID Luo S, Chiang P, Chao A, Liou G, Lin R, Lin T, et al. Enterovirus 71 Maternal Antibodies in Infants, Taiwan. Emerg Infect Dis. 2009;15(4):581-584. https://dx.doi.org/10.3201/eid1504.081550
AMA Luo S, Chiang P, Chao A, et al. Enterovirus 71 Maternal Antibodies in Infants, Taiwan. Emerging Infectious Diseases. 2009;15(4):581-584. doi:10.3201/eid1504.081550.
APA Luo, S., Chiang, P., Chao, A., Liou, G., Lin, R., Lin, T....Lee, M. (2009). Enterovirus 71 Maternal Antibodies in Infants, Taiwan. Emerging Infectious Diseases, 15(4), 581-584. https://dx.doi.org/10.3201/eid1504.081550.

Correlation between Tick Density and Pathogen Endemicity, New Hampshire [PDF - 212 KB - 3 pages]
S. T. Walk et al.

To assess the endemicity of tick-borne pathogens in New Hampshire, we surveyed adult tick vectors. Pathogens were more prevalent in areas of high tick density, suggesting a correlation between tick establishment and pathogen endemicity. Infection rates in ticks correlated with disease frequency in humans.

EID Walk ST, Xu G, Stull JW, Rich SM. Correlation between Tick Density and Pathogen Endemicity, New Hampshire. Emerg Infect Dis. 2009;15(4):585-587. https://dx.doi.org/10.3201/eid1504.080940
AMA Walk ST, Xu G, Stull JW, et al. Correlation between Tick Density and Pathogen Endemicity, New Hampshire. Emerging Infectious Diseases. 2009;15(4):585-587. doi:10.3201/eid1504.080940.
APA Walk, S. T., Xu, G., Stull, J. W., & Rich, S. M. (2009). Correlation between Tick Density and Pathogen Endemicity, New Hampshire. Emerging Infectious Diseases, 15(4), 585-587. https://dx.doi.org/10.3201/eid1504.080940.

Lobomycosis in Offshore Bottlenose Dolphins (Tursiops truncatus), North Carolina [PDF - 205 KB - 3 pages]
D. S. Rotstein et al.

Lacazia loboi, a cutaneous fungus, is found in humans and dolphins from transitional tropical (Florida) and tropical (South America) regions. We report 2 cases of lobomycosis in stranded bottlenose dolphins (Tursiops truncatus) and 1 case of lobomycosis-like disease in 1 free-swimming, pelagic, offshore bottlenose dolphin from North Carolina, where no cases have previously been observed.

EID Rotstein DS, Burdett LG, McLellan W, Schwacke L, Rowles T, Terio KA, et al. Lobomycosis in Offshore Bottlenose Dolphins (Tursiops truncatus), North Carolina. Emerg Infect Dis. 2009;15(4):588-590. https://dx.doi.org/10.3201/eid1504.081358
AMA Rotstein DS, Burdett LG, McLellan W, et al. Lobomycosis in Offshore Bottlenose Dolphins (Tursiops truncatus), North Carolina. Emerging Infectious Diseases. 2009;15(4):588-590. doi:10.3201/eid1504.081358.
APA Rotstein, D. S., Burdett, L. G., McLellan, W., Schwacke, L., Rowles, T., Terio, K. A....Pabst, A. (2009). Lobomycosis in Offshore Bottlenose Dolphins (Tursiops truncatus), North Carolina. Emerging Infectious Diseases, 15(4), 588-590. https://dx.doi.org/10.3201/eid1504.081358.

Concurrent Chikungunya and Dengue Virus Infections during Simultaneous Outbreaks, Gabon, 2007 [PDF - 211 KB - 3 pages]
E. M. Leroy et al.

An outbreak of febrile illness occurred in Gabon in 2007, with 20,000 suspected cases. Chikungunya or dengue-2 virus infections were identified in 321 patients; 8 patients had documented co-infections. Aedes albopictus was identified as the principal vector for the transmission of both viruses.

EID Leroy EM, Nkoghe D, Ollomo B, Nze-Nkogue C, Becquart P, Grard G, et al. Concurrent Chikungunya and Dengue Virus Infections during Simultaneous Outbreaks, Gabon, 2007. Emerg Infect Dis. 2009;15(4):591-593. https://dx.doi.org/10.3201/eid1504.080664
AMA Leroy EM, Nkoghe D, Ollomo B, et al. Concurrent Chikungunya and Dengue Virus Infections during Simultaneous Outbreaks, Gabon, 2007. Emerging Infectious Diseases. 2009;15(4):591-593. doi:10.3201/eid1504.080664.
APA Leroy, E. M., Nkoghe, D., Ollomo, B., Nze-Nkogue, C., Becquart, P., Grard, G....de Lamballerie, X. (2009). Concurrent Chikungunya and Dengue Virus Infections during Simultaneous Outbreaks, Gabon, 2007. Emerging Infectious Diseases, 15(4), 591-593. https://dx.doi.org/10.3201/eid1504.080664.

Gnathostomiasis Acquired by British Tourists in Botswana [PDF - 304 KB - 4 pages]
J. S. Herman et al.

Infection with Gnathostoma spinigerum has been generally confined to Southeast Asia and Central and South America. However, gnathostomiasis was recently found in British tourists who had visited Botswana. Consequently, travel to Africa should now be considered a risk factor for gnathostomiasis.

EID Herman JS, Wall EC, van Tulleken C, Godfrey-Faussett P, Bailey RL, Chiodini P. Gnathostomiasis Acquired by British Tourists in Botswana. Emerg Infect Dis. 2009;15(4):594-597. https://dx.doi.org/10.3201/eid1504.081646
AMA Herman JS, Wall EC, van Tulleken C, et al. Gnathostomiasis Acquired by British Tourists in Botswana. Emerging Infectious Diseases. 2009;15(4):594-597. doi:10.3201/eid1504.081646.
APA Herman, J. S., Wall, E. C., van Tulleken, C., Godfrey-Faussett, P., Bailey, R. L., & Chiodini, P. (2009). Gnathostomiasis Acquired by British Tourists in Botswana. Emerging Infectious Diseases, 15(4), 594-597. https://dx.doi.org/10.3201/eid1504.081646.

Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain [PDF - 219 KB - 3 pages]
H. Ternavasio-de la Vega et al.

An unusual skin and soft tissue infection of the lower limbs has been observed in immigrants from sub-Saharan Africa who cross the Atlantic Ocean crowded on small fishing boats (pateras). Response to conventional treatment is usually poor. Extreme extrinsic factors (including new pathogens) may contribute to the etiology of the infection and its pathogenesis.

EID Ternavasio-de la Vega H, Ángel-Moreno A, Hernández-Cabrera M, Pisos-Álamo E, Bolaños-Rivero M, Carranza-Rodriguez C, et al. Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain. Emerg Infect Dis. 2009;15(4):598-600. https://dx.doi.org/10.3201/eid1504.081457
AMA Ternavasio-de la Vega H, Ángel-Moreno A, Hernández-Cabrera M, et al. Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain. Emerging Infectious Diseases. 2009;15(4):598-600. doi:10.3201/eid1504.081457.
APA Ternavasio-de la Vega, H., Ángel-Moreno, A., Hernández-Cabrera, M., Pisos-Álamo, E., Bolaños-Rivero, M., Carranza-Rodriguez, C....Pérez-Arellano, J. (2009). Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain. Emerging Infectious Diseases, 15(4), 598-600. https://dx.doi.org/10.3201/eid1504.081457.

Congenital Transmission of Chagas Disease in Latin American Immigrants in Switzerland [PDF - 176 KB - 3 pages]
Y. Jackson et al.

International migration has changed the epidemiologic patterns of Chagas disease. Recently, 2 cases of Chagas disease transmitted from Latin American women to their newborns were diagnosed in Geneva, Switzerland. A retrospective study to detect Chagas disease showed a prevalence of 9.7% among 72 Latin American women tested during pregnancy in Switzerland.

EID Jackson Y, Myers C, Diana A, Marti H, Wolff H, Chappuis F, et al. Congenital Transmission of Chagas Disease in Latin American Immigrants in Switzerland. Emerg Infect Dis. 2009;15(4):601-603. https://dx.doi.org/10.3201/eid1504.080438
AMA Jackson Y, Myers C, Diana A, et al. Congenital Transmission of Chagas Disease in Latin American Immigrants in Switzerland. Emerging Infectious Diseases. 2009;15(4):601-603. doi:10.3201/eid1504.080438.
APA Jackson, Y., Myers, C., Diana, A., Marti, H., Wolff, H., Chappuis, F....Gervaix, A. (2009). Congenital Transmission of Chagas Disease in Latin American Immigrants in Switzerland. Emerging Infectious Diseases, 15(4), 601-603. https://dx.doi.org/10.3201/eid1504.080438.

Isolation of Genotype V St. Louis Encephalitis Virus in Florida [PDF - 158 KB - 3 pages]
C. L. Ottendorfer et al.

We isolated and characterized St. Louis encephalitis virus (SLEV) from cloacal swabs of naturally exposed adult sentinel chickens in 2006. Phylogenetic analysis of SLEV strains isolated in Florida indicated that Brazilian SLEV circulated in 1972 and 2006; lineages were VA and VB.

EID Ottendorfer CL, Ambrose JH, White GS, Unnasch TR, Stark LM. Isolation of Genotype V St. Louis Encephalitis Virus in Florida. Emerg Infect Dis. 2009;15(4):604-606. https://dx.doi.org/10.3201/eid1504.081094
AMA Ottendorfer CL, Ambrose JH, White GS, et al. Isolation of Genotype V St. Louis Encephalitis Virus in Florida. Emerging Infectious Diseases. 2009;15(4):604-606. doi:10.3201/eid1504.081094.
APA Ottendorfer, C. L., Ambrose, J. H., White, G. S., Unnasch, T. R., & Stark, L. M. (2009). Isolation of Genotype V St. Louis Encephalitis Virus in Florida. Emerging Infectious Diseases, 15(4), 604-606. https://dx.doi.org/10.3201/eid1504.081094.
Letters

Chagasic Cardiomyopathy in Immigrants from Latin America to Spain [PDF - 68 KB - 2 pages]
A. Pérez de Ayala et al.
EID Pérez de Ayala A, Pérez-Molina J, Norman FF, López-Vélez R. Chagasic Cardiomyopathy in Immigrants from Latin America to Spain. Emerg Infect Dis. 2009;15(4):607-608. https://dx.doi.org/10.3201/eid1504.080938
AMA Pérez de Ayala A, Pérez-Molina J, Norman FF, et al. Chagasic Cardiomyopathy in Immigrants from Latin America to Spain. Emerging Infectious Diseases. 2009;15(4):607-608. doi:10.3201/eid1504.080938.
APA Pérez de Ayala, A., Pérez-Molina, J., Norman, F. F., & López-Vélez, R. (2009). Chagasic Cardiomyopathy in Immigrants from Latin America to Spain. Emerging Infectious Diseases, 15(4), 607-608. https://dx.doi.org/10.3201/eid1504.080938.

Spotted Fever Group Rickettsia sp. Closely Related to R. japonica, Thailand [PDF - 114 KB - 2 pages]
N. Takada et al.
EID Takada N, Fujita H, Kawabata H, Takajo I, Sakata A, Takano A, et al. Spotted Fever Group Rickettsia sp. Closely Related to R. japonica, Thailand. Emerg Infect Dis. 2009;15(4):610-611. https://dx.doi.org/10.3201/eid1504.071271
AMA Takada N, Fujita H, Kawabata H, et al. Spotted Fever Group Rickettsia sp. Closely Related to R. japonica, Thailand. Emerging Infectious Diseases. 2009;15(4):610-611. doi:10.3201/eid1504.071271.
APA Takada, N., Fujita, H., Kawabata, H., Takajo, I., Sakata, A., Takano, A....Chaithong, U. (2009). Spotted Fever Group Rickettsia sp. Closely Related to R. japonica, Thailand. Emerging Infectious Diseases, 15(4), 610-611. https://dx.doi.org/10.3201/eid1504.071271.

Segniliparus rugosus Infection, Australia [PDF - 79 KB - 3 pages]
T. Hansen et al.
EID Hansen T, Van Kerckhof J, Jelfs P, Wainwright C, Ryan P, Coulter C. Segniliparus rugosus Infection, Australia. Emerg Infect Dis. 2009;15(4):611-613. https://dx.doi.org/10.3201/eid1504.081479
AMA Hansen T, Van Kerckhof J, Jelfs P, et al. Segniliparus rugosus Infection, Australia. Emerging Infectious Diseases. 2009;15(4):611-613. doi:10.3201/eid1504.081479.
APA Hansen, T., Van Kerckhof, J., Jelfs, P., Wainwright, C., Ryan, P., & Coulter, C. (2009). Segniliparus rugosus Infection, Australia. Emerging Infectious Diseases, 15(4), 611-613. https://dx.doi.org/10.3201/eid1504.081479.

Multigenotype Q Fever Outbreak, the Netherlands [PDF - 65 KB - 2 pages]
C. H. Klaassen et al.
EID Klaassen CH, Nabuurs-Franssen MH, Tilburg JJ, Hamans MA, Horrevorts AM. Multigenotype Q Fever Outbreak, the Netherlands. Emerg Infect Dis. 2009;15(4):613-614. https://dx.doi.org/10.3201/eid1504.081612
AMA Klaassen CH, Nabuurs-Franssen MH, Tilburg JJ, et al. Multigenotype Q Fever Outbreak, the Netherlands. Emerging Infectious Diseases. 2009;15(4):613-614. doi:10.3201/eid1504.081612.
APA Klaassen, C. H., Nabuurs-Franssen, M. H., Tilburg, J. J., Hamans, M. A., & Horrevorts, A. M. (2009). Multigenotype Q Fever Outbreak, the Netherlands. Emerging Infectious Diseases, 15(4), 613-614. https://dx.doi.org/10.3201/eid1504.081612.

Correlation between Buruli Ulcer and Vector-borne Notifiable Diseases, Victoria, Australia [PDF - 67 KB - 2 pages]
P. Johnson and C. J. Lavender
EID Johnson P, Lavender CJ. Correlation between Buruli Ulcer and Vector-borne Notifiable Diseases, Victoria, Australia. Emerg Infect Dis. 2009;15(4):614-615. https://dx.doi.org/10.3201/eid1504.081162
AMA Johnson P, Lavender CJ. Correlation between Buruli Ulcer and Vector-borne Notifiable Diseases, Victoria, Australia. Emerging Infectious Diseases. 2009;15(4):614-615. doi:10.3201/eid1504.081162.
APA Johnson, P., & Lavender, C. J. (2009). Correlation between Buruli Ulcer and Vector-borne Notifiable Diseases, Victoria, Australia. Emerging Infectious Diseases, 15(4), 614-615. https://dx.doi.org/10.3201/eid1504.081162.

Avian Influenza Risk Perception among Poultry Workers, Nigeria [PDF - 69 KB - 2 pages]
F. O. Fasina et al.
EID Fasina FO, Bisschop SP, Ibironke AA, Meseko CA. Avian Influenza Risk Perception among Poultry Workers, Nigeria. Emerg Infect Dis. 2009;15(4):616-617. https://dx.doi.org/10.3201/eid1504.070159
AMA Fasina FO, Bisschop SP, Ibironke AA, et al. Avian Influenza Risk Perception among Poultry Workers, Nigeria. Emerging Infectious Diseases. 2009;15(4):616-617. doi:10.3201/eid1504.070159.
APA Fasina, F. O., Bisschop, S. P., Ibironke, A. A., & Meseko, C. A. (2009). Avian Influenza Risk Perception among Poultry Workers, Nigeria. Emerging Infectious Diseases, 15(4), 616-617. https://dx.doi.org/10.3201/eid1504.070159.

Mycobacterium avium subsp. hominissuis Infection in a Pet Parrot [PDF - 80 KB - 3 pages]
E. J. Shitaye et al.
EID Shitaye EJ, Grymova V, Grym M, Halouzka R, Horvathova A, Moravkova M, et al. Mycobacterium avium subsp. hominissuis Infection in a Pet Parrot. Emerg Infect Dis. 2009;15(4):617-619. https://dx.doi.org/10.3201/eid1504.081003
AMA Shitaye EJ, Grymova V, Grym M, et al. Mycobacterium avium subsp. hominissuis Infection in a Pet Parrot. Emerging Infectious Diseases. 2009;15(4):617-619. doi:10.3201/eid1504.081003.
APA Shitaye, E. J., Grymova, V., Grym, M., Halouzka, R., Horvathova, A., Moravkova, M....Pavlik, I. (2009). Mycobacterium avium subsp. hominissuis Infection in a Pet Parrot. Emerging Infectious Diseases, 15(4), 617-619. https://dx.doi.org/10.3201/eid1504.081003.

Mycobacterium colombiense and Pseudotuberculous Lymphadenopathy [PDF - 80 KB - 2 pages]
K. Vuorenmaa et al.
EID Vuorenmaa K, Ben Salah I, Barlogis V, Chambost H, Drancourt M. Mycobacterium colombiense and Pseudotuberculous Lymphadenopathy. Emerg Infect Dis. 2009;15(4):619-620. https://dx.doi.org/10.3201/eid1504.081436
AMA Vuorenmaa K, Ben Salah I, Barlogis V, et al. Mycobacterium colombiense and Pseudotuberculous Lymphadenopathy. Emerging Infectious Diseases. 2009;15(4):619-620. doi:10.3201/eid1504.081436.
APA Vuorenmaa, K., Ben Salah, I., Barlogis, V., Chambost, H., & Drancourt, M. (2009). Mycobacterium colombiense and Pseudotuberculous Lymphadenopathy. Emerging Infectious Diseases, 15(4), 619-620. https://dx.doi.org/10.3201/eid1504.081436.

Leptospira noguchii and Human and Animal Leptospirosis, Southern Brazil [PDF - 112 KB - 3 pages]
É. F. Silva et al.
EID Silva ÉF, Cerqueira GM, Seyffert N, Seixas FK, Hartwig DD, Athanazio DA, et al. Leptospira noguchii and Human and Animal Leptospirosis, Southern Brazil. Emerg Infect Dis. 2009;15(4):621-623. https://dx.doi.org/10.3201/eid1504.071669
AMA Silva ÉF, Cerqueira GM, Seyffert N, et al. Leptospira noguchii and Human and Animal Leptospirosis, Southern Brazil. Emerging Infectious Diseases. 2009;15(4):621-623. doi:10.3201/eid1504.071669.
APA Silva, É. F., Cerqueira, G. M., Seyffert, N., Seixas, F. K., Hartwig, D. D., Athanazio, D. A....Dellagostin, O. A. (2009). Leptospira noguchii and Human and Animal Leptospirosis, Southern Brazil. Emerging Infectious Diseases, 15(4), 621-623. https://dx.doi.org/10.3201/eid1504.071669.

Aquaculture and Florfenicol Resistance in Salmonella enterica Serovar Typhimurium DT104 [PDF - 120 KB - 2 pages]
F. C. Cabello and P. Smith
EID Cabello FC, Smith P. Aquaculture and Florfenicol Resistance in Salmonella enterica Serovar Typhimurium DT104. Emerg Infect Dis. 2009;15(4):623-624. https://dx.doi.org/10.3201/eid1504.081171
AMA Cabello FC, Smith P. Aquaculture and Florfenicol Resistance in Salmonella enterica Serovar Typhimurium DT104. Emerging Infectious Diseases. 2009;15(4):623-624. doi:10.3201/eid1504.081171.
APA Cabello, F. C., & Smith, P. (2009). Aquaculture and Florfenicol Resistance in Salmonella enterica Serovar Typhimurium DT104. Emerging Infectious Diseases, 15(4), 623-624. https://dx.doi.org/10.3201/eid1504.081171.

Lethal Bluetongue Virus Serotype 1 Infection in Llamas [PDF - 122 KB - 3 pages]
G. Meyer et al.
EID Meyer G, Lacroux C, Léger S, Top S, Goyeau K, Deplanche M, et al. Lethal Bluetongue Virus Serotype 1 Infection in Llamas. Emerg Infect Dis. 2009;15(4):608-610. https://dx.doi.org/10.3201/eid1504.081514
AMA Meyer G, Lacroux C, Léger S, et al. Lethal Bluetongue Virus Serotype 1 Infection in Llamas. Emerging Infectious Diseases. 2009;15(4):608-610. doi:10.3201/eid1504.081514.
APA Meyer, G., Lacroux, C., Léger, S., Top, S., Goyeau, K., Deplanche, M....Lemaire, M. (2009). Lethal Bluetongue Virus Serotype 1 Infection in Llamas. Emerging Infectious Diseases, 15(4), 608-610. https://dx.doi.org/10.3201/eid1504.081514.
Another Dimension

Travels in Gene Space [PDF - 141 KB - 1 page]
J. W. Tang
EID Tang JW. Travels in Gene Space. Emerg Infect Dis. 2009;15(4):681. https://dx.doi.org/10.3201/eid1504.080823
AMA Tang JW. Travels in Gene Space. Emerging Infectious Diseases. 2009;15(4):681. doi:10.3201/eid1504.080823.
APA Tang, J. W. (2009). Travels in Gene Space. Emerging Infectious Diseases, 15(4), 681. https://dx.doi.org/10.3201/eid1504.080823.
About the Cover

When You Were a Tadpole and I Was a Fish [PDF - 236 KB - 2 pages]
P. Potter
EID Potter P. When You Were a Tadpole and I Was a Fish. Emerg Infect Dis. 2009;15(4):682-683. https://dx.doi.org/10.3201/eid1504.ac1504
AMA Potter P. When You Were a Tadpole and I Was a Fish. Emerging Infectious Diseases. 2009;15(4):682-683. doi:10.3201/eid1504.ac1504.
APA Potter, P. (2009). When You Were a Tadpole and I Was a Fish. Emerging Infectious Diseases, 15(4), 682-683. https://dx.doi.org/10.3201/eid1504.ac1504.
Conference Summaries

International Course on Emerging Viruses in the Amazon Region
A. L. Gomes et al.
Corrections

Erratum—Vol. 15, No. 2 [PDF - 155 KB - 1 page]
EID Erratum—Vol. 15, No. 2. Emerg Infect Dis. 2009;15(4):680. https://dx.doi.org/10.3201/eid1504.c11504
AMA Erratum—Vol. 15, No. 2. Emerging Infectious Diseases. 2009;15(4):680. doi:10.3201/eid1504.c11504.
APA (2009). Erratum—Vol. 15, No. 2. Emerging Infectious Diseases, 15(4), 680. https://dx.doi.org/10.3201/eid1504.c11504.
News and Notes

Etymologia: Kaposi [PDF - 131 KB - 1 page]
EID Etymologia: Kaposi. Emerg Infect Dis. 2009;15(4):662. https://dx.doi.org/10.3201/eid1504.et1504
AMA Etymologia: Kaposi. Emerging Infectious Diseases. 2009;15(4):662. doi:10.3201/eid1504.et1504.
APA (2009). Etymologia: Kaposi. Emerging Infectious Diseases, 15(4), 662. https://dx.doi.org/10.3201/eid1504.et1504.
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Page updated: June 07, 2012
Page reviewed: June 07, 2012
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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