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Issue Cover for Volume 19, Number 9—September 2013

Volume 19, Number 9—September 2013

[PDF - 11.46 MB - 207 pages]

Perspective

Acute Encephalitis Syndrome Surveillance, Kushinagar District, Uttar Pradesh, India, 2011–2012 [PDF - 1.28 MB - 2 pages]
M. Kakkar et al.

In India, quality surveillance for acute encephalitis syndrome (AES), including laboratory testing, is necessary for understanding the epidemiology and etiology of AES, planning interventions, and developing policy. We reviewed AES surveillance data for January 2011–June 2012 from Kushinagar District, Uttar Pradesh, India. Data were cleaned, incidence was determined, and demographic characteristics of cases and data quality were analyzed. A total of 812 AES case records were identified, of which 23% had illogical entries. AES incidence was highest among boys <6 years of age, and cases peaked during monsoon season. Records for laboratory results (available for Japanese encephalitis but not AES) and vaccination history were largely incomplete, so inferences about the epidemiology and etiology of AES could not be made. The low-quality AES/Japanese encephalitis surveillance data in this area provide little evidence to support development of prevention and control measures, estimate the effect of interventions, and avoid the waste of public health resources.

EID Kakkar M, Rogawski ET, Abbas S, Chaturvedi S, Dhole TN, Hossain S, et al. Acute Encephalitis Syndrome Surveillance, Kushinagar District, Uttar Pradesh, India, 2011–2012. Emerg Infect Dis. 2013;19(9):1361-1369. https://dx.doi.org/10.3201/eid1909.121855
AMA Kakkar M, Rogawski ET, Abbas S, et al. Acute Encephalitis Syndrome Surveillance, Kushinagar District, Uttar Pradesh, India, 2011–2012. Emerging Infectious Diseases. 2013;19(9):1361-1369. doi:10.3201/eid1909.121855.
APA Kakkar, M., Rogawski, E. T., Abbas, S., Chaturvedi, S., Dhole, T. N., Hossain, S....Krishnan, S. K. (2013). Acute Encephalitis Syndrome Surveillance, Kushinagar District, Uttar Pradesh, India, 2011–2012. Emerging Infectious Diseases, 19(9), 1361-1369. https://dx.doi.org/10.3201/eid1909.121855.
Synopses

Detection of Diphtheritic Polyneuropathy by Acute Flaccid Paralysis Surveillance, India [PDF - 484 KB - 6 pages]
F. J. Mateen et al.

Diphtheritic polyneuropathy is a vaccine-preventable illness caused by exotoxin-producing strains of Corynebacterium diphtheriae. We present a retrospective convenience case series of 15 children (6 girls) <15 years of age (mean age 5.2 years, case-fatality rate 53%, and 1 additional case-patient who was ventilator dependent at the time of last follow-up; median follow-up period 60 days) with signs and symptoms suggestive of diphtheritic polyneuropathy. All cases were identified through national acute flaccid paralysis surveillance, which was designed to detect poliomyelitis in India during 2002–2008. We also report data on detection of diphtheritic polyneuropathy compared with other causes of acute flaccid paralysis identified by this surveillance system.

EID Mateen FJ, Bahl S, Khera A, Sutter RW. Detection of Diphtheritic Polyneuropathy by Acute Flaccid Paralysis Surveillance, India. Emerg Infect Dis. 2013;19(9):1370-1373. https://dx.doi.org/10.3201/eid1909.130117
AMA Mateen FJ, Bahl S, Khera A, et al. Detection of Diphtheritic Polyneuropathy by Acute Flaccid Paralysis Surveillance, India. Emerging Infectious Diseases. 2013;19(9):1370-1373. doi:10.3201/eid1909.130117.
APA Mateen, F. J., Bahl, S., Khera, A., & Sutter, R. W. (2013). Detection of Diphtheritic Polyneuropathy by Acute Flaccid Paralysis Surveillance, India. Emerging Infectious Diseases, 19(9), 1370-1373. https://dx.doi.org/10.3201/eid1909.130117.

Nodding Syndrome [PDF - 561 KB - 11 pages]
S. F. Dowell et al.

An epidemic illness characterized by head nodding associated with onchocerciasis has been described in eastern Africa since the early 1960s; we summarize published reports and recent studies. Onset of nodding occurs in previously healthy 5–15-year-old children and is often triggered by eating or cold temperatures and accompanied by cognitive impairment. Its incidence has increased in Uganda and South Sudan over the past 10 years. Four case–control studies identified modest and inconsistent associations. There were nonspecific lesions seen by magnetic resonance imaging, no cerebrospinal fluid inflammation, and markedly abnormal electroencephalography results. Nodding episodes are atonic seizures. Testing has failed to demonstrate associations with trypanosomiasis, cysticercosis, loiasis, lymphatic filariasis, cerebral malaria, measles, prion disease, or novel pathogens; or deficiencies of folate, cobalamin, pyridoxine, retinol, or zinc; or toxicity from mercury, copper, or homocysteine. There is a consistent enigmatic association with onchocerciasis detected by skin snip or serologic analysis. Nodding syndrome is an unexplained epidemic epilepsy.

EID Dowell SF, Sejvar JJ, Riek L, Vandemaele K, Lamunu M, Kuesel AC, et al. Nodding Syndrome. Emerg Infect Dis. 2013;19(9):1374-1373. https://dx.doi.org/10.3201/eid1909.130401
AMA Dowell SF, Sejvar JJ, Riek L, et al. Nodding Syndrome. Emerging Infectious Diseases. 2013;19(9):1374-1373. doi:10.3201/eid1909.130401.
APA Dowell, S. F., Sejvar, J. J., Riek, L., Vandemaele, K., Lamunu, M., Kuesel, A. C....Mbonye, A. K. (2013). Nodding Syndrome. Emerging Infectious Diseases, 19(9), 1374-1373. https://dx.doi.org/10.3201/eid1909.130401.
Research

Divergent Astrovirus Associated with Neurologic Disease in Cattle [PDF - 587 KB - 8 pages]
L. Li et al.

Using viral metagenomics of brain tissue from a young adult crossbreed steer with acute onset of neurologic disease, we sequenced the complete genome of a novel astrovirus (BoAstV-NeuroS1) that was phylogenetically related to an ovine astrovirus. In a retrospective analysis of 32 cases of bovine encephalitides of unknown etiology, 3 other infected animals were detected by using PCR and in situ hybridization for viral RNA. Viral RNA was restricted to the nervous system and detected in the cytoplasm of affected neurons within the spinal cord, brainstem, and cerebellum. Microscopically, the lesions were of widespread neuronal necrosis, microgliosis, and perivascular cuffing preferentially distributed in gray matter and most severe in the cerebellum and brainstem, with increasing intensity caudally down the spinal cord. These results suggest that infection with BoAstV-NeuroS1 is a potential cause of neurologic disease in cattle.

EID Li L, Diab S, McGraw S, Barr B, Traslavina R, Higgins R, et al. Divergent Astrovirus Associated with Neurologic Disease in Cattle. Emerg Infect Dis. 2013;19(9):1385-1392. https://dx.doi.org/10.3201/eid1909.130682
AMA Li L, Diab S, McGraw S, et al. Divergent Astrovirus Associated with Neurologic Disease in Cattle. Emerging Infectious Diseases. 2013;19(9):1385-1392. doi:10.3201/eid1909.130682.
APA Li, L., Diab, S., McGraw, S., Barr, B., Traslavina, R., Higgins, R....Delwart, E. (2013). Divergent Astrovirus Associated with Neurologic Disease in Cattle. Emerging Infectious Diseases, 19(9), 1385-1392. https://dx.doi.org/10.3201/eid1909.130682.

Antigenic and Molecular Characterization of Avian Influenza A(H9N2) Viruses, Bangladesh [PDF - 721 KB - 10 pages]
K. Shanmuganatham et al.

Human infection with avian influenza A(H9N2) virus was identified in Bangladesh in 2011. Surveillance for influenza viruses in apparently healthy poultry in live-bird markets in Bangladesh during 2008–2011 showed that subtype H9N2 viruses are isolated year-round, whereas highly pathogenic subtype H5N1 viruses are co-isolated with subtype H9N2 primarily during the winter months. Phylogenetic analysis of the subtype H9N2 viruses showed that they are reassortants possessing 3 gene segments related to subtype H7N3; the remaining gene segments were from the subtype H9N2 G1 clade. We detected no reassortment with subtype H5N1 viruses. Serologic analyses of subtype H9N2 viruses from chickens revealed antigenic conservation, whereas analyses of viruses from quail showed antigenic drift. Molecular analysis showed that multiple mammalian-specific mutations have become fixed in the subtype H9N2 viruses, including changes in the hemagglutinin, matrix, and polymerase proteins. Our results indicate that these viruses could mutate to be transmissible from birds to mammals, including humans.

EID Shanmuganatham K, Feeroz MM, Jones-Engel L, Smith G, Fourment M, Walker D, et al. Antigenic and Molecular Characterization of Avian Influenza A(H9N2) Viruses, Bangladesh. Emerg Infect Dis. 2013;19(9):1393-1402. https://dx.doi.org/10.3201/eid1909.130336
AMA Shanmuganatham K, Feeroz MM, Jones-Engel L, et al. Antigenic and Molecular Characterization of Avian Influenza A(H9N2) Viruses, Bangladesh. Emerging Infectious Diseases. 2013;19(9):1393-1402. doi:10.3201/eid1909.130336.
APA Shanmuganatham, K., Feeroz, M. M., Jones-Engel, L., Smith, G., Fourment, M., Walker, D....Webster, R. G. (2013). Antigenic and Molecular Characterization of Avian Influenza A(H9N2) Viruses, Bangladesh. Emerging Infectious Diseases, 19(9), 1393-1402. https://dx.doi.org/10.3201/eid1909.130336.

Protection by Face Masks against Influenza A(H1N1)pdm09 Virus on Trans-Pacific Passenger Aircraft, 2009 [PDF - 765 KB - 8 pages]
L. Zhang et al.

In response to several influenza A(H1N1)pdm09 infections that developed in passengers after they traveled on the same 2 flights from New York, New York, USA, to Hong Kong, China, to Fuzhou, China, we assessed transmission of influenza A(H1N1)pdm09 virus on these flights. We defined a case of infection as onset of fever and respiratory symptoms and detection of virus by PCR in a passenger or crew member of either flight. Illness developed only in passengers who traveled on the New York to Hong Kong flight. We compared exposures of 9 case-passengers with those of 32 asymptomatic control-passengers. None of the 9 case-passengers, compared with 47% (15/32) of control-passengers, wore a face mask for the entire flight (odds ratio 0, 95% CI 0–0.71). The source case-passenger was not identified. Wearing a face mask was a protective factor against influenza infection. We recommend a more comprehensive intervention study to accurately estimate this effect.

EID Zhang L, Peng Z, Ou J, Zeng G, Fontaine RE, Liu M, et al. Protection by Face Masks against Influenza A(H1N1)pdm09 Virus on Trans-Pacific Passenger Aircraft, 2009. Emerg Infect Dis. 2013;19(9):1403-1410. https://dx.doi.org/10.3201/eid1909.121765
AMA Zhang L, Peng Z, Ou J, et al. Protection by Face Masks against Influenza A(H1N1)pdm09 Virus on Trans-Pacific Passenger Aircraft, 2009. Emerging Infectious Diseases. 2013;19(9):1403-1410. doi:10.3201/eid1909.121765.
APA Zhang, L., Peng, Z., Ou, J., Zeng, G., Fontaine, R. E., Liu, M....Yu, H. (2013). Protection by Face Masks against Influenza A(H1N1)pdm09 Virus on Trans-Pacific Passenger Aircraft, 2009. Emerging Infectious Diseases, 19(9), 1403-1410. https://dx.doi.org/10.3201/eid1909.121765.

Medscape CME Activity
Mumps Postexposure Prophylaxis with a Third Dose of Measles-Mumps-Rubella Vaccine, Orange County, New York, USA [PDF - 544 KB - 7 pages]
A. Fiebelkorn et al.

Although the measles-mumps-rubella (MMR) vaccine is not recommended for mumps postexposure prophylaxis (PEP), data on its effectiveness are limited. During the 2009–2010 mumps outbreak in the northeastern United States, we assessed effectiveness of PEP with a third dose of MMR vaccine among contacts in Orthodox Jewish households who were given a third dose within 5 days of mumps onset in the household’s index patient. We compared mumps attack rates between persons who received a third MMR dose during the first incubation period after onset in the index patient and 2-dose vaccinated persons who had not. Twenty-eight (11.7%) of 239 eligible household members received a third MMR dose as PEP. Mumps attack rates were 0% among third-dose recipients versus 5.2% among 2-dose recipients without PEP (p = 0.57). Although a third MMR dose administered as PEP did not have a significant effect, it may offer some benefits in specific outbreak contexts.

EID Fiebelkorn A, Lawler J, Curns AT, Brandeburg C, Wallace GS. Mumps Postexposure Prophylaxis with a Third Dose of Measles-Mumps-Rubella Vaccine, Orange County, New York, USA. Emerg Infect Dis. 2013;19(9):1411-1417. https://dx.doi.org/10.3201/eid1909.130299
AMA Fiebelkorn A, Lawler J, Curns AT, et al. Mumps Postexposure Prophylaxis with a Third Dose of Measles-Mumps-Rubella Vaccine, Orange County, New York, USA. Emerging Infectious Diseases. 2013;19(9):1411-1417. doi:10.3201/eid1909.130299.
APA Fiebelkorn, A., Lawler, J., Curns, A. T., Brandeburg, C., & Wallace, G. S. (2013). Mumps Postexposure Prophylaxis with a Third Dose of Measles-Mumps-Rubella Vaccine, Orange County, New York, USA. Emerging Infectious Diseases, 19(9), 1411-1417. https://dx.doi.org/10.3201/eid1909.130299.

Continued Evolution of West Nile Virus, Houston, Texas, USA, 2002–2012 [PDF - 878 KB - 10 pages]
B. R. Mann et al.

We investigated the genetics and evolution of West Nile virus (WNV) since initial detection in the United States in 1999 on the basis of continual surveillance studies in the Houston, Texas, USA, metropolitan area (Harris County) as a surrogate model for WNV evolution on a national scale. Full-length genomic sequencing of 14 novel 2010–2012 WNV isolates collected from resident birds in Harris County demonstrates emergence of 4 independent genetic groups distinct from historical strains circulating in the greater Houston region since 2002. Phylogenetic and geospatial analyses of the 2012 WNV isolates indicate closer genetic relationship with 2003–2006 Harris County isolates than more recent 2007–2011 isolates. Inferred monophyletic relationships of these groups with several 2006–2009 northeastern US isolates supports potential introduction of a novel WNV strain in Texas since 2010. These results emphasize the need to maintain WNV surveillance activities to better understand WNV transmission dynamics in the United States.

EID Mann BR, McMullen AR, Swetnam DM, Salvato V, Reyna M, Guzman H, et al. Continued Evolution of West Nile Virus, Houston, Texas, USA, 2002–2012. Emerg Infect Dis. 2013;19(9):1418-1427. https://dx.doi.org/10.3201/eid1909.130377
AMA Mann BR, McMullen AR, Swetnam DM, et al. Continued Evolution of West Nile Virus, Houston, Texas, USA, 2002–2012. Emerging Infectious Diseases. 2013;19(9):1418-1427. doi:10.3201/eid1909.130377.
APA Mann, B. R., McMullen, A. R., Swetnam, D. M., Salvato, V., Reyna, M., Guzman, H....Barrett, A. (2013). Continued Evolution of West Nile Virus, Houston, Texas, USA, 2002–2012. Emerging Infectious Diseases, 19(9), 1418-1427. https://dx.doi.org/10.3201/eid1909.130377.

Underreporting of Viral Encephalitis and Viral Meningitis, Ireland, 2005–2008 [PDF - 462 KB - 9 pages]
T. A. Kelly et al.

Viral encephalitis (VE) and viral meningitis (VM) have been notifiable infectious diseases under surveillance in the Republic of Ireland since 1981. Laboratories have reported confirmed cases by detection of viral nucleic acid in cerebrospinal fluid since 2004. To determine the prevalence of these diseases in Ireland during 2005–2008, we analyzed 3 data sources: Hospital In-patient Enquiry data (from hospitalized following patients discharge) accessed through Health Intelligence Ireland, laboratory confirmations from the National Virus Reference Laboratory, and events from the Computerised Infectious Disease Reporting surveillance system. We found that the national surveillance system underestimates the incidence of these diseases in Ireland with a 10-fold higher VE hospitalization rate and 3-fold higher VM hospitalization rate than the reporting rate. Herpesviruses were responsible for most specified VE and enteroviruses for most specified VM from all 3 sources. Recommendations from this study have been implemented to improve the surveillance of these diseases in Ireland.

EID Kelly TA, O’Lorcain P, Moran J, Garvey P, McKeown P, Connell J, et al. Underreporting of Viral Encephalitis and Viral Meningitis, Ireland, 2005–2008. Emerg Infect Dis. 2013;19(9):1428-1436. https://dx.doi.org/10.3201/eid1909.130201
AMA Kelly TA, O’Lorcain P, Moran J, et al. Underreporting of Viral Encephalitis and Viral Meningitis, Ireland, 2005–2008. Emerging Infectious Diseases. 2013;19(9):1428-1436. doi:10.3201/eid1909.130201.
APA Kelly, T. A., O’Lorcain, P., Moran, J., Garvey, P., McKeown, P., Connell, J....Cotter, S. (2013). Underreporting of Viral Encephalitis and Viral Meningitis, Ireland, 2005–2008. Emerging Infectious Diseases, 19(9), 1428-1436. https://dx.doi.org/10.3201/eid1909.130201.

High Rates of Mycobacterium tuberculosis among Socially Marginalized Immigrants in Low-Incidence Area, 1991–2010, Italy [PDF - 724 KB - 9 pages]
I. Baussano et al.

Migration from low- and middle-income countries to high-income countries increasingly determines the severity of tuberculosis (TB) cases in the adopted country. Socially marginalized groups, about whom little is known, may account for a reservoir of TB among the immigrant populations. We investigated the rates of and risk factors for Mycobacterium tuberculosis transmission, infection, and disease in a cohort of 27,358 socially marginalized immigrants who were systematically screened (1991–2010) in an area of Italy with low TB incidence. Overall TB and latent TB infection prevalence and annual tuberculin skin testing conversion rates (i.e., incidence of new infection) were 2.7%, 34.6%, and 1.7%, respectively. Prevalence of both TB and latent TB infection and incidence of infection increased as a function of the estimated TB incidence in the immigrants’ countries of origin. Annual infection incidence decreased with time elapsed since immigration. These findings have implications for control policy and immigrant screening in countries with a low prevalence of TB.

EID Baussano I, Mercadante S, Pareek M, Lalvani A, Bugiani M. High Rates of Mycobacterium tuberculosis among Socially Marginalized Immigrants in Low-Incidence Area, 1991–2010, Italy. Emerg Infect Dis. 2013;19(9):1437-1445. https://dx.doi.org/10.3201/eid1909.120200
AMA Baussano I, Mercadante S, Pareek M, et al. High Rates of Mycobacterium tuberculosis among Socially Marginalized Immigrants in Low-Incidence Area, 1991–2010, Italy. Emerging Infectious Diseases. 2013;19(9):1437-1445. doi:10.3201/eid1909.120200.
APA Baussano, I., Mercadante, S., Pareek, M., Lalvani, A., & Bugiani, M. (2013). High Rates of Mycobacterium tuberculosis among Socially Marginalized Immigrants in Low-Incidence Area, 1991–2010, Italy. Emerging Infectious Diseases, 19(9), 1437-1445. https://dx.doi.org/10.3201/eid1909.120200.

Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania [PDF - 509 KB - 9 pages]
D. Minja et al.

Intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) is a key strategy in the control of pregnancy-associated malaria. However, this strategy is compromised by widespread drug resistance from single-nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. During September 2008–October 2010, we monitored a cohort of 924 pregnant women in an area of Tanzania with declining malaria transmission. P. falciparum parasites were genotyped, and the effect of infecting haplotypes on birthweight was assessed. Of the genotyped parasites, 9.3%, 46.3%, and 44.4% had quadruple or less, quintuple, and sextuple mutated haplotypes, respectively. Mutant haplotypes were unrelated to SP doses. Compared with infections with the less-mutated haplotypes, infections with the sextuple haplotype mutation were associated with lower (359 g) birthweights. Continued use of the suboptimal IPTp-SP regimen should be reevaluated, and alternative strategies (e.g., intermittent screening and treatment or intermittent treatment with safe and effective alternative drugs) should be evaluated.

EID Minja D, Schmiegelow C, Mmbando B, Boström S, Oesterholt M, Magistrado P, et al. Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania. Emerg Infect Dis. 2013;19(9):1446-1454. https://dx.doi.org/10.3201/eid1909.130133
AMA Minja D, Schmiegelow C, Mmbando B, et al. Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania. Emerging Infectious Diseases. 2013;19(9):1446-1454. doi:10.3201/eid1909.130133.
APA Minja, D., Schmiegelow, C., Mmbando, B., Boström, S., Oesterholt, M., Magistrado, P....Alifrangis, M. (2013). Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania. Emerging Infectious Diseases, 19(9), 1446-1454. https://dx.doi.org/10.3201/eid1909.130133.

New Estimates of Incidence of Encephalitis in England [PDF - 406 KB - 8 pages]
J. Granerod et al.

Encephalitis causes high rates of illness and death, yet its epidemiology remains poorly understood. To improve incidence estimates in England and inform priority setting and treatment and prevention strategies, we used hospitalization data to estimate incidence of infectious and noninfectious encephalitis during 2005–2009. Hospitalization data were linked to a dataset of extensively investigated cases of encephalitis from a prospective study, and capture–recapture models were applied. Incidence was estimated from unlinked hospitalization data as 4.32 cases/100,000 population/year. Capture–recapture models gave a best estimate of encephalitis incidence of 5.23 cases/100,000/year, although the models’ indicated incidence could be as high as 8.66 cases/100,000/year. This analysis indicates that the incidence of encephalitis in England is considerably higher than previously estimated. Therefore, encephalitis should be a greater priority for clinicians, researchers, and public health officials.

EID Granerod J, Cousens S, Davies N, Crowcroft NS, Thomas SL. New Estimates of Incidence of Encephalitis in England. Emerg Infect Dis. 2013;19(9):1455-1462. https://dx.doi.org/10.3201/eid1909.130064
AMA Granerod J, Cousens S, Davies N, et al. New Estimates of Incidence of Encephalitis in England. Emerging Infectious Diseases. 2013;19(9):1455-1462. doi:10.3201/eid1909.130064.
APA Granerod, J., Cousens, S., Davies, N., Crowcroft, N. S., & Thomas, S. L. (2013). New Estimates of Incidence of Encephalitis in England. Emerging Infectious Diseases, 19(9), 1455-1462. https://dx.doi.org/10.3201/eid1909.130064.

Enzootic and Epizootic Rabies Associated with Vampire Bats, Peru [PDF - 409 KB - 7 pages]
R. Condori-Condori et al.

During the past decade, incidence of human infection with rabies virus (RABV) spread by the common vampire bat (Desmodus rotundus) increased considerably in South America, especially in remote areas of the Amazon rainforest, where these bats commonly feed on humans. To better understand the epizootiology of rabies associated with vampire bats, we used complete sequences of the nucleoprotein gene to infer phylogenetic relationships among 157 RABV isolates collected from humans, domestic animals, and wildlife, including bats, in Peru during 2002–2007. This analysis revealed distinct geographic structuring that indicates that RABVs spread gradually and involve different vampire bat subpopulations with different transmission cycles. Three putative new RABV lineages were found in 3 non–vampire bat species that may represent new virus reservoirs. Detection of novel RABV variants and accurate identification of reservoir hosts are critically important for the prevention and control of potential virus transmission, especially to humans.

EID Condori-Condori R, Streicker DG, Cabezas-Sanchez C, Velasco-Villa A. Enzootic and Epizootic Rabies Associated with Vampire Bats, Peru. Emerg Infect Dis. 2013;19(9):1463-1469. https://dx.doi.org/10.3201/eid1909.130083
AMA Condori-Condori R, Streicker DG, Cabezas-Sanchez C, et al. Enzootic and Epizootic Rabies Associated with Vampire Bats, Peru. Emerging Infectious Diseases. 2013;19(9):1463-1469. doi:10.3201/eid1909.130083.
APA Condori-Condori, R., Streicker, D. G., Cabezas-Sanchez, C., & Velasco-Villa, A. (2013). Enzootic and Epizootic Rabies Associated with Vampire Bats, Peru. Emerging Infectious Diseases, 19(9), 1463-1469. https://dx.doi.org/10.3201/eid1909.130083.

Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections [PDF - 539 KB - 8 pages]
C. Hsu et al.

No agent is implicated in most central nervous system (CNS) infections. To investigate cerebrospinal fluid samples from patients with CNS infections of unknown cause in 1 hospital in Taiwan, we used a staged molecular approach, incorporating techniques including multiplex MassTag PCR, 16S rRNA PCR, DNA microarray, and high-throughput pyrosequencing. We determined the infectious agent for 31 (24%) of 131 previously negative samples. Candidate pathogens were identified for 25 (27%) of 94 unexplained meningitis cases and 6 (16%) of 37 unexplained encephalitis cases. Epstein-Barr virus (18 infections) accounted for most of the identified agents in unexplained meningitis cases, followed by Escherichia coli (5), enterovirus (2), human herpesvirus 2 (1), and Mycobacterium tuberculosis. Herpesviruses were identified in samples from patients with unexplained encephalitis cases, including varicella-zoster virus (3 infections), human herpesvirus 1 (2), and cytomegalovirus (1). Our study confirms the power of multiplex MassTag PCR as a rapid diagnostic tool for identifying pathogens causing unexplained CNS infections.

EID Hsu C, Tokarz R, Briese T, Tsai H, Quan P, Lipkin W. Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections. Emerg Infect Dis. 2013;19(9):1470-1477. https://dx.doi.org/10.3201/eid1909.130474
AMA Hsu C, Tokarz R, Briese T, et al. Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections. Emerging Infectious Diseases. 2013;19(9):1470-1477. doi:10.3201/eid1909.130474.
APA Hsu, C., Tokarz, R., Briese, T., Tsai, H., Quan, P., & Lipkin, W. (2013). Use of Staged Molecular Analysis to Determine Causes of Unexplained Central Nervous System Infections. Emerging Infectious Diseases, 19(9), 1470-1477. https://dx.doi.org/10.3201/eid1909.130474.
Historical Review

Quinto Tiberio Angelerio and New Measures for Controlling Plague in 16th-Century Alghero, Sardinia [PDF - 544 KB - 6 pages]
R. Bianucci et al.

Plague, a zoonotic disease caused by the bacterium Yersinia pestis, has been responsible for at least 3 pandemics. During 1582–1583, a plague outbreak devastated the seaport of Alghero in Sardinia. By analyzing contemporary medical texts and local documentation, we uncovered the pivotal role played by the Protomedicus of Alghero, Quinto Tiberio Angelerio (1532–1617), in controlling the epidemic. Angelerio imposed rules and antiepidemic measures new to the 16th-century sanitary system of Sardinia. Those measures undoubtedly spared the surrounding districts from the spread of the contagion. Angelerio seems to have been an extremely successful public health officer in the history of plague epidemics in Sardinia.

EID Bianucci R, Benedictow O, Fornaciari G, Giuffra V. Quinto Tiberio Angelerio and New Measures for Controlling Plague in 16th-Century Alghero, Sardinia. Emerg Infect Dis. 2013;19(9):1478-1483. https://dx.doi.org/10.3201/eid1909.120311
AMA Bianucci R, Benedictow O, Fornaciari G, et al. Quinto Tiberio Angelerio and New Measures for Controlling Plague in 16th-Century Alghero, Sardinia. Emerging Infectious Diseases. 2013;19(9):1478-1483. doi:10.3201/eid1909.120311.
APA Bianucci, R., Benedictow, O., Fornaciari, G., & Giuffra, V. (2013). Quinto Tiberio Angelerio and New Measures for Controlling Plague in 16th-Century Alghero, Sardinia. Emerging Infectious Diseases, 19(9), 1478-1483. https://dx.doi.org/10.3201/eid1909.120311.
Dispatches

Microsporidial Keratoconjunctivitis after Rugby Tournament, Singapore [PDF - 315 KB - 3 pages]
J. Tan et al.

We investigated an outbreak of 47 probable and 6 confirmed cases of microsporidial keratoconjunctivitis involving participants of an international rugby tournament in Singapore in April 2012.The mode of transmission was eye contact with soil. Vittaforma corneae was identified in 4 of 6 corneal scrapings and in 1 of 12 soil water samples.

EID Tan J, Lee P, Lai Y, Hishamuddin P, Tay J, Tan A, et al. Microsporidial Keratoconjunctivitis after Rugby Tournament, Singapore. Emerg Infect Dis. 2013;19(9):1484-1486. https://dx.doi.org/10.3201/eid1909.121464
AMA Tan J, Lee P, Lai Y, et al. Microsporidial Keratoconjunctivitis after Rugby Tournament, Singapore. Emerging Infectious Diseases. 2013;19(9):1484-1486. doi:10.3201/eid1909.121464.
APA Tan, J., Lee, P., Lai, Y., Hishamuddin, P., Tay, J., Tan, A....Goh, K. (2013). Microsporidial Keratoconjunctivitis after Rugby Tournament, Singapore. Emerging Infectious Diseases, 19(9), 1484-1486. https://dx.doi.org/10.3201/eid1909.121464.

Novel Bunyavirus in Domestic and Captive Farmed Animals, Minnesota, USA [PDF - 421 KB - 3 pages]
Z. Xing et al.

We tested blood samples from domestic and captive farmed animals in Minnesota, USA, to determine exposure to severe fever with thrombocytopenia syndrome virus and Heartland-like virus. We found antibodies against virus nucleoproteins in 10%–18% of samples from cattle, sheep, goats, deer, and elk in 24 Minnesota counties.

EID Xing Z, Schefers J, Schwabenlander M, Jiao Y, Liang M, Qi X, et al. Novel Bunyavirus in Domestic and Captive Farmed Animals, Minnesota, USA. Emerg Infect Dis. 2013;19(9):1487-1489. https://dx.doi.org/10.3201/eid1909.130165
AMA Xing Z, Schefers J, Schwabenlander M, et al. Novel Bunyavirus in Domestic and Captive Farmed Animals, Minnesota, USA. Emerging Infectious Diseases. 2013;19(9):1487-1489. doi:10.3201/eid1909.130165.
APA Xing, Z., Schefers, J., Schwabenlander, M., Jiao, Y., Liang, M., Qi, X....Murtaugh, M. P. (2013). Novel Bunyavirus in Domestic and Captive Farmed Animals, Minnesota, USA. Emerging Infectious Diseases, 19(9), 1487-1489. https://dx.doi.org/10.3201/eid1909.130165.

Benznidazole Treatment of Chagasic Encephalitis in Pregnant Woman with AIDS [PDF - 354 KB - 3 pages]
M. Bisio et al.

We report a case of chagasic meningoencephalitis reactivation in a pregnant woman co-infected with Trypanosoma cruzi and HIV that was successfully managed with benznidazole and highly active antiretroviral therapy. Early diagnosis enabled rapid specific treatment that improved the health of the patient and her baby.

EID Bisio M, Altcheh J, Lattner J, Moscatelli G, Fink V, Burgos JM, et al. Benznidazole Treatment of Chagasic Encephalitis in Pregnant Woman with AIDS. Emerg Infect Dis. 2013;19(9):1490-1492. https://dx.doi.org/10.3201/eid1909.130667
AMA Bisio M, Altcheh J, Lattner J, et al. Benznidazole Treatment of Chagasic Encephalitis in Pregnant Woman with AIDS. Emerging Infectious Diseases. 2013;19(9):1490-1492. doi:10.3201/eid1909.130667.
APA Bisio, M., Altcheh, J., Lattner, J., Moscatelli, G., Fink, V., Burgos, J. M....Freilij, H. (2013). Benznidazole Treatment of Chagasic Encephalitis in Pregnant Woman with AIDS. Emerging Infectious Diseases, 19(9), 1490-1492. https://dx.doi.org/10.3201/eid1909.130667.

Mycobacterium chelonae Abscesses Associated with Biomesotherapy, Australia, 2008 [PDF - 324 KB - 3 pages]
M. Ivan et al.

An outbreak of skin abscesses occurred in Adelaide, Australia, in association with biomesotherapy, an alternative therapy practice. Mycobacterium chelonae was identified in 8 patient and 3 environmental samples. Our findings show M. chelonae infection can be associated with alternative therapies when infection-control breaches occur. Tighter regulations of alternative therapy practices are needed.

EID Ivan M, Dancer C, Koehler AP, Hobby M, Lease C. Mycobacterium chelonae Abscesses Associated with Biomesotherapy, Australia, 2008. Emerg Infect Dis. 2013;19(9):1493-1495. https://dx.doi.org/10.3201/eid1909.120898
AMA Ivan M, Dancer C, Koehler AP, et al. Mycobacterium chelonae Abscesses Associated with Biomesotherapy, Australia, 2008. Emerging Infectious Diseases. 2013;19(9):1493-1495. doi:10.3201/eid1909.120898.
APA Ivan, M., Dancer, C., Koehler, A. P., Hobby, M., & Lease, C. (2013). Mycobacterium chelonae Abscesses Associated with Biomesotherapy, Australia, 2008. Emerging Infectious Diseases, 19(9), 1493-1495. https://dx.doi.org/10.3201/eid1909.120898.

Spread of Neisseria meningitidis Serogroup W Clone, China [PDF - 535 KB - 4 pages]
H. Zhou et al.

During February 2011–June 2012, invasive infection with Neisseria meningitidis serogroup W was identified in 11 persons in southeastern China. All isolates tested had matching or near-matching pulsed-field gel electrophoresis patterns and belonged to multilocus sequence type 11. The epidemiologic investigation suggested recent transmission of this clonal complex in southeastern China.

EID Zhou H, Liu W, Xu L, Deng L, Deng Q, Zhuo J, et al. Spread of Neisseria meningitidis Serogroup W Clone, China. Emerg Infect Dis. 2013;19(9):1496-1499. https://dx.doi.org/10.3201/eid1909.130160
AMA Zhou H, Liu W, Xu L, et al. Spread of Neisseria meningitidis Serogroup W Clone, China. Emerging Infectious Diseases. 2013;19(9):1496-1499. doi:10.3201/eid1909.130160.
APA Zhou, H., Liu, W., Xu, L., Deng, L., Deng, Q., Zhuo, J....Shao, Z. (2013). Spread of Neisseria meningitidis Serogroup W Clone, China. Emerging Infectious Diseases, 19(9), 1496-1499. https://dx.doi.org/10.3201/eid1909.130160.

Human Parainfluenza Virus Type 3 in Wild Nonhuman Primates, Zambia [PDF - 557 KB - 4 pages]
M. Sasaki et al.

Human parainfluenza virus type 3 (HPIV3) genome was detected in 4 baboons in Zambia. Antibody for HPIV3 was detected in 13 baboons and 6 vervet monkeys in 2 distinct areas in Zambia. Our findings suggest that wild nonhuman primates are susceptible to HPIV3 infection.

EID Sasaki M, Ishii A, Orba Y, Thomas Y, Hang’ombe BM, Moonga L, et al. Human Parainfluenza Virus Type 3 in Wild Nonhuman Primates, Zambia. Emerg Infect Dis. 2013;19(9):1500-1503. https://dx.doi.org/10.3201/eid1909.121404
AMA Sasaki M, Ishii A, Orba Y, et al. Human Parainfluenza Virus Type 3 in Wild Nonhuman Primates, Zambia. Emerging Infectious Diseases. 2013;19(9):1500-1503. doi:10.3201/eid1909.121404.
APA Sasaki, M., Ishii, A., Orba, Y., Thomas, Y., Hang’ombe, B. M., Moonga, L....Sawa, H. (2013). Human Parainfluenza Virus Type 3 in Wild Nonhuman Primates, Zambia. Emerging Infectious Diseases, 19(9), 1500-1503. https://dx.doi.org/10.3201/eid1909.121404.

Powassan Meningoencephalitis, New York, New York, USA [PDF - 303 KB - 3 pages]
S. Sung et al.

Disease caused by Powassan virus (POWV), a tick-borne flavivirus, ranges from asymptomatic to severe neurologic compromise and death. Two cases of POWV meningoencephalitis in New York, USA, highlight diagnostic techniques, neurologic outcomes, and the effect of POWV on communities to which it is endemic.

EID Sung S, Wurcel AG, Whittier S, Kulas K, Kramer LD, Flam R, et al. Powassan Meningoencephalitis, New York, New York, USA. Emerg Infect Dis. 2013;19(9):1504-1506. https://dx.doi.org/10.3201/eid1909.121846
AMA Sung S, Wurcel AG, Whittier S, et al. Powassan Meningoencephalitis, New York, New York, USA. Emerging Infectious Diseases. 2013;19(9):1504-1506. doi:10.3201/eid1909.121846.
APA Sung, S., Wurcel, A. G., Whittier, S., Kulas, K., Kramer, L. D., Flam, R....Tsiouris, S. (2013). Powassan Meningoencephalitis, New York, New York, USA. Emerging Infectious Diseases, 19(9), 1504-1506. https://dx.doi.org/10.3201/eid1909.121846.

Serogroup W135 Meningococcal Disease, The Gambia, 2012 [PDF - 358 KB - 4 pages]
M. Hossain et al.

In 2012, an outbreak of Neisseria meningitidis serogroup W135 occurred in The Gambia. The attack rate was highest among young children. The associated risk factors were male sex, contact with meningitis patients, and difficult breathing. Enhanced surveillance facilitates early epidemic detection, and multiserogroup conjugate vaccine could reduce meningococcal epidemics in The Gambia.

EID Hossain M, Roca A, Mackenzie GA, Jasseh M, Hossain M, Muhammad S, et al. Serogroup W135 Meningococcal Disease, The Gambia, 2012. Emerg Infect Dis. 2013;19(9):1507-1515. https://dx.doi.org/10.3201/eid1909.130077
AMA Hossain M, Roca A, Mackenzie GA, et al. Serogroup W135 Meningococcal Disease, The Gambia, 2012. Emerging Infectious Diseases. 2013;19(9):1507-1515. doi:10.3201/eid1909.130077.
APA Hossain, M., Roca, A., Mackenzie, G. A., Jasseh, M., Hossain, M., Muhammad, S....D’Alessandro, U. (2013). Serogroup W135 Meningococcal Disease, The Gambia, 2012. Emerging Infectious Diseases, 19(9), 1507-1515. https://dx.doi.org/10.3201/eid1909.130077.

Novel Cyclovirus in Human Cerebrospinal Fluid, Malawi, 2010–2011 [PDF - 381 KB - 3 pages]
S. L. Smits et al.

To identify unknown human viruses, we analyzed serum and cerebrospinal fluid samples from patients with unexplained paraplegia from Malawi by using viral metagenomics. A novel cyclovirus species was identified and subsequently found in 15% and 10% of serum and cerebrospinal fluid samples, respectively. These data expand our knowledge of cyclovirus diversity and tropism.

EID Smits SL, Zijlstra E, van Hellemond JJ, Schapendonk C, Bodewes R, Schürch AC, et al. Novel Cyclovirus in Human Cerebrospinal Fluid, Malawi, 2010–2011. Emerg Infect Dis. 2013;19(9):1511-1513. https://dx.doi.org/10.3201/eid1909.130404
AMA Smits SL, Zijlstra E, van Hellemond JJ, et al. Novel Cyclovirus in Human Cerebrospinal Fluid, Malawi, 2010–2011. Emerging Infectious Diseases. 2013;19(9):1511-1513. doi:10.3201/eid1909.130404.
APA Smits, S. L., Zijlstra, E., van Hellemond, J. J., Schapendonk, C., Bodewes, R., Schürch, A. C....Osterhaus, A. (2013). Novel Cyclovirus in Human Cerebrospinal Fluid, Malawi, 2010–2011. Emerging Infectious Diseases, 19(9), 1511-1513. https://dx.doi.org/10.3201/eid1909.130404.

Gastroenteritis Outbreak Associated with Unpasteurized Tempeh, North Carolina, USA [PDF - 377 KB - 4 pages]
S. E. Griese et al.

During an investigation of an outbreak of gastroenteritis caused by Salmonella enterica serovar Paratyphi B variant L(+) tartrate(+), we identified unpasteurized tempeh as a novel food vehicle and Rhizopus spp. starter culture as the source of the contamination. Safe handling of uncooked, unpasteurized tempeh should be emphasized for prevention of foodborne illnesses.

EID Griese SE, Fleischauer AT, MacFarquhar JK, Moore Z, Harrelson C, Valiani A, et al. Gastroenteritis Outbreak Associated with Unpasteurized Tempeh, North Carolina, USA. Emerg Infect Dis. 2013;19(9):1514-1517. https://dx.doi.org/10.3201/eid1909.130334
AMA Griese SE, Fleischauer AT, MacFarquhar JK, et al. Gastroenteritis Outbreak Associated with Unpasteurized Tempeh, North Carolina, USA. Emerging Infectious Diseases. 2013;19(9):1514-1517. doi:10.3201/eid1909.130334.
APA Griese, S. E., Fleischauer, A. T., MacFarquhar, J. K., Moore, Z., Harrelson, C., Valiani, A....Davies, M. (2013). Gastroenteritis Outbreak Associated with Unpasteurized Tempeh, North Carolina, USA. Emerging Infectious Diseases, 19(9), 1514-1517. https://dx.doi.org/10.3201/eid1909.130334.

West Nile Virus RNA in Tissues from Donor Associated with Transmission to Organ Transplant Recipients [PDF - 319 KB - 3 pages]
D. M. Blau et al.

We identified West Nile virus (WNV) RNA in skin, fat, muscle, tendon, and bone marrow from a deceased donor associated with WNV transmission through solid organ transplantation. WNV could not be cultured from the RNA-positive tissues. Further studies are needed to determine if WNV can be transmitted from postmortem tissues.

EID Blau DM, Rabe IB, Bhatnagar J, Civen R, Trivedi KK, Rollin D, et al. West Nile Virus RNA in Tissues from Donor Associated with Transmission to Organ Transplant Recipients. Emerg Infect Dis. 2013;19(9):1518-1520. https://dx.doi.org/10.3201/eid1909.130365
AMA Blau DM, Rabe IB, Bhatnagar J, et al. West Nile Virus RNA in Tissues from Donor Associated with Transmission to Organ Transplant Recipients. Emerging Infectious Diseases. 2013;19(9):1518-1520. doi:10.3201/eid1909.130365.
APA Blau, D. M., Rabe, I. B., Bhatnagar, J., Civen, R., Trivedi, K. K., Rollin, D....Fischer, M. (2013). West Nile Virus RNA in Tissues from Donor Associated with Transmission to Organ Transplant Recipients. Emerging Infectious Diseases, 19(9), 1518-1520. https://dx.doi.org/10.3201/eid1909.130365.

R292K Substitution and Drug Susceptibility of Influenza A(H7N9) Viruses [PDF - 562 KB - 4 pages]
K. Sleeman et al.

Neuraminidase inhibitors are the only licensed antiviral medications available to treat avian influenza A(H7N9) virus infections in humans. According to a neuraminidase inhibition assay, an R292K substitution reduced antiviral efficacy of inhibitors, especially oseltamivir, and decreased viral fitness in cell culture. Monitoring emergence of R292K-carrying viruses using a pH-modified neuraminidase inhibition assay should be considered.

EID Sleeman K, Guo Z, Barnes J, Shaw M, Stevens J, Gubareva LV. R292K Substitution and Drug Susceptibility of Influenza A(H7N9) Viruses. Emerg Infect Dis. 2013;19(9):1521-1524. https://dx.doi.org/10.3201/eid1909.130724
AMA Sleeman K, Guo Z, Barnes J, et al. R292K Substitution and Drug Susceptibility of Influenza A(H7N9) Viruses. Emerging Infectious Diseases. 2013;19(9):1521-1524. doi:10.3201/eid1909.130724.
APA Sleeman, K., Guo, Z., Barnes, J., Shaw, M., Stevens, J., & Gubareva, L. V. (2013). R292K Substitution and Drug Susceptibility of Influenza A(H7N9) Viruses. Emerging Infectious Diseases, 19(9), 1521-1524. https://dx.doi.org/10.3201/eid1909.130724.

Macrolide-Resistant Mycoplasma pneumoniae in Humans, Ontario, Canada, 2010–2011 [PDF - 377 KB - 3 pages]
A. Eshaghi et al.

Antimicrobial drug resistance rates for Mycoplasma pneumoniae was determined in clinical specimens and isolates obtained during 2011–2012 in Ontario, Canada. Of 91 M. pneumoniae drug-resistant specimens, 11 (12.1%) carried nucleotide mutations associated with macrolide resistance in the 23S rRNA gene. None of the M. pneumoniae specimens were resistant to fluoroquinolones or tetracyclines.

EID Eshaghi A, Memari N, Tang P, Olsha R, Farrell DJ, Low DE, et al. Macrolide-Resistant Mycoplasma pneumoniae in Humans, Ontario, Canada, 2010–2011. Emerg Infect Dis. 2013;19(9):1525-1527. https://dx.doi.org/10.3201/eid1909.121466
AMA Eshaghi A, Memari N, Tang P, et al. Macrolide-Resistant Mycoplasma pneumoniae in Humans, Ontario, Canada, 2010–2011. Emerging Infectious Diseases. 2013;19(9):1525-1527. doi:10.3201/eid1909.121466.
APA Eshaghi, A., Memari, N., Tang, P., Olsha, R., Farrell, D. J., Low, D. E....Patel, S. N. (2013). Macrolide-Resistant Mycoplasma pneumoniae in Humans, Ontario, Canada, 2010–2011. Emerging Infectious Diseases, 19(9), 1525-1527. https://dx.doi.org/10.3201/eid1909.121466.

Hepatitis E Virus Genotype 4, Nanjing, China, 2001–2011 [PDF - 328 KB - 3 pages]
X. Dai et al.

During 2001–2011, hepatitis E virus (HEV) was found in the blood of patients in Nanjing, China. All HEV-positive patients had virus genotype 4; subgenotype 4a was predominant. The effective population of HEV in Nanjing increased in ≈1980 and continued until ≈2003 when it plateaued.

EID Dai X, Dong C, Zhou Z, Liang J, Dong M, Yang Y, et al. Hepatitis E Virus Genotype 4, Nanjing, China, 2001–2011. Emerg Infect Dis. 2013;19(9):1528-1530. https://dx.doi.org/10.3201/eid1909.130013
AMA Dai X, Dong C, Zhou Z, et al. Hepatitis E Virus Genotype 4, Nanjing, China, 2001–2011. Emerging Infectious Diseases. 2013;19(9):1528-1530. doi:10.3201/eid1909.130013.
APA Dai, X., Dong, C., Zhou, Z., Liang, J., Dong, M., Yang, Y....Purdy, M. A. (2013). Hepatitis E Virus Genotype 4, Nanjing, China, 2001–2011. Emerging Infectious Diseases, 19(9), 1528-1530. https://dx.doi.org/10.3201/eid1909.130013.

Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry Workers, Mexico, 2012 [PDF - 731 KB - 4 pages]
I. Lopez-Martinez et al.

We identified 2 poultry workers with conjunctivitis caused by highly pathogenic avian influenza A(H7N3) viruses in Jalisco, Mexico. Genomic and antigenic analyses of 1 isolate indicated relatedness to poultry and wild bird subtype H7N3 viruses from North America. This isolate had a multibasic cleavage site that might have been derived from recombination with host rRNA.

EID Lopez-Martinez I, Balish A, Barrera-Badillo G, Jones J, Nuñez-García TE, Jang Y, et al. Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry Workers, Mexico, 2012. Emerg Infect Dis. 2013;19(9):1531-1534. https://dx.doi.org/10.3201/eid1909.130087
AMA Lopez-Martinez I, Balish A, Barrera-Badillo G, et al. Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry Workers, Mexico, 2012. Emerging Infectious Diseases. 2013;19(9):1531-1534. doi:10.3201/eid1909.130087.
APA Lopez-Martinez, I., Balish, A., Barrera-Badillo, G., Jones, J., Nuñez-García, T. E., Jang, Y....Diaz-Quiñonez, J. (2013). Highly Pathogenic Avian Influenza A(H7N3) Virus in Poultry Workers, Mexico, 2012. Emerging Infectious Diseases, 19(9), 1531-1534. https://dx.doi.org/10.3201/eid1909.130087.

Outbreak of Chikungunya Virus Infection, Vanimo, Papua New Guinea [PDF - 480 KB - 4 pages]
P. F. Horwood et al.

In June 2012, health authorities in Papua New Guinea detected an increase in febrile illnesses in Vanimo. Chikungunya virus of the Eastern/Central/Southern African genotype harboring the E1:A226V mutation was identified. This ongoing outbreak has spread to ≥8 other provinces and has had a harmful effect on public health.

EID Horwood PF, Reimer LJ, Dagina R, Susapu M, Bande G, Katusele M, et al. Outbreak of Chikungunya Virus Infection, Vanimo, Papua New Guinea. Emerg Infect Dis. 2013;19(9):1535-1538. https://dx.doi.org/10.3201/eid1909.130130
AMA Horwood PF, Reimer LJ, Dagina R, et al. Outbreak of Chikungunya Virus Infection, Vanimo, Papua New Guinea. Emerging Infectious Diseases. 2013;19(9):1535-1538. doi:10.3201/eid1909.130130.
APA Horwood, P. F., Reimer, L. J., Dagina, R., Susapu, M., Bande, G., Katusele, M....Pavlin, B. I. (2013). Outbreak of Chikungunya Virus Infection, Vanimo, Papua New Guinea. Emerging Infectious Diseases, 19(9), 1535-1538. https://dx.doi.org/10.3201/eid1909.130130.
Letters

Clostridium difficile Infection Caused by Binary Toxin–Positive Strains [PDF - 358 KB - 2 pages]
M. Hensgens and E. J. Kuijper
EID Hensgens M, Kuijper EJ. Clostridium difficile Infection Caused by Binary Toxin–Positive Strains. Emerg Infect Dis. 2013;19(9):1540. https://dx.doi.org/10.3201/eid1909.110814
AMA Hensgens M, Kuijper EJ. Clostridium difficile Infection Caused by Binary Toxin–Positive Strains. Emerging Infectious Diseases. 2013;19(9):1540. doi:10.3201/eid1909.110814.
APA Hensgens, M., & Kuijper, E. J. (2013). Clostridium difficile Infection Caused by Binary Toxin–Positive Strains. Emerging Infectious Diseases, 19(9), 1540. https://dx.doi.org/10.3201/eid1909.110814.

Spread of Kyasanur Forest Disease, Bandipur Tiger Reserve, India, 2012–2013 [PDF - 329 KB - 1 page]
D. T. Mourya et al.
EID Mourya DT, Yadav PD, Sandhya K, Reddy S. Spread of Kyasanur Forest Disease, Bandipur Tiger Reserve, India, 2012–2013. Emerg Infect Dis. 2013;19(9):1540-1541. https://dx.doi.org/10.3201/eid1909.121884
AMA Mourya DT, Yadav PD, Sandhya K, et al. Spread of Kyasanur Forest Disease, Bandipur Tiger Reserve, India, 2012–2013. Emerging Infectious Diseases. 2013;19(9):1540-1541. doi:10.3201/eid1909.121884.
APA Mourya, D. T., Yadav, P. D., Sandhya, K., & Reddy, S. (2013). Spread of Kyasanur Forest Disease, Bandipur Tiger Reserve, India, 2012–2013. Emerging Infectious Diseases, 19(9), 1540-1541. https://dx.doi.org/10.3201/eid1909.121884.

Chikungunya Virus Infection, Brazzaville, Republic of Congo, 2011 [PDF - 327 KB - 2 pages]
J. Mombouli et al.
EID Mombouli J, Bitsindou P, Elion D, Grolla A, Feldmann H, Niama FR, et al. Chikungunya Virus Infection, Brazzaville, Republic of Congo, 2011. Emerg Infect Dis. 2013;19(9):1542-1543. https://dx.doi.org/10.3201/eid1909.130451
AMA Mombouli J, Bitsindou P, Elion D, et al. Chikungunya Virus Infection, Brazzaville, Republic of Congo, 2011. Emerging Infectious Diseases. 2013;19(9):1542-1543. doi:10.3201/eid1909.130451.
APA Mombouli, J., Bitsindou, P., Elion, D., Grolla, A., Feldmann, H., Niama, F. R....Munster, V. J. (2013). Chikungunya Virus Infection, Brazzaville, Republic of Congo, 2011. Emerging Infectious Diseases, 19(9), 1542-1543. https://dx.doi.org/10.3201/eid1909.130451.

Chorea and Tick-Borne Encephalitis, Poland [PDF - 558 KB - 2 pages]
J. Zajkowska et al.
EID Zajkowska J, Moniuszko A, Czupryna P, Drozdowski W, Krupa W, Guziejko K, et al. Chorea and Tick-Borne Encephalitis, Poland. Emerg Infect Dis. 2013;19(9):1544-1545. https://dx.doi.org/10.3201/eid1909.130804
AMA Zajkowska J, Moniuszko A, Czupryna P, et al. Chorea and Tick-Borne Encephalitis, Poland. Emerging Infectious Diseases. 2013;19(9):1544-1545. doi:10.3201/eid1909.130804.
APA Zajkowska, J., Moniuszko, A., Czupryna, P., Drozdowski, W., Krupa, W., Guziejko, K....Pancewicz, S. (2013). Chorea and Tick-Borne Encephalitis, Poland. Emerging Infectious Diseases, 19(9), 1544-1545. https://dx.doi.org/10.3201/eid1909.130804.

Streptococcus suis Meningitis and Bacteremia in Man, French Guiana [PDF - 320 KB - 2 pages]
M. Demar et al.
EID Demar M, Belzunce C, Simonnet C, Renaux A, Abboud P, Okandze A, et al. Streptococcus suis Meningitis and Bacteremia in Man, French Guiana. Emerg Infect Dis. 2013;19(9):1545-1546. https://dx.doi.org/10.3201/eid1909.121872
AMA Demar M, Belzunce C, Simonnet C, et al. Streptococcus suis Meningitis and Bacteremia in Man, French Guiana. Emerging Infectious Diseases. 2013;19(9):1545-1546. doi:10.3201/eid1909.121872.
APA Demar, M., Belzunce, C., Simonnet, C., Renaux, A., Abboud, P., Okandze, A....Djossou, F. (2013). Streptococcus suis Meningitis and Bacteremia in Man, French Guiana. Emerging Infectious Diseases, 19(9), 1545-1546. https://dx.doi.org/10.3201/eid1909.121872.

Alaria alata Infection in European Mink [PDF - 408 KB - 3 pages]
F. Tăbăran et al.
EID Tăbăran F, Sándor A, Marinov M, Cătoi C, Mihalca A. Alaria alata Infection in European Mink. Emerg Infect Dis. 2013;19(9):1547-1549. https://dx.doi.org/10.3201/eid1909.130081
AMA Tăbăran F, Sándor A, Marinov M, et al. Alaria alata Infection in European Mink. Emerging Infectious Diseases. 2013;19(9):1547-1549. doi:10.3201/eid1909.130081.
APA Tăbăran, F., Sándor, A., Marinov, M., Cătoi, C., & Mihalca, A. (2013). Alaria alata Infection in European Mink. Emerging Infectious Diseases, 19(9), 1547-1549. https://dx.doi.org/10.3201/eid1909.130081.

Serologic Survey of Plague in Animals, Western Iran [PDF - 378 KB - 3 pages]
S. Esamaeili et al.
EID Esamaeili S, Azadmanesh K, Naddaf S, Rajerison M, Carniel E, Mostafavi E. Serologic Survey of Plague in Animals, Western Iran. Emerg Infect Dis. 2013;19(9):1549-1551. https://dx.doi.org/10.3201/eid1909.121829
AMA Esamaeili S, Azadmanesh K, Naddaf S, et al. Serologic Survey of Plague in Animals, Western Iran. Emerging Infectious Diseases. 2013;19(9):1549-1551. doi:10.3201/eid1909.121829.
APA Esamaeili, S., Azadmanesh, K., Naddaf, S., Rajerison, M., Carniel, E., & Mostafavi, E. (2013). Serologic Survey of Plague in Animals, Western Iran. Emerging Infectious Diseases, 19(9), 1549-1551. https://dx.doi.org/10.3201/eid1909.121829.

Livestock Density as Risk Factor for Livestock-associated Methicillin-Resistant Staphylococcus aureus, the Netherlands [PDF - 333 KB - 2 pages]
P. R. Davies et al.
EID Davies PR, Feingold BJ, Alexander BH, Kluytmans J, Bender JB, van Cleef B, et al. Livestock Density as Risk Factor for Livestock-associated Methicillin-Resistant Staphylococcus aureus, the Netherlands. Emerg Infect Dis. 2013;19(9):1552. https://dx.doi.org/10.3201/eid1909.121577
AMA Davies PR, Feingold BJ, Alexander BH, et al. Livestock Density as Risk Factor for Livestock-associated Methicillin-Resistant Staphylococcus aureus, the Netherlands. Emerging Infectious Diseases. 2013;19(9):1552. doi:10.3201/eid1909.121577.
APA Davies, P. R., Feingold, B. J., Alexander, B. H., Kluytmans, J., Bender, J. B., van Cleef, B....Stevenson, M. A. (2013). Livestock Density as Risk Factor for Livestock-associated Methicillin-Resistant Staphylococcus aureus, the Netherlands. Emerging Infectious Diseases, 19(9), 1552. https://dx.doi.org/10.3201/eid1909.121577.
Books and Media

Neuroinfections (What Do I Do Now?) [PDF - 319 KB - 1 page]
J. J. Sejvar
EID Sejvar JJ. Neuroinfections (What Do I Do Now?). Emerg Infect Dis. 2013;19(9):1553. https://dx.doi.org/10.3201/eid1909.130975
AMA Sejvar JJ. Neuroinfections (What Do I Do Now?). Emerging Infectious Diseases. 2013;19(9):1553. doi:10.3201/eid1909.130975.
APA Sejvar, J. J. (2013). Neuroinfections (What Do I Do Now?). Emerging Infectious Diseases, 19(9), 1553. https://dx.doi.org/10.3201/eid1909.130975.
About the Cover

When at night I go to sleep / Fourteen angels watch do keep [PDF - 255 KB - 2 pages]
P. Potter
EID Potter P. When at night I go to sleep / Fourteen angels watch do keep1. Emerg Infect Dis. 2013;19(9):1554-1555. https://dx.doi.org/10.3201/eid1909.ac1909
AMA Potter P. When at night I go to sleep / Fourteen angels watch do keep1. Emerging Infectious Diseases. 2013;19(9):1554-1555. doi:10.3201/eid1909.ac1909.
APA Potter, P. (2013). When at night I go to sleep / Fourteen angels watch do keep1. Emerging Infectious Diseases, 19(9), 1554-1555. https://dx.doi.org/10.3201/eid1909.ac1909.
Etymologia

Etymologia: Staphylococcus [PDF - 319 KB - 1 page]
G. Licitra
EID Licitra G. Etymologia: Staphylococcus. Emerg Infect Dis. 2013;19(9):1553. https://dx.doi.org/10.3201/eid1909.et1909
AMA Licitra G. Etymologia: Staphylococcus. Emerging Infectious Diseases. 2013;19(9):1553. doi:10.3201/eid1909.et1909.
APA Licitra, G. (2013). Etymologia: Staphylococcus. Emerging Infectious Diseases, 19(9), 1553. https://dx.doi.org/10.3201/eid1909.et1909.
Page created: December 05, 2013
Page updated: December 05, 2013
Page reviewed: December 05, 2013
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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