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Issue Cover for Volume 20, Number 4—April 2014

Volume 20, Number 4—April 2014

[PDF - 10.30 MB - 223 pages]

Synopses

Distribution of Pandemic Influenza Vaccine and Reporting of Doses Administered, New York, New York, USA [PDF - 937 KB - 7 pages]
R. Marcello et al.

In 2009, the New York City Department of Health and Mental Hygiene delivered influenza A(H1N1)pdm09 (pH1N1) vaccine to health care providers, who were required to report all administered doses to the Citywide Immunization Registry. Using data from this registry and a provider survey, we estimated the number of all pH1N1 vaccine doses administered. Of 2.8 million doses distributed during October 1, 2009–March 4, 2010, a total of 988,298 doses were administered and reported; another 172,289 doses were administered but not reported, for a total of 1,160,587 doses administered during this period. Reported doses represented an estimated 80%–85% of actual doses administered. Reporting by a wide range of provider types was feasible during a pandemic. Pediatric-care providers had the highest reporting rate (93%). Other private-care providers who routinely did not report vaccinations indicated that they had few, if any, problems, thereby suggesting that mandatory reporting of all vaccines would be feasible.

EID Marcello R, Papadouka V, Misener M, Wake E, Mandell R, Zucker JR. Distribution of Pandemic Influenza Vaccine and Reporting of Doses Administered, New York, New York, USA. Emerg Infect Dis. 2014;20(4):525-531. https://dx.doi.org/10.3201/eid2004.131114
AMA Marcello R, Papadouka V, Misener M, et al. Distribution of Pandemic Influenza Vaccine and Reporting of Doses Administered, New York, New York, USA. Emerging Infectious Diseases. 2014;20(4):525-531. doi:10.3201/eid2004.131114.
APA Marcello, R., Papadouka, V., Misener, M., Wake, E., Mandell, R., & Zucker, J. R. (2014). Distribution of Pandemic Influenza Vaccine and Reporting of Doses Administered, New York, New York, USA. Emerging Infectious Diseases, 20(4), 525-531. https://dx.doi.org/10.3201/eid2004.131114.
Research

Antibodies against MERS Coronavirus in Dromedary Camels, United Arab Emirates, 2003 and 2013 [PDF - 493 KB - 8 pages]
B. Meyer et al.

Middle East respiratory syndrome coronavirus (MERS-CoV) has caused an ongoing outbreak of severe acute respiratory tract infection in humans in the Arabian Peninsula since 2012. Dromedary camels have been implicated as possible viral reservoirs. We used serologic assays to analyze 651 dromedary camel serum samples from the United Arab Emirates; 151 of 651 samples were obtained in 2003, well before onset of the current epidemic, and 500 serum samples were obtained in 2013. Recombinant spike protein–specific immunofluorescence and virus neutralization tests enabled clear discrimination between MERS-CoV and bovine CoV infections. Most (632/651, 97.1%) camels had antibodies against MERS-CoV. This result included all 151 serum samples obtained in 2003. Most (389/651, 59.8%) serum samples had MERS-CoV–neutralizing antibody titers >1,280. Dromedary camels from the United Arab Emirates were infected at high rates with MERS-CoV or a closely related, probably conspecific, virus long before the first human MERS cases.

EID Meyer B, Müller MA, Corman VM, Reusken C, Ritz D, Godeke G, et al. Antibodies against MERS Coronavirus in Dromedary Camels, United Arab Emirates, 2003 and 2013. Emerg Infect Dis. 2014;20(4):552-559. https://dx.doi.org/10.3201/eid2004.131746
AMA Meyer B, Müller MA, Corman VM, et al. Antibodies against MERS Coronavirus in Dromedary Camels, United Arab Emirates, 2003 and 2013. Emerging Infectious Diseases. 2014;20(4):552-559. doi:10.3201/eid2004.131746.
APA Meyer, B., Müller, M. A., Corman, V. M., Reusken, C., Ritz, D., Godeke, G....Drosten, C. (2014). Antibodies against MERS Coronavirus in Dromedary Camels, United Arab Emirates, 2003 and 2013. Emerging Infectious Diseases, 20(4), 552-559. https://dx.doi.org/10.3201/eid2004.131746.

Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006 [PDF - 480 KB - 8 pages]
H. W. Chesson et al.

Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts. In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level. We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006. We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection. These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance.

EID Chesson HW, Kirkcaldy RD, Gift TL, Owusu-Edusei K, Weinstock HS. Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006. Emerg Infect Dis. 2014;20(4):612-619. https://dx.doi.org/10.3201/eid2004.131288
AMA Chesson HW, Kirkcaldy RD, Gift TL, et al. Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006. Emerging Infectious Diseases. 2014;20(4):612-619. doi:10.3201/eid2004.131288.
APA Chesson, H. W., Kirkcaldy, R. D., Gift, T. L., Owusu-Edusei, K., & Weinstock, H. S. (2014). Ciprofloxacin Resistance and Gonorrhea Incidence Rates in 17 Cities, United States, 1991–2006. Emerging Infectious Diseases, 20(4), 612-619. https://dx.doi.org/10.3201/eid2004.131288.

Active Surveillance for Avian Influenza Virus, Egypt, 2010–2012 [PDF - 799 KB - 10 pages]
G. Kayali et al.

Continuous circulation of influenza A(H5N1) virus among poultry in Egypt has created an epicenter in which the viruses evolve into newer subclades and continue to cause disease in humans. To detect influenza viruses in Egypt, since 2009 we have actively surveyed various regions and poultry production sectors. From August 2010 through January 2013, >11,000 swab samples were collected; 10% were positive by matrix gene reverse transcription PCR. During this period, subtype H9N2 viruses emerged, cocirculated with subtype H5N1 viruses, and frequently co-infected the same avian host. Genetic and antigenic analyses of viruses revealed that influenza A(H5N1) clade 2.2.1 viruses are dominant and that all subtype H9N2 viruses are G1-like. Cocirculation of different subtypes poses concern for potential reassortment. Avian influenza continues to threaten public and animal health in Egypt, and continuous surveillance for avian influenza virus is needed.

EID Kayali G, Kandeil A, El-Shesheny R, Kayed AS, Gomaa MM, Maatouq AM, et al. Active Surveillance for Avian Influenza Virus, Egypt, 2010–2012. Emerg Infect Dis. 2014;20(4):542-551. https://dx.doi.org/10.3201/eid2004.131295
AMA Kayali G, Kandeil A, El-Shesheny R, et al. Active Surveillance for Avian Influenza Virus, Egypt, 2010–2012. Emerging Infectious Diseases. 2014;20(4):542-551. doi:10.3201/eid2004.131295.
APA Kayali, G., Kandeil, A., El-Shesheny, R., Kayed, A. S., Gomaa, M. M., Maatouq, A. M....Ali, M. A. (2014). Active Surveillance for Avian Influenza Virus, Egypt, 2010–2012. Emerging Infectious Diseases, 20(4), 542-551. https://dx.doi.org/10.3201/eid2004.131295.

Contact Investigation for Imported Case of Middle East Respiratory Syndrome, Germany [PDF - 359 KB - 6 pages]
A. Reuss et al.

On March 19, 2013, a patient from United Arab Emirates who had severe respiratory infection was transferred to a hospital in Germany, 11 days after symptom onset. Infection with Middle East respiratory syndrome coronavirus (MERS-CoV) was suspected on March 21 and confirmed on March 23; the patient, who had contact with an ill camel shortly before symptom onset, died on March 26. A contact investigation was initiated to identify possible person-to-person transmission and assess infection control measures. Of 83 identified contacts, 81 were available for follow-up. Ten contacts experienced mild symptoms, but test results for respiratory and serum samples were negative for MERS-CoV. Serologic testing was done for 53 (75%) of 71 nonsymptomatic contacts; all results were negative. Among contacts, the use of FFP2/FFP3 face masks during aerosol exposure was more frequent after MERS-CoV infection was suspected than before. Infection control measures may have prevented nosocomial transmission of the virus.

EID Reuss A, Litterst A, Drosten C, Seilmaier M, Böhmer M, Graf P, et al. Contact Investigation for Imported Case of Middle East Respiratory Syndrome, Germany. Emerg Infect Dis. 2014;20(4):620-625. https://dx.doi.org/10.3201/eid2004.131375
AMA Reuss A, Litterst A, Drosten C, et al. Contact Investigation for Imported Case of Middle East Respiratory Syndrome, Germany. Emerging Infectious Diseases. 2014;20(4):620-625. doi:10.3201/eid2004.131375.
APA Reuss, A., Litterst, A., Drosten, C., Seilmaier, M., Böhmer, M., Graf, P....Buchholz, U. (2014). Contact Investigation for Imported Case of Middle East Respiratory Syndrome, Germany. Emerging Infectious Diseases, 20(4), 620-625. https://dx.doi.org/10.3201/eid2004.131375.

Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009 [PDF - 462 KB - 6 pages]
S. Saha et al.

During October 23–December 8, 2009, the Los Angeles County Department of Public Health used points of dispensing (PODs) to improve access to and increase the number of vaccinations against influenza A(H1N1)pdm09. We assessed the efficiency of these units and access to vaccines among ethnic groups. An average of 251 persons per hour (SE 65) were vaccinated at the PODs; a 10% increase in use of live-attenuated monovalent vaccines reduced that rate by 23 persons per hour (SE 7). Vaccination rates were highest for Asians (257/10,000 persons), followed by Hispanics (114/10,000), whites (75/100,000), and African Americans (37/10,000). Average distance traveled to a POD was highest for whites (6.6 miles; SD 6.5) and lowest for Hispanics (4.7 miles; SD ±5.3). Placing PODs in areas of high population density could be an effective strategy to reach large numbers of persons for mass vaccination, but additional PODs may be needed to improve coverage for specific populations.

EID Saha S, Dean B, Teutsch S, Borse RH, Meltzer MI, Bagwell D, et al. Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009. Emerg Infect Dis. 2014;20(4):590-595. https://dx.doi.org/10.3201/eid2004.130725
AMA Saha S, Dean B, Teutsch S, et al. Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009. Emerging Infectious Diseases. 2014;20(4):590-595. doi:10.3201/eid2004.130725.
APA Saha, S., Dean, B., Teutsch, S., Borse, R. H., Meltzer, M. I., Bagwell, D....Fielding, J. (2014). Efficiency of Points of Dispensing for Influenza A(H1N1)pdm09 Vaccination, Los Angeles County, California, USA, 2009. Emerging Infectious Diseases, 20(4), 590-595. https://dx.doi.org/10.3201/eid2004.130725.

Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012 [PDF - 694 KB - 6 pages]
J. Sane et al.

To analyze the epidemiology of a nationwide mumps epidemic in the Netherlands, we reviewed 1,557 notified mumps cases in persons who had disease onset during September 1, 2009–August 31, 2012. Seasonality peaked in spring and autumn. Most case-patients were males (59%), 18–25 years of age (67.9%), and vaccinated twice with measles-mumps-rubella vaccine (67.7%). Nearly half (46.6%) of cases occurred in university students or in persons with student contacts. Receipt of 2 doses of vaccine reduced the risk for orchitis, the most frequently reported complication (vaccine effectiveness [VE] 74%, 95% CI 57%–85%); complications overall (VE 76%, 95% CI 61%–86%); and hospitalization (VE 82%, 95% CI 53%–93%). Over time, the age distribution of case-patients changed, and proportionally more cases were reported from nonuniversity cities (p<0.001). Changes in age and geographic distribution over time may reflect increased immunity among students resulting from intense exposure to circulating mumps virus.

EID Sane J, Gouma S, Koopmans M, de Melker H, Swaan C, van Binnendijk R, et al. Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012. Emerg Infect Dis. 2014;20(4):643-648. https://dx.doi.org/10.3201/eid2004.131681
AMA Sane J, Gouma S, Koopmans M, et al. Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012. Emerging Infectious Diseases. 2014;20(4):643-648. doi:10.3201/eid2004.131681.
APA Sane, J., Gouma, S., Koopmans, M., de Melker, H., Swaan, C., van Binnendijk, R....Hahné, S. (2014). Epidemic of Mumps among Vaccinated Persons, the Netherlands, 2009–2012. Emerging Infectious Diseases, 20(4), 643-648. https://dx.doi.org/10.3201/eid2004.131681.

Rapid Increase in Pertactin-deficient Bordetella pertussis Isolates, Australia [PDF - 566 KB - 8 pages]
C. Lam et al.

Acellular vaccines against Bordetella pertussis were introduced in Australia in 1997. By 2000, these vaccines had replaced whole-cell vaccines. During 2008–2012, a large outbreak of pertussis occurred. During this period, 30% (96/320) of B. pertussis isolates did not express the vaccine antigen pertactin (prn). Multiple mechanisms of prn inactivation were documented, including IS481 and IS1002 disruptions, a variation within a homopolymeric tract, and deletion of the prn gene. The mechanism of lack of expression of prn in 16 (17%) isolates could not be determined at the sequence level. These findings suggest that B. pertussis not expressing prn arose independently multiple times since 2008, rather than by expansion of a single prn-negative clone. All but 1 isolate had ptxA1, prn2, and ptxP3, the alleles representative of currently circulating strains in Australia. This pattern is consistent with continuing evolution of B. pertussis in response to vaccine selection pressure.

EID Lam C, Octavia S, Ricafort L, Sintchenko V, Gilbert GL, Wood N, et al. Rapid Increase in Pertactin-deficient Bordetella pertussis Isolates, Australia. Emerg Infect Dis. 2014;20(4):626-633. https://dx.doi.org/10.3201/eid2004.131478
AMA Lam C, Octavia S, Ricafort L, et al. Rapid Increase in Pertactin-deficient Bordetella pertussis Isolates, Australia. Emerging Infectious Diseases. 2014;20(4):626-633. doi:10.3201/eid2004.131478.
APA Lam, C., Octavia, S., Ricafort, L., Sintchenko, V., Gilbert, G. L., Wood, N....Lan, R. (2014). Rapid Increase in Pertactin-deficient Bordetella pertussis Isolates, Australia. Emerging Infectious Diseases, 20(4), 626-633. https://dx.doi.org/10.3201/eid2004.131478.

Underdiagnosis of Foodborne Hepatitis A, the Netherlands, 2008–2010 [PDF - 380 KB - 7 pages]
M. Petrignani et al.

Outbreaks of foodborne hepatitis A are rarely recognized as such. Detection of these infections is challenging because of the infection’s long incubation period and patients’ recall bias. Nevertheless, the complex food market might lead to reemergence of hepatitis A virus outside of disease-endemic areas. To assess the role of food as a source of infection, we combined routine surveillance with real-time strain sequencing in the Netherlands during 2008–2010. Virus RNA from serum of 248 (59%) of 421 reported case-patients could be sequenced. Without typing, foodborne transmission was suspected for only 4% of reported case-patients. With typing, foodborne transmission increased to being the most probable source of infection for 16%. We recommend routine implementation of an enhanced surveillance system that includes prompt forwarding and typing of hepatitis A virus RNA isolated from serum, standard use of questionnaires, data sharing, and centralized interpretation of data.

EID Petrignani M, Verhoef L, Vennema H, van Hunen R, Baas D, van Steenbergen JE, et al. Underdiagnosis of Foodborne Hepatitis A, the Netherlands, 2008–2010. Emerg Infect Dis. 2014;20(4):596-602. https://dx.doi.org/10.3201/eid2004.130753
AMA Petrignani M, Verhoef L, Vennema H, et al. Underdiagnosis of Foodborne Hepatitis A, the Netherlands, 2008–2010. Emerging Infectious Diseases. 2014;20(4):596-602. doi:10.3201/eid2004.130753.
APA Petrignani, M., Verhoef, L., Vennema, H., van Hunen, R., Baas, D., van Steenbergen, J. E....Koopmans, M. (2014). Underdiagnosis of Foodborne Hepatitis A, the Netherlands, 2008–2010. Emerging Infectious Diseases, 20(4), 596-602. https://dx.doi.org/10.3201/eid2004.130753.

Regional Variation in Travel-related Illness acquired in Africa, March 1997–May 2011 [PDF - 558 KB - 10 pages]
M. Mendelson et al.

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.

EID Mendelson M, Han PV, Vincent P, von Sonnenburg F, Cramer JP, Loutan L, et al. Regional Variation in Travel-related Illness acquired in Africa, March 1997–May 2011. Emerg Infect Dis. 2014;20(4):532-541. https://dx.doi.org/10.3201/eid2004.131128
AMA Mendelson M, Han PV, Vincent P, et al. Regional Variation in Travel-related Illness acquired in Africa, March 1997–May 2011. Emerging Infectious Diseases. 2014;20(4):532-541. doi:10.3201/eid2004.131128.
APA Mendelson, M., Han, P. V., Vincent, P., von Sonnenburg, F., Cramer, J. P., Loutan, L....Schlagenhauf, P. (2014). Regional Variation in Travel-related Illness acquired in Africa, March 1997–May 2011. Emerging Infectious Diseases, 20(4), 532-541. https://dx.doi.org/10.3201/eid2004.131128.

Large Outbreak of Cryptosporidium hominis Infection Transmitted through the Public Water Supply, Sweden [PDF - 1.03 MB - 9 pages]
M. Widerström et al.

In November 2010, ≈27,000 (≈45%) inhabitants of Östersund, Sweden, were affected by a waterborne outbreak of cryptosporidiosis. The outbreak was characterized by a rapid onset and high attack rate, especially among young and middle-aged persons. Young age, number of infected family members, amount of water consumed daily, and gluten intolerance were identified as risk factors for acquiring cryptosporidiosis. Also, chronic intestinal disease and young age were significantly associated with prolonged diarrhea. Identification of Cryptosporidium hominis subtype IbA10G2 in human and environmental samples and consistently low numbers of oocysts in drinking water confirmed insufficient reduction of parasites by the municipal water treatment plant. The current outbreak shows that use of inadequate microbial barriers at water treatment plants can have serious consequences for public health. This risk can be minimized by optimizing control of raw water quality and employing multiple barriers that remove or inactivate all groups of pathogens.

EID Widerström M, Schönning C, Lilja M, Lebbad M, Ljung T, Allestam G, et al. Large Outbreak of Cryptosporidium hominis Infection Transmitted through the Public Water Supply, Sweden. Emerg Infect Dis. 2014;20(4):581-589. https://dx.doi.org/10.3201/eid2004.121415
AMA Widerström M, Schönning C, Lilja M, et al. Large Outbreak of Cryptosporidium hominis Infection Transmitted through the Public Water Supply, Sweden. Emerging Infectious Diseases. 2014;20(4):581-589. doi:10.3201/eid2004.121415.
APA Widerström, M., Schönning, C., Lilja, M., Lebbad, M., Ljung, T., Allestam, G....Lindh, J. (2014). Large Outbreak of Cryptosporidium hominis Infection Transmitted through the Public Water Supply, Sweden. Emerging Infectious Diseases, 20(4), 581-589. https://dx.doi.org/10.3201/eid2004.121415.

Gnathostoma spinigerum in Live Asian Swamp Eels (Monopterus spp.) from Food Markets and Wild Populations, United States [PDF - 642 KB - 9 pages]
R. A. Cole et al.

In Southeast Asia, swamp eels (Synbranchidae: Monopterus spp.) are a common source of human gnathostomiasis, a foodborne zoonosis caused by advanced third-stage larvae (AL3) of Gnathostoma spp. nematodes. Live Asian swamp eels are imported to US ethnic food markets, and wild populations exist in several states. To determine whether these eels are infected, we examined 47 eels from markets and 67 wild-caught specimens. Nematodes were identified by morphologic features and ribosomal intergenic transcribed spacer–2 gene sequencing. Thirteen (27.7%) M. cuchia eels from markets were infected with 36 live G. spinigerum AL3: 21 (58.3%) in liver; 7 (19.4%) in muscle; 5 (13.8%) in gastrointestinal tract, and 3 (8.3%) in kidneys. Three (4.5%) wild-caught M. albus eels were infected with 5 G. turgidum AL3 in muscle, and 1 G. lamothei AL3 was found in a kidney (both North American spp.). Imported live eels are a potential source of human gnathostomiasis in the United States.

EID Cole RA, Choudhury A, Nico LG, Griffin KM. Gnathostoma spinigerum in Live Asian Swamp Eels (Monopterus spp.) from Food Markets and Wild Populations, United States. Emerg Infect Dis. 2014;20(4):634-642. https://dx.doi.org/10.3201/eid2004.131566
AMA Cole RA, Choudhury A, Nico LG, et al. Gnathostoma spinigerum in Live Asian Swamp Eels (Monopterus spp.) from Food Markets and Wild Populations, United States. Emerging Infectious Diseases. 2014;20(4):634-642. doi:10.3201/eid2004.131566.
APA Cole, R. A., Choudhury, A., Nico, L. G., & Griffin, K. M. (2014). Gnathostoma spinigerum in Live Asian Swamp Eels (Monopterus spp.) from Food Markets and Wild Populations, United States. Emerging Infectious Diseases, 20(4), 634-642. https://dx.doi.org/10.3201/eid2004.131566.

Medscape CME Activity
Travel-associated Antimicrobial Drug–Resistant Nontyphoidal Salmonellae, 2004–2009 [PDF - 669 KB - 9 pages]
R. S. Barlow et al.

To evaluate trends in and risk factors for acquisition of antimicrobial-drug resistant nontyphoidal Salmonella infections, we searched Oregon surveillance data for 2004–2009 for all culture-confirmed cases of salmonellosis. We defined clinically important resistance (CIR) as decreased susceptibility to ampicillin, ceftriaxone, ciprofloxacin, gentamicin, or trimethoprim/sulfamethoxazole. Of 2,153 cases, 2,127 (99%) nontyphoidal Salmonella isolates were obtained from a specific source (e.g., feces, urine, blood, or other normally sterile tissue) and had been tested for drug susceptibility. Among these, 347 (16%) isolates had CIR. The odds of acquiring CIR infection significantly increased each year. Hospitalization was more likely for patients with than without CIR infections. Among patients with isolates that had been tested, we analyzed data from 1,813 (84%) who were interviewed. Travel to eastern or Southeast Asia was associated with increased CIR. Isolates associated with outbreaks were less likely to have CIR. Future surveillance activities should evaluate resistance with respect to international travel.

EID Barlow RS, DeBess EE, Winthrop KL, Lapidus JA, Vega R, Cieslak PR. Travel-associated Antimicrobial Drug–Resistant Nontyphoidal Salmonellae, 2004–2009. Emerg Infect Dis. 2014;20(4):603-611. https://dx.doi.org/10.3201/eid2004.131063
AMA Barlow RS, DeBess EE, Winthrop KL, et al. Travel-associated Antimicrobial Drug–Resistant Nontyphoidal Salmonellae, 2004–2009. Emerging Infectious Diseases. 2014;20(4):603-611. doi:10.3201/eid2004.131063.
APA Barlow, R. S., DeBess, E. E., Winthrop, K. L., Lapidus, J. A., Vega, R., & Cieslak, P. R. (2014). Travel-associated Antimicrobial Drug–Resistant Nontyphoidal Salmonellae, 2004–2009. Emerging Infectious Diseases, 20(4), 603-611. https://dx.doi.org/10.3201/eid2004.131063.

Rotavirus Surveillance in Urban and Rural Areas of Niger, April 2010–March 2012 [PDF - 460 KB - 8 pages]
A. Page et al.

Knowledge of rotavirus epidemiology is necessary to make informed decisions about vaccine introduction and to evaluate vaccine impact. During April 2010–March 2012, rotavirus surveillance was conducted among 9,745 children <5 years of age in 14 hospitals/health centers in Niger, where rotavirus vaccine has not been introduced. Study participants had acute watery diarrhea and moderate to severe dehydration, and 20% of the children were enrolled in a nutrition program. Of the 9,745 children, 30.6% were rotavirus positive. Genotyping of a subset of positive samples showed a variety of genotypes during the first year, although G2P[4] predominated. G12 genotypes, including G12P[8], which has emerged as a predominant strain in western Africa, represented >80% of isolates during the second year. Hospitalization and death rates and severe dehydration among rotavirus case-patients did not differ during the 2 years. The emergence of G12P[8] warrants close attention to the characteristics of associated epidemics and possible prevention measures.

EID Page A, Jusot V, Mamaty A, Adamou L, Kaplon J, Pothier P, et al. Rotavirus Surveillance in Urban and Rural Areas of Niger, April 2010–March 2012. Emerg Infect Dis. 2014;20(4):573-580. https://dx.doi.org/10.3201/eid2004.131328
AMA Page A, Jusot V, Mamaty A, et al. Rotavirus Surveillance in Urban and Rural Areas of Niger, April 2010–March 2012. Emerging Infectious Diseases. 2014;20(4):573-580. doi:10.3201/eid2004.131328.
APA Page, A., Jusot, V., Mamaty, A., Adamou, L., Kaplon, J., Pothier, P....Grais, R. F. (2014). Rotavirus Surveillance in Urban and Rural Areas of Niger, April 2010–March 2012. Emerging Infectious Diseases, 20(4), 573-580. https://dx.doi.org/10.3201/eid2004.131328.

Novel Betacoronavirus in Dromedaries of the Middle East, 2013 [PDF - 749 KB - 13 pages]
P. Woo et al.

In 2013, a novel betacoronavirus was identified in fecal samples from dromedaries in Dubai, United Arab Emirates. Antibodies against the recombinant nucleocapsid protein of the virus, which we named dromedary camel coronavirus (DcCoV) UAE-HKU23, were detected in 52% of 59 dromedary serum samples tested. In an analysis of 3 complete DcCoV UAE-HKU23 genomes, we identified the virus as a betacoronavirus in lineage A1. The DcCoV UAE-HKU23 genome has G+C contents; a general preference for G/C in the third position of codons; a cleavage site for spike protein; and a membrane protein of similar length to that of other betacoronavirus A1 members, to which DcCoV UAE-HKU23 is phylogenetically closely related. Along with this coronavirus, viruses of at least 8 other families have been found to infect camels. Because camels have a close association with humans, continuous surveillance should be conducted to understand the potential for virus emergence in camels and for virus transmission to humans.

EID Woo P, Lau S, Wernery U, Wong E, Tsang A, Johnson B, et al. Novel Betacoronavirus in Dromedaries of the Middle East, 2013. Emerg Infect Dis. 2014;20(4):560-572. https://dx.doi.org/10.3201/eid2004.131769
AMA Woo P, Lau S, Wernery U, et al. Novel Betacoronavirus in Dromedaries of the Middle East, 2013. Emerging Infectious Diseases. 2014;20(4):560-572. doi:10.3201/eid2004.131769.
APA Woo, P., Lau, S., Wernery, U., Wong, E., Tsang, A., Johnson, B....Yuen, K. (2014). Novel Betacoronavirus in Dromedaries of the Middle East, 2013. Emerging Infectious Diseases, 20(4), 560-572. https://dx.doi.org/10.3201/eid2004.131769.

High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands [PDF - 1.23 MB - 9 pages]
C. von Wintersdorff et al.

We investigated the effect of international travel on the gut resistome of 122 healthy travelers from the Netherlands by using a targeted metagenomic approach. Our results confirm high acquisition rates of the extended-spectrum β-lactamase encoding gene blaCTX-M, documenting a rise in prevalence from 9.0% before travel to 33.6% after travel (p<0.001). The prevalence of quinolone resistance encoding genes qnrB and qnrS increased from 6.6% and 8.2% before travel to 36.9% and 55.7% after travel, respectively (both p<0.001). Travel to Southeast Asia and the Indian subcontinent was associated with the highest acquisition rates of qnrS and both blaCTX-M and qnrS, respectively. Investigation of the associations between the acquisitions of the blaCTX-M and qnr genes showed that acquisition of a blaCTX-M gene was not associated with that of a qnrB (p = 0.305) or qnrS (p = 0.080) gene. These findings support the increasing evidence that travelers contribute to the spread of antimicrobial drug resistance.

EID von Wintersdorff C, Penders J, Stobberingh EE, Lashof A, Hoebe C, Savelkoul P, et al. High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands. Emerg Infect Dis. 2014;20(4):649-657. https://dx.doi.org/10.3201/eid2004.131718
AMA von Wintersdorff C, Penders J, Stobberingh EE, et al. High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands. Emerging Infectious Diseases. 2014;20(4):649-657. doi:10.3201/eid2004.131718.
APA von Wintersdorff, C., Penders, J., Stobberingh, E. E., Lashof, A., Hoebe, C., Savelkoul, P....Wolffs, P. (2014). High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands. Emerging Infectious Diseases, 20(4), 649-657. https://dx.doi.org/10.3201/eid2004.131718.
Dispatches

Spread of Virulent Group A Streptococcus Type emm59 from Montana to Wyoming, USA [PDF - 286 KB - 3 pages]
C. C. Brown et al.

Full-genome sequencing showed that a recently emerged and hypervirulent clone of group A Streptococcus type emm59 active in Canada and parts of the United States has now caused severe invasive infections in rural northeastern Wyoming. Phylogenetic analysis of genome data indicated that the strain was likely introduced from Montana.

EID Brown CC, Olsen RJ, Fittipaldi N, Morman ML, Fort PL, Neuwirth R, et al. Spread of Virulent Group A Streptococcus Type emm59 from Montana to Wyoming, USA. Emerg Infect Dis. 2014;20(4):658-660. https://dx.doi.org/10.3201/eid2004.130564
AMA Brown CC, Olsen RJ, Fittipaldi N, et al. Spread of Virulent Group A Streptococcus Type emm59 from Montana to Wyoming, USA. Emerging Infectious Diseases. 2014;20(4):658-660. doi:10.3201/eid2004.130564.
APA Brown, C. C., Olsen, R. J., Fittipaldi, N., Morman, M. L., Fort, P. L., Neuwirth, R....Musser, J. M. (2014). Spread of Virulent Group A Streptococcus Type emm59 from Montana to Wyoming, USA. Emerging Infectious Diseases, 20(4), 658-660. https://dx.doi.org/10.3201/eid2004.130564.

Burkholderia pseudomallei Type G in Western Hemisphere [PDF - 468 KB - 3 pages]
J. E. Gee et al.

Burkholderia pseudomallei isolates from the Western Hemisphere are difficult to differentiate from those from regions in which melioidosis is traditionally endemic. We used internal transcribed spacer typing to determine that B. pseudomallei isolates from the Western Hemisphere are consistently type G. Knowledge of this relationship might be useful for epidemiologic investigations.

EID Gee JE, Allender CJ, Tuanyok A, Elrod MG, Hoffmaster AR. Burkholderia pseudomallei Type G in Western Hemisphere. Emerg Infect Dis. 2014;20(4):661-663. https://dx.doi.org/10.3201/eid2004.130960
AMA Gee JE, Allender CJ, Tuanyok A, et al. Burkholderia pseudomallei Type G in Western Hemisphere. Emerging Infectious Diseases. 2014;20(4):661-663. doi:10.3201/eid2004.130960.
APA Gee, J. E., Allender, C. J., Tuanyok, A., Elrod, M. G., & Hoffmaster, A. R. (2014). Burkholderia pseudomallei Type G in Western Hemisphere. Emerging Infectious Diseases, 20(4), 661-663. https://dx.doi.org/10.3201/eid2004.130960.

Invasive Salmonella enterica Serotype Typhimurium Infections, Democratic Republic of the Congo, 2007–2011 [PDF - 419 KB - 4 pages]
B. Ley et al.

Infection with Salmonella enterica serotype Typhimurium sequence type (ST) 313 is associated with high rates of drug resistance, bloodstream infections, and death. To determine whether ST313 is dominant in the Democratic Republic of the Congo, we studied 180 isolates collected during 2007–2011; 96% belonged to CRISPOL type CT28, which is associated with ST313.

EID Ley B, Le Hello S, Lunguya O, Lejon V, Muyembe J, Weill F, et al. Invasive Salmonella enterica Serotype Typhimurium Infections, Democratic Republic of the Congo, 2007–2011. Emerg Infect Dis. 2014;20(4):701-704. https://dx.doi.org/10.3201/eid2004.131488
AMA Ley B, Le Hello S, Lunguya O, et al. Invasive Salmonella enterica Serotype Typhimurium Infections, Democratic Republic of the Congo, 2007–2011. Emerging Infectious Diseases. 2014;20(4):701-704. doi:10.3201/eid2004.131488.
APA Ley, B., Le Hello, S., Lunguya, O., Lejon, V., Muyembe, J., Weill, F....Jacobs, J. (2014). Invasive Salmonella enterica Serotype Typhimurium Infections, Democratic Republic of the Congo, 2007–2011. Emerging Infectious Diseases, 20(4), 701-704. https://dx.doi.org/10.3201/eid2004.131488.

Complete Genome of Hepatitis E Virus from Laboratory Ferrets [PDF - 867 KB - 4 pages]
T. Li et al.

The complete genome of hepatitis E virus (HEV) from laboratory ferrets imported from the United States was identified. This virus shared only 82.4%–82.5% nt sequence identities with strains from the Netherlands, which indicated that the ferret HEV genome is genetically diverse. Some laboratory ferrets were contaminated with HEV.

EID Li T, Yang T, Ami Y, Suzaki Y, Shirakura M, Kishida N, et al. Complete Genome of Hepatitis E Virus from Laboratory Ferrets. Emerg Infect Dis. 2014;20(4):709-712. https://dx.doi.org/10.3201/eid2004.131815
AMA Li T, Yang T, Ami Y, et al. Complete Genome of Hepatitis E Virus from Laboratory Ferrets. Emerging Infectious Diseases. 2014;20(4):709-712. doi:10.3201/eid2004.131815.
APA Li, T., Yang, T., Ami, Y., Suzaki, Y., Shirakura, M., Kishida, N....Takaji, W. (2014). Complete Genome of Hepatitis E Virus from Laboratory Ferrets. Emerging Infectious Diseases, 20(4), 709-712. https://dx.doi.org/10.3201/eid2004.131815.

New Alphacoronavirus in Mystacina tuberculata Bats, New Zealand [PDF - 541 KB - 4 pages]
R. J. Hall et al.

Because of recent interest in bats as reservoirs of emerging diseases, we investigated the presence of viruses in Mystacina tuberculata bats in New Zealand. A novel alphacoronavirus sequence was detected in guano from roosts of M. tuberculata bats in pristine indigenous forest on a remote offshore island (Codfish Island).

EID Hall RJ, Wang J, Peacey M, Moore NE, McInnes K, Tompkins DM. New Alphacoronavirus in Mystacina tuberculata Bats, New Zealand. Emerg Infect Dis. 2014;20(4):697-700. https://dx.doi.org/10.3201/eid2004.131441
AMA Hall RJ, Wang J, Peacey M, et al. New Alphacoronavirus in Mystacina tuberculata Bats, New Zealand. Emerging Infectious Diseases. 2014;20(4):697-700. doi:10.3201/eid2004.131441.
APA Hall, R. J., Wang, J., Peacey, M., Moore, N. E., McInnes, K., & Tompkins, D. M. (2014). New Alphacoronavirus in Mystacina tuberculata Bats, New Zealand. Emerging Infectious Diseases, 20(4), 697-700. https://dx.doi.org/10.3201/eid2004.131441.

Vibrio parahaemolyticus, Southern Coastal Region of China, 2007–2012 [PDF - 390 KB - 4 pages]
Y. Li et al.

We analyzed the prevalence and characteristics of Vibrio parahaemolyticus among patients with acute infectious diarrhea in the southern coastal region of China. V. parahaemolyticus was the leading cause of bacterial infectious diarrhea in this region during 2007–2012. Serotype O3:K6 strains were most common, followed by serotypes O4:K8 and O3:K29.

EID Li Y, Xie X, Shi X, Lin Y, Mou J, Chen Q, et al. Vibrio parahaemolyticus, Southern Coastal Region of China, 2007–2012. Emerg Infect Dis. 2014;20(4):685-688. https://dx.doi.org/10.3201/eid2004.130744
AMA Li Y, Xie X, Shi X, et al. Vibrio parahaemolyticus, Southern Coastal Region of China, 2007–2012. Emerging Infectious Diseases. 2014;20(4):685-688. doi:10.3201/eid2004.130744.
APA Li, Y., Xie, X., Shi, X., Lin, Y., Mou, J., Chen, Q....Hu, Q. (2014). Vibrio parahaemolyticus, Southern Coastal Region of China, 2007–2012. Emerging Infectious Diseases, 20(4), 685-688. https://dx.doi.org/10.3201/eid2004.130744.

Pathology of US Porcine Epidemic Diarrhea Virus Strain PC21A in Gnotobiotic Pigs [PDF - 386 KB - 4 pages]
K. Jung et al.

To understand the progression of porcine epidemic diarrhea virus infection, we inoculated gnotobiotic pigs with a newly emerged US strain, PC21A, of the virus. At 24–48 hours postinoculation, the pigs exhibited severe diarrhea and vomiting, fecal shedding, viremia, and severe atrophic enteritis. These findings confirm that strain PC21A is highly enteropathogenic.

EID Jung K, Wang Q, Scheuer KA, Lu Z, Zhang Y, Saif LJ. Pathology of US Porcine Epidemic Diarrhea Virus Strain PC21A in Gnotobiotic Pigs. Emerg Infect Dis. 2014;20(4):668-671. https://dx.doi.org/10.3201/eid2004.131685
AMA Jung K, Wang Q, Scheuer KA, et al. Pathology of US Porcine Epidemic Diarrhea Virus Strain PC21A in Gnotobiotic Pigs. Emerging Infectious Diseases. 2014;20(4):668-671. doi:10.3201/eid2004.131685.
APA Jung, K., Wang, Q., Scheuer, K. A., Lu, Z., Zhang, Y., & Saif, L. J. (2014). Pathology of US Porcine Epidemic Diarrhea Virus Strain PC21A in Gnotobiotic Pigs. Emerging Infectious Diseases, 20(4), 668-671. https://dx.doi.org/10.3201/eid2004.131685.

Cetacean Morbillivirus in Coastal Indo-Pacific Bottlenose Dolphins, Western Australia [PDF - 614 KB - 5 pages]
N. Stephens et al.

Cetacean morbillivirus (CeMV) has caused several epizootics in multiple species of cetaceans globally and is an emerging disease among cetaceans in Australia. We detected CeMV in 2 stranded coastal Indo-Pacific bottlenose dolphins (Tursiops aduncus) in Western Australia. Preliminary phylogenetic data suggest that this virus variant is divergent from known strains.

EID Stephens N, Duignan PJ, Wang J, Bingham J, Finn H, Bejder L, et al. Cetacean Morbillivirus in Coastal Indo-Pacific Bottlenose Dolphins, Western Australia. Emerg Infect Dis. 2014;20(4):672-676. https://dx.doi.org/10.3201/eid2004.131714
AMA Stephens N, Duignan PJ, Wang J, et al. Cetacean Morbillivirus in Coastal Indo-Pacific Bottlenose Dolphins, Western Australia. Emerging Infectious Diseases. 2014;20(4):672-676. doi:10.3201/eid2004.131714.
APA Stephens, N., Duignan, P. J., Wang, J., Bingham, J., Finn, H., Bejder, L....Holyoake, C. (2014). Cetacean Morbillivirus in Coastal Indo-Pacific Bottlenose Dolphins, Western Australia. Emerging Infectious Diseases, 20(4), 672-676. https://dx.doi.org/10.3201/eid2004.131714.

Hepatitis E Antibodies in Laboratory Rabbits from 2 US Vendors [PDF - 550 KB - 4 pages]
L. Birke et al.

We tested laboratory rabbits from 2 US vendors for antibodies against hepatitis E virus (HEV); Seroprevalences were 40% and 50%. Retrospective analysis of an ocular herpes simplex 1 experiment demonstrated that HEV seropositivity had no effect on experiment outcome. HEV probably is widespread in research rabbits, but effects on research remain unknown.

EID Birke L, Cormier SA, You D, Stout RW, Clement C, Johnson M, et al. Hepatitis E Antibodies in Laboratory Rabbits from 2 US Vendors. Emerg Infect Dis. 2014;20(4):693-696. https://dx.doi.org/10.3201/eid2004.131229
AMA Birke L, Cormier SA, You D, et al. Hepatitis E Antibodies in Laboratory Rabbits from 2 US Vendors. Emerging Infectious Diseases. 2014;20(4):693-696. doi:10.3201/eid2004.131229.
APA Birke, L., Cormier, S. A., You, D., Stout, R. W., Clement, C., Johnson, M....Thompson, H. (2014). Hepatitis E Antibodies in Laboratory Rabbits from 2 US Vendors. Emerging Infectious Diseases, 20(4), 693-696. https://dx.doi.org/10.3201/eid2004.131229.

Clinical Malaria along the China–Myanmar Border, Yunnan Province, China, January 2011–August 2012 [PDF - 432 KB - 4 pages]
G. Zhou et al.

Passive surveillance for malaria cases was conducted in Yunnan Province, China, along the China–Myanmar border. Infection with Plasmodium vivax and P. falciparum protozoa accounted for 69% and 28% of the cases, respectively. Most patients were adult men. Cross-border travel into Myanmar was a key risk factor for P. falciparum malaria in China.

EID Zhou G, Sun L, Xia R, Duan Y, Xu J, Yang H, et al. Clinical Malaria along the China–Myanmar Border, Yunnan Province, China, January 2011–August 2012. Emerg Infect Dis. 2014;20(4):681-684. https://dx.doi.org/10.3201/eid2004.130647
AMA Zhou G, Sun L, Xia R, et al. Clinical Malaria along the China–Myanmar Border, Yunnan Province, China, January 2011–August 2012. Emerging Infectious Diseases. 2014;20(4):681-684. doi:10.3201/eid2004.130647.
APA Zhou, G., Sun, L., Xia, R., Duan, Y., Xu, J., Yang, H....Yang, Z. (2014). Clinical Malaria along the China–Myanmar Border, Yunnan Province, China, January 2011–August 2012. Emerging Infectious Diseases, 20(4), 681-684. https://dx.doi.org/10.3201/eid2004.130647.

Characteristics of Patients Infected with Norovirus GII.4 Sydney 2012, Hong Kong, China [PDF - 479 KB - 4 pages]
M. Chan et al.

Norovirus GII.4 Sydney 2012 has spread globally since late 2012. We report hospitalization of patients infected with this strain skewed toward infants and young children among 174 cases during August 2012–July 2013 in Hong Kong, China. This group had higher fecal viral load (≈10-fold) than did older children and adults.

EID Chan M, Leung TF, Kwok AK, Lee N, Chan P. Characteristics of Patients Infected with Norovirus GII.4 Sydney 2012, Hong Kong, China. Emerg Infect Dis. 2014;20(4):664-667. https://dx.doi.org/10.3201/eid2004.131457
AMA Chan M, Leung TF, Kwok AK, et al. Characteristics of Patients Infected with Norovirus GII.4 Sydney 2012, Hong Kong, China. Emerging Infectious Diseases. 2014;20(4):664-667. doi:10.3201/eid2004.131457.
APA Chan, M., Leung, T. F., Kwok, A. K., Lee, N., & Chan, P. (2014). Characteristics of Patients Infected with Norovirus GII.4 Sydney 2012, Hong Kong, China. Emerging Infectious Diseases, 20(4), 664-667. https://dx.doi.org/10.3201/eid2004.131457.

Salmonella Subtypes with Increased MICs for Azithromycin in Travelers Returned to the Netherlands [PDF - 394 KB - 4 pages]
R. Hassing et al.

Antimicrobial susceptibility was analyzed for 354 typhoidal Salmonella isolates collected during 1999–2012 in the Netherlands. In 16.1% of all isolates and in 23.8% of all isolates that showed increased MICs for ciprofloxacin, the MIC for azithromycin was increased. This resistance may complicate empirical treatment of enteric fever.

EID Hassing R, Goessens W, van Pelt W, Mevius DJ, Stricker BH, Molhoek N, et al. Salmonella Subtypes with Increased MICs for Azithromycin in Travelers Returned to the Netherlands. Emerg Infect Dis. 2014;20(4):705-708. https://dx.doi.org/10.3201/eid2004.131536
AMA Hassing R, Goessens W, van Pelt W, et al. Salmonella Subtypes with Increased MICs for Azithromycin in Travelers Returned to the Netherlands. Emerging Infectious Diseases. 2014;20(4):705-708. doi:10.3201/eid2004.131536.
APA Hassing, R., Goessens, W., van Pelt, W., Mevius, D. J., Stricker, B. H., Molhoek, N....van Genderen, P. (2014). Salmonella Subtypes with Increased MICs for Azithromycin in Travelers Returned to the Netherlands. Emerging Infectious Diseases, 20(4), 705-708. https://dx.doi.org/10.3201/eid2004.131536.

Diagnostic Methods for and Clinical Pictures of Polyomavirus Primary Infections in Children, Finland [PDF - 351 KB - 4 pages]
T. Chen et al.

We used comprehensive serodiagnostic methods (IgM, IgG, and IgG avidity) and PCR to study Merkel cell polyomavirus and trichodysplasia spinulosa-associated polyomavirus infections in children observed from infancy to adolescence. Comparing seroconversion intervals with previous and subsequent intervals, we found that primary infections with these 2 viruses were asymptomatic in childhood.

EID Chen T, Tanner L, Simell V, Hedman L, Mäkinen M, Sadeghi M, et al. Diagnostic Methods for and Clinical Pictures of Polyomavirus Primary Infections in Children, Finland. Emerg Infect Dis. 2014;20(4):689-692. https://dx.doi.org/10.3201/eid2004.131015
AMA Chen T, Tanner L, Simell V, et al. Diagnostic Methods for and Clinical Pictures of Polyomavirus Primary Infections in Children, Finland. Emerging Infectious Diseases. 2014;20(4):689-692. doi:10.3201/eid2004.131015.
APA Chen, T., Tanner, L., Simell, V., Hedman, L., Mäkinen, M., Sadeghi, M....Hedman, K. (2014). Diagnostic Methods for and Clinical Pictures of Polyomavirus Primary Infections in Children, Finland. Emerging Infectious Diseases, 20(4), 689-692. https://dx.doi.org/10.3201/eid2004.131015.

Genetic Characterization of Clade 2.3.2.1 Avian Influenza A(H5N1) Viruses, Indonesia, 2012 [PDF - 518 KB - 4 pages]
N. Dharmayanti et al.

After reports of unusually high mortality rates among ducks on farms in Java Island, Indonesia, in September 2012, influenza A(H5N1) viruses were detected and characterized. Sequence analyses revealed all genes clustered with contemporary clade 2.3.2.1 viruses, rather than enzootic clade 2.1.3 viruses, indicating the introduction of an exotic H5N1 clade into Indonesia.

EID Dharmayanti N, Hartawan R, Pudjiatmoko, Wibawa H, Hardiman, Balish A, et al. Genetic Characterization of Clade 2.3.2.1 Avian Influenza A(H5N1) Viruses, Indonesia, 2012. Emerg Infect Dis. 2014;20(4):671-674. https://dx.doi.org/10.3201/eid2004.130517
AMA Dharmayanti N, Hartawan R, Pudjiatmoko, et al. Genetic Characterization of Clade 2.3.2.1 Avian Influenza A(H5N1) Viruses, Indonesia, 2012. Emerging Infectious Diseases. 2014;20(4):671-674. doi:10.3201/eid2004.130517.
APA Dharmayanti, N., Hartawan, R., Pudjiatmoko., Wibawa, H., Hardiman., Balish, A....Samaan, G. (2014). Genetic Characterization of Clade 2.3.2.1 Avian Influenza A(H5N1) Viruses, Indonesia, 2012. Emerging Infectious Diseases, 20(4), 671-674. https://dx.doi.org/10.3201/eid2004.130517.
Commentaries

Incorporating Research and Evaluation into Pandemic Influenza Vaccination Preparedness and Response [PDF - 722 KB - 2 pages]
T. T. Shimabukuro and S. C. Redd
EID Shimabukuro TT, Redd SC. Incorporating Research and Evaluation into Pandemic Influenza Vaccination Preparedness and Response. Emerg Infect Dis. 2014;20(4):713-714. https://dx.doi.org/10.3201/eid2004.140224
AMA Shimabukuro TT, Redd SC. Incorporating Research and Evaluation into Pandemic Influenza Vaccination Preparedness and Response. Emerging Infectious Diseases. 2014;20(4):713-714. doi:10.3201/eid2004.140224.
APA Shimabukuro, T. T., & Redd, S. C. (2014). Incorporating Research and Evaluation into Pandemic Influenza Vaccination Preparedness and Response. Emerging Infectious Diseases, 20(4), 713-714. https://dx.doi.org/10.3201/eid2004.140224.
Letters

Decline of Salmonella enterica Serotype Choleraesuis Infections, Taiwan [PDF - 311 KB - 2 pages]
L. Su et al.
EID Su L, Wu T, Chiu C. Decline of Salmonella enterica Serotype Choleraesuis Infections, Taiwan. Emerg Infect Dis. 2014;20(4):715-716. https://dx.doi.org/10.3201/eid2004.130240
AMA Su L, Wu T, Chiu C. Decline of Salmonella enterica Serotype Choleraesuis Infections, Taiwan. Emerging Infectious Diseases. 2014;20(4):715-716. doi:10.3201/eid2004.130240.
APA Su, L., Wu, T., & Chiu, C. (2014). Decline of Salmonella enterica Serotype Choleraesuis Infections, Taiwan. Emerging Infectious Diseases, 20(4), 715-716. https://dx.doi.org/10.3201/eid2004.130240.

Q Fever Endocarditis and New Coxiella burnetii Genotype, Saudi Arabia [PDF - 307 KB - 3 pages]
E. Angelakis et al.
EID Angelakis E, Johani S, Ahsan A, Memish Z, Raoult D. Q Fever Endocarditis and New Coxiella burnetii Genotype, Saudi Arabia. Emerg Infect Dis. 2014;20(4):726-728. https://dx.doi.org/10.3201/eid2004.131603
AMA Angelakis E, Johani S, Ahsan A, et al. Q Fever Endocarditis and New Coxiella burnetii Genotype, Saudi Arabia. Emerging Infectious Diseases. 2014;20(4):726-728. doi:10.3201/eid2004.131603.
APA Angelakis, E., Johani, S., Ahsan, A., Memish, Z., & Raoult, D. (2014). Q Fever Endocarditis and New Coxiella burnetii Genotype, Saudi Arabia. Emerging Infectious Diseases, 20(4), 726-728. https://dx.doi.org/10.3201/eid2004.131603.

Nosocomial Drug-Resistant Bacteremia in 2 Cohorts with Cryptococcal Meningitis, Africa [PDF - 283 KB - 3 pages]
R. Rajasingham et al.
EID Rajasingham R, Williams D, Meya DB, Meintjes G, Boulware DR, Scriven J. Nosocomial Drug-Resistant Bacteremia in 2 Cohorts with Cryptococcal Meningitis, Africa. Emerg Infect Dis. 2014;20(4):722-724. https://dx.doi.org/10.3201/eid2004.131277
AMA Rajasingham R, Williams D, Meya DB, et al. Nosocomial Drug-Resistant Bacteremia in 2 Cohorts with Cryptococcal Meningitis, Africa. Emerging Infectious Diseases. 2014;20(4):722-724. doi:10.3201/eid2004.131277.
APA Rajasingham, R., Williams, D., Meya, D. B., Meintjes, G., Boulware, D. R., & Scriven, J. (2014). Nosocomial Drug-Resistant Bacteremia in 2 Cohorts with Cryptococcal Meningitis, Africa. Emerging Infectious Diseases, 20(4), 722-724. https://dx.doi.org/10.3201/eid2004.131277.

Detection of Rickettsia sibirica mongolitimonae by Using Cutaneous Swab Samples and Quantitative PCR [PDF - 338 KB - 3 pages]
J. Solary et al.
EID Solary J, Socolovschi C, Aubry C, Brouqui P, Raoult D, Parola P. Detection of Rickettsia sibirica mongolitimonae by Using Cutaneous Swab Samples and Quantitative PCR. Emerg Infect Dis. 2014;20(4):716-718. https://dx.doi.org/10.3201/eid2004.130575
AMA Solary J, Socolovschi C, Aubry C, et al. Detection of Rickettsia sibirica mongolitimonae by Using Cutaneous Swab Samples and Quantitative PCR. Emerging Infectious Diseases. 2014;20(4):716-718. doi:10.3201/eid2004.130575.
APA Solary, J., Socolovschi, C., Aubry, C., Brouqui, P., Raoult, D., & Parola, P. (2014). Detection of Rickettsia sibirica mongolitimonae by Using Cutaneous Swab Samples and Quantitative PCR. Emerging Infectious Diseases, 20(4), 716-718. https://dx.doi.org/10.3201/eid2004.130575.

Severe Babesiosis in Immunocompetent Man, Spain, 2011 [PDF - 279 KB - 3 pages]
L. M. Gonzalez et al.
EID Gonzalez LM, Rojo S, Gonzalez-Camacho F, Luque D, Lobo CA, Montero E. Severe Babesiosis in Immunocompetent Man, Spain, 2011. Emerg Infect Dis. 2014;20(4):724-726. https://dx.doi.org/10.3201/eid2004.131409
AMA Gonzalez LM, Rojo S, Gonzalez-Camacho F, et al. Severe Babesiosis in Immunocompetent Man, Spain, 2011. Emerging Infectious Diseases. 2014;20(4):724-726. doi:10.3201/eid2004.131409.
APA Gonzalez, L. M., Rojo, S., Gonzalez-Camacho, F., Luque, D., Lobo, C. A., & Montero, E. (2014). Severe Babesiosis in Immunocompetent Man, Spain, 2011. Emerging Infectious Diseases, 20(4), 724-726. https://dx.doi.org/10.3201/eid2004.131409.

St. Louis Encephalitis Virus Infection in Woman, Peru [PDF - 315 KB - 3 pages]
V. Felices et al.
EID Felices V, Ampuero JS, Guevara C, Caceda ER, Gomez J, Santiago-Maldonado FW, et al. St. Louis Encephalitis Virus Infection in Woman, Peru. Emerg Infect Dis. 2014;20(4):730-732. https://dx.doi.org/10.3201/eid2004.131735
AMA Felices V, Ampuero JS, Guevara C, et al. St. Louis Encephalitis Virus Infection in Woman, Peru. Emerging Infectious Diseases. 2014;20(4):730-732. doi:10.3201/eid2004.131735.
APA Felices, V., Ampuero, J. S., Guevara, C., Caceda, E. R., Gomez, J., Santiago-Maldonado, F. W....Halsey, E. S. (2014). St. Louis Encephalitis Virus Infection in Woman, Peru. Emerging Infectious Diseases, 20(4), 730-732. https://dx.doi.org/10.3201/eid2004.131735.

Pandemic Vibrio parahaemolyticus, Maryland, USA, 2012 [PDF - 303 KB - 3 pages]
J. Haendiges et al.
EID Haendiges J, Rock M, Myers RA, Brown EW, Evans P, Gonzalez-Escalona N. Pandemic Vibrio parahaemolyticus, Maryland, USA, 2012. Emerg Infect Dis. 2014;20(4):718-720. https://dx.doi.org/10.3201/eid2004.130818
AMA Haendiges J, Rock M, Myers RA, et al. Pandemic Vibrio parahaemolyticus, Maryland, USA, 2012. Emerging Infectious Diseases. 2014;20(4):718-720. doi:10.3201/eid2004.130818.
APA Haendiges, J., Rock, M., Myers, R. A., Brown, E. W., Evans, P., & Gonzalez-Escalona, N. (2014). Pandemic Vibrio parahaemolyticus, Maryland, USA, 2012. Emerging Infectious Diseases, 20(4), 718-720. https://dx.doi.org/10.3201/eid2004.130818.

Serologic Evidence of Leptospirosis in Humans, Union of the Comoros, 2011 [PDF - 286 KB - 3 pages]
Y. Gomard et al.
EID Gomard Y, Silai R, Hoarau G, Bon K, Gonneau F, Yssouf A, et al. Serologic Evidence of Leptospirosis in Humans, Union of the Comoros, 2011. Emerg Infect Dis. 2014;20(4):720-722. https://dx.doi.org/10.3201/eid2004.131207
AMA Gomard Y, Silai R, Hoarau G, et al. Serologic Evidence of Leptospirosis in Humans, Union of the Comoros, 2011. Emerging Infectious Diseases. 2014;20(4):720-722. doi:10.3201/eid2004.131207.
APA Gomard, Y., Silai, R., Hoarau, G., Bon, K., Gonneau, F., Yssouf, A....Tortosa, P. (2014). Serologic Evidence of Leptospirosis in Humans, Union of the Comoros, 2011. Emerging Infectious Diseases, 20(4), 720-722. https://dx.doi.org/10.3201/eid2004.131207.

Whole-Genome Sequencing for Risk Assessment of Long-term Shiga Toxin–producing Escherichia coli [PDF - 269 KB - 3 pages]
J. Knobloch et al.
EID Knobloch J, Niemann S, Kohl TA, Lindner U, Nitschke M, Sayk F, et al. Whole-Genome Sequencing for Risk Assessment of Long-term Shiga Toxin–producing Escherichia coli. Emerg Infect Dis. 2014;20(4):732-733. https://dx.doi.org/10.3201/eid2004.131782
AMA Knobloch J, Niemann S, Kohl TA, et al. Whole-Genome Sequencing for Risk Assessment of Long-term Shiga Toxin–producing Escherichia coli. Emerging Infectious Diseases. 2014;20(4):732-733. doi:10.3201/eid2004.131782.
APA Knobloch, J., Niemann, S., Kohl, T. A., Lindner, U., Nitschke, M., Sayk, F....Solbach, W. (2014). Whole-Genome Sequencing for Risk Assessment of Long-term Shiga Toxin–producing Escherichia coli. Emerging Infectious Diseases, 20(4), 732-733. https://dx.doi.org/10.3201/eid2004.131782.

Lack of MERS Coronavirus but Prevalence of Influenza Virus in French Pilgrims after 2013 Hajj [PDF - 287 KB - 3 pages]
P. Gautret et al.
EID Gautret P, Charrel R, Benkouiten S, Belhouchat K, Nougairede A, Drali T, et al. Lack of MERS Coronavirus but Prevalence of Influenza Virus in French Pilgrims after 2013 Hajj. Emerg Infect Dis. 2014;20(4):726-728. https://dx.doi.org/10.3201/eid2004.131708
AMA Gautret P, Charrel R, Benkouiten S, et al. Lack of MERS Coronavirus but Prevalence of Influenza Virus in French Pilgrims after 2013 Hajj. Emerging Infectious Diseases. 2014;20(4):726-728. doi:10.3201/eid2004.131708.
APA Gautret, P., Charrel, R., Benkouiten, S., Belhouchat, K., Nougairede, A., Drali, T....Parola, P. (2014). Lack of MERS Coronavirus but Prevalence of Influenza Virus in French Pilgrims after 2013 Hajj. Emerging Infectious Diseases, 20(4), 726-728. https://dx.doi.org/10.3201/eid2004.131708.
About the Cover

Truth in the Details [PDF - 341 KB - 2 pages]
S. Bloom and E. M. Weeks
EID Bloom S, Weeks EM. Truth in the Details. Emerg Infect Dis. 2014;20(4):734-735. https://dx.doi.org/10.3201/eid2004.ac2004
AMA Bloom S, Weeks EM. Truth in the Details. Emerging Infectious Diseases. 2014;20(4):734-735. doi:10.3201/eid2004.ac2004.
APA Bloom, S., & Weeks, E. M. (2014). Truth in the Details. Emerging Infectious Diseases, 20(4), 734-735. https://dx.doi.org/10.3201/eid2004.ac2004.
Etymologia

Etymologia: Pertactin [PDF - 290 KB - 1 page]
EID Etymologia: Pertactin. Emerg Infect Dis. 2014;20(4):633. https://dx.doi.org/10.3201/eid2004.et2004
AMA Etymologia: Pertactin. Emerging Infectious Diseases. 2014;20(4):633. doi:10.3201/eid2004.et2004.
APA (2014). Etymologia: Pertactin. Emerging Infectious Diseases, 20(4), 633. https://dx.doi.org/10.3201/eid2004.et2004.
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Page updated: March 14, 2016
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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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