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Volume 21, Number 8—August 2015

Volume 21, Number 8—August 2015   PDF Version [PDF - 9.44 MB - 220 pages]

Perspective

  • Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection PDF Version [PDF - 2.66 MB - 8 pages]
    S. H. Olson et al.
    View Summary

    Improved and expanded data collection is required to fulfil the promise of an early-warning digital system.

        View Abstract

    The growing field of digital disease detection, or epidemic intelligence, attempts to improve timely detection and awareness of infectious disease (ID) events. Early detection remains an important priority; thus, the next frontier for ID surveillance is to improve the recognition and monitoring of drivers (antecedent conditions) of ID emergence for signals that precede disease events. These data could help alert public health officials to indicators of elevated ID risk, thereby triggering targeted active surveillance and interventions. We believe that ID emergence risks can be anticipated through surveillance of their drivers, just as successful warning systems of climate-based, meteorologically sensitive diseases are supported by improved temperature and precipitation data. We present approaches to driver surveillance, gaps in the current literature, and a scientific framework for the creation of a digital warning system. Fulfilling the promise of driver surveillance will require concerted action to expand the collection of appropriate digital driver data.

        Cite This Article
    EID Olson SH, Benedum CM, Mekaru SR, Preston ND, Mazet J, Joly DO, et al. Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection. Emerg Infect Dis. 2015;21(8):1285-1292. https://dx.doi.org/10.3201/eid2108.141156
    AMA Olson SH, Benedum CM, Mekaru SR, et al. Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection. Emerging Infectious Diseases. 2015;21(8):1285-1292. doi:10.3201/eid2108.141156.
    APA Olson, S. H., Benedum, C. M., Mekaru, S. R., Preston, N. D., Mazet, J., Joly, D. O....Brownstein, J. S. (2015). Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection. Emerging Infectious Diseases, 21(8), 1285-1292. https://dx.doi.org/10.3201/eid2108.141156.

Synopses

  • Medscape CME Activity
    Escherichia coli O157 Outbreaks in the United States, 2003–2012 PDF Version [PDF - 1.58 MB - 9 pages]
    K. E. Heiman et al.
    View Summary

    Beef and leafy vegetables were the most common sources of these outbreaks.

        View Abstract

    Infections with the Shiga toxin–producing bacterium Escherichia coli O157 can cause severe illness and death. We summarized reported outbreaks of E. coli O157 infections in the United States during 2003–2012, including demographic characteristics of patients and epidemiologic findings by transmission mode and food category. We identified 390 outbreaks, which included 4,928 illnesses, 1,272 hospitalizations, and 33 deaths. Transmission was through food (255 outbreaks, 65%), person-to-person contact (39, 10%), indirect or direct contact with animals (39, 10%), and water (15, 4%); 42 (11%) had a different or unknown mode of transmission. Beef and leafy vegetables, combined, were the source of >25% of all reported E. coli outbreaks and of >40% of related illnesses. Outbreaks attributed to foods generally consumed raw caused higher hospitalization rates than those attributed to foods generally consumed cooked (35% vs. 28%). Most (87%) waterborne E. coli outbreaks occurred in states bordering the Mississippi River.

        Cite This Article
    EID Heiman KE, Mody RK, Johnson SD, Griffin PM, Gould L. Escherichia coli O157 Outbreaks in the United States, 2003–2012. Emerg Infect Dis. 2015;21(8):1293-1301. https://dx.doi.org/10.3201/eid2108.141364
    AMA Heiman KE, Mody RK, Johnson SD, et al. Escherichia coli O157 Outbreaks in the United States, 2003–2012. Emerging Infectious Diseases. 2015;21(8):1293-1301. doi:10.3201/eid2108.141364.
    APA Heiman, K. E., Mody, R. K., Johnson, S. D., Griffin, P. M., & Gould, L. (2015). Escherichia coli O157 Outbreaks in the United States, 2003–2012. Emerging Infectious Diseases, 21(8), 1293-1301. https://dx.doi.org/10.3201/eid2108.141364.
  • Real-Time Microbiology Laboratory Surveillance System to Detect Abnormal Events and Emerging Infections, Marseille, France PDF Version [PDF - 4.68 MB - 9 pages]
    C. Abat et al.
    View Summary

    We implemented a laboratory data–based syndromic surveillance system that can be rapidly applied and used as a first tool.

        View Abstract

    Infectious diseases are a major threat to humanity, and accurate surveillance is essential. We describe how to implement a laboratory data–based surveillance system in a clinical microbiology laboratory. Two historical Microsoft Excel databases were implemented. The data were then sorted and used to execute the following 2 surveillance systems in Excel: the Bacterial real-time Laboratory-based Surveillance System (BALYSES) for monitoring the number of patients infected with bacterial species isolated at least once in our laboratory during the study periodl and the Marseille Antibiotic Resistance Surveillance System (MARSS), which surveys the primary β-lactam resistance phenotypes for 15 selected bacterial species. The first historical database contained 174,853 identifications of bacteria, and the second contained 12,062 results of antibiotic susceptibility testing. From May 21, 2013, through June 4, 2014, BALYSES and MARSS enabled the detection of 52 abnormal events for 24 bacterial species, leading to 19 official reports. This system is currently being refined and improved.

        Cite This Article
    EID Abat C, Chaudet H, Colson P, Rolain J, Raoult D. Real-Time Microbiology Laboratory Surveillance System to Detect Abnormal Events and Emerging Infections, Marseille, France. Emerg Infect Dis. 2015;21(8):1302-1310. https://dx.doi.org/10.3201/eid2108.141419
    AMA Abat C, Chaudet H, Colson P, et al. Real-Time Microbiology Laboratory Surveillance System to Detect Abnormal Events and Emerging Infections, Marseille, France. Emerging Infectious Diseases. 2015;21(8):1302-1310. doi:10.3201/eid2108.141419.
    APA Abat, C., Chaudet, H., Colson, P., Rolain, J., & Raoult, D. (2015). Real-Time Microbiology Laboratory Surveillance System to Detect Abnormal Events and Emerging Infections, Marseille, France. Emerging Infectious Diseases, 21(8), 1302-1310. https://dx.doi.org/10.3201/eid2108.141419.
  • Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola PDF Version [PDF - 1.22 MB - 6 pages]
    T. M. Sharp et al.
    View Summary

    Case detection should be improved by instituting routine laboratory-based surveillance for acute febrile illnesses in Africa.

    Dengue in Angola

        View Abstract

    During the 2013 dengue epidemic in Luanda, Angola, 811 dengue rapid diagnostic test–positive cases were reported to the Ministry of Health. To better understand the magnitude of the epidemic and identify risk factors for dengue virus (DENV) infection, we conducted cluster surveys around households of case-patients and randomly selected households 6 weeks after the peak of the epidemic. Of 173 case cluster participants, 16 (9%) exhibited evidence of recent DENV infection. Of 247 random cluster participants, 25 (10%) had evidence of recent DENV infection. Of 13 recently infected participants who had a recent febrile illness, 7 (54%) had sought medical care, and 1 (14%) was hospitalized with symptoms consistent with severe dengue; however, none received a diagnosis of dengue. Behavior associated with protection from DENV infection included recent use of mosquito repellent or a bed net. These findings suggest that the 2013 dengue epidemic was larger than indicated by passive surveillance data.

        Cite This Article
    EID Sharp TM, Moreira R, Soares M, Miguel da Costa L, Mann J, Delorey MJ, et al. Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola. Emerg Infect Dis. 2015;21(8):1311-1316. https://dx.doi.org/10.3201/eid2108.150368
    AMA Sharp TM, Moreira R, Soares M, et al. Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola. Emerging Infectious Diseases. 2015;21(8):1311-1316. doi:10.3201/eid2108.150368.
    APA Sharp, T. M., Moreira, R., Soares, M., Miguel da Costa, L., Mann, J., Delorey, M. J....Tomashek, K. M. (2015). Underrecognition of Dengue during 2013 Epidemic in Luanda, Angola. Emerging Infectious Diseases, 21(8), 1311-1316. https://dx.doi.org/10.3201/eid2108.150368.
  • Health Care–Associated Infection Outbreak Investigations in Outpatient Settings, Los Angeles County, California, USA, 2000−2012 PDF Version [PDF - 310 KB - 5 pages]
    K. OYong et al.
    View Summary

    Most investigations identified a control breach as the source of infections.

        View Abstract

    Health care services are increasingly delivered in outpatient settings. However, infection control oversight in outpatient settings to ensure patient safety has not improved and literature quantifying reported health care–associated infection outbreaks in outpatient settings is scarce. The objective of this analysis was to characterize investigations of suspected and confirmed outbreaks in outpatient settings in Los Angeles County, California, USA, reported during 2000–2012, by using internal logs; publications; records; and correspondence of outbreak investigations by characteristics of the setting, number, and type of infection control breaches found during investigations, outcomes of cases, and public health responses. Twenty-eight investigations met the inclusion criteria. Investigations occurred frequently, in diverse settings, and required substantial public health resources. Most outpatient settings investigated had >1 infection control breach. Lapses in infection control were suspected to be the outbreak source for 16 of the reviewed investigations.

        Cite This Article
    EID OYong K, Coelho L, Bancroft E, Terashita D. Health Care–Associated Infection Outbreak Investigations in Outpatient Settings, Los Angeles County, California, USA, 2000−2012. Emerg Infect Dis. 2015;21(8):1317-1321. https://dx.doi.org/10.3201/eid2108.141251
    AMA OYong K, Coelho L, Bancroft E, et al. Health Care–Associated Infection Outbreak Investigations in Outpatient Settings, Los Angeles County, California, USA, 2000−2012. Emerging Infectious Diseases. 2015;21(8):1317-1321. doi:10.3201/eid2108.141251.
    APA OYong, K., Coelho, L., Bancroft, E., & Terashita, D. (2015). Health Care–Associated Infection Outbreak Investigations in Outpatient Settings, Los Angeles County, California, USA, 2000−2012. Emerging Infectious Diseases, 21(8), 1317-1321. https://dx.doi.org/10.3201/eid2108.141251.

Research

  • Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands PDF Version [PDF - 520 KB - 9 pages]
    S. P. Keijmel et al.
    View Summary

    Distinguishing acute Q fever from respiratory infections, fever, or hepatitis requires serologic testing or PCR.

        View Abstract

    Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case–control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower respiratory tract symptoms, or fever and hepatitis, but had negative serologic results for Q fever. Patients with acute Q fever were younger and had higher C-reactive protein levels but lower leukocyte counts. However, a large overlap was found. In patients with an indication for prophylaxis, chronic Q fever did not develop after patients received prophylaxis but did develop in 50% of patients who did not receive prophylaxis. Differentiating acute Q fever from other respiratory infections, fever, or hepatitis is not possible without serologic testing or PCR. If risk factors for chronic Q fever are present, prophylactic treatment is advised.

        Cite This Article
    EID Keijmel SP, Krijger E, Delsing CE, Sprong T, Nabuurs-Franssen MH, Bleeker-Rovers CP, et al. Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands. Emerg Infect Dis. 2015;21(8):1348-1356. https://dx.doi.org/10.3201/eid2108.140196
    AMA Keijmel SP, Krijger E, Delsing CE, et al. Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands. Emerging Infectious Diseases. 2015;21(8):1348-1356. doi:10.3201/eid2108.140196.
    APA Keijmel, S. P., Krijger, E., Delsing, C. E., Sprong, T., Nabuurs-Franssen, M. H., & Bleeker-Rovers, C. P. (2015). Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands. Emerging Infectious Diseases, 21(8), 1348-1356. https://dx.doi.org/10.3201/eid2108.140196.
  • Medscape CME Activity
    Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010−2013 PDF Version [PDF - 1.43 MB - 8 pages]
    M. M. Kratz et al.
    View Summary

    Questions about how to protect this at-risk population deserve careful consideration.

        View Abstract

    In September 2012, the New York City Department of Health and Mental Hygiene identified an outbreak of Neisseria meningitidis serogroup C invasive meningococcal disease among men who have sex with men (MSM). Twenty-two case-patients and 7 deaths were identified during August 2010−February 2013. During this period, 7 cases in non-MSM were diagnosed. The slow-moving outbreak was linked to the use of websites and mobile phone applications that connect men with male sexual partners, which complicated the epidemiologic investigation and prevention efforts. We describe the outbreak and steps taken to interrupt transmission, including an innovative and wide-ranging outreach campaign that involved direct, internet-based, and media-based communications; free vaccination events; and engagement of community and government partners. We conclude by discussing the challenges of managing an outbreak affecting a discrete community of MSM and the benefits of using social networking technology to reach this at-risk population.

        Cite This Article
    EID Kratz MM, Weiss D, Ridpath A, Zucker JR, Geevarughese A, Rakeman JL, et al. Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010−2013. Emerg Infect Dis. 2015;21(8):1386. https://dx.doi.org/10.3201/eid2108.141837
    AMA Kratz MM, Weiss D, Ridpath A, et al. Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010−2013. Emerging Infectious Diseases. 2015;21(8):1386. doi:10.3201/eid2108.141837.
    APA Kratz, M. M., Weiss, D., Ridpath, A., Zucker, J. R., Geevarughese, A., Rakeman, J. L....Varma, J. K. (2015). Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010−2013. Emerging Infectious Diseases, 21(8), 1386. https://dx.doi.org/10.3201/eid2108.141837.
  • Risk for Mycobacterial Disease among Patients with Rheumatoid Arthritis, Taiwan, 2001–2011 PDF Version [PDF - 937 KB - 9 pages]
    T. Liao et al.
    View Summary

    Risk for illness and death are increased for these patients.

        View Abstract

    Increasing evidence indicates that the risk of acquiring tuberculosis (TB) and nontuberculous mycobacterial disease is elevated among patients with rheumatoid arthritis (RA). To determine the epidemiology of mycobacterial diseases among RA patients in Asia, we conducted a retrospective cohort study. We used a nationwide database to investigate the association of RA with mycobacterial diseases. The risk for development of TB or nontuberculous mycobacterial disease was 2.28-fold and 6.24-fold higher among RA patients than among the general population, respectively. Among RA patients, risk for development of mycobacterial disease was higher among those who were older, male, or both. Furthermore, among RA patients with mycobacterial infections, the risk for death was increased. Therefore, RA patients, especially those with other risk factors, should be closely monitored for development of mycobacterial disease.

        Cite This Article
    EID Liao T, Lin C, Shen G, Chang C, Lin C, Chen D, et al. Risk for Mycobacterial Disease among Patients with Rheumatoid Arthritis, Taiwan, 2001–2011. Emerg Infect Dis. 2015;21(8):1387-1395. https://dx.doi.org/10.3201/eid2108.141846
    AMA Liao T, Lin C, Shen G, et al. Risk for Mycobacterial Disease among Patients with Rheumatoid Arthritis, Taiwan, 2001–2011. Emerging Infectious Diseases. 2015;21(8):1387-1395. doi:10.3201/eid2108.141846.
    APA Liao, T., Lin, C., Shen, G., Chang, C., Lin, C., & Chen, D. (2015). Risk for Mycobacterial Disease among Patients with Rheumatoid Arthritis, Taiwan, 2001–2011. Emerging Infectious Diseases, 21(8), 1387-1395. https://dx.doi.org/10.3201/eid2108.141846.
  • Phylogeography of Influenza A(H3N2) Virus in Peru, 2010–2012 PDF Version [PDF - 2.76 MB - 9 pages]
    S. Pollett et al.
    View Summary

    Peru did not fit the source–sink model for the global spread of this virus.

        View Abstract

    It remains unclear whether lineages of influenza A(H3N2) virus can persist in the tropics and seed temperate areas. We used viral gene sequence data sampled from Peru to test this source–sink model for a Latin American country. Viruses were obtained during 2010–2012 from influenza surveillance cohorts in Cusco, Tumbes, Puerto Maldonado, and Lima. Specimens positive for influenza A(H3N2) virus were randomly selected and underwent hemagglutinin sequencing and phylogeographic analyses. Analysis of 389 hemagglutinin sequences from Peru and 2,192 global sequences demonstrated interseasonal extinction of Peruvian lineages. Extensive mixing occurred with global clades, but some spatial structure was observed at all sites; this structure was weakest in Lima and Puerto Maldonado, indicating that these locations may experience greater viral traffic. The broad diversity and co-circulation of many simultaneous lineages of H3N2 virus in Peru suggests that this country should not be overlooked as a potential source for novel pandemic strains.

        Cite This Article
    EID Pollett S, Nelson MI, Kasper MR, Tinoco Y, Simons M, Romero C, et al. Phylogeography of Influenza A(H3N2) Virus in Peru, 2010–2012. Emerg Infect Dis. 2015;21(8):1330-1338. https://dx.doi.org/10.3201/eid2108.150084
    AMA Pollett S, Nelson MI, Kasper MR, et al. Phylogeography of Influenza A(H3N2) Virus in Peru, 2010–2012. Emerging Infectious Diseases. 2015;21(8):1330-1338. doi:10.3201/eid2108.150084.
    APA Pollett, S., Nelson, M. I., Kasper, M. R., Tinoco, Y., Simons, M., Romero, C....Bausch, D. G. (2015). Phylogeography of Influenza A(H3N2) Virus in Peru, 2010–2012. Emerging Infectious Diseases, 21(8), 1330-1338. https://dx.doi.org/10.3201/eid2108.150084.
  • Susceptibility of Carrion Crows to Experimental Infection with Lineage 1 and 2 West Nile Viruses PDF Version [PDF - 1.19 MB - 9 pages]
    S. M. Lim et al.
    View Summary

    These birds are highly susceptible to strains circulating in Europe and, thus, may serve as surveillance sentinels.

        View Abstract

    West Nile virus (WNV) outbreaks in North America have been characterized by substantial die-offs of American crows (Corvus brachyrhynchos). In contrast, a low incidence of bird deaths has been observed during WNV epidemic activity in Europe. To examine the susceptibility of the western European counterpart of American crows, we inoculated carrion crows (Corvus corone) with WNV strains isolated in Greece (Gr-10), Italy (FIN and Ita09), and Hungary (578/10) and with the highly virulent North American genotype strain (NY99). We also inoculated American crows with a selection of these strains to examine the strains’ virulence in a highly susceptible bird species. Infection with all strains, except WNV FIN, resulted in high rates of death and high-level viremia in both bird species and virus dissemination to several organs. These results suggest that carrion crows are highly susceptible to WNV and may potentially be useful as part of dead bird surveillance for early warning of WNV activity in Europe.

        Cite This Article
    EID Lim SM, Brault AC, van Amerongen G, Bosco-Lauth AM, Romo H, Sewbalaksing VD, et al. Susceptibility of Carrion Crows to Experimental Infection with Lineage 1 and 2 West Nile Viruses. Emerg Infect Dis. 2015;21(8):1357-1365. https://dx.doi.org/10.3201/eid2108.140714
    AMA Lim SM, Brault AC, van Amerongen G, et al. Susceptibility of Carrion Crows to Experimental Infection with Lineage 1 and 2 West Nile Viruses. Emerging Infectious Diseases. 2015;21(8):1357-1365. doi:10.3201/eid2108.140714.
    APA Lim, S. M., Brault, A. C., van Amerongen, G., Bosco-Lauth, A. M., Romo, H., Sewbalaksing, V. D....Martina, B. (2015). Susceptibility of Carrion Crows to Experimental Infection with Lineage 1 and 2 West Nile Viruses. Emerging Infectious Diseases, 21(8), 1357-1365. https://dx.doi.org/10.3201/eid2108.140714.
  • Response Strategies against Meningitis Epidemics after Elimination of Serogroup A Meningococci, Niger PDF Version [PDF - 1.90 MB - 8 pages]
    H. Maïnassara et al.
    View Summary

    Surveillance and epidemic vaccine response would be most effective at the health area level.

        View Abstract

    To inform epidemic response strategies for the African meningitis belt after a meningococcal serogroup A conjugate vaccine was introduced in 2010, we compared the effectiveness and efficiency of meningitis surveillance and vaccine response strategies at district and health area levels using various thresholds of weekly incidence rates. We analyzed reports of suspected cases from 3 regions in Niger during 2002–2012 (154,392 health area weeks), simulating elimination of serogroup A meningitis by excluding health area years with identification of such cases. Effectiveness was highest for health area surveillance and district vaccination (58–366 cases; thresholds 7–20 cases/100,000 doses), whereas efficiency was optimized with health area vaccination (5.6–7.7 cases/100,000 doses). District-level intervention prevented <6 cases (0.2 cases/100,000 doses). Reducing the delay between epidemic signal and vaccine protection by 2 weeks doubled efficiency. Subdistrict surveillance and response might be most appropriate for meningitis epidemic response after elimination of serogroup A meningitis.

        Cite This Article
    EID Maïnassara H, Paireau J, Idi I, Pelat J, Oukem-Boyer O, Fontanet A, et al. Response Strategies against Meningitis Epidemics after Elimination of Serogroup A Meningococci, Niger. Emerg Infect Dis. 2015;21(8):1322-1329. https://dx.doi.org/10.3201/eid2108.141361
    AMA Maïnassara H, Paireau J, Idi I, et al. Response Strategies against Meningitis Epidemics after Elimination of Serogroup A Meningococci, Niger. Emerging Infectious Diseases. 2015;21(8):1322-1329. doi:10.3201/eid2108.141361.
    APA Maïnassara, H., Paireau, J., Idi, I., Pelat, J., Oukem-Boyer, O., Fontanet, A....Mueller, J. E. (2015). Response Strategies against Meningitis Epidemics after Elimination of Serogroup A Meningococci, Niger. Emerging Infectious Diseases, 21(8), 1322-1329. https://dx.doi.org/10.3201/eid2108.141361.
  • Influenza A Viruses of Human Origin in Swine, Brazil PDF Version [PDF - 1.70 MB - 9 pages]
    M. I. Nelson et al.
    View Summary

    Multiple divergent lineages challenge the design of cross-protective vaccines and highlight the need for additional surveillance.

        View Abstract

    The evolutionary origins of the influenza A(H1N1)pdm09 virus that caused the first outbreak of the 2009 pandemic in Mexico remain unclear, highlighting the lack of swine surveillance in Latin American countries. Although Brazil has one of the largest swine populations in the world, influenza was not thought to be endemic in Brazil’s swine until the major outbreaks of influenza A(H1N1)pdm09 in 2009. Through phylogenetic analysis of whole-genome sequences of influenza viruses of the H1N1, H1N2, and H3N2 subtypes collected in swine in Brazil during 2009–2012, we identified multiple previously uncharacterized influenza viruses of human seasonal H1N2 and H3N2 virus origin that have circulated undetected in swine for more than a decade. Viral diversity has further increased in Brazil through reassortment between co-circulating viruses, including A(H1N1)pdm09. The circulation of multiple divergent hemagglutinin lineages challenges the design of effective cross-protective vaccines and highlights the need for additional surveillance.

        Cite This Article
    EID Nelson MI, Schaefer R, Gava D, Cantão M, Ciacci-Zanella J. Influenza A Viruses of Human Origin in Swine, Brazil. Emerg Infect Dis. 2015;21(8):1339-1347. https://dx.doi.org/10.3201/eid2108.141891
    AMA Nelson MI, Schaefer R, Gava D, et al. Influenza A Viruses of Human Origin in Swine, Brazil. Emerging Infectious Diseases. 2015;21(8):1339-1347. doi:10.3201/eid2108.141891.
    APA Nelson, M. I., Schaefer, R., Gava, D., Cantão, M., & Ciacci-Zanella, J. (2015). Influenza A Viruses of Human Origin in Swine, Brazil. Emerging Infectious Diseases, 21(8), 1339-1347. https://dx.doi.org/10.3201/eid2108.141891.
  • Prevalence of Hepatitis E Virus Infection in Pigs at the Time of Slaughter, United Kingdom, 2013 PDF Version [PDF - 532 KB - 6 pages]
    S. Grierson et al.
    View Summary

    Pigs raised in the United Kingdom are unlikely to be the source of UK human infections.

        View Abstract

    Since 2010, reports of infection with hepatitis E virus (HEV) have increased in England and Wales. Despite mounting evidence regarding the zoonotic potential of porcine HEV, there are limited data on its prevalence in pigs in the United Kingdom. We investigated antibody prevalence, active infection, and virus variation in serum and cecal content samples from 629 pigs at slaughter. Prevalence of antibodies to HEV was 92.8% (584/629), and HEV RNA was detected in 15% of cecal contents (93/629), 3% of plasma samples (22/629), and 2% of both (14/629). However, although HEV is prevalent in pigs in the United Kingdom and viremic pigs are entering the food chain, most (22/23) viral sequences clustered separately from the dominant type seen in humans. Thus, pigs raised in the United Kingdom are unlikely to be the main source of human HEV infections in the United Kingdom. Further research is needed to identify the source of these infections.

        Cite This Article
    EID Grierson S, Heaney J, Cheney T, Morgan D, Wyllie S, Powell L, et al. Prevalence of Hepatitis E Virus Infection in Pigs at the Time of Slaughter, United Kingdom, 2013. Emerg Infect Dis. 2015;21(8):1396-1401. https://dx.doi.org/10.3201/eid2108.141995
    AMA Grierson S, Heaney J, Cheney T, et al. Prevalence of Hepatitis E Virus Infection in Pigs at the Time of Slaughter, United Kingdom, 2013. Emerging Infectious Diseases. 2015;21(8):1396-1401. doi:10.3201/eid2108.141995.
    APA Grierson, S., Heaney, J., Cheney, T., Morgan, D., Wyllie, S., Powell, L....Tedder, R. S. (2015). Prevalence of Hepatitis E Virus Infection in Pigs at the Time of Slaughter, United Kingdom, 2013. Emerging Infectious Diseases, 21(8), 1396-1401. https://dx.doi.org/10.3201/eid2108.141995.
  • Hospital Resource Utilization and Patient Outcomes Associated with Respiratory Viral Testing in Hospitalized Patients PDF Version [PDF - 743 KB - 6 pages]
    S. Mulpuru et al.
    View Summary

    Results suggest that health care providers do not use viral test results in making management decisions.

        View Abstract

    Testing patients for respiratory viruses should guide isolation precautions and provide a rationale for antimicrobial drug therapies, but few studies have evaluated these assumptions. To determine the association between viral testing, patient outcomes, and care processes, we identified adults hospitalized with respiratory symptoms from 2004 through 2012 at a large, academic, tertiary hospital in Canada. Viral testing was performed in 11% (2,722/24,567) of hospital admissions and was not associated with reduced odds for death (odds ratio 0.90, 95% CI 0.76–1.10) or longer length of stay (+1 day for those tested). Viral testing resulted in more resource utilization, including intensive care unit admission, but positive test results were not associated with less antibiotic use or shorter duration of isolation. Results suggest that health care providers do not use viral test results in making management decisions at this hospital. Further research is needed to evaluate the effectiveness of respiratory infection control policies.

        Cite This Article
    EID Mulpuru S, Aaron SD, Ronksley PE, Lawrence N, Forster AJ. Hospital Resource Utilization and Patient Outcomes Associated with Respiratory Viral Testing in Hospitalized Patients. Emerg Infect Dis. 2015;21(8):1366-1371. https://dx.doi.org/10.3201/eid2108.140978
    AMA Mulpuru S, Aaron SD, Ronksley PE, et al. Hospital Resource Utilization and Patient Outcomes Associated with Respiratory Viral Testing in Hospitalized Patients. Emerging Infectious Diseases. 2015;21(8):1366-1371. doi:10.3201/eid2108.140978.
    APA Mulpuru, S., Aaron, S. D., Ronksley, P. E., Lawrence, N., & Forster, A. J. (2015). Hospital Resource Utilization and Patient Outcomes Associated with Respiratory Viral Testing in Hospitalized Patients. Emerging Infectious Diseases, 21(8), 1366-1371. https://dx.doi.org/10.3201/eid2108.140978.
  • Development of Framework for Assessing Influenza Virus Pandemic Risk PDF Version [PDF - 670 KB - 7 pages]
    S. C. Trock et al.
    View Summary

    This simple, additive, multiattribute assessment tool can evaluate the risk posed by novel influenza A viruses.

        View Abstract

    Although predicting which influenza virus subtype will cause the next pandemic is not yet possible, public health authorities must continually assess the pandemic risk associated with animal influenza viruses, particularly those that have caused infections in humans, and determine what resources should be dedicated to mitigating that risk. To accomplish this goal, a risk assessment framework was created in collaboration with an international group of influenza experts. Compared with the previously used approach, this framework, named the Influenza Risk Assessment Tool, provides a systematic and transparent approach for assessing and comparing threats posed primarily by avian and swine influenza viruses. This tool will be useful to the international influenza community and will remain flexible and responsive to changing information.

        Cite This Article
    EID Trock SC, Burke SA, Cox NJ. Development of Framework for Assessing Influenza Virus Pandemic Risk. Emerg Infect Dis. 2015;21(8):1372-1378. https://dx.doi.org/10.3201/eid2108.141086
    AMA Trock SC, Burke SA, Cox NJ. Development of Framework for Assessing Influenza Virus Pandemic Risk. Emerging Infectious Diseases. 2015;21(8):1372-1378. doi:10.3201/eid2108.141086.
    APA Trock, S. C., Burke, S. A., & Cox, N. J. (2015). Development of Framework for Assessing Influenza Virus Pandemic Risk. Emerging Infectious Diseases, 21(8), 1372-1378. https://dx.doi.org/10.3201/eid2108.141086.
  • Estimates of Outbreak Risk from New Introductions of Ebola with Immediate and Delayed Transmission Control PDF Version [PDF - 812 KB - 7 pages]
    D. Toth et al.
    View Summary

    Identifying incoming patients can have a larger risk-reduction effect than efforts to reduce transmissions from identified patients.

        View Abstract

    While the ongoing Ebola outbreak continues in the West Africa countries of Guinea, Sierra Leone, and Liberia, health officials elsewhere prepare for new introductions of Ebola from infected evacuees or travelers. We analyzed transmission data from patients (i.e., evacuees, international travelers, and those with locally acquired illness) in countries other than the 3 with continuing Ebola epidemics and quantitatively assessed the outbreak risk from new introductions by using different assumptions for transmission control (i.e., immediate and delayed). Results showed that, even in countries that can quickly limit expected number of transmissions per case to <1, the probability that a single introduction will lead to a substantial number of transmissions is not negligible, particularly if transmission variability is high. Identifying incoming infected travelers before symptom onset can decrease worst-case outbreak sizes more than reducing transmissions from patients with locally acquired cases, but performing both actions can have a synergistic effect.

        Cite This Article
    EID Toth D, Gundlapalli AV, Khader K, Pettey W, Rubin MA, Adler FR, et al. Estimates of Outbreak Risk from New Introductions of Ebola with Immediate and Delayed Transmission Control. Emerg Infect Dis. 2015;21(8):1402-1408. https://dx.doi.org/10.3201/eid2108.150170
    AMA Toth D, Gundlapalli AV, Khader K, et al. Estimates of Outbreak Risk from New Introductions of Ebola with Immediate and Delayed Transmission Control. Emerging Infectious Diseases. 2015;21(8):1402-1408. doi:10.3201/eid2108.150170.
    APA Toth, D., Gundlapalli, A. V., Khader, K., Pettey, W., Rubin, M. A., Adler, F. R....Samore, M. H. (2015). Estimates of Outbreak Risk from New Introductions of Ebola with Immediate and Delayed Transmission Control. Emerging Infectious Diseases, 21(8), 1402-1408. https://dx.doi.org/10.3201/eid2108.150170.

Dispatches

  • Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014 PDF Version [PDF - 1.03 MB - 3 pages]
    A. Filia et al.
        View Abstract

    We report a measles outbreak in Sardinia, Italy, that originated in a cruise ship passenger. The outbreak showed extensive nosocomial transmission (44 of 80 cases). To minimize nosocomial transmission, health care facilities should ensure that susceptible health care workers are vaccinated against measles and should implement effective infection control procedures.

        Cite This Article
    EID Filia A, Bella A, Cadeddu G, Milia M, Del Manso M, Rota M, et al. Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014. Emerg Infect Dis. 2015;21(8):1444-1446. https://dx.doi.org/10.3201/eid2108.141105
    AMA Filia A, Bella A, Cadeddu G, et al. Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014. Emerging Infectious Diseases. 2015;21(8):1444-1446. doi:10.3201/eid2108.141105.
    APA Filia, A., Bella, A., Cadeddu, G., Milia, M., Del Manso, M., Rota, M....Declich, S. (2015). Extensive Nosocomial Transmission of Measles Originating in Cruise Ship Passenger, Sardinia, Italy, 2014. Emerging Infectious Diseases, 21(8), 1444-1446. https://dx.doi.org/10.3201/eid2108.141105.
  • Smallpox Vaccination of Laboratory Workers at US Variola Testing Sites PDF Version [PDF - 634 KB - 3 pages]
    S. Medcalf et al.
        View Abstract

    To evaluate the need to revaccinate laboratory workers against smallpox, we assessed regular revaccination at the US Laboratory Response Network’s variola testing sites by examining barriers to revaccination and the potential for persistence of immunity. Our data do not provide evidence to suggest prolonging the recommended interval for revaccination.

        Cite This Article
    EID Medcalf S, Bilek L, Hartman T, Iwen PC, Leuschen P, Miller H, et al. Smallpox Vaccination of Laboratory Workers at US Variola Testing Sites. Emerg Infect Dis. 2015;21(8):1437-1439. https://dx.doi.org/10.3201/eid2108.140956
    AMA Medcalf S, Bilek L, Hartman T, et al. Smallpox Vaccination of Laboratory Workers at US Variola Testing Sites. Emerging Infectious Diseases. 2015;21(8):1437-1439. doi:10.3201/eid2108.140956.
    APA Medcalf, S., Bilek, L., Hartman, T., Iwen, P. C., Leuschen, P., Miller, H....Smith, P. W. (2015). Smallpox Vaccination of Laboratory Workers at US Variola Testing Sites. Emerging Infectious Diseases, 21(8), 1437-1439. https://dx.doi.org/10.3201/eid2108.140956.
  • Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden PDF Version [PDF - 631 KB - 4 pages]
    A. Grankvist et al.
        View Abstract

    The prevalence of Candidatus Neoehrlichia mikurensis infection was determined in 102 persons bitten by ticks in Sweden. Two infected women had erythematous rashes; 1 was co-infected with a Borrelia sp., and the other showed seroconversion for Anaplasma phagocytophilum. Both patients had increased levels of Neoehrlichia DNA and serum cytokines for several months.

        Cite This Article
    EID Grankvist A, Sandelin L, Andersson J, Fryland L, Wilhelmsson P, Lindgren P, et al. Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden. Emerg Infect Dis. 2015;21(8):1462-1465. https://dx.doi.org/10.3201/eid2108.150060
    AMA Grankvist A, Sandelin L, Andersson J, et al. Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden. Emerging Infectious Diseases. 2015;21(8):1462-1465. doi:10.3201/eid2108.150060.
    APA Grankvist, A., Sandelin, L., Andersson, J., Fryland, L., Wilhelmsson, P., Lindgren, P....Wennerås, C. (2015). Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden. Emerging Infectious Diseases, 21(8), 1462-1465. https://dx.doi.org/10.3201/eid2108.150060.
  • Occupational Exposure to Dromedaries and Risk for MERS-CoV Infection, Qatar, 2013–2014 PDF Version [PDF - 1.04 MB - 4 pages]
    C. Reusken et al.
        View Abstract

    We determined the presence of neutralizing antibodies to Middle East respiratory syndrome coronavirus in persons in Qatar with and without dromedary contact. Antibodies were only detected in those with contact, suggesting dromedary exposure as a risk factor for infection. Findings also showed evidence for substantial underestimation of the infection in populations at risk in Qatar.

        Cite This Article
    EID Reusken C, Farag E, Haagmans BL, Mohran KA, Godeke G, Raj S, et al. Occupational Exposure to Dromedaries and Risk for MERS-CoV Infection, Qatar, 2013–2014. Emerg Infect Dis. 2015;21(8):1422-1425. https://dx.doi.org/10.3201/eid2108.150481
    AMA Reusken C, Farag E, Haagmans BL, et al. Occupational Exposure to Dromedaries and Risk for MERS-CoV Infection, Qatar, 2013–2014. Emerging Infectious Diseases. 2015;21(8):1422-1425. doi:10.3201/eid2108.150481.
    APA Reusken, C., Farag, E., Haagmans, B. L., Mohran, K. A., Godeke, G., Raj, S....Koopmans, M. (2015). Occupational Exposure to Dromedaries and Risk for MERS-CoV Infection, Qatar, 2013–2014. Emerging Infectious Diseases, 21(8), 1422-1425. https://dx.doi.org/10.3201/eid2108.150481.
  • Genome of Emerging Norovirus GII.17, United States, 2014 PDF Version [PDF - 913 KB - 3 pages]
    G. I. Parra and K. Y. Green
        View Abstract

    To determine whether the norovirus strain GII.17 recently detected in Maryland, USA, (Hu/GII.17/Gaithersburg/2014/US) is spreading globally, we characterized the genome. High similarity with the norovirus GII.17 that caused recent outbreaks in Asia indicates that the same strain was present in the United States during the 2014–15 norovirus season (winter).

        Cite This Article
    EID Parra GI, Green KY. Genome of Emerging Norovirus GII.17, United States, 2014. Emerg Infect Dis. 2015;21(8):1477-1479. https://dx.doi.org/10.3201/eid2108.150652
    AMA Parra GI, Green KY. Genome of Emerging Norovirus GII.17, United States, 2014. Emerging Infectious Diseases. 2015;21(8):1477-1479. doi:10.3201/eid2108.150652.
    APA Parra, G. I., & Green, K. Y. (2015). Genome of Emerging Norovirus GII.17, United States, 2014. Emerging Infectious Diseases, 21(8), 1477-1479. https://dx.doi.org/10.3201/eid2108.150652.
  • Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012 PDF Version [PDF - 2.45 MB - 4 pages]
    J. Landier et al.
        View Abstract

    To determine when risk for Buruli ulcer is highest, we examined seasonal patterns in a highly disease-endemic area of Cameroon during 2002–2012. Cases peaked in March, suggesting that risk is highest during the high rainy season. During and after this season, populations should increase protective behaviors, and case detection efforts should be intensified.

        Cite This Article
    EID Landier J, Constantin de Magny G, Garchitorena A, Guégan J, Gaudart J, Marsollier L, et al. Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012. Emerg Infect Dis. 2015;21(8):1414-1417. https://dx.doi.org/10.3201/eid2108.141336
    AMA Landier J, Constantin de Magny G, Garchitorena A, et al. Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012. Emerging Infectious Diseases. 2015;21(8):1414-1417. doi:10.3201/eid2108.141336.
    APA Landier, J., Constantin de Magny, G., Garchitorena, A., Guégan, J., Gaudart, J., Marsollier, L....Texier, G. (2015). Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012. Emerging Infectious Diseases, 21(8), 1414-1417. https://dx.doi.org/10.3201/eid2108.141336.
  • Human–Bat Interactions in Rural West Africa PDF Version [PDF - 2.14 MB - 4 pages]
    P. Anti et al.
        View Abstract

    Because some bats host viruses with zoonotic potential, we investigated human–bat interactions in rural Ghana during 2011–2012. Nearly half (46.6%) of respondents regularly visited bat caves; 37.4% had been bitten, scratched, or exposed to bat urine; and 45.6% ate bat meat. Human–bat interactions in rural Ghana are frequent and diverse.

        Cite This Article
    EID Anti P, Owusu M, Agbenyega O, Annan A, Badu E, Nkrumah E, et al. Human–Bat Interactions in Rural West Africa. Emerg Infect Dis. 2015;21(8):1418-1421. https://dx.doi.org/10.3201/eid2108.142015
    AMA Anti P, Owusu M, Agbenyega O, et al. Human–Bat Interactions in Rural West Africa. Emerging Infectious Diseases. 2015;21(8):1418-1421. doi:10.3201/eid2108.142015.
    APA Anti, P., Owusu, M., Agbenyega, O., Annan, A., Badu, E., Nkrumah, E....Park, S. (2015). Human–Bat Interactions in Rural West Africa. Emerging Infectious Diseases, 21(8), 1418-1421. https://dx.doi.org/10.3201/eid2108.142015.
  • Enterovirus A71 Meningoencephalitis Outbreak, Rostov-on-Don, Russia, 2013 PDF Version [PDF - 1.10 MB - 4 pages]
    L. V. Akhmadishina et al.
        View Abstract

    Seventy-eight cases of enterovirus infection, including 25 neuroinfections, occurred in Rostov-on-Don, Russia, during May–June 2013. The outbreak was caused by an enterovirus A type 71 (EV-A71) subgenotype C4 lineage that spread to neighboring countries from China ≈3 years earlier. Enterovirus associated neuroinfection may emerge in areas with a preceding background circulation of EV-A71 with apparently asymptomatic infection.

        Cite This Article
    EID Akhmadishina LV, Govorukhina MV, Kovalev EV, Nenadskaya SA, Ivanova OE, Lukashev AN, et al. Enterovirus A71 Meningoencephalitis Outbreak, Rostov-on-Don, Russia, 2013. Emerg Infect Dis. 2015;21(8):1440-1443. https://dx.doi.org/10.3201/eid2108.141084
    AMA Akhmadishina LV, Govorukhina MV, Kovalev EV, et al. Enterovirus A71 Meningoencephalitis Outbreak, Rostov-on-Don, Russia, 2013. Emerging Infectious Diseases. 2015;21(8):1440-1443. doi:10.3201/eid2108.141084.
    APA Akhmadishina, L. V., Govorukhina, M. V., Kovalev, E. V., Nenadskaya, S. A., Ivanova, O. E., & Lukashev, A. N. (2015). Enterovirus A71 Meningoencephalitis Outbreak, Rostov-on-Don, Russia, 2013. Emerging Infectious Diseases, 21(8), 1440-1443. https://dx.doi.org/10.3201/eid2108.141084.
  • Detection and Full-Length Genome Characterization of Novel Canine Vesiviruses PDF Version [PDF - 928 KB - 4 pages]
    V. Martella et al.
        View Abstract

    Vesiviruses have been detected in several animal species and as accidental contaminants of cells. We detected vesiviruses in asymptomatic kennel dogs (64.8%) and symptomatic (1.1%) and asymptomatic (3.5%) household dogs in Italy. The full-length genome of 1 strain, Bari/212/07/ITA, shared 89%–90% nt identity with vesiviruses previously detected in contaminated cells.

        Cite This Article
    EID Martella V, Pinto P, Lorusso E, Di Martino B, Wang Q, Larocca V, et al. Detection and Full-Length Genome Characterization of Novel Canine Vesiviruses. Emerg Infect Dis. 2015;21(8):1433-1436. https://dx.doi.org/10.3201/eid2108.140900
    AMA Martella V, Pinto P, Lorusso E, et al. Detection and Full-Length Genome Characterization of Novel Canine Vesiviruses. Emerging Infectious Diseases. 2015;21(8):1433-1436. doi:10.3201/eid2108.140900.
    APA Martella, V., Pinto, P., Lorusso, E., Di Martino, B., Wang, Q., Larocca, V....Buonavoglia, C. (2015). Detection and Full-Length Genome Characterization of Novel Canine Vesiviruses. Emerging Infectious Diseases, 21(8), 1433-1436. https://dx.doi.org/10.3201/eid2108.140900.
  • Multidrug-Resistant Tuberculosis in Patients for Whom First-Line Treatment Failed, Mongolia, 2010–2011 PDF Version [PDF - 1.00 MB - 4 pages]
    C. C. Dobler et al.
        View Abstract

    In Ulaanbaatar, Mongolia, multidrug-resistant tuberculosis (MDR TB) was diagnosed for more than a third of new sputum smear–positive tuberculosis patients for whom treatment had failed. This finding suggests a significant risk for community-acquired MDR TB and a need to make rapid molecular drug susceptibility testing available to more people.

        Cite This Article
    EID Dobler CC, Korver S, Batbayar O, Nyamdulam B, Oyuntsetseg S, Tsolmon B, et al. Multidrug-Resistant Tuberculosis in Patients for Whom First-Line Treatment Failed, Mongolia, 2010–2011. Emerg Infect Dis. 2015;21(8):1451-1454. https://dx.doi.org/10.3201/eid2108.141860
    AMA Dobler CC, Korver S, Batbayar O, et al. Multidrug-Resistant Tuberculosis in Patients for Whom First-Line Treatment Failed, Mongolia, 2010–2011. Emerging Infectious Diseases. 2015;21(8):1451-1454. doi:10.3201/eid2108.141860.
    APA Dobler, C. C., Korver, S., Batbayar, O., Nyamdulam, B., Oyuntsetseg, S., Tsolmon, B....Marais, B. J. (2015). Multidrug-Resistant Tuberculosis in Patients for Whom First-Line Treatment Failed, Mongolia, 2010–2011. Emerging Infectious Diseases, 21(8), 1451-1454. https://dx.doi.org/10.3201/eid2108.141860.
  • Rabies Postexposure Prophylaxis for Travelers Injured by Nonhuman Primates, Marseille, France, 2001–2014 PDF Version [PDF - 1.84 MB - 4 pages]
    A. Blaise et al.
        View Abstract

    Most exposures of residents of Marseille to nonhuman primates occurred among unvaccinated adult travelers to Southeast Asia within the first 10 days of their arrival at 2 major tourist locations in Thailand and 1 in Indonesia. A small proportion of travelers received rabies immunoglobulin in the country of exposure.

        Cite This Article
    EID Blaise A, Parola P, Brouqui P, Gautret P. Rabies Postexposure Prophylaxis for Travelers Injured by Nonhuman Primates, Marseille, France, 2001–2014. Emerg Infect Dis. 2015;21(8):1473-1476. https://dx.doi.org/10.3201/eid2108.150346
    AMA Blaise A, Parola P, Brouqui P, et al. Rabies Postexposure Prophylaxis for Travelers Injured by Nonhuman Primates, Marseille, France, 2001–2014. Emerging Infectious Diseases. 2015;21(8):1473-1476. doi:10.3201/eid2108.150346.
    APA Blaise, A., Parola, P., Brouqui, P., & Gautret, P. (2015). Rabies Postexposure Prophylaxis for Travelers Injured by Nonhuman Primates, Marseille, France, 2001–2014. Emerging Infectious Diseases, 21(8), 1473-1476. https://dx.doi.org/10.3201/eid2108.150346.
  • Cutaneous Legionella longbeachae Infection in Immunosuppressed Woman, United Kingdom PDF Version [PDF - 1.84 MB - 8 pages]
    D. Grimstead et al.
        View Abstract

    We report a rare case of cutaneous Legionella longbeachae infection in a patient receiving long-term corticosteroids for immune thrombocytopenia. Such infections cannot be identified by using Legionella urinary antigen testing but are commonly seen after exposure to commercial potting compost, particularly in immunocompromised patients.

        Cite This Article
    EID Grimstead D, Tucker D, Harris K, Turner D. Cutaneous Legionella longbeachae Infection in Immunosuppressed Woman, United Kingdom. Emerg Infect Dis. 2015;21(8):1426-1428. https://dx.doi.org/10.3201/eid2108.140828
    AMA Grimstead D, Tucker D, Harris K, et al. Cutaneous Legionella longbeachae Infection in Immunosuppressed Woman, United Kingdom. Emerging Infectious Diseases. 2015;21(8):1426-1428. doi:10.3201/eid2108.140828.
    APA Grimstead, D., Tucker, D., Harris, K., & Turner, D. (2015). Cutaneous Legionella longbeachae Infection in Immunosuppressed Woman, United Kingdom. Emerging Infectious Diseases, 21(8), 1426-1428. https://dx.doi.org/10.3201/eid2108.140828.
  • Ribavirin for Chronic Hepatitis Prevention among Patients with Hematologic Malignancies PDF Version [PDF - 814 KB - 4 pages]
    S. Tavitian et al.
        View Abstract

    Findings among a cohort of 26 patients who had hematologic malignancies and hepatitis E virus (HEV) infection support that HEV can induce chronic hepatitis. However, a 3-month course of ribavirin can induce a rapid viral clearance, reducing the risk for chronic hepatitis and enabling continuation of cytotoxic treatments for underlying malignancies.

        Cite This Article
    EID Tavitian S, Peron J, Huguet F, Kamar N, Abravanel F, Beyne-Rauzy O, et al. Ribavirin for Chronic Hepatitis Prevention among Patients with Hematologic Malignancies. Emerg Infect Dis. 2015;21(8):1466-1469. https://dx.doi.org/10.3201/eid2108.150199
    AMA Tavitian S, Peron J, Huguet F, et al. Ribavirin for Chronic Hepatitis Prevention among Patients with Hematologic Malignancies. Emerging Infectious Diseases. 2015;21(8):1466-1469. doi:10.3201/eid2108.150199.
    APA Tavitian, S., Peron, J., Huguet, F., Kamar, N., Abravanel, F., Beyne-Rauzy, O....Recher, C. (2015). Ribavirin for Chronic Hepatitis Prevention among Patients with Hematologic Malignancies. Emerging Infectious Diseases, 21(8), 1466-1469. https://dx.doi.org/10.3201/eid2108.150199.
  • Transmission Models of Historical Ebola Outbreaks PDF Version [PDF - 724 KB - 4 pages]
    J. M. Drake et al.
        View Abstract

    To guide the collection of data under emergent epidemic conditions, we reviewed compartmental models of historical Ebola outbreaks to determine their implications and limitations. We identified future modeling directions and propose that the minimal epidemiologic dataset for Ebola model construction comprises duration of incubation period and symptomatic period, distribution of secondary cases by infection setting, and compliance with intervention recommendations.

        Cite This Article
    EID Drake JM, Bakach I, Just MR, O’Regan SM, Gambhir M, Fung I, et al. Transmission Models of Historical Ebola Outbreaks. Emerg Infect Dis. 2015;21(8):1447-1450. https://dx.doi.org/10.3201/eid2108.141613
    AMA Drake JM, Bakach I, Just MR, et al. Transmission Models of Historical Ebola Outbreaks. Emerging Infectious Diseases. 2015;21(8):1447-1450. doi:10.3201/eid2108.141613.
    APA Drake, J. M., Bakach, I., Just, M. R., O’Regan, S. M., Gambhir, M., & Fung, I. (2015). Transmission Models of Historical Ebola Outbreaks. Emerging Infectious Diseases, 21(8), 1447-1450. https://dx.doi.org/10.3201/eid2108.141613.
  • Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA PDF Version [PDF - 1.47 MB - 4 pages]
    A. Ridpath et al.
        View Abstract

    Risk factors for illness during a serogroup C meningococcal disease outbreak among men who have sex with men in New York City, New York, USA, in 2012–2013 included methamphetamine and cocaine use and sexually transmitted infections. Outbreak investigations should consider routinely capturing information regarding drug use and sex-related risk factors.

        Cite This Article
    EID Ridpath A, Greene SK, Robinson BF, Weiss D. Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA. Emerg Infect Dis. 2015;21(8):1458-1461. https://dx.doi.org/10.3201/eid2108.141932
    AMA Ridpath A, Greene SK, Robinson BF, et al. Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA. Emerging Infectious Diseases. 2015;21(8):1458-1461. doi:10.3201/eid2108.141932.
    APA Ridpath, A., Greene, S. K., Robinson, B. F., & Weiss, D. (2015). Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA. Emerging Infectious Diseases, 21(8), 1458-1461. https://dx.doi.org/10.3201/eid2108.141932.
  • Macrolide-Resistant Mycoplasma pneumoniae, United States PDF Version [PDF - 574 KB - 3 pages]
    X. Zheng et al.
        View Abstract

    Macrolide-resistant Mycoplasma pneumoniae (MRMP) is highly prevalent in Asia and is now being reported from Europe. Few data on MRMP are available in the United States. Using genotypic and phenotypic methods, we detected high-level MRMP in 13.2% of 91 M. pneumoniae­–positive specimens from 6 US locations.

        Cite This Article
    EID Zheng X, Lee S, Selvarangan R, Qin X, Tang Y, Stiles J, et al. Macrolide-Resistant Mycoplasma pneumoniae, United States. Emerg Infect Dis. 2015;21(8):1470-1472. https://dx.doi.org/10.3201/eid2108.150273
    AMA Zheng X, Lee S, Selvarangan R, et al. Macrolide-Resistant Mycoplasma pneumoniae, United States. Emerging Infectious Diseases. 2015;21(8):1470-1472. doi:10.3201/eid2108.150273.
    APA Zheng, X., Lee, S., Selvarangan, R., Qin, X., Tang, Y., Stiles, J....Waites, K. B. (2015). Macrolide-Resistant Mycoplasma pneumoniae, United States. Emerging Infectious Diseases, 21(8), 1470-1472. https://dx.doi.org/10.3201/eid2108.150273.
  • Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil PDF Version [PDF - 2.34 MB - 4 pages]
    R. Siciliano et al.
        View Abstract

    We evaluated culture-negative, community-acquired endocarditis by using indirect immunofluorescent assays and molecular analyses for Bartonella spp. and Coxiella burnetii and found a prevalence of 19.6% and 7.8%, respectively. Our findings reinforce the need to study these organisms in patients with culture-negative, community-acquired endocarditis, especially B. henselae in cat owners.

        Cite This Article
    EID Siciliano R, Castelli J, Mansur A, Pereira dos Santos F, Colombo S, do Nascimento E, et al. Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil. Emerg Infect Dis. 2015;21(8):1429-1432. https://dx.doi.org/10.3201/eid2108.140343
    AMA Siciliano R, Castelli J, Mansur A, et al. Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil. Emerging Infectious Diseases. 2015;21(8):1429-1432. doi:10.3201/eid2108.140343.
    APA Siciliano, R., Castelli, J., Mansur, A., Pereira dos Santos, F., Colombo, S., do Nascimento, E....Strabelli, T. (2015). Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil. Emerging Infectious Diseases, 21(8), 1429-1432. https://dx.doi.org/10.3201/eid2108.140343.
  • Genomic Assays for Identification of Chikungunya Virus in Blood Donors, Puerto Rico, 2014 PDF Version [PDF - 3.13 MB - 5 pages]
    C. Y. Chiu et al.
        View Abstract

    A newly developed transcription-mediated amplification assay was used to detect chikungunya virus infection in 3 of 557 asymptomatic donors (0.54%) from Puerto Rico during the 2014–2015 Caribbean epidemic. Viral detection was confirmed by using PCR, microarray, and next-generation sequencing. Molecular clock analysis dated the emergence of the Puerto Rico strains to early 2013.

        Cite This Article
    EID Chiu CY, Bres V, Yu G, Krysztof D, Naccache SN, Lee D, et al. Genomic Assays for Identification of Chikungunya Virus in Blood Donors, Puerto Rico, 2014. Emerg Infect Dis. 2015;21(8):1409-1413. https://dx.doi.org/10.3201/eid2108.150458
    AMA Chiu CY, Bres V, Yu G, et al. Genomic Assays for Identification of Chikungunya Virus in Blood Donors, Puerto Rico, 2014. Emerging Infectious Diseases. 2015;21(8):1409-1413. doi:10.3201/eid2108.150458.
    APA Chiu, C. Y., Bres, V., Yu, G., Krysztof, D., Naccache, S. N., Lee, D....Stramer, S. L. (2015). Genomic Assays for Identification of Chikungunya Virus in Blood Donors, Puerto Rico, 2014. Emerging Infectious Diseases, 21(8), 1409-1413. https://dx.doi.org/10.3201/eid2108.150458.
  • Geographic Distribution and Expansion of Human Lyme Disease, United States PDF Version [PDF - 507 KB - 3 pages]
    K. J. Kugeler et al.
        View Abstract

    Lyme disease occurs in specific geographic regions of the United States. We present a method for defining high-risk counties based on observed versus expected number of reported human Lyme disease cases. Applying this method to successive periods shows substantial geographic expansion of counties at high risk for Lyme disease.

        Cite This Article
    EID Kugeler KJ, Farley GM, Forrester JD, Mead P. Geographic Distribution and Expansion of Human Lyme Disease, United States. Emerg Infect Dis. 2015;21(8):1455-1457. https://dx.doi.org/10.3201/eid2108.141878
    AMA Kugeler KJ, Farley GM, Forrester JD, et al. Geographic Distribution and Expansion of Human Lyme Disease, United States. Emerging Infectious Diseases. 2015;21(8):1455-1457. doi:10.3201/eid2108.141878.
    APA Kugeler, K. J., Farley, G. M., Forrester, J. D., & Mead, P. (2015). Geographic Distribution and Expansion of Human Lyme Disease, United States. Emerging Infectious Diseases, 21(8), 1455-1457. https://dx.doi.org/10.3201/eid2108.141878.

Letters

  • Measles Vaccination Coverage and Cases among Vaccinated Persons PDF Version [PDF - 365 KB - 2 pages]
    C. L. Althaus and M. Salathé
            Cite This Article
    EID Althaus CL, Salathé M. Measles Vaccination Coverage and Cases among Vaccinated Persons. Emerg Infect Dis. 2015;21(8):1480-1481. https://dx.doi.org/10.3201/eid2108.150284
    AMA Althaus CL, Salathé M. Measles Vaccination Coverage and Cases among Vaccinated Persons. Emerging Infectious Diseases. 2015;21(8):1480-1481. doi:10.3201/eid2108.150284.
    APA Althaus, C. L., & Salathé, M. (2015). Measles Vaccination Coverage and Cases among Vaccinated Persons. Emerging Infectious Diseases, 21(8), 1480-1481. https://dx.doi.org/10.3201/eid2108.150284.
  • Rickettsia felis Infection among Humans, Bangladesh, 2012–2013 PDF Version [PDF - 368 KB - 3 pages]
    F. Ferdouse et al.
            Cite This Article
    EID Ferdouse F, Hossain M, Paul S, Ahmed S, Mahmud M, Ahmed R, et al. Rickettsia felis Infection among Humans, Bangladesh, 2012–2013. Emerg Infect Dis. 2015;21(8):1483-1485. https://dx.doi.org/10.3201/eid2108.150328
    AMA Ferdouse F, Hossain M, Paul S, et al. Rickettsia felis Infection among Humans, Bangladesh, 2012–2013. Emerging Infectious Diseases. 2015;21(8):1483-1485. doi:10.3201/eid2108.150328.
    APA Ferdouse, F., Hossain, M., Paul, S., Ahmed, S., Mahmud, M., Ahmed, R....Kobayashi, N. (2015). Rickettsia felis Infection among Humans, Bangladesh, 2012–2013. Emerging Infectious Diseases, 21(8), 1483-1485. https://dx.doi.org/10.3201/eid2108.150328.
  • Avian Gyrovirus 2 DNA in Fowl from Live Poultry Markets and in Healthy Humans, China PDF Version [PDF - 788 KB - 3 pages]
    J. Ye et al.
            Cite This Article
    EID Ye J, Tian X, Xie Q, Zhang Y, Sheng Y, Zhang Z, et al. Avian Gyrovirus 2 DNA in Fowl from Live Poultry Markets and in Healthy Humans, China. Emerg Infect Dis. 2015;21(8):1486-1488. https://dx.doi.org/10.3201/eid2108.150203
    AMA Ye J, Tian X, Xie Q, et al. Avian Gyrovirus 2 DNA in Fowl from Live Poultry Markets and in Healthy Humans, China. Emerging Infectious Diseases. 2015;21(8):1486-1488. doi:10.3201/eid2108.150203.
    APA Ye, J., Tian, X., Xie, Q., Zhang, Y., Sheng, Y., Zhang, Z....Qin, A. (2015). Avian Gyrovirus 2 DNA in Fowl from Live Poultry Markets and in Healthy Humans, China. Emerging Infectious Diseases, 21(8), 1486-1488. https://dx.doi.org/10.3201/eid2108.150203.
  • Malaria Prophylaxis Failure with Doxycycline, Central African Republic, 2014 PDF Version [PDF - 290 KB - 2 pages]
    M. Madamet et al.
            Cite This Article
    EID Madamet M, Gaillard T, Velut G, Ficko C, Houzé P, Bylicki C, et al. Malaria Prophylaxis Failure with Doxycycline, Central African Republic, 2014. Emerg Infect Dis. 2015;21(8):1485-1486. https://dx.doi.org/10.3201/eid2108.150524
    AMA Madamet M, Gaillard T, Velut G, et al. Malaria Prophylaxis Failure with Doxycycline, Central African Republic, 2014. Emerging Infectious Diseases. 2015;21(8):1485-1486. doi:10.3201/eid2108.150524.
    APA Madamet, M., Gaillard, T., Velut, G., Ficko, C., Houzé, P., Bylicki, C....Pradines, B. (2015). Malaria Prophylaxis Failure with Doxycycline, Central African Republic, 2014. Emerging Infectious Diseases, 21(8), 1485-1486. https://dx.doi.org/10.3201/eid2108.150524.
  • Lassa Virus in Multimammate Rats, Côte d’Ivoire, 2013 PDF Version [PDF - 376 KB - 3 pages]
    L. Kouadio et al.
            Cite This Article
    EID Kouadio L, Nowak K, Akoua-Koffi C, Weiss S, Allali BK, Witkowski PT, et al. Lassa Virus in Multimammate Rats, Côte d’Ivoire, 2013. Emerg Infect Dis. 2015;21(8):1481-1483. https://dx.doi.org/10.3201/eid2108.150312
    AMA Kouadio L, Nowak K, Akoua-Koffi C, et al. Lassa Virus in Multimammate Rats, Côte d’Ivoire, 2013. Emerging Infectious Diseases. 2015;21(8):1481-1483. doi:10.3201/eid2108.150312.
    APA Kouadio, L., Nowak, K., Akoua-Koffi, C., Weiss, S., Allali, B. K., Witkowski, P. T....Leendertz, F. H. (2015). Lassa Virus in Multimammate Rats, Côte d’Ivoire, 2013. Emerging Infectious Diseases, 21(8), 1481-1483. https://dx.doi.org/10.3201/eid2108.150312.

Books and Media

  • Mapping Disease Transmission Risk: Enriching Models Using Biogeography and Ecology PDF Version [PDF - 252 KB - 1 page]
    J. P. Townsend
            Cite This Article
    EID Townsend JP. Mapping Disease Transmission Risk: Enriching Models Using Biogeography and Ecology. Emerg Infect Dis. 2015;21(8):1489. https://dx.doi.org/10.3201/eid2108.150665
    AMA Townsend JP. Mapping Disease Transmission Risk: Enriching Models Using Biogeography and Ecology. Emerging Infectious Diseases. 2015;21(8):1489. doi:10.3201/eid2108.150665.
    APA Townsend, J. P. (2015). Mapping Disease Transmission Risk: Enriching Models Using Biogeography and Ecology. Emerging Infectious Diseases, 21(8), 1489. https://dx.doi.org/10.3201/eid2108.150665.

About the Cover

  • Beyond First Impressions PDF Version [PDF - 3.11 MB - 2 pages]
    B. Breedlove and J. Friedberg
            Cite This Article
    EID Breedlove B, Friedberg J. Beyond First Impressions. Emerg Infect Dis. 2015;21(8):1490-1491. https://dx.doi.org/10.3201/eid2108.AC2108
    AMA Breedlove B, Friedberg J. Beyond First Impressions. Emerging Infectious Diseases. 2015;21(8):1490-1491. doi:10.3201/eid2108.AC2108.
    APA Breedlove, B., & Friedberg, J. (2015). Beyond First Impressions. Emerging Infectious Diseases, 21(8), 1490-1491. https://dx.doi.org/10.3201/eid2108.AC2108.

Etymologia

  • Etymologia: Escherichia coli PDF Version [PDF - 375 KB - 1 page]
            Cite This Article
    EID Etymologia: Escherichia coli. Emerg Infect Dis. 2015;21(8):1310. https://dx.doi.org/10.3201/eid2108.ET2108
    AMA Etymologia: Escherichia coli. Emerging Infectious Diseases. 2015;21(8):1310. doi:10.3201/eid2108.ET2108.
    APA (2015). Etymologia: Escherichia coli. Emerging Infectious Diseases, 21(8), 1310. https://dx.doi.org/10.3201/eid2108.ET2108.

Conference Summaries

  • The Role of Scientific Collections in Scientific Preparedness
    D. DiEuliis
    View Summary

    The role of scientific collections in detecting emerging pathogens is explained in the results of a workshop.

        View Abstract

    Building on the findings and recommendations of the Interagency Working Group on Scientific Collections, Scientific Collections International (SciColl) aims to improve the rapid access to science collections across disciplines within the federal government and globally, between government agencies and private research institutions. SciColl offered a novel opportunity for the US Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, to explore the value of scientific research collections under the science preparedness initiative and integrate it as a research resource at each stage in the emergence of the infectious diseases cycle. Under the leadership of SciColl’s executive secretariat at the Smithsonian Institution, and with multiple federal and international partners, a workshop during October 2014 fully explored the intersections of the infectious disease cycle and the role scientific collections could play as an evidentiary scientific resource to mitigate risks associated with emerging infectious diseases.

       

Corrections

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