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Issue Cover for Volume 22, Number 11—November 2016

Volume 22, Number 11—November 2016

[PDF - 7.49 MB - 176 pages]

Synopses

Medscape CME Activity
Transmission of Babesia microti Parasites by Solid Organ Transplantation [PDF - 1.12 MB - 8 pages]
M. B. Brennan et al.

Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries. The organ donor and recipients had no identified risk factors for tickborne infection. Antibodies against B. microti parasites were not detected by serologic testing of archived pretransplant specimens. However, 1 of the organ donor’s blood donors was seropositive when tested postdonation and had risk factors for tick exposure. The organ donor probably served as a conduit of Babesia parasites from the seropositive blood donor to both kidney recipients. Babesiosis should be included in the differential diagnosis of unexplained fever and hemolytic anemia after blood transfusion or organ transplantation.

EID Brennan MB, Herwaldt BL, Kazmierczak JJ, Weiss JW, Klein CL, Leith CP, et al. Transmission of Babesia microti Parasites by Solid Organ Transplantation. Emerg Infect Dis. 2016;22(11):1869-1876. https://dx.doi.org/10.3201/eid2211.151028
AMA Brennan MB, Herwaldt BL, Kazmierczak JJ, et al. Transmission of Babesia microti Parasites by Solid Organ Transplantation. Emerging Infectious Diseases. 2016;22(11):1869-1876. doi:10.3201/eid2211.151028.
APA Brennan, M. B., Herwaldt, B. L., Kazmierczak, J. J., Weiss, J. W., Klein, C. L., Leith, C. P....Gauthier, G. M. (2016). Transmission of Babesia microti Parasites by Solid Organ Transplantation. Emerging Infectious Diseases, 22(11), 1869-1876. https://dx.doi.org/10.3201/eid2211.151028.
Research

Immune Responses to Invasive Group B Streptococcal Disease in Adults [PDF - 1.00 MB - 7 pages]
M. S. Edwards et al.

Immunization of nonpregnant adults could help prevent invasive group B Streptococcus (GBS) infections, but adult immune responses have not been investigated. We defined capsular polysaccharide (CPS) and pilus island (PI) surface antigen distribution and expression and immune responses to GBS infection in nonpregnant adults. Prospective surveillance from 7 hospitals in Houston, Texas, USA, identified 102 adults with GBS bacteremia; 43% had skin/soft tissue infection, 16% bacteremia without focus, and 12% osteomyelitis. CPS-specific IgG was determined by ELISA and pilus-specific IgG by multiplex immunoassay. CPS types were Ia (24.5%), Ib (12.7%), II (9.8%), III (16.7%), IV (13.7%), and V (12.7%); 9.8% were nontypeable by serologic methods. Pili, expressed by 89%, were most often PI-2a. CPS and pilus-specific IgG increased during convalescence among patients with strains expressing CPS or PI. All GBS expressed CPS or PI; 79% expressed both. Increased antibodies to CPS and PI during recovery suggests that GBS bacteremia in adults is potentially vaccine preventable.

EID Edwards MS, Rench MA, Rinaudo C, Fabbrini M, Tuscano G, Buffi G, et al. Immune Responses to Invasive Group B Streptococcal Disease in Adults. Emerg Infect Dis. 2016;22(11):1877-1883. https://dx.doi.org/10.3201/eid2211.160914
AMA Edwards MS, Rench MA, Rinaudo C, et al. Immune Responses to Invasive Group B Streptococcal Disease in Adults. Emerging Infectious Diseases. 2016;22(11):1877-1883. doi:10.3201/eid2211.160914.
APA Edwards, M. S., Rench, M. A., Rinaudo, C., Fabbrini, M., Tuscano, G., Buffi, G....Margarit, I. (2016). Immune Responses to Invasive Group B Streptococcal Disease in Adults. Emerging Infectious Diseases, 22(11), 1877-1883. https://dx.doi.org/10.3201/eid2211.160914.

Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015 [PDF - 2.49 MB - 9 pages]
A. Mirand et al.

The clinical impact of enteroviruses associated with hand, foot and mouth disease (HFMD) is unknown outside Asia, and the prevalence of enterovirus A71 (EV-A71) in particular might be underestimated. To investigate the prevalence of enterovirus serotypes and the clinical presentations associated with HFMD in France, we conducted prospective ambulatory clinic–based surveillance of children during April 2014–March 2015. Throat or buccal swabs were collected from children with HFMD and tested for the enterovirus genome. Physical examinations were recorded on a standardized form. An enterovirus infection was detected in 523 (79.3%) of 659 children tested. Two epidemic waves occurred, dominated by coxsackievirus (CV) A6, which was detected in 53.9% of enterovirus-infected children. CV-A6 was more frequently related to atypical HFMD manifestations (eruptions extended to limbs and face). Early awareness and documentation of HFMD outbreaks can be achieved by syndromic surveillance of HFMD by ambulatory pediatricians and rapid enterovirus testing and genotyping.

EID Mirand A, le Sage F, Pereira B, Cohen R, Levy C, Archimbaud C, et al. Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015. Emerg Infect Dis. 2016;22(11):1884-1893. https://dx.doi.org/10.3201/eid2211.160590
AMA Mirand A, le Sage F, Pereira B, et al. Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015. Emerging Infectious Diseases. 2016;22(11):1884-1893. doi:10.3201/eid2211.160590.
APA Mirand, A., le Sage, F., Pereira, B., Cohen, R., Levy, C., Archimbaud, C....Henquell, C. (2016). Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015. Emerging Infectious Diseases, 22(11), 1884-1893. https://dx.doi.org/10.3201/eid2211.160590.

Increased Hospitalizations for Neuropathies as Indicators of Zika Virus Infection, according to Health Information System Data, Brazil [PDF - 981 KB - 6 pages]
C. Barcellos et al.

Evidence is increasing that Zika virus can cause extensive damage to the central nervous system, affecting both fetuses and adults. We sought to identify traces of possible clinical manifestations of nervous system diseases among the registers of hospital admissions recorded in the Brazilian Unified Health System. Time series of several diagnoses from the International Classification of Diseases, 10th Revision, were analyzed by using control diagrams, during January 2008–February 2016. Beginning in mid-2014, we observed an unprecedented and significant rise in the hospitalization rate for congenital malformations of the nervous system, Guillain-Barré syndrome, encephalitis, myelitis, and encephalomyelitis. These conditions are compatible with viral infection and inflammation-associated manifestations and may have been due to the entrance of Zika virus into Brazil. These findings show the necessity of adequately diagnosing and treating suspected cases of Zika virus infection and also that health surveillance systems can be improved by using routine data.

EID Barcellos C, Xavier D, Pavão A, Boccolini C, Pina M, Pedroso M, et al. Increased Hospitalizations for Neuropathies as Indicators of Zika Virus Infection, according to Health Information System Data, Brazil. Emerg Infect Dis. 2016;22(11):1894-1899. https://dx.doi.org/10.3201/eid2211.160901
AMA Barcellos C, Xavier D, Pavão A, et al. Increased Hospitalizations for Neuropathies as Indicators of Zika Virus Infection, according to Health Information System Data, Brazil. Emerging Infectious Diseases. 2016;22(11):1894-1899. doi:10.3201/eid2211.160901.
APA Barcellos, C., Xavier, D., Pavão, A., Boccolini, C., Pina, M., Pedroso, M....Romão, A. (2016). Increased Hospitalizations for Neuropathies as Indicators of Zika Virus Infection, according to Health Information System Data, Brazil. Emerging Infectious Diseases, 22(11), 1894-1899. https://dx.doi.org/10.3201/eid2211.160901.

Global Escherichia coli Sequence Type 131 Clade with blaCTX-M-27 Gene [PDF - 5.82 MB - 8 pages]
Y. Matsumura et al.

The Escherichia coli sequence type (ST) 131 C2/H30Rx clade with the blaCTX-M-15 gene had been most responsible for the global dissemination of extended-spectrum β-lactamase (ESBL)–producing E. coli. ST131 C1/H30R with blaCTX-M-27 emerged among ESBL-producing E. coli in Japan during the late 2000s. To investigate the possible expansion of a single clade, we performed whole-genome sequencing for 43 Japan and 10 global ST131 isolates with blaCTX-M-27 (n = 16), blaCTX-M-14 (n = 16), blaCTX-M-15 (n = 13), and others (n = 8). We also included 8 ST131 genomes available in public databases. Core genome-based analysis of 61 isolates showed that ST131 with blaCTX-M-27 from 5 countries formed a distinct cluster within the C1/H30R clade, named C1-M27 clade. Accessory genome analysis identified a unique prophage-like region, supporting C1-M27 as a distinct clade. Our findings indicate that the increase of ESBL-producing E. coli in Japan is due mainly to emergence of the C1-M27 clade.

EID Matsumura Y, Pitout J, Gomi R, Matsuda T, Noguchi T, Yamamoto M, et al. Global Escherichia coli Sequence Type 131 Clade with blaCTX-M-27 Gene. Emerg Infect Dis. 2016;22(11):1900-1907. https://dx.doi.org/10.3201/eid2211.160519
AMA Matsumura Y, Pitout J, Gomi R, et al. Global Escherichia coli Sequence Type 131 Clade with blaCTX-M-27 Gene. Emerging Infectious Diseases. 2016;22(11):1900-1907. doi:10.3201/eid2211.160519.
APA Matsumura, Y., Pitout, J., Gomi, R., Matsuda, T., Noguchi, T., Yamamoto, M....Ichiyama, S. (2016). Global Escherichia coli Sequence Type 131 Clade with blaCTX-M-27 Gene. Emerging Infectious Diseases, 22(11), 1900-1907. https://dx.doi.org/10.3201/eid2211.160519.

Medscape CME Activity
Multidrug-Resistant Corynebacterium striatum Associated with Increased Use of Parenteral Antimicrobial Drugs [PDF - 2.32 MB - 7 pages]
W. O. Hahn et al.

Corynebacterium striatum is an emerging multidrug-resistant bacteria. We retrospectively identified 179 isolates in a clinical database. Clinical relevance, in vitro susceptibility, and length of parenteral antimicrobial drug use were obtained from patient records. For patients with hardware- or device-associated infections, those with C. striatum infections were matched with patients infected with coagulase-negative staphylococci for case–control analysis. A total of 87 (71%) of 121 isolates were resistant to all oral antimicrobial drugs tested, including penicillin, tetracycline, clindamycin, erythromycin, and ciprofloxacin. When isolated from hardware or devices, C. striatum was pathogenic in 38 (87%) of 44 cases. Patients with hardware-associated C. striatum infections received parenteral antimicrobial drugs longer than patients with hardware-associated coagulase-negative staphylococci infections (mean ± SD 69 ± 5 days vs. 25 ± 4 days; p<0.001). C. striatum commonly shows resistance to antimicrobial drugs with oral bioavailability and is associated with increased use of parenteral antimicrobial drugs.

EID Hahn WO, Werth BJ, Butler-Wu SM, Rakita RM. Multidrug-Resistant Corynebacterium striatum Associated with Increased Use of Parenteral Antimicrobial Drugs. Emerg Infect Dis. 2016;22(11):1908-1914. https://dx.doi.org/10.3201/eid2211.160141
AMA Hahn WO, Werth BJ, Butler-Wu SM, et al. Multidrug-Resistant Corynebacterium striatum Associated with Increased Use of Parenteral Antimicrobial Drugs. Emerging Infectious Diseases. 2016;22(11):1908-1914. doi:10.3201/eid2211.160141.
APA Hahn, W. O., Werth, B. J., Butler-Wu, S. M., & Rakita, R. M. (2016). Multidrug-Resistant Corynebacterium striatum Associated with Increased Use of Parenteral Antimicrobial Drugs. Emerging Infectious Diseases, 22(11), 1908-1914. https://dx.doi.org/10.3201/eid2211.160141.

Risk Factors for Middle East Respiratory Syndrome Coronavirus Infection among Healthcare Personnel [PDF - 495 KB - 6 pages]
B. M. Alraddadi et al.

Healthcare settings can amplify transmission of Middle East respiratory syndrome coronavirus (MERS-CoV), but knowledge gaps about the epidemiology of transmission remain. We conducted a retrospective cohort study among healthcare personnel in hospital units that treated MERS-CoV patients. Participants were interviewed about exposures to MERS-CoV patients, use of personal protective equipment, and signs and symptoms of illness after exposure. Infection status was determined by the presence of antibodies against MERS-CoV. To assess risk factors, we compared infected and uninfected participants. Healthcare personnel caring for MERS-CoV patients were at high risk for infection, but infection most often resulted in a relatively mild illness that might be unrecognized. In the healthcare personnel cohort reported here, infections occurred exclusively among those who had close contact with MERS-CoV patients.

EID Alraddadi BM, Al-Salmi HS, Jacobs-Slifka K, Slayton RB, Estivariz CF, Geller AI, et al. Risk Factors for Middle East Respiratory Syndrome Coronavirus Infection among Healthcare Personnel. Emerg Infect Dis. 2016;22(11):1915-1920. https://dx.doi.org/10.3201/eid2211.160920
AMA Alraddadi BM, Al-Salmi HS, Jacobs-Slifka K, et al. Risk Factors for Middle East Respiratory Syndrome Coronavirus Infection among Healthcare Personnel. Emerging Infectious Diseases. 2016;22(11):1915-1920. doi:10.3201/eid2211.160920.
APA Alraddadi, B. M., Al-Salmi, H. S., Jacobs-Slifka, K., Slayton, R. B., Estivariz, C. F., Geller, A. I....Madani, T. A. (2016). Risk Factors for Middle East Respiratory Syndrome Coronavirus Infection among Healthcare Personnel. Emerging Infectious Diseases, 22(11), 1915-1920. https://dx.doi.org/10.3201/eid2211.160920.

Epidemiology of La Crosse Virus Emergence, Appalachia Region, United States [PDF - 1.50 MB - 9 pages]
S. Bewick et al.

La Crosse encephalitis is a viral disease that has emerged in new locations across the Appalachian region of the United States. Conventional wisdom suggests that ongoing emergence of La Crosse virus (LACV) could stem from the invasive Asian tiger (Aedes albopictus) mosquito. Efforts to prove this, however, are complicated by the numerous transmission routes and species interactions involved in LACV dynamics. To analyze LACV transmission by Asian tiger mosquitoes, we constructed epidemiologic models. These models accurately predict empirical infection rates. They do not, however, support the hypothesis that Asian tiger mosquitoes are responsible for the recent emergence of LACV at new foci. Consequently, we conclude that other factors, including different invasive mosquitoes, changes in climate variables, or changes in wildlife densities, should be considered as alternative explanations for recent increases in La Crosse encephalitis.

EID Bewick S, Agusto F, Calabrese JM, Muturi EJ, Fagan WF. Epidemiology of La Crosse Virus Emergence, Appalachia Region, United States. Emerg Infect Dis. 2016;22(11):1921-1929. https://dx.doi.org/10.3201/eid2211.160308
AMA Bewick S, Agusto F, Calabrese JM, et al. Epidemiology of La Crosse Virus Emergence, Appalachia Region, United States. Emerging Infectious Diseases. 2016;22(11):1921-1929. doi:10.3201/eid2211.160308.
APA Bewick, S., Agusto, F., Calabrese, J. M., Muturi, E. J., & Fagan, W. F. (2016). Epidemiology of La Crosse Virus Emergence, Appalachia Region, United States. Emerging Infectious Diseases, 22(11), 1921-1929. https://dx.doi.org/10.3201/eid2211.160308.

Reassortant Eurasian Avian-Like Influenza A(H1N1) Virus from a Severely Ill Child, Hunan Province, China, 2015 [PDF - 2.38 MB - 7 pages]
W. Zhu et al.

In 2015, a novel influenza A(H1N1) virus was isolated from a boy in China who had severe pneumonia. The virus was a genetic reassortant of Eurasian avian-like influenza A(H1N1) (EA-H1N1) virus. The hemagglutinin, neuraminidase, and matrix genes of the reassortant virus were highly similar to genes in EA-H1N1 swine influenza viruses, the polybasic 1 and 2, polymerase acidic, and nucleoprotein genes originated from influenza A(H1N1)pdm09 virus, and the nonstructural protein gene derived from classical swine influenza A(H1N1) (CS H1N1) virus. In a mouse model, the reassortant virus, termed influenza A/Hunan/42443/2015(H1N1) virus, showed higher infectivity and virulence than another human EA-H1N1 isolate, influenza A/Jiangsu/1/2011(H1N1) virus. In the respiratory tract of mice, virus replication by influenza A/Hunan/42443/2015(H1N1) virus was substantially higher than that by influenza A/Jiangsu/1/2011(H1N1) virus. Human-to-human transmission of influenza A/Hunan/42443/2015(H1N1) virus has not been detected; however, given the circulation of novel EA-H1N1 viruses in pigs, enhanced surveillance should be instituted among swine and humans.

EID Zhu W, Zhang H, Xiang X, Zhong L, Yang L, Guo J, et al. Reassortant Eurasian Avian-Like Influenza A(H1N1) Virus from a Severely Ill Child, Hunan Province, China, 2015. Emerg Infect Dis. 2016;22(11):1930-1936. https://dx.doi.org/10.3201/eid2211.160181
AMA Zhu W, Zhang H, Xiang X, et al. Reassortant Eurasian Avian-Like Influenza A(H1N1) Virus from a Severely Ill Child, Hunan Province, China, 2015. Emerging Infectious Diseases. 2016;22(11):1930-1936. doi:10.3201/eid2211.160181.
APA Zhu, W., Zhang, H., Xiang, X., Zhong, L., Yang, L., Guo, J....Shu, Y. (2016). Reassortant Eurasian Avian-Like Influenza A(H1N1) Virus from a Severely Ill Child, Hunan Province, China, 2015. Emerging Infectious Diseases, 22(11), 1930-1936. https://dx.doi.org/10.3201/eid2211.160181.
Dispatches

Serotype IV Sequence Type 468 Group B Streptococcus Neonatal Invasive Disease, Minnesota, USA [PDF - 1.11 MB - 4 pages]
S. Teatero et al.

To further understand the emergence of serotype IV group B Streptococcus (GBS) invasive disease, we used whole-genome sequencing to characterize 3 sequence type 468 strains isolated from neonates in Minnesota, USA. We found that strains of tetracycline-resistant sequence type 468 GBS have acquired virulence genes from a putative clonal complex 17 GBS donor by recombination.

EID Teatero S, Ferrieri P, Fittipaldi N. Serotype IV Sequence Type 468 Group B Streptococcus Neonatal Invasive Disease, Minnesota, USA. Emerg Infect Dis. 2016;22(11):1937-1940. https://dx.doi.org/10.3201/eid2211.152031
AMA Teatero S, Ferrieri P, Fittipaldi N. Serotype IV Sequence Type 468 Group B Streptococcus Neonatal Invasive Disease, Minnesota, USA. Emerging Infectious Diseases. 2016;22(11):1937-1940. doi:10.3201/eid2211.152031.
APA Teatero, S., Ferrieri, P., & Fittipaldi, N. (2016). Serotype IV Sequence Type 468 Group B Streptococcus Neonatal Invasive Disease, Minnesota, USA. Emerging Infectious Diseases, 22(11), 1937-1940. https://dx.doi.org/10.3201/eid2211.152031.

Capsular Switching and Other Large-Scale Recombination Events in Invasive Sequence Type 1 Group B Streptococcus [PDF - 1.76 MB - 4 pages]
A. Neemuchwala et al.

We report several cases of recombination events leading to capsular switching among sequence type (ST) 1 group B Streptococcus strains. These strains otherwise shared a common genome backbone with serotype V ST1 strains. However, the genomes of ST1 serotype V strains and those of serotypes VI, VII, and VIII strains differed substantially.

EID Neemuchwala A, Teatero S, Athey T, McGeer A, Fittipaldi N. Capsular Switching and Other Large-Scale Recombination Events in Invasive Sequence Type 1 Group B Streptococcus. Emerg Infect Dis. 2016;22(11):1941-1944. https://dx.doi.org/10.3201/eid2211.152064
AMA Neemuchwala A, Teatero S, Athey T, et al. Capsular Switching and Other Large-Scale Recombination Events in Invasive Sequence Type 1 Group B Streptococcus. Emerging Infectious Diseases. 2016;22(11):1941-1944. doi:10.3201/eid2211.152064.
APA Neemuchwala, A., Teatero, S., Athey, T., McGeer, A., & Fittipaldi, N. (2016). Capsular Switching and Other Large-Scale Recombination Events in Invasive Sequence Type 1 Group B Streptococcus. Emerging Infectious Diseases, 22(11), 1941-1944. https://dx.doi.org/10.3201/eid2211.152064.

Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010–2015 [PDF - 740 KB - 3 pages]
O. Peuchant et al.

We describe a change in the molecular epidemiology of Chlamydia trachomatis strains involved in an outbreak of rectal lymphogranuloma venereum in France during January 2010–April 2015. Until 2012, the C. trachomatis L2b strain predominated; however, starting in 2013, most cases involved the L2 strain. We also identified 4 genetic L2b ompA variants.

EID Peuchant O, Touati A, Sperandio C, Hénin N, Laurier-Nadalié C, Bébéar C, et al. Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010–2015. Emerg Infect Dis. 2016;22(11):1945-1947. https://dx.doi.org/10.3201/eid2211.160247
AMA Peuchant O, Touati A, Sperandio C, et al. Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010–2015. Emerging Infectious Diseases. 2016;22(11):1945-1947. doi:10.3201/eid2211.160247.
APA Peuchant, O., Touati, A., Sperandio, C., Hénin, N., Laurier-Nadalié, C., Bébéar, C....de Barbeyrac, B. (2016). Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010–2015. Emerging Infectious Diseases, 22(11), 1945-1947. https://dx.doi.org/10.3201/eid2211.160247.

ESBL-Producing and Macrolide-Resistant Shigella sonnei Infections among Men Who Have Sex with Men, England, 2015 [PDF - 1.50 MB - 5 pages]
P. Mook et al.

In England in 2015, Shigella sonnei isolates from men who have sex with men produced extended-spectrum β-lactamases and exhibited macrolide resistance. Whole-genome sequencing showed a close relationship among the isolates, which harbored a plasmid that was previously identified in a shigellosis outbreak among this population but has acquired a mobile element.

EID Mook P, McCormick J, Bains M, Cowley LA, Chattaway MA, Jenkins C, et al. ESBL-Producing and Macrolide-Resistant Shigella sonnei Infections among Men Who Have Sex with Men, England, 2015. Emerg Infect Dis. 2016;22(11):1948-1952. https://dx.doi.org/10.3201/eid2211.160653
AMA Mook P, McCormick J, Bains M, et al. ESBL-Producing and Macrolide-Resistant Shigella sonnei Infections among Men Who Have Sex with Men, England, 2015. Emerging Infectious Diseases. 2016;22(11):1948-1952. doi:10.3201/eid2211.160653.
APA Mook, P., McCormick, J., Bains, M., Cowley, L. A., Chattaway, M. A., Jenkins, C....Crook, P. (2016). ESBL-Producing and Macrolide-Resistant Shigella sonnei Infections among Men Who Have Sex with Men, England, 2015. Emerging Infectious Diseases, 22(11), 1948-1952. https://dx.doi.org/10.3201/eid2211.160653.

Early Growth and Neurologic Outcomes of Infants with Probable Congenital Zika Virus Syndrome [PDF - 1.00 MB - 4 pages]
A. Moura da Silva et al.

We report the early growth and neurologic findings of 48 infants in Brazil diagnosed with probable congenital Zika virus syndrome and followed to age 1–8 months. Most of these infants had microcephaly (86.7%) and craniofacial disproportion (95.8%). The clinical pattern included poor head growth with increasingly negative z-scores, pyramidal/extrapyramidal symptoms, and epilepsy.

EID Moura da Silva A, Ganz J, Sousa P, Doriqui M, Ribeiro M, Branco M, et al. Early Growth and Neurologic Outcomes of Infants with Probable Congenital Zika Virus Syndrome. Emerg Infect Dis. 2016;22(11):1953-1956. https://dx.doi.org/10.3201/eid2211.160956
AMA Moura da Silva A, Ganz J, Sousa P, et al. Early Growth and Neurologic Outcomes of Infants with Probable Congenital Zika Virus Syndrome. Emerging Infectious Diseases. 2016;22(11):1953-1956. doi:10.3201/eid2211.160956.
APA Moura da Silva, A., Ganz, J., Sousa, P., Doriqui, M., Ribeiro, M., Branco, M....Soares de Britto e Alves, M. (2016). Early Growth and Neurologic Outcomes of Infants with Probable Congenital Zika Virus Syndrome. Emerging Infectious Diseases, 22(11), 1953-1956. https://dx.doi.org/10.3201/eid2211.160956.

Severe Fever with Thrombocytopenia Syndrome Complicated by Co-infection with Spotted Fever Group Rickettsiae, China [PDF - 1.56 MB - 4 pages]
Q. Lu et al.

During 2013–2015 in central China, co-infection with spotted fever group rickettsiae was identified in 77 of 823 patients infected with severe fever with thrombocytopenia syndrome virus. Co-infection resulted in delayed recovery and increased risk for death, prompting clinical practices in the region to consider co-infection in patients with severe fever with thrombocytopenia syndrome.

EID Lu Q, Li H, Zhang P, Cui N, Yang Z, Fan Y, et al. Severe Fever with Thrombocytopenia Syndrome Complicated by Co-infection with Spotted Fever Group Rickettsiae, China. Emerg Infect Dis. 2016;22(11):1957-1960. https://dx.doi.org/10.3201/eid2211.161021
AMA Lu Q, Li H, Zhang P, et al. Severe Fever with Thrombocytopenia Syndrome Complicated by Co-infection with Spotted Fever Group Rickettsiae, China. Emerging Infectious Diseases. 2016;22(11):1957-1960. doi:10.3201/eid2211.161021.
APA Lu, Q., Li, H., Zhang, P., Cui, N., Yang, Z., Fan, Y....Cao, W. (2016). Severe Fever with Thrombocytopenia Syndrome Complicated by Co-infection with Spotted Fever Group Rickettsiae, China. Emerging Infectious Diseases, 22(11), 1957-1960. https://dx.doi.org/10.3201/eid2211.161021.

Guinea Worm (Dracunculus medinensis) Infection in a Wild-Caught Frog, Chad [PDF - 938 KB - 2 pages]
M. L. Eberhard et al.

A third-stage (infective) larva of Dracunculus medinensis, the causative agent of Guinea worm disease, was recovered from a wild-caught Phrynobatrachus francisci frog in Chad. Although green frogs (Lithobates clamitans) have been experimentally infected with D. medinensis worms, our findings prove that frogs can serve as natural paratenic hosts.

EID Eberhard ML, Cleveland CA, Zirimwabagabo H, Yabsley MJ, Ouakou P, Ruiz-Tiben E. Guinea Worm (Dracunculus medinensis) Infection in a Wild-Caught Frog, Chad. Emerg Infect Dis. 2016;22(11):1961-1962. https://dx.doi.org/10.3201/eid2211.161332
AMA Eberhard ML, Cleveland CA, Zirimwabagabo H, et al. Guinea Worm (Dracunculus medinensis) Infection in a Wild-Caught Frog, Chad. Emerging Infectious Diseases. 2016;22(11):1961-1962. doi:10.3201/eid2211.161332.
APA Eberhard, M. L., Cleveland, C. A., Zirimwabagabo, H., Yabsley, M. J., Ouakou, P., & Ruiz-Tiben, E. (2016). Guinea Worm (Dracunculus medinensis) Infection in a Wild-Caught Frog, Chad. Emerging Infectious Diseases, 22(11), 1961-1962. https://dx.doi.org/10.3201/eid2211.161332.

Dog-Mediated Human Rabies Death, Haiti, 2016 [PDF - 969 KB - 3 pages]
R. M. Wallace et al.

Haiti has experienced numerous barriers to rabies control over the past decades and is one of the remaining Western Hemisphere countries to report dog-mediated human rabies deaths. We describe the circumstances surrounding a reported human rabies death in 2016 as well as barriers to treatment and surveillance reporting.

EID Wallace RM, Etheart MD, Doty J, Monroe B, Crowdis K, Augustin P, et al. Dog-Mediated Human Rabies Death, Haiti, 2016. Emerg Infect Dis. 2016;22(11):1963-1965. https://dx.doi.org/10.3201/eid2211.160826
AMA Wallace RM, Etheart MD, Doty J, et al. Dog-Mediated Human Rabies Death, Haiti, 2016. Emerging Infectious Diseases. 2016;22(11):1963-1965. doi:10.3201/eid2211.160826.
APA Wallace, R. M., Etheart, M. D., Doty, J., Monroe, B., Crowdis, K., Augustin, P....Fenelon, N. (2016). Dog-Mediated Human Rabies Death, Haiti, 2016. Emerging Infectious Diseases, 22(11), 1963-1965. https://dx.doi.org/10.3201/eid2211.160826.

Staphylococcus aureus Colonization and Long-Term Risk for Death, United States [PDF - 823 KB - 4 pages]
A. Mendy et al.

To examine the association of colonization by Staphylococcus aureus and general population mortality, we followed 10,598 adults for 8.5 years on average. Methicillin-susceptible S. aureus colonization was not associated with death. Methicillin-resistant S. aureus carriage predicted death in a crude analysis but not after adjustment for socioeconomic status and co-morbidities.

EID Mendy A, Vieira ER, Albatineh AN, Gasana J. Staphylococcus aureus Colonization and Long-Term Risk for Death, United States. Emerg Infect Dis. 2016;22(11):1966-1969. https://dx.doi.org/10.3201/eid2211.160220
AMA Mendy A, Vieira ER, Albatineh AN, et al. Staphylococcus aureus Colonization and Long-Term Risk for Death, United States. Emerging Infectious Diseases. 2016;22(11):1966-1969. doi:10.3201/eid2211.160220.
APA Mendy, A., Vieira, E. R., Albatineh, A. N., & Gasana, J. (2016). Staphylococcus aureus Colonization and Long-Term Risk for Death, United States. Emerging Infectious Diseases, 22(11), 1966-1969. https://dx.doi.org/10.3201/eid2211.160220.

Group B Streptococcus Serotype III Sequence Type 283 Bacteremia Associated with Consumption of Raw Fish, Singapore [PDF - 860 KB - 4 pages]
S. Tan et al.

We conducted a retrospective study of 40 case-patients and 58 controls as part of a nationwide investigation of a group B Streptococcus outbreak in Singapore in 2015. Eating a Chinese-style raw fish dish (yusheng) was a major risk factor for bacteremia, particularly caused by serotype III sequence type 283.

EID Tan S, Lin Y, Foo K, Koh H, Tow C, Zhang Y, et al. Group B Streptococcus Serotype III Sequence Type 283 Bacteremia Associated with Consumption of Raw Fish, Singapore. Emerg Infect Dis. 2016;22(11):1970-1973. https://dx.doi.org/10.3201/eid2211.160210
AMA Tan S, Lin Y, Foo K, et al. Group B Streptococcus Serotype III Sequence Type 283 Bacteremia Associated with Consumption of Raw Fish, Singapore. Emerging Infectious Diseases. 2016;22(11):1970-1973. doi:10.3201/eid2211.160210.
APA Tan, S., Lin, Y., Foo, K., Koh, H., Tow, C., Zhang, Y....Cutter, J. (2016). Group B Streptococcus Serotype III Sequence Type 283 Bacteremia Associated with Consumption of Raw Fish, Singapore. Emerging Infectious Diseases, 22(11), 1970-1973. https://dx.doi.org/10.3201/eid2211.160210.

Group B Streptococcus Sequence Type 283 Disease Linked to Consumption of Raw Fish, Singapore [PDF - 533 KB - 4 pages]
P. Rajendram et al.

An outbreak of invasive group B Streptococcus (GBS) disease occurred in Singapore in mid-2015. We conducted a case–control study of 22 adults with invasive GBS infections during June 21–November 21, 2015. Consumption of raw fish was strongly associated with invasive sequence type 283 infections, but not with non–sequence type 283 infections.

EID Rajendram P, Mar Kyaw W, Leo Y, Ho HJ, Chen W, Lin R, et al. Group B Streptococcus Sequence Type 283 Disease Linked to Consumption of Raw Fish, Singapore. Emerg Infect Dis. 2016;22(11):1974-1977. https://dx.doi.org/10.3201/eid2211.160252
AMA Rajendram P, Mar Kyaw W, Leo Y, et al. Group B Streptococcus Sequence Type 283 Disease Linked to Consumption of Raw Fish, Singapore. Emerging Infectious Diseases. 2016;22(11):1974-1977. doi:10.3201/eid2211.160252.
APA Rajendram, P., Mar Kyaw, W., Leo, Y., Ho, H. J., Chen, W., Lin, R....Chow, A. (2016). Group B Streptococcus Sequence Type 283 Disease Linked to Consumption of Raw Fish, Singapore. Emerging Infectious Diseases, 22(11), 1974-1977. https://dx.doi.org/10.3201/eid2211.160252.

Novel Levofloxacin-Resistant Multidrug-Resistant Streptococcus pneumoniae Serotype 11A Isolates, South Korea [PDF - 386 KB - 3 pages]
M. Park et al.

Of 608 Streptococcus pneumoniae clinical strains isolated at a hospital in South Korea during 2009–2014, sixteen (2.6%) were identified as levofloxacin resistant. The predominant serotype was 11A (9 isolates). Two novel sequence types of multidrug-resistant S. pneumoniae with serotype 11A were identified, indicating continuous diversification of resistant strains.

EID Park M, Kim H, Kim H, Park J, Song W, Cho H, et al. Novel Levofloxacin-Resistant Multidrug-Resistant Streptococcus pneumoniae Serotype 11A Isolates, South Korea. Emerg Infect Dis. 2016;22(11):1978-1980. https://dx.doi.org/10.3201/eid2211.151450
AMA Park M, Kim H, Kim H, et al. Novel Levofloxacin-Resistant Multidrug-Resistant Streptococcus pneumoniae Serotype 11A Isolates, South Korea. Emerging Infectious Diseases. 2016;22(11):1978-1980. doi:10.3201/eid2211.151450.
APA Park, M., Kim, H., Kim, H., Park, J., Song, W., Cho, H....Kim, J. (2016). Novel Levofloxacin-Resistant Multidrug-Resistant Streptococcus pneumoniae Serotype 11A Isolates, South Korea. Emerging Infectious Diseases, 22(11), 1978-1980. https://dx.doi.org/10.3201/eid2211.151450.

Imported Chikungunya Virus Strains, Taiwan, 2006–2014 [PDF - 1.40 MB - 4 pages]
C. Yang et al.

We identified 78 imported chikungunya cases in Taiwan during 2006–2014. Sixty-six (84.6%) cases were initially suspected to be dengue, which indicates the necessity for laboratory diagnostics in differentiation between dengue and chikungunya. Results also emphasize the need for active surveillance of febrile illness at points of entry.

EID Yang C, Su C, Hsu T, Chang S, Lin C, Shu P. Imported Chikungunya Virus Strains, Taiwan, 2006–2014. Emerg Infect Dis. 2016;22(11):1981-1984. https://dx.doi.org/10.3201/eid2211.160404
AMA Yang C, Su C, Hsu T, et al. Imported Chikungunya Virus Strains, Taiwan, 2006–2014. Emerging Infectious Diseases. 2016;22(11):1981-1984. doi:10.3201/eid2211.160404.
APA Yang, C., Su, C., Hsu, T., Chang, S., Lin, C., & Shu, P. (2016). Imported Chikungunya Virus Strains, Taiwan, 2006–2014. Emerging Infectious Diseases, 22(11), 1981-1984. https://dx.doi.org/10.3201/eid2211.160404.

Neutralizing Antibodies to Severe Fever with Thrombocytopenia Syndrome Virus 4 Years after Hospitalization, China [PDF - 1.82 MB - 3 pages]
Y. Huang et al.

Severe fever with thrombocytopenia syndrome is an emerging hemorrhagic fever disease in eastern Asia, caused by a tickborne bunyavirus. Of 25 patients hospitalized with this disease in China, 100% produced and maintained neutralizing antibodies to severe fever with thrombocytopenia syndrome virus for the study period of 4 years.

EID Huang Y, Zhao L, Wen H, Yang Y, Yu H, Yu X. Neutralizing Antibodies to Severe Fever with Thrombocytopenia Syndrome Virus 4 Years after Hospitalization, China. Emerg Infect Dis. 2016;22(11):1985-1987. https://dx.doi.org/10.3201/eid2211.160414
AMA Huang Y, Zhao L, Wen H, et al. Neutralizing Antibodies to Severe Fever with Thrombocytopenia Syndrome Virus 4 Years after Hospitalization, China. Emerging Infectious Diseases. 2016;22(11):1985-1987. doi:10.3201/eid2211.160414.
APA Huang, Y., Zhao, L., Wen, H., Yang, Y., Yu, H., & Yu, X. (2016). Neutralizing Antibodies to Severe Fever with Thrombocytopenia Syndrome Virus 4 Years after Hospitalization, China. Emerging Infectious Diseases, 22(11), 1985-1987. https://dx.doi.org/10.3201/eid2211.160414.

Increased Community-Associated Infections Caused by Panton-Valentine Leukocidin–Negative MRSA, Shanghai, 2005–2014 [PDF - 1.22 MB - 4 pages]
M. Li et al.

During 2005–2014, community-associated methicillin-resistant Staphylococcus aureus infections increased in Shanghai, China. Most infections were caused by sequence type 59 S. aureus that lacked Panton-Valentine leukocidin. This finding challenges the notion that Panton-Valentine leukocidin is necessary for epidemiologic success of community-associated methicillin-resistant S. aureus.

EID Li M, Wang Y, Zhu Y, Dai Y, Hong X, Liu Q, et al. Increased Community-Associated Infections Caused by Panton-Valentine Leukocidin–Negative MRSA, Shanghai, 2005–2014. Emerg Infect Dis. 2016;22(11):1988-1991. https://dx.doi.org/10.3201/eid2211.160587
AMA Li M, Wang Y, Zhu Y, et al. Increased Community-Associated Infections Caused by Panton-Valentine Leukocidin–Negative MRSA, Shanghai, 2005–2014. Emerging Infectious Diseases. 2016;22(11):1988-1991. doi:10.3201/eid2211.160587.
APA Li, M., Wang, Y., Zhu, Y., Dai, Y., Hong, X., Liu, Q....Otto, M. (2016). Increased Community-Associated Infections Caused by Panton-Valentine Leukocidin–Negative MRSA, Shanghai, 2005–2014. Emerging Infectious Diseases, 22(11), 1988-1991. https://dx.doi.org/10.3201/eid2211.160587.

Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus [PDF - 1.37 MB - 4 pages]
Y. Wi et al.

To determine prevalence of severe fever with thrombocytopenia syndrome in South Korea, we examined serum samples from patients with fever and insect bite history in scrub typhus–endemic areas. During the 2013 scrub typhus season, prevalence of this syndrome among patients suspected of having scrub typhus was high (23.0%), suggesting possible co-infection.

EID Wi Y, Woo H, Park D, Lee K, Kang C, Chung D, et al. Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus. Emerg Infect Dis. 2016;22(11):1992-1995. https://dx.doi.org/10.3201/eid2211.160597
AMA Wi Y, Woo H, Park D, et al. Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus. Emerging Infectious Diseases. 2016;22(11):1992-1995. doi:10.3201/eid2211.160597.
APA Wi, Y., Woo, H., Park, D., Lee, K., Kang, C., Chung, D....Song, J. (2016). Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus. Emerging Infectious Diseases, 22(11), 1992-1995. https://dx.doi.org/10.3201/eid2211.160597.

Nasopharyngeal Pneumococcal Density and Evolution of Acute Respiratory Illnesses in Young Children, Peru, 2009–2011 [PDF - 424 KB - 4 pages]
R. R. Fan et al.

We examined nasopharyngeal pneumococcal colonization density patterns surrounding acute respiratory illnesses (ARI) in young children in Peru. Pneumococcal densities were dynamic, gradually increasing leading up to an ARI, peaking during the ARI, and decreasing after the ARI. Rhinovirus co-infection was associated with higher pneumococcal densities.

EID Fan RR, Howard LM, Griffin MR, Edwards KM, Zhu Y, Williams JV, et al. Nasopharyngeal Pneumococcal Density and Evolution of Acute Respiratory Illnesses in Young Children, Peru, 2009–2011. Emerg Infect Dis. 2016;22(11):1996-1999. https://dx.doi.org/10.3201/eid2211.160902
AMA Fan RR, Howard LM, Griffin MR, et al. Nasopharyngeal Pneumococcal Density and Evolution of Acute Respiratory Illnesses in Young Children, Peru, 2009–2011. Emerging Infectious Diseases. 2016;22(11):1996-1999. doi:10.3201/eid2211.160902.
APA Fan, R. R., Howard, L. M., Griffin, M. R., Edwards, K. M., Zhu, Y., Williams, J. V....Grijalva, C. G. (2016). Nasopharyngeal Pneumococcal Density and Evolution of Acute Respiratory Illnesses in Young Children, Peru, 2009–2011. Emerging Infectious Diseases, 22(11), 1996-1999. https://dx.doi.org/10.3201/eid2211.160902.

Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015 [PDF - 766 KB - 3 pages]
J. Lednicky et al.

Mayaro virus has been associated with small outbreaks in northern South America. We isolated this virus from a child with acute febrile illness in rural Haiti, confirming its role as a cause of mosquitoborne illness in the Caribbean region. The clinical presentation can mimic that of chikungunya, dengue, and Zika virus infections.

EID Lednicky J, De Rochars V, Elbadry M, Loeb J, Telisma T, Chavannes S, et al. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015. Emerg Infect Dis. 2016;22(11):2000-2002. https://dx.doi.org/10.3201/eid2211.161015
AMA Lednicky J, De Rochars V, Elbadry M, et al. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015. Emerging Infectious Diseases. 2016;22(11):2000-2002. doi:10.3201/eid2211.161015.
APA Lednicky, J., De Rochars, V., Elbadry, M., Loeb, J., Telisma, T., Chavannes, S....Morris, J. (2016). Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015. Emerging Infectious Diseases, 22(11), 2000-2002. https://dx.doi.org/10.3201/eid2211.161015.

Co-infections with Chikungunya and Dengue Viruses, Guatemala, 2015 [PDF - 839 KB - 3 pages]
T. Edwards et al.

We screened serum samples referred to the national reference laboratory in Guatemala that were positive for chikungunya or dengue viruses in June 2015. Co-infection with both viruses was detected by reverse transcription PCR in 46 (32%) of 144 samples. Specimens should be tested for both arboviruses to detect co-infections.

EID Edwards T, Signor L, Williams C, Donis E, Cuevas LE, Adams ER. Co-infections with Chikungunya and Dengue Viruses, Guatemala, 2015. Emerg Infect Dis. 2016;22(11):2003-2005. https://dx.doi.org/10.3201/eid2211.161017
AMA Edwards T, Signor L, Williams C, et al. Co-infections with Chikungunya and Dengue Viruses, Guatemala, 2015. Emerging Infectious Diseases. 2016;22(11):2003-2005. doi:10.3201/eid2211.161017.
APA Edwards, T., Signor, L., Williams, C., Donis, E., Cuevas, L. E., & Adams, E. R. (2016). Co-infections with Chikungunya and Dengue Viruses, Guatemala, 2015. Emerging Infectious Diseases, 22(11), 2003-2005. https://dx.doi.org/10.3201/eid2211.161017.
Letters

Early Mention of the Term Epidemiology [PDF - 272 KB - 1 page]
J. Tuells
EID Tuells J. Early Mention of the Term Epidemiology. Emerg Infect Dis. 2016;22(11):2006. https://dx.doi.org/10.3201/eid2211.141466
AMA Tuells J. Early Mention of the Term Epidemiology. Emerging Infectious Diseases. 2016;22(11):2006. doi:10.3201/eid2211.141466.
APA Tuells, J. (2016). Early Mention of the Term Epidemiology. Emerging Infectious Diseases, 22(11), 2006. https://dx.doi.org/10.3201/eid2211.141466.

Marseillevirus in the Pharynx of a Patient with Neurologic Disorders [PDF - 949 KB - 3 pages]
S. Aherfi et al.
EID Aherfi S, Colson P, Raoult D. Marseillevirus in the Pharynx of a Patient with Neurologic Disorders. Emerg Infect Dis. 2016;22(11):2008-2010. https://dx.doi.org/10.3201/eid2211.160189
AMA Aherfi S, Colson P, Raoult D. Marseillevirus in the Pharynx of a Patient with Neurologic Disorders. Emerging Infectious Diseases. 2016;22(11):2008-2010. doi:10.3201/eid2211.160189.
APA Aherfi, S., Colson, P., & Raoult, D. (2016). Marseillevirus in the Pharynx of a Patient with Neurologic Disorders. Emerging Infectious Diseases, 22(11), 2008-2010. https://dx.doi.org/10.3201/eid2211.160189.

Lack of Mimivirus Detection in Patients with Respiratory Disease, China [PDF - 305 KB - 2 pages]
X. Zhang et al.
EID Zhang X, Zhu T, Zhang P, Li H, Li Y, Liu E, et al. Lack of Mimivirus Detection in Patients with Respiratory Disease, China. Emerg Infect Dis. 2016;22(11):2011-2012. https://dx.doi.org/10.3201/eid2211.160687
AMA Zhang X, Zhu T, Zhang P, et al. Lack of Mimivirus Detection in Patients with Respiratory Disease, China. Emerging Infectious Diseases. 2016;22(11):2011-2012. doi:10.3201/eid2211.160687.
APA Zhang, X., Zhu, T., Zhang, P., Li, H., Li, Y., Liu, E....Cao, W. (2016). Lack of Mimivirus Detection in Patients with Respiratory Disease, China. Emerging Infectious Diseases, 22(11), 2011-2012. https://dx.doi.org/10.3201/eid2211.160687.

Severe Pneumonia Associated with Adenovirus Type 55 Infection, France, 2014 [PDF - 457 KB - 3 pages]
J. Lafolie et al.
EID Lafolie J, Mirand A, Salmona M, Lautrette A, Archimbaud C, Brebion A, et al. Severe Pneumonia Associated with Adenovirus Type 55 Infection, France, 2014. Emerg Infect Dis. 2016;22(11):2012-2014. https://dx.doi.org/10.3201/eid2211.160728
AMA Lafolie J, Mirand A, Salmona M, et al. Severe Pneumonia Associated with Adenovirus Type 55 Infection, France, 2014. Emerging Infectious Diseases. 2016;22(11):2012-2014. doi:10.3201/eid2211.160728.
APA Lafolie, J., Mirand, A., Salmona, M., Lautrette, A., Archimbaud, C., Brebion, A....Henquell, C. (2016). Severe Pneumonia Associated with Adenovirus Type 55 Infection, France, 2014. Emerging Infectious Diseases, 22(11), 2012-2014. https://dx.doi.org/10.3201/eid2211.160728.

Spotted Fever Group Rickettsia in the Pampa Biome, Brazil, 2015–2016 [PDF - 1.13 MB - 3 pages]
B. Weck et al.
EID Weck B, Dall’Agnol B, Souza U, Webster A, Stenzel B, Klafke G, et al. Spotted Fever Group Rickettsia in the Pampa Biome, Brazil, 2015–2016. Emerg Infect Dis. 2016;22(11):2014-2016. https://dx.doi.org/10.3201/eid2211.160859
AMA Weck B, Dall’Agnol B, Souza U, et al. Spotted Fever Group Rickettsia in the Pampa Biome, Brazil, 2015–2016. Emerging Infectious Diseases. 2016;22(11):2014-2016. doi:10.3201/eid2211.160859.
APA Weck, B., Dall’Agnol, B., Souza, U., Webster, A., Stenzel, B., Klafke, G....Reck, J. (2016). Spotted Fever Group Rickettsia in the Pampa Biome, Brazil, 2015–2016. Emerging Infectious Diseases, 22(11), 2014-2016. https://dx.doi.org/10.3201/eid2211.160859.

Shigella flexneri with Ciprofloxacin Resistance and Reduced Azithromycin Susceptibility, Canada, 2015 [PDF - 397 KB - 3 pages]
C. Gaudreau et al.
EID Gaudreau C, Pilon PA, Cornut G, Marchand-Senecal X, Bekal S. Shigella flexneri with Ciprofloxacin Resistance and Reduced Azithromycin Susceptibility, Canada, 2015. Emerg Infect Dis. 2016;22(11):2016-2018. https://dx.doi.org/10.3201/eid2211.160883
AMA Gaudreau C, Pilon PA, Cornut G, et al. Shigella flexneri with Ciprofloxacin Resistance and Reduced Azithromycin Susceptibility, Canada, 2015. Emerging Infectious Diseases. 2016;22(11):2016-2018. doi:10.3201/eid2211.160883.
APA Gaudreau, C., Pilon, P. A., Cornut, G., Marchand-Senecal, X., & Bekal, S. (2016). Shigella flexneri with Ciprofloxacin Resistance and Reduced Azithromycin Susceptibility, Canada, 2015. Emerging Infectious Diseases, 22(11), 2016-2018. https://dx.doi.org/10.3201/eid2211.160883.

HIV/Hepatitis C Virus Co-infection among Adults Beginning Antiretroviral Therapy, Malawi [PDF - 349 KB - 3 pages]
M. Demir et al.
EID Demir M, Phiri S, Kaiser R, Chaweza T, Neuhann F, Tweya H, et al. HIV/Hepatitis C Virus Co-infection among Adults Beginning Antiretroviral Therapy, Malawi. Emerg Infect Dis. 2016;22(11):2018-2020. https://dx.doi.org/10.3201/eid2211.160892
AMA Demir M, Phiri S, Kaiser R, et al. HIV/Hepatitis C Virus Co-infection among Adults Beginning Antiretroviral Therapy, Malawi. Emerging Infectious Diseases. 2016;22(11):2018-2020. doi:10.3201/eid2211.160892.
APA Demir, M., Phiri, S., Kaiser, R., Chaweza, T., Neuhann, F., Tweya, H....Steffen, H. (2016). HIV/Hepatitis C Virus Co-infection among Adults Beginning Antiretroviral Therapy, Malawi. Emerging Infectious Diseases, 22(11), 2018-2020. https://dx.doi.org/10.3201/eid2211.160892.

Exposures among MERS Case-Patients, Saudi Arabia, January–February 2016 [PDF - 317 KB - 3 pages]
R. Alhakeem et al.
EID Alhakeem R, Midgley CM, Assiri AM, Alessa M, Al Hawaj H, Saeed A, et al. Exposures among MERS Case-Patients, Saudi Arabia, January–February 2016. Emerg Infect Dis. 2016;22(11):2020-2022. https://dx.doi.org/10.3201/eid2211.161042
AMA Alhakeem R, Midgley CM, Assiri AM, et al. Exposures among MERS Case-Patients, Saudi Arabia, January–February 2016. Emerging Infectious Diseases. 2016;22(11):2020-2022. doi:10.3201/eid2211.161042.
APA Alhakeem, R., Midgley, C. M., Assiri, A. M., Alessa, M., Al Hawaj, H., Saeed, A....Watson, J. T. (2016). Exposures among MERS Case-Patients, Saudi Arabia, January–February 2016. Emerging Infectious Diseases, 22(11), 2020-2022. https://dx.doi.org/10.3201/eid2211.161042.

Leishmania major Cutaneous Leishmaniasis in 3 Travelers Returning from Israel to the Netherlands [PDF - 372 KB - 3 pages]
J. S. Kuilder et al.
EID Kuilder JS, Wismans PJ, Baerveldt EM, van Hellemond JJ, Melo M, van Genderen P. Leishmania major Cutaneous Leishmaniasis in 3 Travelers Returning from Israel to the Netherlands. Emerg Infect Dis. 2016;22(11):2022-2024. https://dx.doi.org/10.3201/eid2211.161154
AMA Kuilder JS, Wismans PJ, Baerveldt EM, et al. Leishmania major Cutaneous Leishmaniasis in 3 Travelers Returning from Israel to the Netherlands. Emerging Infectious Diseases. 2016;22(11):2022-2024. doi:10.3201/eid2211.161154.
APA Kuilder, J. S., Wismans, P. J., Baerveldt, E. M., van Hellemond, J. J., Melo, M., & van Genderen, P. (2016). Leishmania major Cutaneous Leishmaniasis in 3 Travelers Returning from Israel to the Netherlands. Emerging Infectious Diseases, 22(11), 2022-2024. https://dx.doi.org/10.3201/eid2211.161154.

Molecular Evidence of Oysters as Vehicle of Norovirus GII.P17-GII.17 [PDF - 297 KB - 2 pages]
L. Rasmussen et al.
EID Rasmussen L, Schultz A, Uhrbrand K, Jensen T, Fischer T. Molecular Evidence of Oysters as Vehicle of Norovirus GII.P17-GII.17. Emerg Infect Dis. 2016;22(11):2024-2025. https://dx.doi.org/10.3201/eid2211.161171
AMA Rasmussen L, Schultz A, Uhrbrand K, et al. Molecular Evidence of Oysters as Vehicle of Norovirus GII.P17-GII.17. Emerging Infectious Diseases. 2016;22(11):2024-2025. doi:10.3201/eid2211.161171.
APA Rasmussen, L., Schultz, A., Uhrbrand, K., Jensen, T., & Fischer, T. (2016). Molecular Evidence of Oysters as Vehicle of Norovirus GII.P17-GII.17. Emerging Infectious Diseases, 22(11), 2024-2025. https://dx.doi.org/10.3201/eid2211.161171.

Recent Chikungunya Virus Infection in 2 Travelers Returning from Mogadishu, Somalia, to Italy, 2016 [PDF - 359 KB - 3 pages]
L. Zammarchi et al.
EID Zammarchi L, Fortuna C, Venturi G, Rinaldi F, Capobianco T, Remoli M, et al. Recent Chikungunya Virus Infection in 2 Travelers Returning from Mogadishu, Somalia, to Italy, 2016. Emerg Infect Dis. 2016;22(11):2025-2027. https://dx.doi.org/10.3201/eid2211.161225
AMA Zammarchi L, Fortuna C, Venturi G, et al. Recent Chikungunya Virus Infection in 2 Travelers Returning from Mogadishu, Somalia, to Italy, 2016. Emerging Infectious Diseases. 2016;22(11):2025-2027. doi:10.3201/eid2211.161225.
APA Zammarchi, L., Fortuna, C., Venturi, G., Rinaldi, F., Capobianco, T., Remoli, M....Bartoloni, A. (2016). Recent Chikungunya Virus Infection in 2 Travelers Returning from Mogadishu, Somalia, to Italy, 2016. Emerging Infectious Diseases, 22(11), 2025-2027. https://dx.doi.org/10.3201/eid2211.161225.

Meningococcal Disease in US Military Personnel before and after Adoption of Conjugate Vaccine [PDF - 507 KB - 2 pages]
M. D. Decker
EID Decker MD. Meningococcal Disease in US Military Personnel before and after Adoption of Conjugate Vaccine. Emerg Infect Dis. 2016;22(11):2027-2028. https://dx.doi.org/10.3201/eid2211.150498
AMA Decker MD. Meningococcal Disease in US Military Personnel before and after Adoption of Conjugate Vaccine. Emerging Infectious Diseases. 2016;22(11):2027-2028. doi:10.3201/eid2211.150498.
APA Decker, M. D. (2016). Meningococcal Disease in US Military Personnel before and after Adoption of Conjugate Vaccine. Emerging Infectious Diseases, 22(11), 2027-2028. https://dx.doi.org/10.3201/eid2211.150498.

Travel-Associated Vibrio cholerae O1 El Tor, Russia [PDF - 520 KB]
K. V. Kuleshov et al.
EID Kuleshov KV, Vodop’ianov SO, Dedkov VG, Markelov ML, Deviatkin AA, Kruglikov VD, et al. Travel-Associated Vibrio cholerae O1 El Tor, Russia. Emerg Infect Dis. 2016;22(11):2006-2008. https://dx.doi.org/10.3201/eid2211.151727
AMA Kuleshov KV, Vodop’ianov SO, Dedkov VG, et al. Travel-Associated Vibrio cholerae O1 El Tor, Russia. Emerging Infectious Diseases. 2016;22(11):2006-2008. doi:10.3201/eid2211.151727.
APA Kuleshov, K. V., Vodop’ianov, S. O., Dedkov, V. G., Markelov, M. L., Deviatkin, A. A., Kruglikov, V. D....Shipulin, G. A. (2016). Travel-Associated Vibrio cholerae O1 El Tor, Russia. Emerging Infectious Diseases, 22(11), 2006-2008. https://dx.doi.org/10.3201/eid2211.151727.
Books and Media

Deadly River: Cholera and Cover-Up in Post-Earthquake Haiti [PDF - 681 KB - 2 pages]
J. Morris
EID Morris J. Deadly River: Cholera and Cover-Up in Post-Earthquake Haiti. Emerg Infect Dis. 2016;22(11):2029-2030. https://dx.doi.org/10.3201/eid2211.161215
AMA Morris J. Deadly River: Cholera and Cover-Up in Post-Earthquake Haiti. Emerging Infectious Diseases. 2016;22(11):2029-2030. doi:10.3201/eid2211.161215.
APA Morris, J. (2016). Deadly River: Cholera and Cover-Up in Post-Earthquake Haiti. Emerging Infectious Diseases, 22(11), 2029-2030. https://dx.doi.org/10.3201/eid2211.161215.
About the Cover

A Simple Sketch Symbolizing Self-Reliance [PDF - 1.03 MB - 2 pages]
B. Breedlove
EID Breedlove B. A Simple Sketch Symbolizing Self-Reliance. Emerg Infect Dis. 2016;22(11):2031-2032. https://dx.doi.org/10.3201/eid2211.ac2211
AMA Breedlove B. A Simple Sketch Symbolizing Self-Reliance. Emerging Infectious Diseases. 2016;22(11):2031-2032. doi:10.3201/eid2211.ac2211.
APA Breedlove, B. (2016). A Simple Sketch Symbolizing Self-Reliance. Emerging Infectious Diseases, 22(11), 2031-2032. https://dx.doi.org/10.3201/eid2211.ac2211.
Etymologia

Etymologia: Streptococcus [PDF - 381 KB - 1 page]
EID Etymologia: Streptococcus. Emerg Infect Dis. 2016;22(11):1977. https://dx.doi.org/10.3201/eid2211.et2211
AMA Etymologia: Streptococcus. Emerging Infectious Diseases. 2016;22(11):1977. doi:10.3201/eid2211.et2211.
APA (2016). Etymologia: Streptococcus. Emerging Infectious Diseases, 22(11), 1977. https://dx.doi.org/10.3201/eid2211.et2211.
Corrections

Correction: Vol. 22, No. 9 [PDF - 457 KB - 1 page]
EID Correction: Vol. 22, No. 9. Emerg Infect Dis. 2016;22(11):2028. https://dx.doi.org/10.3201/eid2211.c12211
AMA Correction: Vol. 22, No. 9. Emerging Infectious Diseases. 2016;22(11):2028. doi:10.3201/eid2211.c12211.
APA (2016). Correction: Vol. 22, No. 9. Emerging Infectious Diseases, 22(11), 2028. https://dx.doi.org/10.3201/eid2211.c12211.

Correction: Vol. 22, No. 8 [PDF - 457 KB - 1 page]
EID Correction: Vol. 22, No. 8. Emerg Infect Dis. 2016;22(11):2028. https://dx.doi.org/10.3201/eid2211.c22211
AMA Correction: Vol. 22, No. 8. Emerging Infectious Diseases. 2016;22(11):2028. doi:10.3201/eid2211.c22211.
APA (2016). Correction: Vol. 22, No. 8. Emerging Infectious Diseases, 22(11), 2028. https://dx.doi.org/10.3201/eid2211.c22211.

Correction: Vol. 22, No. 9 [PDF - 457 KB - 1 page]
EID Correction: Vol. 22, No. 9. Emerg Infect Dis. 2016;22(11):2028. https://dx.doi.org/10.3201/eid2211.c32211
AMA Correction: Vol. 22, No. 9. Emerging Infectious Diseases. 2016;22(11):2028. doi:10.3201/eid2211.c32211.
APA (2016). Correction: Vol. 22, No. 9. Emerging Infectious Diseases, 22(11), 2028. https://dx.doi.org/10.3201/eid2211.c32211.
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Page updated: March 10, 2017
Page reviewed: March 10, 2017
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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