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Issue Cover for Volume 22, Number 8—August 2016

Volume 22, Number 8—August 2016

[PDF - 8.77 MB - 204 pages]

Synopses

Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo [PDF - 4.50 MB - 7 pages]
D. Tappe et al.

Snakeborne Armillifer pentastomiasis is an emerging human parasitic infection in rural tropical areas where snake meat is eaten. After a series of severe ocular A. grandis larval infections and anecdotal abdominal infection in Sankuru District, Democratic Republic of the Congo, during 2014–2015, we systematically investigated possible pentastomid etiology in patients who underwent surgery in the region. Histologic and molecular analyses by established pentastomid 18S rDNA- and newly developed Armillifer-specific cytochrome oxidase PCRs revealed larval pentastomid lesions in 3.7% of patients. Some persons had A. armillatus and A. grandis co-infections. Another pentastomid larva, Raillietiella sp., was molecularly detected in 1 patient who had concomitant A. grandis and A. armillatus infection. The PCRs used were suitable for detecting pentastomid species even in highly necrotic tissues. Phylogenetic analyses of Armillifer cytochrome oxidase genes detected multiple local strains.

EID Tappe D, Sulyok M, Riu T, Rózsa L, Bodó I, Schoen C, et al. Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo. Emerg Infect Dis. 2016;22(8):1333-1339. https://dx.doi.org/10.3201/eid2208.151895
AMA Tappe D, Sulyok M, Riu T, et al. Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo. Emerging Infectious Diseases. 2016;22(8):1333-1339. doi:10.3201/eid2208.151895.
APA Tappe, D., Sulyok, M., Riu, T., Rózsa, L., Bodó, I., Schoen, C....Hardi, R. (2016). Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo. Emerging Infectious Diseases, 22(8), 1333-1339. https://dx.doi.org/10.3201/eid2208.151895.

Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013–2014 [PDF - 936 KB - 8 pages]
D. Schnabel et al.

During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment.

EID Schnabel D, Esposito DH, Gaines J, Ridpath A, Barry M, Feldman KA, et al. Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013–2014. Emerg Infect Dis. 2016;22(8):1340-1347. https://dx.doi.org/10.3201/eid2208.151938
AMA Schnabel D, Esposito DH, Gaines J, et al. Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013–2014. Emerging Infectious Diseases. 2016;22(8):1340-1347. doi:10.3201/eid2208.151938.
APA Schnabel, D., Esposito, D. H., Gaines, J., Ridpath, A., Barry, M., Feldman, K. A....Sotir, M. (2016). Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013–2014. Emerging Infectious Diseases, 22(8), 1340-1347. https://dx.doi.org/10.3201/eid2208.151938.

Probable Rabies Virus Transmission through Organ Transplantation, China, 2015 [PDF - 710 KB - 5 pages]
H. Zhou et al.

During July 2015, physicians at a hospital in Beijing, China, diagnosed rabies in 2 patients who had each received a kidney from a common organ donor who had died from acute progressive encephalitis of unknown cause. The patients had rabies incubation periods of 42 and 48 days. Altered mental status developed in both patients and progressively worsened to deep coma within 80 days after transplantation; both patients died. Two other transplant recipients received corneas but remained well after receiving timely rabies prophylaxis. An effective regulatory system for testing donors should be implemented to decrease the occurrence of donor-derived infectious diseases. In addition, health education should be improved to enhance public awareness of transplant-associated infectious diseases. Transplant recipients and other persons with exposure to organs or tissues from donors with rabies must be provided consistent health monitoring and follow-up, including rabies postexposure prophylaxis; any remaining organs and tissues must be quarantined and not transplanted.

EID Zhou H, Zhu W, Zeng J, He J, Liu K, Li Y, et al. Probable Rabies Virus Transmission through Organ Transplantation, China, 2015. Emerg Infect Dis. 2016;22(8):1348-1352. https://dx.doi.org/10.3201/eid2208.151993
AMA Zhou H, Zhu W, Zeng J, et al. Probable Rabies Virus Transmission through Organ Transplantation, China, 2015. Emerging Infectious Diseases. 2016;22(8):1348-1352. doi:10.3201/eid2208.151993.
APA Zhou, H., Zhu, W., Zeng, J., He, J., Liu, K., Li, Y....Wei, S. (2016). Probable Rabies Virus Transmission through Organ Transplantation, China, 2015. Emerging Infectious Diseases, 22(8), 1348-1352. https://dx.doi.org/10.3201/eid2208.151993.
Research

Virulence and Evolution of West Nile Virus, Australia, 1960–2012 [PDF - 1.60 MB - 10 pages]
N. A. Prow et al.

Worldwide, West Nile virus (WNV) causes encephalitis in humans, horses, and birds. The Kunjin strain of WNV (WNVKUN) is endemic to northern Australia, but infections are usually asymptomatic. In 2011, an unprecedented outbreak of equine encephalitis occurred in southeastern Australia; most of the ≈900 reported cases were attributed to a newly emerged WNVKUN strain. To investigate the origins of this virus, we performed genetic analysis and in vitro and in vivo studies of 13 WNVKUN isolates collected from different regions of Australia during 1960–2012. Although no disease was recorded for 1984, 2000, or 2012, isolates collected during those years (from Victoria, Queensland, and New South Wales, respectively) exhibited levels of virulence in mice similar to that of the 2011 outbreak strain. Thus, virulent strains of WNVKUN have circulated in Australia for >30 years, and the first extensive outbreak of equine disease in Australia probably resulted from a combination of specific ecologic and epidemiologic conditions.

EID Prow NA, Edmonds JH, Williams DT, Setoh YX, Bielefeldt-Ohmann H, Suen WW, et al. Virulence and Evolution of West Nile Virus, Australia, 1960–2012. Emerg Infect Dis. 2016;22(8):1353-1362. https://dx.doi.org/10.3201/eid2208.151719
AMA Prow NA, Edmonds JH, Williams DT, et al. Virulence and Evolution of West Nile Virus, Australia, 1960–2012. Emerging Infectious Diseases. 2016;22(8):1353-1362. doi:10.3201/eid2208.151719.
APA Prow, N. A., Edmonds, J. H., Williams, D. T., Setoh, Y. X., Bielefeldt-Ohmann, H., Suen, W. W....Hall, R. A. (2016). Virulence and Evolution of West Nile Virus, Australia, 1960–2012. Emerging Infectious Diseases, 22(8), 1353-1362. https://dx.doi.org/10.3201/eid2208.151719.

Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013 [PDF - 2.18 MB - 8 pages]
X. Xu et al.

To identify township-level high-risk foci of malaria transmission in Yunnan Province, China, along the international border, we retrospectively reviewed data collected in hospitals and clinics of 58 townships in 4 counties during 2011–2013. We analyzed spatiotemporal distribution, especially hot spots of confirmed malaria, using geographic information systems and Getis-Ord Gi*(d) cluster analysis. Malaria incidence, transmission seasonality, and Plasmodium vivax:P. falciparum ratio remained almost unchanged from 2011 to 2013, but heterogeneity in distribution increased. The number of townships with confirmed malaria decreased significantly during the 3 years; incidence became increasingly concentrated within a few townships. High-/low-incidence clusters of P. falciparum shifted in location and size every year, whereas the locations of high-incidence P. vivax townships remained unchanged. All high-incidence clusters were located along the China–Myanmar border. Because of increasing heterogeneity in malaria distribution, microgeographic analysis of malaria transmission hot spots provided useful information for designing targeted malaria intervention during the elimination phase.

EID Xu X, Zhou G, Wang Y, Hu Y, Ruan Y, Fan Q, et al. Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013. Emerg Infect Dis. 2016;22(8):1363-1370. https://dx.doi.org/10.3201/eid2208.150390
AMA Xu X, Zhou G, Wang Y, et al. Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013. Emerging Infectious Diseases. 2016;22(8):1363-1370. doi:10.3201/eid2208.150390.
APA Xu, X., Zhou, G., Wang, Y., Hu, Y., Ruan, Y., Fan, Q....Yan, G. (2016). Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013. Emerging Infectious Diseases, 22(8), 1363-1370. https://dx.doi.org/10.3201/eid2208.150390.

Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia [PDF - 2.73 MB - 10 pages]
R. Yusof et al.

Infections of humans with the zoonotic simian malaria parasite Plasmodium knowlesi occur throughout Southeast Asia, although most cases have occurred in Malaysia, where P. knowlesi is now the dominant malaria species. This apparently skewed distribution prompted an investigation of the phylogeography of this parasite in 2 geographically separated regions of Malaysia, Peninsular Malaysia and Malaysian Borneo. We investigated samples collected from humans and macaques in these regions. Haplotype network analyses of sequences from 2 P. knowlesi genes, type A small subunit ribosomal 18S RNA and cytochrome c oxidase subunit I, showed 2 genetically distinct divergent clusters, 1 from each of the 2 regions of Malaysia. We propose that these parasites represent 2 distinct P. knowlesi types that independently became zoonotic. These types would have evolved after the sea-level rise at the end of the last ice age, which separated Malaysian Borneo from Peninsular Malaysia.

EID Yusof R, Ahmed M, Jelip J, Ngian H, Mustakim S, Hussin H, et al. Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia. Emerg Infect Dis. 2016;22(8):1371-1380. https://dx.doi.org/10.3201/eid2208.151885
AMA Yusof R, Ahmed M, Jelip J, et al. Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia. Emerging Infectious Diseases. 2016;22(8):1371-1380. doi:10.3201/eid2208.151885.
APA Yusof, R., Ahmed, M., Jelip, J., Ngian, H., Mustakim, S., Hussin, H....Lau, Y. (2016). Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia. Emerging Infectious Diseases, 22(8), 1371-1380. https://dx.doi.org/10.3201/eid2208.151885.

Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria [PDF - 887 KB - 6 pages]
F. Kurth et al.

Episodes of delayed hemolysis 2–6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3–2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR −0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia.

EID Kurth F, Lingscheid T, Steiner F, Stegemann MS, Bélard S, Menner N, et al. Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria. Emerg Infect Dis. 2016;22(8):1381-1386. https://dx.doi.org/10.3201/eid2208.151905
AMA Kurth F, Lingscheid T, Steiner F, et al. Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria. Emerging Infectious Diseases. 2016;22(8):1381-1386. doi:10.3201/eid2208.151905.
APA Kurth, F., Lingscheid, T., Steiner, F., Stegemann, M. S., Bélard, S., Menner, N....Zoller, T. (2016). Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria. Emerging Infectious Diseases, 22(8), 1381-1386. https://dx.doi.org/10.3201/eid2208.151905.

Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014 [PDF - 972 KB - 8 pages]
N. Aliabadi et al.

During August 8, 2014–October 14, 2014, a total of 11 children with acute flaccid myelitis and distinctive neuroimaging changes were identified near Denver, Colorado, USA. A respiratory prodrome was experienced by 10, and nasopharyngeal specimens were positive for enterovirus D68 (EV-D68) for 4. To determine whether an association exists between EV-D68 infection and acute flaccid myelitis, we conducted a retrospective case–control study comparing these patients with 2 groups of outpatient control children (1 group tested for acute respiratory illness and 1 for Bordetella pertussis infection). Adjusted analyses indicated that, for children with acute flaccid myelitis, the odds of having EV-D68 infection were 10.3 times greater than for those tested for acute respiratory infection and 4.5 times greater than for those tested for B. pertussis infection. No statistical association was seen between acute flaccid myelitis and non–EV-D68 enterovirus or rhinovirus infection. These findings support an association between EV-D68 infection and acute flaccid myelitis.

EID Aliabadi N, Messacar K, Pastula DM, Robinson CC, Leshem E, Sejvar J, et al. Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014. Emerg Infect Dis. 2016;22(8):1387-1394. https://dx.doi.org/10.3201/eid2208.151949
AMA Aliabadi N, Messacar K, Pastula DM, et al. Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014. Emerging Infectious Diseases. 2016;22(8):1387-1394. doi:10.3201/eid2208.151949.
APA Aliabadi, N., Messacar, K., Pastula, D. M., Robinson, C. C., Leshem, E., Sejvar, J....Dominguez, S. R. (2016). Enterovirus D68 Infection in Children with Acute Flaccid Myelitis, Colorado, USA, 2014. Emerging Infectious Diseases, 22(8), 1387-1394. https://dx.doi.org/10.3201/eid2208.151949.

Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014 [PDF - 2.04 MB - 8 pages]
M. Arwady et al.

Risk factors for human-to-human transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) are largely unknown. After MERS-CoV infections occurred in an extended family in Saudi Arabia in 2014, relatives were tested by using real-time reverse transcription PCR (rRT-PCR) and serologic methods. Among 79 relatives, 19 (24%) were MERS-CoV positive; 11 were hospitalized, and 2 died. Eleven (58%) tested positive by rRT-PCR; 8 (42%) tested negative by rRT-PCR but positive by serology. Compared with MERS-CoV–negative adult relatives, MERS-CoV–positive adult relatives were older and more likely to be male and to have chronic medical conditions. Risk factors for household transmission included sleeping in an index patient’s room and touching respiratory secretions from an index patient. Casual contact and simple proximity were not associated with transmission. Serology was more sensitive than standard rRT-PCR for identifying infected relatives, highlighting the value of including serology in future investigations.

EID Arwady M, Alraddadi BM, Basler C, Azhar EI, Abuelzein E, Sindy AI, et al. Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014. Emerg Infect Dis. 2016;22(8):1395-1402. https://dx.doi.org/10.3201/eid2208.152015
AMA Arwady M, Alraddadi BM, Basler C, et al. Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014. Emerging Infectious Diseases. 2016;22(8):1395-1402. doi:10.3201/eid2208.152015.
APA Arwady, M., Alraddadi, B. M., Basler, C., Azhar, E. I., Abuelzein, E., Sindy, A. I....Madani, T. A. (2016). Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014. Emerging Infectious Diseases, 22(8), 1395-1402. https://dx.doi.org/10.3201/eid2208.152015.

Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households, Sierra Leone [PDF - 1.13 MB - 9 pages]
H. Bower et al.

Using histories of household members of Ebola virus disease (EVD) survivors in Sierra Leone, we calculated risk of EVD by age and exposure level, adjusting for confounding and clustering, and estimated relative risks. Of 937 household members in 94 households, 448 (48%) had had EVD. Highly correlated with exposure, EVD risk ranged from 83% for touching a corpse to 8% for minimal contact and varied by age group: 43% for children <2 years of age; 30% for those 5–14 years of age; and >60% for adults >30 years of age. Compared with risk for persons 20–29 years of age, exposure-adjusted relative risks were lower for those 5–9 (0.70), 10–14 (0.64), and 15–19 (0.71) years of age but not for children <2 (0.92) or 2–4 (0.97) years of age. Lower risk for 5–19-year-olds, after adjustment for exposure, suggests decreased susceptibility in this group.

EID Bower H, Johnson S, Bangura MS, Kamara A, Kamara O, Mansaray SH, et al. Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households, Sierra Leone. Emerg Infect Dis. 2016;22(8):1403-1411. https://dx.doi.org/10.3201/eid2208.160163
AMA Bower H, Johnson S, Bangura MS, et al. Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households, Sierra Leone. Emerging Infectious Diseases. 2016;22(8):1403-1411. doi:10.3201/eid2208.160163.
APA Bower, H., Johnson, S., Bangura, M. S., Kamara, A., Kamara, O., Mansaray, S. H....Glynn, J. R. (2016). Exposure-Specific and Age-Specific Attack Rates for Ebola Virus Disease in Ebola-Affected Households, Sierra Leone. Emerging Infectious Diseases, 22(8), 1403-1411. https://dx.doi.org/10.3201/eid2208.160163.

Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014 [PDF - 900 KB - 8 pages]
S. Haviari et al.

We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13–October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case–control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.

EID Haviari S, Cassier P, Dananché C, Hulin M, Dauwalder O, Rouvière O, et al. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014. Emerg Infect Dis. 2016;22(8):1412-1419. https://dx.doi.org/10.3201/eid2208.151423
AMA Haviari S, Cassier P, Dananché C, et al. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014. Emerging Infectious Diseases. 2016;22(8):1412-1419. doi:10.3201/eid2208.151423.
APA Haviari, S., Cassier, P., Dananché, C., Hulin, M., Dauwalder, O., Rouvière, O....Vanhems, P. (2016). Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014. Emerging Infectious Diseases, 22(8), 1412-1419. https://dx.doi.org/10.3201/eid2208.151423.

Medscape CME Activity
Cutaneous Melioidosis Cluster Caused by Contaminated Wound Irrigation Fluid [PDF - 1.17 MB - 8 pages]
A. J. Merritt et al.

Melioidosis usually occurs after environmental exposure to Burkholderia pseudomallei in the tropics. A cluster of 5 cutaneous melioidosis cases occurred in suburban southwest Australia after an earlier case in January 2012. We collected environmental samples at the first patient’s home in January 2012 and from a nearby health center in December 2013 after 2 new cases occurred in the same postal district. We isolated genotypically identical B. pseudomallei from the first patient and 5 other patients in the district. Environmental sampling implicated an opened bottle of saline wound irrigation fluid containing >106 B. pseudomallei/mL. The bottle included instructions to discard within 24 hours of opening. No further cases of B. pseudomallei infection occurred after removing the contaminated bottle. This cutaneous melioidosis cluster demonstrates that B. pseudomallei can survive and disseminate in widely used medical fluids beyond its known geographic distribution, highlighting a need to use these products according to manufacturers’ instructions.

EID Merritt AJ, Peck M, Gayle D, Levy A, Ler Y, Raby E, et al. Cutaneous Melioidosis Cluster Caused by Contaminated Wound Irrigation Fluid. Emerg Infect Dis. 2016;22(8):1420-1427. https://dx.doi.org/10.3201/eid2208.151149
AMA Merritt AJ, Peck M, Gayle D, et al. Cutaneous Melioidosis Cluster Caused by Contaminated Wound Irrigation Fluid. Emerging Infectious Diseases. 2016;22(8):1420-1427. doi:10.3201/eid2208.151149.
APA Merritt, A. J., Peck, M., Gayle, D., Levy, A., Ler, Y., Raby, E....Inglis, T. (2016). Cutaneous Melioidosis Cluster Caused by Contaminated Wound Irrigation Fluid. Emerging Infectious Diseases, 22(8), 1420-1427. https://dx.doi.org/10.3201/eid2208.151149.

Possible Role of Fish and Frogs as Paratenic Hosts of Dracunculus medinensis, Chad [PDF - 320 KB - 3 pages]
M. L. Eberhard et al.

Copepods infected with Dracunculus medinensis larvae collected from infected dogs in Chad were fed to 2 species of fish and tadpoles. Although they readily ingested copepods, neither species of fish, Nile tilapia (Oreochromis niloticus) nor fathead minnow (Pimephalis promelas), were found to harbor Dracunculus larvae when examined 2–3 weeks later. Tadpoles ingested copepods much more slowly; however, upon examination at the same time interval, tadpoles of green frogs (Lithobates [Rana] clamitans) were found to harbor small numbers of Dracunculus larvae. Two ferrets (Mustela putorius furo) were fed fish or tadpoles that had been exposed to infected copepods. Only the ferret fed tadpoles harbored developing Dracunculus larvae at necropsy 70–80 days postexposure. These observations confirm that D. medinensis, like other species in the genus Dracunculus, can readily survive and remain infective in potential paratenic hosts, especially tadpoles.

EID Eberhard ML, Yabsley MJ, Zirimwabagabo H, Bishop H, Cleveland CA, Maerz JC, et al. Possible Role of Fish and Frogs as Paratenic Hosts of Dracunculus medinensis, Chad. Emerg Infect Dis. 2016;22(8):1428-1430. https://dx.doi.org/10.3201/eid2208.160043
AMA Eberhard ML, Yabsley MJ, Zirimwabagabo H, et al. Possible Role of Fish and Frogs as Paratenic Hosts of Dracunculus medinensis, Chad. Emerging Infectious Diseases. 2016;22(8):1428-1430. doi:10.3201/eid2208.160043.
APA Eberhard, M. L., Yabsley, M. J., Zirimwabagabo, H., Bishop, H., Cleveland, C. A., Maerz, J. C....Ruiz-Tiben, E. (2016). Possible Role of Fish and Frogs as Paratenic Hosts of Dracunculus medinensis, Chad. Emerging Infectious Diseases, 22(8), 1428-1430. https://dx.doi.org/10.3201/eid2208.160043.

Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015 [PDF - 1010 KB - 7 pages]
R. Ratnayake et al.

In 2015, community event–based surveillance (CEBS) was implemented in Sierra Leone to assist with the detection of Ebola virus disease (EVD) cases. We assessed the sensitivity of CEBS for finding EVD cases during a 7-month period, and in a 6-week subanalysis, we assessed the timeliness of reporting cases with no known epidemiologic links at time of detection. Of the 12,126 CEBS reports, 287 (2%) met the suspected case definition, and 16 were confirmed positive. CEBS detected 30% (16/53) of the EVD cases identified during the study period. During the subanalysis, CEBS staff identified 4 of 6 cases with no epidemiologic links. These CEBS-detected cases were identified more rapidly than those detected by the national surveillance system; however, too few cases were detected to determine system timeliness. Although CEBS detected EVD cases, it largely generated false alerts. Future versions of community-based surveillance could improve case detection through increased staff training and community engagement.

EID Ratnayake R, Crowe SJ, Jasperse J, Privette G, Stone E, Miller L, et al. Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015. Emerg Infect Dis. 2016;22(8):1431-1437. https://dx.doi.org/10.3201/eid2208.160205
AMA Ratnayake R, Crowe SJ, Jasperse J, et al. Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015. Emerging Infectious Diseases. 2016;22(8):1431-1437. doi:10.3201/eid2208.160205.
APA Ratnayake, R., Crowe, S. J., Jasperse, J., Privette, G., Stone, E., Miller, L....Morgan, O. (2016). Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015. Emerging Infectious Diseases, 22(8), 1431-1437. https://dx.doi.org/10.3201/eid2208.160205.

Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil [PDF - 618 KB - 7 pages]
I. Paploski et al.

Zika virus infection emerged as a public health emergency after increasing evidence for its association with neurologic disorders and congenital malformations. In Salvador, Brazil, outbreaks of acute exanthematous illness (AEI) attributed to Zika virus, Guillain-Barré syndrome (GBS), and microcephaly occurred in 2015. We investigated temporal correlations and time lags between these outbreaks to identify a common link between them by using epidemic curves and time series cross-correlations. Number of GBS cases peaked after a lag of 5–9 weeks from the AEI peak. Number of suspected cases of microcephaly peaked after a lag of 30–33 weeks from the AEI peak, which corresponded to time of potential infections of pregnant mothers during the first trimester. These findings support the association of GBS and microcephaly with Zika virus infection and provide evidence for a temporal relationship between timing of arboviral infection of pregnant women during the first trimester and birth outcome.

EID Paploski I, Prates A, Cardoso CW, Kikuti M, Silva M, Waller LA, et al. Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil. Emerg Infect Dis. 2016;22(8):1438-1444. https://dx.doi.org/10.3201/eid2208.160496
AMA Paploski I, Prates A, Cardoso CW, et al. Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil. Emerging Infectious Diseases. 2016;22(8):1438-1444. doi:10.3201/eid2208.160496.
APA Paploski, I., Prates, A., Cardoso, C. W., Kikuti, M., Silva, M., Waller, L. A....Ribeiro, G. S. (2016). Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil. Emerging Infectious Diseases, 22(8), 1438-1444. https://dx.doi.org/10.3201/eid2208.160496.
Dispatches

Human Babesiosis, Bolivia, 2013 [PDF - 626 KB - 3 pages]
S. Gabrielli et al.

To investigate human babesiosis in the Bolivian Chaco, in 2013 we tested blood samples from 271 healthy persons living in 2 rural communities in this region. Microscopy and PCR indicated that 3.3% of persons were positive for Babesia microti parasites (US lineage); seroprevalence was 45.7%. Appropriate screening should mitigate the risk for transfusion-associated babesiosis.

EID Gabrielli S, Totino V, Macchioni F, Zuñiga F, Rojas P, Lara Y, et al. Human Babesiosis, Bolivia, 2013. Emerg Infect Dis. 2016;22(8):1445-1447. https://dx.doi.org/10.3201/eid2208.150195
AMA Gabrielli S, Totino V, Macchioni F, et al. Human Babesiosis, Bolivia, 2013. Emerging Infectious Diseases. 2016;22(8):1445-1447. doi:10.3201/eid2208.150195.
APA Gabrielli, S., Totino, V., Macchioni, F., Zuñiga, F., Rojas, P., Lara, Y....Cancrini, G. (2016). Human Babesiosis, Bolivia, 2013. Emerging Infectious Diseases, 22(8), 1445-1447. https://dx.doi.org/10.3201/eid2208.150195.

Use of Unamplified RNA/cDNA–Hybrid Nanopore Sequencing for Rapid Detection and Characterization of RNA Viruses [PDF - 826 KB - 4 pages]
A. Kilianski et al.

Nanopore sequencing, a novel genomics technology, has potential applications for routine biosurveillance, clinical diagnosis, and outbreak investigation of virus infections. Using rapid sequencing of unamplified RNA/cDNA hybrids, we identified Venezuelan equine encephalitis virus and Ebola virus in 3 hours from sample receipt to data acquisition, demonstrating a fieldable technique for RNA virus characterization.

EID Kilianski A, Roth PA, Liem AT, Hill JM, Willis KL, Rossmaier RD, et al. Use of Unamplified RNA/cDNA–Hybrid Nanopore Sequencing for Rapid Detection and Characterization of RNA Viruses. Emerg Infect Dis. 2016;22(8):1448-1451. https://dx.doi.org/10.3201/eid2208.160270
AMA Kilianski A, Roth PA, Liem AT, et al. Use of Unamplified RNA/cDNA–Hybrid Nanopore Sequencing for Rapid Detection and Characterization of RNA Viruses. Emerging Infectious Diseases. 2016;22(8):1448-1451. doi:10.3201/eid2208.160270.
APA Kilianski, A., Roth, P. A., Liem, A. T., Hill, J. M., Willis, K. L., Rossmaier, R. D....Rosenzweig, C. (2016). Use of Unamplified RNA/cDNA–Hybrid Nanopore Sequencing for Rapid Detection and Characterization of RNA Viruses. Emerging Infectious Diseases, 22(8), 1448-1451. https://dx.doi.org/10.3201/eid2208.160270.

Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia [PDF - 1.37 MB - 4 pages]
L. A. Messenger et al.

We report the characterization of Trypanosoma cruzi of southern South American origin among humans, domestic vectors, and peridomestic hosts in Colombia using high-resolution nuclear and mitochondrial genotyping. Expanding our understanding of the geographic range of lineage TcVI, which is associated with severe Chagas disease, will help clarify risk of human infection for improved disease control.

EID Messenger LA, Ramirez J, Llewellyn MS, Guhl F, Miles MA. Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia. Emerg Infect Dis. 2016;22(8):1452-1455. https://dx.doi.org/10.3201/eid2208.150786
AMA Messenger LA, Ramirez J, Llewellyn MS, et al. Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia. Emerging Infectious Diseases. 2016;22(8):1452-1455. doi:10.3201/eid2208.150786.
APA Messenger, L. A., Ramirez, J., Llewellyn, M. S., Guhl, F., & Miles, M. A. (2016). Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia. Emerging Infectious Diseases, 22(8), 1452-1455. https://dx.doi.org/10.3201/eid2208.150786.

Lyssavirus in Indian Flying Foxes, Sri Lanka [PDF - 1.01 MB - 4 pages]
P. S. Gunawardena et al.

A novel lyssavirus was isolated from brains of Indian flying foxes (Pteropus medius) in Sri Lanka. Phylogenetic analysis of complete virus genome sequences, and geographic location and host species, provides strong evidence that this virus is a putative new lyssavirus species, designated as Gannoruwa bat lyssavirus.

EID Gunawardena PS, Marston DA, Ellis RJ, Wise EL, Karawita AC, Breed AC, et al. Lyssavirus in Indian Flying Foxes, Sri Lanka. Emerg Infect Dis. 2016;22(8):1456-1459. https://dx.doi.org/10.3201/eid2208.151986
AMA Gunawardena PS, Marston DA, Ellis RJ, et al. Lyssavirus in Indian Flying Foxes, Sri Lanka. Emerging Infectious Diseases. 2016;22(8):1456-1459. doi:10.3201/eid2208.151986.
APA Gunawardena, P. S., Marston, D. A., Ellis, R. J., Wise, E. L., Karawita, A. C., Breed, A. C....Fooks, A. R. (2016). Lyssavirus in Indian Flying Foxes, Sri Lanka. Emerging Infectious Diseases, 22(8), 1456-1459. https://dx.doi.org/10.3201/eid2208.151986.

Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures [PDF - 457 KB - 4 pages]
S. Dittrich et al.

Orientia tsutsugamushi, which requires specialized facilities for culture, is a substantial cause of disease in Asia. We demonstrate that O. tsutsugamushi numbers increased for up to 5 days in conventional hemocultures. Performing such a culture step before molecular testing could increase the sensitivity of O. tsutsugamushi molecular diagnosis.

EID Dittrich S, Card E, Phuklia W, Rudgard WE, Silousok J, Phoumin P, et al. Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures. Emerg Infect Dis. 2016;22(8):1460-1463. https://dx.doi.org/10.3201/eid2208.151259
AMA Dittrich S, Card E, Phuklia W, et al. Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures. Emerging Infectious Diseases. 2016;22(8):1460-1463. doi:10.3201/eid2208.151259.
APA Dittrich, S., Card, E., Phuklia, W., Rudgard, W. E., Silousok, J., Phoumin, P....Newton, P. N. (2016). Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures. Emerging Infectious Diseases, 22(8), 1460-1463. https://dx.doi.org/10.3201/eid2208.151259.

Multilocus Sequence Typing Tool for Cyclospora cayetanensis [PDF - 1.00 MB - 4 pages]
Y. Guo et al.

Because the lack of typing tools for Cyclospora cayetanensis has hampered outbreak investigations, we sequenced its genome and developed a genotyping tool. We observed 2 to 10 geographically segregated sequence types at each of 5 selected loci. This new tool could be useful for case linkage and infection/contamination source tracking.

EID Guo Y, Roellig DM, Li N, Tang K, Frace M, Ortega Y, et al. Multilocus Sequence Typing Tool for Cyclospora cayetanensis. Emerg Infect Dis. 2016;22(8):1464-1467. https://dx.doi.org/10.3201/eid2208.150696
AMA Guo Y, Roellig DM, Li N, et al. Multilocus Sequence Typing Tool for Cyclospora cayetanensis. Emerging Infectious Diseases. 2016;22(8):1464-1467. doi:10.3201/eid2208.150696.
APA Guo, Y., Roellig, D. M., Li, N., Tang, K., Frace, M., Ortega, Y....Xiao, L. (2016). Multilocus Sequence Typing Tool for Cyclospora cayetanensis. Emerging Infectious Diseases, 22(8), 1464-1467. https://dx.doi.org/10.3201/eid2208.150696.

Chagas Disease Screening in Maternal Donors of Publicly Banked Umbilical Cord Blood, United States [PDF - 1.20 MB - 3 pages]
J. M. Edwards et al.

To assess patterns of Chagas disease, we reviewed results of screening umbilical cord blood from a US public cord blood bank during 2007–2014. Nineteen maternal donors tested positive for Trypanosoma cruzi parasites (0.04%). Because perinatal transmission of Chagas disease is associated with substantial illness, targeted prenatal programs should screen for this disease.

EID Edwards JM, Gilner JB, Hernandez J, Kurtzberg J, Heine R. Chagas Disease Screening in Maternal Donors of Publicly Banked Umbilical Cord Blood, United States. Emerg Infect Dis. 2016;22(8):1468-1470. https://dx.doi.org/10.3201/eid2208.151622
AMA Edwards JM, Gilner JB, Hernandez J, et al. Chagas Disease Screening in Maternal Donors of Publicly Banked Umbilical Cord Blood, United States. Emerging Infectious Diseases. 2016;22(8):1468-1470. doi:10.3201/eid2208.151622.
APA Edwards, J. M., Gilner, J. B., Hernandez, J., Kurtzberg, J., & Heine, R. (2016). Chagas Disease Screening in Maternal Donors of Publicly Banked Umbilical Cord Blood, United States. Emerging Infectious Diseases, 22(8), 1468-1470. https://dx.doi.org/10.3201/eid2208.151622.

Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015 [PDF - 1.51 MB - 3 pages]
D. A. Jobe et al.

We confirmed Borrelia miyamotoi infection in 7 patients who had contracted an illness while near La Crosse, Wisconsin, USA, an area where Ixodes scapularis ticks are endemic. B. miyamatoi infection should now be considered among differential diagnoses for patients from the midwestern United States who have signs and symptoms suggestive of tickborne illness.

EID Jobe DA, Lovrich SD, Oldenburg DG, Kowalski TJ, Callister SM. Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015. Emerg Infect Dis. 2016;22(8):1471-1473. https://dx.doi.org/10.3201/eid2208.151878
AMA Jobe DA, Lovrich SD, Oldenburg DG, et al. Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015. Emerging Infectious Diseases. 2016;22(8):1471-1473. doi:10.3201/eid2208.151878.
APA Jobe, D. A., Lovrich, S. D., Oldenburg, D. G., Kowalski, T. J., & Callister, S. M. (2016). Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015. Emerging Infectious Diseases, 22(8), 1471-1473. https://dx.doi.org/10.3201/eid2208.151878.

Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014 [PDF - 429 KB - 3 pages]
J. S. Barkley et al.

In November 2014, the Rhode Island Department of Health investigated a cluster of 3 listeriosis cases. Using whole-genome sequencing to support epidemiologic, laboratory, and environmental investigations, the department identified 1 restaurant as the likely source of the outbreak and also linked the establishment to a listeriosis case that occurred in 2013.

EID Barkley JS, Gosciminski M, Miller A. Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014. Emerg Infect Dis. 2016;22(8):1474-1476. https://dx.doi.org/10.3201/eid2208.151917
AMA Barkley JS, Gosciminski M, Miller A. Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014. Emerging Infectious Diseases. 2016;22(8):1474-1476. doi:10.3201/eid2208.151917.
APA Barkley, J. S., Gosciminski, M., & Miller, A. (2016). Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014. Emerging Infectious Diseases, 22(8), 1474-1476. https://dx.doi.org/10.3201/eid2208.151917.

Onchocerca lupi Nematodes in Dogs Exported from the United States into Canada [PDF - 576 KB - 3 pages]
G. G. Verocai et al.

The Onchocerca lupi nematode is an emerging helminth capable of infecting pets and humans. We detected this parasite in 2 dogs that were imported into Canada from the southwestern United States, a region to which this nematode is endemic. We discuss risk for establishment of O. lupi in Canada.

EID Verocai GG, Conboy G, Lejeune M, Marron F, Hanna P, MacDonald E, et al. Onchocerca lupi Nematodes in Dogs Exported from the United States into Canada. Emerg Infect Dis. 2016;22(8):1477-1479. https://dx.doi.org/10.3201/eid2208.151918
AMA Verocai GG, Conboy G, Lejeune M, et al. Onchocerca lupi Nematodes in Dogs Exported from the United States into Canada. Emerging Infectious Diseases. 2016;22(8):1477-1479. doi:10.3201/eid2208.151918.
APA Verocai, G. G., Conboy, G., Lejeune, M., Marron, F., Hanna, P., MacDonald, E....Gilleard, J. S. (2016). Onchocerca lupi Nematodes in Dogs Exported from the United States into Canada. Emerging Infectious Diseases, 22(8), 1477-1479. https://dx.doi.org/10.3201/eid2208.151918.

Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA [PDF - 1018 KB - 5 pages]
C. Langelier et al.

After severe neurocognitive decline developed in an otherwise healthy 63-year-old man, brain magnetic resonance imaging showed eosinophilic meningoencephalitis and enhancing lesions. The patient tested positive for antibodies to Baylisascaris spp. roundworms, was treated with albendazole and dexamethasone, and showed improvement after 3 months. Baylisascariasis should be considered for all patients with eosinophilic meningitis.

EID Langelier C, Reid MJ, Halabi C, Witek N, LaRiviere A, Shah M, et al. Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA. Emerg Infect Dis. 2016;22(8):1480-1484. https://dx.doi.org/10.3201/eid2208.151939
AMA Langelier C, Reid MJ, Halabi C, et al. Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA. Emerging Infectious Diseases. 2016;22(8):1480-1484. doi:10.3201/eid2208.151939.
APA Langelier, C., Reid, M. J., Halabi, C., Witek, N., LaRiviere, A., Shah, M....Babik, J. M. (2016). Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA. Emerging Infectious Diseases, 22(8), 1480-1484. https://dx.doi.org/10.3201/eid2208.151939.

Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick [PDF - 385 KB - 3 pages]
A. J. Henningsson et al.

We report a case of human tick-borne encephalitis (TBE) in which the TBE virus was isolated from the biting tick. Viral growth and sequence were characterized and compared with those of a reference strain. Virus isolation from ticks from patients with TBE may offer a new approach for studies of epidemiology and pathogenicity.

EID Henningsson AJ, Lindqvist R, Norberg P, Lindblom P, Roth A, Forsberg P, et al. Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick. Emerg Infect Dis. 2016;22(8):1485-1487. https://dx.doi.org/10.3201/eid2208.151962
AMA Henningsson AJ, Lindqvist R, Norberg P, et al. Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick. Emerging Infectious Diseases. 2016;22(8):1485-1487. doi:10.3201/eid2208.151962.
APA Henningsson, A. J., Lindqvist, R., Norberg, P., Lindblom, P., Roth, A., Forsberg, P....Lindgren, P. (2016). Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick. Emerging Infectious Diseases, 22(8), 1485-1487. https://dx.doi.org/10.3201/eid2208.151962.

Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues [PDF - 433 KB - 3 pages]
A. Bouin et al.

We performed deep sequencing analysis of the enterovirus 5′ noncoding region in cardiac biopsies from a patient with dilated cardiomyopathy. Results displayed a mix of deleted and full-length coxsackievirus B3, characterized by a low viral RNA load (8.102 copies/μg of nucleic acids) and a low viral RNA positive-sense to RNA negative-sense ratio of 4.8.

EID Bouin A, Nguyen Y, Wehbe M, Renois F, Fornes P, Bani-Sadr F, et al. Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues. Emerg Infect Dis. 2016;22(8):1488-1490. https://dx.doi.org/10.3201/eid2208.160186
AMA Bouin A, Nguyen Y, Wehbe M, et al. Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues. Emerging Infectious Diseases. 2016;22(8):1488-1490. doi:10.3201/eid2208.160186.
APA Bouin, A., Nguyen, Y., Wehbe, M., Renois, F., Fornes, P., Bani-Sadr, F....Andreoletti, L. (2016). Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues. Emerging Infectious Diseases, 22(8), 1488-1490. https://dx.doi.org/10.3201/eid2208.160186.

Seroconversions for Coxiella and Rickettsial Pathogens among US Marines Deployed to Afghanistan, 2001–2010 [PDF - 429 KB - 3 pages]
C. M. Farris et al.

We assessed serum samples from 1,000 US Marines deployed to Afghanistan during 2001–2010 to find evidence of 4 rickettsial pathogens. Analysis of predeployment and postdeployment samples showed that 3.4% and 0.5% of the Marines seroconverted for the causative agents of Q fever and spotted fever group rickettsiosis, respectively.

EID Farris CM, Pho N, Myers TE, Richards AL. Seroconversions for Coxiella and Rickettsial Pathogens among US Marines Deployed to Afghanistan, 2001–2010. Emerg Infect Dis. 2016;22(8):1491-1493. https://dx.doi.org/10.3201/eid2208.160221
AMA Farris CM, Pho N, Myers TE, et al. Seroconversions for Coxiella and Rickettsial Pathogens among US Marines Deployed to Afghanistan, 2001–2010. Emerging Infectious Diseases. 2016;22(8):1491-1493. doi:10.3201/eid2208.160221.
APA Farris, C. M., Pho, N., Myers, T. E., & Richards, A. L. (2016). Seroconversions for Coxiella and Rickettsial Pathogens among US Marines Deployed to Afghanistan, 2001–2010. Emerging Infectious Diseases, 22(8), 1491-1493. https://dx.doi.org/10.3201/eid2208.160221.

Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda [PDF - 1.38 MB - 5 pages]
M. E. Roh et al.

A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections.

EID Roh ME, Oyet C, Orikiriza P, Wade M, Kiwanuka GN, Mwanga-Amumpaire J, et al. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda. Emerg Infect Dis. 2016;22(8):1494-1498. https://dx.doi.org/10.3201/eid2208.160619
AMA Roh ME, Oyet C, Orikiriza P, et al. Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda. Emerging Infectious Diseases. 2016;22(8):1494-1498. doi:10.3201/eid2208.160619.
APA Roh, M. E., Oyet, C., Orikiriza, P., Wade, M., Kiwanuka, G. N., Mwanga-Amumpaire, J....Boum, Y. (2016). Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda. Emerging Infectious Diseases, 22(8), 1494-1498. https://dx.doi.org/10.3201/eid2208.160619.
Photo Quizzes

Photo Quiz [PDF - 870 KB - 3 pages]
R. Curtis-Robles and C. B. Beard
EID Curtis-Robles R, Beard CB. Photo Quiz. Emerg Infect Dis. 2016;22(8):1499-1501. https://dx.doi.org/10.3201/eid2208.151678
AMA Curtis-Robles R, Beard CB. Photo Quiz. Emerging Infectious Diseases. 2016;22(8):1499-1501. doi:10.3201/eid2208.151678.
APA Curtis-Robles, R., & Beard, C. B. (2016). Photo Quiz. Emerging Infectious Diseases, 22(8), 1499-1501. https://dx.doi.org/10.3201/eid2208.151678.
Letters

Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014 [PDF - 327 KB - 2 pages]
M. Baldi et al.
EID Baldi M, Alvarado G, Smith S, Santoro M, Bolaños N, Jiménez C, et al. Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014. Emerg Infect Dis. 2016;22(8):1502-1503. https://dx.doi.org/10.3201/eid2208.151627
AMA Baldi M, Alvarado G, Smith S, et al. Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014. Emerging Infectious Diseases. 2016;22(8):1502-1503. doi:10.3201/eid2208.151627.
APA Baldi, M., Alvarado, G., Smith, S., Santoro, M., Bolaños, N., Jiménez, C....Walzer, C. (2016). Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014. Emerging Infectious Diseases, 22(8), 1502-1503. https://dx.doi.org/10.3201/eid2208.151627.

Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border [PDF - 354 KB - 3 pages]
M. Boullé et al.
EID Boullé M, Witkowski B, Duru V, Sriprawat K, Nair SK, McDew-White M, et al. Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border. Emerg Infect Dis. 2016;22(8):1503-1505. https://dx.doi.org/10.3201/eid2208.160004
AMA Boullé M, Witkowski B, Duru V, et al. Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border. Emerging Infectious Diseases. 2016;22(8):1503-1505. doi:10.3201/eid2208.160004.
APA Boullé, M., Witkowski, B., Duru, V., Sriprawat, K., Nair, S. K., McDew-White, M....Nosten, F. (2016). Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border. Emerging Infectious Diseases, 22(8), 1503-1505. https://dx.doi.org/10.3201/eid2208.160004.

Meningococcal Group W Disease in Infants and Potential Prevention by Vaccination [PDF - 850 KB - 3 pages]
S. R. Parikh et al.
EID Parikh SR, Campbell H, Beebeejaun K, Ribeiro S, Gray SJ, Borrow R, et al. Meningococcal Group W Disease in Infants and Potential Prevention by Vaccination. Emerg Infect Dis. 2016;22(8):1505-1507. https://dx.doi.org/10.3201/eid2208.160128
AMA Parikh SR, Campbell H, Beebeejaun K, et al. Meningococcal Group W Disease in Infants and Potential Prevention by Vaccination. Emerging Infectious Diseases. 2016;22(8):1505-1507. doi:10.3201/eid2208.160128.
APA Parikh, S. R., Campbell, H., Beebeejaun, K., Ribeiro, S., Gray, S. J., Borrow, R....Ladhani, S. (2016). Meningococcal Group W Disease in Infants and Potential Prevention by Vaccination. Emerging Infectious Diseases, 22(8), 1505-1507. https://dx.doi.org/10.3201/eid2208.160128.

Novel Reassortant Avian Influenza A(H5N6) Viruses in Humans, Guangdong, China, 2015 [PDF - 444 KB - 3 pages]
Y. Shen et al.
EID Shen Y, Ke C, Li Q, Yuan R, Xiang D, Jia W, et al. Novel Reassortant Avian Influenza A(H5N6) Viruses in Humans, Guangdong, China, 2015. Emerg Infect Dis. 2016;22(8):1507-1509. https://dx.doi.org/10.3201/eid2208.160146
AMA Shen Y, Ke C, Li Q, et al. Novel Reassortant Avian Influenza A(H5N6) Viruses in Humans, Guangdong, China, 2015. Emerging Infectious Diseases. 2016;22(8):1507-1509. doi:10.3201/eid2208.160146.
APA Shen, Y., Ke, C., Li, Q., Yuan, R., Xiang, D., Jia, W....Liao, M. (2016). Novel Reassortant Avian Influenza A(H5N6) Viruses in Humans, Guangdong, China, 2015. Emerging Infectious Diseases, 22(8), 1507-1509. https://dx.doi.org/10.3201/eid2208.160146.

Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia [PDF - 838 KB - 3 pages]
C. V. Moore et al.
EID Moore CV, Thompson R, Jabbar A, Williams JV, Rasiah K, Pallant L, et al. Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia. Emerg Infect Dis. 2016;22(8):1510-1512. https://dx.doi.org/10.3201/eid2208.160156
AMA Moore CV, Thompson R, Jabbar A, et al. Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia. Emerging Infectious Diseases. 2016;22(8):1510-1512. doi:10.3201/eid2208.160156.
APA Moore, C. V., Thompson, R., Jabbar, A., Williams, J. V., Rasiah, K., Pallant, L....Weldhagen, G. F. (2016). Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia. Emerging Infectious Diseases, 22(8), 1510-1512. https://dx.doi.org/10.3201/eid2208.160156.

Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013 [PDF - 344 KB - 2 pages]
S. Puzelli et al.
EID Puzelli S, Rizzo C, Fabiani C, Facchini M, Gaibani P, Landini MP, et al. Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013. Emerg Infect Dis. 2016;22(8):1512-1513. https://dx.doi.org/10.3201/eid2208.160246
AMA Puzelli S, Rizzo C, Fabiani C, et al. Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013. Emerging Infectious Diseases. 2016;22(8):1512-1513. doi:10.3201/eid2208.160246.
APA Puzelli, S., Rizzo, C., Fabiani, C., Facchini, M., Gaibani, P., Landini, M. P....Castrucci, M. R. (2016). Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013. Emerging Infectious Diseases, 22(8), 1512-1513. https://dx.doi.org/10.3201/eid2208.160246.

Increase in Eyeworm Infections in Eastern Europe [PDF - 374 KB - 3 pages]
V. Colella et al.
EID Colella V, Kirkova Z, Fok É, Mihalca AD, Tasić-Otašević S, Hodžić A, et al. Increase in Eyeworm Infections in Eastern Europe. Emerg Infect Dis. 2016;22(8):1513-1515. https://dx.doi.org/10.3201/eid2208.160792
AMA Colella V, Kirkova Z, Fok É, et al. Increase in Eyeworm Infections in Eastern Europe. Emerging Infectious Diseases. 2016;22(8):1513-1515. doi:10.3201/eid2208.160792.
APA Colella, V., Kirkova, Z., Fok, É., Mihalca, A. D., Tasić-Otašević, S., Hodžić, A....Otranto, D. (2016). Increase in Eyeworm Infections in Eastern Europe. Emerging Infectious Diseases, 22(8), 1513-1515. https://dx.doi.org/10.3201/eid2208.160792.

Febrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panama [PDF - 480 KB - 3 pages]
D. Araúz et al.
EID Araúz D, De Urriola L, Jones J, Castillo M, Martínez A, Murillo E, et al. Febrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panama. Emerg Infect Dis. 2016;22(8):1515-1517. https://dx.doi.org/10.3201/eid2208.160292
AMA Araúz D, De Urriola L, Jones J, et al. Febrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panama. Emerging Infectious Diseases. 2016;22(8):1515-1517. doi:10.3201/eid2208.160292.
APA Araúz, D., De Urriola, L., Jones, J., Castillo, M., Martínez, A., Murillo, E....Moreno, B. (2016). Febrile or Exanthematous Illness Associated with Zika, Dengue, and Chikungunya Viruses, Panama. Emerging Infectious Diseases, 22(8), 1515-1517. https://dx.doi.org/10.3201/eid2208.160292.

Influenza D Virus Infection in Herd of Cattle, Japan [PDF - 704 KB - 3 pages]
S. Murakami et al.
EID Murakami S, Endoh M, Kobayashi T, Takenaka-Uema A, Chambers JK, Uchida K, et al. Influenza D Virus Infection in Herd of Cattle, Japan. Emerg Infect Dis. 2016;22(8):1517-1519. https://dx.doi.org/10.3201/eid2208.160362
AMA Murakami S, Endoh M, Kobayashi T, et al. Influenza D Virus Infection in Herd of Cattle, Japan. Emerging Infectious Diseases. 2016;22(8):1517-1519. doi:10.3201/eid2208.160362.
APA Murakami, S., Endoh, M., Kobayashi, T., Takenaka-Uema, A., Chambers, J. K., Uchida, K....Horimoto, T. (2016). Influenza D Virus Infection in Herd of Cattle, Japan. Emerging Infectious Diseases, 22(8), 1517-1519. https://dx.doi.org/10.3201/eid2208.160362.

Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24 [PDF - 349 KB - 2 pages]
A. Kerdsin et al.
EID Kerdsin A, Gottschalk M, Hatrongjit R, Hamada S, Akeda Y, Oishi K. Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24. Emerg Infect Dis. 2016;22(8):1519-1520. https://dx.doi.org/10.3201/eid2208.160452
AMA Kerdsin A, Gottschalk M, Hatrongjit R, et al. Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24. Emerging Infectious Diseases. 2016;22(8):1519-1520. doi:10.3201/eid2208.160452.
APA Kerdsin, A., Gottschalk, M., Hatrongjit, R., Hamada, S., Akeda, Y., & Oishi, K. (2016). Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24. Emerging Infectious Diseases, 22(8), 1519-1520. https://dx.doi.org/10.3201/eid2208.160452.

Zika Virus Disease in Traveler Returning from Vietnam to Israel [PDF - 399 KB - 2 pages]
E. Schwartz et al.
EID Schwartz E, Lustig Y, Leshem E, Levy R, Gottesman G, Weissmann R, et al. Zika Virus Disease in Traveler Returning from Vietnam to Israel. Emerg Infect Dis. 2016;22(8):1521-1522. https://dx.doi.org/10.3201/eid2208.160480
AMA Schwartz E, Lustig Y, Leshem E, et al. Zika Virus Disease in Traveler Returning from Vietnam to Israel. Emerging Infectious Diseases. 2016;22(8):1521-1522. doi:10.3201/eid2208.160480.
APA Schwartz, E., Lustig, Y., Leshem, E., Levy, R., Gottesman, G., Weissmann, R....Schwartz, E. (2016). Zika Virus Disease in Traveler Returning from Vietnam to Israel. Emerging Infectious Diseases, 22(8), 1521-1522. https://dx.doi.org/10.3201/eid2208.160480.
Books and Media

Adventures of a Female Medical Detective: In Pursuit of Smallpox and AIDS [PDF - 203 KB - 1 page]
P. Potter
EID Potter P. Adventures of a Female Medical Detective: In Pursuit of Smallpox and AIDS. Emerg Infect Dis. 2016;22(8):1523. https://dx.doi.org/10.3201/eid2208.160532
AMA Potter P. Adventures of a Female Medical Detective: In Pursuit of Smallpox and AIDS. Emerging Infectious Diseases. 2016;22(8):1523. doi:10.3201/eid2208.160532.
APA Potter, P. (2016). Adventures of a Female Medical Detective: In Pursuit of Smallpox and AIDS. Emerging Infectious Diseases, 22(8), 1523. https://dx.doi.org/10.3201/eid2208.160532.
About the Cover

“I Am a Son of the Red Earth” [PDF - 1.56 MB - 2 pages]
B. Breedlove and F. J. Sorvillo
EID Breedlove B, Sorvillo FJ. “I Am a Son of the Red Earth”. Emerg Infect Dis. 2016;22(8):1524-1525. https://dx.doi.org/10.3201/eid2208.ac2208
AMA Breedlove B, Sorvillo FJ. “I Am a Son of the Red Earth”. Emerging Infectious Diseases. 2016;22(8):1524-1525. doi:10.3201/eid2208.ac2208.
APA Breedlove, B., & Sorvillo, F. J. (2016). “I Am a Son of the Red Earth”. Emerging Infectious Diseases, 22(8), 1524-1525. https://dx.doi.org/10.3201/eid2208.ac2208.
Etymologia

Etymologia: Dracunculus medinensis [PDF - 661 KB - 1 page]
EID Etymologia: Dracunculus medinensis. Emerg Infect Dis. 2016;22(8):1437. https://dx.doi.org/10.3201/eid2208.et2208
AMA Etymologia: Dracunculus medinensis. Emerging Infectious Diseases. 2016;22(8):1437. doi:10.3201/eid2208.et2208.
APA (2016). Etymologia: Dracunculus medinensis. Emerging Infectious Diseases, 22(8), 1437. https://dx.doi.org/10.3201/eid2208.et2208.
Online Reports

Toward Developing a Preventive MERS-CoV Vaccine—Report from a Workshop Organized by the Saudi Arabia Ministry of Health and the International Vaccine Institute, Riyadh, Saudi Arabia, November 14–15, 2015 [PDF - 822 KB - 7 pages]
J. Excler et al.

Middle East respiratory syndrome (MERS) remains a serious international public health threat. With the goal of accelerating the development of countermeasures against MERS coronavirus (MERS-CoV), funding agencies, nongovernmental organizations, and researchers across the world assembled in Riyadh, Saudi Arabia, on November 14–15, 2015, to discuss vaccine development challenges. The meeting was spearheaded by the Saudi Ministry of Health and co-organized by the International Vaccine Institute, South Korea. Accelerating the development of a preventive vaccine requires a better understanding of MERS epidemiology, transmission, and pathogenesis in humans and animals. A combination of rodent and nonhuman primate models should be considered in evaluating and developing preventive and therapeutic vaccine candidates. Dromedary camels should be considered for the development of veterinary vaccines. Several vaccine technology platforms targeting the MERS-CoV spike protein were discussed. Mechanisms to maximize investment, provide robust data, and affect public health are urgently needed.

Corrections

Correction: Vol. 22, No. 4 [PDF - 259 KB - 1 page]
EID Correction: Vol. 22, No. 4. Emerg Infect Dis. 2016;22(8):1523. https://dx.doi.org/10.3201/eid2208.c12208
AMA Correction: Vol. 22, No. 4. Emerging Infectious Diseases. 2016;22(8):1523. doi:10.3201/eid2208.c12208.
APA (2016). Correction: Vol. 22, No. 4. Emerging Infectious Diseases, 22(8), 1523. https://dx.doi.org/10.3201/eid2208.c12208.

Correction: Vol. 22, No. 5 [PDF - 259 KB - 1 page]
EID Correction: Vol. 22, No. 5. Emerg Infect Dis. 2016;22(8):1523. https://dx.doi.org/10.3201/eid2208.c22208
AMA Correction: Vol. 22, No. 5. Emerging Infectious Diseases. 2016;22(8):1523. doi:10.3201/eid2208.c22208.
APA (2016). Correction: Vol. 22, No. 5. Emerging Infectious Diseases, 22(8), 1523. https://dx.doi.org/10.3201/eid2208.c22208.
Page created: September 12, 2016
Page updated: February 03, 2017
Page reviewed: February 03, 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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