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Issue Cover for Volume 23, Number 1—January 2017

Volume 23, Number 1—January 2017

[PDF - 6.95 MB - 184 pages]

Perspective

A Framework for Modeling Emerging Diseases to Inform Management [PDF - 424 KB - 6 pages]
R. E. Russell et al.

The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

EID Russell RE, Katz RA, Richgels K, Walsh DP, Grant E. A Framework for Modeling Emerging Diseases to Inform Management. Emerg Infect Dis. 2017;23(1):1-6. https://dx.doi.org/10.3201/eid2301.161452
AMA Russell RE, Katz RA, Richgels K, et al. A Framework for Modeling Emerging Diseases to Inform Management. Emerging Infectious Diseases. 2017;23(1):1-6. doi:10.3201/eid2301.161452.
APA Russell, R. E., Katz, R. A., Richgels, K., Walsh, D. P., & Grant, E. (2017). A Framework for Modeling Emerging Diseases to Inform Management. Emerging Infectious Diseases, 23(1), 1-6. https://dx.doi.org/10.3201/eid2301.161452.
Research

Medscape CME Activity
Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–2012 [PDF - 1.77 MB - 7 pages]
S. Strollo et al.

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis–associated hospitalizations in the United States. We extracted data for 33 states for 2002–2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005–2012 for men (annual change –3.9%) and women (annual change –4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease.

EID Strollo S, Lionakis MS, Adjemian J, Steiner CA, Prevots D. Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–2012. Emerg Infect Dis. 2017;23(1):7-13. https://dx.doi.org/10.3201/eid2301.161198
AMA Strollo S, Lionakis MS, Adjemian J, et al. Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–2012. Emerging Infectious Diseases. 2017;23(1):7-13. doi:10.3201/eid2301.161198.
APA Strollo, S., Lionakis, M. S., Adjemian, J., Steiner, C. A., & Prevots, D. (2017). Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–2012. Emerging Infectious Diseases, 23(1), 7-13. https://dx.doi.org/10.3201/eid2301.161198.

Epidemiology of Human Anthrax in China, 1955−2014 [PDF - 3.32 MB - 8 pages]
Y. Li et al.

Using national surveillance data for 120,111 human anthrax cases recorded during 1955−2014, we analyzed the temporal, seasonal, geographic, and demographic distribution of this disease in China. After 1978, incidence decreased until 2013, when it reached a low of 0.014 cases/100,000 population. The case-fatality rate, cumulatively 3.6% during the study period, has also decreased since 1990. Cases occurred throughout the year, peaking in August. Geographic distribution decreased overall from west to east, but the cumulative number of affected counties increased during 2005−2014. The disease has shifted from industrial to agricultural workers; 86.7% of cases occurred in farmers and herdsmen. Most (97.7%) reported cases were the cutaneous form. Although progress has been made in reducing incidence, this study highlights areas that need improvement. Adequate laboratory diagnosis is lacking; only 7.6% of cases received laboratory confirmation. Geographic expansion of the disease indicates that livestock control programs will be essential in eradicating anthrax.

EID Li Y, Yin W, Hugh-Jones M, Wang L, Mu D, Ren X, et al. Epidemiology of Human Anthrax in China, 1955−2014. Emerg Infect Dis. 2017;23(1):14-21. https://dx.doi.org/10.3201/eid2301.150947
AMA Li Y, Yin W, Hugh-Jones M, et al. Epidemiology of Human Anthrax in China, 1955−2014. Emerging Infectious Diseases. 2017;23(1):14-21. doi:10.3201/eid2301.150947.
APA Li, Y., Yin, W., Hugh-Jones, M., Wang, L., Mu, D., Ren, X....Wei, S. (2017). Epidemiology of Human Anthrax in China, 1955−2014. Emerging Infectious Diseases, 23(1), 14-21. https://dx.doi.org/10.3201/eid2301.150947.

Mathematical Modeling of Programmatic Requirements for Yaws Eradication [PDF - 930 KB - 7 pages]
M. Marks et al.

Yaws is targeted for eradication by 2020. The mainstay of the eradication strategy is mass treatment followed by case finding. Modeling has been used to inform programmatic requirements for other neglected tropical diseases and could provide insights into yaws eradication. We developed a model of yaws transmission varying the coverage and number of rounds of treatment. The estimated number of cases arising from an index case (basic reproduction number [R0]) ranged from 1.08 to 3.32. To have 80% probability of achieving eradication, 8 rounds of treatment with 80% coverage were required at low estimates of R0 (1.45). This requirement increased to 95% at high estimates of R0 (2.47). Extending the treatment interval to 12 months increased requirements at all estimates of R0. At high estimates of R0 with 12 monthly rounds of treatment, no combination of variables achieved eradication. Models should be used to guide the scale-up of yaws eradication.

EID Marks M, Mitjà O, Fitzpatrick C, Asiedu K, Solomon AW, Mabey D, et al. Mathematical Modeling of Programmatic Requirements for Yaws Eradication. Emerg Infect Dis. 2017;23(1):22-28. https://dx.doi.org/10.3201/eid2301.160487
AMA Marks M, Mitjà O, Fitzpatrick C, et al. Mathematical Modeling of Programmatic Requirements for Yaws Eradication. Emerging Infectious Diseases. 2017;23(1):22-28. doi:10.3201/eid2301.160487.
APA Marks, M., Mitjà, O., Fitzpatrick, C., Asiedu, K., Solomon, A. W., Mabey, D....Funk, S. (2017). Mathematical Modeling of Programmatic Requirements for Yaws Eradication. Emerging Infectious Diseases, 23(1), 22-28. https://dx.doi.org/10.3201/eid2301.160487.

Estimated Incidence of Antimicrobial Drug–Resistant Nontyphoidal Salmonella Infections, United States, 2004–2012 [PDF - 1.85 MB - 9 pages]
F. Medalla et al.

Salmonella infections are a major cause of illness in the United States. The antimicrobial agents used to treat severe infections include ceftriaxone, ciprofloxacin, and ampicillin. Antimicrobial drug resistance has been associated with adverse clinical outcomes. To estimate the incidence of resistant culture-confirmed nontyphoidal Salmonella infections, we used Bayesian hierarchical models of 2004–2012 data from the Centers for Disease Control and Prevention National Antimicrobial Resistance Monitoring System and Laboratory-based Enteric Disease Surveillance. We based 3 mutually exclusive resistance categories on susceptibility testing: ceftriaxone and ampicillin resistant, ciprofloxacin nonsusceptible but ceftriaxone susceptible, and ampicillin resistant but ceftriaxone and ciprofloxacin susceptible. We estimated the overall incidence of resistant infections as 1.07/100,000 person-years for ampicillin-only resistance, 0.51/100,000 person-years for ceftriaxone and ampicillin resistance, and 0.35/100,000 person-years for ciprofloxacin nonsusceptibility, or ≈6,200 resistant culture-confirmed infections annually. These national estimates help define the magnitude of the resistance problem so that control measures can be appropriately targeted.

EID Medalla F, Gu W, Mahon B, Judd M, Folster JP, Griffin PM, et al. Estimated Incidence of Antimicrobial Drug–Resistant Nontyphoidal Salmonella Infections, United States, 2004–2012. Emerg Infect Dis. 2017;23(1):29-37. https://dx.doi.org/10.3201/eid2301.160771
AMA Medalla F, Gu W, Mahon B, et al. Estimated Incidence of Antimicrobial Drug–Resistant Nontyphoidal Salmonella Infections, United States, 2004–2012. Emerging Infectious Diseases. 2017;23(1):29-37. doi:10.3201/eid2301.160771.
APA Medalla, F., Gu, W., Mahon, B., Judd, M., Folster, J. P., Griffin, P. M....Hoekstra, R. M. (2017). Estimated Incidence of Antimicrobial Drug–Resistant Nontyphoidal Salmonella Infections, United States, 2004–2012. Emerging Infectious Diseases, 23(1), 29-37. https://dx.doi.org/10.3201/eid2301.160771.

Oral Cholera Vaccine Coverage during an Outbreak and Humanitarian Crisis, Iraq, 2015 [PDF - 757 KB - 8 pages]
E. Lam et al.

During November–December 2015, as part of the 2015 cholera outbreak response in Iraq, the Iraqi Ministry of Health targeted ≈255,000 displaced persons >1 year of age with 2 doses of oral cholera vaccine (OCV). All persons who received vaccines were living in selected refugee camps, internally displaced persons camps, and collective centers. We conducted a multistage cluster survey to obtain OCV coverage estimates in 10 governorates that were targeted during the campaign. In total, 1,226 household and 5,007 individual interviews were conducted. Overall, 2-dose OCV coverage in the targeted camps was 87% (95% CI 85%–89%). Two-dose OCV coverage in the 3 northern governorates (91%; 95% CI 87%–94%) was higher than that in the 7 southern and central governorates (80%; 95% CI 77%–82%). The experience in Iraq demonstrates that OCV campaigns can be successfully implemented as part of a comprehensive response to cholera outbreaks among high-risk populations in conflict settings.

EID Lam E, Al-Tamimi W, Russell S, Butt M, Blanton C, Musani A, et al. Oral Cholera Vaccine Coverage during an Outbreak and Humanitarian Crisis, Iraq, 2015. Emerg Infect Dis. 2017;23(1):38-45. https://dx.doi.org/10.3201/eid2301.160881
AMA Lam E, Al-Tamimi W, Russell S, et al. Oral Cholera Vaccine Coverage during an Outbreak and Humanitarian Crisis, Iraq, 2015. Emerging Infectious Diseases. 2017;23(1):38-45. doi:10.3201/eid2301.160881.
APA Lam, E., Al-Tamimi, W., Russell, S., Butt, M., Blanton, C., Musani, A....Date, K. A. (2017). Oral Cholera Vaccine Coverage during an Outbreak and Humanitarian Crisis, Iraq, 2015. Emerging Infectious Diseases, 23(1), 38-45. https://dx.doi.org/10.3201/eid2301.160881.

Modeling Tool for Decision Support during Early Days of an Anthrax Event [PDF - 1.22 MB - 10 pages]
G. Rainisch et al.

Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices. With only 3 days of case counts, the model can predict final attack sizes for simulated Sverdlovsk-like events (1979 USSR) with sufficient accuracy for decision making and confirms the value of early postexposure prophylaxis initiation. According to a baseline scenario, hospital treatment volume peaks 15 days after exposure, deaths peak earlier (day 5), and recovery peaks later (day 23). This tool gives public health, hospital, and emergency planners scenario-specific information for developing quantitative response plans for this threat.

EID Rainisch G, Meltzer MI, Shadomy S, Bower WA, Hupert N. Modeling Tool for Decision Support during Early Days of an Anthrax Event. Emerg Infect Dis. 2017;23(1):46-55. https://dx.doi.org/10.3201/eid2301.151787
AMA Rainisch G, Meltzer MI, Shadomy S, et al. Modeling Tool for Decision Support during Early Days of an Anthrax Event. Emerging Infectious Diseases. 2017;23(1):46-55. doi:10.3201/eid2301.151787.
APA Rainisch, G., Meltzer, M. I., Shadomy, S., Bower, W. A., & Hupert, N. (2017). Modeling Tool for Decision Support during Early Days of an Anthrax Event. Emerging Infectious Diseases, 23(1), 46-55. https://dx.doi.org/10.3201/eid2301.151787.

Medscape CME Activity
Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009–2010 [PDF - 956 KB - 10 pages]
X. Cui et al.

We studied anthrax immune globulin intravenous (AIG-IV) use from a 2009–2010 outbreak of Bacillus anthracis soft tissue infection in injection drug users in Scotland, UK, and we compared findings from 15 AIG-IV recipients with findings from 28 nonrecipients. Death rates did not differ significantly between recipients and nonrecipients (33% vs. 21%). However, whereas only 8 (27%) of 30 patients at low risk for death (admission sequential organ failure assessment score of 0–5) received AIG-IV, 7 (54%) of the 13 patients at high risk for death (sequential organ failure assessment score of 6–11) received treatment. AIG-IV recipients had surgery more often and, among survivors, had longer hospital stays than did nonrecipients. AIG-IV recipients were sicker than nonrecipients. This difference and the small number of higher risk patients confound assessment of AIG-IV effectiveness in this outbreak.

EID Cui X, Nolen LD, Sun J, Booth M, Donaldson L, Quinn CP, et al. Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009–2010. Emerg Infect Dis. 2017;23(1):56-65. https://dx.doi.org/10.3201/eid2301.160608
AMA Cui X, Nolen LD, Sun J, et al. Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009–2010. Emerging Infectious Diseases. 2017;23(1):56-65. doi:10.3201/eid2301.160608.
APA Cui, X., Nolen, L. D., Sun, J., Booth, M., Donaldson, L., Quinn, C. P....Eichacker, P. Q. (2017). Analysis of Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009–2010. Emerging Infectious Diseases, 23(1), 56-65. https://dx.doi.org/10.3201/eid2301.160608.

Sequelae and Other Conditions in Ebola Virus Disease Survivors, Sierra Leone, 2015 [PDF - 1.36 MB - 8 pages]
H. Mohammed et al.

We rapidly assessed the health of Ebola virus disease (EVD) survivors in Kenema, Sierra Leone, by reviewing medical charts of all patients attending the Survivor Clinic of Kenema Government Hospital. Data were abstracted on signs and symptoms at every attendance. As of November 2015, a total of 621 attendances by 115 survivors with laboratory-confirmed EVD were made to the Survivor Clinic. Most (60.9%) survivors were women. Survivors’ median age was 28 years (range 0.25–70 years). Survivors attended the clinic a median of 5 times (range 1–21 times) each, and the median time from EVD discharge to attendance was 261 days (range 4–504 days). The most commonly reported signs and symptoms among the 621 attendances were headache (63.1%), fever (61.7%), and myalgia (43.3%). Because health needs of EVD survivors are complex, rapid chart reviews at survivor clinics should be repeated regularly to assess the extent of illness and prioritize service delivery.

EID Mohammed H, Vandy AO, Stretch R, Otieno D, Prajapati M, Calderon M, et al. Sequelae and Other Conditions in Ebola Virus Disease Survivors, Sierra Leone, 2015. Emerg Infect Dis. 2017;23(1):66-73. https://dx.doi.org/10.3201/eid2301.160631
AMA Mohammed H, Vandy AO, Stretch R, et al. Sequelae and Other Conditions in Ebola Virus Disease Survivors, Sierra Leone, 2015. Emerging Infectious Diseases. 2017;23(1):66-73. doi:10.3201/eid2301.160631.
APA Mohammed, H., Vandy, A. O., Stretch, R., Otieno, D., Prajapati, M., Calderon, M....Vandi, M. (2017). Sequelae and Other Conditions in Ebola Virus Disease Survivors, Sierra Leone, 2015. Emerging Infectious Diseases, 23(1), 66-73. https://dx.doi.org/10.3201/eid2301.160631.

Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016 [PDF - 1.08 MB - 9 pages]
R. Li et al.

We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs.

EID Li R, Simmons KB, Bertolli J, Rivera-Garcia B, Cox S, Romero L, et al. Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016. Emerg Infect Dis. 2017;23(1):74-82. https://dx.doi.org/10.3201/eid2301.161322
AMA Li R, Simmons KB, Bertolli J, et al. Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016. Emerging Infectious Diseases. 2017;23(1):74-82. doi:10.3201/eid2301.161322.
APA Li, R., Simmons, K. B., Bertolli, J., Rivera-Garcia, B., Cox, S., Romero, L....Grosse, S. D. (2017). Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016. Emerging Infectious Diseases, 23(1), 74-82. https://dx.doi.org/10.3201/eid2301.161322.
Dispatches

Host-Associated Absence of Human Puumala Virus Infections in Northern and Eastern Germany [PDF - 3.74 MB - 4 pages]
S. Drewes et al.

Human hantavirus disease cases, caused by Puumala virus (PUUV), are mainly recorded in western and southern areas of Germany. This bank vole reservoir survey confirmed PUUV presence in these regions but its absence in northern and eastern regions. PUUV occurrence is associated with the presence of the Western bank vole phylogroup.

EID Drewes S, Ali H, Saxenhofer M, Rosenfeld UM, Binder F, Cuypers F, et al. Host-Associated Absence of Human Puumala Virus Infections in Northern and Eastern Germany. Emerg Infect Dis. 2017;23(1):83-86. https://dx.doi.org/10.3201/eid2301.160224
AMA Drewes S, Ali H, Saxenhofer M, et al. Host-Associated Absence of Human Puumala Virus Infections in Northern and Eastern Germany. Emerging Infectious Diseases. 2017;23(1):83-86. doi:10.3201/eid2301.160224.
APA Drewes, S., Ali, H., Saxenhofer, M., Rosenfeld, U. M., Binder, F., Cuypers, F....Ulrich, R. G. (2017). Host-Associated Absence of Human Puumala Virus Infections in Northern and Eastern Germany. Emerging Infectious Diseases, 23(1), 83-86. https://dx.doi.org/10.3201/eid2301.160224.

Norovirus Infection in Harbor Porpoises [PDF - 2.47 MB - 5 pages]
M. de Graaf et al.

A norovirus was detected in harbor porpoises, a previously unknown host for norovirus. This norovirus had low similarity to any known norovirus. Viral RNA was detected primarily in intestinal tissue, and specific serum antibodies were detected in 8 (24%) of 34 harbor porpoises from the North Sea.

EID de Graaf M, Bodewes R, van Elk CE, van de Bildt M, Getu S, Aron GI, et al. Norovirus Infection in Harbor Porpoises. Emerg Infect Dis. 2017;23(1):87-91. https://dx.doi.org/10.3201/eid2301.161081
AMA de Graaf M, Bodewes R, van Elk CE, et al. Norovirus Infection in Harbor Porpoises. Emerging Infectious Diseases. 2017;23(1):87-91. doi:10.3201/eid2301.161081.
APA de Graaf, M., Bodewes, R., van Elk, C. E., van de Bildt, M., Getu, S., Aron, G. I....Koopmans, M. (2017). Norovirus Infection in Harbor Porpoises. Emerging Infectious Diseases, 23(1), 87-91. https://dx.doi.org/10.3201/eid2301.161081.

Reconstruction of Zika Virus Introduction in Brazil [PDF - 1.17 MB - 4 pages]
K. Zinszer et al.

We estimated the speed of Zika virus introduction in Brazil by using confirmed cases at the municipal level. Our models indicate a southward pattern of introduction starting from the northeastern coast and a pattern of movement toward the western border with an average speed of spread of 42 km/day or 15,367 km/year.

EID Zinszer K, Morrison K, Brownstein JS, Marinho F, Santos AF, Nsoesie EO. Reconstruction of Zika Virus Introduction in Brazil. Emerg Infect Dis. 2017;23(1):91-94. https://dx.doi.org/10.3201/eid2301.161274
AMA Zinszer K, Morrison K, Brownstein JS, et al. Reconstruction of Zika Virus Introduction in Brazil. Emerging Infectious Diseases. 2017;23(1):91-94. doi:10.3201/eid2301.161274.
APA Zinszer, K., Morrison, K., Brownstein, J. S., Marinho, F., Santos, A. F., & Nsoesie, E. O. (2017). Reconstruction of Zika Virus Introduction in Brazil. Emerging Infectious Diseases, 23(1), 91-94. https://dx.doi.org/10.3201/eid2301.161274.

Acute Respiratory Disease in US Army Trainees 3 Years after Reintroduction of Adenovirus Vaccine [PDF - 1.58 MB - 4 pages]
N. S. Clemmons et al.

The 1999 cessation of vaccination against adenovirus types 4 and 7 among US Army trainees resulted in reemergence of acute respiratory disease (ARD) outbreaks. The 2011 implementation of a replacement vaccine led to dramatic and sustained decreases in ARD cases, supporting continuation of vaccination in this population at high risk for ARD.

EID Clemmons NS, McCormic ZD, Gaydos JC, Hawksworth AW, Jordan NN. Acute Respiratory Disease in US Army Trainees 3 Years after Reintroduction of Adenovirus Vaccine. Emerg Infect Dis. 2017;23(1):95-98. https://dx.doi.org/10.3201/eid2301.161297
AMA Clemmons NS, McCormic ZD, Gaydos JC, et al. Acute Respiratory Disease in US Army Trainees 3 Years after Reintroduction of Adenovirus Vaccine. Emerging Infectious Diseases. 2017;23(1):95-98. doi:10.3201/eid2301.161297.
APA Clemmons, N. S., McCormic, Z. D., Gaydos, J. C., Hawksworth, A. W., & Jordan, N. N. (2017). Acute Respiratory Disease in US Army Trainees 3 Years after Reintroduction of Adenovirus Vaccine. Emerging Infectious Diseases, 23(1), 95-98. https://dx.doi.org/10.3201/eid2301.161297.

Prolonged Detection of Zika Virus in Vaginal Secretions and Whole Blood [PDF - 430 KB - 3 pages]
K. O. Murray et al.

Infection with Zika virus is an emerging public health crisis. We observed prolonged detection of virus RNA in vaginal mucosal swab specimens and whole blood for a US traveler with acute Zika virus infection who had visited Honduras. These findings advance understanding of Zika virus infection and provide data for additional testing strategies.

EID Murray KO, Gorchakov R, Carlson AR, Berry R, Lai L, Natrajan M, et al. Prolonged Detection of Zika Virus in Vaginal Secretions and Whole Blood. Emerg Infect Dis. 2017;23(1):99-101. https://dx.doi.org/10.3201/eid2301.161394
AMA Murray KO, Gorchakov R, Carlson AR, et al. Prolonged Detection of Zika Virus in Vaginal Secretions and Whole Blood. Emerging Infectious Diseases. 2017;23(1):99-101. doi:10.3201/eid2301.161394.
APA Murray, K. O., Gorchakov, R., Carlson, A. R., Berry, R., Lai, L., Natrajan, M....Mulligan, M. J. (2017). Prolonged Detection of Zika Virus in Vaginal Secretions and Whole Blood. Emerging Infectious Diseases, 23(1), 99-101. https://dx.doi.org/10.3201/eid2301.161394.

Frequent Transmission of Gonorrhea in Men Who Have Sex with Men [PDF - 538 KB - 3 pages]
C. K. Fairley et al.

The rate of gonorrhea is much higher in men who have sex with men than in heterosexuals. Because of unique behavioral characteristics, asymptomatic sites of infection, mainly the pharynx, are principal drivers of gonorrhea prevalence in men who have sex with men. On the basis of this observation, we call for interventions.

EID Fairley CK, Hocking JS, Zhang L, Chow E. Frequent Transmission of Gonorrhea in Men Who Have Sex with Men. Emerg Infect Dis. 2017;23(1):102-104. https://dx.doi.org/10.3201/eid2301.161205
AMA Fairley CK, Hocking JS, Zhang L, et al. Frequent Transmission of Gonorrhea in Men Who Have Sex with Men. Emerging Infectious Diseases. 2017;23(1):102-104. doi:10.3201/eid2301.161205.
APA Fairley, C. K., Hocking, J. S., Zhang, L., & Chow, E. (2017). Frequent Transmission of Gonorrhea in Men Who Have Sex with Men. Emerging Infectious Diseases, 23(1), 102-104. https://dx.doi.org/10.3201/eid2301.161205.

Sequence Analysis of Toxin Gene–Bearing Corynebacterium diphtheriae Strains, Australia [PDF - 321 KB - 3 pages]
C. J. Doyle et al.

By conducting a molecular characterization of Corynebacterium diphtheriae strains in Australia, we identified novel sequences, nonfunctional toxin genes, and 5 recent cases of toxigenic cutaneous diphtheria. These findings highlight the importance of extrapharyngeal infections for toxin gene–bearing (functional or not) and non–toxin gene–bearing C. diphtheriae strains. Continued surveillance is recommended.

EID Doyle CJ, Mazins A, Graham R, Fang N, Smith HV, Jennison AV. Sequence Analysis of Toxin Gene–Bearing Corynebacterium diphtheriae Strains, Australia. Emerg Infect Dis. 2017;23(1):105-107. https://dx.doi.org/10.3201/eid2301.160584
AMA Doyle CJ, Mazins A, Graham R, et al. Sequence Analysis of Toxin Gene–Bearing Corynebacterium diphtheriae Strains, Australia. Emerging Infectious Diseases. 2017;23(1):105-107. doi:10.3201/eid2301.160584.
APA Doyle, C. J., Mazins, A., Graham, R., Fang, N., Smith, H. V., & Jennison, A. V. (2017). Sequence Analysis of Toxin Gene–Bearing Corynebacterium diphtheriae Strains, Australia. Emerging Infectious Diseases, 23(1), 105-107. https://dx.doi.org/10.3201/eid2301.160584.

Media Messages and Perception of Risk for Ebola Virus Infection, United States [PDF - 783 KB - 4 pages]
T. Sell et al.

News media have been blamed for sensationalizing Ebola in the United States, causing unnecessary alarm. To investigate this issue, we analyzed US-focused news stories about Ebola virus disease during July 1–November 30, 2014. We found frequent use of risk-elevating messages, which may have contributed to increased public concern.

EID Sell T, Boddie C, McGinty EE, Pollack K, Smith K, Burke TA, et al. Media Messages and Perception of Risk for Ebola Virus Infection, United States. Emerg Infect Dis. 2017;23(1):108-111. https://dx.doi.org/10.3201/eid2301.160589
AMA Sell T, Boddie C, McGinty EE, et al. Media Messages and Perception of Risk for Ebola Virus Infection, United States. Emerging Infectious Diseases. 2017;23(1):108-111. doi:10.3201/eid2301.160589.
APA Sell, T., Boddie, C., McGinty, E. E., Pollack, K., Smith, K., Burke, T. A....Rutkow, L. (2017). Media Messages and Perception of Risk for Ebola Virus Infection, United States. Emerging Infectious Diseases, 23(1), 108-111. https://dx.doi.org/10.3201/eid2301.160589.

Haemophilus influenzae Type b Invasive Disease in Amish Children, Missouri, USA, 2014 [PDF - 809 KB - 3 pages]
A. L. Myers et al.

During 5 months in 2014, three Amish children in Missouri, USA, were diagnosed with invasive Haemophilus influenzae type b infection. Two were rural neighbors infected with a genetically similar rare strain, sequence type 45. One child had recently traveled, raising the possibility of maintenance of this strain among unvaccinated carriers in Amish communities.

EID Myers AL, Jackson M, Zhang L, Swanson DS, Gilsdorf JR. Haemophilus influenzae Type b Invasive Disease in Amish Children, Missouri, USA, 2014. Emerg Infect Dis. 2017;23(1):112-114. https://dx.doi.org/10.3201/eid2301.160593
AMA Myers AL, Jackson M, Zhang L, et al. Haemophilus influenzae Type b Invasive Disease in Amish Children, Missouri, USA, 2014. Emerging Infectious Diseases. 2017;23(1):112-114. doi:10.3201/eid2301.160593.
APA Myers, A. L., Jackson, M., Zhang, L., Swanson, D. S., & Gilsdorf, J. R. (2017). Haemophilus influenzae Type b Invasive Disease in Amish Children, Missouri, USA, 2014. Emerging Infectious Diseases, 23(1), 112-114. https://dx.doi.org/10.3201/eid2301.160593.

Meningitis Associated with Simultaneous Infection by Multiple Dengue Virus Serotypes in Children, Brazil [PDF - 732 KB - 4 pages]
P. Marinho et al.

To determine the causes of viral meningitis, we analyzed 22 cerebrospinal fluid samples collected during the 2014–2015 dengue epidemics in Brazil. We identified 3 serotypes of dengue virus (DENV-1, -2, and -3), as well as co-infection with 2 or 3 serotypes. We also detected the Asian II genotype of DENV-2.

EID Marinho P, Bretas de Oliveira D, Candiani T, Crispim A, Alvarenga P, Castro F, et al. Meningitis Associated with Simultaneous Infection by Multiple Dengue Virus Serotypes in Children, Brazil. Emerg Infect Dis. 2017;23(1):115-118. https://dx.doi.org/10.3201/eid2301.160817
AMA Marinho P, Bretas de Oliveira D, Candiani T, et al. Meningitis Associated with Simultaneous Infection by Multiple Dengue Virus Serotypes in Children, Brazil. Emerging Infectious Diseases. 2017;23(1):115-118. doi:10.3201/eid2301.160817.
APA Marinho, P., Bretas de Oliveira, D., Candiani, T., Crispim, A., Alvarenga, P., Castro, F....Lima, M. (2017). Meningitis Associated with Simultaneous Infection by Multiple Dengue Virus Serotypes in Children, Brazil. Emerging Infectious Diseases, 23(1), 115-118. https://dx.doi.org/10.3201/eid2301.160817.

Travel-Related Tick-Borne Encephalitis, Israel, 2006–2014 [PDF - 340 KB - 3 pages]
E. Meltzer et al.

During 2006–2014, four tick-borne encephalitis (TBE) cases occurred among Israeli travelers. We calculated TBE incidence at 321.0, 45.0, 13.2, and 7.5 cases/100,000 travelers/year of travel to Sweden, Switzerland, Austria, and Germany, respectively. TBE incidence among travelers to these destinations appears to justify TBE vaccination in accordance with World Health Organization recommendations.

EID Meltzer E, Paran Y, Lustig Y, Stienlauf S, Weinberger M, Schwartz E. Travel-Related Tick-Borne Encephalitis, Israel, 2006–2014. Emerg Infect Dis. 2017;23(1):119-121. https://dx.doi.org/10.3201/eid2301.160888
AMA Meltzer E, Paran Y, Lustig Y, et al. Travel-Related Tick-Borne Encephalitis, Israel, 2006–2014. Emerging Infectious Diseases. 2017;23(1):119-121. doi:10.3201/eid2301.160888.
APA Meltzer, E., Paran, Y., Lustig, Y., Stienlauf, S., Weinberger, M., & Schwartz, E. (2017). Travel-Related Tick-Borne Encephalitis, Israel, 2006–2014. Emerging Infectious Diseases, 23(1), 119-121. https://dx.doi.org/10.3201/eid2301.160888.

Increased Invasive Pneumococcal Disease, North East England, UK [PDF - 2.60 MB - 5 pages]
C. Houseman et al.

Since April 2014, invasive pneumococcal disease incidence has increased substantially across North East England, United Kingdom, reversing the decline that followed the 2006 introduction of pneumococcal conjugate vaccines. Significant increases occurred in 23-valent polysaccharide vaccine serotypes and nonvaccine serotypes. Trends in other regions and long-term effects of multivalent vaccines require further investigation.

EID Houseman C, Hughes GJ, Chapman KE, Wilson D, Gorton R. Increased Invasive Pneumococcal Disease, North East England, UK. Emerg Infect Dis. 2017;23(1):122-126. https://dx.doi.org/10.3201/eid2301.160897
AMA Houseman C, Hughes GJ, Chapman KE, et al. Increased Invasive Pneumococcal Disease, North East England, UK. Emerging Infectious Diseases. 2017;23(1):122-126. doi:10.3201/eid2301.160897.
APA Houseman, C., Hughes, G. J., Chapman, K. E., Wilson, D., & Gorton, R. (2017). Increased Invasive Pneumococcal Disease, North East England, UK. Emerging Infectious Diseases, 23(1), 122-126. https://dx.doi.org/10.3201/eid2301.160897.

Streptococcal Toxic Shock Syndrome Caused by Group G Streptococcus, United Kingdom [PDF - 989 KB - 3 pages]
M. Baxter and M. Morgan

We describe successful management of 3 patients with streptococcal toxic shock syndrome (STSS) attributable to group G Streptococcus infection. This small series supports recognition of group G Streptococcus in the etiology of STSS. We propose intravenous immunoglobulin be used in treatment as it is for STSS caused by group A Streptococcus.

EID Baxter M, Morgan M. Streptococcal Toxic Shock Syndrome Caused by Group G Streptococcus, United Kingdom. Emerg Infect Dis. 2017;23(1):127-129. https://dx.doi.org/10.3201/eid2301.161009
AMA Baxter M, Morgan M. Streptococcal Toxic Shock Syndrome Caused by Group G Streptococcus, United Kingdom. Emerging Infectious Diseases. 2017;23(1):127-129. doi:10.3201/eid2301.161009.
APA Baxter, M., & Morgan, M. (2017). Streptococcal Toxic Shock Syndrome Caused by Group G Streptococcus, United Kingdom. Emerging Infectious Diseases, 23(1), 127-129. https://dx.doi.org/10.3201/eid2301.161009.

Hepatitis E Virus in Wild Boars and Spillover Infection in Red and Roe Deer, Germany, 2013–2015 [PDF - 566 KB - 4 pages]
H. E. Anheyer-Behmenburg et al.

To determine animal hepatitis E virus (HEV) reservoirs, we analyzed serologic and molecular markers of HEV infection among wild animals in Germany. We detected HEV genotype 3 strains in inner organs and muscle tissues of a high percentage of wild boars and a lower percentage of deer, indicating a risk for foodborne infection of humans.

EID Anheyer-Behmenburg HE, Szabo K, Schotte U, Binder A, Klein G, Johne R. Hepatitis E Virus in Wild Boars and Spillover Infection in Red and Roe Deer, Germany, 2013–2015. Emerg Infect Dis. 2017;23(1):130-133. https://dx.doi.org/10.3201/eid2301.161169
AMA Anheyer-Behmenburg HE, Szabo K, Schotte U, et al. Hepatitis E Virus in Wild Boars and Spillover Infection in Red and Roe Deer, Germany, 2013–2015. Emerging Infectious Diseases. 2017;23(1):130-133. doi:10.3201/eid2301.161169.
APA Anheyer-Behmenburg, H. E., Szabo, K., Schotte, U., Binder, A., Klein, G., & Johne, R. (2017). Hepatitis E Virus in Wild Boars and Spillover Infection in Red and Roe Deer, Germany, 2013–2015. Emerging Infectious Diseases, 23(1), 130-133. https://dx.doi.org/10.3201/eid2301.161169.

Guillain-Barré Syndrome and Healthcare Needs during Zika Virus Transmission, Puerto Rico, 2016 [PDF - 304 KB - 3 pages]
E. Dirlikov et al.

To assist with public health preparedness activities, we estimated the number of expected cases of Zika virus in Puerto Rico and associated healthcare needs. Estimated annual incidence is 3.2–5.1 times the baseline, and long-term care needs are predicted to be 3–5 times greater than in years with no Zika virus.

EID Dirlikov E, Kniss K, Major C, Thomas D, Virgen CA, Mayshack M, et al. Guillain-Barré Syndrome and Healthcare Needs during Zika Virus Transmission, Puerto Rico, 2016. Emerg Infect Dis. 2017;23(1):134-136. https://dx.doi.org/10.3201/eid2301.161290
AMA Dirlikov E, Kniss K, Major C, et al. Guillain-Barré Syndrome and Healthcare Needs during Zika Virus Transmission, Puerto Rico, 2016. Emerging Infectious Diseases. 2017;23(1):134-136. doi:10.3201/eid2301.161290.
APA Dirlikov, E., Kniss, K., Major, C., Thomas, D., Virgen, C. A., Mayshack, M....Rivera-Garcia, B. (2017). Guillain-Barré Syndrome and Healthcare Needs during Zika Virus Transmission, Puerto Rico, 2016. Emerging Infectious Diseases, 23(1), 134-136. https://dx.doi.org/10.3201/eid2301.161290.

Persistent Zika Virus Detection in Semen in a Traveler Returning to the United Kingdom from Brazil, 2016 [PDF - 586 KB - 3 pages]
K. M. Gaskell et al.

Zika virus is normally transmitted by mosquitos, but cases of sexual transmission have been reported. We describe a patient with symptomatic Zika virus infection in whom the virus was detected in semen for 92 days. Our findings support recommendations for 6 months of barrier contraceptive use after symptomatic Zika virus infection.

EID Gaskell KM, Houlihan C, Nastouli E, Checkley AM. Persistent Zika Virus Detection in Semen in a Traveler Returning to the United Kingdom from Brazil, 2016. Emerg Infect Dis. 2017;23(1):137-139. https://dx.doi.org/10.3201/eid2301.161300
AMA Gaskell KM, Houlihan C, Nastouli E, et al. Persistent Zika Virus Detection in Semen in a Traveler Returning to the United Kingdom from Brazil, 2016. Emerging Infectious Diseases. 2017;23(1):137-139. doi:10.3201/eid2301.161300.
APA Gaskell, K. M., Houlihan, C., Nastouli, E., & Checkley, A. M. (2017). Persistent Zika Virus Detection in Semen in a Traveler Returning to the United Kingdom from Brazil, 2016. Emerging Infectious Diseases, 23(1), 137-139. https://dx.doi.org/10.3201/eid2301.161300.

Upsurge of Enterovirus D68, the Netherlands, 2016 [PDF - 475 KB - 4 pages]
M. Knoester et al.

In June and July 2016, we identified 8 adults and 17 children with respiratory enterovirus D68 infections. Thirteen children required intensive care unit admission because of respiratory insufficiency, and 1 had concomitant acute flaccid myelitis. Phylogenetic analysis showed that all of 20 sequences obtained belong to the recently described clade B3.

EID Knoester M, Schölvinck EH, Poelman R, Smit S, Vermont CL, Niesters H, et al. Upsurge of Enterovirus D68, the Netherlands, 2016. Emerg Infect Dis. 2017;23(1):140-143. https://dx.doi.org/10.3201/eid2301.161313
AMA Knoester M, Schölvinck EH, Poelman R, et al. Upsurge of Enterovirus D68, the Netherlands, 2016. Emerging Infectious Diseases. 2017;23(1):140-143. doi:10.3201/eid2301.161313.
APA Knoester, M., Schölvinck, E. H., Poelman, R., Smit, S., Vermont, C. L., Niesters, H....Van Leer-Buter, C. C. (2017). Upsurge of Enterovirus D68, the Netherlands, 2016. Emerging Infectious Diseases, 23(1), 140-143. https://dx.doi.org/10.3201/eid2301.161313.
Letters

Dolphin Morbillivirus Associated with a Mass Stranding of Sperm Whales, Italy [PDF - 893 KB - 3 pages]
S. Mazzariol et al.

In September 2014, seven sperm whales were stranded along Italy’s Adriatic coastline. Postmortem investigations on 3 female adult whales and 1 male fetus carried by the largest female revealed molecular and immunohistochemical evidence of dolphin morbillivirus infection. A possible role of the virus in the stranding event was considered.

EID Mazzariol S, Centelleghe C, Di Provvido A, Di Renzo L, Cardeti G, Cersini A, et al. Dolphin Morbillivirus Associated with a Mass Stranding of Sperm Whales, Italy. Emerg Infect Dis. 2017;23(1):144-146. https://dx.doi.org/10.3201/eid2301.160239
AMA Mazzariol S, Centelleghe C, Di Provvido A, et al. Dolphin Morbillivirus Associated with a Mass Stranding of Sperm Whales, Italy. Emerging Infectious Diseases. 2017;23(1):144-146. doi:10.3201/eid2301.160239.
APA Mazzariol, S., Centelleghe, C., Di Provvido, A., Di Renzo, L., Cardeti, G., Cersini, A....Di Guardo, G. (2017). Dolphin Morbillivirus Associated with a Mass Stranding of Sperm Whales, Italy. Emerging Infectious Diseases, 23(1), 144-146. https://dx.doi.org/10.3201/eid2301.160239.

Hepatitis E Virus Infection after Platelet Transfusion in an Immunocompetent Trauma Patient [PDF - 304 KB - 2 pages]
E. Loyrion et al.

Hepatitis E virus (HEV) infection causes acute liver disease, but severe infections are rare in immunocompetent patients. We describe a case of HEV infection in a previously healthy male trauma patient in France who received massive transfusions. Genotyping confirmed HEV in a transfused platelet pool and the donor.

EID Loyrion E, Trouve-Buisson T, Pouzol P, Larrat S, Decaens T, Payen J. Hepatitis E Virus Infection after Platelet Transfusion in an Immunocompetent Trauma Patient. Emerg Infect Dis. 2017;23(1):146-147. https://dx.doi.org/10.3201/eid2301.160923
AMA Loyrion E, Trouve-Buisson T, Pouzol P, et al. Hepatitis E Virus Infection after Platelet Transfusion in an Immunocompetent Trauma Patient. Emerging Infectious Diseases. 2017;23(1):146-147. doi:10.3201/eid2301.160923.
APA Loyrion, E., Trouve-Buisson, T., Pouzol, P., Larrat, S., Decaens, T., & Payen, J. (2017). Hepatitis E Virus Infection after Platelet Transfusion in an Immunocompetent Trauma Patient. Emerging Infectious Diseases, 23(1), 146-147. https://dx.doi.org/10.3201/eid2301.160923.

Scrub Typhus Leading to Acute Encephalitis Syndrome, Assam, India [PDF - 405 KB - 3 pages]
S. A. Khan et al.

To determine the contribution of Orientia tsutsugamushi, the agent of scrub typhus, as a cause of acute encephalitis syndrome (AES) in Assam, India, we conducted a retrospective study of hospital patients with symptoms of AES during 2013–2015. Our findings suggest that O. tsutsugamushi infection leads to AES and the resulting illness and death.

EID Khan SA, Bora T, Laskar B, Khan AM, Dutta P. Scrub Typhus Leading to Acute Encephalitis Syndrome, Assam, India. Emerg Infect Dis. 2017;23(1):148-150. https://dx.doi.org/10.3201/eid2301.161038
AMA Khan SA, Bora T, Laskar B, et al. Scrub Typhus Leading to Acute Encephalitis Syndrome, Assam, India. Emerging Infectious Diseases. 2017;23(1):148-150. doi:10.3201/eid2301.161038.
APA Khan, S. A., Bora, T., Laskar, B., Khan, A. M., & Dutta, P. (2017). Scrub Typhus Leading to Acute Encephalitis Syndrome, Assam, India. Emerging Infectious Diseases, 23(1), 148-150. https://dx.doi.org/10.3201/eid2301.161038.

Group B Streptococcal Toxic Shock Syndrome and covR/S Mutations Revisited [PDF - 307 KB - 3 pages]
P. Sendi et al.

Gene mutations in the virulence regulator CovR/S of group A Streptococcus play a substantial role in the pathogenesis of streptococcal toxic shock syndrome. We screened 25 group B Streptococcus (GBS) isolates obtained from patients with streptococcal toxic shock syndrome and found only 1 GBS clone harboring this kind of mutation.

EID Sendi P, el Hay M, Brandt CM, Spellerberg B. Group B Streptococcal Toxic Shock Syndrome and covR/S Mutations Revisited. Emerg Infect Dis. 2017;23(1):150-152. https://dx.doi.org/10.3201/eid2301.161063
AMA Sendi P, el Hay M, Brandt CM, et al. Group B Streptococcal Toxic Shock Syndrome and covR/S Mutations Revisited. Emerging Infectious Diseases. 2017;23(1):150-152. doi:10.3201/eid2301.161063.
APA Sendi, P., el Hay, M., Brandt, C. M., & Spellerberg, B. (2017). Group B Streptococcal Toxic Shock Syndrome and covR/S Mutations Revisited. Emerging Infectious Diseases, 23(1), 150-152. https://dx.doi.org/10.3201/eid2301.161063.

Whole-Genome Characterization of a Novel Human Influenza A(H1N2) Virus Variant, Brazil [PDF - 283 KB - 3 pages]
P. Resende et al.

We report the characterization of a novel reassortant influenza A(H1N2) virus not previously reported in humans. Recovered from a a pig farm worker in southeast Brazil who had influenza-like illness, this virus is a triple reassortant containing gene segments from subtypes H1N2 (hemagglutinin), H3N2 (neuraminidase), and pandemic H1N1 (remaining genes).

EID Resende P, Born P, Matos A, Motta F, Caetano B, Debur M, et al. Whole-Genome Characterization of a Novel Human Influenza A(H1N2) Virus Variant, Brazil. Emerg Infect Dis. 2017;23(1):152-154. https://dx.doi.org/10.3201/eid2301.161122
AMA Resende P, Born P, Matos A, et al. Whole-Genome Characterization of a Novel Human Influenza A(H1N2) Virus Variant, Brazil. Emerging Infectious Diseases. 2017;23(1):152-154. doi:10.3201/eid2301.161122.
APA Resende, P., Born, P., Matos, A., Motta, F., Caetano, B., Debur, M....Siqueira, M. M. (2017). Whole-Genome Characterization of a Novel Human Influenza A(H1N2) Virus Variant, Brazil. Emerging Infectious Diseases, 23(1), 152-154. https://dx.doi.org/10.3201/eid2301.161122.

Avian Pox in Native Captive Psittacines, Brazil, 2015 [PDF - 311 KB - 3 pages]
F. Esteves et al.

To investigate an outbreak of avian pox in psittacines in a conservation facility, we examined 94 birds of 10 psittacine species, including sick and healthy birds. We found psittacine pox virus in 23 of 27 sick birds and 4 of 67 healthy birds. Further characterization is needed for these isolates.

EID Esteves F, Marín SY, Resende M, Silva A, Coelho H, Barbosa MB, et al. Avian Pox in Native Captive Psittacines, Brazil, 2015. Emerg Infect Dis. 2017;23(1):154-156. https://dx.doi.org/10.3201/eid2301.161133
AMA Esteves F, Marín SY, Resende M, et al. Avian Pox in Native Captive Psittacines, Brazil, 2015. Emerging Infectious Diseases. 2017;23(1):154-156. doi:10.3201/eid2301.161133.
APA Esteves, F., Marín, S. Y., Resende, M., Silva, A., Coelho, H., Barbosa, M. B....Martins, N. (2017). Avian Pox in Native Captive Psittacines, Brazil, 2015. Emerging Infectious Diseases, 23(1), 154-156. https://dx.doi.org/10.3201/eid2301.161133.

Chikungunya Fever in Traveler from Angola to Japan, 2016 [PDF - 385 KB - 3 pages]
S. Takaya et al.

Simultaneous circulation of multiple arboviruses presents diagnostic challenges. In May 2016, chikungunya fever was diagnosed in a traveler from Angola to Japan. Travel history, incubation period, and phylogenetic analysis indicated probable infection acquisition in Angola, where a yellow fever outbreak is ongoing. Thus, local transmission of chikungunya virus probably also occurs in Angola.

EID Takaya S, Kutsuna S, Nakayama E, Taniguchi S, Tajima S, Katanami Y, et al. Chikungunya Fever in Traveler from Angola to Japan, 2016. Emerg Infect Dis. 2017;23(1):156-158. https://dx.doi.org/10.3201/eid2301.161395
AMA Takaya S, Kutsuna S, Nakayama E, et al. Chikungunya Fever in Traveler from Angola to Japan, 2016. Emerging Infectious Diseases. 2017;23(1):156-158. doi:10.3201/eid2301.161395.
APA Takaya, S., Kutsuna, S., Nakayama, E., Taniguchi, S., Tajima, S., Katanami, Y....Ohmagari, N. (2017). Chikungunya Fever in Traveler from Angola to Japan, 2016. Emerging Infectious Diseases, 23(1), 156-158. https://dx.doi.org/10.3201/eid2301.161395.

Puumala Virus in Bank Voles, Lithuania [PDF - 415 KB - 3 pages]
P. Straková et al.

Little is known about the presence of human pathogenic Puumala virus (PUUV) in Lithuania. We detected this virus in bank voles (Myodes glareolus) in a region of this country in which previously PUUV-seropositive humans were identified. Our results are consistent with heterogeneous distributions of PUUV in other countries in Europe.

EID Straková P, Jagdmann S, Balčiauskas L, Balčiauskienė L, Drewes S, Ulrich RG. Puumala Virus in Bank Voles, Lithuania. Emerg Infect Dis. 2017;23(1):158-160. https://dx.doi.org/10.3201/eid2301.161400
AMA Straková P, Jagdmann S, Balčiauskas L, et al. Puumala Virus in Bank Voles, Lithuania. Emerging Infectious Diseases. 2017;23(1):158-160. doi:10.3201/eid2301.161400.
APA Straková, P., Jagdmann, S., Balčiauskas, L., Balčiauskienė, L., Drewes, S., & Ulrich, R. G. (2017). Puumala Virus in Bank Voles, Lithuania. Emerging Infectious Diseases, 23(1), 158-160. https://dx.doi.org/10.3201/eid2301.161400.

Loiasis in US Traveler Returning from Bioko Island, Equatorial Guinea, 2016 [PDF - 507 KB - 3 pages]
D. H. Priest and T. B. Nutman

The filarial parasite Loa loa overlaps geographically with Onchocera volvulus and Wuchereria bancrofti filariae in central Africa. Accurate information regarding this overlap is critical to elimination programs targeting O. volvulus and W. bancrofti. We describe a case of loiasis in a traveler returning from Bioko Island, Equatorial Guinea, a location heretofore unknown for L. loa transmission.

EID Priest DH, Nutman TB. Loiasis in US Traveler Returning from Bioko Island, Equatorial Guinea, 2016. Emerg Infect Dis. 2017;23(1):160-162. https://dx.doi.org/10.3201/eid2301.161427
AMA Priest DH, Nutman TB. Loiasis in US Traveler Returning from Bioko Island, Equatorial Guinea, 2016. Emerging Infectious Diseases. 2017;23(1):160-162. doi:10.3201/eid2301.161427.
APA Priest, D. H., & Nutman, T. B. (2017). Loiasis in US Traveler Returning from Bioko Island, Equatorial Guinea, 2016. Emerging Infectious Diseases, 23(1), 160-162. https://dx.doi.org/10.3201/eid2301.161427.

Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia [PDF - 303 KB - 3 pages]
S. E. Morales-López et al.

Candida auris is an emerging multidrug-resistant fungus that causes a wide range of symptoms. We report finding 17 cases of C. auris infection that were originally misclassified but correctly identified 27.5 days later on average. Patients with a delayed diagnosis of C. auris had a 30-day mortality rate of 35.2%.

EID Morales-López SE, Parra-Giraldo CM, Ceballos-Garzón A, Martínez HP, Rodríguez GJ, Álvarez-Moreno CA, et al. Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia. Emerg Infect Dis. 2017;23(1):162-164. https://dx.doi.org/10.3201/eid2301.161497
AMA Morales-López SE, Parra-Giraldo CM, Ceballos-Garzón A, et al. Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia. Emerging Infectious Diseases. 2017;23(1):162-164. doi:10.3201/eid2301.161497.
APA Morales-López, S. E., Parra-Giraldo, C. M., Ceballos-Garzón, A., Martínez, H. P., Rodríguez, G. J., Álvarez-Moreno, C. A....Rodríguez, J. Y. (2017). Invasive Infections with Multidrug-Resistant Yeast Candida auris, Colombia. Emerging Infectious Diseases, 23(1), 162-164. https://dx.doi.org/10.3201/eid2301.161497.

Zika Virus Knowledge among Pregnant Women Who Were in Areas with Active Transmission [PDF - 279 KB - 3 pages]
K. Whittemore et al.

We surveyed women in New York, New York, USA, who were in areas with active Zika virus transmission while pregnant. Of 99 women who were US residents, 30 were unaware of the government travel advisory to areas with active Zika virus transmission while pregnant, and 37 were unaware of their pregnancies during travel.

EID Whittemore K, Tate A, Illescas A, Saffa A, Collins A, Varma JK, et al. Zika Virus Knowledge among Pregnant Women Who Were in Areas with Active Transmission. Emerg Infect Dis. 2017;23(1):164-166. https://dx.doi.org/10.3201/eid2301.161614
AMA Whittemore K, Tate A, Illescas A, et al. Zika Virus Knowledge among Pregnant Women Who Were in Areas with Active Transmission. Emerging Infectious Diseases. 2017;23(1):164-166. doi:10.3201/eid2301.161614.
APA Whittemore, K., Tate, A., Illescas, A., Saffa, A., Collins, A., Varma, J. K....Vora, N. M. (2017). Zika Virus Knowledge among Pregnant Women Who Were in Areas with Active Transmission. Emerging Infectious Diseases, 23(1), 164-166. https://dx.doi.org/10.3201/eid2301.161614.

Multidrug-Resistant Pathogens in Hospitalized Syrian Children [PDF - 1.34 MB - 3 pages]
D. Kassem et al.

Since 2013, wounded and ill children from Syria have received treatment in Israel. Screening cultures indicated that multidrug-resistant (MDR) pathogens colonized 89 (83%) of 107 children. For 58% of MDR infections, the pathogen was similar to that identified during screening. MDR screening of these children is valuable for purposes of isolation and treatment.

EID Kassem D, Hoffmann Y, Shahar N, Ocampo S, Salomon L, Zonis Z, et al. Multidrug-Resistant Pathogens in Hospitalized Syrian Children. Emerg Infect Dis. 2017;23(1):166-168. https://dx.doi.org/10.3201/eid2301.161204
AMA Kassem D, Hoffmann Y, Shahar N, et al. Multidrug-Resistant Pathogens in Hospitalized Syrian Children. Emerging Infectious Diseases. 2017;23(1):166-168. doi:10.3201/eid2301.161204.
APA Kassem, D., Hoffmann, Y., Shahar, N., Ocampo, S., Salomon, L., Zonis, Z....Glikman, D. (2017). Multidrug-Resistant Pathogens in Hospitalized Syrian Children. Emerging Infectious Diseases, 23(1), 166-168. https://dx.doi.org/10.3201/eid2301.161204.

Human Tick-Borne Encephalitis, the Netherlands [PDF - 756 KB - 1 page]
V. Hira and B. Rockx
EID Hira V, Rockx B. Human Tick-Borne Encephalitis, the Netherlands. Emerg Infect Dis. 2017;23(1):169. https://dx.doi.org/10.3201/eid2301.161405
AMA Hira V, Rockx B. Human Tick-Borne Encephalitis, the Netherlands. Emerging Infectious Diseases. 2017;23(1):169. doi:10.3201/eid2301.161405.
APA Hira, V., & Rockx, B. (2017). Human Tick-Borne Encephalitis, the Netherlands. Emerging Infectious Diseases, 23(1), 169. https://dx.doi.org/10.3201/eid2301.161405.
Books and Media

Disease Selection: The Way Disease Changed the World [PDF - 237 KB - 1 page]
J. Goldman
EID Goldman J. Disease Selection: The Way Disease Changed the World. Emerg Infect Dis. 2017;23(1):170. https://dx.doi.org/10.3201/eid2301.161590
AMA Goldman J. Disease Selection: The Way Disease Changed the World. Emerging Infectious Diseases. 2017;23(1):170. doi:10.3201/eid2301.161590.
APA Goldman, J. (2017). Disease Selection: The Way Disease Changed the World. Emerging Infectious Diseases, 23(1), 170. https://dx.doi.org/10.3201/eid2301.161590.
About the Cover

Extrapolation Yields Painting, Probability, and Predictions [PDF - 430 KB - 2 pages]
B. Breedlove and M. I. Meltzer
EID Breedlove B, Meltzer MI. Extrapolation Yields Painting, Probability, and Predictions. Emerg Infect Dis. 2017;23(1):171-172. https://dx.doi.org/10.3201/eid2301.ac2301
AMA Breedlove B, Meltzer MI. Extrapolation Yields Painting, Probability, and Predictions. Emerging Infectious Diseases. 2017;23(1):171-172. doi:10.3201/eid2301.ac2301.
APA Breedlove, B., & Meltzer, M. I. (2017). Extrapolation Yields Painting, Probability, and Predictions. Emerging Infectious Diseases, 23(1), 171-172. https://dx.doi.org/10.3201/eid2301.ac2301.
Etymologia

Etymologia: Bayesian Probability [PDF - 369 KB - 1 page]
R. Henry and M. I. Meltzer
EID Henry R, Meltzer MI. Etymologia: Bayesian Probability. Emerg Infect Dis. 2017;23(1):28. https://dx.doi.org/10.3201/eid2301.et2301
AMA Henry R, Meltzer MI. Etymologia: Bayesian Probability. Emerging Infectious Diseases. 2017;23(1):28. doi:10.3201/eid2301.et2301.
APA Henry, R., & Meltzer, M. I. (2017). Etymologia: Bayesian Probability. Emerging Infectious Diseases, 23(1), 28. https://dx.doi.org/10.3201/eid2301.et2301.
Page created: December 16, 2016
Page updated: December 16, 2016
Page reviewed: December 16, 2016
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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