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Issue Cover for Volume 23, Number 2—February 2017

Volume 23, Number 2—February 2017

[PDF - 71.82 MB - 208 pages]

Perspective

Delivering on Antimicrobial Resistance Agenda Not Possible without Improving Fungal Diagnostic Capabilities [PDF - 1.06 MB - 7 pages]
D. W. Denning et al.

Antimicrobial resistance, a major public health concern, largely arises from excess use of antibiotic and antifungal drugs. Lack of routine diagnostic testing for fungal diseases exacerbates the problem of antimicrobial drug empiricism, both antibiotic and antifungal. In support of this contention, we cite 4 common clinical situations that illustrate this problem: 1) inaccurate diagnosis of fungal sepsis in hospitals and intensive care units, resulting in inappropriate use of broad-spectrum antibacterial drugs in patients with invasive candidiasis; 2) failure to diagnose chronic pulmonary aspergillosis in patients with smear-negative pulmonary tuberculosis; 3) misdiagnosis of fungal asthma, resulting in unnecessary treatment with antibacterial drugs instead of antifungal drugs and missed diagnoses of life-threatening invasive aspergillosis in patients with chronic obstructive pulmonary disease; and 4) overtreatment and undertreatment of Pneumocystis pneumonia in HIV-positive patients. All communities should have access to nonculture fungal diagnostics, which can substantially benefit clinical outcome, antimicrobial stewardship, and control of antimicrobial resistance.

EID Denning DW, Perlin DS, Muldoon EG, Colombo A, Chakrabarti A, Richardson MD, et al. Delivering on Antimicrobial Resistance Agenda Not Possible without Improving Fungal Diagnostic Capabilities. Emerg Infect Dis. 2017;23(2):177-183. https://dx.doi.org/10.3201/eid2302.152042
AMA Denning DW, Perlin DS, Muldoon EG, et al. Delivering on Antimicrobial Resistance Agenda Not Possible without Improving Fungal Diagnostic Capabilities. Emerging Infectious Diseases. 2017;23(2):177-183. doi:10.3201/eid2302.152042.
APA Denning, D. W., Perlin, D. S., Muldoon, E. G., Colombo, A., Chakrabarti, A., Richardson, M. D....Sorrell, T. C. (2017). Delivering on Antimicrobial Resistance Agenda Not Possible without Improving Fungal Diagnostic Capabilities. Emerging Infectious Diseases, 23(2), 177-183. https://dx.doi.org/10.3201/eid2302.152042.
Synopses

Changing Epidemiology of Human Brucellosis, China, 1955–2014 [PDF - 6.39 MB - 10 pages]
S. Lai et al.

Brucellosis, a zoonotic disease, was made statutorily notifiable in China in 1955. We analyzed the incidence and spatial–temporal distribution of human brucellosis during 1955–2014 in China using notifiable surveillance data: aggregated data for 1955–2003 and individual case data for 2004–2014. A total of 513,034 brucellosis cases were recorded, of which 99.3% were reported in northern China during 1955–2014, and 69.1% (258, 462/374, 141) occurred during February–July in 1990–2014. Incidence remained high during 1955–1978 (interquartile range 0.42–1.0 cases/100,000 residents), then decreased dramatically in 1979–1994. However, brucellosis has reemerged since 1995 (interquartile range 0.11–0.23 in 1995–2003 and 1.48–2.89 in 2004–2014); the historical high occurred in 2014, and the affected area expanded from northern pastureland provinces to the adjacent grassland and agricultural areas, then to southern coastal and southwestern areas. Control strategies in China should be adjusted to account for these changes by adopting a One Health approach.

EID Lai S, Zhou H, Xiong W, Yu H, Huang Z, Yu J, et al. Changing Epidemiology of Human Brucellosis, China, 1955–2014. Emerg Infect Dis. 2017;23(2):184-194. https://dx.doi.org/10.3201/eid2302.151710
AMA Lai S, Zhou H, Xiong W, et al. Changing Epidemiology of Human Brucellosis, China, 1955–2014. Emerging Infectious Diseases. 2017;23(2):184-194. doi:10.3201/eid2302.151710.
APA Lai, S., Zhou, H., Xiong, W., Yu, H., Huang, Z., Yu, J....Wei, S. (2017). Changing Epidemiology of Human Brucellosis, China, 1955–2014. Emerging Infectious Diseases, 23(2), 184-194. https://dx.doi.org/10.3201/eid2302.151710.
Research

Medscape CME Activity
Multidrug-Resistant Candida haemulonii and C. auris, Tel Aviv, Israel [PDF - 2.69 MB - 9 pages]
R. Ben-Ami et al.

Candida auris and C. haemulonii are closely related, multidrug-resistant emerging fungal pathogens that are not readily distinguishable with phenotypic assays. We studied C. auris and C. haemulonii clinical isolates from 2 hospitals in central Israel. C. auris was isolated in 5 patients with nosocomial bloodstream infection, and C. haemulonii was found as a colonizer of leg wounds at a peripheral vascular disease clinic. Liberal use of topical miconazole and close contact among patients were implicated in C. haemulonii transmission. C. auris exhibited higher thermotolerance, virulence in a mouse infection model, and ATP-dependent drug efflux activity than C. haemulonii. Comparison of ribosomal DNA sequences found that C. auris strains from Israel were phylogenetically distinct from isolates from East Asia, South Africa and Kuwait, whereas C. haemulonii strains from different countries were closely interrelated. Our findings highlight the pathogenicity of C. auris and underscore the need to limit its spread.

EID Ben-Ami R, Berman J, Novikov A, Bash E, Shachor-Meyouhas Y, Zakin S, et al. Multidrug-Resistant Candida haemulonii and C. auris, Tel Aviv, Israel. Emerg Infect Dis. 2017;23(2):195-203. https://dx.doi.org/10.3201/eid2302.161486
AMA Ben-Ami R, Berman J, Novikov A, et al. Multidrug-Resistant Candida haemulonii and C. auris, Tel Aviv, Israel. Emerging Infectious Diseases. 2017;23(2):195-203. doi:10.3201/eid2302.161486.
APA Ben-Ami, R., Berman, J., Novikov, A., Bash, E., Shachor-Meyouhas, Y., Zakin, S....Finn, T. (2017). Multidrug-Resistant Candida haemulonii and C. auris, Tel Aviv, Israel. Emerging Infectious Diseases, 23(2), 195-203. https://dx.doi.org/10.3201/eid2302.161486.

Detection of Multiple Parallel Transmission Outbreak of Streptococcus suis Human Infection by Use of Genome Epidemiology, China, 2005 [PDF - 5.64 MB - 8 pages]
P. Du et al.

Streptococcus suis sequence type 7 emerged and caused 2 of the largest human infection outbreaks in China in 1998 and 2005. To determine the major risk factors and source of the infections, we analyzed whole genomes of 95 outbreak-associated isolates, identified 160 single nucleotide polymorphisms, and classified them into 6 clades. Molecular clock analysis revealed that clade 1 (responsible for the 1998 outbreak) emerged in October 1997. Clades 2–6 (responsible for the 2005 outbreak) emerged separately during February 2002–August 2004. A total of 41 lineages of S. suis emerged by the end of 2004 and rapidly expanded to 68 genome types through single base mutations when the outbreak occurred in June 2005. We identified 32 identical isolates and classified them into 8 groups, which were distributed in a large geographic area with no transmission link. These findings suggest that persons were infected in parallel in respective geographic sites.

EID Du P, Zheng H, Zhou J, Lan R, Ye C, Jing H, et al. Detection of Multiple Parallel Transmission Outbreak of Streptococcus suis Human Infection by Use of Genome Epidemiology, China, 2005. Emerg Infect Dis. 2017;23(2):204-211. https://dx.doi.org/10.3201/eid2302.160297
AMA Du P, Zheng H, Zhou J, et al. Detection of Multiple Parallel Transmission Outbreak of Streptococcus suis Human Infection by Use of Genome Epidemiology, China, 2005. Emerging Infectious Diseases. 2017;23(2):204-211. doi:10.3201/eid2302.160297.
APA Du, P., Zheng, H., Zhou, J., Lan, R., Ye, C., Jing, H....Xu, J. (2017). Detection of Multiple Parallel Transmission Outbreak of Streptococcus suis Human Infection by Use of Genome Epidemiology, China, 2005. Emerging Infectious Diseases, 23(2), 204-211. https://dx.doi.org/10.3201/eid2302.160297.

Correlation of West Nile Virus Incidence in Donated Blood with West Nile Neuroinvasive Disease Rates, United States, 2010–2012 [PDF - 1.73 MB - 8 pages]
E. Betsem et al.

Over the past decade, West Nile virus (WNV) has spread across the United States. We aggregated blood donor data from 2010–2012 and then calculated the incidence of WNV RNA–positive donations and compared the incidence with neuroinvasive disease (NID) case data from the ArboNET surveillance system. Of 10,107,853 donations, 640 were confirmed positive. The seasonal WNV incidence rate per 100,000 persons was 33.4 (95% CI 22–45) in 2010, 25.7 (95% CI 15–34) in 2011, and 119.9 (95% CI 98–141) in 2012. NID to blood donor ratios were 1 in 164 (95% CI 152–178) in 2010, 1 in 158 (95% CI 145–174) in 2011, and 1 in 131 (95% CI 127–136) in 2012. We updated estimates of the ratio of NID to WNV infection rates, demonstrating stable disease penetrance over the study period. Blood donor WNV RNA screening is a valuable public health tool for WNV surveillance.

EID Betsem E, Kaidarova Z, Stramer SL, Shaz B, Sayers M, LeParc G, et al. Correlation of West Nile Virus Incidence in Donated Blood with West Nile Neuroinvasive Disease Rates, United States, 2010–2012. Emerg Infect Dis. 2017;23(2):212-219. https://dx.doi.org/10.3201/eid2302.161058
AMA Betsem E, Kaidarova Z, Stramer SL, et al. Correlation of West Nile Virus Incidence in Donated Blood with West Nile Neuroinvasive Disease Rates, United States, 2010–2012. Emerging Infectious Diseases. 2017;23(2):212-219. doi:10.3201/eid2302.161058.
APA Betsem, E., Kaidarova, Z., Stramer, S. L., Shaz, B., Sayers, M., LeParc, G....Murphy, E. L. (2017). Correlation of West Nile Virus Incidence in Donated Blood with West Nile Neuroinvasive Disease Rates, United States, 2010–2012. Emerging Infectious Diseases, 23(2), 212-219. https://dx.doi.org/10.3201/eid2302.161058.

Highly Pathogenic Influenza A(H5Nx) Viruses with Altered H5 Receptor-Binding Specificity [PDF - 5.08 MB - 12 pages]
H. Guo et al.

Emergence and intercontinental spread of highly pathogenic avian influenza A(H5Nx) virus clade 2.3.4.4 is unprecedented. H5N8 and H5N2 viruses have caused major economic losses in the poultry industry in Europe and North America, and lethal human infections with H5N6 virus have occurred in Asia. Knowledge of the evolution of receptor-binding specificity of these viruses, which might affect host range, is urgently needed. We report that emergence of these viruses is accompanied by a change in receptor-binding specificity. In contrast to ancestral clade 2.3.4 H5 proteins, novel clade 2.3.4.4 H5 proteins bind to fucosylated sialosides because of substitutions K222Q and S227R, which are unique for highly pathogenic influenza virus H5 proteins. North American clade 2.3.4.4 virus isolates have retained only the K222Q substitution but still bind fucosylated sialosides. Altered receptor-binding specificity of virus clade 2.3.4.4 H5 proteins might have contributed to emergence and spread of H5Nx viruses.

EID Guo H, de Vries E, McBride R, Dekkers J, Peng W, Bouwman KM, et al. Highly Pathogenic Influenza A(H5Nx) Viruses with Altered H5 Receptor-Binding Specificity. Emerg Infect Dis. 2017;23(2):220-231. https://dx.doi.org/10.3201/eid2302.161072
AMA Guo H, de Vries E, McBride R, et al. Highly Pathogenic Influenza A(H5Nx) Viruses with Altered H5 Receptor-Binding Specificity. Emerging Infectious Diseases. 2017;23(2):220-231. doi:10.3201/eid2302.161072.
APA Guo, H., de Vries, E., McBride, R., Dekkers, J., Peng, W., Bouwman, K. M....de Haan, C. (2017). Highly Pathogenic Influenza A(H5Nx) Viruses with Altered H5 Receptor-Binding Specificity. Emerging Infectious Diseases, 23(2), 220-231. https://dx.doi.org/10.3201/eid2302.161072.

Livestock Susceptibility to Infection with Middle East Respiratory Syndrome Coronavirus [PDF - 3.52 MB - 9 pages]
J. Vergara-Alert et al.

Middle East respiratory syndrome (MERS) cases continue to be reported, predominantly in Saudi Arabia and occasionally other countries. Although dromedaries are the main reservoir, other animal species might be susceptible to MERS coronavirus (MERS-CoV) infection and potentially serve as reservoirs. To determine whether other animals are potential reservoirs, we inoculated MERS-CoV into llamas, pigs, sheep, and horses and collected nasal and rectal swab samples at various times. The presence of MERS-CoV in the nose of pigs and llamas was confirmed by PCR, titration of infectious virus, immunohistochemistry, and in situ hybridization; seroconversion was detected in animals of both species. Conversely, in sheep and horses, virus-specific antibodies did not develop and no evidence of viral replication in the upper respiratory tract was found. These results prove the susceptibility of llamas and pigs to MERS-CoV infection. Thus, the possibility of MERS-CoV circulation in animals other than dromedaries, such as llamas and pigs, is not negligible.

EID Vergara-Alert J, van den Brand J, Widagdo W, Muñoz M, Raj S, Schipper D, et al. Livestock Susceptibility to Infection with Middle East Respiratory Syndrome Coronavirus. Emerg Infect Dis. 2017;23(2):232-240. https://dx.doi.org/10.3201/eid2302.161239
AMA Vergara-Alert J, van den Brand J, Widagdo W, et al. Livestock Susceptibility to Infection with Middle East Respiratory Syndrome Coronavirus. Emerging Infectious Diseases. 2017;23(2):232-240. doi:10.3201/eid2302.161239.
APA Vergara-Alert, J., van den Brand, J., Widagdo, W., Muñoz, M., Raj, S., Schipper, D....Segalés, J. (2017). Livestock Susceptibility to Infection with Middle East Respiratory Syndrome Coronavirus. Emerging Infectious Diseases, 23(2), 232-240. https://dx.doi.org/10.3201/eid2302.161239.

Swine Influenza Virus (H1N2) Characterization and Transmission in Ferrets, Chile [PDF - 4.89 MB - 11 pages]
N. Bravo-Vasquez et al.

Phylogenetic analysis of the influenza hemagglutinin gene (HA) has suggested that commercial pigs in Chile harbor unique human seasonal H1-like influenza viruses, but further information, including characterization of these viruses, was unavailable. We isolated influenza virus (H1N2) from a swine in a backyard production farm in Central Chile and demonstrated that the HA gene was identical to that in a previous report. Its HA and neuraminidase genes were most similar to human H1 and N2 viruses from the early 1990s and internal segments were similar to influenza A(H1N1)pdm09 virus. The virus replicated efficiently in vitro and in vivo and transmitted in ferrets by respiratory droplet. Antigenically, it was distinct from other swine viruses. Hemagglutination inhibition analysis suggested that antibody titers to the swine Chilean H1N2 virus were decreased in persons born after 1990. Further studies are needed to characterize the potential risk to humans, as well as the ecology of influenza in swine in South America.

EID Bravo-Vasquez N, Karlsson EA, Jimenez-Bluhm P, Meliopoulos V, Kaplan B, Marvin S, et al. Swine Influenza Virus (H1N2) Characterization and Transmission in Ferrets, Chile. Emerg Infect Dis. 2017;23(2):241-251. https://dx.doi.org/10.3201/eid2302.161374
AMA Bravo-Vasquez N, Karlsson EA, Jimenez-Bluhm P, et al. Swine Influenza Virus (H1N2) Characterization and Transmission in Ferrets, Chile. Emerging Infectious Diseases. 2017;23(2):241-251. doi:10.3201/eid2302.161374.
APA Bravo-Vasquez, N., Karlsson, E. A., Jimenez-Bluhm, P., Meliopoulos, V., Kaplan, B., Marvin, S....Schultz-Cherry, S. (2017). Swine Influenza Virus (H1N2) Characterization and Transmission in Ferrets, Chile. Emerging Infectious Diseases, 23(2), 241-251. https://dx.doi.org/10.3201/eid2302.161374.

Ancylostoma ceylanicum Hookworm in the Solomon Islands [PDF - 1.08 MB - 6 pages]
R. S. Bradbury et al.

Although hookworm is highly prevalent in the Solomon Islands, the species involved are unknown. We initiated this study in response to finding Ancylostoma ceylanicum hookworm in a peacekeeper in Australia who had returned from the Solomon Islands. Kato-Katz fecal surveys performed in 2013 and 2014 in 2 village groups in East Malaita, Solomon Islands, identified hookworm-positive samples. These specimens were tested by cytochrome oxidase 1 (cox-1) gene multiplex PCR and sequenced. Of 66 positive specimens, 54 (81.8%) contained only Necator americanus, 11 (16.7%) contained only A. ceylanicum, and 1 (1.5%) contained both species. A. duodenale was not found. Haplotype analysis of cox-1 sequences placed all human isolates (99% bootstrap support) of A. ceylanicum within the zoonotic clade rather than the human-specific clade. This study confirms that A. ceylanicum is endemic in the East Malaita region of this Pacific Island nation. The strain of the A. ceylanicum in this region can be shared among humans, dogs, and cats.

EID Bradbury RS, Hii S, Harrington H, Speare R, Traub R. Ancylostoma ceylanicum Hookworm in the Solomon Islands. Emerg Infect Dis. 2017;23(2):252-257. https://dx.doi.org/10.3201/eid2302.160822
AMA Bradbury RS, Hii S, Harrington H, et al. Ancylostoma ceylanicum Hookworm in the Solomon Islands. Emerging Infectious Diseases. 2017;23(2):252-257. doi:10.3201/eid2302.160822.
APA Bradbury, R. S., Hii, S., Harrington, H., Speare, R., & Traub, R. (2017). Ancylostoma ceylanicum Hookworm in the Solomon Islands. Emerging Infectious Diseases, 23(2), 252-257. https://dx.doi.org/10.3201/eid2302.160822.

Estimated Effect of Inactivated Poliovirus Vaccine Campaigns, Nigeria and Pakistan, January 2014–April 2016 [PDF - 1.00 MB - 6 pages]
G. Shirreff et al.

In 2014, inactivated poliovirus vaccine (IPV) campaigns were implemented in Nigeria and Pakistan after clinical trials showed that IPV boosts intestinal immunity in children previously given oral poliovirus vaccine (OPV). We estimated the effect of these campaigns by using surveillance data collected during January 2014–April 2016. In Nigeria, campaigns with IPV and trivalent OPV (tOPV) substantially reduced the incidence of poliomyelitis caused by circulating serotype-2 vaccine–derived poliovirus (incidence rate ratio [IRR] 0.17 for 90 days after vs. 90 days before campaigns, 95% CI 0.04–0.78) and the prevalence of virus in environmental samples (prevalence ratio [PR] 0.16, 95% CI 0.02–1.33). Campaigns with tOPV alone resulted in similar reductions (IRR 0.59, 95% CI 0.18–1.97; PR 0.45, 95% CI 0.21–0.95). In Pakistan, the effect of IPV+tOPV campaigns on wild-type poliovirus was not significant. Results suggest that administration of IPV alongside OPV can decrease poliovirus transmission if high vaccine coverage is achieved.

EID Shirreff G, Wadood M, Vaz R, Sutter RW, Grassly NC. Estimated Effect of Inactivated Poliovirus Vaccine Campaigns, Nigeria and Pakistan, January 2014–April 2016. Emerg Infect Dis. 2017;23(2):258-263. https://dx.doi.org/10.3201/eid2302.161210
AMA Shirreff G, Wadood M, Vaz R, et al. Estimated Effect of Inactivated Poliovirus Vaccine Campaigns, Nigeria and Pakistan, January 2014–April 2016. Emerging Infectious Diseases. 2017;23(2):258-263. doi:10.3201/eid2302.161210.
APA Shirreff, G., Wadood, M., Vaz, R., Sutter, R. W., & Grassly, N. C. (2017). Estimated Effect of Inactivated Poliovirus Vaccine Campaigns, Nigeria and Pakistan, January 2014–April 2016. Emerging Infectious Diseases, 23(2), 258-263. https://dx.doi.org/10.3201/eid2302.161210.

Spread and Evolution of Respiratory Syncytial Virus A Genotype ON1, Coastal Kenya, 2010–2015 [PDF - 1.65 MB - 8 pages]
J. R. Otieno et al.

In February 2012, the novel respiratory syncytial virus (RSV) group A, genotype ON1, was detected in Kilifi County, coastal Kenya. ON1 is characterized by a 72-nt duplication within the highly variable G gene (encoding the immunogenic attachment surface protein). Cases were diagnosed through surveillance of pneumonia in children at the county hospital. Analysis of epidemiologic, clinical, and sequence data of RSV-A viruses detected over 5 RSV seasons (2010/2011 to 2014/2015) indicated the following: 1) replacement of previously circulating genotype GA2 by ON1, 2) an abrupt expansion in the number of ON1 variants detected in the 2014/2015 epidemic, 3) recent accumulation of amino acid substitutions within the ON1 duplicated sequence, and 4) no clear evidence of altered pathogenicity relative to GA2. The study demonstrates the public health importance of molecular surveillance in defining the spread, clinical effects, and evolution of novel respiratory virus variants.

EID Otieno JR, Kamau EM, Agoti CN, Lewa C, Otieno G, Bett A, et al. Spread and Evolution of Respiratory Syncytial Virus A Genotype ON1, Coastal Kenya, 2010–2015. Emerg Infect Dis. 2017;23(2):264-271. https://dx.doi.org/10.3201/eid2302.161149
AMA Otieno JR, Kamau EM, Agoti CN, et al. Spread and Evolution of Respiratory Syncytial Virus A Genotype ON1, Coastal Kenya, 2010–2015. Emerging Infectious Diseases. 2017;23(2):264-271. doi:10.3201/eid2302.161149.
APA Otieno, J. R., Kamau, E. M., Agoti, C. N., Lewa, C., Otieno, G., Bett, A....Nokes, D. (2017). Spread and Evolution of Respiratory Syncytial Virus A Genotype ON1, Coastal Kenya, 2010–2015. Emerging Infectious Diseases, 23(2), 264-271. https://dx.doi.org/10.3201/eid2302.161149.
Dispatches

Genetic Diversity and New Lineages of Dengue Virus Serotypes 3 and 4 in Returning Travelers, Germany, 2006–2015 [PDF - 2.03 MB - 4 pages]
S. Shihada et al.

During 2006–2015, we analyzed 70 dengue virus (DENV) strains isolated from febrile travelers returning to Germany. High genetic diversity, including multiple co-circulating DENV lineages and emerging new lineages of DENV-3 and DENV-4, was demonstrated. Our passive surveillance system based on returning travelers yielded substantial information on DENV diversity.

EID Shihada S, Emmerich P, Thomé-Bolduan C, Jansen S, Günther S, Frank C, et al. Genetic Diversity and New Lineages of Dengue Virus Serotypes 3 and 4 in Returning Travelers, Germany, 2006–2015. Emerg Infect Dis. 2017;23(2):272-275. https://dx.doi.org/10.3201/eid2302.160751
AMA Shihada S, Emmerich P, Thomé-Bolduan C, et al. Genetic Diversity and New Lineages of Dengue Virus Serotypes 3 and 4 in Returning Travelers, Germany, 2006–2015. Emerging Infectious Diseases. 2017;23(2):272-275. doi:10.3201/eid2302.160751.
APA Shihada, S., Emmerich, P., Thomé-Bolduan, C., Jansen, S., Günther, S., Frank, C....Cadar, D. (2017). Genetic Diversity and New Lineages of Dengue Virus Serotypes 3 and 4 in Returning Travelers, Germany, 2006–2015. Emerging Infectious Diseases, 23(2), 272-275. https://dx.doi.org/10.3201/eid2302.160751.

Changing Epidemiology of Hepatitis A and Hepatitis E Viruses in China, 1990–2014 [PDF - 1.67 MB - 4 pages]
X. Ren et al.

We compared the epidemiology of hepatitis A and hepatitis E cases in China from 1990–2014 to better inform policy and prevention efforts. The incidence of hepatitis A cases declined dramatically, while hepatitis E incidence increased. During 2004–2014, hepatitis E mortality rates surpassed those of hepatitis A.

EID Ren X, Wu P, Wang L, Geng M, Zeng L, Zhang J, et al. Changing Epidemiology of Hepatitis A and Hepatitis E Viruses in China, 1990–2014. Emerg Infect Dis. 2017;23(2):276-279. https://dx.doi.org/10.3201/eid2302.161095
AMA Ren X, Wu P, Wang L, et al. Changing Epidemiology of Hepatitis A and Hepatitis E Viruses in China, 1990–2014. Emerging Infectious Diseases. 2017;23(2):276-279. doi:10.3201/eid2302.161095.
APA Ren, X., Wu, P., Wang, L., Geng, M., Zeng, L., Zhang, J....Wei, S. (2017). Changing Epidemiology of Hepatitis A and Hepatitis E Viruses in China, 1990–2014. Emerging Infectious Diseases, 23(2), 276-279. https://dx.doi.org/10.3201/eid2302.161095.

Fatal Infection with Murray Valley Encephalitis Virus Imported from Australia to Canada, 2011 [PDF - 2.77 MB - 4 pages]
D. J. Niven et al.

Murray Valley encephalitis virus (MVEV), a flavivirus belonging to the Japanese encephalitis serogroup, can cause severe clinical manifestations in humans. We report a fatal case of MVEV infection in a young woman who returned from Australia to Canada. The differential diagnosis for travel-associated encephalitis should include MVEV, particularly during outbreak years.

EID Niven DJ, Afra K, Iftinca M, Tellier R, Fonseca K, Kramer A, et al. Fatal Infection with Murray Valley Encephalitis Virus Imported from Australia to Canada, 2011. Emerg Infect Dis. 2017;23(2):280-283. https://dx.doi.org/10.3201/eid2302.161161
AMA Niven DJ, Afra K, Iftinca M, et al. Fatal Infection with Murray Valley Encephalitis Virus Imported from Australia to Canada, 2011. Emerging Infectious Diseases. 2017;23(2):280-283. doi:10.3201/eid2302.161161.
APA Niven, D. J., Afra, K., Iftinca, M., Tellier, R., Fonseca, K., Kramer, A....Johnson, A. S. (2017). Fatal Infection with Murray Valley Encephalitis Virus Imported from Australia to Canada, 2011. Emerging Infectious Diseases, 23(2), 280-283. https://dx.doi.org/10.3201/eid2302.161161.

Oral Transmission of L-Type Bovine Spongiform Encephalopathy Agent among Cattle [PDF - 1.96 MB - 4 pages]
H. Okada et al.

To determine oral transmissibility of the L-type bovine spongiform encephalopathy (BSE) prion, we orally inoculated 16 calves with brain homogenates of the agent. Only 1 animal, given a high dose, showed signs and died at 88 months. These results suggest low risk for oral transmission of the L-BSE agent among cattle.

EID Okada H, Iwamaru Y, Imamura M, Miyazawa K, Matsuura Y, Masujin K, et al. Oral Transmission of L-Type Bovine Spongiform Encephalopathy Agent among Cattle. Emerg Infect Dis. 2017;23(2):284-287. https://dx.doi.org/10.3201/eid2302.161416
AMA Okada H, Iwamaru Y, Imamura M, et al. Oral Transmission of L-Type Bovine Spongiform Encephalopathy Agent among Cattle. Emerging Infectious Diseases. 2017;23(2):284-287. doi:10.3201/eid2302.161416.
APA Okada, H., Iwamaru, Y., Imamura, M., Miyazawa, K., Matsuura, Y., Masujin, K....Yokoyama, T. (2017). Oral Transmission of L-Type Bovine Spongiform Encephalopathy Agent among Cattle. Emerging Infectious Diseases, 23(2), 284-287. https://dx.doi.org/10.3201/eid2302.161416.

Persistent Infections with Diverse Co-Circulating Astroviruses in Pediatric Oncology Patients, Memphis, Tennessee, USA [PDF - 553 KB - 3 pages]
V. Cortez et al.

Human astroviruses are a major cause of pediatric gastroenteritis, especially in immunocompromised children. We conducted a retrospective study to demonstrate that diverse astrovirus genotypes can co-circulate in pediatric oncology patients. A subset of cases is associated with long-term virus shedding (range 17–183 days).

EID Cortez V, Freiden P, Gu Z, Adderson E, Hayden R, Schultz-Cherry S. Persistent Infections with Diverse Co-Circulating Astroviruses in Pediatric Oncology Patients, Memphis, Tennessee, USA. Emerg Infect Dis. 2017;23(2):288-290. https://dx.doi.org/10.3201/eid2302.161436
AMA Cortez V, Freiden P, Gu Z, et al. Persistent Infections with Diverse Co-Circulating Astroviruses in Pediatric Oncology Patients, Memphis, Tennessee, USA. Emerging Infectious Diseases. 2017;23(2):288-290. doi:10.3201/eid2302.161436.
APA Cortez, V., Freiden, P., Gu, Z., Adderson, E., Hayden, R., & Schultz-Cherry, S. (2017). Persistent Infections with Diverse Co-Circulating Astroviruses in Pediatric Oncology Patients, Memphis, Tennessee, USA. Emerging Infectious Diseases, 23(2), 288-290. https://dx.doi.org/10.3201/eid2302.161436.

mcr-1−Harboring Salmonella enterica Serovar Typhimurium Sequence Type 34 in Pigs, China [PDF - 1.83 MB - 5 pages]
L. Yi et al.

We detected the mcr-1 gene in 21 (14.8%) Salmonella isolates from pigs at slaughter; 19 were serovar Typhimurium sequence type 34. The gene was located on IncHI2-like plasmids that also harbored IncF replicons and lacked a conjugative transfer region. These findings highlight the need to prevent further spread of colistin resistance in animals and humans.

EID Yi L, Wang J, Gao Y, Liu Y, Doi Y, Wu R, et al. mcr-1−Harboring Salmonella enterica Serovar Typhimurium Sequence Type 34 in Pigs, China. Emerg Infect Dis. 2017;23(2):291-295. https://dx.doi.org/10.3201/eid2302.161543
AMA Yi L, Wang J, Gao Y, et al. mcr-1−Harboring Salmonella enterica Serovar Typhimurium Sequence Type 34 in Pigs, China. Emerging Infectious Diseases. 2017;23(2):291-295. doi:10.3201/eid2302.161543.
APA Yi, L., Wang, J., Gao, Y., Liu, Y., Doi, Y., Wu, R....Liu, J. (2017). mcr-1−Harboring Salmonella enterica Serovar Typhimurium Sequence Type 34 in Pigs, China. Emerging Infectious Diseases, 23(2), 291-295. https://dx.doi.org/10.3201/eid2302.161543.

Low Circulation of Zika Virus, Cambodia, 2007–2016 [PDF - 1.34 MB - 4 pages]
V. Duong et al.

We describe a retrospective study on circulation of Zika virus in Cambodia during 2007–2016 among patients with dengue-like symptoms and Aedes aegypti mosquitoes. Our findings suggest that Zika virus in Cambodia belongs to the Asia genotype, is endemic, has low prevalence, and has had low-level impact on public health.

EID Duong V, Ong S, Leang R, Huy R, Ly S, Mounier U, et al. Low Circulation of Zika Virus, Cambodia, 2007–2016. Emerg Infect Dis. 2017;23(2):296-299. https://dx.doi.org/10.3201/eid2302.161432
AMA Duong V, Ong S, Leang R, et al. Low Circulation of Zika Virus, Cambodia, 2007–2016. Emerging Infectious Diseases. 2017;23(2):296-299. doi:10.3201/eid2302.161432.
APA Duong, V., Ong, S., Leang, R., Huy, R., Ly, S., Mounier, U....Dussart, P. (2017). Low Circulation of Zika Virus, Cambodia, 2007–2016. Emerging Infectious Diseases, 23(2), 296-299. https://dx.doi.org/10.3201/eid2302.161432.

Seroprevalence and Transmission of Human Influenza A(H5N1) Virus before and after Virus Reassortment, Cambodia, 2006–2014 [PDF - 2.47 MB - 4 pages]
S. Ly et al.

Thirty-five human influenza A(H5N1) cases were reported in Cambodia during 2013–2014 after emergence of a clade 1.1.2 reassortant virus. We tested 881 villagers and found 2 cases of pauci- or asymptomatic infection. Seroprevalence after emergence of the reassortant strain (0.2%) was lower than the aggregate seroprevalence of 1.3% reported in earlier studies.

EID Ly S, Horwood PF, Chan M, Rith S, Sorn S, Oeung K, et al. Seroprevalence and Transmission of Human Influenza A(H5N1) Virus before and after Virus Reassortment, Cambodia, 2006–2014. Emerg Infect Dis. 2017;23(2):300-303. https://dx.doi.org/10.3201/eid2302.161232
AMA Ly S, Horwood PF, Chan M, et al. Seroprevalence and Transmission of Human Influenza A(H5N1) Virus before and after Virus Reassortment, Cambodia, 2006–2014. Emerging Infectious Diseases. 2017;23(2):300-303. doi:10.3201/eid2302.161232.
APA Ly, S., Horwood, P. F., Chan, M., Rith, S., Sorn, S., Oeung, K....Tarantola, A. (2017). Seroprevalence and Transmission of Human Influenza A(H5N1) Virus before and after Virus Reassortment, Cambodia, 2006–2014. Emerging Infectious Diseases, 23(2), 300-303. https://dx.doi.org/10.3201/eid2302.161232.

Nosocomial Infections with IMP-19−Producing Pseudomonas aeruginosa Linked to Contaminated Sinks, France [PDF - 672 KB - 4 pages]
L. Amoureux et al.

We isolated IMP-19–producing Pseudomonas aeruginosa from 7 patients with nosocomial infections linked to contaminated sinks in France. We showed that blaIMP-19 was located on various class 1 integrons among 8 species of gram-negative bacilli detected in sinks: P. aeruginosa, Achromobacter xylosoxidans, A. aegrifaciens, P. putida, Stenotrophomonas maltophilia, P. mendocina, Comamonas testosteroni, and Sphingomonas sp.

EID Amoureux L, Riedweg K, Chapuis A, Bador J, Siebor E, Péchinot A, et al. Nosocomial Infections with IMP-19−Producing Pseudomonas aeruginosa Linked to Contaminated Sinks, France. Emerg Infect Dis. 2017;23(2):304-307. https://dx.doi.org/10.3201/eid2302.160649
AMA Amoureux L, Riedweg K, Chapuis A, et al. Nosocomial Infections with IMP-19−Producing Pseudomonas aeruginosa Linked to Contaminated Sinks, France. Emerging Infectious Diseases. 2017;23(2):304-307. doi:10.3201/eid2302.160649.
APA Amoureux, L., Riedweg, K., Chapuis, A., Bador, J., Siebor, E., Péchinot, A....Neuwirth, C. (2017). Nosocomial Infections with IMP-19−Producing Pseudomonas aeruginosa Linked to Contaminated Sinks, France. Emerging Infectious Diseases, 23(2), 304-307. https://dx.doi.org/10.3201/eid2302.160649.

Medscape CME Activity
Risk Factors for Disseminated Coccidioidomycosis, United States [PDF - 464 KB - 4 pages]
C. D. Odio et al.

Of 150,000 new coccidioidomycosis infections that occur annually in the United States, ≈1% disseminate; one third of those cases are fatal. Immunocompromised hosts have higher rates of dissemination. We identified 8 patients with disseminated coccidioidomycosis who had defects in the interleukin-12/interferon-γ and STAT3 axes, indicating that these are critical host defense pathways.

EID Odio CD, Marciano BE, Galgiani JN, Holland SM. Risk Factors for Disseminated Coccidioidomycosis, United States. Emerg Infect Dis. 2017;23(2):311. https://dx.doi.org/10.3201/eid2302.160505
AMA Odio CD, Marciano BE, Galgiani JN, et al. Risk Factors for Disseminated Coccidioidomycosis, United States. Emerging Infectious Diseases. 2017;23(2):311. doi:10.3201/eid2302.160505.
APA Odio, C. D., Marciano, B. E., Galgiani, J. N., & Holland, S. M. (2017). Risk Factors for Disseminated Coccidioidomycosis, United States. Emerging Infectious Diseases, 23(2), 311. https://dx.doi.org/10.3201/eid2302.160505.

Incidence of Norovirus-Associated Diarrhea, Shanghai, China, 2012–2013 [PDF - 995 KB - 4 pages]
J. Yu et al.

We conducted sentinel-based surveillance for norovirus in the Pudong area of Shanghai, China, during 2012–2013, by analyzing 5,324 community surveys, 408,024 medical records, and 771 laboratory-confirmed norovirus infections among 3,877 diarrhea cases. Our analysis indicated an outpatient incidence of 1.5/100 person-years and a community incidence of 8.9/100 person-years for norovirus-associated diarrhea.

EID Yu J, Ye C, Lai S, Zhu W, Zhang Z, Geng Q, et al. Incidence of Norovirus-Associated Diarrhea, Shanghai, China, 2012–2013. Emerg Infect Dis. 2017;23(2):312-315. https://dx.doi.org/10.3201/eid2302.161153
AMA Yu J, Ye C, Lai S, et al. Incidence of Norovirus-Associated Diarrhea, Shanghai, China, 2012–2013. Emerging Infectious Diseases. 2017;23(2):312-315. doi:10.3201/eid2302.161153.
APA Yu, J., Ye, C., Lai, S., Zhu, W., Zhang, Z., Geng, Q....Li, Z. (2017). Incidence of Norovirus-Associated Diarrhea, Shanghai, China, 2012–2013. Emerging Infectious Diseases, 23(2), 312-315. https://dx.doi.org/10.3201/eid2302.161153.

Norovirus GII.17 Natural Infections in Rhesus Monkeys, China [PDF - 1.26 MB - 4 pages]
Z. He et al.

Noroviruses are a leading viral cause of acute gastroenteritis among humans. During the 2014–15 epidemic season, norovirus GII.17 was detected in rhesus monkeys in China. Genetic, structural, and challenge studies revealed virus mutations and verified the infections. Thus, cross-species transmission may occur, and monkeys may be a virus reservoir.

EID He Z, Liu B, Tao Y, Li C, Xia M, Zhong W, et al. Norovirus GII.17 Natural Infections in Rhesus Monkeys, China. Emerg Infect Dis. 2017;23(2):316-319. https://dx.doi.org/10.3201/eid2302.161077
AMA He Z, Liu B, Tao Y, et al. Norovirus GII.17 Natural Infections in Rhesus Monkeys, China. Emerging Infectious Diseases. 2017;23(2):316-319. doi:10.3201/eid2302.161077.
APA He, Z., Liu, B., Tao, Y., Li, C., Xia, M., Zhong, W....Tan, M. (2017). Norovirus GII.17 Natural Infections in Rhesus Monkeys, China. Emerging Infectious Diseases, 23(2), 316-319. https://dx.doi.org/10.3201/eid2302.161077.

Determination of Elizabethkingia Diversity by MALDI-TOF Mass Spectrometry and Whole-Genome Sequencing [PDF - 922 KB - 4 pages]
H. Eriksen et al.

In a hospital-acquired infection with multidrug-resistant Elizabethkingia, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA gene analysis identified the pathogen as Elizabethkingia miricola. Whole-genome sequencing, genus-level core genome analysis, and in silico DNA-DNA hybridization of 35 Elizabethkingia strains indicated that the species taxonomy should be further explored.

EID Eriksen H, Gumpert H, Faurholt C, Westh H. Determination of Elizabethkingia Diversity by MALDI-TOF Mass Spectrometry and Whole-Genome Sequencing. Emerg Infect Dis. 2017;23(2):320-323. https://dx.doi.org/10.3201/eid2302.161321
AMA Eriksen H, Gumpert H, Faurholt C, et al. Determination of Elizabethkingia Diversity by MALDI-TOF Mass Spectrometry and Whole-Genome Sequencing. Emerging Infectious Diseases. 2017;23(2):320-323. doi:10.3201/eid2302.161321.
APA Eriksen, H., Gumpert, H., Faurholt, C., & Westh, H. (2017). Determination of Elizabethkingia Diversity by MALDI-TOF Mass Spectrometry and Whole-Genome Sequencing. Emerging Infectious Diseases, 23(2), 320-323. https://dx.doi.org/10.3201/eid2302.161321.

Characteristics of US Travelers to Zika Virus–Affected Countries in the Americas, March 2015–October 2016 [PDF - 777 KB - 4 pages]
S. Lammert et al.

Zika virus has recently been introduced to the Americas and is spreading rapidly. We evaluated the characteristics of US travelers to Zika virus–affected countries who were seen at Global TravEpiNet sites during March 2015–October 2016. Nearly three quarters of travelers were men or women of reproductive age.

EID Lammert S, Walker A, Erskine S, Rao SR, Esposito DH, Ryan ET, et al. Characteristics of US Travelers to Zika Virus–Affected Countries in the Americas, March 2015–October 2016. Emerg Infect Dis. 2017;23(2):324-327. https://dx.doi.org/10.3201/eid2302.161292
AMA Lammert S, Walker A, Erskine S, et al. Characteristics of US Travelers to Zika Virus–Affected Countries in the Americas, March 2015–October 2016. Emerging Infectious Diseases. 2017;23(2):324-327. doi:10.3201/eid2302.161292.
APA Lammert, S., Walker, A., Erskine, S., Rao, S. R., Esposito, D. H., Ryan, E. T....LaRocque, R. C. (2017). Characteristics of US Travelers to Zika Virus–Affected Countries in the Americas, March 2015–October 2016. Emerging Infectious Diseases, 23(2), 324-327. https://dx.doi.org/10.3201/eid2302.161292.

Biofilm-Forming Capability of Highly Virulent, Multidrug-Resistant Candida auris [PDF - 1.03 MB - 4 pages]
L. Sherry et al.

The emerging multidrug-resistant yeast pathogen Candida auris has attracted considerable attention as a source of healthcare–associated infections. We report that this highly virulent yeast has the capacity to form antifungal resistant biofilms sensitive to the disinfectant chlorhexidine in vitro.

EID Sherry L, Ramage G, Kean R, Borman A, Johnson EM, Richardson MD, et al. Biofilm-Forming Capability of Highly Virulent, Multidrug-Resistant Candida auris. Emerg Infect Dis. 2017;23(2):328-331. https://dx.doi.org/10.3201/eid2302.161320
AMA Sherry L, Ramage G, Kean R, et al. Biofilm-Forming Capability of Highly Virulent, Multidrug-Resistant Candida auris. Emerging Infectious Diseases. 2017;23(2):328-331. doi:10.3201/eid2302.161320.
APA Sherry, L., Ramage, G., Kean, R., Borman, A., Johnson, E. M., Richardson, M. D....Rautemaa-Richardson, R. (2017). Biofilm-Forming Capability of Highly Virulent, Multidrug-Resistant Candida auris. Emerging Infectious Diseases, 23(2), 328-331. https://dx.doi.org/10.3201/eid2302.161320.

Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA [PDF - 450 KB - 4 pages]
K. Murray et al.

Approximately 20% of Shigella isolates tested in New York City, New York, USA, during 2013–2015 displayed decreased azithromycin susceptibility. Case-patients were older and more frequently male and HIV infected than those with azithromycin-susceptible Shigella infection; 90% identified as men who have sex with men. Clinical interpretation guidelines for azithromycin resistance and outcome studies are needed.

EID Murray K, Reddy V, Kornblum J, Waechter H, Chicaiza LF, Rubinstein I, et al. Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA. Emerg Infect Dis. 2017;23(2):332-335. https://dx.doi.org/10.3201/eid2302.161203
AMA Murray K, Reddy V, Kornblum J, et al. Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA. Emerging Infectious Diseases. 2017;23(2):332-335. doi:10.3201/eid2302.161203.
APA Murray, K., Reddy, V., Kornblum, J., Waechter, H., Chicaiza, L. F., Rubinstein, I....Dentinger, C. M. (2017). Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA. Emerging Infectious Diseases, 23(2), 332-335. https://dx.doi.org/10.3201/eid2302.161203.

Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015–2016 [PDF - 649 KB - 4 pages]
E. Toh et al.

At a clinic in Indianapolis, Indiana, USA, we observed an increase in Neisseria gonorrhoeae–negative men with suspected gonococcal urethritis who had urethral cultures positive for N. meningitidis. We describe genomes of 2 of these N. meningitidis sequence type 11 complex urethritis isolates. Clinical evidence suggests these isolates may represent an emerging urethrotropic clade.

EID Toh E, Gangaiah D, Batteiger BE, Williams JA, Arno JN, Tai A, et al. Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015–2016. Emerg Infect Dis. 2017;23(2):336-339. https://dx.doi.org/10.3201/eid2302.161434
AMA Toh E, Gangaiah D, Batteiger BE, et al. Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015–2016. Emerging Infectious Diseases. 2017;23(2):336-339. doi:10.3201/eid2302.161434.
APA Toh, E., Gangaiah, D., Batteiger, B. E., Williams, J. A., Arno, J. N., Tai, A....Nelson, D. E. (2017). Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015–2016. Emerging Infectious Diseases, 23(2), 336-339. https://dx.doi.org/10.3201/eid2302.161434.
Commentaries

H5Nx Panzootic Bird Flu—Influenza’s Newest Worldwide Evolutionary Tour [PDF - 955 KB - 3 pages]
J. K. Taubenberger and D. M. Morens
EID Taubenberger JK, Morens DM. H5Nx Panzootic Bird Flu—Influenza’s Newest Worldwide Evolutionary Tour. Emerg Infect Dis. 2017;23(2):340-342. https://dx.doi.org/10.3201/eid2302.161963
AMA Taubenberger JK, Morens DM. H5Nx Panzootic Bird Flu—Influenza’s Newest Worldwide Evolutionary Tour. Emerging Infectious Diseases. 2017;23(2):340-342. doi:10.3201/eid2302.161963.
APA Taubenberger, J. K., & Morens, D. M. (2017). H5Nx Panzootic Bird Flu—Influenza’s Newest Worldwide Evolutionary Tour. Emerging Infectious Diseases, 23(2), 340-342. https://dx.doi.org/10.3201/eid2302.161963.
Research Letters

Diffuse Unilateral Subacute Neuroretinitis Caused by Ancylostoma Hookworm [PDF - 469 KB - 2 pages]
S. Poppert et al.

Diffuse unilateral subacute neuroretinitis is an ocular infectious disease caused by several distinct nematodes. Definite identification of the involved nematodes is rarely achieved. We report on the molecular-based genetic identification of an Ancylostoma ceylanicum hookworm implicated in a case of diffuse unilateral subacute neuroretinitis in a child.

EID Poppert S, Heideking M, Agostini H, Fritzenwanker M, Wüppenhorst N, Muntau B, et al. Diffuse Unilateral Subacute Neuroretinitis Caused by Ancylostoma Hookworm. Emerg Infect Dis. 2017;23(2):343-344. https://dx.doi.org/10.3201/eid2302.142064
AMA Poppert S, Heideking M, Agostini H, et al. Diffuse Unilateral Subacute Neuroretinitis Caused by Ancylostoma Hookworm. Emerging Infectious Diseases. 2017;23(2):343-344. doi:10.3201/eid2302.142064.
APA Poppert, S., Heideking, M., Agostini, H., Fritzenwanker, M., Wüppenhorst, N., Muntau, B....Hufnagel, M. (2017). Diffuse Unilateral Subacute Neuroretinitis Caused by Ancylostoma Hookworm. Emerging Infectious Diseases, 23(2), 343-344. https://dx.doi.org/10.3201/eid2302.142064.

Azithromycin-Nonsusceptible Shigella flexneri 3a in Men Who Have Sex with Men, Taiwan, 2015–2016 [PDF - 308 KB - 2 pages]
Y. Liao et al.

We report an outbreak of azithromycin-nonsusceptible Shigella flexneri 3a infection in Taiwan associated with men who have sex with men. The bacterial strains belonged to the sublineage A of a recently reported outbreak lineage associated with men who have sex with men, characterized by reduced azithromycin susceptibility and circulation in shigellosis low-risk regions.

EID Liao Y, Liu Y, Lo Y, Chiou C. Azithromycin-Nonsusceptible Shigella flexneri 3a in Men Who Have Sex with Men, Taiwan, 2015–2016. Emerg Infect Dis. 2017;23(2):345-346. https://dx.doi.org/10.3201/eid2302.161260
AMA Liao Y, Liu Y, Lo Y, et al. Azithromycin-Nonsusceptible Shigella flexneri 3a in Men Who Have Sex with Men, Taiwan, 2015–2016. Emerging Infectious Diseases. 2017;23(2):345-346. doi:10.3201/eid2302.161260.
APA Liao, Y., Liu, Y., Lo, Y., & Chiou, C. (2017). Azithromycin-Nonsusceptible Shigella flexneri 3a in Men Who Have Sex with Men, Taiwan, 2015–2016. Emerging Infectious Diseases, 23(2), 345-346. https://dx.doi.org/10.3201/eid2302.161260.

Fatal Emmonsia sp. Infection and Fungemia after Orthotopic Liver Transplantation [PDF - 810 KB - 4 pages]
S. Kappagoda et al.

We report a fatal case of disseminated Emmonsia sp. infection in a 55-year-old man who received an orthotopic liver transplant. The patient had pneumonia and fungemia, and multisystem organ failure developed. As human habitats and the number of immunocompromised patients increase, physicians must be aware of this emerging fungal infection.

EID Kappagoda S, Adams JY, Luo R, Banaei N, Concepcion W, Ho DY. Fatal Emmonsia sp. Infection and Fungemia after Orthotopic Liver Transplantation. Emerg Infect Dis. 2017;23(2):346-349. https://dx.doi.org/10.3201/eid2302.160799
AMA Kappagoda S, Adams JY, Luo R, et al. Fatal Emmonsia sp. Infection and Fungemia after Orthotopic Liver Transplantation. Emerging Infectious Diseases. 2017;23(2):346-349. doi:10.3201/eid2302.160799.
APA Kappagoda, S., Adams, J. Y., Luo, R., Banaei, N., Concepcion, W., & Ho, D. Y. (2017). Fatal Emmonsia sp. Infection and Fungemia after Orthotopic Liver Transplantation. Emerging Infectious Diseases, 23(2), 346-349. https://dx.doi.org/10.3201/eid2302.160799.

Outbreak of Legionnaire’s Disease Caused by Legionella pneumophila Serogroups 1 and 13 [PDF - 350 KB - 3 pages]
T. Kuroki et al.

In Japan, hot springs and public baths are the major sources of legionellosis. In 2015, an outbreak of Legionnaires’ disease occurred among 7 patients who had visited a spa house. Laboratory investigation indicated that L. pneumophila serogroup 1 and 13 strains caused the outbreak and that these strains were genetically related.

EID Kuroki T, Amemura-Maekawa J, Ohya H, Furukawa I, Suzuki M, Masaoka T, et al. Outbreak of Legionnaire’s Disease Caused by Legionella pneumophila Serogroups 1 and 13. Emerg Infect Dis. 2017;23(2):349-351. https://dx.doi.org/10.3201/eid2302.161012
AMA Kuroki T, Amemura-Maekawa J, Ohya H, et al. Outbreak of Legionnaire’s Disease Caused by Legionella pneumophila Serogroups 1 and 13. Emerging Infectious Diseases. 2017;23(2):349-351. doi:10.3201/eid2302.161012.
APA Kuroki, T., Amemura-Maekawa, J., Ohya, H., Furukawa, I., Suzuki, M., Masaoka, T....Kura, F. (2017). Outbreak of Legionnaire’s Disease Caused by Legionella pneumophila Serogroups 1 and 13. Emerging Infectious Diseases, 23(2), 349-351. https://dx.doi.org/10.3201/eid2302.161012.

Diphyllobothrium nihonkaiense Tapeworm Larvae in Salmon from North America [PDF - 771 KB - 3 pages]
R. Kuchta et al.

Diphyllobothriosis is reemerging because of global importation and increased popularity of eating raw fish. We detected Diphyllobothrium nihonkaiense plerocercoids in the musculature of wild pink salmon (Oncorhynchus gorbuscha) from Alaska, USA. Therefore, salmon from the American and Asian Pacific coasts and elsewhere pose potential dangers for persons who eat these fish raw.

EID Kuchta R, Oros M, Ferguson J, Scholz T. Diphyllobothrium nihonkaiense Tapeworm Larvae in Salmon from North America. Emerg Infect Dis. 2017;23(2):351-353. https://dx.doi.org/10.3201/eid2302.161026
AMA Kuchta R, Oros M, Ferguson J, et al. Diphyllobothrium nihonkaiense Tapeworm Larvae in Salmon from North America. Emerging Infectious Diseases. 2017;23(2):351-353. doi:10.3201/eid2302.161026.
APA Kuchta, R., Oros, M., Ferguson, J., & Scholz, T. (2017). Diphyllobothrium nihonkaiense Tapeworm Larvae in Salmon from North America. Emerging Infectious Diseases, 23(2), 351-353. https://dx.doi.org/10.3201/eid2302.161026.

Hepatitis E Virus Infection in Solid Organ Transplant Recipients, France [PDF - 710 KB - 4 pages]
S. Lhomme et al.

The rate of transfusion-transmitted hepatitis E virus (HEV) in transplant recipients is unknown. We identified 60 HEV-positive solid organ transplant patients and retrospectively assessed their blood transfusions for HEV. Seven of 60 patients received transfusions; 3 received HEV-positive blood products. Transfusion is not the major route of infection in this population.

EID Lhomme S, Bardiaux L, Abravanel F, Gallian P, Kamar N, Izopet J. Hepatitis E Virus Infection in Solid Organ Transplant Recipients, France. Emerg Infect Dis. 2017;23(2):353-356. https://dx.doi.org/10.3201/eid2302.161094
AMA Lhomme S, Bardiaux L, Abravanel F, et al. Hepatitis E Virus Infection in Solid Organ Transplant Recipients, France. Emerging Infectious Diseases. 2017;23(2):353-356. doi:10.3201/eid2302.161094.
APA Lhomme, S., Bardiaux, L., Abravanel, F., Gallian, P., Kamar, N., & Izopet, J. (2017). Hepatitis E Virus Infection in Solid Organ Transplant Recipients, France. Emerging Infectious Diseases, 23(2), 353-356. https://dx.doi.org/10.3201/eid2302.161094.

Emergence of blaNDM-7–Producing Enterobacteriaceae in Gabon, 2016 [PDF - 363 KB - 3 pages]
M. Moussounda et al.

Reports of carbapenemase-producing Enterobacteriaceae in Africa remain rare and assess mostly blaOXA-48–producing isolates from Mediterranean countries and South Africa. We identified blaNDM-7–producing Enterobacteriaceae in Gabon in 2016. The isolates contained blaNDM-7 IncX3 plasmids that were unusual and similar to the one described in a colistin-resistant Klebsiella pneumoniae SZ04 isolate from China.

EID Moussounda M, Diene SM, Dos Santos S, Goudeau A, François P, van der Mee-Marquet N. Emergence of blaNDM-7–Producing Enterobacteriaceae in Gabon, 2016. Emerg Infect Dis. 2017;23(2):356-358. https://dx.doi.org/10.3201/eid2302.161182
AMA Moussounda M, Diene SM, Dos Santos S, et al. Emergence of blaNDM-7–Producing Enterobacteriaceae in Gabon, 2016. Emerging Infectious Diseases. 2017;23(2):356-358. doi:10.3201/eid2302.161182.
APA Moussounda, M., Diene, S. M., Dos Santos, S., Goudeau, A., François, P., & van der Mee-Marquet, N. (2017). Emergence of blaNDM-7–Producing Enterobacteriaceae in Gabon, 2016. Emerging Infectious Diseases, 23(2), 356-358. https://dx.doi.org/10.3201/eid2302.161182.

Novel Reassortant Clade 2.3.4.4 Avian Influenza A(H5N8) Virus in Wild Aquatic Birds, Russia, 2016 [PDF - 272 KB - 2 pages]
D. Lee et al.

The emergence of novel avian influenza viruses in migratory birds is of concern because of the potential for virus dissemination during fall migration. We report the identification of novel highly pathogenic avian influenza viruses of subtype H5N8, clade 2.3.4.4, and their reassortment with other avian influenza viruses in waterfowl and shorebirds of Siberia.

EID Lee D, Sharshov K, Swayne DE, Kurskaya O, Sobolev I, Kabilov M, et al. Novel Reassortant Clade 2.3.4.4 Avian Influenza A(H5N8) Virus in Wild Aquatic Birds, Russia, 2016. Emerg Infect Dis. 2017;23(2):359-360. https://dx.doi.org/10.3201/eid2302.161252
AMA Lee D, Sharshov K, Swayne DE, et al. Novel Reassortant Clade 2.3.4.4 Avian Influenza A(H5N8) Virus in Wild Aquatic Birds, Russia, 2016. Emerging Infectious Diseases. 2017;23(2):359-360. doi:10.3201/eid2302.161252.
APA Lee, D., Sharshov, K., Swayne, D. E., Kurskaya, O., Sobolev, I., Kabilov, M....Shestopalov, A. (2017). Novel Reassortant Clade 2.3.4.4 Avian Influenza A(H5N8) Virus in Wild Aquatic Birds, Russia, 2016. Emerging Infectious Diseases, 23(2), 359-360. https://dx.doi.org/10.3201/eid2302.161252.

Detection of Vaccinia Virus in Urban Domestic Cats, Brazil [PDF - 445 KB - 3 pages]
G. Costa et al.

We investigated possible vaccinia virus (VACV) in urban house cats in Brazil. Serum samples from 6 cats were positive for VACV by PCR, indicating likely VACV circulation among house cats in urban areas of Brazil. This finding highlights the importance of epidemiologic surveillance to avoid outbreaks among urban human populations.

EID Costa G, Miranda J, Almeida G, Silva de Oliveira J, Pinheiro M, Gonçalves S, et al. Detection of Vaccinia Virus in Urban Domestic Cats, Brazil. Emerg Infect Dis. 2017;23(2):360-362. https://dx.doi.org/10.3201/eid2302.161341
AMA Costa G, Miranda J, Almeida G, et al. Detection of Vaccinia Virus in Urban Domestic Cats, Brazil. Emerging Infectious Diseases. 2017;23(2):360-362. doi:10.3201/eid2302.161341.
APA Costa, G., Miranda, J., Almeida, G., Silva de Oliveira, J., Pinheiro, M., Gonçalves, S....Trindade, G. (2017). Detection of Vaccinia Virus in Urban Domestic Cats, Brazil. Emerging Infectious Diseases, 23(2), 360-362. https://dx.doi.org/10.3201/eid2302.161341.

Reoccurrence of Avian Influenza A(H5N2) Virus Clade 2.3.4.4 in Wild Birds, Alaska, USA, 2016 [PDF - 583 KB - 3 pages]
D. Lee et al.

We report reoccurrence of highly pathogenic avian influenza A(H5N2) virus clade 2.3.4.4 in a wild mallard in Alaska, USA, in August 2016. Identification of this virus in a migratory species confirms low-frequency persistence in North America and the potential for re-dissemination of the virus during the 2016 fall migration.

EID Lee D, Torchetti MK, Killian M, DeLiberto TJ, Swayne DE. Reoccurrence of Avian Influenza A(H5N2) Virus Clade 2.3.4.4 in Wild Birds, Alaska, USA, 2016. Emerg Infect Dis. 2017;23(2):365-367. https://dx.doi.org/10.3201/eid2302.161616
AMA Lee D, Torchetti MK, Killian M, et al. Reoccurrence of Avian Influenza A(H5N2) Virus Clade 2.3.4.4 in Wild Birds, Alaska, USA, 2016. Emerging Infectious Diseases. 2017;23(2):365-367. doi:10.3201/eid2302.161616.
APA Lee, D., Torchetti, M. K., Killian, M., DeLiberto, T. J., & Swayne, D. E. (2017). Reoccurrence of Avian Influenza A(H5N2) Virus Clade 2.3.4.4 in Wild Birds, Alaska, USA, 2016. Emerging Infectious Diseases, 23(2), 365-367. https://dx.doi.org/10.3201/eid2302.161616.

Increase in Urgent Care Center Visits for Sexually Transmitted Infections, United States, 2010–2014 [PDF - 265 KB - 3 pages]
W. S. Pearson et al.

During 2010–2014, urgent care centers saw a ≈2-fold increase in the number of visits for chlamydia and gonorrhea testing and a >3-fold increase in visits by persons with diagnosed sexually transmitted infections. As urgent care becomes more popular, vigilance is required to ensure proper management of these diseases.

EID Pearson WS, Tao G, Kroeger K, Peterman TA. Increase in Urgent Care Center Visits for Sexually Transmitted Infections, United States, 2010–2014. Emerg Infect Dis. 2017;23(2):367-369. https://dx.doi.org/10.3201/eid2302.161707
AMA Pearson WS, Tao G, Kroeger K, et al. Increase in Urgent Care Center Visits for Sexually Transmitted Infections, United States, 2010–2014. Emerging Infectious Diseases. 2017;23(2):367-369. doi:10.3201/eid2302.161707.
APA Pearson, W. S., Tao, G., Kroeger, K., & Peterman, T. A. (2017). Increase in Urgent Care Center Visits for Sexually Transmitted Infections, United States, 2010–2014. Emerging Infectious Diseases, 23(2), 367-369. https://dx.doi.org/10.3201/eid2302.161707.
Letters

Cutavirus in Cutaneous Malignant Melanoma [PDF - 376 KB - 3 pages]
S. Mollerup et al.

A novel human protoparvovirus related to human bufavirus and preliminarily named cutavirus has been discovered. We detected cutavirus in a sample of cutaneous malignant melanoma by using viral enrichment and high-throughput sequencing. The role of cutaviruses in cutaneous cancers remains to be investigated.

EID Mollerup S, Fridholm H, Vinner L, Kjartansdóttir K, Friis-Nielsen J, Asplund M, et al. Cutavirus in Cutaneous Malignant Melanoma. Emerg Infect Dis. 2017;23(2):363-365. https://dx.doi.org/10.3201/eid2302.161564
AMA Mollerup S, Fridholm H, Vinner L, et al. Cutavirus in Cutaneous Malignant Melanoma. Emerging Infectious Diseases. 2017;23(2):363-365. doi:10.3201/eid2302.161564.
APA Mollerup, S., Fridholm, H., Vinner, L., Kjartansdóttir, K., Friis-Nielsen, J., Asplund, M....Nielsen, L. P. (2017). Cutavirus in Cutaneous Malignant Melanoma. Emerging Infectious Diseases, 23(2), 363-365. https://dx.doi.org/10.3201/eid2302.161564.

Cerebrospinal Fluid Findings in an Adult with Human Metapneumovirus–Associated Encephalitis [PDF - 253 KB - 1 page]
N. Jeannet et al.
EID Jeannet N, van den Hoogen BG, Schefold JC, Suter-Riniker F, Sommerstein R. Cerebrospinal Fluid Findings in an Adult with Human Metapneumovirus–Associated Encephalitis. Emerg Infect Dis. 2017;23(2):370. https://dx.doi.org/10.3201/eid2302.161337
AMA Jeannet N, van den Hoogen BG, Schefold JC, et al. Cerebrospinal Fluid Findings in an Adult with Human Metapneumovirus–Associated Encephalitis. Emerging Infectious Diseases. 2017;23(2):370. doi:10.3201/eid2302.161337.
APA Jeannet, N., van den Hoogen, B. G., Schefold, J. C., Suter-Riniker, F., & Sommerstein, R. (2017). Cerebrospinal Fluid Findings in an Adult with Human Metapneumovirus–Associated Encephalitis. Emerging Infectious Diseases, 23(2), 370. https://dx.doi.org/10.3201/eid2302.161337.
Books and Media

Blue Marble Health: An Innovative Plan to Fight Diseases of the Poor amid Wealth [PDF - 402 KB - 1 page]
J. Iskander
EID Iskander J. Blue Marble Health: An Innovative Plan to Fight Diseases of the Poor amid Wealth. Emerg Infect Dis. 2017;23(2):371. https://dx.doi.org/10.3201/eid2302.161801
AMA Iskander J. Blue Marble Health: An Innovative Plan to Fight Diseases of the Poor amid Wealth. Emerging Infectious Diseases. 2017;23(2):371. doi:10.3201/eid2302.161801.
APA Iskander, J. (2017). Blue Marble Health: An Innovative Plan to Fight Diseases of the Poor amid Wealth. Emerging Infectious Diseases, 23(2), 371. https://dx.doi.org/10.3201/eid2302.161801.
About the Cover

Stillness, Light, and Distance [PDF - 1.56 MB - 2 pages]
B. Breedlove
EID Breedlove B. Stillness, Light, and Distance. Emerg Infect Dis. 2017;23(2):372-373. https://dx.doi.org/10.3201/eid2302.ac2302
AMA Breedlove B. Stillness, Light, and Distance. Emerging Infectious Diseases. 2017;23(2):372-373. doi:10.3201/eid2302.ac2302.
APA Breedlove, B. (2017). Stillness, Light, and Distance. Emerging Infectious Diseases, 23(2), 372-373. https://dx.doi.org/10.3201/eid2302.ac2302.
Etymologia

Etymologia: Emmonsia [PDF - 281 KB - 1 page]
R. Henry
EID Henry R. Etymologia: Emmonsia. Emerg Infect Dis. 2017;23(2):348. https://dx.doi.org/10.3201/eid2302.et2302
AMA Henry R. Etymologia: Emmonsia. Emerging Infectious Diseases. 2017;23(2):348. doi:10.3201/eid2302.et2302.
APA Henry, R. (2017). Etymologia: Emmonsia. Emerging Infectious Diseases, 23(2), 348. https://dx.doi.org/10.3201/eid2302.et2302.
Page created: January 19, 2017
Page updated: January 19, 2017
Page reviewed: January 19, 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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