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Volume 23, Number 3—March 2017

Volume 23, Number 3—March 2017   PDF Version [PDF - 8.86 MB - 200 pages]

Synopses

  • Medscape CME Activity
    Epidemiology of Mycobacterium bovis Disease in Humans in England, Wales, and Northern Ireland, 2002–2014 PDF Version [PDF - 3.41 MB - 10 pages]
    J. A. Davidson et al.
    View Summary

    Despite slightly increased cases in these areas, human infection with this cattle pathogen remains rare.

        View Abstract

    Despite control efforts, Mycobacterium bovis incidence among cattle remains high in parts of England, Wales, and Northern Ireland, attracting political and public health interest in potential spread from animals to humans. To determine incidence among humans and to identify associated factors, we conducted a retrospective cohort analysis of human M. bovis cases in England, Wales, and Northern Ireland during 2002–2014. We identified 357 cases and observed increased annual case numbers (from 17 to 35) and rates. Most patients were >65 years of age and born in the United Kingdom. The median age of UK-born patients decreased over time. For 74% of patients, exposure to risk factors accounting for M. bovis acquisition, most frequently consumption of unpasteurized milk, was known. Despite the small increase in case numbers and reduction in patient age, M. bovis infection of humans in England, Wales, and Northern Ireland remains rare.

        Cite This Article
    EID Davidson JA, Loutet MG, O’Connor C, Kearns C, Smith R, Lalor MK, et al. Epidemiology of Mycobacterium bovis Disease in Humans in England, Wales, and Northern Ireland, 2002–2014. Emerg Infect Dis. 2017;23(3):377-386. https://dx.doi.org/10.3201/eid2303.161408
    AMA Davidson JA, Loutet MG, O’Connor C, et al. Epidemiology of Mycobacterium bovis Disease in Humans in England, Wales, and Northern Ireland, 2002–2014. Emerging Infectious Diseases. 2017;23(3):377-386. doi:10.3201/eid2303.161408.
    APA Davidson, J. A., Loutet, M. G., O’Connor, C., Kearns, C., Smith, R., Lalor, M. K....Zenner, D. (2017). Epidemiology of Mycobacterium bovis Disease in Humans in England, Wales, and Northern Ireland, 2002–2014. Emerging Infectious Diseases, 23(3), 377-386. https://dx.doi.org/10.3201/eid2303.161408.
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  • Medscape CME Activity
    Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis PDF Version [PDF - 2.02 MB - 9 pages]
    R. M. Smith et al.
    View Summary

    Encephalitozoon cuniculi was transmitted from an infected donor to 3 solid organ recipients, 1 of whom died.

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    In April 2014, a kidney transplant recipient in the United States experienced headache, diplopia, and confusion, followed by neurologic decline and death. An investigation to evaluate the possibility of donor-derived infection determined that 3 patients had received 4 organs (kidney, liver, heart/kidney) from the same donor. The liver recipient experienced tremor and gait instability; the heart/kidney and contralateral kidney recipients were hospitalized with encephalitis. None experienced gastrointestinal symptoms. Encephalitozoon cuniculi was detected by tissue PCR in the central nervous system of the deceased kidney recipient and in renal allograft tissue from both kidney recipients. Urine PCR was positive for E. cuniculi in the 2 surviving recipients. Donor serum was positive for E. cuniculi antibodies. E. cuniculi was transmitted to 3 recipients from 1 donor. This rare presentation of disseminated disease resulted in diagnostic delays. Clinicians should consider donor-derived microsporidial infection in organ recipients with unexplained encephalitis, even when gastrointestinal manifestations are absent.

        Cite This Article
    EID Smith RM, Muehlenbachs A, Schaenmann J, Baxi S, Koo S, Blau D, et al. Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis. Emerg Infect Dis. 2017;23(3):387-395. https://dx.doi.org/10.3201/eid2303.161580
    AMA Smith RM, Muehlenbachs A, Schaenmann J, et al. Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis. Emerging Infectious Diseases. 2017;23(3):387-395. doi:10.3201/eid2303.161580.
    APA Smith, R. M., Muehlenbachs, A., Schaenmann, J., Baxi, S., Koo, S., Blau, D....Zaki, S. R. (2017). Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis. Emerging Infectious Diseases, 23(3), 387-395. https://dx.doi.org/10.3201/eid2303.161580.
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  • Epidemiology of Invasive Haemophilus influenzae Disease, Europe, 2007–2014 PDF Version [PDF - 1.27 MB - 9 pages]
    R. Whittaker et al.
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    We describe the epidemiology of invasive Haemophilus influenzae disease during 2007–2014 in 12 European countries and assess overall H. influenzae disease trends by serotype and patient age. Mean annual notification rate was 0.6 cases/100,000 population, with an increasing annual trend of 3.3% (95% CI 2.3% to 4.3%). The notification rate was highest for patients <1 month of age (23.4 cases/100,000 population). Nontypeable H. influenzae (NTHi) caused 78% of all cases and showed increasing trends among persons <1 month and >20 years of age. Serotype f cases showed an increasing trend among persons >60 years of age. Serotype b cases showed decreasing trends among persons 1–5 months, 1–4 years, and >40 years of age. Sustained success of routine H. influenzae serotype b vaccination is evident. Surveillance systems must adopt a broad focus for invasive H. influenzae disease. Increasing reports of NTHi, particularly among neonates, highlight the potential benefit of a vaccine against NTHi.

        Cite This Article
    EID Whittaker R, Economopoulou A, Dias J, Bancroft E, Ramliden M, Celentano L, et al. Epidemiology of Invasive Haemophilus influenzae Disease, Europe, 2007–2014. Emerg Infect Dis. 2017;23(3):396-404. https://dx.doi.org/10.3201/eid2303.161552
    AMA Whittaker R, Economopoulou A, Dias J, et al. Epidemiology of Invasive Haemophilus influenzae Disease, Europe, 2007–2014. Emerging Infectious Diseases. 2017;23(3):396-404. doi:10.3201/eid2303.161552.
    APA Whittaker, R., Economopoulou, A., Dias, J., Bancroft, E., Ramliden, M., & Celentano, L. (2017). Epidemiology of Invasive Haemophilus influenzae Disease, Europe, 2007–2014. Emerging Infectious Diseases, 23(3), 396-404. https://dx.doi.org/10.3201/eid2303.161552.
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Research

  • Zika Virus RNA Replication and Persistence in Brain and Placental Tissue PDF Version [PDF - 3.90 MB - 10 pages]
    J. Bhatnagar et al.
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    Zika virus is causally linked with congenital microcephaly and may be associated with pregnancy loss. However, the mechanisms of Zika virus intrauterine transmission and replication and its tropism and persistence in tissues are poorly understood. We tested tissues from 52 case-patients: 8 infants with microcephaly who died and 44 women suspected of being infected with Zika virus during pregnancy. By reverse transcription PCR, tissues from 32 (62%) case-patients (brains from 8 infants with microcephaly and placental/fetal tissues from 24 women) were positive for Zika virus. In situ hybridization localized replicative Zika virus RNA in brains of 7 infants and in placentas of 9 women who had pregnancy losses during the first or second trimester. These findings demonstrate that Zika virus replicates and persists in fetal brains and placentas, providing direct evidence of its association with microcephaly. Tissue-based reverse transcription PCR extends the time frame of Zika virus detection in congenital and pregnancy-associated infections.

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    EID Bhatnagar J, Rabeneck DB, Martines RB, Reagan-Steiner S, Ermias Y, Estetter L, et al. Zika Virus RNA Replication and Persistence in Brain and Placental Tissue. Emerg Infect Dis. 2017;23(3):405-414. https://dx.doi.org/10.3201/eid2303.161499
    AMA Bhatnagar J, Rabeneck DB, Martines RB, et al. Zika Virus RNA Replication and Persistence in Brain and Placental Tissue. Emerging Infectious Diseases. 2017;23(3):405-414. doi:10.3201/eid2303.161499.
    APA Bhatnagar, J., Rabeneck, D. B., Martines, R. B., Reagan-Steiner, S., Ermias, Y., Estetter, L....Zaki, S. R. (2017). Zika Virus RNA Replication and Persistence in Brain and Placental Tissue. Emerging Infectious Diseases, 23(3), 405-414. https://dx.doi.org/10.3201/eid2303.161499.
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  • Spatiotemporal Fluctuations and Triggers of Ebola Virus Spillover PDF Version [PDF - 3.18 MB - 8 pages]
    J. Schmidt et al.
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    Because the natural reservoir of Ebola virus remains unclear and disease outbreaks in humans have occurred only sporadically over a large region, forecasting when and where Ebola spillovers are most likely to occur constitutes a continuing and urgent public health challenge. We developed a statistical modeling approach that associates 37 human or great ape Ebola spillovers since 1982 with spatiotemporally dynamic covariates including vegetative cover, human population size, and absolute and relative rainfall over 3 decades across sub-Saharan Africa. Our model (area under the curve 0.80 on test data) shows that spillover intensity is highest during transitions between wet and dry seasons; overall, high seasonal intensity occurs over much of tropical Africa; and spillover intensity is greatest at high (>1,000/km2) and very low (<100/km2) human population densities compared with intermediate levels. These results suggest strong seasonality in Ebola spillover from wild reservoirs and indicate particular times and regions for targeted surveillance.

        Cite This Article
    EID Schmidt J, Park AW, Kramer AM, Han BA, Alexander LW, Drake JM, et al. Spatiotemporal Fluctuations and Triggers of Ebola Virus Spillover. Emerg Infect Dis. 2017;23(3):415-422. https://dx.doi.org/10.3201/eid2303.160101
    AMA Schmidt J, Park AW, Kramer AM, et al. Spatiotemporal Fluctuations and Triggers of Ebola Virus Spillover. Emerging Infectious Diseases. 2017;23(3):415-422. doi:10.3201/eid2303.160101.
    APA Schmidt, J., Park, A. W., Kramer, A. M., Han, B. A., Alexander, L. W., & Drake, J. M. (2017). Spatiotemporal Fluctuations and Triggers of Ebola Virus Spillover. Emerging Infectious Diseases, 23(3), 415-422. https://dx.doi.org/10.3201/eid2303.160101.
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  • New Mycobacterium tuberculosis Complex Sublineage, Brazzaville, Congo PDF Version [PDF - 1.08 MB - 7 pages]
    S. Malm et al.
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    Tuberculosis is a leading cause of illness and death in Congo. No data are available about the population structure and transmission dynamics of the Mycobacterium tuberculosis complex strains prevalent in this central Africa country. On the basis of single-nucleotide polymorphisms detected by whole-genome sequencing, we phylogenetically characterized 74 MTBC isolates from Brazzaville, the capital of Congo. The diversity of the study population was high; most strains belonged to the Euro-American lineage, which split into Latin American Mediterranean, Uganda I, Uganda II, Haarlem, X type, and a new dominant sublineage named Congo type (n = 26). Thirty strains were grouped in 5 clusters (each within 12 single-nucleotide polymorphisms), from which 23 belonged to the Congo type. High cluster rates and low genomic diversity indicate recent emergence and transmission of the Congo type, a new Euro-American sublineage of MTBC.

        Cite This Article
    EID Malm S, Linguissi LS, Tekwu EM, Vouvoungui JC, Kohl TA, Beckert P, et al. New Mycobacterium tuberculosis Complex Sublineage, Brazzaville, Congo. Emerg Infect Dis. 2017;23(3):423-429. https://dx.doi.org/10.3201/eid2303.160679
    AMA Malm S, Linguissi LS, Tekwu EM, et al. New Mycobacterium tuberculosis Complex Sublineage, Brazzaville, Congo. Emerging Infectious Diseases. 2017;23(3):423-429. doi:10.3201/eid2303.160679.
    APA Malm, S., Linguissi, L. S., Tekwu, E. M., Vouvoungui, J. C., Kohl, T. A., Beckert, P....Niemann, S. (2017). New Mycobacterium tuberculosis Complex Sublineage, Brazzaville, Congo. Emerging Infectious Diseases, 23(3), 423-429. https://dx.doi.org/10.3201/eid2303.160679.
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  • Whole-Genome Analysis of Bartonella ancashensis, a Novel Pathogen Causing Verruga Peruana, Rural Ancash Region, Peru PDF Version [PDF - 1.96 MB - 9 pages]
    K. E. Mullins et al.
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    The genus Bartonella contains >40 species, and an increasing number of these Bartonella species are being implicated in human disease. One such pathogen is Bartonella ancashensis, which was isolated in blood samples from 2 patients living in Caraz, Peru, during a clinical trial of treatment for bartonellosis. Three B. ancashensis strains were analyzed by using whole-genome restriction mapping and high-throughput pyrosequencing. Genome-wide comparative analysis of Bartonella species showed that B. ancashensis has features seen in modern and ancient lineages of Bartonella species and is more related to B. bacilliformis. The divergence between B. ancashensis and B. bacilliformis is much greater than what is seen between known Bartonella genetic lineages. In addition, B. ancashensis contains type IV secretion system proteins, which are not present in B. bacilliformis. Whole-genome analysis indicates that B. ancashensis might represent a distinct Bartonella lineage phylogenetically related to B. bacilliformis.

        Cite This Article
    EID Mullins KE, Hang J, Clifford RJ, Onmus-Leone F, Yang Y, Jiang J, et al. Whole-Genome Analysis of Bartonella ancashensis, a Novel Pathogen Causing Verruga Peruana, Rural Ancash Region, Peru. Emerg Infect Dis. 2017;23(3):430-438. https://dx.doi.org/10.3201/eid2303.161476
    AMA Mullins KE, Hang J, Clifford RJ, et al. Whole-Genome Analysis of Bartonella ancashensis, a Novel Pathogen Causing Verruga Peruana, Rural Ancash Region, Peru. Emerging Infectious Diseases. 2017;23(3):430-438. doi:10.3201/eid2303.161476.
    APA Mullins, K. E., Hang, J., Clifford, R. J., Onmus-Leone, F., Yang, Y., Jiang, J....Blazes, D. (2017). Whole-Genome Analysis of Bartonella ancashensis, a Novel Pathogen Causing Verruga Peruana, Rural Ancash Region, Peru. Emerging Infectious Diseases, 23(3), 430-438. https://dx.doi.org/10.3201/eid2303.161476.
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  • Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA PDF Version [PDF - 1.22 MB - 9 pages]
    J. Adjemian et al.
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    Previous studies found Hawaiians and Asian-Americans/Pacific Islanders to be independently at increased risk for nontuberculous mycobacterial pulmonary disease (NTMPD) and tuberculosis (TB). To better understand NTM infection and TB risk patterns in Hawaii, USA, we evaluated data on a cohort of patients in Hawaii for 2005–2013. Period prevalence of NTMPD was highest among Japanese, Chinese, and Vietnamese patients (>300/100,000 persons) and lowest among Native Hawaiians and Other Pacific Islanders (50/100,000). Japanese patients were twice as likely as all other racial/ethnic groups to have Mycobacterium abscessus isolated (adjusted odds ratio 2.0, 95% CI 1.2–3.2) but were not at increased risk for infection with other mycobacteria species. In contrast, incidence of TB was stable and was lowest among Japanese patients (no cases) and highest among Filipino, Korean, and Vietnamese patients (>50/100,000). Substantial differences exist in the epidemiology of NTMPD by race/ethnicity, suggesting behavioral and biologic factors that affect disease susceptibility.

        Cite This Article
    EID Adjemian J, Frankland TB, Daida YG, Honda JR, Olivier KN, Zelazny A, et al. Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA. Emerg Infect Dis. 2017;23(3):439-447. https://dx.doi.org/10.3201/eid2303.161827
    AMA Adjemian J, Frankland TB, Daida YG, et al. Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA. Emerging Infectious Diseases. 2017;23(3):439-447. doi:10.3201/eid2303.161827.
    APA Adjemian, J., Frankland, T. B., Daida, Y. G., Honda, J. R., Olivier, K. N., Zelazny, A....Prevots, D. (2017). Epidemiology of Nontuberculous Mycobacterial Lung Disease and Tuberculosis, Hawaii, USA. Emerging Infectious Diseases, 23(3), 439-447. https://dx.doi.org/10.3201/eid2303.161827.
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  • Mycobacterium tuberculosis Transmission among Elderly Persons, Yamagata Prefecture, Japan, 2009–2015 PDF Version [PDF - 872 KB - 8 pages]
    J. Seto et al.
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    In many countries with low to moderate tuberculosis (TB) incidence, cases have shifted to elderly persons. It is unclear, however, whether these cases are associated with recent Mycobacterium tuberculosis transmission or represent reactivation of past disease. During 2009–2015, we performed a population-based TB investigation in Yamagata Prefecture, Japan, using in-depth contact tracing and 24-loci variable-number tandem-repeat typing optimized for Beijing family M. tuberculosis strains. We analyzed 494 strains, of which 387 (78.3%) were derived from elderly patients. Recent transmission with an epidemiologic link was confirmed in 22 clusters (70 cases). In 17 (77.3%) clusters, the source patient was elderly; 11 (64.7%) of the 17 clusters occurred in a hospital or nursing home. In this setting, the increase in TB cases was associated with M. tuberculosis transmissions from elderly persons. Prevention of transmission in places where elderly persons gather will be an effective strategy for decreasing TB incidence among predominantly elderly populations.

        Cite This Article
    EID Seto J, Wada T, Suzuki Y, Ikeda T, Mizuta K, Yamamoto T, et al. Mycobacterium tuberculosis Transmission among Elderly Persons, Yamagata Prefecture, Japan, 2009–2015. Emerg Infect Dis. 2017;23(3):448-455. https://dx.doi.org/10.3201/eid2303.161571
    AMA Seto J, Wada T, Suzuki Y, et al. Mycobacterium tuberculosis Transmission among Elderly Persons, Yamagata Prefecture, Japan, 2009–2015. Emerging Infectious Diseases. 2017;23(3):448-455. doi:10.3201/eid2303.161571.
    APA Seto, J., Wada, T., Suzuki, Y., Ikeda, T., Mizuta, K., Yamamoto, T....Ahiko, T. (2017). Mycobacterium tuberculosis Transmission among Elderly Persons, Yamagata Prefecture, Japan, 2009–2015. Emerging Infectious Diseases, 23(3), 448-455. https://dx.doi.org/10.3201/eid2303.161571.
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  • Comparison of Sputum-Culture Conversion for Mycobacterium bovis and M. tuberculosis PDF Version [PDF - 1.02 MB - 7 pages]
    C. Scott et al.
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    Current US guidelines recommend longer treatment for tuberculosis (TB) caused by pyrazinamide-resistant organisms (e.g., Mycobacterium bovis) than for M. tuberculosis TB. We compared treatment response times for patients with M. bovis TB and M. tuberculosis TB reported in the United States during 2006–2013. We included culture-positive, pulmonary TB patients with genotyping results who received standard 4-drug treatment at the time of diagnosis. Time to sputum-culture conversion was defined as time between treatment start date and date of first consistently culture-negative sputum. We analyzed 297 case-patients with M. bovis TB and 30,848 case-patients with M. tuberculosis TB. After 2 months of treatment, 71% of M. bovis and 65% of M. tuberculosis TB patients showed conversion of sputum cultures to negative. Likelihood of culture conversion was higher for M. bovis than for M. tuberculosis, even after controlling for treatment administration type, sex, and a composite indicator of bacillary burden.

        Cite This Article
    EID Scott C, Cavanaugh JS, Silk BJ, Ershova J, Mazurek GH, LoBue PA, et al. Comparison of Sputum-Culture Conversion for Mycobacterium bovis and M. tuberculosis. Emerg Infect Dis. 2017;23(3):456-462. https://dx.doi.org/10.3201/eid2303.161916
    AMA Scott C, Cavanaugh JS, Silk BJ, et al. Comparison of Sputum-Culture Conversion for Mycobacterium bovis and M. tuberculosis. Emerging Infectious Diseases. 2017;23(3):456-462. doi:10.3201/eid2303.161916.
    APA Scott, C., Cavanaugh, J. S., Silk, B. J., Ershova, J., Mazurek, G. H., LoBue, P. A....Moonan, P. K. (2017). Comparison of Sputum-Culture Conversion for Mycobacterium bovis and M. tuberculosis. Emerging Infectious Diseases, 23(3), 456-462. https://dx.doi.org/10.3201/eid2303.161916.
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  • Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens PDF Version [PDF - 393 KB - 5 pages]
    J. L. Hall et al.
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    Mapping the public health threat of tickborne pathogens requires quantification of not only the density of infected host-seeking ticks but also the rate of human exposure to these ticks. To efficiently sample a high number of persons in a short time, we used a mass-participation outdoor event. In June 2014, we sampled ≈500 persons competing in a 2-day mountain marathon run across predominantly tick-infested habitat in Scotland. From the number of tick bites recorded and prevalence of tick infection with Borrelia burgdoferi sensu lato and B. miyamotoi, we quantified the frequency of competitor exposure to the pathogens. Mass-participation outdoor events have the potential to serve as excellent windows for epidemiologic study of tickborne pathogens; their concerted use should improve spatial and temporal mapping of human exposure to infected ticks.

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    EID Hall JL, Alpers K, Bown KJ, Martin SJ, Birtles RJ. Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens. Emerg Infect Dis. 2017;23(3):463-467. https://dx.doi.org/10.3201/eid2303.161397
    AMA Hall JL, Alpers K, Bown KJ, et al. Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens. Emerging Infectious Diseases. 2017;23(3):463-467. doi:10.3201/eid2303.161397.
    APA Hall, J. L., Alpers, K., Bown, K. J., Martin, S. J., & Birtles, R. J. (2017). Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens. Emerging Infectious Diseases, 23(3), 463-467. https://dx.doi.org/10.3201/eid2303.161397.
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  • Pulmonary Nontuberculous Mycobacteria–Associated Deaths, Ontario, Canada, 2001–2013 PDF Version [PDF - 601 KB - 9 pages]
    T. K. Marras et al.
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    Survival implications of nontuberculous mycobacterial pulmonary disease (NTM-PD) and NTM pulmonary isolation without disease (NTM-PI) are unclear. To study deaths associated with NTM-PD and NTM-PI and differences in survival between them, we conducted a population-based cohort study of persons with microbiologically defined NTM-PD or NTM-PI diagnosed during 2001–2013 in Ontario, Canada. We used propensity score matching and Cox proportional hazards models to compare survival. Among 9,681 NTM-PD patients and 10,936 NTM-PI patients, 87% and 91%, respectively, were successfully matched with unexposed controls. Both NTM-PD and NTM-PI were associated with higher rates of death for all species combined and for most individual species. Compared with NTM-PI, NTM-PD was associated with higher death rates for all species combined, Mycobacterium avium complex, and M. xenopi. NTM-PD and NTM-PI were significantly associated with death, NTM-PD more so than NTM-PI.

        Cite This Article
    EID Marras TK, Campitelli MA, Lu H, Chung H, Brode SK, Marchand-Austin A, et al. Pulmonary Nontuberculous Mycobacteria–Associated Deaths, Ontario, Canada, 2001–2013. Emerg Infect Dis. 2017;23(3):468-476. https://dx.doi.org/10.3201/eid2303.161927
    AMA Marras TK, Campitelli MA, Lu H, et al. Pulmonary Nontuberculous Mycobacteria–Associated Deaths, Ontario, Canada, 2001–2013. Emerging Infectious Diseases. 2017;23(3):468-476. doi:10.3201/eid2303.161927.
    APA Marras, T. K., Campitelli, M. A., Lu, H., Chung, H., Brode, S. K., Marchand-Austin, A....Jamieson, F. B. (2017). Pulmonary Nontuberculous Mycobacteria–Associated Deaths, Ontario, Canada, 2001–2013. Emerging Infectious Diseases, 23(3), 468-476. https://dx.doi.org/10.3201/eid2303.161927.
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Dispatches

  • Variegated Squirrel Bornavirus 1 in Squirrels, Germany and the Netherlands PDF Version [PDF - 1.31 MB - 5 pages]
    K. Schlottau et al.
        View Abstract

    We screened squirrels in Germany and the Netherlands for the novel zoonotic variegated squirrel bornavirus 1 (VSBV-1). The detection of VSBV-1 in 11 squirrels indicates a considerable risk for transmission to humans handling those animals. Therefore, squirrels in contact with humans should routinely be tested for VSBV-1.

        Cite This Article
    EID Schlottau K, Jenckel M, van den Brand J, Fast C, Herden C, Höper D, et al. Variegated Squirrel Bornavirus 1 in Squirrels, Germany and the Netherlands. Emerg Infect Dis. 2017;23(3):477-481. https://dx.doi.org/10.3201/eid2303.161061
    AMA Schlottau K, Jenckel M, van den Brand J, et al. Variegated Squirrel Bornavirus 1 in Squirrels, Germany and the Netherlands. Emerging Infectious Diseases. 2017;23(3):477-481. doi:10.3201/eid2303.161061.
    APA Schlottau, K., Jenckel, M., van den Brand, J., Fast, C., Herden, C., Höper, D....Hoffmann, B. (2017). Variegated Squirrel Bornavirus 1 in Squirrels, Germany and the Netherlands. Emerging Infectious Diseases, 23(3), 477-481. https://dx.doi.org/10.3201/eid2303.161061.
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  • Genetically Diverse Filoviruses in Rousettus and Eonycteris spp. Bats, China, 2009 and 2015 PDF Version [PDF - 1.66 MB - 5 pages]
    X. Yang et al.
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    Genetically divergent filoviruses detected in Rousettus and Eonycteris spp. bats in China exhibited 61%–99% nt identity with reported filoviruses, based on partial replicase sequences, and they demonstrated lung tropism. Co-infection with 4 different filoviruses was found in 1 bat. These results demonstrate that fruit bats are key reservoirs of filoviruses.

        Cite This Article
    EID Yang X, Zhang Y, Jiang R, Guo H, Zhang W, Li B, et al. Genetically Diverse Filoviruses in Rousettus and Eonycteris spp. Bats, China, 2009 and 2015. Emerg Infect Dis. 2017;23(3):482-486. https://dx.doi.org/10.3201/eid2303.161119
    AMA Yang X, Zhang Y, Jiang R, et al. Genetically Diverse Filoviruses in Rousettus and Eonycteris spp. Bats, China, 2009 and 2015. Emerging Infectious Diseases. 2017;23(3):482-486. doi:10.3201/eid2303.161119.
    APA Yang, X., Zhang, Y., Jiang, R., Guo, H., Zhang, W., Li, B....Shi, Z. (2017). Genetically Diverse Filoviruses in Rousettus and Eonycteris spp. Bats, China, 2009 and 2015. Emerging Infectious Diseases, 23(3), 482-486. https://dx.doi.org/10.3201/eid2303.161119.
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  • Molecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana PDF Version [PDF - 999 KB - 4 pages]
    D. Surie et al.
        View Abstract

    During 2012–2015, 10 of 24 patients infected with matching genotypes of Mycobacterium tuberculosis received care at the same hospital in Gaborone, Botswana. Nosocomial transmission was initially suspected, but we discovered plausible sites of community transmission for 20 (95%) of 21 interviewed patients. Active case-finding at these sites could halt ongoing transmission.

        Cite This Article
    EID Surie D, Fane O, Finlay A, Ogopotse M, Tobias JL, Click ES, et al. Molecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana. Emerg Infect Dis. 2017;23(3):487-490. https://dx.doi.org/10.3201/eid2303.161183
    AMA Surie D, Fane O, Finlay A, et al. Molecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana. Emerging Infectious Diseases. 2017;23(3):487-490. doi:10.3201/eid2303.161183.
    APA Surie, D., Fane, O., Finlay, A., Ogopotse, M., Tobias, J. L., Click, E. S....Oeltmann, J. E. (2017). Molecular, Spatial, and Field Epidemiology Suggesting TB Transmission in Community, Not Hospital, Gaborone, Botswana. Emerging Infectious Diseases, 23(3), 487-490. https://dx.doi.org/10.3201/eid2303.161183.
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  • pncA Gene Mutations Associated with Pyrazinamide Resistance in Drug-Resistant Tuberculosis, South Africa and Georgia PDF Version [PDF - 751 KB - 5 pages]
    S. Allana et al.
        View Abstract

    Although pyrazinamide is commonly used for tuberculosis treatment, drug-susceptibility testing is not routinely available. We found polymorphisms in the pncA gene for 70% of multidrug-resistant and 96% of extensively drug-resistant Mycobacterium tuberculosis isolates from South Africa and Georgia. Assessment of pyrazinamide susceptibility may be prudent before using it in regimens for drug-resistant tuberculosis.

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    EID Allana S, Shashkina E, Mathema B, Bablishvili N, Tukvadze N, Shah N, et al. pncA Gene Mutations Associated with Pyrazinamide Resistance in Drug-Resistant Tuberculosis, South Africa and Georgia. Emerg Infect Dis. 2017;23(3):491-495. https://dx.doi.org/10.3201/eid2303.161034
    AMA Allana S, Shashkina E, Mathema B, et al. pncA Gene Mutations Associated with Pyrazinamide Resistance in Drug-Resistant Tuberculosis, South Africa and Georgia. Emerging Infectious Diseases. 2017;23(3):491-495. doi:10.3201/eid2303.161034.
    APA Allana, S., Shashkina, E., Mathema, B., Bablishvili, N., Tukvadze, N., Shah, N....Gandhi, N. R. (2017). pncA Gene Mutations Associated with Pyrazinamide Resistance in Drug-Resistant Tuberculosis, South Africa and Georgia. Emerging Infectious Diseases, 23(3), 491-495. https://dx.doi.org/10.3201/eid2303.161034.
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  • Increase in Tuberculosis Cases among Prisoners, Brazil, 2009–2014 PDF Version [PDF - 1.10 MB - 4 pages]
    P. M. Bourdillon et al.
        View Abstract

    During 2009–2014, incarceration rates in Brazil rose 34%, and tuberculosis (TB) cases among prisoners rose 28.8%. The proportion of national TB cases that occurred among prisoners increased from 6.2% to 8.4% overall and from 19.3% to 25.6% among men 20–29 years of age.

        Cite This Article
    EID Bourdillon PM, Gonçalves C, Pelissari D, Arakaki-Sanchez D, Ko AI, Croda J, et al. Increase in Tuberculosis Cases among Prisoners, Brazil, 2009–2014. Emerg Infect Dis. 2017;23(3):496-499. https://dx.doi.org/10.3201/eid2303.161006
    AMA Bourdillon PM, Gonçalves C, Pelissari D, et al. Increase in Tuberculosis Cases among Prisoners, Brazil, 2009–2014. Emerging Infectious Diseases. 2017;23(3):496-499. doi:10.3201/eid2303.161006.
    APA Bourdillon, P. M., Gonçalves, C., Pelissari, D., Arakaki-Sanchez, D., Ko, A. I., Croda, J....Andrews, J. R. (2017). Increase in Tuberculosis Cases among Prisoners, Brazil, 2009–2014. Emerging Infectious Diseases, 23(3), 496-499. https://dx.doi.org/10.3201/eid2303.161006.
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  • Likely Autochthonous Transmission of Trypanosoma cruzi to Humans, South Central Texas, USA PDF Version [PDF - 527 KB - 4 pages]
    S. M. Gunter et al.
        View Abstract

    Chagas disease, caused by Trypanosoma cruzi, is a major neglected tropical disease affecting the Americas. The epidemiology of this disease in the United States is incomplete. We report evidence of likely autochthonous vectorborne transmission of T. cruzi and health outcomes in T. cruzi–seropositive blood donors in south central Texas, USA.

        Cite This Article
    EID Gunter SM, Murray KO, Gorchakov R, Beddard R, Rossmann SN, Montgomery SP, et al. Likely Autochthonous Transmission of Trypanosoma cruzi to Humans, South Central Texas, USA. Emerg Infect Dis. 2017;23(3):500-503. https://dx.doi.org/10.3201/eid2303.161157
    AMA Gunter SM, Murray KO, Gorchakov R, et al. Likely Autochthonous Transmission of Trypanosoma cruzi to Humans, South Central Texas, USA. Emerging Infectious Diseases. 2017;23(3):500-503. doi:10.3201/eid2303.161157.
    APA Gunter, S. M., Murray, K. O., Gorchakov, R., Beddard, R., Rossmann, S. N., Montgomery, S. P....Garcia, M. N. (2017). Likely Autochthonous Transmission of Trypanosoma cruzi to Humans, South Central Texas, USA. Emerging Infectious Diseases, 23(3), 500-503. https://dx.doi.org/10.3201/eid2303.161157.
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  • Mycobacterium tuberculosis in Wild Asian Elephants, Southern India PDF Version [PDF - 1.60 MB - 3 pages]
    A. Zachariah et al.
        View Abstract

    We tested wild Asian elephants (Elephas maximus) in southern India and confirmed infection in 3 animals with Mycobacterium tuberculosis, an obligate human pathogen, by PCR and genetic sequencing. Our results indicate that tuberculosis may be spilling over from humans (reverse zoonosis) and emerging in wild elephants.

        Cite This Article
    EID Zachariah A, Pandiyan J, Madhavilatha G, Mundayoor S, Chandramohan B, Sajesh P, et al. Mycobacterium tuberculosis in Wild Asian Elephants, Southern India. Emerg Infect Dis. 2017;23(3):504-506. https://dx.doi.org/10.3201/eid2303.161741
    AMA Zachariah A, Pandiyan J, Madhavilatha G, et al. Mycobacterium tuberculosis in Wild Asian Elephants, Southern India. Emerging Infectious Diseases. 2017;23(3):504-506. doi:10.3201/eid2303.161741.
    APA Zachariah, A., Pandiyan, J., Madhavilatha, G., Mundayoor, S., Chandramohan, B., Sajesh, P....Mikota, S. K. (2017). Mycobacterium tuberculosis in Wild Asian Elephants, Southern India. Emerging Infectious Diseases, 23(3), 504-506. https://dx.doi.org/10.3201/eid2303.161741.
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  • Mycobacterium chimaera in Heater–Cooler Units in Denmark Related to Isolates from the United States and United Kingdom PDF Version [PDF - 480 KB - 3 pages]
    E. Svensson et al.
        View Abstract

    Mycobacterium chimaera was present at high rates (>80%) in heater–cooler units (HCUs) from all 5 thoracic surgery departments in Denmark. Isolates were clonal to HCU-associated isolates from the United States (including some from patients) and United Kingdom. However, M. chimaera from 2 brands of HCU were genetically distinct.

        Cite This Article
    EID Svensson E, Jensen E, Rasmussen E, Folkvardsen D, Norman A, Lillebaek T, et al. Mycobacterium chimaera in Heater–Cooler Units in Denmark Related to Isolates from the United States and United Kingdom. Emerg Infect Dis. 2017;23(3):507-509. https://dx.doi.org/10.3201/eid2303.161941
    AMA Svensson E, Jensen E, Rasmussen E, et al. Mycobacterium chimaera in Heater–Cooler Units in Denmark Related to Isolates from the United States and United Kingdom. Emerging Infectious Diseases. 2017;23(3):507-509. doi:10.3201/eid2303.161941.
    APA Svensson, E., Jensen, E., Rasmussen, E., Folkvardsen, D., Norman, A., & Lillebaek, T. (2017). Mycobacterium chimaera in Heater–Cooler Units in Denmark Related to Isolates from the United States and United Kingdom. Emerging Infectious Diseases, 23(3), 507-509. https://dx.doi.org/10.3201/eid2303.161941.
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  • Rhodococcus Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients PDF Version [PDF - 387 KB - 3 pages]
    P. Vergidis et al.
        View Abstract

    We conducted a case–control study of 18 US transplant recipients with Rhodococcus infection and 36 matched controls. The predominant types of infection were pneumonia and bacteremia. Diabetes mellitus and recent opportunistic infection were independently associated with disease. Outcomes were generally favorable except for 1 relapse and 1 death.

        Cite This Article
    EID Vergidis P, Ariza-Heredia EJ, Nellore A, Kotton CN, Kaul DR, Morris MI, et al. Rhodococcus Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients. Emerg Infect Dis. 2017;23(3):510-512. https://dx.doi.org/10.3201/eid2303.160633
    AMA Vergidis P, Ariza-Heredia EJ, Nellore A, et al. Rhodococcus Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients. Emerging Infectious Diseases. 2017;23(3):510-512. doi:10.3201/eid2303.160633.
    APA Vergidis, P., Ariza-Heredia, E. J., Nellore, A., Kotton, C. N., Kaul, D. R., Morris, M. I....Razonable, R. R. (2017). Rhodococcus Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients. Emerging Infectious Diseases, 23(3), 510-512. https://dx.doi.org/10.3201/eid2303.160633.
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  • Mycobacterium tuberculosis Infection among Asian Elephants in Captivity PDF Version [PDF - 1.76 MB - 4 pages]
    G. Simpson et al.
        View Abstract

    Although awareness of tuberculosis among captive elephants is increasing, antituberculosis therapy for these animals is not standardized. We describe Mycobacterium tuberculosis transmission between captive elephants based on whole genome analysis and report a successful combination treatment. Infection control protocols and careful monitoring of treatment of captive elephants with tuberculosis are warranted.

        Cite This Article
    EID Simpson G, Zimmerman R, Shashkina E, Chen L, Richard M, Bradford CM, et al. Mycobacterium tuberculosis Infection among Asian Elephants in Captivity. Emerg Infect Dis. 2017;23(3):513-516. https://dx.doi.org/10.3201/eid2303.160726
    AMA Simpson G, Zimmerman R, Shashkina E, et al. Mycobacterium tuberculosis Infection among Asian Elephants in Captivity. Emerging Infectious Diseases. 2017;23(3):513-516. doi:10.3201/eid2303.160726.
    APA Simpson, G., Zimmerman, R., Shashkina, E., Chen, L., Richard, M., Bradford, C. M....Kreiswirth, B. N. (2017). Mycobacterium tuberculosis Infection among Asian Elephants in Captivity. Emerging Infectious Diseases, 23(3), 513-516. https://dx.doi.org/10.3201/eid2303.160726.
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  • Molecular Evidence of Drug Resistance in Asymptomatic Malaria Infections, Myanmar, 2015 PDF Version [PDF - 798 KB - 4 pages]
    M. Nyunt et al.
        View Abstract

    Artemisinin resistance containment in Myanmar was initiated in 2011 after artemisinin-resistant Plasmodium falciparum malaria was reported. Molecular evidence suggests that asymptomatic malaria infections harboring drug resistance genes are present among residents of the Myanmar artemisinin resistance containment zone. This evidence supports efforts to eliminate these hidden infections.

        Cite This Article
    EID Nyunt M, Shein T, Zaw N, Han S, Muh F, Lee S, et al. Molecular Evidence of Drug Resistance in Asymptomatic Malaria Infections, Myanmar, 2015. Emerg Infect Dis. 2017;23(3):517-520. https://dx.doi.org/10.3201/eid2303.161363
    AMA Nyunt M, Shein T, Zaw N, et al. Molecular Evidence of Drug Resistance in Asymptomatic Malaria Infections, Myanmar, 2015. Emerging Infectious Diseases. 2017;23(3):517-520. doi:10.3201/eid2303.161363.
    APA Nyunt, M., Shein, T., Zaw, N., Han, S., Muh, F., Lee, S....Kyaw, M. (2017). Molecular Evidence of Drug Resistance in Asymptomatic Malaria Infections, Myanmar, 2015. Emerging Infectious Diseases, 23(3), 517-520. https://dx.doi.org/10.3201/eid2303.161363.
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  • Pneumonic Plague Transmission, Moramanga, Madagascar, 2015 PDF Version [PDF - 1.21 MB - 4 pages]
    B. Ramasindrazana et al.
        View Abstract

    During a pneumonic plague outbreak in Moramanga, Madagascar, we identified 4 confirmed, 1 presumptive, and 9 suspected plague case-patients. Human-to-human transmission among close contacts was high (reproductive number 1.44) and the case fatality rate was 71%. Phylogenetic analysis showed that the Yersinia pestis isolates belonged to group q3, different from the previous outbreak.

        Cite This Article
    EID Ramasindrazana B, Andrianaivoarimanana V, Rakotondramanga J, Birdsell DN, Ratsitorahina M, Rajerison M, et al. Pneumonic Plague Transmission, Moramanga, Madagascar, 2015. Emerg Infect Dis. 2017;23(3):521-524. https://dx.doi.org/10.3201/eid2303.161406
    AMA Ramasindrazana B, Andrianaivoarimanana V, Rakotondramanga J, et al. Pneumonic Plague Transmission, Moramanga, Madagascar, 2015. Emerging Infectious Diseases. 2017;23(3):521-524. doi:10.3201/eid2303.161406.
    APA Ramasindrazana, B., Andrianaivoarimanana, V., Rakotondramanga, J., Birdsell, D. N., Ratsitorahina, M., & Rajerison, M. (2017). Pneumonic Plague Transmission, Moramanga, Madagascar, 2015. Emerging Infectious Diseases, 23(3), 521-524. https://dx.doi.org/10.3201/eid2303.161406.
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  • Outbreaks of Disease Associated with Food Imported into the United States, 1996–2014 PDF Version [PDF - 989 KB - 3 pages]
    L. Gould et al.
        View Abstract

    The proportion of US food that is imported is increasing; most seafood and half of fruits are imported. We identified a small but increasing number of foodborne disease outbreaks associated with imported foods, most commonly fish and produce. New outbreak investigation tools and federal regulatory authority are key to maintaining food safety.

        Cite This Article
    EID Gould L, Kline J, Monahan C, Vierk K. Outbreaks of Disease Associated with Food Imported into the United States, 1996–2014. Emerg Infect Dis. 2017;23(3):525-528. https://dx.doi.org/10.3201/eid2303.161462
    AMA Gould L, Kline J, Monahan C, et al. Outbreaks of Disease Associated with Food Imported into the United States, 1996–2014. Emerging Infectious Diseases. 2017;23(3):525-528. doi:10.3201/eid2303.161462.
    APA Gould, L., Kline, J., Monahan, C., & Vierk, K. (2017). Outbreaks of Disease Associated with Food Imported into the United States, 1996–2014. Emerging Infectious Diseases, 23(3), 525-528. https://dx.doi.org/10.3201/eid2303.161462.
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  • Zoonotic Transmission of mcr-1 Colistin Resistance Gene from Small-Scale Poultry Farms, Vietnam PDF Version [PDF - 599 KB - 4 pages]
    N. Trung et al.
        View Abstract

    We investigated the consequences of colistin use in backyard chicken farms in Vietnam by examining the prevalence of mcr-1 in fecal samples from chickens and humans. Detection of mcr-1–carrying bacteria in chicken samples was associated with colistin use and detection in human samples with exposure to mcr-1–positive chickens.

        Cite This Article
    EID Trung N, Matamoros S, Carrique-Mas JJ, Nghia N, Nhung N, Chieu T, et al. Zoonotic Transmission of mcr-1 Colistin Resistance Gene from Small-Scale Poultry Farms, Vietnam. Emerg Infect Dis. 2017;23(3):529-532. https://dx.doi.org/10.3201/eid2303.161553
    AMA Trung N, Matamoros S, Carrique-Mas JJ, et al. Zoonotic Transmission of mcr-1 Colistin Resistance Gene from Small-Scale Poultry Farms, Vietnam. Emerging Infectious Diseases. 2017;23(3):529-532. doi:10.3201/eid2303.161553.
    APA Trung, N., Matamoros, S., Carrique-Mas, J. J., Nghia, N., Nhung, N., Chieu, T....Hoa, N. (2017). Zoonotic Transmission of mcr-1 Colistin Resistance Gene from Small-Scale Poultry Farms, Vietnam. Emerging Infectious Diseases, 23(3), 529-532. https://dx.doi.org/10.3201/eid2303.161553.
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  • Disseminated Nontuberculous Mycobacteria in HIV-Infected Patients, Oregon, USA, 2007–2012 PDF Version [PDF - 387 KB - 3 pages]
    C. D. Varley et al.
        View Abstract

    We determined disseminated nontuberculous mycobacteria incidence in the HIV-infected population of Oregon, USA, during 2007–2012 by using statewide laboratory surveillance. We identified 37 disseminated nontuberculous mycobacteria cases among 7,349 patients with median annual incidence of 110/100,000 HIV person-years and the highest incidence in those with CD4 counts <50 cells/mm3 (5,300/100,000 person-years).

        Cite This Article
    EID Varley CD, Ku JH, Henkle E, Schafer SD, Winthrop KL. Disseminated Nontuberculous Mycobacteria in HIV-Infected Patients, Oregon, USA, 2007–2012. Emerg Infect Dis. 2017;23(3):533-535. https://dx.doi.org/10.3201/eid2303.161708
    AMA Varley CD, Ku JH, Henkle E, et al. Disseminated Nontuberculous Mycobacteria in HIV-Infected Patients, Oregon, USA, 2007–2012. Emerging Infectious Diseases. 2017;23(3):533-535. doi:10.3201/eid2303.161708.
    APA Varley, C. D., Ku, J. H., Henkle, E., Schafer, S. D., & Winthrop, K. L. (2017). Disseminated Nontuberculous Mycobacteria in HIV-Infected Patients, Oregon, USA, 2007–2012. Emerging Infectious Diseases, 23(3), 533-535. https://dx.doi.org/10.3201/eid2303.161708.
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Research Letters

  • Autochthonous Outbreak and Expansion of Canine Visceral Leishmaniasis, Uruguay PDF Version [PDF - 519 KB - 3 pages]
    D. Satragno et al.
        View Abstract

    We report an outbreak of canine visceral leishmaniasis in Uruguay. Blood specimens from 11/45 dogs tested positive for Leishmania spp. Specimens of Lutzomyia longipalpis sand flies were captured; typing revealed Leishmania infantum. Our findings document an expansion of visceral leishmaniasis to southern South America and risk for vectorborne transmission to humans.

        Cite This Article
    EID Satragno D, Faral-Tello P, Canneva B, Verger L, Lozano A, Vitale E, et al. Autochthonous Outbreak and Expansion of Canine Visceral Leishmaniasis, Uruguay. Emerg Infect Dis. 2017;23(3):536-538. https://dx.doi.org/10.3201/eid2303.160377
    AMA Satragno D, Faral-Tello P, Canneva B, et al. Autochthonous Outbreak and Expansion of Canine Visceral Leishmaniasis, Uruguay. Emerging Infectious Diseases. 2017;23(3):536-538. doi:10.3201/eid2303.160377.
    APA Satragno, D., Faral-Tello, P., Canneva, B., Verger, L., Lozano, A., Vitale, E....Basmadjián, Y. (2017). Autochthonous Outbreak and Expansion of Canine Visceral Leishmaniasis, Uruguay. Emerging Infectious Diseases, 23(3), 536-538. https://dx.doi.org/10.3201/eid2303.160377.
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  • Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis PDF Version [PDF - 297 KB - 2 pages]
    M. Butin et al.
        View Abstract

    A multidrug-resistant Staphylococcus capitis clone, NRCS-A, has been isolated from neonatal intensive care units in 17 countries throughout the world. S. capitis NRCS-A prevalence is high in some neonatal intensive care units in France. These data highlight the worldwide endemicity and epidemiologic relevance of this multidrug-resistant, coagulase-negative staphylococci clone.

        Cite This Article
    EID Butin M, Martins-Simões P, Rasigade J, Picaud J, Laurent F. Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerg Infect Dis. 2017;23(3):538-539. https://dx.doi.org/10.3201/eid2303.160833
    AMA Butin M, Martins-Simões P, Rasigade J, et al. Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerging Infectious Diseases. 2017;23(3):538-539. doi:10.3201/eid2303.160833.
    APA Butin, M., Martins-Simões, P., Rasigade, J., Picaud, J., & Laurent, F. (2017). Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerging Infectious Diseases, 23(3), 538-539. https://dx.doi.org/10.3201/eid2303.160833.
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  • Potentially Zoonotic Bartonella in Bats from France and Spain PDF Version [PDF - 535 KB - 3 pages]
    M. J. Stuckey et al.
        View Abstract

    We detected Bartonella in 11 of 109 insectivorous bats from France and 1 of 26 bats from Spain. These genetic variants are closely related to bat-associated Bartonella described in Finland and the United Kingdom and to B. mayotimonensis, the agent of a human endocarditis case in the United States.

        Cite This Article
    EID Stuckey MJ, Boulouis H, Cliquet F, Picard-Meyer E, Servat A, Aréchiga-Ceballos N, et al. Potentially Zoonotic Bartonella in Bats from France and Spain. Emerg Infect Dis. 2017;23(3):539-541. https://dx.doi.org/10.3201/eid2303.160934
    AMA Stuckey MJ, Boulouis H, Cliquet F, et al. Potentially Zoonotic Bartonella in Bats from France and Spain. Emerging Infectious Diseases. 2017;23(3):539-541. doi:10.3201/eid2303.160934.
    APA Stuckey, M. J., Boulouis, H., Cliquet, F., Picard-Meyer, E., Servat, A., Aréchiga-Ceballos, N....Chomel, B. B. (2017). Potentially Zoonotic Bartonella in Bats from France and Spain. Emerging Infectious Diseases, 23(3), 539-541. https://dx.doi.org/10.3201/eid2303.160934.
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  • Two Cases of Neisseria meningitidis Proctitis in HIV-Positive Men Who Have Sex with Men PDF Version [PDF - 291 KB - 2 pages]
    J. Gutierrez-Fernandez et al.
        View Abstract

    We report 2 cases from Spain of infectious proctitis caused by Neisseria meningitidis in HIV-positive men who have sex with men. Genetic characterization of the isolates showed that they are unusual strains not found in other more frequent meningococcal locations. This finding suggests an association between specific strains and anogenital tract colonization.

        Cite This Article
    EID Gutierrez-Fernandez J, Medina V, Hidalgo-Tenorio C, Abad R. Two Cases of Neisseria meningitidis Proctitis in HIV-Positive Men Who Have Sex with Men. Emerg Infect Dis. 2017;23(3):542-543. https://dx.doi.org/10.3201/eid2303.161039
    AMA Gutierrez-Fernandez J, Medina V, Hidalgo-Tenorio C, et al. Two Cases of Neisseria meningitidis Proctitis in HIV-Positive Men Who Have Sex with Men. Emerging Infectious Diseases. 2017;23(3):542-543. doi:10.3201/eid2303.161039.
    APA Gutierrez-Fernandez, J., Medina, V., Hidalgo-Tenorio, C., & Abad, R. (2017). Two Cases of Neisseria meningitidis Proctitis in HIV-Positive Men Who Have Sex with Men. Emerging Infectious Diseases, 23(3), 542-543. https://dx.doi.org/10.3201/eid2303.161039.
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  • Association of Diabetes and Tuberculosis Disease among US-Bound Adult Refugees, 2009–2014 PDF Version [PDF - 346 KB - 3 pages]
    S. R. Benoit et al.
        View Abstract

    Diabetes is associated with an increased risk for active tuberculosis (TB) disease. We conducted a case–control study and found a significant association between diabetes and TB disease among US-bound refugees. These findings underscore the value of collaborative management of both diseases.

        Cite This Article
    EID Benoit SR, Gregg EW, Jonnalagadda S, Phares CR, Zhou W, Painter JA, et al. Association of Diabetes and Tuberculosis Disease among US-Bound Adult Refugees, 2009–2014. Emerg Infect Dis. 2017;23(3):543-545. https://dx.doi.org/10.3201/eid2303.161053
    AMA Benoit SR, Gregg EW, Jonnalagadda S, et al. Association of Diabetes and Tuberculosis Disease among US-Bound Adult Refugees, 2009–2014. Emerging Infectious Diseases. 2017;23(3):543-545. doi:10.3201/eid2303.161053.
    APA Benoit, S. R., Gregg, E. W., Jonnalagadda, S., Phares, C. R., Zhou, W., & Painter, J. A. (2017). Association of Diabetes and Tuberculosis Disease among US-Bound Adult Refugees, 2009–2014. Emerging Infectious Diseases, 23(3), 543-545. https://dx.doi.org/10.3201/eid2303.161053.
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  • Molecular Verification of New World Mansonella perstans Parasitemias PDF Version [PDF - 412 KB - 3 pages]
    L. Tavares da Silva et al.
        View Abstract

    We obtained ribosomal and mitochondrial DNA sequences from residents of Amazonas state, Brazil, with Mansonella parasitemias. Phylogenetic analysis of these sequences confirm that M. ozzardi and M. perstans parasites occur in sympatry and reveal the close relationship between M. perstans in Africa and Brazil, providing insights into the parasite’s New World origins.

        Cite This Article
    EID Tavares da Silva L, Crainey J, Ribeiro da Silva T, Suwa U, Vicente A, Fernandes de Medeiros J, et al. Molecular Verification of New World Mansonella perstans Parasitemias. Emerg Infect Dis. 2017;23(3):545-547. https://dx.doi.org/10.3201/eid2303.161159
    AMA Tavares da Silva L, Crainey J, Ribeiro da Silva T, et al. Molecular Verification of New World Mansonella perstans Parasitemias. Emerging Infectious Diseases. 2017;23(3):545-547. doi:10.3201/eid2303.161159.
    APA Tavares da Silva, L., Crainey, J., Ribeiro da Silva, T., Suwa, U., Vicente, A., Fernandes de Medeiros, J....Luz, S. (2017). Molecular Verification of New World Mansonella perstans Parasitemias. Emerging Infectious Diseases, 23(3), 545-547. https://dx.doi.org/10.3201/eid2303.161159.
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  • Imported Leptospira licerasiae Infection in Traveler Returning to Japan from Brazil PDF Version [PDF - 344 KB - 2 pages]
    M. Tsuboi et al.
        View Abstract

    We describe a case of intermediate leptospirosis resulting from Leptospira licerasiae infection in a traveler returning to Japan from Brazil. Intermediate leptospirosis should be included in the differential diagnosis for travelers with fever returning from South America. This case highlights the need for strategies that detect pathogenic and intermediate Leptospira species.

        Cite This Article
    EID Tsuboi M, Koizumi N, Hayakawa K, Kanagawa S, Ohmagari N, Kato Y, et al. Imported Leptospira licerasiae Infection in Traveler Returning to Japan from Brazil. Emerg Infect Dis. 2017;23(3):548-549. https://dx.doi.org/10.3201/eid2303.161262
    AMA Tsuboi M, Koizumi N, Hayakawa K, et al. Imported Leptospira licerasiae Infection in Traveler Returning to Japan from Brazil. Emerging Infectious Diseases. 2017;23(3):548-549. doi:10.3201/eid2303.161262.
    APA Tsuboi, M., Koizumi, N., Hayakawa, K., Kanagawa, S., Ohmagari, N., & Kato, Y. (2017). Imported Leptospira licerasiae Infection in Traveler Returning to Japan from Brazil. Emerging Infectious Diseases, 23(3), 548-549. https://dx.doi.org/10.3201/eid2303.161262.
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  • Serologic Evidence for MERS-CoV Infection in Dromedary Camels, Punjab, Pakistan, 2012–2015 PDF Version [PDF - 285 KB - 2 pages]
    M. Saqib et al.
        View Abstract

    Dromedary camels from Africa and Arabia are an established source for zoonotic Middle East respiratory syndrome coronavirus (MERS-CoV) infection among humans. In Pakistan, we found specific neutralizing antibodies in samples from 39.5% of 565 dromedaries, documenting significant expansion of the enzootic range of MERS-CoV to Asia.

        Cite This Article
    EID Saqib M, Sieberg A, Hussain M, Mansoor M, Zohaib A, Lattwein E, et al. Serologic Evidence for MERS-CoV Infection in Dromedary Camels, Punjab, Pakistan, 2012–2015. Emerg Infect Dis. 2017;23(3):550-551. https://dx.doi.org/10.3201/eid2303.161285
    AMA Saqib M, Sieberg A, Hussain M, et al. Serologic Evidence for MERS-CoV Infection in Dromedary Camels, Punjab, Pakistan, 2012–2015. Emerging Infectious Diseases. 2017;23(3):550-551. doi:10.3201/eid2303.161285.
    APA Saqib, M., Sieberg, A., Hussain, M., Mansoor, M., Zohaib, A., Lattwein, E....Corman, V. (2017). Serologic Evidence for MERS-CoV Infection in Dromedary Camels, Punjab, Pakistan, 2012–2015. Emerging Infectious Diseases, 23(3), 550-551. https://dx.doi.org/10.3201/eid2303.161285.
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  • Fungal Contamination of Methylprednisolone Causing Recurrent Lumbosacral Intradural Abscess PDF Version [PDF - 588 KB - 2 pages]
    J. J. Renfrow et al.
        View Abstract

    Fungal meningitis transmitted through injections of methylprednisolone contaminated with Exserohilum rostratum affected 753 persons and caused 61 deaths in the United States in 2012. We report a case of infection recurrence after 24-months with the unique manifestation of an intradural fungal abscess. Fungal disease should remain on the differential diagnosis list for previously exposed patients.

        Cite This Article
    EID Renfrow JJ, Frenkel MB, Hsu W. Fungal Contamination of Methylprednisolone Causing Recurrent Lumbosacral Intradural Abscess. Emerg Infect Dis. 2017;23(3):552-553. https://dx.doi.org/10.3201/eid2303.161334
    AMA Renfrow JJ, Frenkel MB, Hsu W. Fungal Contamination of Methylprednisolone Causing Recurrent Lumbosacral Intradural Abscess. Emerging Infectious Diseases. 2017;23(3):552-553. doi:10.3201/eid2303.161334.
    APA Renfrow, J. J., Frenkel, M. B., & Hsu, W. (2017). Fungal Contamination of Methylprednisolone Causing Recurrent Lumbosacral Intradural Abscess. Emerging Infectious Diseases, 23(3), 552-553. https://dx.doi.org/10.3201/eid2303.161334.
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  • Successful Treatment of Human Plague with Oral Ciprofloxacin PDF Version [PDF - 645 KB - 3 pages]
    T. Apangu et al.
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    The US Food and Drug Administration recently approved ciprofloxacin for treatment of plague (Yersina pestis infection) based on animal studies. Published evidence of efficacy in humans is sparse. We report 5 cases of culture-confirmed human plague treated successfully with oral ciprofloxacin, including 1 case of pneumonic plague.

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    EID Apangu T, Griffith K, Abaru J, Candini G, Apio H, Okoth F, et al. Successful Treatment of Human Plague with Oral Ciprofloxacin. Emerg Infect Dis. 2017;23(3):553-555. https://dx.doi.org/10.3201/eid2303.161212
    AMA Apangu T, Griffith K, Abaru J, et al. Successful Treatment of Human Plague with Oral Ciprofloxacin. Emerging Infectious Diseases. 2017;23(3):553-555. doi:10.3201/eid2303.161212.
    APA Apangu, T., Griffith, K., Abaru, J., Candini, G., Apio, H., Okoth, F....Mead, P. (2017). Successful Treatment of Human Plague with Oral Ciprofloxacin. Emerging Infectious Diseases, 23(3), 553-555. https://dx.doi.org/10.3201/eid2303.161212.
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  • Mycobacterium tuberculosis Infection in Free-Roaming Wild Asian Elephant PDF Version [PDF - 1.03 MB - 3 pages]
    B. Chandranaik et al.
        View Abstract

    Postmortem examination of a wild Asian elephant at Rajiv Gandhi National Park, India, revealed nodular lesions, granulomas with central caseation, and acid-fast bacilli in the lungs. PCR and nucleotide sequencing confirmed the presence of Mycobacterium tuberculosis. This study indicates that wild elephants can harbor M. tuberculosis that can become fatal.

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    EID Chandranaik B, Shivashankar B, Umashankar K, Nandini P, Giridhar P, Byregowda S, et al. Mycobacterium tuberculosis Infection in Free-Roaming Wild Asian Elephant. Emerg Infect Dis. 2017;23(3):555-557. https://dx.doi.org/10.3201/eid2303.161439
    AMA Chandranaik B, Shivashankar B, Umashankar K, et al. Mycobacterium tuberculosis Infection in Free-Roaming Wild Asian Elephant. Emerging Infectious Diseases. 2017;23(3):555-557. doi:10.3201/eid2303.161439.
    APA Chandranaik, B., Shivashankar, B., Umashankar, K., Nandini, P., Giridhar, P., Byregowda, S....Shrinivasa, B. (2017). Mycobacterium tuberculosis Infection in Free-Roaming Wild Asian Elephant. Emerging Infectious Diseases, 23(3), 555-557. https://dx.doi.org/10.3201/eid2303.161439.
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  • Mycobacterium bovis in a Free-Ranging Black Rhinoceros, Kruger National Park, South Africa, 2016 PDF Version [PDF - 312 KB - 2 pages]
    M. A. Miller et al.
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    Mycobacterium bovis in a Free-Ranging Black Rhinoceros, Kruger National Park, South Africa, 2016

        View Abstract

    In 2016, an emaciated black rhinoceros (Diceros bicornis) was found in Kruger National Park, South Africa. An interferon-γ response was detected against mycobacterial antigens, and lung tissue was positive for Mycobacterium bovis. This case highlights the risk that tuberculosis presents to rhinoceros in M. bovis–endemic areas.

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    EID Miller MA, Buss PE, van Helden PD, Parsons S. Mycobacterium bovis in a Free-Ranging Black Rhinoceros, Kruger National Park, South Africa, 2016. Emerg Infect Dis. 2017;23(3):557-558. https://dx.doi.org/10.3201/eid2303.161622
    AMA Miller MA, Buss PE, van Helden PD, et al. Mycobacterium bovis in a Free-Ranging Black Rhinoceros, Kruger National Park, South Africa, 2016. Emerging Infectious Diseases. 2017;23(3):557-558. doi:10.3201/eid2303.161622.
    APA Miller, M. A., Buss, P. E., van Helden, P. D., & Parsons, S. (2017). Mycobacterium bovis in a Free-Ranging Black Rhinoceros, Kruger National Park, South Africa, 2016. Emerging Infectious Diseases, 23(3), 557-558. https://dx.doi.org/10.3201/eid2303.161622.
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  • Zika Virus Vector Competency of Mosquitoes, Gulf Coast, United States PDF Version [PDF - 300 KB - 2 pages]
    C. E. Hart et al.
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    Zika virus has recently spread throughout the Americas. Although Aedes aegypti mosquitoes are considered the primary vector, Culex quinquefasciatus and mosquitoes of other species may also be vectors. We tested Cx. quinquefasciatus and Ae. taeniorhynchus mosquitoes from the US Gulf Coast; both were refractory to infection and incapable of transmission.

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    EID Hart CE, Roundy CM, Azar SR, Huang JH, Yun R, Reynolds E, et al. Zika Virus Vector Competency of Mosquitoes, Gulf Coast, United States. Emerg Infect Dis. 2017;23(3):559-560. https://dx.doi.org/10.3201/eid2303.161636
    AMA Hart CE, Roundy CM, Azar SR, et al. Zika Virus Vector Competency of Mosquitoes, Gulf Coast, United States. Emerging Infectious Diseases. 2017;23(3):559-560. doi:10.3201/eid2303.161636.
    APA Hart, C. E., Roundy, C. M., Azar, S. R., Huang, J. H., Yun, R., Reynolds, E....Vasilakis, N. (2017). Zika Virus Vector Competency of Mosquitoes, Gulf Coast, United States. Emerging Infectious Diseases, 23(3), 559-560. https://dx.doi.org/10.3201/eid2303.161636.
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  • Keeping It in the Family: the Childhood Burden of Tuberculosis PDF Version [PDF - 5.70 MB - 2 pages]
    T. Chorba and J. Jereb
            Cite This Article
    EID Chorba T, Jereb J. Keeping It in the Family: the Childhood Burden of Tuberculosis. Emerg Infect Dis. 2017;23(3):561-562. https://dx.doi.org/10.3201/eid2303.AC2303
    AMA Chorba T, Jereb J. Keeping It in the Family: the Childhood Burden of Tuberculosis. Emerging Infectious Diseases. 2017;23(3):561-562. doi:10.3201/eid2303.AC2303.
    APA Chorba, T., & Jereb, J. (2017). Keeping It in the Family: the Childhood Burden of Tuberculosis. Emerging Infectious Diseases, 23(3), 561-562. https://dx.doi.org/10.3201/eid2303.AC2303.
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