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Issue Cover for Volume 23, Number 5—May 2017

Volume 23, Number 5—May 2017

[PDF - 7.78 MB - 168 pages]

Synopses

Medscape CME Activity
Exposure Characteristics of Hantavirus Pulmonary Syndrome Patients, United States, 1993–2015 [PDF - 533 KB - 7 pages]
A. de St. Maurice et al.
EID de St. Maurice A, Ervin E, Schumacher M, Yaglom H, VinHatton E, Melman S, et al. Exposure Characteristics of Hantavirus Pulmonary Syndrome Patients, United States, 1993–2015. Emerg Infect Dis. 2017;23(5):733-739. https://dx.doi.org/10.3201/eid2305.161770
AMA de St. Maurice A, Ervin E, Schumacher M, et al. Exposure Characteristics of Hantavirus Pulmonary Syndrome Patients, United States, 1993–2015. Emerging Infectious Diseases. 2017;23(5):733-739. doi:10.3201/eid2305.161770.
APA de St. Maurice, A., Ervin, E., Schumacher, M., Yaglom, H., VinHatton, E., Melman, S....Knust, B. (2017). Exposure Characteristics of Hantavirus Pulmonary Syndrome Patients, United States, 1993–2015. Emerging Infectious Diseases, 23(5), 733-739. https://dx.doi.org/10.3201/eid2305.161770.
Research

Control of Malaria Vector Mosquitoes by Insecticide-Treated Combinations of Window Screens and Eave Baffles [PDF - 1.27 MB - 8 pages]
G. F. Killeen et al.

We assessed window screens and eave baffles (WSEBs), which enable mosquitoes to enter but not exit houses, as an alternative to indoor residual spraying (IRS) for malaria vector control. WSEBs treated with water, the pyrethroid lambda-cyhalothrin, or the organophosphate pirimiphos-methyl, with and without a binding agent for increasing insecticide persistence on netting, were compared with IRS in experimental huts. Compared with IRS containing the same insecticide, WSEBs killed similar proportions of Anopheles funestus mosquitoes that were resistant to pyrethroids, carbamates and organochlorines and greater proportions of pyrethroid-resistant, early exiting An. arabiensis mosquitoes. WSEBs with pirimiphos-methyl killed greater proportions of both vectors than lambda-cyhalothrin or lambda-cyhalothrin plus pirimiphos-methyl and were equally efficacious when combined with binding agent. WSEBs required far less insecticide than IRS, and binding agents might enhance durability. WSEBs might enable affordable deployment of insecticide combinations to mitigate against physiologic insecticide resistance and improve control of behaviorally resistant, early exiting vectors.

EID Killeen GF, Masalu JP, Chinula D, Fotakis EA, Kavishe DR, Malone D, et al. Control of Malaria Vector Mosquitoes by Insecticide-Treated Combinations of Window Screens and Eave Baffles. Emerg Infect Dis. 2017;23(5):782-789. https://dx.doi.org/10.3201/eid2305.160662
AMA Killeen GF, Masalu JP, Chinula D, et al. Control of Malaria Vector Mosquitoes by Insecticide-Treated Combinations of Window Screens and Eave Baffles. Emerging Infectious Diseases. 2017;23(5):782-789. doi:10.3201/eid2305.160662.
APA Killeen, G. F., Masalu, J. P., Chinula, D., Fotakis, E. A., Kavishe, D. R., Malone, D....Okumu, F. (2017). Control of Malaria Vector Mosquitoes by Insecticide-Treated Combinations of Window Screens and Eave Baffles. Emerging Infectious Diseases, 23(5), 782-789. https://dx.doi.org/10.3201/eid2305.160662.

Insecticide-Treated Nets and Protection against Insecticide-Resistant Malaria Vectors in Western Kenya [PDF - 928 KB - 7 pages]
E. Ochomo et al.

Insecticide resistance might reduce the efficacy of malaria vector control. In 2013 and 2014, malaria vectors from 50 villages, of varying pyrethroid resistance, in western Kenya were assayed for resistance to deltamethrin. Long-lasting insecticide-treated nets (LLIN) were distributed to households at universal coverage. Children were recruited into 2 cohorts, cleared of malaria-causing parasites, and tested every 2 weeks for reinfection. Infection incidence rates for the 2 cohorts were 2.2 (95% CI 1.9–2.5) infections/person-year and 2.8 (95% CI 2.5–3.0) infections/person-year. LLIN users had lower infection rates than non-LLIN users in both low-resistance (rate ratio 0.61, 95% CI 0.42–0.88) and high-resistance (rate ratio 0.55, 95% CI 0.35–0.87) villages (p = 0.63). The association between insecticide resistance and infection incidence was not significant (p = 0.99). Although the incidence of infection was high among net users, LLINs provided significant protection (p = 0.01) against infection with malaria parasite regardless of vector insecticide resistance.

EID Ochomo E, Chahilu M, Cook J, Kinyari T, Bayoh NM, West P, et al. Insecticide-Treated Nets and Protection against Insecticide-Resistant Malaria Vectors in Western Kenya. Emerg Infect Dis. 2017;23(5):758-764. https://dx.doi.org/10.3201/eid2305.161315
AMA Ochomo E, Chahilu M, Cook J, et al. Insecticide-Treated Nets and Protection against Insecticide-Resistant Malaria Vectors in Western Kenya. Emerging Infectious Diseases. 2017;23(5):758-764. doi:10.3201/eid2305.161315.
APA Ochomo, E., Chahilu, M., Cook, J., Kinyari, T., Bayoh, N. M., West, P....Mbogo, C. (2017). Insecticide-Treated Nets and Protection against Insecticide-Resistant Malaria Vectors in Western Kenya. Emerging Infectious Diseases, 23(5), 758-764. https://dx.doi.org/10.3201/eid2305.161315.

Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China [PDF - 1.62 MB - 8 pages]
F. Cui et al.

China’s hepatitis B virus (HBV) prevention policy has been evaluated through nationally representative serologic surveys conducted in 1992 and 2006. We report results of a 2014 serologic survey and reanalysis of the 1992 and 2006 surveys in the context of program policy. The 2014 survey used a 2-stage sample strategy in which townships were selected from 160 longstanding, nationally representative, county-level disease surveillance points, and persons 1–29 years of age were invited to participate. The 2014 sample size was 31,713; the response rate was 83.3%. Compared with the 1992 pre–recombinant vaccine survey, HBV surface antigen prevalence declined 46% by 2006 and by 52% by 2014. Among children <5 years of age, the decline was 97%. China’s HBV prevention program, targeted toward interrupting perinatal transmission, has been highly successful and increasingly effective. However, this progress must be sustained for decades to come, and elimination of HBV transmission will require augmented strategies.

EID Cui F, Shen L, Li L, Wang H, Wang F, Bi S, et al. Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerg Infect Dis. 2017;23(5):765-772. https://dx.doi.org/10.3201/eid2305.161477
AMA Cui F, Shen L, Li L, et al. Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerging Infectious Diseases. 2017;23(5):765-772. doi:10.3201/eid2305.161477.
APA Cui, F., Shen, L., Li, L., Wang, H., Wang, F., Bi, S....Yin, Z. (2017). Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerging Infectious Diseases, 23(5), 765-772. https://dx.doi.org/10.3201/eid2305.161477.

Medscape CME Activity
Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia [PDF - 2.39 MB - 10 pages]
J. L. Morris et al.

Neurologic melioidosis is a serious, potentially fatal form of Burkholderia pseudomallei infection. Recently, we reported that a subset of clinical isolates of B. pseudomallei from Australia have heightened virulence and potential for dissemination to the central nervous system. In this study, we demonstrate that this subset has a B. mallei–like sequence variation of the actin-based motility gene, bimA. Compared with B. pseudomallei isolates having typical bimA alleles, isolates that contain the B. mallei–like variation demonstrate increased persistence in phagocytic cells and increased virulence with rapid systemic dissemination and replication within multiple tissues, including the brain and spinal cord, in an experimental model. These findings highlight the implications of bimA variation on disease progression of B. pseudomallei infection and have considerable clinical and public health implications with respect to the degree of neurotropic threat posed to human health.

EID Morris JL, Fane A, Sarovich D, Price EP, Rush CM, Govan BL, et al. Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia. Emerg Infect Dis. 2017;23(5):740-749. https://dx.doi.org/10.3201/eid2305.151417
AMA Morris JL, Fane A, Sarovich D, et al. Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia. Emerging Infectious Diseases. 2017;23(5):740-749. doi:10.3201/eid2305.151417.
APA Morris, J. L., Fane, A., Sarovich, D., Price, E. P., Rush, C. M., Govan, B. L....Ketheesan, N. (2017). Increased Neurotropic Threat from Burkholderia pseudomallei Strains with a B. mallei–like Variation in the bimA Motility Gene, Australia. Emerging Infectious Diseases, 23(5), 740-749. https://dx.doi.org/10.3201/eid2305.151417.

Population Genomics of Legionella longbeachae and Hidden Complexities of Infection Source Attribution [PDF - 3.54 MB - 8 pages]
R. Bacigalupe et al.

Legionella longbeachae is the primary cause of legionellosis in Australasia and Southeast Asia and an emerging pathogen in Europe and the United States; however, our understanding of the population diversity of L. longbeachae from patient and environmental sources is limited. We analyzed the genomes of 64 L. longbeachae isolates, of which 29 were from a cluster of legionellosis cases linked to commercial growing media in Scotland in 2013 and 35 were non–outbreak-associated isolates from Scotland and other countries. We identified extensive genetic diversity across the L. longbeachae species, associated with intraspecies and interspecies gene flow, and a wide geographic distribution of closely related genotypes. Of note, we observed a highly diverse pool of L. longbeachae genotypes within compost samples that precluded the genetic establishment of an infection source. These data represent a view of the genomic diversity of L. longbeachae that will inform strategies for investigating future outbreaks.

EID Bacigalupe R, Lindsay D, Edwards G, Fitzgerald J. Population Genomics of Legionella longbeachae and Hidden Complexities of Infection Source Attribution. Emerg Infect Dis. 2017;23(5):750-757. https://dx.doi.org/10.3201/eid2305.161165
AMA Bacigalupe R, Lindsay D, Edwards G, et al. Population Genomics of Legionella longbeachae and Hidden Complexities of Infection Source Attribution. Emerging Infectious Diseases. 2017;23(5):750-757. doi:10.3201/eid2305.161165.
APA Bacigalupe, R., Lindsay, D., Edwards, G., & Fitzgerald, J. (2017). Population Genomics of Legionella longbeachae and Hidden Complexities of Infection Source Attribution. Emerging Infectious Diseases, 23(5), 750-757. https://dx.doi.org/10.3201/eid2305.161165.

Lack of Durable Cross-Neutralizing Antibodies Against Zika Virus from Dengue Virus Infection [PDF - 1.72 MB - 9 pages]
M. H. Collins et al.

Cross-reactive antibodies elicited by dengue virus (DENV) infection might affect Zika virus infection and confound serologic tests. Recent data demonstrate neutralization of Zika virus by monoclonal antibodies or human serum collected early after DENV infection. Whether this finding is true in late DENV convalescence (>6 months after infection) is unknown. We studied late convalescent serum samples from persons with prior DENV or Zika virus exposure. Despite extensive cross-reactivity in IgG binding, Zika virus neutralization was not observed among primary DENV infections. We observed low-frequency (23%) Zika virus cross-neutralization in repeat DENV infections. DENV-immune persons who had Zika virus as a secondary infection had distinct populations of antibodies that neutralized DENVs and Zika virus, as shown by DENV-reactive antibody depletion experiments. These data suggest that most DENV infections do not induce durable, high-level Zika virus cross-neutralizing antibodies. Zika virus–specific antibody populations develop after Zika virus infection irrespective of prior DENV immunity.

EID Collins MH, McGowan E, Jadi R, Young E, Lopez CA, Baric RS, et al. Lack of Durable Cross-Neutralizing Antibodies Against Zika Virus from Dengue Virus Infection. Emerg Infect Dis. 2017;23(5):773-781. https://dx.doi.org/10.3201/eid2305.161630
AMA Collins MH, McGowan E, Jadi R, et al. Lack of Durable Cross-Neutralizing Antibodies Against Zika Virus from Dengue Virus Infection. Emerging Infectious Diseases. 2017;23(5):773-781. doi:10.3201/eid2305.161630.
APA Collins, M. H., McGowan, E., Jadi, R., Young, E., Lopez, C. A., Baric, R. S....de Silva, A. M. (2017). Lack of Durable Cross-Neutralizing Antibodies Against Zika Virus from Dengue Virus Infection. Emerging Infectious Diseases, 23(5), 773-781. https://dx.doi.org/10.3201/eid2305.161630.

Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April–August 2016 [PDF - 1.22 MB - 6 pages]
M. S. Chevalier et al.

Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3–August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts.

EID Chevalier MS, Biggerstaff BJ, Basavaraju SV, Ocfemia M, Alsina JO, Climent-Peris C, et al. Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April–August 2016. Emerg Infect Dis. 2017;23(5):790-795. https://dx.doi.org/10.3201/eid2305.161873
AMA Chevalier MS, Biggerstaff BJ, Basavaraju SV, et al. Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April–August 2016. Emerging Infectious Diseases. 2017;23(5):790-795. doi:10.3201/eid2305.161873.
APA Chevalier, M. S., Biggerstaff, B. J., Basavaraju, S. V., Ocfemia, M., Alsina, J. O., Climent-Peris, C....Kuehnert, M. J. (2017). Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April–August 2016. Emerging Infectious Diseases, 23(5), 790-795. https://dx.doi.org/10.3201/eid2305.161873.

Invasive Nontuberculous Mycobacterial Infections among Cardiothoracic Surgical Patients Exposed to Heater–Cooler Devices [PDF - 1.99 MB - 10 pages]
M. M. Lyman et al.

Invasive nontuberculous mycobacteria (NTM) infections may result from a previously unrecognized source of transmission, heater–cooler devices (HCDs) used during cardiac surgery. In July 2015, the Pennsylvania Department of Health notified the Centers for Disease Control and Prevention (CDC) about a cluster of NTM infections among cardiothoracic surgical patients at 1 hospital. We conducted a case–control study to identify exposures causing infection, examining 11 case-patients and 48 control-patients. Eight (73%) case-patients had a clinical specimen identified as Mycobacterium avium complex (MAC). HCD exposure was associated with increased odds of invasive NTM infection; laboratory testing identified patient isolates and HCD samples as closely related strains of M. chimaera, a MAC species. This investigation confirmed a large US outbreak of invasive MAC infections in a previously unaffected patient population and suggested transmission occurred by aerosolization from HCDs. Recommendations have been issued for enhanced surveillance to identify potential infections associated with HCDs and measures to mitigate transmission risk.

EID Lyman MM, Grigg C, Kinsey C, Keckler M, Moulton-Meissner H, Cooper E, et al. Invasive Nontuberculous Mycobacterial Infections among Cardiothoracic Surgical Patients Exposed to Heater–Cooler Devices. Emerg Infect Dis. 2017;23(5):796-805. https://dx.doi.org/10.3201/eid2305.161899
AMA Lyman MM, Grigg C, Kinsey C, et al. Invasive Nontuberculous Mycobacterial Infections among Cardiothoracic Surgical Patients Exposed to Heater–Cooler Devices. Emerging Infectious Diseases. 2017;23(5):796-805. doi:10.3201/eid2305.161899.
APA Lyman, M. M., Grigg, C., Kinsey, C., Keckler, M., Moulton-Meissner, H., Cooper, E....Perkins, K. M. (2017). Invasive Nontuberculous Mycobacterial Infections among Cardiothoracic Surgical Patients Exposed to Heater–Cooler Devices. Emerging Infectious Diseases, 23(5), 796-805. https://dx.doi.org/10.3201/eid2305.161899.
Historical Review

Anthrax Cases Associated with Animal-Hair Shaving Brushes [PDF - 560 KB - 3 pages]
C. M. Szablewski et al.

During the First World War, anthrax cases in the United States and England increased greatly and seemed to be associated with use of new shaving brushes. Further investigation revealed that the source material and origin of shaving brushes had changed during the war. Cheap brushes of imported horsehair were being made to look like the preferred badger-hair brushes. Unfortunately, some of these brushes were not effectively disinfected and brought with them a nasty stowaway: Bacillus anthracis. A review of outbreak summaries, surveillance data, and case reports indicated that these cases originated from the use of ineffectively disinfected animal-hair shaving brushes. This historical information is relevant to current public health practice because renewed interest in vintage and animal-hair shaving brushes has been seen in popular culture. This information should help healthcare providers and public health officials answer questions on this topic.

EID Szablewski CM, Hendricks K, Bower WA, Shadomy S, Hupert N. Anthrax Cases Associated with Animal-Hair Shaving Brushes. Emerg Infect Dis. 2017;23(5):806-808. https://dx.doi.org/10.3201/eid2305.161554
AMA Szablewski CM, Hendricks K, Bower WA, et al. Anthrax Cases Associated with Animal-Hair Shaving Brushes. Emerging Infectious Diseases. 2017;23(5):806-808. doi:10.3201/eid2305.161554.
APA Szablewski, C. M., Hendricks, K., Bower, W. A., Shadomy, S., & Hupert, N. (2017). Anthrax Cases Associated with Animal-Hair Shaving Brushes. Emerging Infectious Diseases, 23(5), 806-808. https://dx.doi.org/10.3201/eid2305.161554.
Dispatches

Exposure Risk for Infection and Lack of Human-to-Human Transmission of Mycobacterium ulcerans Disease, Australia [PDF - 600 KB - 4 pages]
D. P. O’Brien et al.

We conducted epidemiologic and genetic analyses of family clusters of Mycobacterium ulcerans (Buruli ulcer) disease in southeastern Australia. We found that the incidence of M. ulcerans disease in family members was increased. However, the risk for exposure appeared short-term and not related to human-human transmission.

EID O’Brien DP, Wynne JW, Buultjens AH, Michalski WP, Stinear TP, Friedman N, et al. Exposure Risk for Infection and Lack of Human-to-Human Transmission of Mycobacterium ulcerans Disease, Australia. Emerg Infect Dis. 2017;23(5):837-840. https://dx.doi.org/10.3201/eid2305.160809
AMA O’Brien DP, Wynne JW, Buultjens AH, et al. Exposure Risk for Infection and Lack of Human-to-Human Transmission of Mycobacterium ulcerans Disease, Australia. Emerging Infectious Diseases. 2017;23(5):837-840. doi:10.3201/eid2305.160809.
APA O’Brien, D. P., Wynne, J. W., Buultjens, A. H., Michalski, W. P., Stinear, T. P., Friedman, N....Athan, E. (2017). Exposure Risk for Infection and Lack of Human-to-Human Transmission of Mycobacterium ulcerans Disease, Australia. Emerging Infectious Diseases, 23(5), 837-840. https://dx.doi.org/10.3201/eid2305.160809.

Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis [PDF - 594 KB - 3 pages]
Y. Katanami et al.

There is no proven alternative to penicillin for treatment of maternal syphilis. We report 2 case-patients with maternal syphilis who were successfully treated without penicillin. We used amoxicillin and probenecid for the first case-patient and amoxicillin, probenecid, and ceftriaxone for the second case-patient.

EID Katanami Y, Hashimoto T, Takaya S, Yamamoto K, Kutsuna S, Takeshita N, et al. Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis. Emerg Infect Dis. 2017;23(5):827-829. https://dx.doi.org/10.3201/eid2305.161936
AMA Katanami Y, Hashimoto T, Takaya S, et al. Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis. Emerging Infectious Diseases. 2017;23(5):827-829. doi:10.3201/eid2305.161936.
APA Katanami, Y., Hashimoto, T., Takaya, S., Yamamoto, K., Kutsuna, S., Takeshita, N....Ohmagari, N. (2017). Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis. Emerging Infectious Diseases, 23(5), 827-829. https://dx.doi.org/10.3201/eid2305.161936.

Increasing Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium [PDF - 9.10 MB - 4 pages]
G. L. Murray et al.

Escalating resistance to azithromycin and moxifloxacin is being reported for Mycoplasma genitalium in the Asia-Pacific region. Analyzing 140 infections, we found pretreatment fluoroquinolone-resistance mutations in parC (13.6%) and gyrA (5%). ParC S83 changes were associated with moxifloxacin failure. Combined macrolide/fluoroquinolone-resistance mutations were in 8.6% of specimens, for which recommended therapies would be ineffective.

EID Murray GL, Bradshaw CS, Bissessor M, Danielewski JA, Garland SM, Jensen JS, et al. Increasing Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium. Emerg Infect Dis. 2017;23(5):809-812. https://dx.doi.org/10.3201/eid2305.161745
AMA Murray GL, Bradshaw CS, Bissessor M, et al. Increasing Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium. Emerging Infectious Diseases. 2017;23(5):809-812. doi:10.3201/eid2305.161745.
APA Murray, G. L., Bradshaw, C. S., Bissessor, M., Danielewski, J. A., Garland, S. M., Jensen, J. S....Tabrizi, S. N. (2017). Increasing Macrolide and Fluoroquinolone Resistance in Mycoplasma genitalium. Emerging Infectious Diseases, 23(5), 809-812. https://dx.doi.org/10.3201/eid2305.161745.

Reassortant Clade 2.3.4.4 Avian Influenza A(H5N6) Virus in a Wild Mandarin Duck, South Korea, 2016 [PDF - 1.48 MB - 4 pages]
J. Kwon et al.

A reassortant clade 2.3.4.4 avian influenza A(H5N6) virus was isolated from a fecal sample of a Mandarin duck (Aix galericulata) in South Korea during October 2016. This virus was genetically similar to H5N6 subtype virus isolates from China, Vietnam, Laos, and Hong Kong, including human isolates.

EID Kwon J, Lee D, Swayne DE, Noh J, Yuk S, Erdene-Ochir T, et al. Reassortant Clade 2.3.4.4 Avian Influenza A(H5N6) Virus in a Wild Mandarin Duck, South Korea, 2016. Emerg Infect Dis. 2017;23(5):822-826. https://dx.doi.org/10.3201/eid2305.161905
AMA Kwon J, Lee D, Swayne DE, et al. Reassortant Clade 2.3.4.4 Avian Influenza A(H5N6) Virus in a Wild Mandarin Duck, South Korea, 2016. Emerging Infectious Diseases. 2017;23(5):822-826. doi:10.3201/eid2305.161905.
APA Kwon, J., Lee, D., Swayne, D. E., Noh, J., Yuk, S., Erdene-Ochir, T....Song, C. (2017). Reassortant Clade 2.3.4.4 Avian Influenza A(H5N6) Virus in a Wild Mandarin Duck, South Korea, 2016. Emerging Infectious Diseases, 23(5), 822-826. https://dx.doi.org/10.3201/eid2305.161905.

Regional Transmission of Salmonella Paratyphi A, China, 1998–2012 [PDF - 1.59 MB - 4 pages]
X. Lu et al.

To explore transmission patterns and genetic relationships of Salmonella enterica serovar Paratyphi A in China, we conducted a genome-wide single-nucleotide polymorphism analysis on the strains in the 4 provinces in which incidence was highest during 1998–2012. Markedly phylogeographic clustering suggested regional virus circulation after introduction from areas in southeastern China.

EID Lu X, Li Z, Yan M, Pang B, Xu J, Kan B. Regional Transmission of Salmonella Paratyphi A, China, 1998–2012. Emerg Infect Dis. 2017;23(5):833-836. https://dx.doi.org/10.3201/eid2305.151539
AMA Lu X, Li Z, Yan M, et al. Regional Transmission of Salmonella Paratyphi A, China, 1998–2012. Emerging Infectious Diseases. 2017;23(5):833-836. doi:10.3201/eid2305.151539.
APA Lu, X., Li, Z., Yan, M., Pang, B., Xu, J., & Kan, B. (2017). Regional Transmission of Salmonella Paratyphi A, China, 1998–2012. Emerging Infectious Diseases, 23(5), 833-836. https://dx.doi.org/10.3201/eid2305.151539.

Survey of Treponemal Infections in Free-Ranging and Captive Macaques, 1999–2012 [PDF - 612 KB - 4 pages]
A. R. Klegarth et al.

Survey results showed treponemal infection among pet macaques in Southeast Asia, a region with a high prevalence of human yaws. This finding, along with studies showing treponemal infection in nonhuman primates in Africa, should encourage a One Health approach to yaws eradication and surveillance activities, possibly including monitoring of nonhuman primates in yaws-endemic regions.

EID Klegarth AR, Ezeonwu CA, Rompis A, Lee B, Aggimarangsee N, Chalise M, et al. Survey of Treponemal Infections in Free-Ranging and Captive Macaques, 1999–2012. Emerg Infect Dis. 2017;23(5):816-819. https://dx.doi.org/10.3201/eid2305.161838
AMA Klegarth AR, Ezeonwu CA, Rompis A, et al. Survey of Treponemal Infections in Free-Ranging and Captive Macaques, 1999–2012. Emerging Infectious Diseases. 2017;23(5):816-819. doi:10.3201/eid2305.161838.
APA Klegarth, A. R., Ezeonwu, C. A., Rompis, A., Lee, B., Aggimarangsee, N., Chalise, M....Jones-Engel, L. (2017). Survey of Treponemal Infections in Free-Ranging and Captive Macaques, 1999–2012. Emerging Infectious Diseases, 23(5), 816-819. https://dx.doi.org/10.3201/eid2305.161838.

Azithromycin Resistance and Decreased Ceftriaxone Susceptibility in Neisseria gonorrhoeae, Hawaii, USA [PDF - 507 KB - 3 pages]
J. Papp et al.

During 2016, eight Neisseria gonorrhoeae isolates from 7 patients in Hawaii were resistant to azithromycin; 5 had decreased in vitro susceptibility to ceftriaxone. Genomic analysis demonstrated a distinct phylogenetic clade when compared with local contemporary strains. Continued evolution and widespread transmission of these strains might challenge the effectiveness of current therapeutic options.

EID Papp J, Abrams A, Nash E, Katz AR, Kirkcaldy RD, O’Connor NP, et al. Azithromycin Resistance and Decreased Ceftriaxone Susceptibility in Neisseria gonorrhoeae, Hawaii, USA. Emerg Infect Dis. 2017;23(5):830-832. https://dx.doi.org/10.3201/eid2305.170088
AMA Papp J, Abrams A, Nash E, et al. Azithromycin Resistance and Decreased Ceftriaxone Susceptibility in Neisseria gonorrhoeae, Hawaii, USA. Emerging Infectious Diseases. 2017;23(5):830-832. doi:10.3201/eid2305.170088.
APA Papp, J., Abrams, A., Nash, E., Katz, A. R., Kirkcaldy, R. D., O’Connor, N. P....Whelen, A. (2017). Azithromycin Resistance and Decreased Ceftriaxone Susceptibility in Neisseria gonorrhoeae, Hawaii, USA. Emerging Infectious Diseases, 23(5), 830-832. https://dx.doi.org/10.3201/eid2305.170088.

Estimated Incubation Period for Zika Virus Disease [PDF - 1.13 MB - 5 pages]
E. R. Krow-Lucal et al.

Information about the Zika virus disease incubation period can help identify risk periods and local virus transmission. In 2015–2016, data from 197 symptomatic travelers with recent Zika virus infection indicated an estimated incubation period of 3–14 days. For symptomatic persons with symptoms >2 weeks after travel, transmission might be not travel associated.

EID Krow-Lucal ER, Biggerstaff BJ, Staples J. Estimated Incubation Period for Zika Virus Disease. Emerg Infect Dis. 2017;23(5):841-845. https://dx.doi.org/10.3201/eid2305.161715
AMA Krow-Lucal ER, Biggerstaff BJ, Staples J. Estimated Incubation Period for Zika Virus Disease. Emerging Infectious Diseases. 2017;23(5):841-845. doi:10.3201/eid2305.161715.
APA Krow-Lucal, E. R., Biggerstaff, B. J., & Staples, J. (2017). Estimated Incubation Period for Zika Virus Disease. Emerging Infectious Diseases, 23(5), 841-845. https://dx.doi.org/10.3201/eid2305.161715.

Phenotypic and Genotypic Shifts in Hepatitis B Virus in Treatment-Naive Patients, Taiwan, 2008–2012 [PDF - 1.00 MB - 2 pages]
C. Yeh et al.

We examined the characteristic changes of hepatitis B virus (HBV) in antiviral drug treatment–naive patients referred for pretreatment evaluation in Taiwan during 2008–2012. Over time, we observed substantial decreases in the prevalence of HBV e antigen (HBeAg) and increasing prevalence of the precore G1899A mutation and HBV-DNA levels in HBeAg-positive patients.

EID Yeh C, Liang K, Chang M, Hsu C, Chen Y, Lin C, et al. Phenotypic and Genotypic Shifts in Hepatitis B Virus in Treatment-Naive Patients, Taiwan, 2008–2012. Emerg Infect Dis. 2017;23(5):820-821. https://dx.doi.org/10.3201/eid2305.161894
AMA Yeh C, Liang K, Chang M, et al. Phenotypic and Genotypic Shifts in Hepatitis B Virus in Treatment-Naive Patients, Taiwan, 2008–2012. Emerging Infectious Diseases. 2017;23(5):820-821. doi:10.3201/eid2305.161894.
APA Yeh, C., Liang, K., Chang, M., Hsu, C., Chen, Y., Lin, C....Lai, M. (2017). Phenotypic and Genotypic Shifts in Hepatitis B Virus in Treatment-Naive Patients, Taiwan, 2008–2012. Emerging Infectious Diseases, 23(5), 820-821. https://dx.doi.org/10.3201/eid2305.161894.

Population Responses during the Pandemic Phase of the Influenza A(H1N1)pdm09 Epidemic, Hong Kong, China [PDF - 1.85 MB - 3 pages]
N. Yeung et al.

During August 2009–July 2010, we conducted 7 longitudinal telephone surveys among 503 adults in Hong Kong, China, to explore changes in their behavioral and psychological responses to the influenza A(H1N1)pdm09 virus epidemic. Trends were examined using generalized estimating equations models. Findings showed that responses varied with the course of the pandemic.

EID Yeung N, Lau J, Choi K, Griffiths S. Population Responses during the Pandemic Phase of the Influenza A(H1N1)pdm09 Epidemic, Hong Kong, China. Emerg Infect Dis. 2017;23(5):813-815. https://dx.doi.org/10.3201/eid2305.160768
AMA Yeung N, Lau J, Choi K, et al. Population Responses during the Pandemic Phase of the Influenza A(H1N1)pdm09 Epidemic, Hong Kong, China. Emerging Infectious Diseases. 2017;23(5):813-815. doi:10.3201/eid2305.160768.
APA Yeung, N., Lau, J., Choi, K., & Griffiths, S. (2017). Population Responses during the Pandemic Phase of the Influenza A(H1N1)pdm09 Epidemic, Hong Kong, China. Emerging Infectious Diseases, 23(5), 813-815. https://dx.doi.org/10.3201/eid2305.160768.

Virulence Analysis of Bacillus cereus Isolated after Death of Preterm Neonates, Nice, France, 2013 [PDF - 1.32 MB - 4 pages]
R. Lotte et al.

After the deaths of 2 preterm neonates with Bacillus cereus systemic infection in the same intensive care unit, we investigated the pathogenic potential of this bacterium. Genetic and virulence analysis indicated the neonates were infected with 2 different strains with a virulence potential similar to environmental strains, indicating likely patient immune response failure.

EID Lotte R, Hérissé A, Berrouane Y, Lotte L, Casagrande F, Landraud L, et al. Virulence Analysis of Bacillus cereus Isolated after Death of Preterm Neonates, Nice, France, 2013. Emerg Infect Dis. 2017;23(5):845-848. https://dx.doi.org/10.3201/eid2305.161788
AMA Lotte R, Hérissé A, Berrouane Y, et al. Virulence Analysis of Bacillus cereus Isolated after Death of Preterm Neonates, Nice, France, 2013. Emerging Infectious Diseases. 2017;23(5):845-848. doi:10.3201/eid2305.161788.
APA Lotte, R., Hérissé, A., Berrouane, Y., Lotte, L., Casagrande, F., Landraud, L....Ruimy, R. (2017). Virulence Analysis of Bacillus cereus Isolated after Death of Preterm Neonates, Nice, France, 2013. Emerging Infectious Diseases, 23(5), 845-848. https://dx.doi.org/10.3201/eid2305.161788.
Research Letters

Management of Bartonella Prosthetic Valve Endocarditis without Cardiac Surgery [PDF - 336 KB - 3 pages]
P. Papineni et al.

Two cases of Bartonella prosthetic valve endocarditis were cured when treated for 2 weeks with gentamicin and 3 months with doxycycline. Clinical cure correlated with decreased Bartonella antibody titers. This report suggests a strategy to monitor, treat, and cure Bartonella prosthetic valve endocarditis.

EID Papineni P, Carroll A, Radvan J, Hemsley C, Chambers J, Cortes N, et al. Management of Bartonella Prosthetic Valve Endocarditis without Cardiac Surgery. Emerg Infect Dis. 2017;23(5):861-863. https://dx.doi.org/10.3201/eid2305.161238
AMA Papineni P, Carroll A, Radvan J, et al. Management of Bartonella Prosthetic Valve Endocarditis without Cardiac Surgery. Emerging Infectious Diseases. 2017;23(5):861-863. doi:10.3201/eid2305.161238.
APA Papineni, P., Carroll, A., Radvan, J., Hemsley, C., Chambers, J., Cortes, N....Klein, J. L. (2017). Management of Bartonella Prosthetic Valve Endocarditis without Cardiac Surgery. Emerging Infectious Diseases, 23(5), 861-863. https://dx.doi.org/10.3201/eid2305.161238.

Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy
J. R. Sotelo et al.

We detected Zika virus in breast milk of a woman in Brazil infected with the virus during the 36th week of pregnancy. Virus was detected 33 days after onset of signs and symptoms and 9 days after delivery. No abnormalities were found during fetal assessment or after birth of the infant.

EID Sotelo JR, Sotelo AB, Sotelo F, Doi AM, Pinho J, Oliveira R, et al. Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy. Emerg Infect Dis. 2017;23(5):854-856. https://dx.doi.org/10.3201/eid2305.161538
AMA Sotelo JR, Sotelo AB, Sotelo F, et al. Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy. Emerging Infectious Diseases. 2017;23(5):854-856. doi:10.3201/eid2305.161538.
APA Sotelo, J. R., Sotelo, A. B., Sotelo, F., Doi, A. M., Pinho, J., Oliveira, R....Mangueira, C. (2017). Persistence of Zika Virus in Breast Milk after Infection in Late Stage of Pregnancy. Emerging Infectious Diseases, 23(5), 854-856. https://dx.doi.org/10.3201/eid2305.161538.

mcr-1 Colistin Resistance in ESBL-Producing Klebsiella pneumoniae, France [PDF - 352 KB - 3 pages]
Y. Caspar et al.

We report intestinal carriage of an extended-spectrum β-lactamase−producing Klebsiella pneumoniae strain with high-level resistance to colistin (MIC 24 mg/L) in a patient in France who had been hospitalized for fungal meningitis. The strain had the mcr-1 plasmid gene and an inactivated mgrB gene, which are associated with colistin resistance.

EID Caspar Y, Maillet M, Pavese P, Francony G, Brion J, Mallaret M, et al. mcr-1 Colistin Resistance in ESBL-Producing Klebsiella pneumoniae, France. Emerg Infect Dis. 2017;23(5):874-876. https://dx.doi.org/10.3201/eid2305.161942
AMA Caspar Y, Maillet M, Pavese P, et al. mcr-1 Colistin Resistance in ESBL-Producing Klebsiella pneumoniae, France. Emerging Infectious Diseases. 2017;23(5):874-876. doi:10.3201/eid2305.161942.
APA Caspar, Y., Maillet, M., Pavese, P., Francony, G., Brion, J., Mallaret, M....Maurin, M. (2017). mcr-1 Colistin Resistance in ESBL-Producing Klebsiella pneumoniae, France. Emerging Infectious Diseases, 23(5), 874-876. https://dx.doi.org/10.3201/eid2305.161942.

Diagnosis and Management of Borrelia turicatae Infection in Febrile Soldier, Texas, USA [PDF - 328 KB - 2 pages]
A. M. Christensen et al.

In August 2015, a soldier returned from field exercises in Texas, USA, with nonspecific febrile illness. Culture and sequencing of spirochetes from peripheral blood diagnosed Borrelia turicatae infection. The patient recovered after receiving doxycycline. No illness occurred in asymptomatic soldiers potentially exposed to the vector tick and prophylactically given treatment.

EID Christensen AM, Pietralczyk E, Lopez JE, Brooks C, Schriefer M, Wozniak E, et al. Diagnosis and Management of Borrelia turicatae Infection in Febrile Soldier, Texas, USA. Emerg Infect Dis. 2017;23(5):883-884. https://dx.doi.org/10.3201/eid2305.162069
AMA Christensen AM, Pietralczyk E, Lopez JE, et al. Diagnosis and Management of Borrelia turicatae Infection in Febrile Soldier, Texas, USA. Emerging Infectious Diseases. 2017;23(5):883-884. doi:10.3201/eid2305.162069.
APA Christensen, A. M., Pietralczyk, E., Lopez, J. E., Brooks, C., Schriefer, M., Wozniak, E....Stermole, B. (2017). Diagnosis and Management of Borrelia turicatae Infection in Febrile Soldier, Texas, USA. Emerging Infectious Diseases, 23(5), 883-884. https://dx.doi.org/10.3201/eid2305.162069.

Severe MRSA Enterocolitis Caused by a Strain Harboring Enterotoxins D, G, and I [PDF - 948 KB - 3 pages]
M. Bergevin et al.

We describe a case of methicillin-resistant Staphylococcus aureus (MRSA) enterocolitis in a healthy adult with previous antibiotic exposure. Colonoscopy revealed diffuse colitis and mild ileitis without ulceration. Stool cultures demonstrated abundant growth of MRSA and absent normal flora. Oral vancomycin treatment was effective and seems to be the consensus choice for therapy.

EID Bergevin M, Marion A, Farber D, Golding GR, Lévesque S. Severe MRSA Enterocolitis Caused by a Strain Harboring Enterotoxins D, G, and I. Emerg Infect Dis. 2017;23(5):865-867. https://dx.doi.org/10.3201/eid2305.161644
AMA Bergevin M, Marion A, Farber D, et al. Severe MRSA Enterocolitis Caused by a Strain Harboring Enterotoxins D, G, and I. Emerging Infectious Diseases. 2017;23(5):865-867. doi:10.3201/eid2305.161644.
APA Bergevin, M., Marion, A., Farber, D., Golding, G. R., & Lévesque, S. (2017). Severe MRSA Enterocolitis Caused by a Strain Harboring Enterotoxins D, G, and I. Emerging Infectious Diseases, 23(5), 865-867. https://dx.doi.org/10.3201/eid2305.161644.

Reemergence of African Swine Fever in Zimbabwe, 2015 [PDF - 396 KB - 2 pages]
J. van Heerden et al.

Zimbabwe is the only country in southern Africa with no reported African swine fever (ASF) outbreaks during 1993–2014. However, the 2015 discovery of genotype II ASF virus in Zimbabwe indicates the reemergence of ASF in this country and suggests that this viral genotype may be spreading through eastern and southern Africa.

EID van Heerden J, Malan K, Gadaga BM, Spargo RM. Reemergence of African Swine Fever in Zimbabwe, 2015. Emerg Infect Dis. 2017;23(5):860-861. https://dx.doi.org/10.3201/eid2305.161195
AMA van Heerden J, Malan K, Gadaga BM, et al. Reemergence of African Swine Fever in Zimbabwe, 2015. Emerging Infectious Diseases. 2017;23(5):860-861. doi:10.3201/eid2305.161195.
APA van Heerden, J., Malan, K., Gadaga, B. M., & Spargo, R. M. (2017). Reemergence of African Swine Fever in Zimbabwe, 2015. Emerging Infectious Diseases, 23(5), 860-861. https://dx.doi.org/10.3201/eid2305.161195.

Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016 [PDF - 368 KB - 3 pages]
H. M. Soeters et al.

In response to a university-based serogroup B meningococcal disease outbreak, the serogroup B meningococcal vaccine Trumenba was recommended for students, a rare instance in which a specific vaccine brand was recommended. This outbreak highlights the challenges of using molecular and immunologic data to inform real-time response.

EID Soeters HM, Dinitz-Sklar J, Kulkarni PA, MacNeil JR, McNamara LA, Zaremski E, et al. Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016. Emerg Infect Dis. 2017;23(5):867-869. https://dx.doi.org/10.3201/eid2305.161870
AMA Soeters HM, Dinitz-Sklar J, Kulkarni PA, et al. Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016. Emerging Infectious Diseases. 2017;23(5):867-869. doi:10.3201/eid2305.161870.
APA Soeters, H. M., Dinitz-Sklar, J., Kulkarni, P. A., MacNeil, J. R., McNamara, L. A., Zaremski, E....Montana, B. (2017). Serogroup B Meningococcal Disease Vaccine Recommendations at a University, New Jersey, USA, 2016. Emerging Infectious Diseases, 23(5), 867-869. https://dx.doi.org/10.3201/eid2305.161870.

Carbapenem-Resistant Enterobacter cloacae in Patients from the US Veterans Health Administration, 2006–2015 [PDF - 653 KB - 3 pages]
B. M. Wilson et al.

We analyzed carbapenem-resistant Enterobacteriaceae (CRE) trends among patients from the US Veterans Health Administration (VHA). After the emergence of CRE in the eastern United States, resistance rates remained stable in Klebsiella pneumoniae but increased in Enterobacter cloacae complex, suggesting a "second epidemic". VHA offers a vantage point for monitoring nationwide CRE trends.

EID Wilson BM, El Chakhtoura NG, Patel S, Saade E, Donskey CJ, Bonomo RA, et al. Carbapenem-Resistant Enterobacter cloacae in Patients from the US Veterans Health Administration, 2006–2015. Emerg Infect Dis. 2017;23(5):878-880. https://dx.doi.org/10.3201/eid2305.162034
AMA Wilson BM, El Chakhtoura NG, Patel S, et al. Carbapenem-Resistant Enterobacter cloacae in Patients from the US Veterans Health Administration, 2006–2015. Emerging Infectious Diseases. 2017;23(5):878-880. doi:10.3201/eid2305.162034.
APA Wilson, B. M., El Chakhtoura, N. G., Patel, S., Saade, E., Donskey, C. J., Bonomo, R. A....Perez, F. (2017). Carbapenem-Resistant Enterobacter cloacae in Patients from the US Veterans Health Administration, 2006–2015. Emerging Infectious Diseases, 23(5), 878-880. https://dx.doi.org/10.3201/eid2305.162034.

Zika Virus Infection and Prolonged Viremia in Whole-Blood Specimens [PDF - 450 KB - 3 pages]
J. Mansuy et al.

We tested whole-blood and plasma samples from immunocompetent patients who had had benign Zika virus infections and found that Zika virus RNA persisted in whole blood substantially longer than in plasma. This finding may have implications for diagnosis of acute symptomatic and asymptomatic infections and for testing of blood donations.

EID Mansuy J, Mengelle C, Pasquier C, Chapuy-Regaud S, Delobel P, Martin-Blondel G, et al. Zika Virus Infection and Prolonged Viremia in Whole-Blood Specimens. Emerg Infect Dis. 2017;23(5):863-865. https://dx.doi.org/10.3201/eid2305.161631
AMA Mansuy J, Mengelle C, Pasquier C, et al. Zika Virus Infection and Prolonged Viremia in Whole-Blood Specimens. Emerging Infectious Diseases. 2017;23(5):863-865. doi:10.3201/eid2305.161631.
APA Mansuy, J., Mengelle, C., Pasquier, C., Chapuy-Regaud, S., Delobel, P., Martin-Blondel, G....Izopet, J. (2017). Zika Virus Infection and Prolonged Viremia in Whole-Blood Specimens. Emerging Infectious Diseases, 23(5), 863-865. https://dx.doi.org/10.3201/eid2305.161631.

Clinical Manifestations of Punta Toro Virus Species Complex Infections, Panama, 2009 [PDF - 821 KB - 3 pages]
N. D. Gundacker et al.

An investigation in Panama found that Punta Toro virus species complex (PTVs) may contribute to febrile illnesses with symptoms mirroring those of dengue fever. However, further studies are needed to determine if PTV infection causes only a mild disease or if it can have more serious manifestations in some patients.

EID Gundacker ND, Carrera J, Castillo M, Díaz Y, Valenzuela J, Tamhane A, et al. Clinical Manifestations of Punta Toro Virus Species Complex Infections, Panama, 2009. Emerg Infect Dis. 2017;23(5):872-874. https://dx.doi.org/10.3201/eid2305.161925
AMA Gundacker ND, Carrera J, Castillo M, et al. Clinical Manifestations of Punta Toro Virus Species Complex Infections, Panama, 2009. Emerging Infectious Diseases. 2017;23(5):872-874. doi:10.3201/eid2305.161925.
APA Gundacker, N. D., Carrera, J., Castillo, M., Díaz, Y., Valenzuela, J., Tamhane, A....López-Vergès, S. (2017). Clinical Manifestations of Punta Toro Virus Species Complex Infections, Panama, 2009. Emerging Infectious Diseases, 23(5), 872-874. https://dx.doi.org/10.3201/eid2305.161925.

Chromosomal 16S Ribosomal RNA Methyltransferase RmtE1 in Escherichia coli Sequence Type 448 [PDF - 341 KB - 3 pages]
B. Li et al.

We identified rmtE1, an uncommon 16S ribosomal methyltransferase gene, in an aminoglycoside- and cephalosporin-resistant Escherichia coli sequence type 448 clinical strain co-harboring blaCMY-2. Long-read sequencing revealed insertion of a 101,257-bp fragment carrying both resistance genes to the chromosome. Our findings underscore E. coli sequence type 448 as a potential high-risk multidrug-resistant clone.

EID Li B, Pacey MP, Doi Y. Chromosomal 16S Ribosomal RNA Methyltransferase RmtE1 in Escherichia coli Sequence Type 448. Emerg Infect Dis. 2017;23(5):876-878. https://dx.doi.org/10.3201/eid2305.162000
AMA Li B, Pacey MP, Doi Y. Chromosomal 16S Ribosomal RNA Methyltransferase RmtE1 in Escherichia coli Sequence Type 448. Emerging Infectious Diseases. 2017;23(5):876-878. doi:10.3201/eid2305.162000.
APA Li, B., Pacey, M. P., & Doi, Y. (2017). Chromosomal 16S Ribosomal RNA Methyltransferase RmtE1 in Escherichia coli Sequence Type 448. Emerging Infectious Diseases, 23(5), 876-878. https://dx.doi.org/10.3201/eid2305.162000.

Vertical Transmission of Zika Virus by Aedes aegypti and Ae. albopictus Mosquitoes [PDF - 343 KB - 3 pages]
A. T. Ciota et al.

To determine the potential role of vertical transmission in Zika virus expansion, we evaluated larval pools of perorally infected Aedes aegypti and Ae. albopictus adult female mosquitoes; ≈1/84 larvae tested were Zika virus–positive; and rates varied among mosquito populations. Thus, vertical transmission may play a role in Zika virus spread and maintenance.

EID Ciota AT, Bialosuknia SM, Ehrbar DJ, Kramer LD. Vertical Transmission of Zika Virus by Aedes aegypti and Ae. albopictus Mosquitoes. Emerg Infect Dis. 2017;23(5):880-882. https://dx.doi.org/10.3201/eid2305.162041
AMA Ciota AT, Bialosuknia SM, Ehrbar DJ, et al. Vertical Transmission of Zika Virus by Aedes aegypti and Ae. albopictus Mosquitoes. Emerging Infectious Diseases. 2017;23(5):880-882. doi:10.3201/eid2305.162041.
APA Ciota, A. T., Bialosuknia, S. M., Ehrbar, D. J., & Kramer, L. D. (2017). Vertical Transmission of Zika Virus by Aedes aegypti and Ae. albopictus Mosquitoes. Emerging Infectious Diseases, 23(5), 880-882. https://dx.doi.org/10.3201/eid2305.162041.

No Such Thing as Chronic Q Fever [PDF - 303 KB - 2 pages]
M. Million and D. Raoult

Modern diagnostic methods enable clinicians to look beyond a diagnosis of chronic Q fever and discern whether patients instead have persistent focalized Coxiella burnetii infection(s). Use of these methods and development of criteria to define and treat such infections, especially cardiovascular infections, will improve the prognosis for patients previously thought to have chronic Q fever.

EID Million M, Raoult D. No Such Thing as Chronic Q Fever. Emerg Infect Dis. 2017;23(5):856-857. https://dx.doi.org/10.3201/eid2305.151159
AMA Million M, Raoult D. No Such Thing as Chronic Q Fever. Emerging Infectious Diseases. 2017;23(5):856-857. doi:10.3201/eid2305.151159.
APA Million, M., & Raoult, D. (2017). No Such Thing as Chronic Q Fever. Emerging Infectious Diseases, 23(5), 856-857. https://dx.doi.org/10.3201/eid2305.151159.

ESBL- and Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, Yangon, Myanmar, 2014 [PDF - 348 KB - 3 pages]
T. O. Myat et al.

Among 42 gram-negative bloodstream isolates from inpatients in 3 hospitals in Yangon, Myanmar, admitted during July–December 2014, 16 (38%) were extended-spectrum β-lactamase–producing Enterobacteriaceae and 6 (14%) produced carbapenemase. The high prevalence of multidrug-resistant gram-negative bacteria raises concerns about the empiric treatment of patients with sepsis in Yangon.

EID Myat TO, Hannaway RF, Zin KN, Htike WW, Win KK, Crump JA, et al. ESBL- and Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, Yangon, Myanmar, 2014. Emerg Infect Dis. 2017;23(5):857-859. https://dx.doi.org/10.3201/eid2305.161100
AMA Myat TO, Hannaway RF, Zin KN, et al. ESBL- and Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, Yangon, Myanmar, 2014. Emerging Infectious Diseases. 2017;23(5):857-859. doi:10.3201/eid2305.161100.
APA Myat, T. O., Hannaway, R. F., Zin, K. N., Htike, W. W., Win, K. K., Crump, J. A....Ussher, J. E. (2017). ESBL- and Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, Yangon, Myanmar, 2014. Emerging Infectious Diseases, 23(5), 857-859. https://dx.doi.org/10.3201/eid2305.161100.

Meningococci of Serogroup X Clonal Complex 181 in Refugee Camps, Italy [PDF - 673 KB - 3 pages]
P. Stefanelli et al.

Four cases of infection with serogroup X meningococci (MenX) (1 in 2015 and 3 in 2016) occurred in migrants living in refugee camps or reception centers in Italy. All MenX isolates were identified as clonal complex 181. Our report suggests that serogroup X represents an emerging health threat for persons arriving from African countries.

EID Stefanelli P, Neri A, Vacca P, Picicco D, Daprai L, Mainardi G, et al. Meningococci of Serogroup X Clonal Complex 181 in Refugee Camps, Italy. Emerg Infect Dis. 2017;23(5):870-872. https://dx.doi.org/10.3201/eid2305.161713
AMA Stefanelli P, Neri A, Vacca P, et al. Meningococci of Serogroup X Clonal Complex 181 in Refugee Camps, Italy. Emerging Infectious Diseases. 2017;23(5):870-872. doi:10.3201/eid2305.161713.
APA Stefanelli, P., Neri, A., Vacca, P., Picicco, D., Daprai, L., Mainardi, G....Fazio, C. (2017). Meningococci of Serogroup X Clonal Complex 181 in Refugee Camps, Italy. Emerging Infectious Diseases, 23(5), 870-872. https://dx.doi.org/10.3201/eid2305.161713.
Letters

CTX-M-27–Producing Escherichia coli of Sequence Type 131 and Clade C1-M27, France [PDF - 311 KB - 1 page]
A. Birgy et al.
EID Birgy A, Bidet P, Levy C, Sobral E, Cohen R, Bonacorsi S. CTX-M-27–Producing Escherichia coli of Sequence Type 131 and Clade C1-M27, France. Emerg Infect Dis. 2017;23(5):885. https://dx.doi.org/10.3201/eid2305.161865
AMA Birgy A, Bidet P, Levy C, et al. CTX-M-27–Producing Escherichia coli of Sequence Type 131 and Clade C1-M27, France. Emerging Infectious Diseases. 2017;23(5):885. doi:10.3201/eid2305.161865.
APA Birgy, A., Bidet, P., Levy, C., Sobral, E., Cohen, R., & Bonacorsi, S. (2017). CTX-M-27–Producing Escherichia coli of Sequence Type 131 and Clade C1-M27, France. Emerging Infectious Diseases, 23(5), 885. https://dx.doi.org/10.3201/eid2305.161865.

Antimicrobial Drug Resistance among Refugees from Syria, Jordan [PDF - 1.05 MB]
A. Abbara et al.
EID Abbara A, Al-Harbat N, Karah N, Abo-Yahya B, El-Amin W, Hatcher J, et al. Antimicrobial Drug Resistance among Refugees from Syria, Jordan. Emerg Infect Dis. 2017;23(5):885-886. https://dx.doi.org/10.3201/eid2305.170117
AMA Abbara A, Al-Harbat N, Karah N, et al. Antimicrobial Drug Resistance among Refugees from Syria, Jordan. Emerging Infectious Diseases. 2017;23(5):885-886. doi:10.3201/eid2305.170117.
APA Abbara, A., Al-Harbat, N., Karah, N., Abo-Yahya, B., El-Amin, W., Hatcher, J....Gabbar, O. (2017). Antimicrobial Drug Resistance among Refugees from Syria, Jordan. Emerging Infectious Diseases, 23(5), 885-886. https://dx.doi.org/10.3201/eid2305.170117.
Another Dimension

The Discovery of Penicillin—New Insights After More Than 75 Years of Clinical Use [PDF - 1.48 MB - 5 pages]
R. Gaynes

After just over 75 years of penicillin’s clinical use, the world can see that its impact was immediate and profound. In 1928, a chance event in Alexander Fleming’s London laboratory changed the course of medicine. However, the purification and first clinical use of penicillin would take more than a decade. Unprecedented United States/Great Britain cooperation to produce penicillin was incredibly successful by 1943. This success overshadowed efforts to produce penicillin during World War II in Europe, particularly in the Netherlands. Information about these efforts, available only in the last 10–15 years, provides new insights into the story of the first antibiotic. Researchers in the Netherlands produced penicillin using their own production methods and marketed it in 1946, which eventually increased the penicillin supply and decreased the price. The unusual serendipity involved in the discovery of penicillin demonstrates the difficulties in finding new antibiotics and should remind health professionals to expertly manage these extraordinary medicines.

EID Gaynes R. The Discovery of Penicillin—New Insights After More Than 75 Years of Clinical Use. Emerg Infect Dis. 2017;23(5):849-853. https://dx.doi.org/10.3201/eid2305.161556
AMA Gaynes R. The Discovery of Penicillin—New Insights After More Than 75 Years of Clinical Use. Emerging Infectious Diseases. 2017;23(5):849-853. doi:10.3201/eid2305.161556.
APA Gaynes, R. (2017). The Discovery of Penicillin—New Insights After More Than 75 Years of Clinical Use. Emerging Infectious Diseases, 23(5), 849-853. https://dx.doi.org/10.3201/eid2305.161556.
About the Cover

Naïve Arrogance and Vulnerability [PDF - 1.60 MB - 2 pages]
B. Breedlove and P. M. Arguin
EID Breedlove B, Arguin PM. Naïve Arrogance and Vulnerability. Emerg Infect Dis. 2017;23(5):887-888. https://dx.doi.org/10.3201/eid2305.ac2305
AMA Breedlove B, Arguin PM. Naïve Arrogance and Vulnerability. Emerging Infectious Diseases. 2017;23(5):887-888. doi:10.3201/eid2305.ac2305.
APA Breedlove, B., & Arguin, P. M. (2017). Naïve Arrogance and Vulnerability. Emerging Infectious Diseases, 23(5), 887-888. https://dx.doi.org/10.3201/eid2305.ac2305.
Etymologia

Etymologia: Fluoroquinolone [PDF - 363 KB - 1 page]
R. Henry
EID Henry R. Etymologia: Fluoroquinolone. Emerg Infect Dis. 2017;23(5):812. https://dx.doi.org/10.3201/eid2305.et2305
AMA Henry R. Etymologia: Fluoroquinolone. Emerging Infectious Diseases. 2017;23(5):812. doi:10.3201/eid2305.et2305.
APA Henry, R. (2017). Etymologia: Fluoroquinolone. Emerging Infectious Diseases, 23(5), 812. https://dx.doi.org/10.3201/eid2305.et2305.
Online Reports

Translation of Real-Time Infectious Disease Modeling into Routine Public Health Practice [PDF - 311 KB - 6 pages]
D. J. Muscatello et al.

Infectious disease dynamic modeling can support outbreak emergency responses. We conducted a workshop to canvas the needs of stakeholders in Australia for practical, real-time modeling tools for infectious disease emergencies. The workshop was attended by 29 participants who represented government, defense, general practice, and academia stakeholders. We found that modeling is underused in Australia and its potential is poorly understood by practitioners involved in epidemic responses. The development of better modeling tools is desired. Ideal modeling tools for operational use would be easy to use, clearly indicate underlying parameterization and assumptions, and assist with policy and decision making.

Corrections

Correction: Vol. 16, No. 1 [PDF - 238 KB - 1 page]
Page created: May 30, 2017
Page updated: May 30, 2017
Page reviewed: May 30, 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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