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Issue Cover for Volume 24, Number 11—November 2018

Volume 24, Number 11—November 2018

[PDF - 6.31 MB - 176 pages]

Synopses

Leishmaniasis in Northern Syria during Civil War [PDF - 1.77 MB - 9 pages]
K. Rehman et al.

Since the onset of the ongoing civil war in Syria, the governmental surveillance system for leishmaniasis has lost access to provinces of northern Syria. The MENTOR Initiative, an international not-for-profit organization, was commissioned to implement an integrated leishmaniasis control program, providing an opportunity to reassess the epidemiology of leishmaniasis in northern Syria. Epidemiologic data and biologic samples for molecular species diagnostics were collected from collaborating local health centers. Incidence peaked in March 2015 at 7,743 estimated monthly cases. High levels of transmission were observed in traditional endemic regions but extended to previously hypoendemic regions, such as Al-Raqqa and Al-Hasakah. Incidence decreased to 3,209 in July 2015. Data indicate that the prewar trend of increasing incidence of cutaneous leishmaniasis accelerated during the beginning of armed conflict but declined after implementation of the comprehensive control program by the MENTOR Initiative. Molecular analysis revealed a spectrum of Leishmania species and sporadic cases of visceral leishmaniasis.

EID Rehman K, Walochnik J, Mischlinger J, Alassil B, Allan R, Ramharter M. Leishmaniasis in Northern Syria during Civil War. Emerg Infect Dis. 2018;24(11):1973-1981. https://dx.doi.org/10.3201/eid2411.172146
AMA Rehman K, Walochnik J, Mischlinger J, et al. Leishmaniasis in Northern Syria during Civil War. Emerging Infectious Diseases. 2018;24(11):1973-1981. doi:10.3201/eid2411.172146.
APA Rehman, K., Walochnik, J., Mischlinger, J., Alassil, B., Allan, R., & Ramharter, M. (2018). Leishmaniasis in Northern Syria during Civil War. Emerging Infectious Diseases, 24(11), 1973-1981. https://dx.doi.org/10.3201/eid2411.172146.

Medscape CME Activity
Rickettsia typhi as Cause of Fatal Encephalitic Typhus in Hospitalized Patients, Hamburg, Germany, 1940–1944 [PDF - 3.69 MB - 6 pages]
J. Rauch et al.

We evaluated formalin-fixed paraffin-embedded tissue specimens from 7 patients who died with encephalitic typhus in Hamburg, Germany, during World War II. The archived specimens included only central nervous system tissues >70 years old that had been stored at room temperature. We demonstrated successful detection of Rickettsia typhi DNA by a nested qPCR specific to prsA in 2 patients. These results indicate that R. typhi infections contributed to typhus outbreaks during World War II. Immunohistochemical analyses of brain tissue specimens of R. typhi DNA–positive and –negative specimens showed perivascular B-cell accumulation. Around blood vessels, nodular cell accumulations consisted of CD4-positive and CD8-positive T cells and CD68-positive microglia and macrophages; neutrophils were found rarely. These findings are similar to those of previously reported R. prowazekii tissue specimen testing. Because R. typhi and R. prowazekii infections can be clinically and histopathologically similar, molecular analyses should be performed to distinguish the 2 pathogens.

EID Rauch J, Muntau B, Eggert P, Tappe D. Rickettsia typhi as Cause of Fatal Encephalitic Typhus in Hospitalized Patients, Hamburg, Germany, 1940–1944. Emerg Infect Dis. 2018;24(11):1982-1987. https://dx.doi.org/10.3201/eid2411.171373
AMA Rauch J, Muntau B, Eggert P, et al. Rickettsia typhi as Cause of Fatal Encephalitic Typhus in Hospitalized Patients, Hamburg, Germany, 1940–1944. Emerging Infectious Diseases. 2018;24(11):1982-1987. doi:10.3201/eid2411.171373.
APA Rauch, J., Muntau, B., Eggert, P., & Tappe, D. (2018). Rickettsia typhi as Cause of Fatal Encephalitic Typhus in Hospitalized Patients, Hamburg, Germany, 1940–1944. Emerging Infectious Diseases, 24(11), 1982-1987. https://dx.doi.org/10.3201/eid2411.171373.

Epidemiology of Buruli Ulcer Infections, Victoria, Australia, 2011–2016 [PDF - 1.50 MB - 10 pages]
M. J. Loftus et al.

Buruli ulcer (BU) is a destructive soft-tissue infection caused by the environmental pathogen Mycobacterium ulcerans. In response to rising BU notifications in the state of Victoria, Australia, we reviewed all cases that occurred during 2011–2016 to precisely map the time and likely place of M. ulcerans acquisition. We found that 600 cases of BU had been notified; just over half were in residents and the remainder in visitors to defined BU-endemic areas. During the study period, notifications increased almost 3-fold, from 66 in 2013 to 182 in 2016. We identified 4 BU-endemic areas: Bellarine Peninsula, Mornington Peninsula, Frankston region, and the southeastern Bayside suburbs of Melbourne. We observed a decline in cases on the Bellarine Peninsula but a progressive increase elsewhere. Acquisitions peaked in late summer. The appearance of new BU-endemic areas and the decline in established areas probably correlate with changes in the level of local environmental contamination with M. ulcerans.

EID Loftus MJ, Tay E, Globan M, Lavender CJ, Crouch SR, Johnson P, et al. Epidemiology of Buruli Ulcer Infections, Victoria, Australia, 2011–2016. Emerg Infect Dis. 2018;24(11):1988-1997. https://dx.doi.org/10.3201/eid2411.171593
AMA Loftus MJ, Tay E, Globan M, et al. Epidemiology of Buruli Ulcer Infections, Victoria, Australia, 2011–2016. Emerging Infectious Diseases. 2018;24(11):1988-1997. doi:10.3201/eid2411.171593.
APA Loftus, M. J., Tay, E., Globan, M., Lavender, C. J., Crouch, S. R., Johnson, P....Fyfe, J. (2018). Epidemiology of Buruli Ulcer Infections, Victoria, Australia, 2011–2016. Emerging Infectious Diseases, 24(11), 1988-1997. https://dx.doi.org/10.3201/eid2411.171593.

Medscape CME Activity
Cryptococcus gattii Complex Infections in HIV-Infected Patients, Southeastern United States [PDF - 553 KB - 5 pages]
K. T. Bruner et al.

Cryptococcus gattii traditionally infects immunocompetent hosts and causes devastating pulmonary or central nervous system disease. However, this infection rarely occurs in patients infected with HIV. We report 3 cases of HIV-associated C. gattii complex infections in the southeastern United States. Detection of C. gattii in HIV-infected patients in this region warrants increased awareness of this threat to ensure appropriate diagnosis and treatment to optimize patient outcomes.

EID Bruner KT, Franco-Paredes C, Henao-Martínez AF, Steele GM, Chastain DB. Cryptococcus gattii Complex Infections in HIV-Infected Patients, Southeastern United States. Emerg Infect Dis. 2018;24(11):1998-2002. https://dx.doi.org/10.3201/eid2411.180787
AMA Bruner KT, Franco-Paredes C, Henao-Martínez AF, et al. Cryptococcus gattii Complex Infections in HIV-Infected Patients, Southeastern United States. Emerging Infectious Diseases. 2018;24(11):1998-2002. doi:10.3201/eid2411.180787.
APA Bruner, K. T., Franco-Paredes, C., Henao-Martínez, A. F., Steele, G. M., & Chastain, D. B. (2018). Cryptococcus gattii Complex Infections in HIV-Infected Patients, Southeastern United States. Emerging Infectious Diseases, 24(11), 1998-2002. https://dx.doi.org/10.3201/eid2411.180787.
Research

Detection of Tickborne Relapsing Fever Spirochete, Austin, Texas, USA [PDF - 2.36 MB - 7 pages]
J. D. Bissett et al.

In March 2017, a patient became febrile within 4 days after visiting a rustic conference center in Austin, Texas, USA, where Austin Public Health suspected an outbreak of tickborne relapsing fever a month earlier. Evaluation of a patient blood smear and molecular diagnostic assays identified Borrelia turicatae as the causative agent. We could not gain access to the property to collect ticks. Thus, we focused efforts at a nearby public park, <1 mile from the suspected exposure site. We trapped Ornithodoros turicata ticks from 2 locations in the park, and laboratory evaluation resulted in cultivation of 3 B. turicatae isolates. Multilocus sequencing of 3 chromosomal loci (flaB, rrs, and gyrB) indicated that the isolates were identical to those of B. turicatae 91E135 (a tick isolate) and BTE5EL (a human isolate). We identified the endemicity of O. turicata ticks and likely emergence of B. turicatae in this city.

EID Bissett JD, Ledet S, Krishnavajhala A, Armstrong BA, Klioueva A, Sexton C, et al. Detection of Tickborne Relapsing Fever Spirochete, Austin, Texas, USA. Emerg Infect Dis. 2018;24(11):2003-2009. https://dx.doi.org/10.3201/eid2411.172033
AMA Bissett JD, Ledet S, Krishnavajhala A, et al. Detection of Tickborne Relapsing Fever Spirochete, Austin, Texas, USA. Emerging Infectious Diseases. 2018;24(11):2003-2009. doi:10.3201/eid2411.172033.
APA Bissett, J. D., Ledet, S., Krishnavajhala, A., Armstrong, B. A., Klioueva, A., Sexton, C....Lopez, J. E. (2018). Detection of Tickborne Relapsing Fever Spirochete, Austin, Texas, USA. Emerging Infectious Diseases, 24(11), 2003-2009. https://dx.doi.org/10.3201/eid2411.172033.

Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017 [PDF - 2.95 MB - 11 pages]
K. Ubukata et al.

To clarify year-to-year changes in capsular serotypes, resistance genotypes, and multilocus sequence types of Streptococcus pneumoniae, we compared isolates collected from patients with invasive pneumococcal disease before and after introductions of 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PVC13, respectively). From April 2010 through March 2017, we collected 2,856 isolates from children and adults throughout Japan. Proportions of PCV13 serotypes among children decreased from 89.0% in fiscal year 2010 to 12.1% in fiscal year 2016 and among adults from 74.1% to 36.2%. Although nonvaccine serotypes increased after introduction of PCV13, genotypic penicillin resistance decreased from 54.3% in 2010 to 11.2% in 2016 among children and from 32.4% to 15.5% among adults. However, genotypic penicillin resistance emerged in 9 nonvaccine serotypes, but not 15A and 35B. Multilocus sequence typing suggested that resistant strains among nonvaccine serotypes may have evolved from clonal complexes 156 and 81. A more broadly effective vaccine is needed.

EID Ubukata K, Takata M, Morozumi M, Chiba N, Wajima T, Hanada S, et al. Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017. Emerg Infect Dis. 2018;24(11):2010-2020. https://dx.doi.org/10.3201/eid2411.180326
AMA Ubukata K, Takata M, Morozumi M, et al. Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017. Emerging Infectious Diseases. 2018;24(11):2010-2020. doi:10.3201/eid2411.180326.
APA Ubukata, K., Takata, M., Morozumi, M., Chiba, N., Wajima, T., Hanada, S....Iwata, S. (2018). Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017. Emerging Infectious Diseases, 24(11), 2010-2020. https://dx.doi.org/10.3201/eid2411.180326.

Norovirus Gastroenteritis among Hospitalized Patients, Germany, 2007–2012 [PDF - 1.86 MB - 8 pages]
F. Kowalzik et al.

We estimated numbers of hospitalizations for norovirus gastroenteritis (NGE) and associated medical costs in Germany, where norovirus testing is high because reimbursement is affected. We extracted aggregate data for patients hospitalized with a primary or secondary code from the International Classification of Diseases, 10th Revision (ICD-10), NGE diagnosis during 2007–2012 from the German Federal Statistics Office. We assessed reliability of the coding system in patient records from a large academic hospital. Approximately 53,000–90,000 NGE hospitalizations occurred annually in Germany (21,000–33,000 with primary and 32,000–57,000 with secondary ICD-10–coded NGE diagnoses). Rates of hospitalization with NGE as primary diagnosis were highest in children <2 years of age; rates of hospitalization with NGE as secondary diagnosis were highest in adults >85 years of age. The average annual reimbursed direct medical cost of NGE hospitalizations was €31–43 million. Among patients with a NGE ICD-10 code, 87.6% had positive norovirus laboratory results.

EID Kowalzik F, Binder H, Zöller D, Riera-Montes M, Clemens R, Verstraeten T, et al. Norovirus Gastroenteritis among Hospitalized Patients, Germany, 2007–2012. Emerg Infect Dis. 2018;24(11):2021-2028. https://dx.doi.org/10.3201/eid2411.170820
AMA Kowalzik F, Binder H, Zöller D, et al. Norovirus Gastroenteritis among Hospitalized Patients, Germany, 2007–2012. Emerging Infectious Diseases. 2018;24(11):2021-2028. doi:10.3201/eid2411.170820.
APA Kowalzik, F., Binder, H., Zöller, D., Riera-Montes, M., Clemens, R., Verstraeten, T....Zepp, F. (2018). Norovirus Gastroenteritis among Hospitalized Patients, Germany, 2007–2012. Emerging Infectious Diseases, 24(11), 2021-2028. https://dx.doi.org/10.3201/eid2411.170820.

Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo [PDF - 1.43 MB - 7 pages]
M. Kayomo et al.

After an alert regarding ≈31 tuberculosis (TB) cases, 3 of which were rifampin-resistant TB cases, in Mbuji-Mayi Central Prison, Democratic Republic of the Congo, we conducted an outbreak investigation in January 2015. We analyzed sputum of presumptive TB patients by using the Xpert MTB/RIF assay. We also assessed the Mycobacterium tuberculosis isolates’ drug-susceptibility patterns and risk factors for TB infection. Among a prison population of 918 inmates, 29 TB case-patients were already undergoing treatment. We found an additional 475 presumptive TB case-patients and confirmed TB in 170 of them. In March 2015, the prevalence rate of confirmed TB was 21.7% (199/918 inmates). We detected an additional 14 cases of rifampin-resistant TB and initiated treatment in all 14 of these case-patients. Overcrowded living conditions and poor nutrition appeared to be the driving factors behind the high TB incidence in this prison.

EID Kayomo M, Hasker E, Aloni M, Nkuku L, Kazadi M, Kabengele T, et al. Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo. Emerg Infect Dis. 2018;24(11):2029-2035. https://dx.doi.org/10.3201/eid2411.180769
AMA Kayomo M, Hasker E, Aloni M, et al. Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo. Emerging Infectious Diseases. 2018;24(11):2029-2035. doi:10.3201/eid2411.180769.
APA Kayomo, M., Hasker, E., Aloni, M., Nkuku, L., Kazadi, M., Kabengele, T....Boelaert, M. (2018). Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo. Emerging Infectious Diseases, 24(11), 2029-2035. https://dx.doi.org/10.3201/eid2411.180769.

Candida auris in South Africa, 2012–2016 [PDF - 809 KB - 5 pages]
N. P. Govender et al.

To determine the epidemiology of Candida auris in South Africa, we reviewed data from public- and private-sector diagnostic laboratories that reported confirmed and probable cases of invasive disease and colonization for October 2012–November 2016. We defined a case as a first isolation of C. auris from any specimen from a person of any age admitted to any healthcare facility in South Africa. We defined probable cases as cases where the diagnostic laboratory had used a nonconfirmatory biochemical identification method and C. haemulonii was cultured. We analyzed 1,692 cases; 93% were from private-sector healthcare facilities, and 92% of cases from known locations were from Gauteng Province. Of cases with available data, 29% were invasive infections. The number of cases increased from 18 (October 2012–November 2013) to 861 (October 2015–November 2016). Our results show a large increase in C. auris cases during the study period, centered on private hospitals in Gauteng Province.

EID Govender NP, Magobo RE, Mpembe R, Mhlanga M, Matlapeng P, Corcoran C, et al. Candida auris in South Africa, 2012–2016. Emerg Infect Dis. 2018;24(11):2036-2040. https://dx.doi.org/10.3201/eid2411.180368
AMA Govender NP, Magobo RE, Mpembe R, et al. Candida auris in South Africa, 2012–2016. Emerging Infectious Diseases. 2018;24(11):2036-2040. doi:10.3201/eid2411.180368.
APA Govender, N. P., Magobo, R. E., Mpembe, R., Mhlanga, M., Matlapeng, P., Corcoran, C....Thomas, J. (2018). Candida auris in South Africa, 2012–2016. Emerging Infectious Diseases, 24(11), 2036-2040. https://dx.doi.org/10.3201/eid2411.180368.

Rickettsia rickettsii Co-feeding Transmission among Amblyomma aureolatum Ticks [PDF - 845 KB - 8 pages]
J. Moraes-Filho et al.

Amblyomma aureolatum ticks are vectors of Rickettsia rickettsii, the etiologic agent of Rocky Mountain spotted fever in Brazil. Maintenance of R. rickettsii in nature depends on horizontal transmission along tick generations. Although such transmission is known to occur when uninfected and infected ticks feed simultaneously on susceptible animals (co-feeding systemic transmission), we investigated co-feeding nonsystemic transmission, which was based on R. rickettsii–infected and –uninfected A. aureolatum ticks feeding simultaneously on guinea pigs immune to R. rickettsii. Our acquisition and transmission infestations demonstrated that horizontal transmission of R. rickettsii by co-feeding ticks on immune hosts with no systemic infection did not occur when uninfected larvae fed distantly from infected nymphs but did occur in a few cases when uninfected larvae fed side-by-side with infected nymphs, suggesting that they shared the same feeding site. The co-feeding nonsystemic transmission type might have no epidemiologic importance for Rocky Mountain spotted fever.

EID Moraes-Filho J, Costa FB, Gerardi M, Soares HS, Labruna MB. Rickettsia rickettsii Co-feeding Transmission among Amblyomma aureolatum Ticks. Emerg Infect Dis. 2018;24(11):2041-2048. https://dx.doi.org/10.3201/eid2411.180451
AMA Moraes-Filho J, Costa FB, Gerardi M, et al. Rickettsia rickettsii Co-feeding Transmission among Amblyomma aureolatum Ticks. Emerging Infectious Diseases. 2018;24(11):2041-2048. doi:10.3201/eid2411.180451.
APA Moraes-Filho, J., Costa, F. B., Gerardi, M., Soares, H. S., & Labruna, M. B. (2018). Rickettsia rickettsii Co-feeding Transmission among Amblyomma aureolatum Ticks. Emerging Infectious Diseases, 24(11), 2041-2048. https://dx.doi.org/10.3201/eid2411.180451.
Historical Review

Hantavirus Pulmonary Syndrome—The 25th Anniversary of the Four Corners Outbreak [PDF - 321 KB - 5 pages]
C. J. Van Hook

During the spring of 1993, a mysterious respiratory disease struck the Four Corners region of the southwestern United States. Persons who became ill were generally young and previously healthy before succumbing to an acute febrile illness that began with simple influenza-like symptoms and often culminated in death by pulmonary edema and cardiovascular collapse. With astonishing speed and efficiency, a collaborative team of federal, state, and local healthcare workers, including clinicians, epidemiologists, and laboratory scientists, identified a newly discovered species of hantavirus as the causative agent of the outbreak. In the ensuing 25 years, the epidemiology, virology, pathophysiology, clinical course, and treatment of hantavirus pulmonary syndrome have been the focus of ongoing research. Because of its rarity, and because of the need for early acute intervention in the face of precipitous decline, recognition of the unique laboratory profile of hantavirus pulmonary syndrome in the setting of a predisposing exposure history is of paramount importance.

EID Van Hook CJ. Hantavirus Pulmonary Syndrome—The 25th Anniversary of the Four Corners Outbreak. Emerg Infect Dis. 2018;24(11):2056-2060. https://dx.doi.org/10.3201/eid2411.180381
AMA Van Hook CJ. Hantavirus Pulmonary Syndrome—The 25th Anniversary of the Four Corners Outbreak. Emerging Infectious Diseases. 2018;24(11):2056-2060. doi:10.3201/eid2411.180381.
APA Van Hook, C. J. (2018). Hantavirus Pulmonary Syndrome—The 25th Anniversary of the Four Corners Outbreak. Emerging Infectious Diseases, 24(11), 2056-2060. https://dx.doi.org/10.3201/eid2411.180381.
Policy Review

Stakeholder Insights from Zika Virus Infections in Houston, Texas, USA, 2016–2017 [PDF - 381 KB - 7 pages]
S. R. Morain et al.

Responding to Zika virus infections in Houston, Texas, USA, presented numerous challenges across the health system. As the nation’s fourth-largest city, in a subtropical region with high travel volume to Latin America and the Caribbean, Houston was an ideal location for studying experiences encountered by clinicians and public health officials as they responded to the Zika virus crisis. To identify the challenges encountered in the response and to explore strategies to improve future responses to emerging infectious diseases, we interviewed 38 key stakeholders who were clinical, scientific, operational, and public health leaders. From the responses, we identified 4 key challenges: testing, travel screening, patient demographics and immigration status, and insufficient collaboration (between public health officials and clinicians and among clinical providers). We also identified 5 strategic areas as potential solutions: improved electronic health record support, specialty centers and referral systems, standardized forms, centralized testing databases, and joint academic/public health task forces.

EID Morain SR, Eppes CS, Fisher JW, Bruce CR, Rac M, Aagaard KM, et al. Stakeholder Insights from Zika Virus Infections in Houston, Texas, USA, 2016–2017. Emerg Infect Dis. 2018;24(11):2049-2055. https://dx.doi.org/10.3201/eid2411.172108
AMA Morain SR, Eppes CS, Fisher JW, et al. Stakeholder Insights from Zika Virus Infections in Houston, Texas, USA, 2016–2017. Emerging Infectious Diseases. 2018;24(11):2049-2055. doi:10.3201/eid2411.172108.
APA Morain, S. R., Eppes, C. S., Fisher, J. W., Bruce, C. R., Rac, M., Aagaard, K. M....Raphael, J. L. (2018). Stakeholder Insights from Zika Virus Infections in Houston, Texas, USA, 2016–2017. Emerging Infectious Diseases, 24(11), 2049-2055. https://dx.doi.org/10.3201/eid2411.172108.
Dispatches

Human Babesiosis, Yucatán State, Mexico, 2015 [PDF - 593 KB - 2 pages]
G. Peniche-Lara et al.

In 2015, we detected clinical cases of babesiosis caused by Babesia microti in Yucatán State, Mexico. Cases occurred in 4 children from a small town who became ill during the same month. Diagnosis was confirmed using conventional PCR followed by sequencing of the DNA fragment obtained.

EID Peniche-Lara G, Balmaceda L, Perez-Osorio C, Munoz-Zanzi C. Human Babesiosis, Yucatán State, Mexico, 2015. Emerg Infect Dis. 2018;24(11):2061-2062. https://dx.doi.org/10.3201/eid2411.170512
AMA Peniche-Lara G, Balmaceda L, Perez-Osorio C, et al. Human Babesiosis, Yucatán State, Mexico, 2015. Emerging Infectious Diseases. 2018;24(11):2061-2062. doi:10.3201/eid2411.170512.
APA Peniche-Lara, G., Balmaceda, L., Perez-Osorio, C., & Munoz-Zanzi, C. (2018). Human Babesiosis, Yucatán State, Mexico, 2015. Emerging Infectious Diseases, 24(11), 2061-2062. https://dx.doi.org/10.3201/eid2411.170512.

Detection and Characterization of Human Pegivirus 2, Vietnam [PDF - 1.37 MB - 5 pages]
N. Anh et al.

We report human pegivirus 2 (HPgV-2) infection in Vietnam. We detected HPgV-2 in some patients with hepatitis C virus/HIV co-infection but not in patients with HIV or hepatitis A, B, or C virus infection, nor in healthy controls. HPgV-2 strains in Vietnam are phylogenetically related to global strains.

EID Anh N, Hong N, Nhu L, Thanh T, Anscombe C, Chau L, et al. Detection and Characterization of Human Pegivirus 2, Vietnam. Emerg Infect Dis. 2018;24(11):2063-2067. https://dx.doi.org/10.3201/eid2411.180668
AMA Anh N, Hong N, Nhu L, et al. Detection and Characterization of Human Pegivirus 2, Vietnam. Emerging Infectious Diseases. 2018;24(11):2063-2067. doi:10.3201/eid2411.180668.
APA Anh, N., Hong, N., Nhu, L., Thanh, T., Anscombe, C., Chau, L....Van Tan, L. (2018). Detection and Characterization of Human Pegivirus 2, Vietnam. Emerging Infectious Diseases, 24(11), 2063-2067. https://dx.doi.org/10.3201/eid2411.180668.

African Histoplasmosis in HIV-Negative Patients, Kimpese, Democratic Republic of the Congo [PDF - 923 KB - 3 pages]
N. Pakasa et al.

We describe a case series of histoplasmosis caused by Histoplasma capsulatum var. duboisii during July 2011–January 2014 in Kimpese, Democratic Republic of the Congo. Cases were confirmed by histopathology, immunohistochemistry, and reverse transcription PCR. All patients were HIV negative. Putative sources for the pathogen were cellar bats and guano fertilizer exploitation.

EID Pakasa N, Biber A, Nsiangana S, Imposo D, Sumaili E, Muhindo H, et al. African Histoplasmosis in HIV-Negative Patients, Kimpese, Democratic Republic of the Congo. Emerg Infect Dis. 2018;24(11):2068-2070. https://dx.doi.org/10.3201/eid2411.180236
AMA Pakasa N, Biber A, Nsiangana S, et al. African Histoplasmosis in HIV-Negative Patients, Kimpese, Democratic Republic of the Congo. Emerging Infectious Diseases. 2018;24(11):2068-2070. doi:10.3201/eid2411.180236.
APA Pakasa, N., Biber, A., Nsiangana, S., Imposo, D., Sumaili, E., Muhindo, H....Schwartz, E. (2018). African Histoplasmosis in HIV-Negative Patients, Kimpese, Democratic Republic of the Congo. Emerging Infectious Diseases, 24(11), 2068-2070. https://dx.doi.org/10.3201/eid2411.180236.

Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018 [PDF - 626 KB - 3 pages]
S. Ali et al.

In winter 2018, schools in Hong Kong were closed 1 week before the scheduled Chinese New Year holiday to mitigate an influenza B virus epidemic. The intervention occurred after the epidemic peak and reduced overall incidence by ≈4.2%. School-based vaccination programs should be implemented to more effectively reduce influenza illnesses.

EID Ali S, Cowling BJ, Lau E, Fang VJ, Leung GM. Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018. Emerg Infect Dis. 2018;24(11):2071-2073. https://dx.doi.org/10.3201/eid2411.180612
AMA Ali S, Cowling BJ, Lau E, et al. Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018. Emerging Infectious Diseases. 2018;24(11):2071-2073. doi:10.3201/eid2411.180612.
APA Ali, S., Cowling, B. J., Lau, E., Fang, V. J., & Leung, G. M. (2018). Mitigation of Influenza B Epidemic with School Closures, Hong Kong, 2018. Emerging Infectious Diseases, 24(11), 2071-2073. https://dx.doi.org/10.3201/eid2411.180612.

World Health Organization Early Warning, Alert and Response System in the Rohingya Crisis, Bangladesh, 2017–2018 [PDF - 1.02 MB - 3 pages]
B. Karo et al.

The Early Warning, Alert and Response System (EWARS) is a web-based system and mobile application for outbreak detection and response in emergency settings. EWARS provided timely information on epidemic-potential diseases among >700,000 Rohingya refugees across settlements. EWARS helped in targeting new measles vaccination campaigns and investigating suspected outbreaks of acute jaundice syndrome.

EID Karo B, Haskew C, Khan AS, Polonsky JA, Mazhar M, Buddha N. World Health Organization Early Warning, Alert and Response System in the Rohingya Crisis, Bangladesh, 2017–2018. Emerg Infect Dis. 2018;24(11):2074-2076. https://dx.doi.org/10.3201/eid2411.181237
AMA Karo B, Haskew C, Khan AS, et al. World Health Organization Early Warning, Alert and Response System in the Rohingya Crisis, Bangladesh, 2017–2018. Emerging Infectious Diseases. 2018;24(11):2074-2076. doi:10.3201/eid2411.181237.
APA Karo, B., Haskew, C., Khan, A. S., Polonsky, J. A., Mazhar, M., & Buddha, N. (2018). World Health Organization Early Warning, Alert and Response System in the Rohingya Crisis, Bangladesh, 2017–2018. Emerging Infectious Diseases, 24(11), 2074-2076. https://dx.doi.org/10.3201/eid2411.181237.

Rickettsia japonica Infections in Humans, Zhejiang Province, China, 2015 [PDF - 1.71 MB - 3 pages]
Q. Lu et al.

We investigated 16 Japanese spotted fever cases that occurred in southeastern China during September–October 2015. Patients had fever, rash, eschar, and lymphadenopathy. We confirmed 9 diagnoses and obtained 2 isolates with high identity to Rickettsia japonica strain YH. R. japonica infection should be considered for febrile patients in China.

EID Lu Q, Yu J, Yu L, Zhang Y, Chen Y, Lin M, et al. Rickettsia japonica Infections in Humans, Zhejiang Province, China, 2015. Emerg Infect Dis. 2018;24(11):2077-2079. https://dx.doi.org/10.3201/eid2411.170044
AMA Lu Q, Yu J, Yu L, et al. Rickettsia japonica Infections in Humans, Zhejiang Province, China, 2015. Emerging Infectious Diseases. 2018;24(11):2077-2079. doi:10.3201/eid2411.170044.
APA Lu, Q., Yu, J., Yu, L., Zhang, Y., Chen, Y., Lin, M....Fang, X. (2018). Rickettsia japonica Infections in Humans, Zhejiang Province, China, 2015. Emerging Infectious Diseases, 24(11), 2077-2079. https://dx.doi.org/10.3201/eid2411.170044.

Emergence of Neisseria meningitidis Serogroup W, Central African Republic, 2015–2016 [PDF - 643 KB - 4 pages]
T. Frank et al.

We analyzed data from the 2015 and 2016 meningitis epidemic seasons in Central African Republic as part of the national disease surveillance. Of 80 tested specimens, 66 belonged to meningococcal serogroup W. Further analysis found that 97.7% of 44 isolates belonged to the hyperinvasive clonal complex sequence type 11.

EID Frank T, Hong E, Mbecko J, Lombart J, Taha M, Rubbo P. Emergence of Neisseria meningitidis Serogroup W, Central African Republic, 2015–2016. Emerg Infect Dis. 2018;24(11):2080-2083. https://dx.doi.org/10.3201/eid2411.170817
AMA Frank T, Hong E, Mbecko J, et al. Emergence of Neisseria meningitidis Serogroup W, Central African Republic, 2015–2016. Emerging Infectious Diseases. 2018;24(11):2080-2083. doi:10.3201/eid2411.170817.
APA Frank, T., Hong, E., Mbecko, J., Lombart, J., Taha, M., & Rubbo, P. (2018). Emergence of Neisseria meningitidis Serogroup W, Central African Republic, 2015–2016. Emerging Infectious Diseases, 24(11), 2080-2083. https://dx.doi.org/10.3201/eid2411.170817.

Fatal Case of Diphtheria and Risk for Reemergence, Singapore [PDF - 388 KB - 3 pages]
Y. Lai et al.

We report a fatal autochthonous diphtheria case in a migrant worker in Singapore. This case highlights the risk for individual cases in undervaccinated subpopulations, despite high vaccination coverage in the general population. Prompt implementation of public health measures and maintaining immunization coverage are critical to prevent reemergence of diphtheria.

EID Lai Y, Purnima P, Ho M, Ang M, Deepak RN, Chew K, et al. Fatal Case of Diphtheria and Risk for Reemergence, Singapore. Emerg Infect Dis. 2018;24(11):2084-2086. https://dx.doi.org/10.3201/eid2411.180198
AMA Lai Y, Purnima P, Ho M, et al. Fatal Case of Diphtheria and Risk for Reemergence, Singapore. Emerging Infectious Diseases. 2018;24(11):2084-2086. doi:10.3201/eid2411.180198.
APA Lai, Y., Purnima, P., Ho, M., Ang, M., Deepak, R. N., Chew, K....Lee, V. (2018). Fatal Case of Diphtheria and Risk for Reemergence, Singapore. Emerging Infectious Diseases, 24(11), 2084-2086. https://dx.doi.org/10.3201/eid2411.180198.

Ehrlichia Infections, North Carolina, USA, 2016 [PDF - 1.75 MB - 4 pages]
R. M. Boyce et al.

Nearly two thirds of persons suspected of having tickborne illness in central North Carolina, USA, were not tested for Ehrlichia. Failure to test may have resulted in a missed diagnosis for ≈13% of these persons, who were therefore substantially less likely to receive antimicrobial treatment and to have follow-up testing performed.

EID Boyce RM, Sanfilippo AM, Boulos JM, Cleinmark M, Schmitz J, Meshnick S. Ehrlichia Infections, North Carolina, USA, 2016. Emerg Infect Dis. 2018;24(11):2087-2090. https://dx.doi.org/10.3201/eid2411.180496
AMA Boyce RM, Sanfilippo AM, Boulos JM, et al. Ehrlichia Infections, North Carolina, USA, 2016. Emerging Infectious Diseases. 2018;24(11):2087-2090. doi:10.3201/eid2411.180496.
APA Boyce, R. M., Sanfilippo, A. M., Boulos, J. M., Cleinmark, M., Schmitz, J., & Meshnick, S. (2018). Ehrlichia Infections, North Carolina, USA, 2016. Emerging Infectious Diseases, 24(11), 2087-2090. https://dx.doi.org/10.3201/eid2411.180496.

Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA [PDF - 649 KB - 4 pages]
J. E. Gee et al.

The bacterium Burkholderia thailandensis, a member of the Burkholderia pseudomallei complex, is generally considered nonpathogenic; however, on rare occasions, B. thailandensis infections have been reported. We describe a clinical isolate of B. thailandensis, BtAR2017, recovered from a patient with an infected wound in Arkansas, USA, in 2017.

EID Gee JE, Elrod MG, Gulvik CA, Haselow DT, Waters C, Liu L, et al. Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA. Emerg Infect Dis. 2018;24(11):2091-2094. https://dx.doi.org/10.3201/eid2411.180821
AMA Gee JE, Elrod MG, Gulvik CA, et al. Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA. Emerging Infectious Diseases. 2018;24(11):2091-2094. doi:10.3201/eid2411.180821.
APA Gee, J. E., Elrod, M. G., Gulvik, C. A., Haselow, D. T., Waters, C., Liu, L....Hoffmaster, A. R. (2018). Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA. Emerging Infectious Diseases, 24(11), 2091-2094. https://dx.doi.org/10.3201/eid2411.180821.

Timing the Origin of Cryptococcus gattii sensu stricto, Southeastern United States [PDF - 594 KB - 3 pages]
S. R. Lockhart et al.

We conducted molecular clock analysis of whole-genome sequences from a set of autochthonous isolates of Cryptococcus gattii sensu stricto from the southeastern United States. Our analysis indicates that C. gattii arrived in the southeastern United States approximately 9,000–19,000 years ago, long before its arrival in the Pacific Northwest.

EID Lockhart SR, Roe CC, Engelthaler DM. Timing the Origin of Cryptococcus gattii sensu stricto, Southeastern United States. Emerg Infect Dis. 2018;24(11):2095-2097. https://dx.doi.org/10.3201/eid2411.180975
AMA Lockhart SR, Roe CC, Engelthaler DM. Timing the Origin of Cryptococcus gattii sensu stricto, Southeastern United States. Emerging Infectious Diseases. 2018;24(11):2095-2097. doi:10.3201/eid2411.180975.
APA Lockhart, S. R., Roe, C. C., & Engelthaler, D. M. (2018). Timing the Origin of Cryptococcus gattii sensu stricto, Southeastern United States. Emerging Infectious Diseases, 24(11), 2095-2097. https://dx.doi.org/10.3201/eid2411.180975.

Hospitalizations for Influenza-Associated Severe Acute Respiratory Infection, Beijing, China, 2014–2016 [PDF - 941 KB - 5 pages]
Y. Zhang et al.

We analyzed surveillance data for 2 sentinel hospitals to estimate the influenza-associated severe acute respiratory infection hospitalization rate in Beijing, China. The rate was 39 and 37 per 100,000 persons during the 2014–15 and 2015–16 influenza seasons, respectively. Rates were highest for children <5 years of age.

EID Zhang Y, Muscatello DJ, Wang Q, Yang P, Pan Y, Huo D, et al. Hospitalizations for Influenza-Associated Severe Acute Respiratory Infection, Beijing, China, 2014–2016. Emerg Infect Dis. 2018;24(11):2098-2102. https://dx.doi.org/10.3201/eid2411.171410
AMA Zhang Y, Muscatello DJ, Wang Q, et al. Hospitalizations for Influenza-Associated Severe Acute Respiratory Infection, Beijing, China, 2014–2016. Emerging Infectious Diseases. 2018;24(11):2098-2102. doi:10.3201/eid2411.171410.
APA Zhang, Y., Muscatello, D. J., Wang, Q., Yang, P., Pan, Y., Huo, D....MacIntyre, C. (2018). Hospitalizations for Influenza-Associated Severe Acute Respiratory Infection, Beijing, China, 2014–2016. Emerging Infectious Diseases, 24(11), 2098-2102. https://dx.doi.org/10.3201/eid2411.171410.
Research Letters

Severe Fever with Thrombocytopenia Syndrome Virus Infection, South Korea, 2010 [PDF - 400 KB - 3 pages]
Y. Kim et al.

Severe fever with thrombocytopenia syndrome (SFTS) was reported in China in 2009 and in South Korea in 2012. We found retrospective evidence of SFTS virus infection in South Korea in 2010, suggesting that infections in South Korea occurred before previously reported and were more concurrent with those in China.

EID Kim Y, Yun Y, Bae S, Park D, Kim S, Lee J, et al. Severe Fever with Thrombocytopenia Syndrome Virus Infection, South Korea, 2010. Emerg Infect Dis. 2018;24(11):2103-2105. https://dx.doi.org/10.3201/eid2411.170756
AMA Kim Y, Yun Y, Bae S, et al. Severe Fever with Thrombocytopenia Syndrome Virus Infection, South Korea, 2010. Emerging Infectious Diseases. 2018;24(11):2103-2105. doi:10.3201/eid2411.170756.
APA Kim, Y., Yun, Y., Bae, S., Park, D., Kim, S., Lee, J....Lee, K. (2018). Severe Fever with Thrombocytopenia Syndrome Virus Infection, South Korea, 2010. Emerging Infectious Diseases, 24(11), 2103-2105. https://dx.doi.org/10.3201/eid2411.170756.

Spotted Fever Group Rickettsiae in Inner Mongolia, China, 2015–2016 [PDF - 357 KB - 3 pages]
G. Gaowa et al.

We found Rickettsia raoultii infection in 6/261 brucellosis-negative patients with fever of unknown origin in brucellosis-endemic Inner Mongolia, China. We further identified Hyalomma asiaticum ticks associated with R. raoultii, H. marginatum ticks associated with R. aeschlimannii, and Dermacentor nuttalli ticks associated with both rickettsiae species in the autonomous region.

EID Gaowa G, Wulantuya W, Yin X, Guo S, Ding C, Cao M, et al. Spotted Fever Group Rickettsiae in Inner Mongolia, China, 2015–2016. Emerg Infect Dis. 2018;24(11):2105-2107. https://dx.doi.org/10.3201/eid2411.162094
AMA Gaowa G, Wulantuya W, Yin X, et al. Spotted Fever Group Rickettsiae in Inner Mongolia, China, 2015–2016. Emerging Infectious Diseases. 2018;24(11):2105-2107. doi:10.3201/eid2411.162094.
APA Gaowa, G., Wulantuya, W., Yin, X., Guo, S., Ding, C., Cao, M....Ohashi, N. (2018). Spotted Fever Group Rickettsiae in Inner Mongolia, China, 2015–2016. Emerging Infectious Diseases, 24(11), 2105-2107. https://dx.doi.org/10.3201/eid2411.162094.

Japanese Spotted Fever in Eastern China, 2013 [PDF - 601 KB - 3 pages]
J. Li et al.

We isolated Rickettsia japonica from a febrile patient in Lu’an City, China, in 2013. Subsequently, we found an R. japonica seroprevalence of 54.8% (494/902) in the rural population of Anhui Province and an R. japonica prevalence in Haemaphysalis longicornis ticks of 0.5% (5/935). R. japonica and its tick vector exist in China.

EID Li J, Hu W, Wu T, Li H, Hu W, Sun Y, et al. Japanese Spotted Fever in Eastern China, 2013. Emerg Infect Dis. 2018;24(11):2107-2109. https://dx.doi.org/10.3201/eid2411.170264
AMA Li J, Hu W, Wu T, et al. Japanese Spotted Fever in Eastern China, 2013. Emerging Infectious Diseases. 2018;24(11):2107-2109. doi:10.3201/eid2411.170264.
APA Li, J., Hu, W., Wu, T., Li, H., Hu, W., Sun, Y....Liu, B. (2018). Japanese Spotted Fever in Eastern China, 2013. Emerging Infectious Diseases, 24(11), 2107-2109. https://dx.doi.org/10.3201/eid2411.170264.

Burkholderia lata Infections from Intrinsically Contaminated Chlorhexidine Mouthwash, Australia, 2016 [PDF - 454 KB - 3 pages]
L. Leong et al.

Burkholderia lata was isolated from 8 intensive care patients at 2 tertiary hospitals in Australia. Whole-genome sequencing demonstrated that clinical and environmental isolates originated from a batch of contaminated commercial chlorhexidine mouthwash. Genomic analysis identified efflux pump–encoding genes as potential facilitators of bacterial persistence within this biocide.

EID Leong L, Lagana D, Carter GP, Wang Q, Smith K, Stinear TP, et al. Burkholderia lata Infections from Intrinsically Contaminated Chlorhexidine Mouthwash, Australia, 2016. Emerg Infect Dis. 2018;24(11):2109-2111. https://dx.doi.org/10.3201/eid2411.171929
AMA Leong L, Lagana D, Carter GP, et al. Burkholderia lata Infections from Intrinsically Contaminated Chlorhexidine Mouthwash, Australia, 2016. Emerging Infectious Diseases. 2018;24(11):2109-2111. doi:10.3201/eid2411.171929.
APA Leong, L., Lagana, D., Carter, G. P., Wang, Q., Smith, K., Stinear, T. P....Rogers, G. B. (2018). Burkholderia lata Infections from Intrinsically Contaminated Chlorhexidine Mouthwash, Australia, 2016. Emerging Infectious Diseases, 24(11), 2109-2111. https://dx.doi.org/10.3201/eid2411.171929.

Estimating Latent Tuberculosis Infection Using Interferon-γ Release Assay, Japan [PDF - 328 KB - 3 pages]
T. Nishimura et al.

We estimated the latent tuberculosis infection (LTBI) rate for foreign-born students at Keio University, Tokyo, Japan, using an interferon-γ release assay. The LTBI rate for students from countries with estimated tuberculosis incidence >100 cases/100,000 persons was high (10.0%). Universities should screen for LTBI in students from countries with high tuberculosis incidence.

EID Nishimura T, Ota M, Mori M, Hasegawa N, Kawabe H, Kato S. Estimating Latent Tuberculosis Infection Using Interferon-γ Release Assay, Japan. Emerg Infect Dis. 2018;24(11):2111-2113. https://dx.doi.org/10.3201/eid2411.171948
AMA Nishimura T, Ota M, Mori M, et al. Estimating Latent Tuberculosis Infection Using Interferon-γ Release Assay, Japan. Emerging Infectious Diseases. 2018;24(11):2111-2113. doi:10.3201/eid2411.171948.
APA Nishimura, T., Ota, M., Mori, M., Hasegawa, N., Kawabe, H., & Kato, S. (2018). Estimating Latent Tuberculosis Infection Using Interferon-γ Release Assay, Japan. Emerging Infectious Diseases, 24(11), 2111-2113. https://dx.doi.org/10.3201/eid2411.171948.

Effect of Inactivated Poliovirus Vaccine Campaigns, Pakistan, 2014–2017 [PDF - 437 KB - 3 pages]
N. C. Grassly et al.

Pakistan began using inactivated poliovirus vaccine alongside oral vaccine in mass campaigns to accelerate eradication of wild-type poliovirus in 2014. Using case-based and environmental surveillance data for January 2014–October 2017, we found that these campaigns reduced wild-type poliovirus detection more than campaigns that used only oral vaccine.

EID Grassly NC, Wadood M, Safdar RM, Mahamud A, Sutter RW. Effect of Inactivated Poliovirus Vaccine Campaigns, Pakistan, 2014–2017. Emerg Infect Dis. 2018;24(11):2113-2115. https://dx.doi.org/10.3201/eid2411.180050
AMA Grassly NC, Wadood M, Safdar RM, et al. Effect of Inactivated Poliovirus Vaccine Campaigns, Pakistan, 2014–2017. Emerging Infectious Diseases. 2018;24(11):2113-2115. doi:10.3201/eid2411.180050.
APA Grassly, N. C., Wadood, M., Safdar, R. M., Mahamud, A., & Sutter, R. W. (2018). Effect of Inactivated Poliovirus Vaccine Campaigns, Pakistan, 2014–2017. Emerging Infectious Diseases, 24(11), 2113-2115. https://dx.doi.org/10.3201/eid2411.180050.

Enterovirus D68 Surveillance, St. Louis, Missouri, USA, 2016 [PDF - 303 KB - 3 pages]
M. Srinivasan et al.

A fall 2016 outbreak of enterovirus D68 infection in St. Louis, Missouri, USA, had less effect than a fall 2014 outbreak on hospital census, intensive care unit census, and hospitalization for a diagnosis of respiratory illness. Without ongoing surveillance and specific testing, these cases might have been missed.

EID Srinivasan M, Niesen A, Storch GA. Enterovirus D68 Surveillance, St. Louis, Missouri, USA, 2016. Emerg Infect Dis. 2018;24(11):2115-2117. https://dx.doi.org/10.3201/eid2411.180397
AMA Srinivasan M, Niesen A, Storch GA. Enterovirus D68 Surveillance, St. Louis, Missouri, USA, 2016. Emerging Infectious Diseases. 2018;24(11):2115-2117. doi:10.3201/eid2411.180397.
APA Srinivasan, M., Niesen, A., & Storch, G. A. (2018). Enterovirus D68 Surveillance, St. Louis, Missouri, USA, 2016. Emerging Infectious Diseases, 24(11), 2115-2117. https://dx.doi.org/10.3201/eid2411.180397.

Adenovirus-Associated Influenza-Like Illness among College Students, Pennsylvania, USA [PDF - 523 KB - 3 pages]
H. M. Biggs et al.

Among students with influenza-like illness at a Pennsylvania college student health center during 2016–2017, 44 (15%) of 288 with respiratory specimens tested positive for human adenovirus (HAdV). HAdV-3, -7, and -4 predominated, and types clustered temporally. HAdV infection should be considered among college students with acute respiratory illness.

EID Biggs HM, Lu X, Dettinger L, Sakthivel S, Watson JT, Boktor SW. Adenovirus-Associated Influenza-Like Illness among College Students, Pennsylvania, USA. Emerg Infect Dis. 2018;24(11):2117-2119. https://dx.doi.org/10.3201/eid2411.180488
AMA Biggs HM, Lu X, Dettinger L, et al. Adenovirus-Associated Influenza-Like Illness among College Students, Pennsylvania, USA. Emerging Infectious Diseases. 2018;24(11):2117-2119. doi:10.3201/eid2411.180488.
APA Biggs, H. M., Lu, X., Dettinger, L., Sakthivel, S., Watson, J. T., & Boktor, S. W. (2018). Adenovirus-Associated Influenza-Like Illness among College Students, Pennsylvania, USA. Emerging Infectious Diseases, 24(11), 2117-2119. https://dx.doi.org/10.3201/eid2411.180488.

Investigating the Role of Easter Island in Migration of Zika Virus from South Pacific to Americas [PDF - 337 KB - 3 pages]
E. Delatorre et al.

The role of Easter Island in the dissemination of Zika virus from the Pacific islands into the Americas remains unclear. We analyzed new Zika virus sequences from Eastern Island and found that Zika virus was independently disseminated from French Polynesia into the Americas and Easter Island at around the same time.

EID Delatorre E, Fernández J, Bello G. Investigating the Role of Easter Island in Migration of Zika Virus from South Pacific to Americas. Emerg Infect Dis. 2018;24(11):2119-2121. https://dx.doi.org/10.3201/eid2411.180586
AMA Delatorre E, Fernández J, Bello G. Investigating the Role of Easter Island in Migration of Zika Virus from South Pacific to Americas. Emerging Infectious Diseases. 2018;24(11):2119-2121. doi:10.3201/eid2411.180586.
APA Delatorre, E., Fernández, J., & Bello, G. (2018). Investigating the Role of Easter Island in Migration of Zika Virus from South Pacific to Americas. Emerging Infectious Diseases, 24(11), 2119-2121. https://dx.doi.org/10.3201/eid2411.180586.

Novel Multidrug-Resistant Cronobacter sakazakii Causing Meningitis in Neonate, China, 2015 [PDF - 754 KB - 4 pages]
H. Zeng et al.

We report a case of meningitis in a neonate in China, which was caused by a novel multidrug-resistant Cronobacter sakazakii strain, sequence type 256, capsular profile K1:CA1. We identified genetic factors associated with bacterial pathogenicity and antimicrobial drug resistance in the genome and plasmids. Enhanced surveillance of this organism is warranted.

EID Zeng H, Lei T, He W, Zhang J, Liang B, Li C, et al. Novel Multidrug-Resistant Cronobacter sakazakii Causing Meningitis in Neonate, China, 2015. Emerg Infect Dis. 2018;24(11):2121-2124. https://dx.doi.org/10.3201/eid2411.180718
AMA Zeng H, Lei T, He W, et al. Novel Multidrug-Resistant Cronobacter sakazakii Causing Meningitis in Neonate, China, 2015. Emerging Infectious Diseases. 2018;24(11):2121-2124. doi:10.3201/eid2411.180718.
APA Zeng, H., Lei, T., He, W., Zhang, J., Liang, B., Li, C....Wu, Q. (2018). Novel Multidrug-Resistant Cronobacter sakazakii Causing Meningitis in Neonate, China, 2015. Emerging Infectious Diseases, 24(11), 2121-2124. https://dx.doi.org/10.3201/eid2411.180718.

No Plasmodium falciparum Chloroquine Resistance Transporter and Artemisinin Resistance Mutations, Haiti [PDF - 514 KB - 3 pages]
J. P. Vincent et al.

We obtained 78 human blood samples from areas in Haiti with high transmission of malaria and found no drug resistance–associated mutations in Plasmodium falciparum chloroquine resistance transporter and Kelch 13 genes. We recommend maintaining chloroquine as the first-line drug for malaria in Haiti. Artemisinin-based therapy can be used as alternative therapy.

EID Vincent JP, Komaki-Yasuda K, Existe AV, Boncy J, Kano S. No Plasmodium falciparum Chloroquine Resistance Transporter and Artemisinin Resistance Mutations, Haiti. Emerg Infect Dis. 2018;24(11):2124-2126. https://dx.doi.org/10.3201/eid2411.180738
AMA Vincent JP, Komaki-Yasuda K, Existe AV, et al. No Plasmodium falciparum Chloroquine Resistance Transporter and Artemisinin Resistance Mutations, Haiti. Emerging Infectious Diseases. 2018;24(11):2124-2126. doi:10.3201/eid2411.180738.
APA Vincent, J. P., Komaki-Yasuda, K., Existe, A. V., Boncy, J., & Kano, S. (2018). No Plasmodium falciparum Chloroquine Resistance Transporter and Artemisinin Resistance Mutations, Haiti. Emerging Infectious Diseases, 24(11), 2124-2126. https://dx.doi.org/10.3201/eid2411.180738.

Racial/Ethnic Disparities in Antimicrobial Drug Use, United States, 2014–2015 [PDF - 641 KB - 3 pages]
S. W. Olesen and Y. H. Grad

Using a US nationwide survey, we measured disparities in antimicrobial drug acquisition by race/ethnicity for 2014–2015. White persons reported twice as many antimicrobial drug prescription fills per capita as persons of other race/ethnicities. Characterizing antimicrobial drug use by demographic might improve antimicrobial drug stewardship and help address antimicrobial drug resistance.

EID Olesen SW, Grad YH. Racial/Ethnic Disparities in Antimicrobial Drug Use, United States, 2014–2015. Emerg Infect Dis. 2018;24(11):2126-2128. https://dx.doi.org/10.3201/eid2411.180762
AMA Olesen SW, Grad YH. Racial/Ethnic Disparities in Antimicrobial Drug Use, United States, 2014–2015. Emerging Infectious Diseases. 2018;24(11):2126-2128. doi:10.3201/eid2411.180762.
APA Olesen, S. W., & Grad, Y. H. (2018). Racial/Ethnic Disparities in Antimicrobial Drug Use, United States, 2014–2015. Emerging Infectious Diseases, 24(11), 2126-2128. https://dx.doi.org/10.3201/eid2411.180762.

Congenital Zika Virus Infection with Normal Neurodevelopmental Outcome, Brazil [PDF - 428 KB - 3 pages]
A. Lemos de Carvalho et al.

We describe a case of a 20-month-old girl with probable congenital Zika virus infection and normal neurodevelopment, despite microcephaly and abnormal neuroimaging. This case raises questions about early prognostic markers and draws attention to the need for investigation in suspected Zika cases, even if the child’s early neurodevelopment is normal.

EID Lemos de Carvalho A, Brites C, Taguchi T, Pinho S, Campos G, Lucena R. Congenital Zika Virus Infection with Normal Neurodevelopmental Outcome, Brazil. Emerg Infect Dis. 2018;24(11):2128-2130. https://dx.doi.org/10.3201/eid2411.180883
AMA Lemos de Carvalho A, Brites C, Taguchi T, et al. Congenital Zika Virus Infection with Normal Neurodevelopmental Outcome, Brazil. Emerging Infectious Diseases. 2018;24(11):2128-2130. doi:10.3201/eid2411.180883.
APA Lemos de Carvalho, A., Brites, C., Taguchi, T., Pinho, S., Campos, G., & Lucena, R. (2018). Congenital Zika Virus Infection with Normal Neurodevelopmental Outcome, Brazil. Emerging Infectious Diseases, 24(11), 2128-2130. https://dx.doi.org/10.3201/eid2411.180883.

Molecular Characterization of African Swine Fever Virus, China, 2018 [PDF - 485 KB - 3 pages]
S. Ge et al.

On August 3, 2018, an outbreak of African swine fever in pigs was reported in China. We subjected a virus from an African swine fever–positive pig sample to phylogenetic analysis. This analysis showed that the causative strain belonged to the p72 genotype II and CD2v serogroup 8.

EID Ge S, Li J, Fan X, Liu F, Li L, Wang Q, et al. Molecular Characterization of African Swine Fever Virus, China, 2018. Emerg Infect Dis. 2018;24(11):2131-2133. https://dx.doi.org/10.3201/eid2411.181274
AMA Ge S, Li J, Fan X, et al. Molecular Characterization of African Swine Fever Virus, China, 2018. Emerging Infectious Diseases. 2018;24(11):2131-2133. doi:10.3201/eid2411.181274.
APA Ge, S., Li, J., Fan, X., Liu, F., Li, L., Wang, Q....Wang, Z. (2018). Molecular Characterization of African Swine Fever Virus, China, 2018. Emerging Infectious Diseases, 24(11), 2131-2133. https://dx.doi.org/10.3201/eid2411.181274.
Letters

Familial Transmission of emm12 Group A Streptococcus [PDF - 318 KB - 2 pages]
R. Mearkle et al.
EID Mearkle R, Balasegaram S, Sriskandan S, Chalker V, Lamagni T. Familial Transmission of emm12 Group A Streptococcus. Emerg Infect Dis. 2018;24(11):2133-2134. https://dx.doi.org/10.3201/eid2411.171743
AMA Mearkle R, Balasegaram S, Sriskandan S, et al. Familial Transmission of emm12 Group A Streptococcus. Emerging Infectious Diseases. 2018;24(11):2133-2134. doi:10.3201/eid2411.171743.
APA Mearkle, R., Balasegaram, S., Sriskandan, S., Chalker, V., & Lamagni, T. (2018). Familial Transmission of emm12 Group A Streptococcus. Emerging Infectious Diseases, 24(11), 2133-2134. https://dx.doi.org/10.3201/eid2411.171743.

Acquired Resistance to Antituberculosis Drugs [PDF - 564 KB - 1 page]
H. Aung et al.
EID Aung H, Nyunt W, Fong Y, Russell B, Cook GM, Aung S. Acquired Resistance to Antituberculosis Drugs. Emerg Infect Dis. 2018;24(11):2134. https://dx.doi.org/10.3201/eid2411.180465
AMA Aung H, Nyunt W, Fong Y, et al. Acquired Resistance to Antituberculosis Drugs. Emerging Infectious Diseases. 2018;24(11):2134. doi:10.3201/eid2411.180465.
APA Aung, H., Nyunt, W., Fong, Y., Russell, B., Cook, G. M., & Aung, S. (2018). Acquired Resistance to Antituberculosis Drugs. Emerging Infectious Diseases, 24(11), 2134. https://dx.doi.org/10.3201/eid2411.180465.
Books and Media

The Politics of Vaccination: A Global History [PDF - 209 KB - 1 page]
L. E. Power
EID Power LE. The Politics of Vaccination: A Global History. Emerg Infect Dis. 2018;24(11):2135. https://dx.doi.org/10.3201/eid2411.181045
AMA Power LE. The Politics of Vaccination: A Global History. Emerging Infectious Diseases. 2018;24(11):2135. doi:10.3201/eid2411.181045.
APA Power, L. E. (2018). The Politics of Vaccination: A Global History. Emerging Infectious Diseases, 24(11), 2135. https://dx.doi.org/10.3201/eid2411.181045.
About the Cover

Trench Conflict with Combatants and Infectious Disease [PDF - 1.52 MB - 3 pages]
T. Chorba
EID Chorba T. Trench Conflict with Combatants and Infectious Disease. Emerg Infect Dis. 2018;24(11):2136-2137. https://dx.doi.org/10.3201/eid2411.ac2411
AMA Chorba T. Trench Conflict with Combatants and Infectious Disease. Emerging Infectious Diseases. 2018;24(11):2136-2137. doi:10.3201/eid2411.ac2411.
APA Chorba, T. (2018). Trench Conflict with Combatants and Infectious Disease. Emerging Infectious Diseases, 24(11), 2136-2137. https://dx.doi.org/10.3201/eid2411.ac2411.
Etymologia

Etymologia: Cronobacter sakazakii [PDF - 974 KB - 1 page]
R. Henry
EID Henry R. Etymologia: Cronobacter sakazakii. Emerg Infect Dis. 2018;24(11):2124. https://dx.doi.org/10.3201/eid2411.et2411
AMA Henry R. Etymologia: Cronobacter sakazakii. Emerging Infectious Diseases. 2018;24(11):2124. doi:10.3201/eid2411.et2411.
APA Henry, R. (2018). Etymologia: Cronobacter sakazakii. Emerging Infectious Diseases, 24(11), 2124. https://dx.doi.org/10.3201/eid2411.et2411.
Page created: October 23, 2018
Page updated: October 23, 2018
Page reviewed: October 23, 2018
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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