Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Issue Cover for Volume 24, Number 7—July 2018

Volume 24, Number 7—July 2018

[PDF - 11.71 MB - 236 pages]

Perspective

Progress and Remaining Gaps in Estimating the Global Disease Burden of Influenza [PDF - 1.09 MB - 5 pages]
J. Bresee et al.

Influenza has long been a global public health priority because of the threat of another global pandemic. Although data are available for the annual burden of seasonal influenza in many developed countries, fewer disease burden data are available for low-income and tropical countries. In recent years, however, the surveillance systems created as part of national pandemic preparedness efforts have produced substantial data on the epidemiology and impact of influenza in countries where data were sparse. These data are leading to greater interest in seasonal influenza, including implementation of vaccination programs. However, a lack of quality data on severe influenza, nonrespiratory outcomes, and high-risk groups, as well as a need for better mathematical models and economic evaluations, are some of the major gaps that remain. These gaps are the focus of multilateral research and surveillance efforts that will strengthen global efforts in influenza control in the future.

EID Bresee J, Fitzner J, Campbell H, Cohen C, Cozza V, Jara J, et al. Progress and Remaining Gaps in Estimating the Global Disease Burden of Influenza. Emerg Infect Dis. 2018;24(7):1173-1177. https://dx.doi.org/10.3201/eid2407.171270
AMA Bresee J, Fitzner J, Campbell H, et al. Progress and Remaining Gaps in Estimating the Global Disease Burden of Influenza. Emerging Infectious Diseases. 2018;24(7):1173-1177. doi:10.3201/eid2407.171270.
APA Bresee, J., Fitzner, J., Campbell, H., Cohen, C., Cozza, V., Jara, J....Lee,, V. (2018). Progress and Remaining Gaps in Estimating the Global Disease Burden of Influenza. Emerging Infectious Diseases, 24(7), 1173-1177. https://dx.doi.org/10.3201/eid2407.171270.

Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015 [PDF - 2.66 MB - 10 pages]
A. Schuchat et al.

The need for closer linkages between scientific and programmatic areas focused on addressing vaccine-preventable and acute respiratory infections led to establishment of the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention. During its first 10 years (2006–2015), NCIRD worked with partners to improve preparedness and response to pandemic influenza and other emergent respiratory infections, provide an evidence base for addition of 7 newly recommended vaccines, and modernize vaccine distribution. Clinical tools were developed for improved conversations with parents, which helped sustain childhood immunization as a social norm. Coverage increased for vaccines to protect adolescents against pertussis, meningococcal meningitis, and human papillomavirus–associated cancers. NCIRD programs supported outbreak response for new respiratory pathogens and oversaw response of the Centers for Disease Control and Prevention to the 2009 influenza A(H1N1) pandemic. Other national public health institutes might also find closer linkages between epidemiology, laboratory, and immunization programs useful.

EID Schuchat A, Anderson LJ, Rodewald LE, Cox NJ, Hajjeh R, Pallansch MA, et al. Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015. Emerg Infect Dis. 2018;24(7):1178-1187. https://dx.doi.org/10.3201/eid2407.171699
AMA Schuchat A, Anderson LJ, Rodewald LE, et al. Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015. Emerging Infectious Diseases. 2018;24(7):1178-1187. doi:10.3201/eid2407.171699.
APA Schuchat, A., Anderson, L. J., Rodewald, L. E., Cox, N. J., Hajjeh, R., Pallansch, M. A....Wharton, M. (2018). Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015. Emerging Infectious Diseases, 24(7), 1178-1187. https://dx.doi.org/10.3201/eid2407.171699.

Integrated Serologic Surveillance of Population Immunity and Disease Transmission [PDF - 2.44 MB - 7 pages]
B. F. Arnold et al.

Antibodies are unique among biomarkers in their ability to identify persons with protective immunity to vaccine-preventable diseases and to measure past exposure to diverse pathogens. Most infectious disease surveillance maintains a single-disease focus, but broader testing of existing serologic surveys with multiplex antibody assays would create new opportunities for integrated surveillance. In this perspective, we highlight multiple areas for potential synergy where integrated surveillance could add more value to public health efforts than the current trend of independent disease monitoring through vertical programs. We describe innovations in laboratory and data science that should accelerate integration and identify remaining challenges with respect to specimen collection, testing, and analysis. Throughout, we illustrate how information generated through integrated surveillance platforms can create new opportunities to more quickly and precisely identify global health program gaps that range from undervaccination to emerging pathogens to multilayered health disparities that span diverse communicable diseases.

EID Arnold BF, Scobie HM, Priest JW, Lammie PJ. Integrated Serologic Surveillance of Population Immunity and Disease Transmission. Emerg Infect Dis. 2018;24(7):1188-1194. https://dx.doi.org/10.3201/eid2407.171928
AMA Arnold BF, Scobie HM, Priest JW, et al. Integrated Serologic Surveillance of Population Immunity and Disease Transmission. Emerging Infectious Diseases. 2018;24(7):1188-1194. doi:10.3201/eid2407.171928.
APA Arnold, B. F., Scobie, H. M., Priest, J. W., & Lammie, P. J. (2018). Integrated Serologic Surveillance of Population Immunity and Disease Transmission. Emerging Infectious Diseases, 24(7), 1188-1194. https://dx.doi.org/10.3201/eid2407.171928.

Effects of Sexual Network Connectivity and Antimicrobial Drug Use on Antimicrobial Resistance in Neisseria gonorrhoeae [PDF - 1.56 MB - 9 pages]
C. R. Kenyon and I. S. Schwartz

Contemporary strategies to curtail the emergence of antimicrobial resistance in Neisseria gonorrhoeae include screening for and treating asymptomatic infections in high-prevalence populations in whom antimicrobial drug–resistant infections have typically emerged. We argue that antimicrobial resistance in these groups is driven by a combination of dense sexual network connectivity and antimicrobial drug exposure (for example, through screen-and-treat strategies for asymptomatic N. gonorrhoeae infection). Sexual network connectivity sustains a high-equilibrium prevalence of N. gonorrhoeae and increases likelihood of reinfection, whereas antimicrobial drug exposure results in selection pressure for reinfecting N. gonorrhoeae strains to acquire antimicrobial resistance genes from commensal pharyngeal or rectal flora. We propose study designs to test this hypothesis.

EID Kenyon CR, Schwartz IS. Effects of Sexual Network Connectivity and Antimicrobial Drug Use on Antimicrobial Resistance in Neisseria gonorrhoeae. Emerg Infect Dis. 2018;24(7):1195-1203. https://dx.doi.org/10.3201/eid2407.172104
AMA Kenyon CR, Schwartz IS. Effects of Sexual Network Connectivity and Antimicrobial Drug Use on Antimicrobial Resistance in Neisseria gonorrhoeae. Emerging Infectious Diseases. 2018;24(7):1195-1203. doi:10.3201/eid2407.172104.
APA Kenyon, C. R., & Schwartz, I. S. (2018). Effects of Sexual Network Connectivity and Antimicrobial Drug Use on Antimicrobial Resistance in Neisseria gonorrhoeae. Emerging Infectious Diseases, 24(7), 1195-1203. https://dx.doi.org/10.3201/eid2407.172104.
Synopses

Medscape CME Activity
Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016 [PDF - 1.30 MB - 9 pages]
E. van Schalkwyk et al.

Candidemia is a major cause of healthcare-associated infections. We describe a large outbreak of Candida krusei bloodstream infections among infants in Gauteng Province, South Africa, during a 4-month period; a series of candidemia and bacteremia outbreaks in the neonatal unit followed. We detected cases by using enhanced laboratory surveillance and audited hospital wards by environmental sampling and epidemiologic studies. During July–October 2014, among 589 patients, 48 unique cases of C. krusei candidemia occurred (8.2% incidence). Risk factors for candidemia on multivariable analyses were necrotizing enterocolitis, birthweight <1,500 g, receipt of parenteral nutrition, and receipt of blood transfusion. Despite initial interventions, outbreaks of bloodstream infection caused by C. krusei, rarer fungal species, and bacterial pathogens continued in the neonatal unit through July 29, 2016. Multiple factors contributed to these outbreaks; the most functional response is to fortify infection prevention and control.

EID van Schalkwyk E, Iyaloo S, Naicker SD, Maphanga TG, Mpembe RS, Zulu TG, et al. Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016. Emerg Infect Dis. 2018;24(7):1204-1212. https://dx.doi.org/10.3201/eid2407.171087
AMA van Schalkwyk E, Iyaloo S, Naicker SD, et al. Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016. Emerging Infectious Diseases. 2018;24(7):1204-1212. doi:10.3201/eid2407.171087.
APA van Schalkwyk, E., Iyaloo, S., Naicker, S. D., Maphanga, T. G., Mpembe, R. S., Zulu, T. G....Govender, N. P. (2018). Large Outbreaks of Fungal and Bacterial Bloodstream Infections in a Neonatal Unit, South Africa, 2012–2016. Emerging Infectious Diseases, 24(7), 1204-1212. https://dx.doi.org/10.3201/eid2407.171087.

Typhus Group Rickettsiosis, Germany, 2010–2017 [PDF - 1.17 MB - 8 pages]
J. Rauch et al.

Typhus group rickettsiosis is caused by the vectorborne bacteria Rickettsia typhi and R. prowazekii. R. typhi, which causes murine typhus, the less severe endemic form of typhus, is transmitted by fleas; R. prowazekii, which causes the severe epidemic form of typhus, is transmitted by body lice. To examine the immunology of human infection with typhus group rickettsiae, we retrospectively reviewed clinical signs and symptoms, laboratory changes, and travel destinations of 28 patients who had typhus group rickettsiosis diagnosed by the German Reference Center for Tropical Pathogens, Hamburg, Germany, during 2010–2017. Immunofluorescence assays of follow-up serum samples indicated simultaneous seroconversion of IgM, IgA, and IgG or concurrence in the first serum sample. Cytokine levels peaked during the second week of infection, coinciding with organ dysfunction and seroconversion. For 3 patients, R. typhi was detected by species-specific nested quantitative PCR. For all 28 patients, R. typhi was the most likely causative pathogen.

EID Rauch J, Eisermann P, Noack B, Mehlhoop U, Muntau B, Schäfer J, et al. Typhus Group Rickettsiosis, Germany, 2010–2017. Emerg Infect Dis. 2018;24(7):1213-1220. https://dx.doi.org/10.3201/eid2407.180093
AMA Rauch J, Eisermann P, Noack B, et al. Typhus Group Rickettsiosis, Germany, 2010–2017. Emerging Infectious Diseases. 2018;24(7):1213-1220. doi:10.3201/eid2407.180093.
APA Rauch, J., Eisermann, P., Noack, B., Mehlhoop, U., Muntau, B., Schäfer, J....Tappe, D. (2018). Typhus Group Rickettsiosis, Germany, 2010–2017. Emerging Infectious Diseases, 24(7), 1213-1220. https://dx.doi.org/10.3201/eid2407.180093.
Research

Diversity of Influenza A(H5N1) Viruses in Infected Humans, Northern Vietnam, 2004–2010 [PDF - 2.96 MB - 11 pages]
H. Imai et al.

Influenza viruses exist in each host as a collection of genetically diverse variants, which might enhance their adaptive potential. To assess the genetic and functional diversity of highly pathogenic avian influenza A(H5N1) viruses within infected humans, we used deep-sequencing methods to characterize samples obtained from infected patients in northern Vietnam during 2004–2010 on different days after infection, from different anatomic sites, or both. We detected changes in virus genes that affected receptor binding, polymerase activity, or interferon antagonism, suggesting that these factors could play roles in influenza virus adaptation to humans. However, the frequency of most of these mutations remained low in the samples tested, implying that they were not efficiently selected within these hosts. Our data suggest that adaptation of influenza A(H5N1) viruses is probably stepwise and depends on accumulating combinations of mutations that alter function while maintaining fitness.

EID Imai H, Dinis JM, Zhong G, Moncla LH, Lopes T, McBride R, et al. Diversity of Influenza A(H5N1) Viruses in Infected Humans, Northern Vietnam, 2004–2010. Emerg Infect Dis. 2018;24(7):1128-1238. https://dx.doi.org/10.3201/eid2407.171441
AMA Imai H, Dinis JM, Zhong G, et al. Diversity of Influenza A(H5N1) Viruses in Infected Humans, Northern Vietnam, 2004–2010. Emerging Infectious Diseases. 2018;24(7):1128-1238. doi:10.3201/eid2407.171441.
APA Imai, H., Dinis, J. M., Zhong, G., Moncla, L. H., Lopes, T., McBride, R....Kawaoka, Y. (2018). Diversity of Influenza A(H5N1) Viruses in Infected Humans, Northern Vietnam, 2004–2010. Emerging Infectious Diseases, 24(7), 1128-1238. https://dx.doi.org/10.3201/eid2407.171441.

Molecular Epidemiology of Human Adenovirus–Associated Febrile Respiratory Illness in Soldiers, South Korea [PDF - 870 KB - 7 pages]
J. Heo et al.

During January 2013–April 2014, we subjected nasopharyngeal specimens collected from patients with acute febrile respiratory illness in a military hospital to PCR testing to detect 12 respiratory viruses and sequence a partial hexon gene for human adenovirus (HAdV) molecular typing. We analyzed the epidemiologic characteristics of HAdV infections and compared clinical characteristics of HAdV types. Among the 305 patients with acute febrile respiratory illness, we detected respiratory viruses in 139 (45.6%) patients; HAdV was the most prevalent virus (69 cases). Of the 40 adenoviruses identified based on type, HAdV-55 (29 cases) was the most prevalent, followed by HAdV-4 (9 cases). HAdV-55 was common in patients with pneumonia (odds ratio 2.17; 95% CI 0.48–9.86) and hospitalized patients (odds ratio 5.21; 95% CI 1.06–25.50). In soldiers with HAdV infection in Korea, HAdV-55 was the most prevalent type and might be associated with severe clinical outcomes.

EID Heo J, Noh J, Jeong H, Choe K, Song J, Kim W, et al. Molecular Epidemiology of Human Adenovirus–Associated Febrile Respiratory Illness in Soldiers, South Korea1. Emerg Infect Dis. 2018;24(7):1221-1227. https://dx.doi.org/10.3201/eid2407.171222
AMA Heo J, Noh J, Jeong H, et al. Molecular Epidemiology of Human Adenovirus–Associated Febrile Respiratory Illness in Soldiers, South Korea1. Emerging Infectious Diseases. 2018;24(7):1221-1227. doi:10.3201/eid2407.171222.
APA Heo, J., Noh, J., Jeong, H., Choe, K., Song, J., Kim, W....Cheong, H. (2018). Molecular Epidemiology of Human Adenovirus–Associated Febrile Respiratory Illness in Soldiers, South Korea1. Emerging Infectious Diseases, 24(7), 1221-1227. https://dx.doi.org/10.3201/eid2407.171222.

Geographically Diverse Clusters of Nontoxigenic Corynebacterium diphtheriae Infection, Germany, 2016–2017 [PDF - 1.34 MB - 7 pages]
A. Dangel et al.

From 2016 through the middle of 2017, the German Consiliary Laboratory on Diphtheria noted an increase in nontoxigenic Corynebacterium diphtheriae isolates submitted from cities in northern Germany. Many patients for whom epidemiologic data were available were homeless, alcohol or drug abusers, or both. After performing routine diagnostics and multilocus sequence typing (MLST), we analyzed isolates of sequence type (ST) 8 and previously submitted isolates by whole-genome sequencing. Results were analyzed for phylogenetic relationship by core genome MLST (cg-MLST) and whole-genome single-nucleotide polymorphism profiles. Next-generation sequencing–based cg-MLST revealed several outbreak clusters caused by ST8; the geographic focus was in the metropolitan areas of Hamburg and Berlin. To achieve enhanced analytical depth, we used additional cg-MLST target genes and genome-wide single-nucleotide polymorphisms. We identified patient characteristics and detected transmission events, providing evidence that nontoxigenic C. diphtheriae infection is a potential public health threat in industrialized countries.

EID Dangel A, Berger A, Konrad R, Bischoff H, Sing A. Geographically Diverse Clusters of Nontoxigenic Corynebacterium diphtheriae Infection, Germany, 2016–2017. Emerg Infect Dis. 2018;24(7):1239-1245. https://dx.doi.org/10.3201/eid2407.172026
AMA Dangel A, Berger A, Konrad R, et al. Geographically Diverse Clusters of Nontoxigenic Corynebacterium diphtheriae Infection, Germany, 2016–2017. Emerging Infectious Diseases. 2018;24(7):1239-1245. doi:10.3201/eid2407.172026.
APA Dangel, A., Berger, A., Konrad, R., Bischoff, H., & Sing, A. (2018). Geographically Diverse Clusters of Nontoxigenic Corynebacterium diphtheriae Infection, Germany, 2016–2017. Emerging Infectious Diseases, 24(7), 1239-1245. https://dx.doi.org/10.3201/eid2407.172026.

Medscape CME Activity
Epidemiology and Geographic Distribution of Blastomycosis, Histoplasmosis, and Coccidioidomycosis, Ontario, Canada, 1990–2015 [PDF - 1.95 MB - 10 pages]
E. M. Brown et al.

Endemic mycoses represent a growing public health challenge in North America. We describe the epidemiology of 1,392 microbiology laboratory–confirmed cases of blastomycosis, histoplasmosis, and coccidioidomycosis in Ontario during 1990–2015. Blastomycosis was the most common infection (1,092 cases; incidence of 0.41 cases/100,000 population), followed by histoplasmosis (211 cases) and coccidioidomycosis (89 cases). Incidence of blastomycosis increased from 1995 to 2001 and has remained elevated, especially in the northwest region, incorporating several localized hotspots where disease incidence (10.9 cases/100,000 population) is 12.6 times greater than in any other region of the province. This retrospective study substantially increases the number of known endemic fungal infections reported in Canada, confirms Ontario as an important region of endemicity for blastomycosis and histoplasmosis, and provides an epidemiologic baseline for future disease surveillance. Clinicians should include blastomycosis and histoplasmosis in the differential diagnosis of antibiotic-refractory pneumonia in patients traveling to or residing in Ontario.

EID Brown EM, McTaggart LR, Dunn D, Pszczolko E, Tsui K, Morris SK, et al. Epidemiology and Geographic Distribution of Blastomycosis, Histoplasmosis, and Coccidioidomycosis, Ontario, Canada, 1990–2015. Emerg Infect Dis. 2018;24(7):1257-1266. https://dx.doi.org/10.3201/eid2407.172063
AMA Brown EM, McTaggart LR, Dunn D, et al. Epidemiology and Geographic Distribution of Blastomycosis, Histoplasmosis, and Coccidioidomycosis, Ontario, Canada, 1990–2015. Emerging Infectious Diseases. 2018;24(7):1257-1266. doi:10.3201/eid2407.172063.
APA Brown, E. M., McTaggart, L. R., Dunn, D., Pszczolko, E., Tsui, K., Morris, S. K....Richardson, S. E. (2018). Epidemiology and Geographic Distribution of Blastomycosis, Histoplasmosis, and Coccidioidomycosis, Ontario, Canada, 1990–2015. Emerging Infectious Diseases, 24(7), 1257-1266. https://dx.doi.org/10.3201/eid2407.172063.

Registry Cohort Study to Determine Risk for Multiple Sclerosis after Vaccination for Pandemic Influenza A(H1N1) with Arepanrix, Manitoba, Canada [PDF - 394 KB - 8 pages]
S. M. Mahmud et al.

To investigate a potential risk for multiple sclerosis (MS) after vaccination with Arepanrix, the GlaxoSmithKline AS03-adjuvanted influenza A(H1N1)pdm09 vaccine, we used the provincewide immunization registry for Manitoba, Canada, to match 341,347 persons vaccinated during the 2009 pandemic to 485,941 unvaccinated persons on age, sex, address, and a propensity score measuring the probability of vaccination. We used a previously validated algorithm to identify MS cases from provincial hospital, physician, and prescription drug claims databases. After 12 months of follow-up, the age-adjusted incidence rate of MS was 17.7 cases per 100,000 person-years in the Arepanrix cohort and 24.2 per 100,000 in the unvaccinated cohort. The corresponding adjusted hazard ratio was 0.9. We observed similar patterns when we measured incidence over the entire follow-up period. The AS03 adjuvant, a candidate for inclusion in future pandemic vaccines, does not appear to increase the short-term risk for MS when included in influenza vaccines.

EID Mahmud SM, Bozat-Emre S, Mostaço-Guidolin LC, Marrie R. Registry Cohort Study to Determine Risk for Multiple Sclerosis after Vaccination for Pandemic Influenza A(H1N1) with Arepanrix, Manitoba, Canada. Emerg Infect Dis. 2018;24(7):1267-1274. https://dx.doi.org/10.3201/eid2407.161783
AMA Mahmud SM, Bozat-Emre S, Mostaço-Guidolin LC, et al. Registry Cohort Study to Determine Risk for Multiple Sclerosis after Vaccination for Pandemic Influenza A(H1N1) with Arepanrix, Manitoba, Canada. Emerging Infectious Diseases. 2018;24(7):1267-1274. doi:10.3201/eid2407.161783.
APA Mahmud, S. M., Bozat-Emre, S., Mostaço-Guidolin, L. C., & Marrie, R. (2018). Registry Cohort Study to Determine Risk for Multiple Sclerosis after Vaccination for Pandemic Influenza A(H1N1) with Arepanrix, Manitoba, Canada. Emerging Infectious Diseases, 24(7), 1267-1274. https://dx.doi.org/10.3201/eid2407.161783.

Pneumococcal Meningitis in Adults after Introduction of PCV7 and PCV13, Israel, July 2009–June 2015 [PDF - 1.12 MB - 10 pages]
G. Regev-Yochay et al.

The indirect effect of pneumococcal conjugate vaccine on adult pneumococcal meningitis has not been thoroughly investigated. We present data from active surveillance on pneumococcal meningitis in adults in Israel occurring during July 2009–June 2015. Pneumococcal meningitis was diagnosed for 221 patients, 9.4% of all invasive pneumococcal disease (IPD) cases. Although overall IPD incidence decreased during the study period, meningitis increased nonsignificantly from 0.66 to 0.85 cases/100,000 population. Incidence of vaccine type (VT) pneumococcal meningitis (VT13) decreased by 70%, but non-VT13 pneumococcal meningitis increased from 0.32 to 0.75 cases/100,000 population (incident rate ratio 2.35, 95% CI 1.27–4.35). Pneumococcal meningitis patients were younger and healthier than nonmeningitis IPD patients, and 20.2% had a history of previous head surgery or cerebrospinal fluid leak compared with <2.0% of nonmeningitis patients (p<0.0001). Non-VT13 types that rarely cause IPD (15B/C, 6C, 23A, 23B, 24F) seem to be emerging as common causes of meningitis.

EID Regev-Yochay G, Reisenberg K, Katzir M, Wiener-Well Y, Rahav G, Strahilevitz J, et al. Pneumococcal Meningitis in Adults after Introduction of PCV7 and PCV13, Israel, July 2009–June 2015. Emerg Infect Dis. 2018;24(7):1275-1284. https://dx.doi.org/10.3201/eid2407.170721
AMA Regev-Yochay G, Reisenberg K, Katzir M, et al. Pneumococcal Meningitis in Adults after Introduction of PCV7 and PCV13, Israel, July 2009–June 2015. Emerging Infectious Diseases. 2018;24(7):1275-1284. doi:10.3201/eid2407.170721.
APA Regev-Yochay, G., Reisenberg, K., Katzir, M., Wiener-Well, Y., Rahav, G., Strahilevitz, J....Dagan, R. (2018). Pneumococcal Meningitis in Adults after Introduction of PCV7 and PCV13, Israel, July 2009–June 2015. Emerging Infectious Diseases, 24(7), 1275-1284. https://dx.doi.org/10.3201/eid2407.170721.

Reemergence of Reston ebolavirus in Cynomolgus Monkeys, the Philippines, 2015 [PDF - 1.37 MB - 7 pages]
C. Demetria et al.

In August 2015, a nonhuman primate facility south of Manila, the Philippines, noted unusual deaths of 6 cynomolgus monkeys (Macaca fascicularis), characterized by generalized rashes, inappetence, or sudden death. We identified Reston ebolavirus (RESTV) infection in monkeys by using serologic and molecular assays. We isolated viruses in tissues from infected monkeys and determined viral genome sequences. RESTV found in the 2015 outbreak is genetically closer to 1 of the 4 RESTVs that caused the 2008 outbreak among swine. Eight macaques, including 2 also infected with RESTV, tested positive for measles. Concurrently, the measles virus was circulating throughout the Philippines, indicating that the infection of the macaques may be a reverse zoonosis. Improved biosecurity measures will minimize the public health risk, as well as limit the introduction of disease and vectors.

EID Demetria C, Smith I, Tan T, Villarico D, Simon E, Centeno R, et al. Reemergence of Reston ebolavirus in Cynomolgus Monkeys, the Philippines, 2015. Emerg Infect Dis. 2018;24(7):1285-1291. https://dx.doi.org/10.3201/eid2407.171234
AMA Demetria C, Smith I, Tan T, et al. Reemergence of Reston ebolavirus in Cynomolgus Monkeys, the Philippines, 2015. Emerging Infectious Diseases. 2018;24(7):1285-1291. doi:10.3201/eid2407.171234.
APA Demetria, C., Smith, I., Tan, T., Villarico, D., Simon, E., Centeno, R....Fukushi, S. (2018). Reemergence of Reston ebolavirus in Cynomolgus Monkeys, the Philippines, 2015. Emerging Infectious Diseases, 24(7), 1285-1291. https://dx.doi.org/10.3201/eid2407.171234.

Global Distribution of Human Protoparvoviruses [PDF - 1.10 MB - 8 pages]
E. Väisänen et al.

Development of next-generation sequencing and metagenomics has revolutionized detection of novel viruses. Among these viruses are 3 human protoparvoviruses: bufavirus, tusavirus, and cutavirus. These viruses have been detected in feces of children with diarrhea. In addition, cutavirus has been detected in skin biopsy specimens of cutaneous T-cell lymphoma patients in France and in 1 melanoma patient in Denmark. We studied seroprevalences of IgG against bufavirus, tusavirus, and cutavirus in various populations (n = 840), and found a striking geographic difference in prevalence of bufavirus IgG. Although prevalence was low in adult populations in Finland (1.9%) and the United States (3.6%), bufavirus IgG was highly prevalent in populations in Iraq (84.8%), Iran (56.1%), and Kenya (72.3%). Conversely, cutavirus IgG showed evenly low prevalences (0%–5.6%) in all cohorts, and tusavirus IgG was not detected. These results provide new insights on the global distribution and endemic areas of protoparvoviruses.

EID Väisänen E, Mohanraj U, Kinnunen PM, Jokelainen P, Al-Hello H, Barakat AM, et al. Global Distribution of Human Protoparvoviruses. Emerg Infect Dis. 2018;24(7):1292-1299. https://dx.doi.org/10.3201/eid2407.172128
AMA Väisänen E, Mohanraj U, Kinnunen PM, et al. Global Distribution of Human Protoparvoviruses. Emerging Infectious Diseases. 2018;24(7):1292-1299. doi:10.3201/eid2407.172128.
APA Väisänen, E., Mohanraj, U., Kinnunen, P. M., Jokelainen, P., Al-Hello, H., Barakat, A. M....Söderlund-Venermo, M. (2018). Global Distribution of Human Protoparvoviruses. Emerging Infectious Diseases, 24(7), 1292-1299. https://dx.doi.org/10.3201/eid2407.172128.

Mapping of the US Domestic Influenza Virologic Surveillance Landscape [PDF - 690 KB - 7 pages]
B. Jester et al.

Influenza virologic surveillance is critical each season for tracking influenza circulation, following trends in antiviral drug resistance, detecting novel influenza infections in humans, and selecting viruses for use in annual seasonal vaccine production. We developed a framework and process map for characterizing the landscape of US influenza virologic surveillance into 5 tiers of influenza testing: outpatient settings (tier 1), inpatient settings and commercial laboratories (tier 2), state public health laboratories (tier 3), National Influenza Reference Center laboratories (tier 4), and Centers for Disease Control and Prevention laboratories (tier 5). During the 2015–16 season, the numbers of influenza tests directly contributing to virologic surveillance were 804,000 in tiers 1 and 2; 78,000 in tier 3; 2,800 in tier 4; and 3,400 in tier 5. With the release of the 2017 US Pandemic Influenza Plan, the proposed framework will support public health officials in modeling, surveillance, and pandemic planning and response.

EID Jester B, Schwerzmann J, Mustaquim D, Aden T, Brammer L, Humes R, et al. Mapping of the US Domestic Influenza Virologic Surveillance Landscape. Emerg Infect Dis. 2018;24(7):1300-1306. https://dx.doi.org/10.3201/eid2407.180028
AMA Jester B, Schwerzmann J, Mustaquim D, et al. Mapping of the US Domestic Influenza Virologic Surveillance Landscape. Emerging Infectious Diseases. 2018;24(7):1300-1306. doi:10.3201/eid2407.180028.
APA Jester, B., Schwerzmann, J., Mustaquim, D., Aden, T., Brammer, L., Humes, R....Jernigan, D. (2018). Mapping of the US Domestic Influenza Virologic Surveillance Landscape. Emerging Infectious Diseases, 24(7), 1300-1306. https://dx.doi.org/10.3201/eid2407.180028.

Pediatric Complicated Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in 13-Valent Pneumococcal Conjugate Vaccinees, Portugal, 2010–2015 [PDF - 2.10 MB - 8 pages]
C. Silva-Costa et al.

Despite use of 7-valent pneumococcal conjugate vaccine, incidence of pleural effusion and empyema (pediatric complicated pneumococcal pneumonia [PCPP]) is reportedly increasing globally. We cultured and performed PCR on 152 pleural fluid samples recovered from pediatric patients in Portugal during 2010–2015 to identify and serotype Streptococcus pneumoniae. We identified only 17 cases by culture, but molecular methods identified S. pneumoniae in 68% (92/135) of culture-negative samples. The most frequent serotypes were 3, 1, and 19A, together accounting for 62% (68/109) of cases. Nineteen cases attributable to 13-valent pneumococcal conjugate vaccine (PCV13) serotypes (mostly serotype 3) were detected among 22 children age-appropriately vaccinated with PCV13. The dominance of the additional serotypes included in PCV13 among PCPP cases in Portugal continues, even with PCV13 available on the private market (without reimbursement) since 2010 and with average annual coverage of 61% among age-eligible children. Our data suggest reduced effectiveness of PCV13 against serotype 3 PCPP.

EID Silva-Costa C, Brito M, Pinho MD, Friães A, Aguiar SI, Ramirez M, et al. Pediatric Complicated Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in 13-Valent Pneumococcal Conjugate Vaccinees, Portugal, 2010–2015. Emerg Infect Dis. 2018;24(7):1307-1314. https://dx.doi.org/10.3201/eid2407.180029
AMA Silva-Costa C, Brito M, Pinho MD, et al. Pediatric Complicated Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in 13-Valent Pneumococcal Conjugate Vaccinees, Portugal, 2010–2015. Emerging Infectious Diseases. 2018;24(7):1307-1314. doi:10.3201/eid2407.180029.
APA Silva-Costa, C., Brito, M., Pinho, M. D., Friães, A., Aguiar, S. I., Ramirez, M....Melo-Cristino, J. (2018). Pediatric Complicated Pneumonia Caused by Streptococcus pneumoniae Serotype 3 in 13-Valent Pneumococcal Conjugate Vaccinees, Portugal, 2010–2015. Emerging Infectious Diseases, 24(7), 1307-1314. https://dx.doi.org/10.3201/eid2407.180029.

Virus RNA Load in Patients with Tick-Borne Encephalitis, Slovenia [PDF - 2.24 MB - 9 pages]
A. Saksida et al.

We determined levels of tick-borne encephalitis (TBE) virus (TBEV) RNA in serum samples obtained from 80 patients during the initial phase of TBE in Slovenia. For most samples, levels were within the range of 3–6 log10 copies RNA/mL. Levels were higher in female patients than in male patients, but we found no association between virus load and several laboratory and clinical parameters, including severity of TBE. However, a weak humoral immune response was associated with a more severe disease course, suggesting that inefficient clearance of virus results in a more serious illness. To determine whether a certain genetic lineage of TBEV had a higher virulence potential, we obtained 56 partial envelope protein gene sequences by directly sequencing reverse transcription PCR products from clinical samples of patients. This method provided a large set of patient-derived TBEV sequences. We observed no association between phylogenetic clades and virus load or disease severity.

EID Saksida A, Jakopin N, Jelovšek M, Knap N, Fajs L, Lusa L, et al. Virus RNA Load in Patients with Tick-Borne Encephalitis, Slovenia. Emerg Infect Dis. 2018;24(7):1315-1323. https://dx.doi.org/10.3201/eid2407.180059
AMA Saksida A, Jakopin N, Jelovšek M, et al. Virus RNA Load in Patients with Tick-Borne Encephalitis, Slovenia. Emerging Infectious Diseases. 2018;24(7):1315-1323. doi:10.3201/eid2407.180059.
APA Saksida, A., Jakopin, N., Jelovšek, M., Knap, N., Fajs, L., Lusa, L....Avšič-Županc, T. (2018). Virus RNA Load in Patients with Tick-Borne Encephalitis, Slovenia. Emerging Infectious Diseases, 24(7), 1315-1323. https://dx.doi.org/10.3201/eid2407.180059.

Avian Influenza A Virus Infection among Workers at Live Poultry Markets, China, 2013–2016 [PDF - 2.28 MB - 11 pages]
M. Ma et al.

We conducted a 3-year longitudinal serologic survey on an open cohort of poultry workers, swine workers, and general population controls to assess avian influenza A virus (AIV) seroprevalence and seroincidence and virologic diversity at live poultry markets (LPMs) in Wuxi City, Jiangsu Province, China. Of 964 poultry workers, 9 (0.93%) were seropositive for subtype H7N9 virus, 18 (1.87%) for H9N2, and 18 (1.87%) for H5N1. Of 468 poultry workers followed longitudinally, 2 (0.43%), 13 (2.78%), and 7 (1.5%) seroconverted, respectively; incidence was 1.27, 8.28, and 4.46/1,000 person-years for H7N9, H9N2, and H5N1 viruses, respectively. Longitudinal surveillance of AIVs at 9 LPMs revealed high co-circulation of H9, H7, and H5 subtypes. We detected AIVs in 726 (23.3%) of 3,121 samples and identified a high diversity (10 subtypes) of new genetic constellations and reassortant viruses. These data suggest that stronger surveillance for AIVs within LPMs and high-risk populations is imperative.

EID Ma M, Zhao T, Chen S, Xia X, Yang X, Wang G, et al. Avian Influenza A Virus Infection among Workers at Live Poultry Markets, China, 2013–2016. Emerg Infect Dis. 2018;24(7):1246-1256. https://dx.doi.org/10.3201/eid2407.172059
AMA Ma M, Zhao T, Chen S, et al. Avian Influenza A Virus Infection among Workers at Live Poultry Markets, China, 2013–2016. Emerging Infectious Diseases. 2018;24(7):1246-1256. doi:10.3201/eid2407.172059.
APA Ma, M., Zhao, T., Chen, S., Xia, X., Yang, X., Wang, G....Cao, W. (2018). Avian Influenza A Virus Infection among Workers at Live Poultry Markets, China, 2013–2016. Emerging Infectious Diseases, 24(7), 1246-1256. https://dx.doi.org/10.3201/eid2407.172059.
Policy Review

Strengthening Global Public Health Surveillance through Data and Benefit Sharing [PDF - 585 KB - 7 pages]
M. Edelstein et al.

Equitable sharing of public health surveillance data can help prevent or mitigate the effect of infectious diseases. Equitable data sharing includes working toward more equitable sharing of the public health benefits that data sharing brings and requires the engagement of those providing the data, those interpreting and using the data generated by others, those facilitating the data-sharing process, and those deriving and contributing to the benefit. An expert consultation conducted by Chatham House outlined 7 principles to encourage the process of equitable data sharing: 1) building trust; 2) articulating the value; 3) planning for data sharing; 4) achieving quality data; 5) understanding the legal context; 6) creating data-sharing agreements; and 7) monitoring and evaluation. Sharing of public health surveillance data is best done taking into account these principles, which will help to ensure data are shared optimally and ethically, while fulfilling stakeholder expectations and facilitating equitable distribution of benefits.

EID Edelstein M, Lee LM, Herten-Crabb A, Heymann DL, Harper DR. Strengthening Global Public Health Surveillance through Data and Benefit Sharing. Emerg Infect Dis. 2018;24(7):1324-1330. https://dx.doi.org/10.3201/eid2407.151830
AMA Edelstein M, Lee LM, Herten-Crabb A, et al. Strengthening Global Public Health Surveillance through Data and Benefit Sharing. Emerging Infectious Diseases. 2018;24(7):1324-1330. doi:10.3201/eid2407.151830.
APA Edelstein, M., Lee, L. M., Herten-Crabb, A., Heymann, D. L., & Harper, D. R. (2018). Strengthening Global Public Health Surveillance through Data and Benefit Sharing. Emerging Infectious Diseases, 24(7), 1324-1330. https://dx.doi.org/10.3201/eid2407.151830.
Dispatches

Detection of Respiratory Viruses in Deceased Persons, Spain, 2017 [PDF - 940 KB - 4 pages]
A. Navascués et al.

During the 2016–17 influenza season in Spain, we tested specimens from 57 elderly deceased persons for respiratory viruses. Influenza viruses were detected in 18% of the specimens and any respiratory virus in 47%. Only 7% of participants had received a diagnosis of infection with the detected virus before death.

EID Navascués A, Casado I, Pérez-García A, Aguinaga A, Martínez-Baz I, Floristán Y, et al. Detection of Respiratory Viruses in Deceased Persons, Spain, 2017. Emerg Infect Dis. 2018;24(7):1331-1334. https://dx.doi.org/10.3201/eid2407.180162
AMA Navascués A, Casado I, Pérez-García A, et al. Detection of Respiratory Viruses in Deceased Persons, Spain, 2017. Emerging Infectious Diseases. 2018;24(7):1331-1334. doi:10.3201/eid2407.180162.
APA Navascués, A., Casado, I., Pérez-García, A., Aguinaga, A., Martínez-Baz, I., Floristán, Y....Castilla, J. (2018). Detection of Respiratory Viruses in Deceased Persons, Spain, 2017. Emerging Infectious Diseases, 24(7), 1331-1334. https://dx.doi.org/10.3201/eid2407.180162.

Microevolution and Patterns of Transmission of Shigella sonnei within Cyclic Outbreaks Shigellosis, Israel [PDF - 2.74 MB - 5 pages]
A. Behar et al.

Whole-genome sequencing unveiled host and environment-related insights to Shigella sonnei transmission within cyclic epidemics during 2000–2012 in Israel. The Israeli reservoir contains isolates belonging to S. sonnei lineage III but of different origin, shows loss of tetracycline resistance genes, and little genetic variation within the O antigen: highly relevant for Shigella vaccine development.

EID Behar A, Baker K, Bassal R, Ezernitchi A, Valinsky L, Thomson NR, et al. Microevolution and Patterns of Transmission of Shigella sonnei within Cyclic Outbreaks Shigellosis, Israel. Emerg Infect Dis. 2018;24(7):1335-1339. https://dx.doi.org/10.3201/eid2407.171313
AMA Behar A, Baker K, Bassal R, et al. Microevolution and Patterns of Transmission of Shigella sonnei within Cyclic Outbreaks Shigellosis, Israel. Emerging Infectious Diseases. 2018;24(7):1335-1339. doi:10.3201/eid2407.171313.
APA Behar, A., Baker, K., Bassal, R., Ezernitchi, A., Valinsky, L., Thomson, N. R....Cohen, D. (2018). Microevolution and Patterns of Transmission of Shigella sonnei within Cyclic Outbreaks Shigellosis, Israel. Emerging Infectious Diseases, 24(7), 1335-1339. https://dx.doi.org/10.3201/eid2407.171313.

Diphtheria Outbreak in Amerindian Communities, Wonken, Venezuela, 2016–2017 [PDF - 1.27 MB - 5 pages]
A. Lodeiro-Colatosti et al.

In February 2017, a diphtheria outbreak occurred among Amerindians of the Pemón ethnic group in Wonken, Venezuela. A field investigation revealed ≈10 cases; clinical presentation did not include cutaneous or neurologic signs or symptoms. To prevent future outbreaks in Venezuela, Amerindian communities need better access to vaccination and healthcare.

EID Lodeiro-Colatosti A, Reischl U, Holzmann T, Hernández-Pereira CE, Rísquez A, Paniz-Mondolfi AE. Diphtheria Outbreak in Amerindian Communities, Wonken, Venezuela, 2016–2017. Emerg Infect Dis. 2018;24(7):1340-1344. https://dx.doi.org/10.3201/eid2407.171712
AMA Lodeiro-Colatosti A, Reischl U, Holzmann T, et al. Diphtheria Outbreak in Amerindian Communities, Wonken, Venezuela, 2016–2017. Emerging Infectious Diseases. 2018;24(7):1340-1344. doi:10.3201/eid2407.171712.
APA Lodeiro-Colatosti, A., Reischl, U., Holzmann, T., Hernández-Pereira, C. E., Rísquez, A., & Paniz-Mondolfi, A. E. (2018). Diphtheria Outbreak in Amerindian Communities, Wonken, Venezuela, 2016–2017. Emerging Infectious Diseases, 24(7), 1340-1344. https://dx.doi.org/10.3201/eid2407.171712.

Legionnaires’ Disease Outbreak on a Merchant Vessel, Indian Ocean, Australia, 2015 [PDF - 699 KB - 4 pages]
T. Inglis et al.

Two cases of Legionnaires’ disease and 1 of Pontiac fever occurred among the crew of a merchant ship operating off the shores of Australia. PCR assays identified potential sources in the ship’s cabins. Modification of maritime regulations for Legionnaires’ disease prevention in commercial vessels is needed for nonpassenger merchant ships.

EID Inglis T, Spittle C, Carmichael H, Downes J, Chiari M, McQueen-Mason A, et al. Legionnaires’ Disease Outbreak on a Merchant Vessel, Indian Ocean, Australia, 2015. Emerg Infect Dis. 2018;24(7):1345-1348. https://dx.doi.org/10.3201/eid2407.171978
AMA Inglis T, Spittle C, Carmichael H, et al. Legionnaires’ Disease Outbreak on a Merchant Vessel, Indian Ocean, Australia, 2015. Emerging Infectious Diseases. 2018;24(7):1345-1348. doi:10.3201/eid2407.171978.
APA Inglis, T., Spittle, C., Carmichael, H., Downes, J., Chiari, M., McQueen-Mason, A....Dowse, G. K. (2018). Legionnaires’ Disease Outbreak on a Merchant Vessel, Indian Ocean, Australia, 2015. Emerging Infectious Diseases, 24(7), 1345-1348. https://dx.doi.org/10.3201/eid2407.171978.

Guiana Dolphin Unusual Mortality Event and Link to Cetacean Morbillivirus, Brazil [PDF - 1.77 MB - 6 pages]
K. R. Groch et al.

During November–December 2017, a mass die-off of Guiana dolphins (Sotalia guianensis) began in Rio de Janeiro, Brazil. Molecular and pathologic investigations on 20 animals indicated that cetacean morbillivirus played a major role. Our findings increase the knowledge on health and disease aspects of this endangered species.

EID Groch KR, Santos-Neto EB, Díaz-Delgado J, Ikeda J, Carvalho RR, Oliveira RB, et al. Guiana Dolphin Unusual Mortality Event and Link to Cetacean Morbillivirus, Brazil. Emerg Infect Dis. 2018;24(7):1349-1354. https://dx.doi.org/10.3201/eid2407.180139
AMA Groch KR, Santos-Neto EB, Díaz-Delgado J, et al. Guiana Dolphin Unusual Mortality Event and Link to Cetacean Morbillivirus, Brazil. Emerging Infectious Diseases. 2018;24(7):1349-1354. doi:10.3201/eid2407.180139.
APA Groch, K. R., Santos-Neto, E. B., Díaz-Delgado, J., Ikeda, J., Carvalho, R. R., Oliveira, R. B....Catão-Dias, J. L. (2018). Guiana Dolphin Unusual Mortality Event and Link to Cetacean Morbillivirus, Brazil. Emerging Infectious Diseases, 24(7), 1349-1354. https://dx.doi.org/10.3201/eid2407.180139.

Use of Urea Wash ELISA to Distinguish Zika and Dengue Virus Infections [PDF - 1014 KB - 5 pages]
W. Tsai et al.

Serologic testing remains crucial for Zika virus diagnosis. We found that urea wash in a Zika virus nonstructural protein 1 IgG ELISA distinguishes secondary dengue virus infection from Zika virus infection with previous dengue (sensitivity 87.5%, specificity 93.8%). This test will aid serodiagnosis, serosurveillance, and monitoring of Zika complications in dengue-endemic regions.

EID Tsai W, Youn H, Tyson J, Brites C, Tsai J, Pedroso C, et al. Use of Urea Wash ELISA to Distinguish Zika and Dengue Virus Infections. Emerg Infect Dis. 2018;24(7):1355-1359. https://dx.doi.org/10.3201/eid2407.171170
AMA Tsai W, Youn H, Tyson J, et al. Use of Urea Wash ELISA to Distinguish Zika and Dengue Virus Infections. Emerging Infectious Diseases. 2018;24(7):1355-1359. doi:10.3201/eid2407.171170.
APA Tsai, W., Youn, H., Tyson, J., Brites, C., Tsai, J., Pedroso, C....Wang, W. (2018). Use of Urea Wash ELISA to Distinguish Zika and Dengue Virus Infections. Emerging Infectious Diseases, 24(7), 1355-1359. https://dx.doi.org/10.3201/eid2407.171170.

Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Selected Risk Groups, South Africa [PDF - 974 KB - 4 pages]
S. Vawda et al.

Crimean Congo hemorrhagic fever virus (CCHFV) is endemic in South Africa, but whether mild undiagnosed cases occur is unclear. In a seroepidemiologic survey, only 2 of 387 adults considered at risk because of occupational or recreational activities had evidence of previous infection. Seroprevalence in South Africa remains low within the groups investigated.

EID Vawda S, Goedhals D, Bester P, Burt F. Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Selected Risk Groups, South Africa. Emerg Infect Dis. 2018;24(7):1360-1363. https://dx.doi.org/10.3201/eid2407.172096
AMA Vawda S, Goedhals D, Bester P, et al. Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Selected Risk Groups, South Africa. Emerging Infectious Diseases. 2018;24(7):1360-1363. doi:10.3201/eid2407.172096.
APA Vawda, S., Goedhals, D., Bester, P., & Burt, F. (2018). Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Selected Risk Groups, South Africa. Emerging Infectious Diseases, 24(7), 1360-1363. https://dx.doi.org/10.3201/eid2407.172096.

Diagnosis of Methionine/Valine Variant Creutzfeldt-Jakob Disease by Protein Misfolding Cyclic Amplification [PDF - 357 KB - 3 pages]
D. Bougard et al.

A patient with a heterozygous variant of Creutzfeldt-Jakob disease (CJD) with a methionine/valine genotype at codon 129 of the prion protein gene was recently reported. Using an ultrasensitive and specific protein misfolding cyclic amplification–based assay for detecting variant CJD prions in cerebrospinal fluid, we discriminated this heterozygous case of variant CJD from cases of sporadic CJD.

EID Bougard D, Bélondrade M, Mayran C, Bruyère-Ostells L, Lehmann S, Fournier-Wirth C, et al. Diagnosis of Methionine/Valine Variant Creutzfeldt-Jakob Disease by Protein Misfolding Cyclic Amplification. Emerg Infect Dis. 2018;24(7):1364-1366. https://dx.doi.org/10.3201/eid2407.172105
AMA Bougard D, Bélondrade M, Mayran C, et al. Diagnosis of Methionine/Valine Variant Creutzfeldt-Jakob Disease by Protein Misfolding Cyclic Amplification. Emerging Infectious Diseases. 2018;24(7):1364-1366. doi:10.3201/eid2407.172105.
APA Bougard, D., Bélondrade, M., Mayran, C., Bruyère-Ostells, L., Lehmann, S., Fournier-Wirth, C....Green, A. (2018). Diagnosis of Methionine/Valine Variant Creutzfeldt-Jakob Disease by Protein Misfolding Cyclic Amplification. Emerging Infectious Diseases, 24(7), 1364-1366. https://dx.doi.org/10.3201/eid2407.172105.

Highly Pathogenic Avian Influenza A(H5N8) Virus, Cameroon, 2017 [PDF - 1.16 MB - 4 pages]
A. Wade et al.

Highly pathogenic avian influenza A(H5N8) viruses of clade 2.3.4.4 spread into West Africa in late 2016 during the autumn bird migration. Genetic characterization of the complete genome of these viruses detected in wild and domestic birds in Cameroon in January 2017 demonstrated the occurrence of multiple virus introductions.

EID Wade A, Jumbo S, Zecchin B, Fusaro A, Taiga T, Bianco A, et al. Highly Pathogenic Avian Influenza A(H5N8) Virus, Cameroon, 2017. Emerg Infect Dis. 2018;24(7):1367-1370. https://dx.doi.org/10.3201/eid2407.172120
AMA Wade A, Jumbo S, Zecchin B, et al. Highly Pathogenic Avian Influenza A(H5N8) Virus, Cameroon, 2017. Emerging Infectious Diseases. 2018;24(7):1367-1370. doi:10.3201/eid2407.172120.
APA Wade, A., Jumbo, S., Zecchin, B., Fusaro, A., Taiga, T., Bianco, A....Monne, I. (2018). Highly Pathogenic Avian Influenza A(H5N8) Virus, Cameroon, 2017. Emerging Infectious Diseases, 24(7), 1367-1370. https://dx.doi.org/10.3201/eid2407.172120.

Highly Pathogenic Avian Influenza A(H5N8) Virus, Democratic Republic of the Congo, 2017 [PDF - 806 KB - 4 pages]
A. T. Twabela et al.

In 2017, highly pathogenic avian influenza A(H5N8) virus was detected in poultry in the Democratic Republic of the Congo. Whole-genome phylogeny showed the virus clustered with H5N8 clade 2.3.4.4B strains from birds in central and southern Asia. Emergence of this virus in central Africa represents a threat for animal health and food security.

EID Twabela AT, Tshilenge GM, Sakoda Y, Okamatsu M, Bushu E, Kone P, et al. Highly Pathogenic Avian Influenza A(H5N8) Virus, Democratic Republic of the Congo, 2017. Emerg Infect Dis. 2018;24(7):1371-1374. https://dx.doi.org/10.3201/eid2407.172123
AMA Twabela AT, Tshilenge GM, Sakoda Y, et al. Highly Pathogenic Avian Influenza A(H5N8) Virus, Democratic Republic of the Congo, 2017. Emerging Infectious Diseases. 2018;24(7):1371-1374. doi:10.3201/eid2407.172123.
APA Twabela, A. T., Tshilenge, G. M., Sakoda, Y., Okamatsu, M., Bushu, E., Kone, P....Monne, I. (2018). Highly Pathogenic Avian Influenza A(H5N8) Virus, Democratic Republic of the Congo, 2017. Emerging Infectious Diseases, 24(7), 1371-1374. https://dx.doi.org/10.3201/eid2407.172123.
Research Letters

Poultry Infection with Influenza Viruses of Wild Bird Origin, China, 2016 [PDF - 629 KB - 3 pages]
Z. Yu et al.

Migratory birds may play a role in transmission of avian influenza virus. We report the infection of black-tailed gulls and chickens in eastern China with avian influenza (H13N2) and (H13N8) viruses. We found that these H13 viruses were transmitted from migratory birds to domestic poultry.

EID Yu Z, Cheng K, Gao Y. Poultry Infection with Influenza Viruses of Wild Bird Origin, China, 2016. Emerg Infect Dis. 2018;24(7):1375-1377. https://dx.doi.org/10.3201/eid2407.171220
AMA Yu Z, Cheng K, Gao Y. Poultry Infection with Influenza Viruses of Wild Bird Origin, China, 2016. Emerging Infectious Diseases. 2018;24(7):1375-1377. doi:10.3201/eid2407.171220.
APA Yu, Z., Cheng, K., & Gao, Y. (2018). Poultry Infection with Influenza Viruses of Wild Bird Origin, China, 2016. Emerging Infectious Diseases, 24(7), 1375-1377. https://dx.doi.org/10.3201/eid2407.171220.

Rat-Bite Fever in Human with Streptobacillus notomytis Infection, Japan [PDF - 698 KB - 3 pages]
Y. Ogawa et al.

We report a case of rat-bite fever in a 94-year-old woman with Streptobacillus notomytis infection. We established an epidemiologic link between exposure to rats and human infection by performing nested PCRs that detected S. notomytis in the intraoral swab specimens obtained from rats captured in the patient’s house.

EID Ogawa Y, Kasahara K, Lee S, Ito T, Hasegawa H, Hirose S, et al. Rat-Bite Fever in Human with Streptobacillus notomytis Infection, Japan. Emerg Infect Dis. 2018;24(7):1377-1379. https://dx.doi.org/10.3201/eid2407.171580
AMA Ogawa Y, Kasahara K, Lee S, et al. Rat-Bite Fever in Human with Streptobacillus notomytis Infection, Japan. Emerging Infectious Diseases. 2018;24(7):1377-1379. doi:10.3201/eid2407.171580.
APA Ogawa, Y., Kasahara, K., Lee, S., Ito, T., Hasegawa, H., Hirose, S....Mikasa, K. (2018). Rat-Bite Fever in Human with Streptobacillus notomytis Infection, Japan. Emerging Infectious Diseases, 24(7), 1377-1379. https://dx.doi.org/10.3201/eid2407.171580.

Perceptions of Zika Virus Risk during 2016 Outbreak, Miami-Dade County, Florida, USA [PDF - 423 KB - 3 pages]
I. K. Moise et al.

We conducted a survey on Zika virus perceptions and behaviors during the 2016 outbreak in Miami-Dade County, Florida, USA. Among women, Zika knowledge was associated with having a bachelor’s degree. Among men, knowledge was associated with knowing someone at risk. Interventions during future outbreaks could be targeted by sex and education level.

EID Moise IK, Kangmennaang J, Hutchings T, Sheskin IM, Fuller DO. Perceptions of Zika Virus Risk during 2016 Outbreak, Miami-Dade County, Florida, USA. Emerg Infect Dis. 2018;24(7):1379-1381. https://dx.doi.org/10.3201/eid2407.171650
AMA Moise IK, Kangmennaang J, Hutchings T, et al. Perceptions of Zika Virus Risk during 2016 Outbreak, Miami-Dade County, Florida, USA. Emerging Infectious Diseases. 2018;24(7):1379-1381. doi:10.3201/eid2407.171650.
APA Moise, I. K., Kangmennaang, J., Hutchings, T., Sheskin, I. M., & Fuller, D. O. (2018). Perceptions of Zika Virus Risk during 2016 Outbreak, Miami-Dade County, Florida, USA. Emerging Infectious Diseases, 24(7), 1379-1381. https://dx.doi.org/10.3201/eid2407.171650.

Recovery of Cryptococcus gattii from an Infected Ventriculo-Peritoneal Shunt, Illinois, USA [PDF - 328 KB - 2 pages]
D. Moritz et al.

Cryptococcus gattii is a fungal pathogen endemic in tropical and subtropical regions. Isolated cases and outbreaks have been reported in areas of North America and Europe, expanding the distribution pattern beyond warmer regions. We describe a case of ventriculo-peritoneal shunt infection by C. gattii in an immunocompetent person in Illinois.

EID Moritz D, Lora AJ, Blumer B, Harrington AT. Recovery of Cryptococcus gattii from an Infected Ventriculo-Peritoneal Shunt, Illinois, USA. Emerg Infect Dis. 2018;24(7):1382-1383. https://dx.doi.org/10.3201/eid2407.171754
AMA Moritz D, Lora AJ, Blumer B, et al. Recovery of Cryptococcus gattii from an Infected Ventriculo-Peritoneal Shunt, Illinois, USA. Emerging Infectious Diseases. 2018;24(7):1382-1383. doi:10.3201/eid2407.171754.
APA Moritz, D., Lora, A. J., Blumer, B., & Harrington, A. T. (2018). Recovery of Cryptococcus gattii from an Infected Ventriculo-Peritoneal Shunt, Illinois, USA. Emerging Infectious Diseases, 24(7), 1382-1383. https://dx.doi.org/10.3201/eid2407.171754.

Late or Lack of Vaccination Linked to Importation of Yellow Fever from Angola to China [PDF - 511 KB - 4 pages]
R. Song et al.

During March and April 2016, 11 yellow fever cases were identified in China. We report epidemic and viral information for 10 of these patients, 6 of whom had been vaccinated before travel. Phylogenetic analyses suggest these viruses nested within the diversity of strains endemic to Angola, where an outbreak began in 2015.

EID Song R, Guan S, Lee S, Chen Z, Chen C, Han L, et al. Late or Lack of Vaccination Linked to Importation of Yellow Fever from Angola to China. Emerg Infect Dis. 2018;24(7):1383-1386. https://dx.doi.org/10.3201/eid2407.171868
AMA Song R, Guan S, Lee S, et al. Late or Lack of Vaccination Linked to Importation of Yellow Fever from Angola to China. Emerging Infectious Diseases. 2018;24(7):1383-1386. doi:10.3201/eid2407.171868.
APA Song, R., Guan, S., Lee, S., Chen, Z., Chen, C., Han, L....Zhang, F. (2018). Late or Lack of Vaccination Linked to Importation of Yellow Fever from Angola to China. Emerging Infectious Diseases, 24(7), 1383-1386. https://dx.doi.org/10.3201/eid2407.171868.

Enterovirus A71 Infection, Thailand, 2017 [PDF - 249 KB - 2 pages]
J. Puenpa et al.

An outbreak of hand, foot and mouth disease among children in Thailand peaked in August 2017. Enterovirus A71 subgenogroup B5 caused most (33.8%, 163/482) cases. Severe disease (myocarditis and encephalitis) was observed in 1 patient. Coxsackievirus A6 was detected in 6.0% (29/482) of patients, and coxsackievirus A16 was detected in 2.7% (13/482) of patients.

EID Puenpa J, Auphimai C, Korkong S, Vongpunsawad S, Poovorawan Y. Enterovirus A71 Infection, Thailand, 2017. Emerg Infect Dis. 2018;24(7):1386-1387. https://dx.doi.org/10.3201/eid2407.171923
AMA Puenpa J, Auphimai C, Korkong S, et al. Enterovirus A71 Infection, Thailand, 2017. Emerging Infectious Diseases. 2018;24(7):1386-1387. doi:10.3201/eid2407.171923.
APA Puenpa, J., Auphimai, C., Korkong, S., Vongpunsawad, S., & Poovorawan, Y. (2018). Enterovirus A71 Infection, Thailand, 2017. Emerging Infectious Diseases, 24(7), 1386-1387. https://dx.doi.org/10.3201/eid2407.171923.

Influenza D Virus Circulation in Cattle and Swine, Luxembourg, 2012–2016 [PDF - 752 KB - 3 pages]
C. J. Snoeck et al.

We detected antibodies against influenza D in 80.2% of the cattle sampled in Luxembourg in 2016, suggesting widespread virus circulation throughout the country. In swine, seroprevalence of influenza D was low but increased from 0% to 5.9% from 2012 to 2014–2015.

EID Snoeck CJ, Oliva J, Pauly M, Losch S, Wildschutz F, Muller CP, et al. Influenza D Virus Circulation in Cattle and Swine, Luxembourg, 2012–2016. Emerg Infect Dis. 2018;24(7):1388-1389. https://dx.doi.org/10.3201/eid2407.171937
AMA Snoeck CJ, Oliva J, Pauly M, et al. Influenza D Virus Circulation in Cattle and Swine, Luxembourg, 2012–2016. Emerging Infectious Diseases. 2018;24(7):1388-1389. doi:10.3201/eid2407.171937.
APA Snoeck, C. J., Oliva, J., Pauly, M., Losch, S., Wildschutz, F., Muller, C. P....Ducatez, M. F. (2018). Influenza D Virus Circulation in Cattle and Swine, Luxembourg, 2012–2016. Emerging Infectious Diseases, 24(7), 1388-1389. https://dx.doi.org/10.3201/eid2407.171937.

Spillover of Swine Coronaviruses, United States [PDF - 455 KB - 3 pages]
S. N. Bevins et al.

Porcine epidemic diarrhea virus, a pathogen first detected in US domestic swine in 2013, has rapidly spilled over into feral swine populations. A better understanding of the factors associated with pathogen emergence is needed to better manage, and ultimately prevent, future spillover events from domestic to nondomestic animals.

EID Bevins SN, Lutman M, Pedersen K, Barrett N, Gidlewski T, Deliberto TJ, et al. Spillover of Swine Coronaviruses, United States. Emerg Infect Dis. 2018;24(7):1390-1392. https://dx.doi.org/10.3201/eid2407.172077
AMA Bevins SN, Lutman M, Pedersen K, et al. Spillover of Swine Coronaviruses, United States. Emerging Infectious Diseases. 2018;24(7):1390-1392. doi:10.3201/eid2407.172077.
APA Bevins, S. N., Lutman, M., Pedersen, K., Barrett, N., Gidlewski, T., Deliberto, T. J....Franklin, A. B. (2018). Spillover of Swine Coronaviruses, United States. Emerging Infectious Diseases, 24(7), 1390-1392. https://dx.doi.org/10.3201/eid2407.172077.
Letters

Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–2015 [PDF - 275 KB - 2 pages]
B. L. Lynch et al.
EID Lynch BL, Dean J, Brady D, De Gascun C. Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–2015. Emerg Infect Dis. 2018;24(7):1392-1393. https://dx.doi.org/10.3201/eid2407.180137
AMA Lynch BL, Dean J, Brady D, et al. Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–2015. Emerging Infectious Diseases. 2018;24(7):1392-1393. doi:10.3201/eid2407.180137.
APA Lynch, B. L., Dean, J., Brady, D., & De Gascun, C. (2018). Adenovirus Type 4 Respiratory Infections among Civilian Adults, Northeastern United States, 2011–2015. Emerging Infectious Diseases, 24(7), 1392-1393. https://dx.doi.org/10.3201/eid2407.180137.

Novel Highly Pathogenic Avian Influenza A(H5N6) Viruses in the Netherlands [PDF - 247 KB - 1 page]
Y. Xu
EID Xu Y. Novel Highly Pathogenic Avian Influenza A(H5N6) Viruses in the Netherlands. Emerg Infect Dis. 2018;24(7):1393. https://dx.doi.org/10.3201/eid2407.180635
AMA Xu Y. Novel Highly Pathogenic Avian Influenza A(H5N6) Viruses in the Netherlands. Emerging Infectious Diseases. 2018;24(7):1393. doi:10.3201/eid2407.180635.
APA Xu, Y. (2018). Novel Highly Pathogenic Avian Influenza A(H5N6) Viruses in the Netherlands. Emerging Infectious Diseases, 24(7), 1393. https://dx.doi.org/10.3201/eid2407.180635.
About the Cover

A Masterwork of Art, a Metaphor for Prevention [PDF - 2.25 MB - 2 pages]
B. Breedlove and A. Schuchat
EID Breedlove B, Schuchat A. A Masterwork of Art, a Metaphor for Prevention. Emerg Infect Dis. 2018;24(7):1396-1397. https://dx.doi.org/10.3201/eid2407.ac2407
AMA Breedlove B, Schuchat A. A Masterwork of Art, a Metaphor for Prevention. Emerging Infectious Diseases. 2018;24(7):1396-1397. doi:10.3201/eid2407.ac2407.
APA Breedlove, B., & Schuchat, A. (2018). A Masterwork of Art, a Metaphor for Prevention. Emerging Infectious Diseases, 24(7), 1396-1397. https://dx.doi.org/10.3201/eid2407.ac2407.
Etymologia

Etymologia: Cytokines [PDF - 256 KB - 1 page]
T. J. Gryczan
EID Gryczan TJ. Etymologia: Cytokines. Emerg Infect Dis. 2018;24(7):1227. https://dx.doi.org/10.3201/eid2407.et2407
AMA Gryczan TJ. Etymologia: Cytokines. Emerging Infectious Diseases. 2018;24(7):1227. doi:10.3201/eid2407.et2407.
APA Gryczan, T. J. (2018). Etymologia: Cytokines. Emerging Infectious Diseases, 24(7), 1227. https://dx.doi.org/10.3201/eid2407.et2407.
News and Notes

World Health Organization Regional Office for Africa Weekly Bulletin on Outbreaks and Other Emergencies [PDF - 857 KB - 2 pages]
B. Impouma et al.
EID Impouma B, Archer BN, Lukoya O, Hamblion EL, Fall I. World Health Organization Regional Office for Africa Weekly Bulletin on Outbreaks and Other Emergencies. Emerg Infect Dis. 2018;24(7):1394-1395. https://dx.doi.org/10.3201/eid2407.180573
AMA Impouma B, Archer BN, Lukoya O, et al. World Health Organization Regional Office for Africa Weekly Bulletin on Outbreaks and Other Emergencies. Emerging Infectious Diseases. 2018;24(7):1394-1395. doi:10.3201/eid2407.180573.
APA Impouma, B., Archer, B. N., Lukoya, O., Hamblion, E. L., & Fall, I. (2018). World Health Organization Regional Office for Africa Weekly Bulletin on Outbreaks and Other Emergencies. Emerging Infectious Diseases, 24(7), 1394-1395. https://dx.doi.org/10.3201/eid2407.180573.
Page created: June 22, 2018
Page updated: June 22, 2018
Page reviewed: June 22, 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.
edit_01 Submit ManuscriptExternal Link
Issue Select
GO
GO

Get Email Updates

To receive email updates about this page, enter your email address:

file_external