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Issue Cover for Volume 25, Number 1—January 2019

Volume 25, Number 1—January 2019

[PDF - 10.66 MB - 212 pages]

Perspective

Complexity of the Basic Reproduction Number (R0) [PDF - 374 KB - 4 pages]
P. L. Delamater et al.

The basic reproduction number (R0), also called the basic reproduction ratio or rate or the basic reproductive rate, is an epidemiologic metric used to describe the contagiousness or transmissibility of infectious agents. R0 is affected by numerous biological, sociobehavioral, and environmental factors that govern pathogen transmission and, therefore, is usually estimated with various types of complex mathematical models, which make R0 easily misrepresented, misinterpreted, and misapplied. R0 is not a biological constant for a pathogen, a rate over time, or a measure of disease severity, and R0 cannot be modified through vaccination campaigns. R0 is rarely measured directly, and modeled R0 values are dependent on model structures and assumptions. Some R0 values reported in the scientific literature are likely obsolete. R0 must be estimated, reported, and applied with great caution because this basic metric is far from simple.

EID Delamater PL, Street EJ, Leslie TF, Yang Y, Jacobsen KH. Complexity of the Basic Reproduction Number (R0). Emerg Infect Dis. 2019;25(1):1-4. https://dx.doi.org/10.3201/eid2501.171901
AMA Delamater PL, Street EJ, Leslie TF, et al. Complexity of the Basic Reproduction Number (R0). Emerging Infectious Diseases. 2019;25(1):1-4. doi:10.3201/eid2501.171901.
APA Delamater, P. L., Street, E. J., Leslie, T. F., Yang, Y., & Jacobsen, K. H. (2019). Complexity of the Basic Reproduction Number (R0). Emerging Infectious Diseases, 25(1), 1-4. https://dx.doi.org/10.3201/eid2501.171901.
Synopses

Aeromedical Transfer of Patients with Viral Hemorrhagic Fever [PDF - 4.93 MB - 10 pages]
E. D. Nicol et al.

For >40 years, the British Royal Air Force has maintained an aeromedical evacuation facility, the Deployable Air Isolator Team (DAIT), to transport patients with possible or confirmed highly infectious diseases to the United Kingdom. Since 2012, the DAIT, a joint Department of Health and Ministry of Defence asset, has successfully transferred 1 case-patient with Crimean-Congo hemorrhagic fever, 5 case-patients with Ebola virus disease, and 5 case-patients with high-risk Ebola virus exposure. Currently, no UK-published guidelines exist on how to transfer such patients. Here we describe the DAIT procedures from collection at point of illness or exposure to delivery into a dedicated specialist center. We provide illustrations of the challenges faced and, where appropriate, the enhancements made to the process over time.

EID Nicol ED, Mepham S, Naylor J, Mollan I, Adam M, d’Arcy J, et al. Aeromedical Transfer of Patients with Viral Hemorrhagic Fever. Emerg Infect Dis. 2019;25(1):5-14. https://dx.doi.org/10.3201/eid2501.180662
AMA Nicol ED, Mepham S, Naylor J, et al. Aeromedical Transfer of Patients with Viral Hemorrhagic Fever. Emerging Infectious Diseases. 2019;25(1):5-14. doi:10.3201/eid2501.180662.
APA Nicol, E. D., Mepham, S., Naylor, J., Mollan, I., Adam, M., d’Arcy, J....Jacobs, M. (2019). Aeromedical Transfer of Patients with Viral Hemorrhagic Fever. Emerging Infectious Diseases, 25(1), 5-14. https://dx.doi.org/10.3201/eid2501.180662.

Clinical and Radiologic Characteristics of Human Metapneumovirus Infections in Adults, South Korea [PDF - 1.36 MB - 10 pages]
H. Koo et al.

Clinical features of human metapneumovirus (HMPV) infection have not been well documented for adults. We investigated clinical and radiologic features of HMPV infection in 849 adults in a tertiary hospital in South Korea. We classified patients into groups on the basis of underlying diseases: immunocompetent patients, solid tumor patients, solid organ transplantation recipients, hematopoietic stem cell transplant recipients, hematologic malignancy patients, and patients receiving long-term steroid treatment. Of 849 HMPV-infected patients, 756 had community-acquired infections, 579 had pneumonia, and 203 had infections with other pathogens. Mortality rates were highest in hematopoietic stem cell transplantation recipients (22% at 30 days). Older age, current smoking, and underlying disease were associated with HMPV pneumonia. Body mass index and an immunocompromised state were associated with 30-day mortality rates in HMPV-infected patients. Bronchial wall thickening, ground-glass opacity, and ill-defined centrilobular nodules were common computed tomography findings for HMPV pneumonia. Macronodules and consolidation were observed in <50% of patients.

EID Koo H, Lee H, Choi S, Sung H, Kim H, Do K. Clinical and Radiologic Characteristics of Human Metapneumovirus Infections in Adults, South Korea. Emerg Infect Dis. 2019;25(1):15-24. https://dx.doi.org/10.3201/eid2501.181131
AMA Koo H, Lee H, Choi S, et al. Clinical and Radiologic Characteristics of Human Metapneumovirus Infections in Adults, South Korea. Emerging Infectious Diseases. 2019;25(1):15-24. doi:10.3201/eid2501.181131.
APA Koo, H., Lee, H., Choi, S., Sung, H., Kim, H., & Do, K. (2019). Clinical and Radiologic Characteristics of Human Metapneumovirus Infections in Adults, South Korea. Emerging Infectious Diseases, 25(1), 15-24. https://dx.doi.org/10.3201/eid2501.181131.

Medscape CME Activity
Enterovirus A71 Infection and Neurologic Disease, Madrid, Spain, 2016 [PDF - 1.02 MB - 8 pages]
C. Taravilla et al.

We conducted an observational study from January 2016 through January 2017 of patients admitted to a reference pediatric hospital in Madrid, Spain, for neurologic symptoms and enterovirus infection. Among the 30 patients, the most common signs and symptoms were fever, lethargy, myoclonic jerks, and ataxia. Real-time PCR detected enterovirus in the cerebrospinal fluid of 8 patients, nasopharyngeal aspirate in 17, and anal swab samples of 5. The enterovirus was genotyped for 25 of 30 patients; enterovirus A71 was the most common serotype (21/25) and the only serotype detected in patients with brainstem encephalitis or encephalomyelitis. Treatment was intravenous immunoglobulins for 21 patients and corticosteroids for 17. Admission to the pediatric intensive care unit was required for 14 patients. All patients survived. At admission, among patients with the most severe disease, leukocytes were elevated. For children with brainstem encephalitis or encephalomyelitis, clinicians should look for enterovirus and not limit testing to cerebrospinal fluid.

EID Taravilla C, Pérez-Sebastián I, Salido A, Serrano C, Extremera V, Rodríguez A, et al. Enterovirus A71 Infection and Neurologic Disease, Madrid, Spain, 2016. Emerg Infect Dis. 2019;25(1):25-32. https://dx.doi.org/10.3201/eid2501.181089
AMA Taravilla C, Pérez-Sebastián I, Salido A, et al. Enterovirus A71 Infection and Neurologic Disease, Madrid, Spain, 2016. Emerging Infectious Diseases. 2019;25(1):25-32. doi:10.3201/eid2501.181089.
APA Taravilla, C., Pérez-Sebastián, I., Salido, A., Serrano, C., Extremera, V., Rodríguez, A....González, A. (2019). Enterovirus A71 Infection and Neurologic Disease, Madrid, Spain, 2016. Emerging Infectious Diseases, 25(1), 25-32. https://dx.doi.org/10.3201/eid2501.181089.
Research

Epidemiology of Imported Infectious Diseases, China, 2005–2016 [PDF - 1.50 MB - 9 pages]
Y. Wang et al.

Imported infectious diseases are becoming a serious public health threat in China. However, limited information concerning the epidemiologic characteristics of imported infectious diseases is available. In this study, we collected data related to imported infectious diseases in mainland China from the National Information Reporting System of Infectious Diseases and analyzed demographic, temporal, and spatial distributions. The number of types of imported infectious diseases reported increased from 2 in 2005 to 11 in 2016. A total of 31,740 cases of infectious disease were imported to mainland China during 2005–2016; most of them were found in Yunnan Province. The cases were imported mainly from Africa and Asia. As a key and effective measure, pretravel education should be strengthened for all migrant workers and tourists in China, and border screening, cross-border international cooperation, and early warning should be further improved.

EID Wang Y, Wang X, Liu X, Ren R, Zhou L, Li C, et al. Epidemiology of Imported Infectious Diseases, China, 2005–2016. Emerg Infect Dis. 2019;25(1):33-41. https://dx.doi.org/10.3201/eid2501.180178
AMA Wang Y, Wang X, Liu X, et al. Epidemiology of Imported Infectious Diseases, China, 2005–2016. Emerging Infectious Diseases. 2019;25(1):33-41. doi:10.3201/eid2501.180178.
APA Wang, Y., Wang, X., Liu, X., Ren, R., Zhou, L., Li, C....Zhang, Y. (2019). Epidemiology of Imported Infectious Diseases, China, 2005–2016. Emerging Infectious Diseases, 25(1), 33-41. https://dx.doi.org/10.3201/eid2501.180178.

Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea [PDF - 2.18 MB - 10 pages]
M. Choi et al.

Elizabethkingia infections are difficult to treat because of intrinsic antimicrobial resistance, and their incidence has recently increased. We conducted a propensity score–matched case–control study during January 2016–June 2017 in South Korea and retrospectively studied data from patients who were culture positive for Elizabethkingia species during January 2009–June 2017. Furthermore, we conducted epidemiologic studies of the hospital environment and mosquitoes. The incidence of Elizabethkingia increased significantly, by 432.1%, for 2016–2017 over incidence for 2009–2015. Mechanical ventilation was associated with the acquisition of Elizabethkingia species. Because Elizabethkingia infection has a high case-fatality rate and is difficult to eliminate, intensive prevention of contamination is needed.

EID Choi M, Kim M, Jeong S, Choi J, Lee I, Yong T, et al. Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea. Emerg Infect Dis. 2019;25(1):42-51. https://dx.doi.org/10.3201/eid2501.171985
AMA Choi M, Kim M, Jeong S, et al. Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea. Emerging Infectious Diseases. 2019;25(1):42-51. doi:10.3201/eid2501.171985.
APA Choi, M., Kim, M., Jeong, S., Choi, J., Lee, I., Yong, T....Lee, K. (2019). Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea. Emerging Infectious Diseases, 25(1), 42-51. https://dx.doi.org/10.3201/eid2501.171985.

Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings [PDF - 1.75 MB - 11 pages]
G. Conlon-Bingham et al.

This quasi-experimental study investigated the effect of an antibiotic cycling policy based on time-series analysis of epidemiologic data, which identified antimicrobial drugs and time periods for restriction. Cyclical restrictions of amoxicillin/clavulanic acid, piperacillin/tazobactam, and clarithromycin were undertaken over a 2-year period in the intervention hospital. We used segmented regression analysis to compare the effect on the incidence of healthcare-associated Clostridioides difficile infection (HA-CDI), healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA), and new extended-spectrum β-lactamase (ESBL) isolates and on changes in resistance patterns of the HA-MRSA and ESBL organisms between the intervention and control hospitals. HA-CDI incidence did not change. HA-MRSA incidence increased significantly in the intervention hospital. The resistance of new ESBL isolates to amoxicillin/clavulanic acid and piperacillin/tazobactam decreased significantly in the intervention hospital; however, resistance to piperacillin/tazobactam increased after a return to the standard policy. The results question the value of antibiotic cycling to antibiotic stewardship.

EID Conlon-Bingham G, Aldeyab M, Scott M, Kearney M, Farren D, Gilmore F, et al. Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings. Emerg Infect Dis. 2019;25(1):52-62. https://dx.doi.org/10.3201/eid2501.180111
AMA Conlon-Bingham G, Aldeyab M, Scott M, et al. Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings. Emerging Infectious Diseases. 2019;25(1):52-62. doi:10.3201/eid2501.180111.
APA Conlon-Bingham, G., Aldeyab, M., Scott, M., Kearney, M., Farren, D., Gilmore, F....McElnay, J. (2019). Effects of Antibiotic Cycling Policy on Incidence of Healthcare-Associated MRSA and Clostridioides difficile Infection in Secondary Healthcare Settings. Emerging Infectious Diseases, 25(1), 52-62. https://dx.doi.org/10.3201/eid2501.180111.

Association of Increased Receptor-Binding Avidity of Influenza A(H9N2) Viruses with Escape from Antibody-Based Immunity and Enhanced Zoonotic Potential [PDF - 2.35 MB - 10 pages]
J. E. Sealy et al.

We characterized 55 influenza A(H9N2) viruses isolated in Pakistan during 2014–2016 and found that the hemagglutinin gene is of the G1 lineage and that internal genes have differentiated into a variety of novel genotypes. Some isolates had up to 4-fold reduction in hemagglutination inhibition titers compared with older viruses. Viruses with hemagglutinin A180T/V substitutions conveyed this antigenic diversity and also caused up to 3,500-fold greater binding to avian-like and >20-fold greater binding to human-like sialic acid receptor analogs. This enhanced binding avidity led to reduced virus replication in primary and continuous cell culture. We confirmed that altered receptor-binding avidity of H9N2 viruses, including enhanced binding to human-like receptors, results in antigenic variation in avian influenza viruses. Consequently, current vaccine formulations might not induce adequate protective immunity in poultry, and emergence of isolates with marked avidity for human-like receptors increases the zoonotic risk.

EID Sealy JE, Yaqub T, Peacock TP, Chang P, Ermetal B, Clements A, et al. Association of Increased Receptor-Binding Avidity of Influenza A(H9N2) Viruses with Escape from Antibody-Based Immunity and Enhanced Zoonotic Potential. Emerg Infect Dis. 2019;25(1):63-72. https://dx.doi.org/10.3201/eid2501.180616
AMA Sealy JE, Yaqub T, Peacock TP, et al. Association of Increased Receptor-Binding Avidity of Influenza A(H9N2) Viruses with Escape from Antibody-Based Immunity and Enhanced Zoonotic Potential. Emerging Infectious Diseases. 2019;25(1):63-72. doi:10.3201/eid2501.180616.
APA Sealy, J. E., Yaqub, T., Peacock, T. P., Chang, P., Ermetal, B., Clements, A....Iqbal, M. (2019). Association of Increased Receptor-Binding Avidity of Influenza A(H9N2) Viruses with Escape from Antibody-Based Immunity and Enhanced Zoonotic Potential. Emerging Infectious Diseases, 25(1), 63-72. https://dx.doi.org/10.3201/eid2501.180616.

Variable Protease-Sensitive Prionopathy Transmission to Bank Voles [PDF - 1.47 MB - 9 pages]
R. Nonno et al.

Variably protease-sensitive prionopathy (VPSPr), a recently described human sporadic prion disease, features a protease-resistant, disease-related prion protein (resPrPD) displaying 5 fragments reminiscent of Gerstmann-Sträussler-Scheinker disease. Experimental VPSPr transmission to human PrP–expressing transgenic mice, although replication of the VPSPr resPrPD profile succeeded, has been incomplete because of second passage failure. We bioassayed VPSPr in bank voles, which are susceptible to human prion strains. Transmission was complete; first-passage attack rates were 5%–35%, and second-passage rates reached 100% and survival times were 50% shorter. We observed 3 distinct phenotypes and resPrPD profiles; 2 imitated sporadic Creutzfeldt-Jakob disease resPrPD, and 1 resembled Gerstmann-Sträussler-Scheinker disease resPrPD. The first 2 phenotypes may be related to the presence of minor PrPD components in VPSPr. Full VPSPr transmission confirms permissiveness of bank voles to human prions and suggests that bank vole PrP may efficiently reveal an underrepresented native strain but does not replicate the complex VPSPr PrPD profile.

EID Nonno R, Notari S, Di Bari M, Cali I, Pirisinu L, d’Agostino C, et al. Variable Protease-Sensitive Prionopathy Transmission to Bank Voles. Emerg Infect Dis. 2019;25(1):73-81. https://dx.doi.org/10.3201/eid2501.180807
AMA Nonno R, Notari S, Di Bari M, et al. Variable Protease-Sensitive Prionopathy Transmission to Bank Voles. Emerging Infectious Diseases. 2019;25(1):73-81. doi:10.3201/eid2501.180807.
APA Nonno, R., Notari, S., Di Bari, M., Cali, I., Pirisinu, L., d’Agostino, C....Gambetti, P. (2019). Variable Protease-Sensitive Prionopathy Transmission to Bank Voles. Emerging Infectious Diseases, 25(1), 73-81. https://dx.doi.org/10.3201/eid2501.180807.

Zoonotic Source Attribution of Salmonella enterica Serotype Typhimurium Using Genomic Surveillance Data, United States [PDF - 3.42 MB - 9 pages]
S. Zhang et al.

Increasingly, routine surveillance and monitoring of foodborne pathogens using whole-genome sequencing is creating opportunities to study foodborne illness epidemiology beyond routine outbreak investigations and case–control studies. Using a global phylogeny of Salmonella enterica serotype Typhimurium, we found that major livestock sources of the pathogen in the United States can be predicted through whole-genome sequencing data. Relatively steady rates of sequence divergence in livestock lineages enabled the inference of their recent origins. Elevated accumulation of lineage-specific pseudogenes after divergence from generalist populations and possible metabolic acclimation in a representative swine isolate indicates possible emergence of host adaptation. We developed and retrospectively applied a machine learning Random Forest classifier for genomic source prediction of Salmonella Typhimurium that correctly attributed 7 of 8 major zoonotic outbreaks in the United States during 1998–2013. We further identified 50 key genetic features that were sufficient for robust livestock source prediction.

EID Zhang S, Li S, Gu W, den Bakker H, Boxrud D, Taylor A, et al. Zoonotic Source Attribution of Salmonella enterica Serotype Typhimurium Using Genomic Surveillance Data, United States. Emerg Infect Dis. 2019;25(1):82-91. https://dx.doi.org/10.3201/eid2501.180835
AMA Zhang S, Li S, Gu W, et al. Zoonotic Source Attribution of Salmonella enterica Serotype Typhimurium Using Genomic Surveillance Data, United States. Emerging Infectious Diseases. 2019;25(1):82-91. doi:10.3201/eid2501.180835.
APA Zhang, S., Li, S., Gu, W., den Bakker, H., Boxrud, D., Taylor, A....Deng, X. (2019). Zoonotic Source Attribution of Salmonella enterica Serotype Typhimurium Using Genomic Surveillance Data, United States. Emerging Infectious Diseases, 25(1), 82-91. https://dx.doi.org/10.3201/eid2501.180835.

Multiple Introductions of Domestic Cat Feline Leukemia Virus in Endangered Florida Panthers [PDF - 2.19 MB - 10 pages]
E. S. Chiu et al.

The endangered Florida panther (Puma concolor coryi) had an outbreak of infection with feline leukemia virus (FeLV) in the early 2000s that resulted in the deaths of 3 animals. A vaccination campaign was instituted during 2003–2007 and no additional cases were recorded until 2010. During 2010–2016, six additional FeLV cases were documented. We characterized FeLV genomes isolated from Florida panthers from both outbreaks and compared them with full-length genomes of FeLVs isolated from contemporary Florida domestic cats. Phylogenetic analyses identified at least 2 circulating FeLV strains in panthers, which represent separate introductions from domestic cats. The original FeLV virus outbreak strain is either still circulating or another domestic cat transmission event has occurred with a closely related variant. We also report a case of a cross-species transmission event of an oncogenic FeLV recombinant (FeLV-B). Evidence of multiple FeLV strains and detection of FeLV-B indicate Florida panthers are at high risk for FeLV infection.

EID Chiu ES, Kraberger S, Cunningham M, Cusack L, Roelke M, VandeWoude S. Multiple Introductions of Domestic Cat Feline Leukemia Virus in Endangered Florida Panthers. Emerg Infect Dis. 2019;25(1):92-101. https://dx.doi.org/10.3201/eid2501.181347
AMA Chiu ES, Kraberger S, Cunningham M, et al. Multiple Introductions of Domestic Cat Feline Leukemia Virus in Endangered Florida Panthers. Emerging Infectious Diseases. 2019;25(1):92-101. doi:10.3201/eid2501.181347.
APA Chiu, E. S., Kraberger, S., Cunningham, M., Cusack, L., Roelke, M., & VandeWoude, S. (2019). Multiple Introductions of Domestic Cat Feline Leukemia Virus in Endangered Florida Panthers. Emerging Infectious Diseases, 25(1), 92-101. https://dx.doi.org/10.3201/eid2501.181347.

Medscape CME Activity
Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004–2010
A. C. Ewing et al.

Antimicrobial drug resistance is a serious health hazard driven by overuse. Administration of antimicrobial drugs to HIV-exposed, uninfected infants, a population that is growing and at high risk for infection, is poorly studied. We therefore analyzed factors associated with antibacterial drug administration to HIV-exposed, uninfected infants during their first year of life. Our study population was 2,152 HIV-exposed, uninfected infants enrolled in the Breastfeeding, Antiretrovirals and Nutrition study in Lilongwe, Malawi, during 2004–2010. All infants were breastfed through 28 weeks of age. Antibacterial drugs were prescribed frequently (to 80% of infants), and most (67%) of the 5,329 prescriptions were for respiratory indications. Most commonly prescribed were penicillins (43%) and sulfonamides (23%). Factors associated with lower hazard for antibacterial drug prescription included receipt of cotrimoxazole preventive therapy, receipt of antiretroviral drugs, and increased age. Thus, cotrimoxazole preventive therapy may lead to fewer prescriptions for antibacterial drugs for these infants.

EID Ewing AC, Davis NL, Kayira D, Hosseinipour MC, van der Horst C, Jamieson DJ, et al. Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004–2010. Emerg Infect Dis. 2019;25(1):103-112. https://dx.doi.org/10.3201/eid2501.180782
AMA Ewing AC, Davis NL, Kayira D, et al. Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004–2010. Emerging Infectious Diseases. 2019;25(1):103-112. doi:10.3201/eid2501.180782.
APA Ewing, A. C., Davis, N. L., Kayira, D., Hosseinipour, M. C., van der Horst, C., Jamieson, D. J....Kourtis, A. P. (2019). Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004–2010. Emerging Infectious Diseases, 25(1), 103-112. https://dx.doi.org/10.3201/eid2501.180782.
Dispatches

Influenza H5/H7 Virus Vaccination in Poultry and Reduction of Zoonotic Infections, Guangdong Province, China, 2017–18 [PDF - 875 KB - 3 pages]
J. Wu et al.

We compared the detection frequency of avian influenza H7 subtypes at live poultry markets in Guangdong Province, China, before and after the introduction of a bivalent H5/H7 vaccine in poultry. The vaccine was associated with a 92% reduction in H7 positivity rates among poultry and a 98% reduction in human H7N9 cases.

EID Wu J, Ke C, Lau E, Song Y, Cheng K, Zou L, et al. Influenza H5/H7 Virus Vaccination in Poultry and Reduction of Zoonotic Infections, Guangdong Province, China, 2017–18. Emerg Infect Dis. 2019;25(1):116-118. https://dx.doi.org/10.3201/eid2501.181259
AMA Wu J, Ke C, Lau E, et al. Influenza H5/H7 Virus Vaccination in Poultry and Reduction of Zoonotic Infections, Guangdong Province, China, 2017–18. Emerging Infectious Diseases. 2019;25(1):116-118. doi:10.3201/eid2501.181259.
APA Wu, J., Ke, C., Lau, E., Song, Y., Cheng, K., Zou, L....Peiris, M. (2019). Influenza H5/H7 Virus Vaccination in Poultry and Reduction of Zoonotic Infections, Guangdong Province, China, 2017–18. Emerging Infectious Diseases, 25(1), 116-118. https://dx.doi.org/10.3201/eid2501.181259.

Higher Viral Load of Emerging Norovirus GII.P16-GII.2 than Pandemic GII.4 and Epidemic GII.17, Hong Kong, China [PDF - 3.00 MB - 4 pages]
S. Cheung et al.

We compared viral load of emerging recombinant norovirus GII.P16-GII.2 with those for pandemic GII.Pe-GII.4 and epidemic GII.P17-GII.17 genotypes among inpatients in Hong Kong. Viral load of GII.P16-GII.2 was higher than those for other genotypes in different age groups. GII.P16-GII.2 is as replication competent as the pandemic genotype, explaining its high transmissibility and widespread circulation.

EID Cheung S, Kwok K, Zhang L, Mohammad KN, Lui G, Lee N, et al. Higher Viral Load of Emerging Norovirus GII.P16-GII.2 than Pandemic GII.4 and Epidemic GII.17, Hong Kong, China. Emerg Infect Dis. 2019;25(1):119-122. https://dx.doi.org/10.3201/eid2501.180395
AMA Cheung S, Kwok K, Zhang L, et al. Higher Viral Load of Emerging Norovirus GII.P16-GII.2 than Pandemic GII.4 and Epidemic GII.17, Hong Kong, China. Emerging Infectious Diseases. 2019;25(1):119-122. doi:10.3201/eid2501.180395.
APA Cheung, S., Kwok, K., Zhang, L., Mohammad, K. N., Lui, G., Lee, N....Chan, M. (2019). Higher Viral Load of Emerging Norovirus GII.P16-GII.2 than Pandemic GII.4 and Epidemic GII.17, Hong Kong, China. Emerging Infectious Diseases, 25(1), 119-122. https://dx.doi.org/10.3201/eid2501.180395.

Autochthonous Transmission of Coccidioides in Animals, Washington, USA [PDF - 829 KB - 3 pages]
A. E. James et al.

We report 5 cases of coccidioidomycosis in animals that were acquired within Washington, USA, and provide further evidence for the environmental endemicity of Coccidioides immitis within the state. Veterinarians should consider coccidioidomycosis in animals with compatible clinical signs that reside in, or have traveled to, south central Washington.

EID James AE, Pastenkos G, Bradway D, Baszler T. Autochthonous Transmission of Coccidioides in Animals, Washington, USA. Emerg Infect Dis. 2019;25(1):123-125. https://dx.doi.org/10.3201/eid2501.180411
AMA James AE, Pastenkos G, Bradway D, et al. Autochthonous Transmission of Coccidioides in Animals, Washington, USA. Emerging Infectious Diseases. 2019;25(1):123-125. doi:10.3201/eid2501.180411.
APA James, A. E., Pastenkos, G., Bradway, D., & Baszler, T. (2019). Autochthonous Transmission of Coccidioides in Animals, Washington, USA. Emerging Infectious Diseases, 25(1), 123-125. https://dx.doi.org/10.3201/eid2501.180411.

Meat and Fish as Sources of Extended-Spectrum β-Lactamase–Producing Escherichia coli, Cambodia [PDF - 2.29 MB - 6 pages]
M. Nadimpalli et al.

We compared extended-spectrum β-lactamase–producing Escherichia coli isolates from meat and fish, gut-colonized women, and infected patients in Cambodia. Nearly half of isolates from women were phylogenetically related to food-origin isolates; a subset had identical multilocus sequence types, extended-spectrum β-lactamase types, and antimicrobial resistance patterns. Eating sun-dried poultry may be an exposure route.

EID Nadimpalli M, Vuthy Y, de Lauzanne A, Fabre L, Criscuolo A, Gouali M, et al. Meat and Fish as Sources of Extended-Spectrum β-Lactamase–Producing Escherichia coli, Cambodia. Emerg Infect Dis. 2019;25(1):126-131. https://dx.doi.org/10.3201/eid2501.180534
AMA Nadimpalli M, Vuthy Y, de Lauzanne A, et al. Meat and Fish as Sources of Extended-Spectrum β-Lactamase–Producing Escherichia coli, Cambodia. Emerging Infectious Diseases. 2019;25(1):126-131. doi:10.3201/eid2501.180534.
APA Nadimpalli, M., Vuthy, Y., de Lauzanne, A., Fabre, L., Criscuolo, A., Gouali, M....Delarocque-Astagneau, E. (2019). Meat and Fish as Sources of Extended-Spectrum β-Lactamase–Producing Escherichia coli, Cambodia. Emerging Infectious Diseases, 25(1), 126-131. https://dx.doi.org/10.3201/eid2501.180534.

Oral Transmission of Trypanosoma cruzi, Brazilian Amazon [PDF - 1.30 MB - 4 pages]
R. G. Santana et al.

In the Brazilian Amazon, the suspected source of infection in an outbreak of acute Chagas disease involving 10 patients was Euterpe oleracea (açaí berry) juice. Patient blood and juice samples contained Trypanosoma cruzi TcIV, indicating oral transmission of the Chagas disease agent.

EID Santana RG, Guerra M, Sousa DR, Couceiro K, Ortiz JV, Oliveira M, et al. Oral Transmission of Trypanosoma cruzi, Brazilian Amazon. Emerg Infect Dis. 2019;25(1):132-135. https://dx.doi.org/10.3201/eid2501.180646
AMA Santana RG, Guerra M, Sousa DR, et al. Oral Transmission of Trypanosoma cruzi, Brazilian Amazon. Emerging Infectious Diseases. 2019;25(1):132-135. doi:10.3201/eid2501.180646.
APA Santana, R. G., Guerra, M., Sousa, D. R., Couceiro, K., Ortiz, J. V., Oliveira, M....Guerra, J. O. (2019). Oral Transmission of Trypanosoma cruzi, Brazilian Amazon. Emerging Infectious Diseases, 25(1), 132-135. https://dx.doi.org/10.3201/eid2501.180646.

Avian Influenza A(H9N2) Virus in Poultry Worker, Pakistan, 2015 [PDF - 765 KB - 4 pages]
M. Ali et al.

Avian influenza A(H9N2) virus isolated from a poultry worker in Pakistan in 2015 was closely related to viruses detected in poultry farms. Observed mutations in the hemagglutinin related to receptor-binding affinity and antigenicity could affect cross-reactivity with prepandemic H9N2 vaccine strains.

EID Ali M, Yaqub T, Mukhtar N, Imran M, Ghafoor A, Shahid M, et al. Avian Influenza A(H9N2) Virus in Poultry Worker, Pakistan, 2015. Emerg Infect Dis. 2019;25(1):136-139. https://dx.doi.org/10.3201/eid2501.180618
AMA Ali M, Yaqub T, Mukhtar N, et al. Avian Influenza A(H9N2) Virus in Poultry Worker, Pakistan, 2015. Emerging Infectious Diseases. 2019;25(1):136-139. doi:10.3201/eid2501.180618.
APA Ali, M., Yaqub, T., Mukhtar, N., Imran, M., Ghafoor, A., Shahid, M....Su, Y. (2019). Avian Influenza A(H9N2) Virus in Poultry Worker, Pakistan, 2015. Emerging Infectious Diseases, 25(1), 136-139. https://dx.doi.org/10.3201/eid2501.180618.

Puumala Hantavirus Genotypes in Humans, France, 2012–2016 [PDF - 1.93 MB - 4 pages]
J. Reynes et al.

The analysis of the nucleoprotein gene of 77 Puumala hantavirus strains detected in human samples in France during 2012–2016 showed that all belonged to the Central European lineage. We observed 2 main clusters, geographically structured; one included strains with the Q64 signature and the other strains with the R64 signature.

EID Reynes J, Carli D, Thomas D, Castel G. Puumala Hantavirus Genotypes in Humans, France, 2012–2016. Emerg Infect Dis. 2019;25(1):140-143. https://dx.doi.org/10.3201/eid2501.180270
AMA Reynes J, Carli D, Thomas D, et al. Puumala Hantavirus Genotypes in Humans, France, 2012–2016. Emerging Infectious Diseases. 2019;25(1):140-143. doi:10.3201/eid2501.180270.
APA Reynes, J., Carli, D., Thomas, D., & Castel, G. (2019). Puumala Hantavirus Genotypes in Humans, France, 2012–2016. Emerging Infectious Diseases, 25(1), 140-143. https://dx.doi.org/10.3201/eid2501.180270.

New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017 [PDF - 2.51 MB - 4 pages]
C. Chiou et al.

In 2011, a Salmonella enterica serovar Anatum clone emerged in Taiwan. During 2016–2017, infections increased dramatically, strongly associated with emergence and spread of multidrug-resistant strains with a plasmid carrying 11 resistance genes, including blaDHA-1. Because these resistant strains infect humans and food animals, control measures are urgently needed.

EID Chiou C, Hong Y, Liao Y, Wang Y, Tu Y, Chen B, et al. New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017. Emerg Infect Dis. 2019;25(1):144-147. https://dx.doi.org/10.3201/eid2501.181103
AMA Chiou C, Hong Y, Liao Y, et al. New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017. Emerging Infectious Diseases. 2019;25(1):144-147. doi:10.3201/eid2501.181103.
APA Chiou, C., Hong, Y., Liao, Y., Wang, Y., Tu, Y., Chen, B....Chen, Y. (2019). New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017. Emerging Infectious Diseases, 25(1), 144-147. https://dx.doi.org/10.3201/eid2501.181103.

Seroepidemiology of Parechovirus A3 Neutralizing Antibodies, Australia, the Netherlands, and United States [PDF - 1.10 MB - 5 pages]
E. Karelehto et al.

Recent parechovirus A3 (PeV-A3) outbreaks in Australia suggest lower population immunity compared with regions that have endemic PeV-A3 circulation. A serosurvey among populations in the Netherlands, the United States, and Australia before and after the 2013 Australia outbreak showed high PeV-A3 neutralizing antibody prevalence across all regions and time periods, indicating widespread circulation.

EID Karelehto E, Brouwer L, Benschop K, Kok J, Basile K, McMullan B, et al. Seroepidemiology of Parechovirus A3 Neutralizing Antibodies, Australia, the Netherlands, and United States. Emerg Infect Dis. 2019;25(1):148-152. https://dx.doi.org/10.3201/eid2501.180352
AMA Karelehto E, Brouwer L, Benschop K, et al. Seroepidemiology of Parechovirus A3 Neutralizing Antibodies, Australia, the Netherlands, and United States. Emerging Infectious Diseases. 2019;25(1):148-152. doi:10.3201/eid2501.180352.
APA Karelehto, E., Brouwer, L., Benschop, K., Kok, J., Basile, K., McMullan, B....Wolthers, K. C. (2019). Seroepidemiology of Parechovirus A3 Neutralizing Antibodies, Australia, the Netherlands, and United States. Emerging Infectious Diseases, 25(1), 148-152. https://dx.doi.org/10.3201/eid2501.180352.

Identification of Lonepinella sp. in Koala Bite Wound Infections, Queensland, Australia [PDF - 460 KB - 4 pages]
H. Sinclair et al.

We report 3 cases of koala bite wound infection with Lonepinella koalarum–like bacteria requiring antimicrobial and surgical management. The pathogens could not be identified by standard tests. Phylogenetic analysis of 16S rRNA and housekeeping genes identified the genus. Clinicians should isolate bacteria and determine antimicrobial susceptibilities when managing these infections.

EID Sinclair H, Chapman P, Omaleki L, Bergh H, Turni C, Blackall P, et al. Identification of Lonepinella sp. in Koala Bite Wound Infections, Queensland, Australia. Emerg Infect Dis. 2019;25(1):153-156. https://dx.doi.org/10.3201/eid2501.171359
AMA Sinclair H, Chapman P, Omaleki L, et al. Identification of Lonepinella sp. in Koala Bite Wound Infections, Queensland, Australia. Emerging Infectious Diseases. 2019;25(1):153-156. doi:10.3201/eid2501.171359.
APA Sinclair, H., Chapman, P., Omaleki, L., Bergh, H., Turni, C., Blackall, P....Nimmo, G. R. (2019). Identification of Lonepinella sp. in Koala Bite Wound Infections, Queensland, Australia. Emerging Infectious Diseases, 25(1), 153-156. https://dx.doi.org/10.3201/eid2501.171359.

Surgical Site Infections Caused by Highly Virulent Methicillin-Resistant Staphylococcus aureus Sequence Type 398, China [PDF - 833 KB - 4 pages]
L. Sun et al.

We identified 2 methicillin-resistant Staphylococcus aureus strains of sequence type 398 from surgical site infections in China. Genetic analysis and clinical data from these strains suggested that they were human-related but sporadic. Hemolysis analysis and mouse-skin infection models indicated a high virulence potential for these strains.

EID Sun L, Chen Y, Wang D, Wang H, Wu D, Shi K, et al. Surgical Site Infections Caused by Highly Virulent Methicillin-Resistant Staphylococcus aureus Sequence Type 398, China. Emerg Infect Dis. 2019;25(1):157-160. https://dx.doi.org/10.3201/eid2501.171862
AMA Sun L, Chen Y, Wang D, et al. Surgical Site Infections Caused by Highly Virulent Methicillin-Resistant Staphylococcus aureus Sequence Type 398, China. Emerging Infectious Diseases. 2019;25(1):157-160. doi:10.3201/eid2501.171862.
APA Sun, L., Chen, Y., Wang, D., Wang, H., Wu, D., Shi, K....Yu, Y. (2019). Surgical Site Infections Caused by Highly Virulent Methicillin-Resistant Staphylococcus aureus Sequence Type 398, China. Emerging Infectious Diseases, 25(1), 157-160. https://dx.doi.org/10.3201/eid2501.171862.

Canine Influenza Virus A(H3N2) Clade with Antigenic Variation, China, 2016–2017 [PDF - 1.64 MB - 5 pages]
Y. Lyu et al.

During 2012–2017, we collected throat swabs from dogs in China to characterize canine influenza virus (CIV) A(H3N2) isolates. A new antigenically and genetically distinct CIV H3N2 clade possessing mutations associated with mammalian adaptation emerged in 2016 and replaced previously circulating strains. This clade probably poses a risk for zoonotic infection.

EID Lyu Y, Song S, Zhou L, Bing G, Wang Q, Sun H, et al. Canine Influenza Virus A(H3N2) Clade with Antigenic Variation, China, 2016–2017. Emerg Infect Dis. 2019;25(1):161-165. https://dx.doi.org/10.3201/eid2501.171878
AMA Lyu Y, Song S, Zhou L, et al. Canine Influenza Virus A(H3N2) Clade with Antigenic Variation, China, 2016–2017. Emerging Infectious Diseases. 2019;25(1):161-165. doi:10.3201/eid2501.171878.
APA Lyu, Y., Song, S., Zhou, L., Bing, G., Wang, Q., Sun, H....Sun, Y. (2019). Canine Influenza Virus A(H3N2) Clade with Antigenic Variation, China, 2016–2017. Emerging Infectious Diseases, 25(1), 161-165. https://dx.doi.org/10.3201/eid2501.171878.

Isolation and Full-Genome Characterization of Nipah Viruses from Bats, Bangladesh [PDF - 1.38 MB - 5 pages]
D. E. Anderson et al.

Despite molecular and serologic evidence of Nipah virus in bats from various locations, attempts to isolate live virus have been largely unsuccessful. We report isolation and full-genome characterization of 10 Nipah virus isolates from Pteropus medius bats sampled in Bangladesh during 2013 and 2014.

EID Anderson DE, Islam A, Crameri G, Todd S, Islam A, Khan SU, et al. Isolation and Full-Genome Characterization of Nipah Viruses from Bats, Bangladesh. Emerg Infect Dis. 2019;25(1):166-170. https://dx.doi.org/10.3201/eid2501.180267
AMA Anderson DE, Islam A, Crameri G, et al. Isolation and Full-Genome Characterization of Nipah Viruses from Bats, Bangladesh. Emerging Infectious Diseases. 2019;25(1):166-170. doi:10.3201/eid2501.180267.
APA Anderson, D. E., Islam, A., Crameri, G., Todd, S., Islam, A., Khan, S. U....Wang, L. (2019). Isolation and Full-Genome Characterization of Nipah Viruses from Bats, Bangladesh. Emerging Infectious Diseases, 25(1), 166-170. https://dx.doi.org/10.3201/eid2501.180267.

Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA [PDF - 410 KB - 4 pages]
M. Koeck et al.

During August 1, 2014–July 31, 2015, in 2 counties in Minnesota, USA, incidence of invasive methicillin-susceptible Staphylococcus aureus (MSSA) (27.1 cases/100,000 persons) was twice that of invasive methicillin-resistant S. aureus (13.1 cases/100,000 persons). MSSA isolates were more genetically diverse and susceptible to more antimicrobial drugs than methicillin-resistant S. aureus isolates.

EID Koeck M, Como-Sabetti K, Boxrud D, Dobbins G, Glennen A, Anacker M, et al. Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA. Emerg Infect Dis. 2019;25(1):171-174. https://dx.doi.org/10.3201/eid2501.181146
AMA Koeck M, Como-Sabetti K, Boxrud D, et al. Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA. Emerging Infectious Diseases. 2019;25(1):171-174. doi:10.3201/eid2501.181146.
APA Koeck, M., Como-Sabetti, K., Boxrud, D., Dobbins, G., Glennen, A., Anacker, M....Lynfield, R. (2019). Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA. Emerging Infectious Diseases, 25(1), 171-174. https://dx.doi.org/10.3201/eid2501.181146.

Dengue Virus IgM Serotyping by ELISA with Recombinant Mutant Envelope Proteins [PDF - 1.14 MB - 5 pages]
A. Rockstroh et al.

We developed an IgM-based ELISA that identifies the dengue virus serotype of recent infections. Dominant serotypes were detectable in 91.1% of samples from travelers and 86.5% of samples from residents of endemic regions; 97.1% corresponded to the serotype identified by PCR. This ELISA enables more accurate reporting of epidemiologic findings.

EID Rockstroh A, Barzon L, Kumbukgolla W, Su H, Lizarazo E, Vincenti-Gonzalez M, et al. Dengue Virus IgM Serotyping by ELISA with Recombinant Mutant Envelope Proteins. Emerg Infect Dis. 2019;25(1):1111-1115. https://dx.doi.org/10.3201/eid2501.180605
AMA Rockstroh A, Barzon L, Kumbukgolla W, et al. Dengue Virus IgM Serotyping by ELISA with Recombinant Mutant Envelope Proteins. Emerging Infectious Diseases. 2019;25(1):1111-1115. doi:10.3201/eid2501.180605.
APA Rockstroh, A., Barzon, L., Kumbukgolla, W., Su, H., Lizarazo, E., Vincenti-Gonzalez, M....Ulbert, S. (2019). Dengue Virus IgM Serotyping by ELISA with Recombinant Mutant Envelope Proteins. Emerging Infectious Diseases, 25(1), 1111-1115. https://dx.doi.org/10.3201/eid2501.180605.
Research Letters

Orogenital Transmission of Neisseria meningitidis Causing Acute Urethritis in Men Who Have Sex with Men [PDF - 320 KB - 2 pages]
A. Jannic et al.

Neisseria meningitidis sequence type 11 is an emerging cause of urethritis. We demonstrate by using whole-genome sequencing orogenital transmission of a N. meningitidis sequence type 11 isolate causing urethritis in a monogamous couple of men who have sex with men. These results suggest dissemination of this clonal complex among low-risk patients.

EID Jannic A, Mammeri H, Larcher L, Descamps V, Tosini W, Phung B, et al. Orogenital Transmission of Neisseria meningitidis Causing Acute Urethritis in Men Who Have Sex with Men. Emerg Infect Dis. 2019;25(1):175-176. https://dx.doi.org/10.3201/eid2501.171102
AMA Jannic A, Mammeri H, Larcher L, et al. Orogenital Transmission of Neisseria meningitidis Causing Acute Urethritis in Men Who Have Sex with Men. Emerging Infectious Diseases. 2019;25(1):175-176. doi:10.3201/eid2501.171102.
APA Jannic, A., Mammeri, H., Larcher, L., Descamps, V., Tosini, W., Phung, B....Bouscarat, F. (2019). Orogenital Transmission of Neisseria meningitidis Causing Acute Urethritis in Men Who Have Sex with Men. Emerging Infectious Diseases, 25(1), 175-176. https://dx.doi.org/10.3201/eid2501.171102.

Trends in Azole Resistance in Aspergillus fumigatus, the Netherlands, 1994–2016 [PDF - 588 KB - 3 pages]
J. B. Buil et al.

We investigated azole resistance in Aspergillus fumigatus in a tertiary reference hospital in the Netherlands during 1994–2016. The 5-year patient-adjusted proportion of resistance increased from 0.79% for 1996–2001 to 4.25% for 2002–2006, 7.17% for 2007–2011, and 7.04% for 2012–2016. However, we observed substantial variation between years.

EID Buil JB, Snelders E, Denardi L, Melchers W, Verweij PE. Trends in Azole Resistance in Aspergillus fumigatus, the Netherlands, 1994–2016. Emerg Infect Dis. 2019;25(1):176-178. https://dx.doi.org/10.3201/eid2501.171925
AMA Buil JB, Snelders E, Denardi L, et al. Trends in Azole Resistance in Aspergillus fumigatus, the Netherlands, 1994–2016. Emerging Infectious Diseases. 2019;25(1):176-178. doi:10.3201/eid2501.171925.
APA Buil, J. B., Snelders, E., Denardi, L., Melchers, W., & Verweij, P. E. (2019). Trends in Azole Resistance in Aspergillus fumigatus, the Netherlands, 1994–2016. Emerging Infectious Diseases, 25(1), 176-178. https://dx.doi.org/10.3201/eid2501.171925.

Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications [PDF - 311 KB - 2 pages]
J. Guidry et al.

We analyzed Instagram posts about Zika by using the Health Belief Model. We found a high presence of threat messages, yet little engagement with these posts. Public health professionals should focus on posting messages to increase self-efficacy and benefits of protective behavior, especially when a vaccine becomes available.

EID Guidry J, Carlyle KE, LaRose JG, Perrin P, Messner M, Ryan M. Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications. Emerg Infect Dis. 2019;25(1):179-180. https://dx.doi.org/10.3201/eid2501.180824
AMA Guidry J, Carlyle KE, LaRose JG, et al. Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications. Emerging Infectious Diseases. 2019;25(1):179-180. doi:10.3201/eid2501.180824.
APA Guidry, J., Carlyle, K. E., LaRose, J. G., Perrin, P., Messner, M., & Ryan, M. (2019). Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications. Emerging Infectious Diseases, 25(1), 179-180. https://dx.doi.org/10.3201/eid2501.180824.

Zoonotic Endocarditis in a Man, the Netherlands [PDF - 350 KB - 3 pages]
J. Sleutjens et al.

In 2017, endocarditis caused by Streptococcus equi subspecies zooepidemicus was diagnosed in a man in the Netherlands who had daily contact with horses. Whole-genome sequencing of isolates from the man and his horses confirmed the same clone, indicating horse-to-human transmission. Systematic reporting of all zoonotic cases would help with risk assessment.

EID Sleutjens J, Meijer D, Meregalli PG, Bakker L, Wagenaar JA, Duim B, et al. Zoonotic Endocarditis in a Man, the Netherlands. Emerg Infect Dis. 2019;25(1):180-182. https://dx.doi.org/10.3201/eid2501.181029
AMA Sleutjens J, Meijer D, Meregalli PG, et al. Zoonotic Endocarditis in a Man, the Netherlands. Emerging Infectious Diseases. 2019;25(1):180-182. doi:10.3201/eid2501.181029.
APA Sleutjens, J., Meijer, D., Meregalli, P. G., Bakker, L., Wagenaar, J. A., Duim, B....Zomer, A. (2019). Zoonotic Endocarditis in a Man, the Netherlands. Emerging Infectious Diseases, 25(1), 180-182. https://dx.doi.org/10.3201/eid2501.181029.

Trachoma in 3 Amerindian Communities, Venezuelan Amazon, 2018 [PDF - 281 KB - 2 pages]
O. Noya-Alarcón et al.

Trachoma is among the most common infectious causes of blindness. During January–May 2018, a total of 4 trachoma cases were diagnosed among Amerindians of the Yanomami ethnic group in 3 communities of southern Venezuela. This country has social and environmental conditions conducive to the endemicity of this neglected tropical disease.

EID Noya-Alarcón O, Bevilacqua M, Rodríguez-Morales AJ. Trachoma in 3 Amerindian Communities, Venezuelan Amazon, 2018. Emerg Infect Dis. 2019;25(1):182-183. https://dx.doi.org/10.3201/eid2501.181362
AMA Noya-Alarcón O, Bevilacqua M, Rodríguez-Morales AJ. Trachoma in 3 Amerindian Communities, Venezuelan Amazon, 2018. Emerging Infectious Diseases. 2019;25(1):182-183. doi:10.3201/eid2501.181362.
APA Noya-Alarcón, O., Bevilacqua, M., & Rodríguez-Morales, A. J. (2019). Trachoma in 3 Amerindian Communities, Venezuelan Amazon, 2018. Emerging Infectious Diseases, 25(1), 182-183. https://dx.doi.org/10.3201/eid2501.181362.

Phylogeographic Analysis of African Swine Fever Virus, Western Europe, 2018 [PDF - 854 KB - 3 pages]
M. Garigliany et al.

In September 2018, African swine fever in wild boars was detected in Belgium. We used African swine fever–infected spleen samples to perform a phylogenetic analysis of the virus. The causative strain belongs to genotype II, and its closest relatives are viruses previously isolated in Ukraine, Belarus, Estonia, and European Russia.

EID Garigliany M, Desmecht D, Tignon M, Cassart D, Lesenfant C, Paternostre J, et al. Phylogeographic Analysis of African Swine Fever Virus, Western Europe, 2018. Emerg Infect Dis. 2019;25(1):184-186. https://dx.doi.org/10.3201/eid2501.181535
AMA Garigliany M, Desmecht D, Tignon M, et al. Phylogeographic Analysis of African Swine Fever Virus, Western Europe, 2018. Emerging Infectious Diseases. 2019;25(1):184-186. doi:10.3201/eid2501.181535.
APA Garigliany, M., Desmecht, D., Tignon, M., Cassart, D., Lesenfant, C., Paternostre, J....Linden, A. (2019). Phylogeographic Analysis of African Swine Fever Virus, Western Europe, 2018. Emerging Infectious Diseases, 25(1), 184-186. https://dx.doi.org/10.3201/eid2501.181535.

Inaccurate Multilocus Sequence Typing of Acinetobacter baumannii [PDF - 315 KB - 2 pages]
S. Castillo-Ramírez and L. Graña-Miraglia

Multilocus sequence typing has been useful for genotyping pathogens in surveillance and epidemiologic studies. However, it cannot reflect the true relationships of isolates for species with very dynamic genomes. Using a robust genome phylogeny, we demonstrated the limitations of this method for typing Acinetobacter baumannii.

EID Castillo-Ramírez S, Graña-Miraglia L. Inaccurate Multilocus Sequence Typing of Acinetobacter baumannii. Emerg Infect Dis. 2019;25(1):186-187. https://dx.doi.org/10.3201/eid2501.180374
AMA Castillo-Ramírez S, Graña-Miraglia L. Inaccurate Multilocus Sequence Typing of Acinetobacter baumannii. Emerging Infectious Diseases. 2019;25(1):186-187. doi:10.3201/eid2501.180374.
APA Castillo-Ramírez, S., & Graña-Miraglia, L. (2019). Inaccurate Multilocus Sequence Typing of Acinetobacter baumannii. Emerging Infectious Diseases, 25(1), 186-187. https://dx.doi.org/10.3201/eid2501.180374.

Severe Disseminated Infection with Emerging Lineage of Methicillin-Sensitive Staphylococcus aureus [PDF - 490 KB - 3 pages]
P. Jewell et al.

We report a case of severe disseminated infection in an immunocompetent man caused by an emerging lineage of methicillin-sensitive Staphylococcus aureus clonal complex 398. Genes encoding classic virulence factors were absent. The patient made a slow recovery after multiple surgical interventions and a protracted course of intravenous flucloxacillin.

EID Jewell P, Dixon L, Singanayagam A, Ghani R, Wong E, Coleman M, et al. Severe Disseminated Infection with Emerging Lineage of Methicillin-Sensitive Staphylococcus aureus. Emerg Infect Dis. 2019;25(1):187-189. https://dx.doi.org/10.3201/eid2501.180684
AMA Jewell P, Dixon L, Singanayagam A, et al. Severe Disseminated Infection with Emerging Lineage of Methicillin-Sensitive Staphylococcus aureus. Emerging Infectious Diseases. 2019;25(1):187-189. doi:10.3201/eid2501.180684.
APA Jewell, P., Dixon, L., Singanayagam, A., Ghani, R., Wong, E., Coleman, M....Hatcher, J. (2019). Severe Disseminated Infection with Emerging Lineage of Methicillin-Sensitive Staphylococcus aureus. Emerging Infectious Diseases, 25(1), 187-189. https://dx.doi.org/10.3201/eid2501.180684.

Severe Disease Caused by Community-Associated MRSA ST398 Type V, Australia, 2017 [PDF - 437 KB - 3 pages]
G. W. Coombs et al.

Using whole-genome sequencing, we identified a community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) sequence type (ST) 398 type V (5C2&5) isolate (typically found in China) in Australia in 2017. This CA-MRSA ST398 variant was highly virulent, similar to other related CA-MRSAs of ST398. This strain should be monitored to prevent more widespread dissemination.

EID Coombs GW, Pang S, Daley DA, Lee Y, Abraham S, Leroi M. Severe Disease Caused by Community-Associated MRSA ST398 Type V, Australia, 2017. Emerg Infect Dis. 2019;25(1):190-192. https://dx.doi.org/10.3201/eid2501.181136
AMA Coombs GW, Pang S, Daley DA, et al. Severe Disease Caused by Community-Associated MRSA ST398 Type V, Australia, 2017. Emerging Infectious Diseases. 2019;25(1):190-192. doi:10.3201/eid2501.181136.
APA Coombs, G. W., Pang, S., Daley, D. A., Lee, Y., Abraham, S., & Leroi, M. (2019). Severe Disease Caused by Community-Associated MRSA ST398 Type V, Australia, 2017. Emerging Infectious Diseases, 25(1), 190-192. https://dx.doi.org/10.3201/eid2501.181136.

Candida auris Sternal Osteomyelitis in a Man from Kenya Visiting Australia, 2015 [PDF - 814 KB - 3 pages]
C. H. Heath et al.

In Australia in 2015, Candida auris sternal osteomyelitis was diagnosed in a 65-year-old man with a history of intensive care treatment in Kenya in 2012 and without a history of cardiac surgery. The isolate was South Africa clade III. Clinicians should note that C. auris can cause low-grade disease years after colonization.

EID Heath CH, Dyer JR, Pang S, Coombs GW, Gardam DJ. Candida auris Sternal Osteomyelitis in a Man from Kenya Visiting Australia, 2015. Emerg Infect Dis. 2019;25(1):192-194. https://dx.doi.org/10.3201/eid2501.181321
AMA Heath CH, Dyer JR, Pang S, et al. Candida auris Sternal Osteomyelitis in a Man from Kenya Visiting Australia, 2015. Emerging Infectious Diseases. 2019;25(1):192-194. doi:10.3201/eid2501.181321.
APA Heath, C. H., Dyer, J. R., Pang, S., Coombs, G. W., & Gardam, D. J. (2019). Candida auris Sternal Osteomyelitis in a Man from Kenya Visiting Australia, 2015. Emerging Infectious Diseases, 25(1), 192-194. https://dx.doi.org/10.3201/eid2501.181321.
Books and Media

Biological Safety: Principles and Practices, 5th Edition [PDF - 451 KB - 1 page]
I. Schröder
EID Schröder I. Biological Safety: Principles and Practices, 5th Edition. Emerg Infect Dis. 2019;25(1):195. https://dx.doi.org/10.3201/eid2501.180458
AMA Schröder I. Biological Safety: Principles and Practices, 5th Edition. Emerging Infectious Diseases. 2019;25(1):195. doi:10.3201/eid2501.180458.
APA Schröder, I. (2019). Biological Safety: Principles and Practices, 5th Edition. Emerging Infectious Diseases, 25(1), 195. https://dx.doi.org/10.3201/eid2501.180458.

Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine [PDF - 424 KB - 1 page]
K. W. Hamilton
EID Hamilton KW. Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine. Emerg Infect Dis. 2019;25(1):196. https://dx.doi.org/10.3201/eid2501.181184
AMA Hamilton KW. Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine. Emerging Infectious Diseases. 2019;25(1):196. doi:10.3201/eid2501.181184.
APA Hamilton, K. W. (2019). Miracle Cure: The Creation of Antibiotics and the Birth of Modern Medicine. Emerging Infectious Diseases, 25(1), 196. https://dx.doi.org/10.3201/eid2501.181184.
In Memoriam

In Memoriam: Katrin Susanne Kohl (1964–2018) [PDF - 439 KB - 1 page]
N. Marano and S. H. Waterman
EID Marano N, Waterman SH. In Memoriam: Katrin Susanne Kohl (1964–2018). Emerg Infect Dis. 2019;25(1):197. https://dx.doi.org/10.3201/eid2501.180961
AMA Marano N, Waterman SH. In Memoriam: Katrin Susanne Kohl (1964–2018). Emerging Infectious Diseases. 2019;25(1):197. doi:10.3201/eid2501.180961.
APA Marano, N., & Waterman, S. H. (2019). In Memoriam: Katrin Susanne Kohl (1964–2018). Emerging Infectious Diseases, 25(1), 197. https://dx.doi.org/10.3201/eid2501.180961.
About the Cover

Repurpose and Reuse: Artistic Perspectives on Antimicrobial Resistance [PDF - 2.19 MB - 2 pages]
B. Breedlove
EID Breedlove B. Repurpose and Reuse: Artistic Perspectives on Antimicrobial Resistance. Emerg Infect Dis. 2019;25(1):198-199. https://dx.doi.org/10.3201/eid2501.ac2501
AMA Breedlove B. Repurpose and Reuse: Artistic Perspectives on Antimicrobial Resistance. Emerging Infectious Diseases. 2019;25(1):198-199. doi:10.3201/eid2501.ac2501.
APA Breedlove, B. (2019). Repurpose and Reuse: Artistic Perspectives on Antimicrobial Resistance. Emerging Infectious Diseases, 25(1), 198-199. https://dx.doi.org/10.3201/eid2501.ac2501.
Etymologia

Etymologia: Penicillin [PDF - 527 KB - 1 page]
R. Henry
EID Henry R. Etymologia: Penicillin. Emerg Infect Dis. 2019;25(1):62. https://dx.doi.org/10.3201/eid2501.et2501
AMA Henry R. Etymologia: Penicillin. Emerging Infectious Diseases. 2019;25(1):62. doi:10.3201/eid2501.et2501.
APA Henry, R. (2019). Etymologia: Penicillin. Emerging Infectious Diseases, 25(1), 62. https://dx.doi.org/10.3201/eid2501.et2501.
Page created: December 18, 2018
Page updated: December 18, 2018
Page reviewed: December 18, 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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