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Issue Cover for Volume 28, Number 5—May 2022

Volume 28, Number 5—May 2022

[PDF - 64.80 MB - 182 pages]

Synopses

Medscape CME Activity
Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018–2019 [PDF - 854 KB - 9 pages]
L. E. Nabarro et al.

Healthcare-associated invasive group A Streptococcus (iGAS) outbreaks are common worldwide, but only England has reported outbreaks associated with home healthcare (HHC). We describe 10 outbreaks during 2018–2019 in England. A total of 96 iGAS cases (range 2–39 per outbreak) and 28 deaths (case-fatality rate 29%) occurred. Outbreak duration ranged from 3–517 days; median time between sequential cases was 20.5 days (range 1–225 days). Outbreak identification was difficult, but emm typing and whole-genome sequencing improved detection. Network analyses indicated multiple potential transmission routes. Screening of 366 HHC workers from 9 outbreaks identified group A Streptococcus carriage in just 1 worker. Outbreak control required multiple interventions, including improved infection control, equipment decontamination, and antimicrobial prophylaxis for staff. Transmission routes and effective interventions are not yet clear, and iGAS outbreaks likely are underrecognized. To improve patient safety and reduce deaths, public health agencies should be aware of HHC-associated iGAS.

EID Nabarro LE, Brown CS, Balasegaram S, Decraene V, Elston J, Kapadia S, et al. Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018–2019. Emerg Infect Dis. 2022;28(5):915-923. https://doi.org/10.3201/eid2805.211497
AMA Nabarro LE, Brown CS, Balasegaram S, et al. Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018–2019. Emerging Infectious Diseases. 2022;28(5):915-923. doi:10.3201/eid2805.211497.
APA Nabarro, L. E., Brown, C. S., Balasegaram, S., Decraene, V., Elston, J., Kapadia, S....Lamagni, T. (2022). Invasive Group A Streptococcus Outbreaks Associated with Home Healthcare, England, 2018–2019. Emerging Infectious Diseases, 28(5), 915-923. https://doi.org/10.3201/eid2805.211497.
Research

Medscape CME Activity
Genomic Epidemiology of Global Carbapenemase-Producing Escherichia coli, 2015–2017 [PDF - 520 KB - 8 pages]
G. Peirano et al.

We describe the global molecular epidemiology of 229 carbapenemase-producing Escherichia coli in 36 countries during 2015–2017. Common carbapenemases were oxacillinase (OXA) 181 (23%), New Delhi metallo-β-lactamase (NDM) 5 (20%), OXA-48 (17%), Klebsiella pneumoniae carbapenemase 2 (15%), and NDM-1 (10%). We identified 5 dominant sequence types (STs); 4 were global (ST410, ST131, ST167, and ST405), and 1 (ST1284) was limited to Turkey. OXA-181 was frequent in Jordan (because of the ST410-B4/H24RxC subclade) and Turkey (because of ST1284). We found nearly identical IncX3-blaOXA-181 plasmids among 11 STs from 12 countries. NDM-5 was frequent in Egypt, Thailand (linked with ST410-B4/H24RxC and ST167-B subclades), and Vietnam (because of ST448). OXA-48 was common in Turkey (linked with ST11260). Global K. pneumoniae carbapenemases were linked with ST131 C1/H30 subclade and NDM-1 with various STs. The global carbapenemase E. coli population is dominated by diverse STs with different characteristics and varied geographic distributions, requiring ongoing genomic surveillance.

EID Peirano G, Chen L, Nobrega D, Finn TJ, Kreiswirth BN, DeVinney R, et al. Genomic Epidemiology of Global Carbapenemase-Producing Escherichia coli, 2015–2017. Emerg Infect Dis. 2022;28(5):924-931. https://doi.org/10.3201/eid2805.212535
AMA Peirano G, Chen L, Nobrega D, et al. Genomic Epidemiology of Global Carbapenemase-Producing Escherichia coli, 2015–2017. Emerging Infectious Diseases. 2022;28(5):924-931. doi:10.3201/eid2805.212535.
APA Peirano, G., Chen, L., Nobrega, D., Finn, T. J., Kreiswirth, B. N., DeVinney, R....Pitout, J. (2022). Genomic Epidemiology of Global Carbapenemase-Producing Escherichia coli, 2015–2017. Emerging Infectious Diseases, 28(5), 924-931. https://doi.org/10.3201/eid2805.212535.

Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members [PDF - 470 KB - 8 pages]
A. C. Miller et al.

We evaluated whether hospitalized patients without diagnosed Clostridioides difficile infection (CDI) increased the risk for CDI among their family members after discharge. We used 2001–2017 US insurance claims data to compare monthly CDI incidence between persons in households with and without a family member hospitalized in the previous 60 days. CDI incidence among insurance enrollees exposed to a recently hospitalized family member was 73% greater than enrollees not exposed, and incidence increased with length of hospitalization among family members. We identified a dose-response relationship between total days of within-household hospitalization and CDI incidence rate ratio. Compared with persons whose family members were hospitalized <1 day, the incidence rate ratio increased from 1.30 (95% CI 1.19–1.41) for 1–3 days of hospitalization to 2.45 (95% CI 1.66–3.60) for >30 days of hospitalization. Asymptomatic C. difficile carriers discharged from hospitals could be a major source of community-associated CDI cases.

EID Miller AC, Arakkal AT, Sewell DK, Segre AM, Pemmaraju SV, Polgreen PM. Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members. Emerg Infect Dis. 2022;28(5):932-939. https://doi.org/10.3201/eid2805.212023
AMA Miller AC, Arakkal AT, Sewell DK, et al. Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members. Emerging Infectious Diseases. 2022;28(5):932-939. doi:10.3201/eid2805.212023.
APA Miller, A. C., Arakkal, A. T., Sewell, D. K., Segre, A. M., Pemmaraju, S. V., & Polgreen, P. M. (2022). Risk for Asymptomatic Household Transmission of Clostridioides difficile Infection Associated with Recently Hospitalized Family Members. Emerging Infectious Diseases, 28(5), 932-939. https://doi.org/10.3201/eid2805.212023.

Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States [PDF - 1.45 MB - 8 pages]
A. T. Yu et al.

Monitoring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) is critical for public health management of coronavirus disease. Sequencing is resource-intensive and incompletely representative, and not all isolates can be sequenced. Because wastewater SARS-CoV-2 RNA concentrations correlate with coronavirus disease incidence in sewersheds, tracking VOCs through wastewater is appealing. We developed digital reverse transcription PCRs to monitor abundance of select mutations in Alpha and Delta VOCs in wastewater settled solids, applied these to July 2020–August 2021 samples from 2 large US metropolitan sewersheds, and compared results to estimates of VOC abundance from case isolate sequencing. Wastewater measurements tracked closely with case isolate estimates (Alpha, rp 0.82–0.88; Delta, rp 0.97). Mutations were detected in wastewater even at levels <5% of total SARS-CoV-2 RNA and in samples available 1–3 weeks before case isolate results. Wastewater variant monitoring should be strategically deployed to complement case isolate sequencing.

EID Yu AT, Hughes B, Wolfe MK, Leon T, Duong D, Rabe A, et al. Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States. Emerg Infect Dis. 2022;28(5):940-947. https://doi.org/10.3201/eid2805.212488
AMA Yu AT, Hughes B, Wolfe MK, et al. Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States. Emerging Infectious Diseases. 2022;28(5):940-947. doi:10.3201/eid2805.212488.
APA Yu, A. T., Hughes, B., Wolfe, M. K., Leon, T., Duong, D., Rabe, A....Vugia, D. J. (2022). Estimating Relative Abundance of 2 SARS-CoV-2 Variants through Wastewater Surveillance at 2 Large Metropolitan Sites, United States. Emerging Infectious Diseases, 28(5), 940-947. https://doi.org/10.3201/eid2805.212488.

Effectiveness of BNT162b2 Vaccine Booster against SARS-CoV-2 Infection and Breakthrough Complications, Israel [PDF - 1.27 MB - 9 pages]
A. Glatman-Freedman et al.

We estimated vaccine effectiveness (VE) of the BNT162b2 (Pfizer-BioNTech, https://www.pfizer.com) booster dose against SARS-CoV-2 infection and reduction of complications (hospitalization, severe disease, and death) among breakthrough cases in persons in Israel >16 years of age for <20 weeks. VE estimates reached 96.8% (95% CI 96.0%–97.5%) for persons 16–59 years of age and 93.1% (95% CI 91.8%–94.2%) for persons >60 years of age on week 3. VE estimates remained at these levels for 8 weeks in the 16–59 age group and 11 weeks in those >60. A slow decline followed, becoming more pronounced in the last 2–3 weeks of evaluation. Estimates in the last week of evaluation were 77.6% (95% CI 68.4%–84.2%) and 61.3% (52.5%–68.4%) for persons 16–59 years and >60 years, respectively. The more pronounced VE decline coincided with rapid increase in Omicron variant activity. Rate reduction of breakthrough complications remained moderate to high throughout the evaluation.

EID Glatman-Freedman A, Bromberg M, Hershkovitz Y, Sefty H, Kaufman Z, Dichtiar R, et al. Effectiveness of BNT162b2 Vaccine Booster against SARS-CoV-2 Infection and Breakthrough Complications, Israel. Emerg Infect Dis. 2022;28(5):948-956. https://doi.org/10.3201/eid2805.220141
AMA Glatman-Freedman A, Bromberg M, Hershkovitz Y, et al. Effectiveness of BNT162b2 Vaccine Booster against SARS-CoV-2 Infection and Breakthrough Complications, Israel. Emerging Infectious Diseases. 2022;28(5):948-956. doi:10.3201/eid2805.220141.
APA Glatman-Freedman, A., Bromberg, M., Hershkovitz, Y., Sefty, H., Kaufman, Z., Dichtiar, R....Keinan-Boker, L. (2022). Effectiveness of BNT162b2 Vaccine Booster against SARS-CoV-2 Infection and Breakthrough Complications, Israel. Emerging Infectious Diseases, 28(5), 948-956. https://doi.org/10.3201/eid2805.220141.

Effects of Tick-Control Interventions on Tick Abundance, Human Encounters with Ticks, and Incidence of Tickborne Diseases in Residential Neighborhoods, New York, USA [PDF - 1.45 MB - 10 pages]
F. Keesing et al.

Tickborne diseases (TBDs) such as Lyme disease result in ≈500,000 diagnoses annually in the United States. Various methods can reduce the abundance of ticks at small spatial scales, but whether these methods lower incidence of TBDs is poorly understood. We conducted a randomized, replicated, fully crossed, placebo-controlled, masked experiment to test whether 2 environmentally safe interventions, the Tick Control System (TCS) and Met52 fungal spray, used separately or together, affected risk for and incidence of TBDs in humans and pets in 24 residential neighborhoods. All participating properties in a neighborhood received the same treatment. TCS was associated with fewer questing ticks and fewer ticks feeding on rodents. The interventions did not result in a significant difference in incidence of human TBDs but did significantly reduce incidence in pets. Our study is consistent with previous evidence suggesting that reducing tick abundance in residential areas might not reduce incidence of TBDs in humans.

EID Keesing F, Mowry S, Bremer W, Duerr S, Evans AS, Fischhoff IR, et al. Effects of Tick-Control Interventions on Tick Abundance, Human Encounters with Ticks, and Incidence of Tickborne Diseases in Residential Neighborhoods, New York, USA. Emerg Infect Dis. 2022;28(5):957-966. https://doi.org/10.3201/eid2805.211146
AMA Keesing F, Mowry S, Bremer W, et al. Effects of Tick-Control Interventions on Tick Abundance, Human Encounters with Ticks, and Incidence of Tickborne Diseases in Residential Neighborhoods, New York, USA. Emerging Infectious Diseases. 2022;28(5):957-966. doi:10.3201/eid2805.211146.
APA Keesing, F., Mowry, S., Bremer, W., Duerr, S., Evans, A. S., Fischhoff, I. R....Ostfeld, R. S. (2022). Effects of Tick-Control Interventions on Tick Abundance, Human Encounters with Ticks, and Incidence of Tickborne Diseases in Residential Neighborhoods, New York, USA. Emerging Infectious Diseases, 28(5), 957-966. https://doi.org/10.3201/eid2805.211146.

Pertactin-Deficient Bordetella pertussis with Unusual Mechanism of Pertactin Disruption, Spain, 1986–2018 [PDF - 3.11 MB - 10 pages]
A. Mir-Cros et al.

Bordetella pertussis not expressing pertactin has increased in countries using acellular pertussis vaccines (ACV). The deficiency is mostly caused by pertactin gene disruption by IS481. To assess the effect of the transition from whole-cell vaccine to ACV on the emergence of B. pertussis not expressing pertactin in Spain, we studied 342 isolates collected during 1986–2018. We identified 93 pertactin-deficient isolates. All were detected after introduction of ACV and represented 38% of isolates collected during the ACV period; 58.1% belonged to a genetic cluster of isolates carrying the unusual prn::del(–292, 1340) mutation. Pertactin inactivation by IS481 insertion was identified in 23.7% of pertactin-deficient isolates, arising independently multiple times and in different phylogenetic branches. Our findings support the emergence and dissemination of a cluster of B. pertussis with an infrequent mechanism of pertactin disruption in Spain, probably resulting from introduction of ACV.

EID Mir-Cros A, Moreno-Mingorance A, Martín-Gómez M, Abad R, Bloise I, Campins M, et al. Pertactin-Deficient Bordetella pertussis with Unusual Mechanism of Pertactin Disruption, Spain, 1986–2018. Emerg Infect Dis. 2022;28(5):967-976. https://doi.org/10.3201/eid2805.211958
AMA Mir-Cros A, Moreno-Mingorance A, Martín-Gómez M, et al. Pertactin-Deficient Bordetella pertussis with Unusual Mechanism of Pertactin Disruption, Spain, 1986–2018. Emerging Infectious Diseases. 2022;28(5):967-976. doi:10.3201/eid2805.211958.
APA Mir-Cros, A., Moreno-Mingorance, A., Martín-Gómez, M., Abad, R., Bloise, I., Campins, M....González-López, J. (2022). Pertactin-Deficient Bordetella pertussis with Unusual Mechanism of Pertactin Disruption, Spain, 1986–2018. Emerging Infectious Diseases, 28(5), 967-976. https://doi.org/10.3201/eid2805.211958.

Determining Existing Human Population Immunity as Part of Assessing Influenza Pandemic Risk [PDF - 788 KB - 9 pages]
J. Cheung et al.

Zoonotic influenza infections continue to threaten human health. Ongoing surveillance and risk assessment of animal viruses are needed for pandemic preparedness, and population immunity is an important component of risk assessment. We determined age-stratified hemagglutinin inhibition seroprevalence against 5 swine influenza viruses circulating in Hong Kong and Guangzhou in China. Using hemagglutinin inhibition seroprevalence and titers, we modeled the effect of population immunity on the basic reproduction number (R0) if each virus were to become transmissible among humans. Among 353 individual serum samples, we reported low seroprevalence for triple-reassortant H1N2 and Eurasian avian-like H1N1 influenza viruses, which would reduce R0 by only 18%–20%. The smallest R0 needed to cause a pandemic was 1.22–1.24, meaning existing population immunity would be insufficient to block the spread of these H1N1 or H1N2 variants. For human-origin H3N2, existing population immunity could suppress R0 by 47%, thus reducing pandemic risk.

EID Cheung J, Tsang TK, Yen H, Perera R, Mok C, Lin Y, et al. Determining Existing Human Population Immunity as Part of Assessing Influenza Pandemic Risk. Emerg Infect Dis. 2022;28(5):977-985. https://doi.org/10.3201/eid2805.211965
AMA Cheung J, Tsang TK, Yen H, et al. Determining Existing Human Population Immunity as Part of Assessing Influenza Pandemic Risk. Emerging Infectious Diseases. 2022;28(5):977-985. doi:10.3201/eid2805.211965.
APA Cheung, J., Tsang, T. K., Yen, H., Perera, R., Mok, C., Lin, Y....Peiris, M. (2022). Determining Existing Human Population Immunity as Part of Assessing Influenza Pandemic Risk. Emerging Infectious Diseases, 28(5), 977-985. https://doi.org/10.3201/eid2805.211965.
Dispatches

Disparities in First Dose COVID-19 Vaccination Coverage among Children 5–11 Years of Age, United States [PDF - 994 KB - 4 pages]
N. Murthy et al.

We analyzed first-dose coronavirus disease vaccination coverage among US children 5–11 years of age during November–December 2021. Pediatric vaccination coverage varied widely by jurisdiction, age group, and race/ethnicity, and lagged behind vaccination coverage for adolescents aged 12–15 years during the first 2 months of vaccine rollout.

EID Murthy N, Zell E, Fast HE, Murthy B, Meng L, Saelee R, et al. Disparities in First Dose COVID-19 Vaccination Coverage among Children 5–11 Years of Age, United States. Emerg Infect Dis. 2022;28(5):986-989. https://doi.org/10.3201/eid2805.220166
AMA Murthy N, Zell E, Fast HE, et al. Disparities in First Dose COVID-19 Vaccination Coverage among Children 5–11 Years of Age, United States. Emerging Infectious Diseases. 2022;28(5):986-989. doi:10.3201/eid2805.220166.
APA Murthy, N., Zell, E., Fast, H. E., Murthy, B., Meng, L., Saelee, R....Chorba, T. (2022). Disparities in First Dose COVID-19 Vaccination Coverage among Children 5–11 Years of Age, United States. Emerging Infectious Diseases, 28(5), 986-989. https://doi.org/10.3201/eid2805.220166.

Multisystem Inflammatory Syndrome in Children after SARS-CoV-2 Vaccination [PDF - 800 KB - 4 pages]
E. Jain et al.

Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory state that occurs after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We present 2 cases of MIS-C after SARS-CoV-2 vaccination; 1 patient had evidence of recent SARS-CoV-2 infection. Our findings suggest that vaccination modulates the pathogenesis of MIS-C.

EID Jain E, Donowitz JR, Aarons E, Marshall BC, Miller MP. Multisystem Inflammatory Syndrome in Children after SARS-CoV-2 Vaccination. Emerg Infect Dis. 2022;28(5):990-993. https://doi.org/10.3201/eid2805.212418
AMA Jain E, Donowitz JR, Aarons E, et al. Multisystem Inflammatory Syndrome in Children after SARS-CoV-2 Vaccination. Emerging Infectious Diseases. 2022;28(5):990-993. doi:10.3201/eid2805.212418.
APA Jain, E., Donowitz, J. R., Aarons, E., Marshall, B. C., & Miller, M. P. (2022). Multisystem Inflammatory Syndrome in Children after SARS-CoV-2 Vaccination. Emerging Infectious Diseases, 28(5), 990-993. https://doi.org/10.3201/eid2805.212418.

Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever, Nigeria, 2018 [PDF - 586 KB - 4 pages]
J. W. Ashcroft et al.

During the 2018 Lassa fever outbreak in Nigeria, samples from patients with suspected Lassa fever but negative Lassa virus PCR results were processed through custom gene expression array cards and metagenomic sequencing. Results demonstrated no single etiology, but bacterial and viral pathogens (including mixed co-infections) were detected.

EID Ashcroft JW, Olayinka A, Ndodo N, Lewandowski K, Curran MD, Nwafor C, et al. Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever, Nigeria, 2018. Emerg Infect Dis. 2022;28(5):994-997. https://doi.org/10.3201/eid2805.211153
AMA Ashcroft JW, Olayinka A, Ndodo N, et al. Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever, Nigeria, 2018. Emerging Infectious Diseases. 2022;28(5):994-997. doi:10.3201/eid2805.211153.
APA Ashcroft, J. W., Olayinka, A., Ndodo, N., Lewandowski, K., Curran, M. D., Nwafor, C....Ihekweazu, C. (2022). Pathogens that Cause Illness Clinically Indistinguishable from Lassa Fever, Nigeria, 2018. Emerging Infectious Diseases, 28(5), 994-997. https://doi.org/10.3201/eid2805.211153.

Duration of Infectious Virus Shedding by SARS-CoV-2 Omicron Variant–Infected Vaccinees [PDF - 803 KB - 4 pages]
K. Takahashi et al.

To determine virus shedding duration, we examined clinical samples collected from the upper respiratory tracts of persons infected with severe acute respiratory syndrome coronavirus 2 Omicron variant in Japan during November 29–December 18, 2021. Vaccinees with mild or asymptomatic infection shed infectious virus 6–9 days after onset or diagnosis, even after symptom resolution.

EID Takahashi K, Ishikane M, Ujiie M, Iwamoto N, Okumura N, Sato T, et al. Duration of Infectious Virus Shedding by SARS-CoV-2 Omicron Variant–Infected Vaccinees. Emerg Infect Dis. 2022;28(5):998-1001. https://doi.org/10.3201/eid2805.220197
AMA Takahashi K, Ishikane M, Ujiie M, et al. Duration of Infectious Virus Shedding by SARS-CoV-2 Omicron Variant–Infected Vaccinees. Emerging Infectious Diseases. 2022;28(5):998-1001. doi:10.3201/eid2805.220197.
APA Takahashi, K., Ishikane, M., Ujiie, M., Iwamoto, N., Okumura, N., Sato, T....Ohmagari, N. (2022). Duration of Infectious Virus Shedding by SARS-CoV-2 Omicron Variant–Infected Vaccinees. Emerging Infectious Diseases, 28(5), 998-1001. https://doi.org/10.3201/eid2805.220197.

Imported Monkeypox from International Traveler, Maryland, USA, 2021 [PDF - 1.29 MB - 4 pages]
V. Costello et al.

A case of monkeypox was diagnosed in a returning traveler from Nigeria to Maryland, USA. Prompt infection control measures led to no secondary cases in 40 exposed healthcare workers. Given the global health implications, public health systems should be aware of effective strategies to mitigate the potential spread of monkeypox.

EID Costello V, Sowash M, Gaur A, Cardis M, Pasieka H, Wortmann G, et al. Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerg Infect Dis. 2022;28(5):1002-1005. https://doi.org/10.3201/eid2805.220292
AMA Costello V, Sowash M, Gaur A, et al. Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerging Infectious Diseases. 2022;28(5):1002-1005. doi:10.3201/eid2805.220292.
APA Costello, V., Sowash, M., Gaur, A., Cardis, M., Pasieka, H., Wortmann, G....Ramdeen, S. (2022). Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerging Infectious Diseases, 28(5), 1002-1005. https://doi.org/10.3201/eid2805.220292.

Intercontinental Movement of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4 Virus to the United States, 2021 [PDF - 2.40 MB - 6 pages]
S. N. Bevins et al.

We detected Eurasian-origin highly pathogenic avian influenza A(H5N1) virus belonging to the Gs/GD lineage, clade 2.3.4.4b, in wild waterfowl in 2 Atlantic coastal states in the United States. Bird banding data showed widespread movement of waterfowl within the Atlantic Flyway and between neighboring flyways and northern breeding grounds.

EID Bevins SN, Shriner SA, Cumbee JC, Dilione KE, Douglass KE, Ellis JW, et al. Intercontinental Movement of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4 Virus to the United States, 2021. Emerg Infect Dis. 2022;28(5):1006-1011. https://doi.org/10.3201/eid2805.220318
AMA Bevins SN, Shriner SA, Cumbee JC, et al. Intercontinental Movement of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4 Virus to the United States, 2021. Emerging Infectious Diseases. 2022;28(5):1006-1011. doi:10.3201/eid2805.220318.
APA Bevins, S. N., Shriner, S. A., Cumbee, J. C., Dilione, K. E., Douglass, K. E., Ellis, J. W....Lenoch, J. B. (2022). Intercontinental Movement of Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4 Virus to the United States, 2021. Emerging Infectious Diseases, 28(5), 1006-1011. https://doi.org/10.3201/eid2805.220318.

Epidemiologic and Genomic Analysis of SARS-CoV-2 Delta Variant Superspreading Event in Nightclub, the Netherlands, June 2021 [PDF - 1.81 MB - 5 pages]
J. Koopsen et al.

We report a severe acute respiratory syndrome coronavirus 2 superspreading event in the Netherlands after distancing rules were lifted in nightclubs, despite requiring a negative test or vaccination. This occurrence illustrates the potential for rapid dissemination of variants in largely unvaccinated populations under such conditions. We detected subsequent community transmission of this strain.

EID Koopsen J, van Ewijk CE, Bavalia R, Cornelissen A, Bruisten SM, de Gee F, et al. Epidemiologic and Genomic Analysis of SARS-CoV-2 Delta Variant Superspreading Event in Nightclub, the Netherlands, June 2021. Emerg Infect Dis. 2022;28(5):1012-1016. https://doi.org/10.3201/eid2805.212019
AMA Koopsen J, van Ewijk CE, Bavalia R, et al. Epidemiologic and Genomic Analysis of SARS-CoV-2 Delta Variant Superspreading Event in Nightclub, the Netherlands, June 2021. Emerging Infectious Diseases. 2022;28(5):1012-1016. doi:10.3201/eid2805.212019.
APA Koopsen, J., van Ewijk, C. E., Bavalia, R., Cornelissen, A., Bruisten, S. M., de Gee, F....Leenstra, T. (2022). Epidemiologic and Genomic Analysis of SARS-CoV-2 Delta Variant Superspreading Event in Nightclub, the Netherlands, June 2021. Emerging Infectious Diseases, 28(5), 1012-1016. https://doi.org/10.3201/eid2805.212019.

Severe Multisystem Inflammatory Symptoms in 2 Adults after Short Interval between COVID-19 and Subsequent Vaccination [PDF - 710 KB - 4 pages]
E. R. Jenny-Avital and R. A. Howe

We observed multisystem inflammatory syndrome in 2 older adults in the United States who had received mRNA coronavirus disease vaccine soon after natural infection. We identified 5 similar cases from the Vaccine Adverse Events Reporting System. The timing of vaccination soon after natural infection might have an adverse effect on the occurrence of vaccine-related systemic inflammatory disorders.

EID Jenny-Avital ER, Howe RA. Severe Multisystem Inflammatory Symptoms in 2 Adults after Short Interval between COVID-19 and Subsequent Vaccination. Emerg Infect Dis. 2022;28(5):1017-1020. https://doi.org/10.3201/eid2805.212316
AMA Jenny-Avital ER, Howe RA. Severe Multisystem Inflammatory Symptoms in 2 Adults after Short Interval between COVID-19 and Subsequent Vaccination. Emerging Infectious Diseases. 2022;28(5):1017-1020. doi:10.3201/eid2805.212316.
APA Jenny-Avital, E. R., & Howe, R. A. (2022). Severe Multisystem Inflammatory Symptoms in 2 Adults after Short Interval between COVID-19 and Subsequent Vaccination. Emerging Infectious Diseases, 28(5), 1017-1020. https://doi.org/10.3201/eid2805.212316.

Rapid Replacement of SARS-CoV-2 Variants by Delta and Subsequent Arrival of Omicron, Uganda, 2021 [PDF - 1.84 MB - 5 pages]
N. Bbosa et al.

Genomic surveillance in Uganda showed rapid replacement of severe acute respiratory syndrome coronavirus 2 over time by variants, dominated by Delta. However, detection of the more transmissible Omicron variant among travelers and increasing community transmission highlight the need for near–real-time genomic surveillance and adherence to infection control measures to prevent future pandemic waves.

EID Bbosa N, Ssemwanga D, Namagembe H, Kiiza R, Kiconco J, Kayiwa J, et al. Rapid Replacement of SARS-CoV-2 Variants by Delta and Subsequent Arrival of Omicron, Uganda, 2021. Emerg Infect Dis. 2022;28(5):1021-1025. https://doi.org/10.3201/eid2805.220121
AMA Bbosa N, Ssemwanga D, Namagembe H, et al. Rapid Replacement of SARS-CoV-2 Variants by Delta and Subsequent Arrival of Omicron, Uganda, 2021. Emerging Infectious Diseases. 2022;28(5):1021-1025. doi:10.3201/eid2805.220121.
APA Bbosa, N., Ssemwanga, D., Namagembe, H., Kiiza, R., Kiconco, J., Kayiwa, J....Kaleebu, P. (2022). Rapid Replacement of SARS-CoV-2 Variants by Delta and Subsequent Arrival of Omicron, Uganda, 2021. Emerging Infectious Diseases, 28(5), 1021-1025. https://doi.org/10.3201/eid2805.220121.

SARS-CoV-2 Antibody Prevalence and Population-Based Death Rates, Greater Omdurman, Sudan [PDF - 1.52 MB - 5 pages]
W. Moser et al.

In a cross-sectional survey in Omdurman, Sudan, during March–April 2021, we estimated that 54.6% of the population had detectable severe acute respiratory syndrome coronavirus 2 antibodies. Overall population death rates among those >50 years of age increased 74% over the first coronavirus disease pandemic year.

EID Moser W, Fahal M, Abualas E, Bedri S, Elsir M, Mohamed M, et al. SARS-CoV-2 Antibody Prevalence and Population-Based Death Rates, Greater Omdurman, Sudan. Emerg Infect Dis. 2022;28(5):1026-1030. https://doi.org/10.3201/eid2805.211951
AMA Moser W, Fahal M, Abualas E, et al. SARS-CoV-2 Antibody Prevalence and Population-Based Death Rates, Greater Omdurman, Sudan. Emerging Infectious Diseases. 2022;28(5):1026-1030. doi:10.3201/eid2805.211951.
APA Moser, W., Fahal, M., Abualas, E., Bedri, S., Elsir, M., Mohamed, M....Miranda, M. (2022). SARS-CoV-2 Antibody Prevalence and Population-Based Death Rates, Greater Omdurman, Sudan. Emerging Infectious Diseases, 28(5), 1026-1030. https://doi.org/10.3201/eid2805.211951.

Evidence of Prolonged Crimean-Congo Hemorrhagic Fever Virus Endemicity by Retrospective Serosurvey, Eastern Spain [PDF - 1.54 MB - 4 pages]
L. Carrera-Faja et al.

We conducted a retrospective serosurvey for antibodies against Crimean-Congo hemorrhagic fever virus in wild ungulates along the eastern Mediterranean Coast of Spain. The virus has been endemic in this region since 2010 but is mainly restricted to geographic clusters with extremely high seropositivity associated with high density of bovids.

EID Carrera-Faja L, Cardells J, Pailler-García L, Lizana V, Alfaro-Deval G, Espunyes J, et al. Evidence of Prolonged Crimean-Congo Hemorrhagic Fever Virus Endemicity by Retrospective Serosurvey, Eastern Spain. Emerg Infect Dis. 2022;28(5):1031-1034. https://doi.org/10.3201/eid2805.212335
AMA Carrera-Faja L, Cardells J, Pailler-García L, et al. Evidence of Prolonged Crimean-Congo Hemorrhagic Fever Virus Endemicity by Retrospective Serosurvey, Eastern Spain. Emerging Infectious Diseases. 2022;28(5):1031-1034. doi:10.3201/eid2805.212335.
APA Carrera-Faja, L., Cardells, J., Pailler-García, L., Lizana, V., Alfaro-Deval, G., Espunyes, J....Cabezón, O. (2022). Evidence of Prolonged Crimean-Congo Hemorrhagic Fever Virus Endemicity by Retrospective Serosurvey, Eastern Spain. Emerging Infectious Diseases, 28(5), 1031-1034. https://doi.org/10.3201/eid2805.212335.

Lack of Evidence for Crimean–Congo Hemorrhagic Fever Virus in Ticks Collected from Animals, Corsica, France [PDF - 913 KB - 4 pages]
V. Cicculli et al.

In Corsica, France, 9.1% of livestock serum samples collected during 2014–2016 were found to have antibodies against Crimean–Congo hemorrhagic fever virus (CCHFV), an emerging tickborne zoonotic disease. We tested 8,051 ticks for CCHFV RNA and Nairovirus RNA. The results indicate that Corsica is not a hotspot for CCHFV.

EID Cicculli V, Maitre A, Ayhan N, Mondoloni S, Paoli J, Vial L, et al. Lack of Evidence for Crimean–Congo Hemorrhagic Fever Virus in Ticks Collected from Animals, Corsica, France. Emerg Infect Dis. 2022;28(5):1035-1038. https://doi.org/10.3201/eid2805.211996
AMA Cicculli V, Maitre A, Ayhan N, et al. Lack of Evidence for Crimean–Congo Hemorrhagic Fever Virus in Ticks Collected from Animals, Corsica, France. Emerging Infectious Diseases. 2022;28(5):1035-1038. doi:10.3201/eid2805.211996.
APA Cicculli, V., Maitre, A., Ayhan, N., Mondoloni, S., Paoli, J., Vial, L....Falchi, A. (2022). Lack of Evidence for Crimean–Congo Hemorrhagic Fever Virus in Ticks Collected from Animals, Corsica, France. Emerging Infectious Diseases, 28(5), 1035-1038. https://doi.org/10.3201/eid2805.211996.

Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Viruses in Satellite-Tracked Wild Ducks, Ningxia, China, 2020 [PDF - 1.72 MB - 4 pages]
X. Lv et al.

During October 2020, we identified 13 highly pathogenic avian influenza A(H5N8) clade 2.3.4.4b viruses from wild ducks in Ningxia, China. These viruses were genetically related to H5N8 viruses circulating mainly in poultry in Europe during early 2020. We also determined movements of H5N8 virus‒infected wild ducks and evidence for spreading of viruses.

EID Lv X, Li X, Sun H, Li Y, Peng P, Qin S, et al. Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Viruses in Satellite-Tracked Wild Ducks, Ningxia, China, 2020. Emerg Infect Dis. 2022;28(5):1039-1042. https://doi.org/10.3201/eid2805.211580
AMA Lv X, Li X, Sun H, et al. Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Viruses in Satellite-Tracked Wild Ducks, Ningxia, China, 2020. Emerging Infectious Diseases. 2022;28(5):1039-1042. doi:10.3201/eid2805.211580.
APA Lv, X., Li, X., Sun, H., Li, Y., Peng, P., Qin, S....Chai, H. (2022). Highly Pathogenic Avian Influenza A(H5N8) Clade 2.3.4.4b Viruses in Satellite-Tracked Wild Ducks, Ningxia, China, 2020. Emerging Infectious Diseases, 28(5), 1039-1042. https://doi.org/10.3201/eid2805.211580.

Novel Hendra Virus Variant Circulating in Black Flying Foxes and Grey-Headed Flying Foxes, Australia [PDF - 1.04 MB - 5 pages]
A. J. Peel et al.

A novel Hendra virus variant, genotype 2, was recently discovered in a horse that died after acute illness and in Pteropus flying fox tissues in Australia. We detected the variant in flying fox urine, the pathway relevant for spillover, supporting an expanded geographic range of Hendra virus risk to horses and humans.

EID Peel AJ, Yinda C, Annand EJ, Dale AS, Eby P, Eden J, et al. Novel Hendra Virus Variant Circulating in Black Flying Foxes and Grey-Headed Flying Foxes, Australia. Emerg Infect Dis. 2022;28(5):1043-1047. https://doi.org/10.3201/eid2805.212338
AMA Peel AJ, Yinda C, Annand EJ, et al. Novel Hendra Virus Variant Circulating in Black Flying Foxes and Grey-Headed Flying Foxes, Australia. Emerging Infectious Diseases. 2022;28(5):1043-1047. doi:10.3201/eid2805.212338.
APA Peel, A. J., Yinda, C., Annand, E. J., Dale, A. S., Eby, P., Eden, J....Plowright, R. K. (2022). Novel Hendra Virus Variant Circulating in Black Flying Foxes and Grey-Headed Flying Foxes, Australia. Emerging Infectious Diseases, 28(5), 1043-1047. https://doi.org/10.3201/eid2805.212338.
Research Letters

Increased COVID-19 Severity among Pregnant Patients Infected with SARS-CoV-2 Delta Variant, France [PDF - 550 KB - 3 pages]
S. Zayet et al.

We conducted a retrospective study of pregnant persons hospitalized for severe acute respiratory syndrome coronavirus 2 infection in France. Delta variant infection had a relative risk of 14.33 for intensive care unit admission and 9.56 for high supplemental oxygen support. The Delta variant might cause more severe illness during pregnancy.

EID Zayet S, Gendrin V, Gay C, Selles P, Klopfenstein T. Increased COVID-19 Severity among Pregnant Patients Infected with SARS-CoV-2 Delta Variant, France. Emerg Infect Dis. 2022;28(5):1048-1050. https://doi.org/10.3201/eid2805.212080
AMA Zayet S, Gendrin V, Gay C, et al. Increased COVID-19 Severity among Pregnant Patients Infected with SARS-CoV-2 Delta Variant, France. Emerging Infectious Diseases. 2022;28(5):1048-1050. doi:10.3201/eid2805.212080.
APA Zayet, S., Gendrin, V., Gay, C., Selles, P., & Klopfenstein, T. (2022). Increased COVID-19 Severity among Pregnant Patients Infected with SARS-CoV-2 Delta Variant, France. Emerging Infectious Diseases, 28(5), 1048-1050. https://doi.org/10.3201/eid2805.212080.

Cross-Variant Neutralizing Serum Activity after SARS-CoV-2 Breakthrough Infections [PDF - 782 KB - 3 pages]
P. Tober-Lau et al.

To determine neutralizing activity against the severe acute respiratory syndrome coronavirus 2 ancestral strain and 4 variants of concern, we tested serum from 30 persons with breakthrough infection after 2-dose vaccination. Cross-variant neutralizing activity was comparable to that after 3-dose vaccination. Shorter intervals between vaccination and breakthrough infection correlated with lower neutralizing titers.

EID Tober-Lau P, Gruell H, Vanshylla K, Koch WM, Hillus D, Schommers P, et al. Cross-Variant Neutralizing Serum Activity after SARS-CoV-2 Breakthrough Infections. Emerg Infect Dis. 2022;28(5):1050-1052. https://doi.org/10.3201/eid2805.220271
AMA Tober-Lau P, Gruell H, Vanshylla K, et al. Cross-Variant Neutralizing Serum Activity after SARS-CoV-2 Breakthrough Infections. Emerging Infectious Diseases. 2022;28(5):1050-1052. doi:10.3201/eid2805.220271.
APA Tober-Lau, P., Gruell, H., Vanshylla, K., Koch, W. M., Hillus, D., Schommers, P....Kurth, F. (2022). Cross-Variant Neutralizing Serum Activity after SARS-CoV-2 Breakthrough Infections. Emerging Infectious Diseases, 28(5), 1050-1052. https://doi.org/10.3201/eid2805.220271.

Mathematical Modeling for Removing Border Entry and Quarantine Requirements for COVID-19, Vanuatu [PDF - 364 KB - 3 pages]
C. van Gemert et al.

The Pacific Island country of Vanuatu is considering strategies to remove border restrictions implemented during 2020 to prevent imported coronavirus disease. We performed mathematical modeling to estimate the number of infectious travelers who had different entry scenarios and testing strategies. Travel bubbles and testing on entry have the greatest importation risk reduction.

EID van Gemert C, Tarivonda L, Tapo P, Natuman S, Clark G, Mariasua J, et al. Mathematical Modeling for Removing Border Entry and Quarantine Requirements for COVID-19, Vanuatu. Emerg Infect Dis. 2022;28(5):1053-1055. https://doi.org/10.3201/eid2805.211757
AMA van Gemert C, Tarivonda L, Tapo P, et al. Mathematical Modeling for Removing Border Entry and Quarantine Requirements for COVID-19, Vanuatu. Emerging Infectious Diseases. 2022;28(5):1053-1055. doi:10.3201/eid2805.211757.
APA van Gemert, C., Tarivonda, L., Tapo, P., Natuman, S., Clark, G., Mariasua, J....Sacks-Davis, R. (2022). Mathematical Modeling for Removing Border Entry and Quarantine Requirements for COVID-19, Vanuatu. Emerging Infectious Diseases, 28(5), 1053-1055. https://doi.org/10.3201/eid2805.211757.

SARS-CoV-2 Seroprevalence after Third Wave of Infections, South Africa [PDF - 637 KB - 4 pages]
J. Kleynhans et al.

By November 2021, after the third wave of severe acute respiratory syndrome coronavirus 2 infections in South Africa, seroprevalence was 60% in a rural community and 70% in an urban community. High seroprevalence before the Omicron variant emerged may have contributed to reduced illness severity observed in the fourth wave.

EID Kleynhans J, Tempia S, Wolter N, von Gottberg A, Bhiman JN, Buys A, et al. SARS-CoV-2 Seroprevalence after Third Wave of Infections, South Africa. Emerg Infect Dis. 2022;28(5):1055-1058. https://doi.org/10.3201/eid2805.220278
AMA Kleynhans J, Tempia S, Wolter N, et al. SARS-CoV-2 Seroprevalence after Third Wave of Infections, South Africa. Emerging Infectious Diseases. 2022;28(5):1055-1058. doi:10.3201/eid2805.220278.
APA Kleynhans, J., Tempia, S., Wolter, N., von Gottberg, A., Bhiman, J. N., Buys, A....Cohen, C. (2022). SARS-CoV-2 Seroprevalence after Third Wave of Infections, South Africa. Emerging Infectious Diseases, 28(5), 1055-1058. https://doi.org/10.3201/eid2805.220278.

Angiostrongylus cantonensis in a Red Ruffed Lemur at a Zoo, Louisiana, USA [PDF - 799 KB - 3 pages]
J. Rizor et al.

A red ruffed lemur (Varecia rubra) from a zoo in Louisiana, USA, was euthanized for worsening paresis. Brain and spinal cord histology identified eosinophilic meningoencephalomyelitis with intralesional adult Angiostrongylus sp. nematodes. PCR and sequencing confirmed A. cantonensis infection, indicating this parasite constitutes an emerging zoonosis in the southeastern United States.

EID Rizor J, Yanez RA, Thaiwong T, Kiupel M. Angiostrongylus cantonensis in a Red Ruffed Lemur at a Zoo, Louisiana, USA. Emerg Infect Dis. 2022;28(5):1058-1060. https://doi.org/10.3201/eid2805.212287
AMA Rizor J, Yanez RA, Thaiwong T, et al. Angiostrongylus cantonensis in a Red Ruffed Lemur at a Zoo, Louisiana, USA. Emerging Infectious Diseases. 2022;28(5):1058-1060. doi:10.3201/eid2805.212287.
APA Rizor, J., Yanez, R. A., Thaiwong, T., & Kiupel, M. (2022). Angiostrongylus cantonensis in a Red Ruffed Lemur at a Zoo, Louisiana, USA. Emerging Infectious Diseases, 28(5), 1058-1060. https://doi.org/10.3201/eid2805.212287.

Breast Milk as Route of Tick-Borne Encephalitis Virus Transmission from Mother to Infant [PDF - 227 KB - 2 pages]
J. Kerlik et al.

Tick-borne encephalitis virus (TBEV) is transmitted mainly by tick bites, but humans can acquire infection through consuming unpasteurized milk from infected animals. Interhuman transmission of TBEV by breast milk has not been confirmed or ruled out. We report a case of probable transmission of TBEV from an unvaccinated mother to an infant through breast-feeding.

EID Kerlik J, Avdičová M, Musilová M, Bérešová J, Mezencev R. Breast Milk as Route of Tick-Borne Encephalitis Virus Transmission from Mother to Infant. Emerg Infect Dis. 2022;28(5):1060-1061. https://doi.org/10.3201/eid2805.212457
AMA Kerlik J, Avdičová M, Musilová M, et al. Breast Milk as Route of Tick-Borne Encephalitis Virus Transmission from Mother to Infant. Emerging Infectious Diseases. 2022;28(5):1060-1061. doi:10.3201/eid2805.212457.
APA Kerlik, J., Avdičová, M., Musilová, M., Bérešová, J., & Mezencev, R. (2022). Breast Milk as Route of Tick-Borne Encephalitis Virus Transmission from Mother to Infant. Emerging Infectious Diseases, 28(5), 1060-1061. https://doi.org/10.3201/eid2805.212457.

atpE Mutation in Mycobacterium tuberculosis Not Always Predictive of Bedaquiline Treatment Failure [PDF - 847 KB - 3 pages]
L. Le Ray et al.

We report the emergence of an atpE mutation in a clinical Mycobacterium tuberculosis strain. Genotypic and phenotypic bedaquiline susceptibility testing displayed variable results over time and ultimately were not predictive of treatment outcome. This observation highlights the limits of current genotypic and phenotypic methods for detection of bedaquiline resistance.

EID Le Ray L, Aubry A, Sougakoff W, Revest M, Robert J, Bonnet I, et al. atpE Mutation in Mycobacterium tuberculosis Not Always Predictive of Bedaquiline Treatment Failure. Emerg Infect Dis. 2022;28(5):1062-1064. https://doi.org/10.3201/eid2805.212517
AMA Le Ray L, Aubry A, Sougakoff W, et al. atpE Mutation in Mycobacterium tuberculosis Not Always Predictive of Bedaquiline Treatment Failure. Emerging Infectious Diseases. 2022;28(5):1062-1064. doi:10.3201/eid2805.212517.
APA Le Ray, L., Aubry, A., Sougakoff, W., Revest, M., Robert, J., Bonnet, I....Morel, F. (2022). atpE Mutation in Mycobacterium tuberculosis Not Always Predictive of Bedaquiline Treatment Failure. Emerging Infectious Diseases, 28(5), 1062-1064. https://doi.org/10.3201/eid2805.212517.

Emerging Novel Reassortant Influenza A(H5N6) Viruses in Poultry and Humans, China, 2021 [PDF - 1.54 MB - 3 pages]
W. Jiang et al.

A novel highly pathogenic avian influenza A(H5N6) clade 2.3.4.4b virus was isolated from a poultry market in China that a person with a confirmed case had visited. Most genes of the avian and human H5N6 isolates were closely related. The virus also exhibited distinct antigenicity to the Re-11 vaccine strain.

EID Jiang W, Dong C, Liu S, Peng C, Yin X, Liang S, et al. Emerging Novel Reassortant Influenza A(H5N6) Viruses in Poultry and Humans, China, 2021. Emerg Infect Dis. 2022;28(5):1064-1066. https://doi.org/10.3201/eid2805.212163
AMA Jiang W, Dong C, Liu S, et al. Emerging Novel Reassortant Influenza A(H5N6) Viruses in Poultry and Humans, China, 2021. Emerging Infectious Diseases. 2022;28(5):1064-1066. doi:10.3201/eid2805.212163.
APA Jiang, W., Dong, C., Liu, S., Peng, C., Yin, X., Liang, S....Liu, H. (2022). Emerging Novel Reassortant Influenza A(H5N6) Viruses in Poultry and Humans, China, 2021. Emerging Infectious Diseases, 28(5), 1064-1066. https://doi.org/10.3201/eid2805.212163.

Mycobacterium lepromatosis as Cause of Leprosy, Colombia [PDF - 323 KB - 2 pages]
N. Cardona-Castro et al.

Leprosy is a granulomatous infection caused by infection with Mycobacterium leprae or M. lepromatosis. We evaluated skin biopsy and slit skin smear samples from 92 leprosy patients in Colombia by quantitative PCR. Five (5.4%) patients tested positive for M. lepromatosis, providing evidence of the presence of this pathogen in Colombia.

EID Cardona-Castro N, Escobar-Builes M, Serrano-Coll H, Adams LB, Lahiri R. Mycobacterium lepromatosis as Cause of Leprosy, Colombia. Emerg Infect Dis. 2022;28(5):1067-1068. https://doi.org/10.3201/eid2805.212015
AMA Cardona-Castro N, Escobar-Builes M, Serrano-Coll H, et al. Mycobacterium lepromatosis as Cause of Leprosy, Colombia. Emerging Infectious Diseases. 2022;28(5):1067-1068. doi:10.3201/eid2805.212015.
APA Cardona-Castro, N., Escobar-Builes, M., Serrano-Coll, H., Adams, L. B., & Lahiri, R. (2022). Mycobacterium lepromatosis as Cause of Leprosy, Colombia. Emerging Infectious Diseases, 28(5), 1067-1068. https://doi.org/10.3201/eid2805.212015.

Rare Case of Rickettsiosis Caused by Rickettsia monacensis, Portugal, 2021 [PDF - 616 KB - 4 pages]
R. de Sousa et al.

We report a case of rickettsiosis caused by Rickettsia monacensis in an immunocompetent 67-year-old man in Portugal who had eschar, erythematous rash, and an attached Ixodes ricinus tick. Seroconversion and eschar biopsy led to confirmed diagnosis by PCR. Physicians should be aware of this rare rickettsiosis, especially in geographic regions with the vector.

EID de Sousa R, dos Santos M, Cruz C, Almeida V, Garrote A, Ramirez F, et al. Rare Case of Rickettsiosis Caused by Rickettsia monacensis, Portugal, 2021. Emerg Infect Dis. 2022;28(5):1068-1071. https://doi.org/10.3201/eid2805.211836
AMA de Sousa R, dos Santos M, Cruz C, et al. Rare Case of Rickettsiosis Caused by Rickettsia monacensis, Portugal, 2021. Emerging Infectious Diseases. 2022;28(5):1068-1071. doi:10.3201/eid2805.211836.
APA de Sousa, R., dos Santos, M., Cruz, C., Almeida, V., Garrote, A., Ramirez, F....Maltez, F. (2022). Rare Case of Rickettsiosis Caused by Rickettsia monacensis, Portugal, 2021. Emerging Infectious Diseases, 28(5), 1068-1071. https://doi.org/10.3201/eid2805.211836.

Domestic Dogs as Sentinels for West Nile Virus but not Aedes-borne Flaviviruses, Mexico [PDF - 1.34 MB - 4 pages]
E. Davila et al.

We tested 294 domestic pet dogs in Mexico for neutralizing antibodies for mosquito-borne flaviviruses. We found high (42.6%) exposure to West Nile virus in Reynosa (northern Mexico) and low (1.2%) exposure in Tuxtla Gutierrez (southern Mexico) but very limited exposure to Aedes-borne flaviviruses. Domestic dogs may be useful sentinels for West Nile virus.

EID Davila E, Fernández-Santos NA, Estrada-Franco J, Wei L, Aguilar-Durán JA, López-López MJ, et al. Domestic Dogs as Sentinels for West Nile Virus but not Aedes-borne Flaviviruses, Mexico. Emerg Infect Dis. 2022;28(5):1071-1074. https://doi.org/10.3201/eid2805.211879
AMA Davila E, Fernández-Santos NA, Estrada-Franco J, et al. Domestic Dogs as Sentinels for West Nile Virus but not Aedes-borne Flaviviruses, Mexico. Emerging Infectious Diseases. 2022;28(5):1071-1074. doi:10.3201/eid2805.211879.
APA Davila, E., Fernández-Santos, N. A., Estrada-Franco, J., Wei, L., Aguilar-Durán, J. A., López-López, M. J....Hamer, G. L. (2022). Domestic Dogs as Sentinels for West Nile Virus but not Aedes-borne Flaviviruses, Mexico. Emerging Infectious Diseases, 28(5), 1071-1074. https://doi.org/10.3201/eid2805.211879.

Viral Hepatitis E Outbreaks in Refugees and Internally Displaced Populations, sub-Saharan Africa, 2010–2020 [PDF - 943 KB - 3 pages]
A. N. Desai et al.

Hepatitis E virus is a common cause of acute viral hepatitis. We analyzed reports of hepatitis E outbreaks among forcibly displaced populations in sub-Saharan Africa during 2010–2020. Twelve independent outbreaks occurred, and >30,000 cases were reported. Transmission was attributed to poor sanitation and overcrowding.

EID Desai AN, Mohareb AM, Elkarsany M, Desalegn H, Madoff LC, Lassmann B. Viral Hepatitis E Outbreaks in Refugees and Internally Displaced Populations, sub-Saharan Africa, 2010–2020. Emerg Infect Dis. 2022;28(5):1074-1076. https://doi.org/10.3201/eid2805.212546
AMA Desai AN, Mohareb AM, Elkarsany M, et al. Viral Hepatitis E Outbreaks in Refugees and Internally Displaced Populations, sub-Saharan Africa, 2010–2020. Emerging Infectious Diseases. 2022;28(5):1074-1076. doi:10.3201/eid2805.212546.
APA Desai, A. N., Mohareb, A. M., Elkarsany, M., Desalegn, H., Madoff, L. C., & Lassmann, B. (2022). Viral Hepatitis E Outbreaks in Refugees and Internally Displaced Populations, sub-Saharan Africa, 2010–2020. Emerging Infectious Diseases, 28(5), 1074-1076. https://doi.org/10.3201/eid2805.212546.

Usutu Virus Africa 3 Lineage, Luxembourg, 2020 [PDF - 918 KB - 4 pages]
C. J. Snoeck et al.

We detected Usutu virus in a dead Eurasian blackbird (Turdus merula) in Luxembourg in September 2020. The strain clustered within the Africa 3.1 lineage identified in Western Europe since 2016. Our results suggest maintenance of the virus in Europe despite little reporting during 2019–2020, rather than a new introduction.

EID Snoeck CJ, Sausy A, Losch S, Wildschutz F, Bourg M, Hübschen JM. Usutu Virus Africa 3 Lineage, Luxembourg, 2020. Emerg Infect Dis. 2022;28(5):1076-1079. https://doi.org/10.3201/eid2805.212012
AMA Snoeck CJ, Sausy A, Losch S, et al. Usutu Virus Africa 3 Lineage, Luxembourg, 2020. Emerging Infectious Diseases. 2022;28(5):1076-1079. doi:10.3201/eid2805.212012.
APA Snoeck, C. J., Sausy, A., Losch, S., Wildschutz, F., Bourg, M., & Hübschen, J. M. (2022). Usutu Virus Africa 3 Lineage, Luxembourg, 2020. Emerging Infectious Diseases, 28(5), 1076-1079. https://doi.org/10.3201/eid2805.212012.
Letters

Guillain-Barré Syndrome Associated with COVID-19 Vaccination [PDF - 237 KB - 2 pages]
J. Finsterer et al.
EID Finsterer J, Scorza FA, Scorza CA. Guillain-Barré Syndrome Associated with COVID-19 Vaccination. Emerg Infect Dis. 2022;28(5):1079-1080. https://doi.org/10.3201/eid2805.212145
AMA Finsterer J, Scorza FA, Scorza CA. Guillain-Barré Syndrome Associated with COVID-19 Vaccination. Emerging Infectious Diseases. 2022;28(5):1079-1080. doi:10.3201/eid2805.212145.
APA Finsterer, J., Scorza, F. A., & Scorza, C. A. (2022). Guillain-Barré Syndrome Associated with COVID-19 Vaccination. Emerging Infectious Diseases, 28(5), 1079-1080. https://doi.org/10.3201/eid2805.212145.

SARS-CoV-2 Cross-Reactivity in Prepandemic Serum from Rural Malaria-Infected Persons, Cambodia [PDF - 237 KB - 2 pages]
J. T. Grassia et al.
EID Grassia JT, Markwalter CF, O’Meara WP, Taylor SM, Obala AA. SARS-CoV-2 Cross-Reactivity in Prepandemic Serum from Rural Malaria-Infected Persons, Cambodia. Emerg Infect Dis. 2022;28(5):1080-1081. https://doi.org/10.3201/eid2805.220404
AMA Grassia JT, Markwalter CF, O’Meara WP, et al. SARS-CoV-2 Cross-Reactivity in Prepandemic Serum from Rural Malaria-Infected Persons, Cambodia. Emerging Infectious Diseases. 2022;28(5):1080-1081. doi:10.3201/eid2805.220404.
APA Grassia, J. T., Markwalter, C. F., O’Meara, W. P., Taylor, S. M., & Obala, A. A. (2022). SARS-CoV-2 Cross-Reactivity in Prepandemic Serum from Rural Malaria-Infected Persons, Cambodia. Emerging Infectious Diseases, 28(5), 1080-1081. https://doi.org/10.3201/eid2805.220404.

Melioidosis in Children, Brazil, 1989–2019 [PDF - 237 KB - 2 pages]
B. Behera et al.
EID Behera B, Radhakrishnan A, Mohapatra S, Mishra B. Melioidosis in Children, Brazil, 1989–2019. Emerg Infect Dis. 2022;28(5):1081-1082. https://doi.org/10.3201/eid2805.211473
AMA Behera B, Radhakrishnan A, Mohapatra S, et al. Melioidosis in Children, Brazil, 1989–2019. Emerging Infectious Diseases. 2022;28(5):1081-1082. doi:10.3201/eid2805.211473.
APA Behera, B., Radhakrishnan, A., Mohapatra, S., & Mishra, B. (2022). Melioidosis in Children, Brazil, 1989–2019. Emerging Infectious Diseases, 28(5), 1081-1082. https://doi.org/10.3201/eid2805.211473.

Melioidosis in Children, Brazil, 1989–2019 (response) [PDF - 212 KB - 1 page]
R. Lima and D. Rolim
EID Lima R, Rolim D. Melioidosis in Children, Brazil, 1989–2019 (response). Emerg Infect Dis. 2022;28(5):1081-1082. https://doi.org/10.3201/eid2805.220479
AMA Lima R, Rolim D. Melioidosis in Children, Brazil, 1989–2019 (response). Emerging Infectious Diseases. 2022;28(5):1081-1082. doi:10.3201/eid2805.220479.
APA Lima, R., & Rolim, D. (2022). Melioidosis in Children, Brazil, 1989–2019 (response). Emerging Infectious Diseases, 28(5), 1081-1082. https://doi.org/10.3201/eid2805.220479.

High-Dose Convalescent Plasma for Treatment of Severe COVID-19 [PDF - 197 KB - 1 page]
D. Focosi and A. Casadevall
EID Focosi D, Casadevall A. High-Dose Convalescent Plasma for Treatment of Severe COVID-19. Emerg Infect Dis. 2022;28(5):1083. https://doi.org/10.3201/eid2805.220191
AMA Focosi D, Casadevall A. High-Dose Convalescent Plasma for Treatment of Severe COVID-19. Emerging Infectious Diseases. 2022;28(5):1083. doi:10.3201/eid2805.220191.
APA Focosi, D., & Casadevall, A. (2022). High-Dose Convalescent Plasma for Treatment of Severe COVID-19. Emerging Infectious Diseases, 28(5), 1083. https://doi.org/10.3201/eid2805.220191.

High-Dose Convalescent Plasma for Treatment of Severe COVID-19 (response) [PDF - 206 KB - 2 pages]
G. C. De Santis and R. T. Calado
EID De Santis GC, Calado RT. High-Dose Convalescent Plasma for Treatment of Severe COVID-19 (response). Emerg Infect Dis. 2022;28(5):1083-1084. https://doi.org/10.3201/eid2805.220363
AMA De Santis GC, Calado RT. High-Dose Convalescent Plasma for Treatment of Severe COVID-19 (response). Emerging Infectious Diseases. 2022;28(5):1083-1084. doi:10.3201/eid2805.220363.
APA De Santis, G. C., & Calado, R. T. (2022). High-Dose Convalescent Plasma for Treatment of Severe COVID-19 (response). Emerging Infectious Diseases, 28(5), 1083-1084. https://doi.org/10.3201/eid2805.220363.
About the Cover

Durable Vitality and Magical Forms [PDF - 2.66 MB - 3 pages]
B. Breedlove
EID Breedlove B. Durable Vitality and Magical Forms. Emerg Infect Dis. 2022;28(5):1085-1087. https://doi.org/10.3201/eid2805.ac2805
AMA Breedlove B. Durable Vitality and Magical Forms. Emerging Infectious Diseases. 2022;28(5):1085-1087. doi:10.3201/eid2805.ac2805.
APA Breedlove, B. (2022). Durable Vitality and Magical Forms. Emerging Infectious Diseases, 28(5), 1085-1087. https://doi.org/10.3201/eid2805.ac2805.
Page created: April 19, 2022
Page updated: April 25, 2022
Page reviewed: April 25, 2022
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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