Early Release

Synopses

• Pasteurella Infections in South Korea and Systematic Review and Meta-analysis of Pasteurella Bacteremia
  S. Jeong et al.
• Campylobacteriosis Outbreak Linked to Municipal Water, Nebraska, USA, 2021
  L. Jansen et al. View Abstract

  In September 2021, eight campylobacteriosis cases were identified in a town in Nebraska, USA. We assessed potential exposures for a case–control analysis. We conducted whole-genome sequencing on Campylobacter isolates from patients’ stool specimens. We collected large-volume dead-end ultrafiltration water samples for Campylobacter and microbial source tracking testing at the Centers for Disease Control and Prevention. We identified 64 cases in 2 waves of illnesses. Untreated municipal tap water consumption was strongly associated with illness (wave 1 odds ratio 15.36; wave 2 odds ratio 16.11). Whole-genome sequencing of 12 isolates identified 2 distinct Campylobacter jejuni subtypes (1 subtype/wave). The town began water chlorination, after which water testing detected coliforms. One dead-end ultrafiltration sample yielded nonculturable Campylobacter and avian-specific fecal rRNA genomic material. Our investigation implicated contaminated, untreated, municipal water as the source. Results of microbial source tracking supported mitigation with continued water chlorination. No further campylobacteriosis cases attributable to water were reported.

Research

• Age- and Gender-Specific Differences in Lyme Disease Health-Related Behaviors, Ontario, Canada, 2015–2022
  J. A. Adams et al.
• Temporal Characterization of Prion Shedding in Secreta of White-Tailed Deer in Longitudinal Study of Chronic Wasting Disease, United States
  N. D. Denkers et al.
• One Health Investigation into Mpox and Pets, United States
  C. N. Morgan et al. View Abstract

  Monkeypox virus (MPXV) is zoonotic and capable of infecting many mammal species. However, whether common companion animals are susceptible to MPXV infection is unclear. During July 2022–March 2023, we collected animal and environmental swab samples within homes of confirmed human mpox case-patients and tested for MPXV and human DNA by PCR. We also used ELISA for orthopoxvirus antibody detection. Overall, 12% (22/191) of animal and 25% (14/56) of environmental swab samples from 4 households, including samples from 4 dogs and 1 cat, were positive for MPXV DNA, but we did not detect viable MPXV or orthopoxvirus antibodies. Among MPXV PCR-positive swab samples, 82% from animals and 93% the environment amplified human DNA with a statistically significant correlation in observed cycle threshold values. Our findings demonstrate likely DNA contamination from the human mpox cases. Despite the high likelihood for exposure, however, we found no indications that companion animals were infected with MPXV.

• Associations between Minority Health Social Vulnerability Index Scores, Rurality, and Histoplasmosis Incidence, 8 US States
  D. J. Smith et al. View Abstract

  To explore associations between histoplasmosis and race and ethnicity, socioeconomic status, and rurality, we conducted an in-depth analysis of social determinants of health and histoplasmosis in 8 US states. Using the Minority Health Social Vulnerability Index (MH SVI), we analyzed county-level histoplasmosis incidence (cases/100,000 population) from the 8 states by applying generalized linear mixed hurdle models. We found that histoplasmosis incidence was higher in counties with limited healthcare infrastructure and access as measured by the MH SVI and in more rural counties. Other social determinants of health measured by the MH SVI tool either were not significantly or were inconsistently associated with histoplasmosis incidence. Increased awareness of histoplasmosis, more accessible diagnostic tests, and investment in rural health services could address histoplasmosis-related health disparities.

• Population Structure and Antimicrobial Resistance in Campylobacter jejuni and C. coli Isolated from Humans with Diarrhea and Poultry, East Africa
  N. P. French et al.
• Rapid Increase in Seroprevalence of Borrelia burgdorferi Antibodies Among Dogs, Northwestern North Carolina, USA, 2017–2021
  P. K. Pretsch et al.
• Pathogenicity of Highly Pathogenic Avian Influenza A(H5N1) Viruses Isolated from Cats in Mice and Ferrets, South Korea, 2023
  I. Kim et al. View Abstract

  The prevalence of highly pathogenic avian influenza (HPAI) A(H5N1) viruses has increased in wild birds and poultry worldwide, and concomitant outbreaks in mammals have occurred. During 2023, outbreaks of HPAI H5N1 virus infections were reported in cats in South Korea. The H5N1 clade 2.3.4.4b viruses isolated from 2 cats harbored mutations in the polymerase basic protein 2 gene encoding single amino acid substitutions E627K or D701N, which are associated with virus adaptation in mammals. Hence, we analyzed the pathogenicity and transmission of the cat-derived H5N1 viruses in other mammals. Both isolates caused fatal infections in mice and ferrets. We observed contact infections between ferrets, confirming the viruses had high pathogenicity and transmission in mammals. Most HPAI H5N1 virus infections in humans have occurred through direct contact with poultry or a contaminated environment. Therefore, One Health surveillance of mammals, wild birds, and poultry is needed to prevent potential zoonotic threats.

• Economic Analysis of National Program for Hepatitis C Elimination, Israel, 2023
  Y. Dadon et al.
• Evidence of Lineage 1 and 3 West Nile Virus in Person with Neuroinvasive Disease, Nebraska, USA, 2023
  E. Davis et al. View Abstract

  West Nile virus (WNV) is the most common cause of human arboviral disease in the contiguous United States, where only lineage 1 (L1) WNV had been found. In 2023, an immunocompetent patient was hospitalized in Nebraska with West Nile neuroinvasive disease and multisystem organ failure. Testing at the Centers for Disease Control and Prevention indicated an unusually high viral load and acute antibody response. Upon sequencing of serum and cerebrospinal fluid, we detected lineage 3 (L3) and L1 WNV genomes. L3 WNV had previously only been found in Central Europe in mosquitoes. The identification of L3 WNV in the United States and the observed clinical and laboratory features raise questions about the potential effect of L3 WNV on the transmission dynamics and pathogenicity of WNV infections. Determining the distribution and prevalence of L3 WNV in the United States and any public health and clinical implications is critical.

• Epidemiologic Quantities for Monkeypox Virus Clade I from Historical Data with Implications for Current Outbreaks, Democratic Republic of the Congo
  V. Marziano et al. View Abstract

  We used published data from outbreak investigations of monkeypox virus clade I in the Democratic Republic of the Congo to estimate the distributions of critical epidemiological parameters. We estimated a mean incubation period of 9.9 days (95% credible interval [CrI] 8.5–11.5 days) and a mean generation time of 17.2 days (95% CrI 14.1–20.9 days) or 11.3 days (95% CrI 9.4–14.0 days), depending on the considered dataset. Presymptomatic transmission was limited. Those estimates suggest generally slower transmission dynamics in clade I than in clade IIb. The time-varying reproduction number for clade I in the Democratic Republic of the Congo was estimated to be below the epidemic threshold in the first half of 2024. However, in the South Kivu Province, where the newly identified subclade Ib has been associated with sustained human-to-human transmission, we estimated an effective reproduction number above the epidemic threshold (95% CrI 0.96–1.27).

• Early Introductions of Candida auris Detected by Wastewater Surveillance, Utah, USA, 2022–2023
  J. Chavez et al.
• Virulence of Burkholderia pseudomallei ATS2021 Unintentionally Imported to United States in Aromatherapy Spray
  C. K. Cote et al. View Abstract

  In the United States in 2021, an outbreak of 4 cases of Burkholderia pseudomallei, the etiologic agent of melioidosis and a Tier One Select Agent (potential for deliberate misuse and subsequent harm), resulted in 2 deaths. The causative strain, B. pseudomallei ATS2021, was unintentionally imported into the United States in an aromatherapy spray manufactured in India. By analyzing virulence, we established that ATS2021 represents a virulent strain of B. pseudomallei capable of robust formation of biofilm at physiologic temperatures that may contribute to virulence. By using mouse melioidosis models, we determined median lethal dose estimates and analyzed the bacteriologic and histopathologic characters of the organism, particularly the potential neurologic pathogenesis that is probably associated with the bimA_Bm allele identified in B. pseudomallei strain ATS2021. Our data, combined with previous case reports and the identification of endemic B. pseudomalleistrains in Mississippi, support the concept that melioidosis is emerging in the United States.

Dispatches

• Dengue Virus Serotype 3 Origins and Genetic Dynamics, Jamaica
  S. A. Redman et al. View Abstract

  We identified 3 clades of dengue virus serotype 3 belonging to genotype III isolated during 2019–2020 in Jamaica by using whole-genome sequencing and phylogenomic and phylogeographic analyses. The viruses likely originated from Asia in 2014. Newly expanded molecular surveillance efforts in Jamaica will guide appropriate public health responses.

• Circovirus Hepatitis in Immunocompromised Patient, Switzerland
  B. Hamelin et al. View Abstract

  We identified a novel human circovirus in an immunocompromised 66-year-old woman with sudden onset of self-limiting hepatitis. We detected human circovirus 1 (HCirV-1) transcripts in hepatocytes and the HCirV-1 genome long-term in the patient’s blood, stool, and urine. HCirV-1 is an emerging human pathogen that persists in susceptible patients.

• OXA-484-Producing Enterobacterales, France, 2018–2023
  C. Emeraud et al.
• Highly Pathogenic Avian Influenza A Virus in Wild Migratory Birds, Qinghai Lake, China, 2022
  X. Zhang et al. View Abstract

  In July 2022, an outbreak of highly pathogenic avian influenza A(H5N1) virus clade 2.3.4.4b occurred among migratory birds at Qinghai Lake in China. The virus circulated in June, and reassortants emerged after its introduction into the area. Surveillance in 2023 showed that the virus did not establish a stable presence in wild waterfowl.

• Investigation of Case of Human Francisella tularensis Infection, United Kingdom, 2023
  A. Thompson et al.
• Mpox Epidemiology and Vaccine Effectiveness, England, 2023
  H. Charles et al. View Abstract

  Reported mpox cases in England continued at a low but steady frequency during 2023. Of 137 cases reported in 2023, approximately half were acquired overseas and half were in vaccinated persons. Estimated effectiveness of 2-dose vaccine was 80%, and no vaccinated mpox patient was hospitalized.

• Presumed Transmission of 2 Distinct Monkeypox Virus Variants from Central African Republic to Democratic Republic of the Congo
  E. Vakaniaki et al. View Abstract

  We linked 4 mpox cases in South Ubangi, Democratic Republic of the Congo, to transboundary transmission from Central African Republic. Viral genome sequencing demonstrated that the monkeypox virus sequences belonged to distinct clusters of subclade Ia. This finding demonstrates the borderless nature of mpox and highlights the need for vigilant regional surveillance.

• Autochthonous Human Babesia divergens Infection, England, United Kingdom
  G. A. Zabala et al.
• Rift Valley Fever Epizootic in Rwanda, 2022
  E. Remera et al.
• Highly Pathogenic Avian Influenza A(H5N1) Virus Clade 2.3.4.4b Infections in Seals, Russia, 2023
  I. Sobolev et al. View Abstract

  Highly pathogenic avian influenza A(H5N1) virus was detected in dead seals on Tyuleniy Island in eastern Russia, in the Sea of Okhotsk. Viruses isolated from dead northern fur seals belong to clade 2.3.4.4b and are closely related to viruses detected predominantly in the Russian Far East and Japan in 2022–2023.

• Chlorine Inactivation of Elizabethkingia Species in Water
  D. A. Holcomb et al.
• Oropouche Fever, Cuba, May 2024
  A. Benitez et al. View Abstract

  Phylogenetic analyses showed that the virus responsible for a May 2024 Oropouche fever outbreak in Cuba was closely related to viruses from Brazil in 2023. Pools of Ceratopogonidae spp. biting midges and Culex quinquefasciatus mosquitoes were positive for Oropouche viral RNA. No cases were severe. Virus extension to new areas may increase case numbers and severity.

• Bluetongue Virus in the Iberian Lynx (Lynx pardinus), 2010–2022
  J. Caballero-Gómez et al.
• Clustering of Polymorphic Membrane Protein E Clade in Chlamydia trachomatis Lineages from Men who Have Sex with Men
  M. Mitobe et al.

Research Letters

• Fatal Renal Abscess Caused by Porphyromonas gingivalis and Subcapsular Hemorrhage, Japan
  Y. Atagi et al.
• Challenges from Migration of Amblyomma maculatum Ticks and Rickettsia parkeri into the Northeastern United States
  G. Molaei et al.
• SARS-CoV-2 and Other Coronaviruses in Rats, Berlin, Germany, 2023
  K. Wernike et al.
• Prosthetic Valve Endocarditis Caused by Pasteurella dagmatis
  F. A. Rottmann et al.
• Spatiotemporal Epidemiology of Oropouche Fever, Brazil, 2015–2024
  P. Martins-Filho et al. View Abstract

  We assessed the spatiotemporal dynamics of Oropouche fever in Brazil during 2015–2024. We found the number of cases substantially increased during that period, particularly in the Amazon region. Our findings underscore the need for improved surveillance and public health measures in response to the disease’s potential spread beyond endemic areas.

• Infectious Disease Physicians’ Knowledge and Practices Regarding Wastewater Surveillance, USA, 2024
  C. Adams et al.
• Correlation Between Viral Wastewater Concentration and Respiratory Tests, Oregon
  N. Lininger et al. View Abstract

  We evaluated the association between wastewater concentration and weekly percent positivity of patient testing for SARS-CoV-2, influenza, and respiratory syncytial virus in Oregon, USA. We found strong, positive correlations for SARS-CoV-2 (ρ = 0.84, p<0.001), influenza (ρ = 0.73, p<0.001) and respiratory syncytial virus (ρ = 0.69, p<0.001).

• Fort Sherman Orthobunyavirus Infection, Peru, 2020
  E. F. de Oliveira-Filho et al.
• RSV Prevalence and Risk Factors among Healthy Term Infants, United States
  F. Cacho et al.

Synopses

• Role of Department of Defense Global Emerging Infections Surveillance Program in Pandemic Preparedness and Response, United States
  K. Creppage et al.
• Serosurveillance for Plasmodium falciparum Malaria in Peruvian Army Peacekeeping Personnel, Central African Republic, 2021–2022
  J. A. Ventocilla et al.

Research

• Molecular Surveillance of Multidrug-Resistant Bacteria among Refugees from Afghanistan in 2 US Military Hospitals during Operation Allies Refuge, 2021
  C. Anderson et al.

Perspective

• Flexible Development Programs for Antibacterial Drugs to Address Unmet Medical Needs
  M. Ghosh et al.

Synopses

• Clinical and Genomic Epidemiology of Coxsackievirus A21 and Enterovirus D68 in Homeless Shelters, King County, Washington, 2019–2021
  S. N. Cox et al.
• Tuberculosis Posttreatment Mortality Rates, Georgia, USA, 2008–2019
  S. Gorvetzian et al.

Research

• Risk for Facial Palsy after COVID-19 Vaccination, South Korea, 2021–2022
  D. Yoon et al.
• Spatial-Temporal Ecologic Analysis of COVID-19 Vaccination Coverage and Outcomes, Oklahoma, USA, February 2020–December 2021
  K. Ding et al.
• Detection of Predominant Azole-Resistant Candida tropicalis Genotype in Orchards Causing Human Candidemia, Taiwan
  K. Tseng et al.

Dispatches

• Clinical and Molecular Characterization of Human Burkholderia mallei Infection, Brazil
  K. G. Luz et al.
• Emerging Monkeypox Virus Sublineage C.1 Causing Community Transmission, Vietnam, 2023
  H. T. Hoa et al.
• Fatal Oropouche Virus Infections in Nonendemic Region, Brazil, 2024
  A. Bandeira et al. View Abstract

  We report acute Oropouche virus infections in 2 previously healthy women from a nonendemic region of Brazil outside the Amazon Basin. Infections rapidly progressed to hemorrhagic manifestations and fatal outcomes in 4–5 days. These cases highlight the critical need for enhanced surveillance to clarify epidemiology of this neglected disease.

Research Letters

• Epidemiology of Streptococcus pyogenes Disease Before, During, and After COVID-19 Pandemic, Germany, 2005–2023
  I. Burckhardt and F. Burckhardt
• Outbreak of Listeriosis Associated with Baker’s Yeast Products, Switzerland, 2022–2024
  R. Stephan et al.

Letter

• Foodborne Outbreak Size Is Dependent on How the Outbreak Is Detected
  C. W. Hedberg et al.

Research

• Cost-Effectiveness Analysis of Japanese Encephalitis Vaccination for Children <15 Years of Age, Bangladesh
  A. Nguyen et al.

Dispatch

• Mycobacterium leprae in Nine-Banded Armadillos (Dasypus novemcinctus), Ecuador
  D. Romero-Alvarez et al.