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Volume 8, Number 9—September 2002

Volume 8, Number 9—September 2002   PDF Version [PDF - 12.09 MB - 138 pages]

Perspective

  • A New Name for Pneumocystis from Humans and New Perspectives on the Host-Pathogen Relationship PDF Version [PDF - 267 KB - 7 pages]
    J. R. Stringer et al.
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    The disease known as Pneumocystis carinii pneumonia (PCP) is a major cause of illness and death in persons with impaired immune systems. While the genus Pneumocystis has been known to science for nearly a century, understanding of its members remained rudimentary until DNA analysis showed its extensive diversity. Pneumocystis organisms from different host species have very different DNA sequences, indicating multiple species. In recognition of its genetic and functional distinctness, the organism that causes human PCP is now named Pneumocystis jiroveci Frenkel 1999. Changing the organism’s name does not preclude the use of the acronym PCP because it can be read “Pneumocystis pneumonia.” DNA varies in samples of P. jiroveci, a feature that allows reexamination of the relationships between host and pathogen. Instead of lifelong latency, transient colonization may be the rule.

        Cite This Article
    EID Stringer JR, Beard CB, Miller RF, Wakefield AE. A New Name for Pneumocystis from Humans and New Perspectives on the Host-Pathogen Relationship. Emerg Infect Dis. 2002;8(9):891-896. https://dx.doi.org/10.3201/eid0809.020096
    AMA Stringer JR, Beard CB, Miller RF, et al. A New Name for Pneumocystis from Humans and New Perspectives on the Host-Pathogen Relationship. Emerging Infectious Diseases. 2002;8(9):891-896. doi:10.3201/eid0809.020096.
    APA Stringer, J. R., Beard, C. B., Miller, R. F., & Wakefield, A. E. (2002). A New Name for Pneumocystis from Humans and New Perspectives on the Host-Pathogen Relationship. Emerging Infectious Diseases, 8(9), 891-896. https://dx.doi.org/10.3201/eid0809.020096.
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  • Biofilms: Microbial Life on Surfaces PDF Version [PDF - 1000 KB - 10 pages]
    R. M. Donlan
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    Microorganisms attach to surfaces and develop biofilms. Biofilm-associated cells can be differentiated from their suspended counterparts by generation of an extracellular polymeric substance (EPS) matrix, reduced growth rates, and the up- and down- regulation of specific genes. Attachment is a complex process regulated by diverse characteristics of the growth medium, substratum, and cell surface. An established biofilm structure comprises microbial cells and EPS, has a defined architecture, and provides an optimal environment for the exchange of genetic material between cells. Cells may also communicate via quorum sensing, which may in turn affect biofilm processes such as detachment. Biofilms have great importance for public health because of their role in certain infectious diseases and importance in a variety of device-related infections. A greater understanding of biofilm processes should lead to novel, effective control strategies for biofilm control and a resulting improvement in patient management.

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    EID Donlan RM. Biofilms: Microbial Life on Surfaces. Emerg Infect Dis. 2002;8(9):881-890. https://dx.doi.org/10.3201/eid0809.020063
    AMA Donlan RM. Biofilms: Microbial Life on Surfaces. Emerging Infectious Diseases. 2002;8(9):881-890. doi:10.3201/eid0809.020063.
    APA Donlan, R. M. (2002). Biofilms: Microbial Life on Surfaces. Emerging Infectious Diseases, 8(9), 881-890. https://dx.doi.org/10.3201/eid0809.020063.
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Research

  • Human Metapneumovirus as a Cause of Community-Acquired Respiratory Illness PDF Version [PDF - 228 KB - 5 pages]
    J. Stockton et al.
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    Human metapneumovirus (HMPV) is a recently identified Paramyxovirus first isolated from hospitalized children with acute respiratory tract infections (ARTI). We sought evidence of HMPV infection in patients who had visited general practitioners, had influenzalike illnesses (ILI), and had negative tests for influenza and Human respiratory syncytial virus (HRSV). As part of national virologic surveillance, sentinel general practices in England and Wales collected samples from patients of all ages with ILI during winter 2000–01. Reverse transcriptase-polymerase chain reaction (PCR) for HMPV, influenza A (H1 and H3), influenza B, and HRSV was used to screen combined nose and throat swabs. PCR products from the HMPV-positive samples were sequenced to confirm identity and construct phylogenetic trees. Of 711 swabs submitted, 408 (57.3%) were negative for influenza and HRSV; HMPV was identified in 9 (2.2%) patients. HMPV appears to be associated with community-acquired ARTI. The extent of illness and possible complications related to this new human virus need to be clarified

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    EID Stockton J, Stephenson I, Fleming D, Zambon M. Human Metapneumovirus as a Cause of Community-Acquired Respiratory Illness. Emerg Infect Dis. 2002;8(9):897-901. https://dx.doi.org/10.3201/eid0809.020084
    AMA Stockton J, Stephenson I, Fleming D, et al. Human Metapneumovirus as a Cause of Community-Acquired Respiratory Illness. Emerging Infectious Diseases. 2002;8(9):897-901. doi:10.3201/eid0809.020084.
    APA Stockton, J., Stephenson, I., Fleming, D., & Zambon, M. (2002). Human Metapneumovirus as a Cause of Community-Acquired Respiratory Illness. Emerging Infectious Diseases, 8(9), 897-901. https://dx.doi.org/10.3201/eid0809.020084.
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  • Molecular Epidemiology of Measles Viruses in the United States, 1997–2001 PDF Version [PDF - 244 KB - 7 pages]
    P. A. Rota et al.
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    From 1997 to 2001, sequence data from 55 clinical specimens were obtained from confirmed measles cases in the United States, representing 21 outbreaks and 34 sporadic cases. Sequence analysis indicated the presence of 11 of the recognized genotypes. The most common genotypes detected were genotype D6, usually identified from imported cases from Europe, and genotype D5, associated with importations from Japan. A number of viruses belonging to genotype D4 were imported from India and Pakistan. Overall, viral genotypes were determined for 13 chains of transmission with an unknown source of virus, and seven different genotypes were identified. Therefore, the diversity of Measles virus genotypes observed in the United States from 1997 to 2001 reflected multiple imported sources of virus and indicated that no strain of measles is endemic in the United States.

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    EID Rota PA, Liffick SL, Rota JS, Katz RS, Redd S, Papania M, et al. Molecular Epidemiology of Measles Viruses in the United States, 1997–2001. Emerg Infect Dis. 2002;8(9):902-908. https://dx.doi.org/10.3201/eid0809.020206
    AMA Rota PA, Liffick SL, Rota JS, et al. Molecular Epidemiology of Measles Viruses in the United States, 1997–2001. Emerging Infectious Diseases. 2002;8(9):902-908. doi:10.3201/eid0809.020206.
    APA Rota, P. A., Liffick, S. L., Rota, J. S., Katz, R. S., Redd, S., Papania, M....Bellini, W. J. (2002). Molecular Epidemiology of Measles Viruses in the United States, 1997–2001. Emerging Infectious Diseases, 8(9), 902-908. https://dx.doi.org/10.3201/eid0809.020206.
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  • Public Health Impact of Reemergence of Rabies, New York PDF Version [PDF - 251 KB - 5 pages]
    H. H. Chang et al.
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    This report summarizes the spread of a raccoon rabies epizootic into New York in the 1990s, the species of animals affected, and human postexposure treatments (PET). A total of 57,008 specimens were submitted to the state laboratory from 1993 to 1998; 8,858 (16%) animals were confirmed rabid, with raccoons the most common species (75%). After exposure to 11,769 animals, 18,238 (45%) persons received PET, mostly because of contact with saliva or nervous tissue. We analyzed expenditure reports to estimate the cost of rabies prevention activities. An estimated $13.9 million was spent in New York State to prevent rabies from 1993 to 1998. Traditional prevention methods such as vaccinating pets, avoiding wildlife, and verifying an animal’s rabies status must be continued to reduce costly PET. To reduce rabid animals, exposures, and costs, oral vaccination of wildlife should also be considered.

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    EID Chang HH, Eidson M, Noonan-Toly C, Trimarchi CV, Rudd R, Wallace BJ, et al. Public Health Impact of Reemergence of Rabies, New York. Emerg Infect Dis. 2002;8(9):909-913. https://dx.doi.org/10.3201/eid0809.010524
    AMA Chang HH, Eidson M, Noonan-Toly C, et al. Public Health Impact of Reemergence of Rabies, New York. Emerging Infectious Diseases. 2002;8(9):909-913. doi:10.3201/eid0809.010524.
    APA Chang, H. H., Eidson, M., Noonan-Toly, C., Trimarchi, C. V., Rudd, R., Wallace, B. J....Morse, D. L. (2002). Public Health Impact of Reemergence of Rabies, New York. Emerging Infectious Diseases, 8(9), 909-913. https://dx.doi.org/10.3201/eid0809.010524.
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  • Impact of El Niño/Southern Oscillation on Visceral Leishmaniasis, Brazil PDF Version [PDF - 231 KB - 4 pages]
    C. R. Franke et al.
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    We used time-series analysis and linear regression to investigate the relationship between the annual Niño-3 index from 1980 to 1998 and the annual incidence of visceral leishmaniasis (VL) in the State of Bahia, Brazil, during 1985–1999. An increase in VL incidence was observed in the post-El Niño years 1989 (+38.7%) and 1995 (+33.5%). The regression model demonstrates that the previous year’s mean Niño-3 index and the temporal trend account for approximately 50% of the variance in the annual incidence of VL in Bahia. The model shows a robust agreement with the real data, as only the influence of El Niño on the cycle of VL was analyzed. The results suggest that this relationship could be used to predict high-risk years for VL and thus help reduce health impact in susceptible regions in Brazil.

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    EID Franke CR, Ziller M, Staubach C, Latif M. Impact of El Niño/Southern Oscillation on Visceral Leishmaniasis, Brazil. Emerg Infect Dis. 2002;8(9):914-917. https://dx.doi.org/10.3201/eid0809.010523
    AMA Franke CR, Ziller M, Staubach C, et al. Impact of El Niño/Southern Oscillation on Visceral Leishmaniasis, Brazil. Emerging Infectious Diseases. 2002;8(9):914-917. doi:10.3201/eid0809.010523.
    APA Franke, C. R., Ziller, M., Staubach, C., & Latif, M. (2002). Impact of El Niño/Southern Oscillation on Visceral Leishmaniasis, Brazil. Emerging Infectious Diseases, 8(9), 914-917. https://dx.doi.org/10.3201/eid0809.010523.
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  • Characterization of Flagella Produced by Clinical Strains of Stenotrophomonas maltophilia PDF Version [PDF - 1.06 MB - 6 pages]
    D. de Oliveira-Garcia et al.
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    Stenotrophomonas maltophilia is an emerging nosocomial pathogen associated with opportunistic infections in patients with cystic fibrosis, cancer, and HIV. Adherence of this organism to abiotic surfaces such as medical implants and catheters represents a major risk for hospitalized patients. The adhesive surface factors involved in adherence of these bacteria are largely unknown, and their flagella have not yet been characterized biochemically and antigenically. We purified and characterized the flagella produced by S. maltophilia clinical strains. The flagella filaments are composed of a 38-kDa subunit, SMFliC, and analysis of its N-terminal amino acid sequence showed considerable sequence identity to the flagellins of Serratia marcescens (78.6%), Escherichia coli, Proteus mirabilis, Shigella sonnei (71.4%), and Pseudomonas aeruginosa (57.2%). Ultrastructural analysis by scanning electron microscopy of bacteria adhering to plastic showed flagellalike structures within the bacterial clusters, suggesting that flagella are produced as the bacteria spread on the abiotic surface.

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    EID de Oliveira-Garcia D, Dall'Agnol M, Rosales M, Azzuz AC, Martinez MB, Girón JA, et al. Characterization of Flagella Produced by Clinical Strains of Stenotrophomonas maltophilia. Emerg Infect Dis. 2002;8(9):918-923. https://dx.doi.org/10.3201/eid0809.010535
    AMA de Oliveira-Garcia D, Dall'Agnol M, Rosales M, et al. Characterization of Flagella Produced by Clinical Strains of Stenotrophomonas maltophilia. Emerging Infectious Diseases. 2002;8(9):918-923. doi:10.3201/eid0809.010535.
    APA de Oliveira-Garcia, D., Dall'Agnol, M., Rosales, M., Azzuz, A. C., Martinez, M. B., & Girón, J. A. (2002). Characterization of Flagella Produced by Clinical Strains of Stenotrophomonas maltophilia. Emerging Infectious Diseases, 8(9), 918-923. https://dx.doi.org/10.3201/eid0809.010535.
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  • Demographic Factors Associated with Hantavirus Infection in Bank Voles (Clethrionomys glareolus) PDF Version [PDF - 358 KB - 6 pages]
    G. E. Olsson et al.
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    The bank vole (Clethrionomys glareolus) is the natural reservoir of Puumala virus (PUUV), a species in the genus Hantavirus. PUUV is the etiologic agent of nephropathia epidemica, a mild form of hemorrhagic fever with renal syndrome. Factors that influence hantavirus transmission within host populations are not well understood. We evaluated a number of factors influencing on the association of increased PUUV infection in bank voles captured in a region in northern Sweden endemic for the virus. Logistic regression showed four factors that together correctly predicted 80% of the model outcome: age, body mass index, population phase during sampling (increase, peak, or decline/low), and gender. This analysis highlights the importance of population demography in the successful circulation of hantavirus. The chance of infection was greatest during the peak of the population cycle, implying that the likelihood of exposure to hantavirus increases with increasing population density.

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    EID Olsson GE, White N, Ahlm C, Elgh F, Verlemyr A, Juto P, et al. Demographic Factors Associated with Hantavirus Infection in Bank Voles (Clethrionomys glareolus). Emerg Infect Dis. 2002;8(9):924-929. https://dx.doi.org/10.3201/eid0809.020037
    AMA Olsson GE, White N, Ahlm C, et al. Demographic Factors Associated with Hantavirus Infection in Bank Voles (Clethrionomys glareolus). Emerging Infectious Diseases. 2002;8(9):924-929. doi:10.3201/eid0809.020037.
    APA Olsson, G. E., White, N., Ahlm, C., Elgh, F., Verlemyr, A., Juto, P....Palo, R. T. (2002). Demographic Factors Associated with Hantavirus Infection in Bank Voles (Clethrionomys glareolus). Emerging Infectious Diseases, 8(9), 924-929. https://dx.doi.org/10.3201/eid0809.020037.
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  • Behavioral, Physiologic, and Habitat Influences on the Dynamics of Puumala virus Infection in Bank Voles (Clethrionomys glareolus) PDF Version [PDF - 343 KB - 7 pages]
    S. Escutenaire et al.
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    Populations of bank voles (Clethrionomys glareolus) were monitored during a 4-year study in southern Belgium to assess the influence of agonistic behavior, reproductive status, mobility, and distribution of the rodents on the dynamics of Puumala virus (abbreviation: PUUV; genus: Hantavirus) infection. Concordance was high between data from serologic testing and results of viral RNA detection. Wounds resulting from biting or scratching were observed mainly in adult rodents. Hantavirus infection in adults was associated with wounds in the fall, i.e., at the end of the breeding season, but not in spring. In addition, sexually active animals were significantly more often wounded and positive for infection. Hantavirus infection was associated with higher mobility in juvenile and subadult males. Seroconversions observed 6 months apart also occurred more frequently in animals that had moved longer distances from their original capture point. During nonepidemic years, the distribution of infection was patchy, and positive foci were mainly located in dense ground vegetation.

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    EID Escutenaire S, Chalon P, de Jaegere F, Karelle-Bui L, Mees G, Brochier B, et al. Behavioral, Physiologic, and Habitat Influences on the Dynamics of Puumala virus Infection in Bank Voles (Clethrionomys glareolus). Emerg Infect Dis. 2002;8(9):930-936. https://dx.doi.org/10.3201/eid0809.010537
    AMA Escutenaire S, Chalon P, de Jaegere F, et al. Behavioral, Physiologic, and Habitat Influences on the Dynamics of Puumala virus Infection in Bank Voles (Clethrionomys glareolus). Emerging Infectious Diseases. 2002;8(9):930-936. doi:10.3201/eid0809.010537.
    APA Escutenaire, S., Chalon, P., de Jaegere, F., Karelle-Bui, L., Mees, G., Brochier, B....Pastoret, P. (2002). Behavioral, Physiologic, and Habitat Influences on the Dynamics of Puumala virus Infection in Bank Voles (Clethrionomys glareolus). Emerging Infectious Diseases, 8(9), 930-936. https://dx.doi.org/10.3201/eid0809.010537.
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  • A Case-Case Comparison of Campylobacter coli and Campylobacter jejuni Infection: A Tool for Generating Hypotheses PDF Version [PDF - 298 KB - 6 pages]
    I. Gillespie et al.
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    Preventing campylobacteriosis depends on a thorough understanding of its epidemiology. We used case-case analysis to compare cases of Campylobacter coli infection with cases of C. jejuni infection, to generate hypotheses for infection from standardized, population-based sentinel surveillance information in England and Wales. Persons with C. coli infection were more likely to have drunk bottled water than were those with C. jejuni infection and, in general, were more likely to have eaten pâté. Important differences in exposures were identified for these two Campylobacter species. Exposures that are a risk for infection for both comparison groups might not be identified or might be underestimated by case-case analysis. Similarly, the magnitude or direction of population risk cannot be assessed accurately. Nevertheless, our findings suggest that case-control studies should be conducted at the species level.

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    EID Gillespie I, O’Brien SJ, Frost JA, Adak GK, Phong LH, Swan AV, et al. A Case-Case Comparison of Campylobacter coli and Campylobacter jejuni Infection: A Tool for Generating Hypotheses. Emerg Infect Dis. 2002;8(9):937-942. https://dx.doi.org/10.3201/eid0809.010187
    AMA Gillespie I, O’Brien SJ, Frost JA, et al. A Case-Case Comparison of Campylobacter coli and Campylobacter jejuni Infection: A Tool for Generating Hypotheses. Emerging Infectious Diseases. 2002;8(9):937-942. doi:10.3201/eid0809.010187.
    APA Gillespie, I., O’Brien, S. J., Frost, J. A., Adak, G. K., Phong, L. H., Swan, A. V....Neal, K. R. (2002). A Case-Case Comparison of Campylobacter coli and Campylobacter jejuni Infection: A Tool for Generating Hypotheses. Emerging Infectious Diseases, 8(9), 937-942. https://dx.doi.org/10.3201/eid0809.010187.
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  • Spatial Analysis of Human Granulocytic Ehrlichiosis near Lyme, Connecticut PDF Version [PDF - 352 KB - 7 pages]
    E. K. Chaput et al.
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    Geographic information systems combined with methods of spatial analysis provide powerful new tools for understanding the epidemiology of diseases and for improving disease prevention and control. In this study, the spatial distribution of a newly recognized tick-borne disease, human granulocytic ehrlichiosis (HGE), was investigated for nonrandom patterns and clusters in an area known to be endemic for tick-borne diseases. Analysis of confirmed cases of HGE identified in 1997–2000 in a 12-town area around Lyme, Connecticut, showed that HGE infections are not distributed randomly. Smoothed HGE incidence was higher around the mouth of the Connecticut River and lower to the north and west. Cluster analysis identified one area of increased HGE risk (relative risk=1.8, p=0.001). This study demonstrates the utility of geographic information systems and spatial analysis to clarify the epidemiology of HGE.

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    EID Chaput EK, Meek JI, Heimer R. Spatial Analysis of Human Granulocytic Ehrlichiosis near Lyme, Connecticut. Emerg Infect Dis. 2002;8(9):943-948. https://dx.doi.org/10.3201/eid0809.020103
    AMA Chaput EK, Meek JI, Heimer R. Spatial Analysis of Human Granulocytic Ehrlichiosis near Lyme, Connecticut. Emerging Infectious Diseases. 2002;8(9):943-948. doi:10.3201/eid0809.020103.
    APA Chaput, E. K., Meek, J. I., & Heimer, R. (2002). Spatial Analysis of Human Granulocytic Ehrlichiosis near Lyme, Connecticut. Emerging Infectious Diseases, 8(9), 943-948. https://dx.doi.org/10.3201/eid0809.020103.
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  • Molecular Characterization of Campylobacter jejuni Clones: A Basis for Epidemiologic Investigation PDF Version [PDF - 296 KB - 7 pages]
    K. E. Dingle et al.
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    A total of 814 isolates of the foodborne pathogen Campylobacter jejuni were characterized by multilocus sequence typing (MLST) and analysis of the variation of two cell-surface components: the heat-stable (HS) serotyping antigen and the flagella protein FlaA short variable region (SVR). We identified 379 combinations of the MLST loci (sequence types) and 215 combinations of the cell-surface components among these isolates, which had been obtained from human disease, animals, food, and the environment. Despite this diversity, 748 (92%) of the isolates belonged to one of 17 clonal complexes, 6 of which contained many (318, 63%) of the human disease isolates. Several clonal complexes exhibited associations with isolation source or particular cell-surface components; however, the latter were poorly predictive of clonal complex. These data demonstrate that the clonal complex, as defined by MLST, is an epidemiologically relevant unit for both long and short-term investigations of C. jejuni epidemiology.

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    EID Dingle KE, Colles FM, Ure R, Wagenaar JA, Duim B, Bolton FJ, et al. Molecular Characterization of Campylobacter jejuni Clones: A Basis for Epidemiologic Investigation. Emerg Infect Dis. 2002;8(9):949-955. https://dx.doi.org/10.3201/eid0809.020122
    AMA Dingle KE, Colles FM, Ure R, et al. Molecular Characterization of Campylobacter jejuni Clones: A Basis for Epidemiologic Investigation. Emerging Infectious Diseases. 2002;8(9):949-955. doi:10.3201/eid0809.020122.
    APA Dingle, K. E., Colles, F. M., Ure, R., Wagenaar, J. A., Duim, B., Bolton, F. J....Maiden, M. C. (2002). Molecular Characterization of Campylobacter jejuni Clones: A Basis for Epidemiologic Investigation. Emerging Infectious Diseases, 8(9), 949-955. https://dx.doi.org/10.3201/eid0809.020122.
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  • The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden PDF Version [PDF - 1000 KB - 5 pages]
    H. Eliasson et al.
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    A widespread outbreak of tularemia in Sweden in 2000 was investigated in a case-control study in which 270 reported cases of tularemia were compared with 438 controls. The outbreak affected parts of Sweden where tularemia had hitherto been rare, and these “emergent” areas were compared with the disease-endemic areas. Multivariate regression analysis showed mosquito bites to be the main risk factor, with an odds ratio (OR) of 8.8. Other risk factors were owning a cat (OR 2.5) and farm work (OR 3.2). Farming was a risk factor only in the disease-endemic area. Swollen lymph nodes and wound infections were more common in the emergent area, while pneumonia was more common in the disease-endemic area. Mosquito bites appear to be important in transmission of tularemia. The association between cat ownership and disease merits further investigation.

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    EID Eliasson H, Lindbäck J, Nuorti JP, Arneborn M, Giesecke J, Tegnell A, et al. The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden. Emerg Infect Dis. 2002;8(9):956-960. https://dx.doi.org/10.3201/eid0809.020051
    AMA Eliasson H, Lindbäck J, Nuorti JP, et al. The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden. Emerging Infectious Diseases. 2002;8(9):956-960. doi:10.3201/eid0809.020051.
    APA Eliasson, H., Lindbäck, J., Nuorti, J. P., Arneborn, M., Giesecke, J., & Tegnell, A. (2002). The 2000 Tularemia Outbreak: A Case-Control Study of Risk Factors in Disease-Endemic and Emergent Areas, Sweden. Emerging Infectious Diseases, 8(9), 956-960. https://dx.doi.org/10.3201/eid0809.020051.
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  • First Characterization of a Cluster of VanA-Type Glycopeptide-Resistant Enterococcus faecium, Colombia PDF Version [PDF - 354 KB - 5 pages]
    D. Panesso et al.
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    From August 1998 to October 1999, glycopeptide-resistant enterococci (GRE) were isolated from 23 infected patients at a teaching hospital in Medellín, Colombia. Identification at the species level and by multiplex polymerase chain reaction assay indicated that all isolates were Enterococcus faecium. The isolates were highly resistant to ampicillin, ciprofloxacin, gentamicin, penicillin, streptomycin, teicoplanin, and vancomycin; they were susceptible only to chloramphenicol, linezolid, and nitrofurantoin. Determination of glycopeptide genotype indicated the presence of the vanA gene in all isolates. Molecular typing by pulsed field gel electrophoresis showed that all isolates were closely related. This study is the first molecular characterization of GRE in Colombia.

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    EID Panesso D, Ospina S, Robledo J, Vela MC, Peña J, Hernández O, et al. First Characterization of a Cluster of VanA-Type Glycopeptide-Resistant Enterococcus faecium, Colombia. Emerg Infect Dis. 2002;8(9):961-965. https://dx.doi.org/10.3201/eid0809.010435
    AMA Panesso D, Ospina S, Robledo J, et al. First Characterization of a Cluster of VanA-Type Glycopeptide-Resistant Enterococcus faecium, Colombia. Emerging Infectious Diseases. 2002;8(9):961-965. doi:10.3201/eid0809.010435.
    APA Panesso, D., Ospina, S., Robledo, J., Vela, M. C., Peña, J., Hernández, O....Arias, C. A. (2002). First Characterization of a Cluster of VanA-Type Glycopeptide-Resistant Enterococcus faecium, Colombia. Emerging Infectious Diseases, 8(9), 961-965. https://dx.doi.org/10.3201/eid0809.010435.
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  • Community-Acquired Methicillin-Resistant Staphylococcus aureus in Institutionalized Adults with Developmental Disabilities PDF Version [PDF - 334 KB - 5 pages]
    A. Borer et al.
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    Methicillin-resistant Staphylococcus aureus (MRSA) has recently been reported to emerge in the community setting. We describe the investigation and control of a community-acquired outbreak of MRSA skin infections in a closed community of institutionalized adults with developmental disabilities. In a 9-month period in 1997, 20 (71%) of 28 residents had 73 infectious episodes. Of the cultures, 60% and 32% obtained from residents and personnel, respectively, grew S. aureus; 96% and 27% were MRSA. All isolates were genetically related by pulsed-field gel electrophoresis and belonged to a phage type not previously described in the region. No known risk factors for MRSA acquisition were found. However, 58 antibiotic courses had been administered to 16 residents during the preceding 9 months. Infection control measures, antibiotic restriction, and appropriate therapy resulted in successful termination of this outbreak. Selective antibiotic pressure may result in the emergence, persistence, and dissemination of MRSA strains, causing prolonged disease.

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    EID Borer A, Gilad J, Yagupsky P, Peled N, Porat N, Trefler R, et al. Community-Acquired Methicillin-Resistant Staphylococcus aureus in Institutionalized Adults with Developmental Disabilities. Emerg Infect Dis. 2002;8(9):966-970. https://dx.doi.org/10.3201/eid0809.020300
    AMA Borer A, Gilad J, Yagupsky P, et al. Community-Acquired Methicillin-Resistant Staphylococcus aureus in Institutionalized Adults with Developmental Disabilities. Emerging Infectious Diseases. 2002;8(9):966-970. doi:10.3201/eid0809.020300.
    APA Borer, A., Gilad, J., Yagupsky, P., Peled, N., Porat, N., Trefler, R....Schlaeffer, F. (2002). Community-Acquired Methicillin-Resistant Staphylococcus aureus in Institutionalized Adults with Developmental Disabilities. Emerging Infectious Diseases, 8(9), 966-970. https://dx.doi.org/10.3201/eid0809.020300.
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Historical Review

  • Biological Warfare at the 1346 Siege of Caffa PDF Version [PDF - 487 KB - 5 pages]
    M. Wheelis
        View Abstract

    On the basis of a 14th-century account by the Genoese Gabriele de’ Mussi, the Black Death is widely believed to have reached Europe from the Crimea as the result of a biological warfare attack. This is not only of great historical interest but also relevant to current efforts to evaluate the threat of military or terrorist use of biological weapons. Based on published translations of the de’ Mussi manuscript, other 14th-century accounts of the Black Death, and secondary scholarly literature, I conclude that the claim that biological warfare was used at Caffa is plausible and provides the best explanation of the entry of plague into the city. This theory is consistent with the technology of the times and with contemporary notions of disease causation; however, the entry of plague into Europe from the Crimea likely occurred independent of this event.

        Cite This Article
    EID Wheelis M. Biological Warfare at the 1346 Siege of Caffa. Emerg Infect Dis. 2002;8(9):971-975. https://dx.doi.org/10.3201/eid0809.010536
    AMA Wheelis M. Biological Warfare at the 1346 Siege of Caffa. Emerging Infectious Diseases. 2002;8(9):971-975. doi:10.3201/eid0809.010536.
    APA Wheelis, M. (2002). Biological Warfare at the 1346 Siege of Caffa. Emerging Infectious Diseases, 8(9), 971-975. https://dx.doi.org/10.3201/eid0809.010536.
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Dispatches

  • Respiratory Tract Reinfections by the New Human Metapneumovirus in an Immunocompromised Child PDF Version [PDF - 238 KB - 3 pages]
    G. Pelletier et al.
        View Abstract

    The human Metapneumovirus (HMPV), a new member of the Paramyxoviridae family, has been recently associated with respiratory tract infections in young children. We report the case of a young, immunocompromised child who had severe lower respiratory tract infections during two consecutive winter seasons caused by genetically distinct HMPV strains.

        Cite This Article
    EID Pelletier G, Déry P, Abed Y, Boivin G. Respiratory Tract Reinfections by the New Human Metapneumovirus in an Immunocompromised Child. Emerg Infect Dis. 2002;8(9):976-978. https://dx.doi.org/10.3201/eid0809.020238
    AMA Pelletier G, Déry P, Abed Y, et al. Respiratory Tract Reinfections by the New Human Metapneumovirus in an Immunocompromised Child. Emerging Infectious Diseases. 2002;8(9):976-978. doi:10.3201/eid0809.020238.
    APA Pelletier, G., Déry, P., Abed, Y., & Boivin, G. (2002). Respiratory Tract Reinfections by the New Human Metapneumovirus in an Immunocompromised Child. Emerging Infectious Diseases, 8(9), 976-978. https://dx.doi.org/10.3201/eid0809.020238.
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  • Detection by Enzyme-Linked Immunosorbent Assay of Antibodies to West Nile virus in Birds PDF Version [PDF - 434 KB - 4 pages]
    G. D. Ebel et al.
        View Abstract

    We adapted an indirect immunoglobulin G enzyme-linked immunosorbent assay to facilitate studies of West Nile virus (WNV) and evaluated its application to taxonomically diverse avian species. Anti-WNV antibodies were detected in 23 bird species, including many exotic species, demonstrating its value in studies of WNV epizootiology.

        Cite This Article
    EID Ebel GD, Dupuis AP, Nicholas D, Young D, Maffei J, Kramer LD, et al. Detection by Enzyme-Linked Immunosorbent Assay of Antibodies to West Nile virus in Birds. Emerg Infect Dis. 2002;8(9):979-982. https://dx.doi.org/10.3201/eid0809.020152
    AMA Ebel GD, Dupuis AP, Nicholas D, et al. Detection by Enzyme-Linked Immunosorbent Assay of Antibodies to West Nile virus in Birds. Emerging Infectious Diseases. 2002;8(9):979-982. doi:10.3201/eid0809.020152.
    APA Ebel, G. D., Dupuis, A. P., Nicholas, D., Young, D., Maffei, J., & Kramer, L. D. (2002). Detection by Enzyme-Linked Immunosorbent Assay of Antibodies to West Nile virus in Birds. Emerging Infectious Diseases, 8(9), 979-982. https://dx.doi.org/10.3201/eid0809.020152.
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  • First Detection of Spotted Fever Group Rickettsiae in Ixodes ricinus from Italy PDF Version [PDF - 309 KB - 4 pages]
    T. Beninati et al.
        View Abstract

    Ixodes ricinus from Italy were examined for the first time to detect whether rickettsiae were present. Using molecular methods, we detected three different spotted fever group rickettsiae, including Rickettsia helvetica. Our results raise the possibility that bacteria other than R. conorii are involved in rickettsial diseases in Italy.

        Cite This Article
    EID Beninati T, Lo N, Noda H, Esposito F, Rizzoli A, Favia G, et al. First Detection of Spotted Fever Group Rickettsiae in Ixodes ricinus from Italy. Emerg Infect Dis. 2002;8(9):983-986. https://dx.doi.org/10.3201/eid0809.020060
    AMA Beninati T, Lo N, Noda H, et al. First Detection of Spotted Fever Group Rickettsiae in Ixodes ricinus from Italy. Emerging Infectious Diseases. 2002;8(9):983-986. doi:10.3201/eid0809.020060.
    APA Beninati, T., Lo, N., Noda, H., Esposito, F., Rizzoli, A., Favia, G....Genchi, C. (2002). First Detection of Spotted Fever Group Rickettsiae in Ixodes ricinus from Italy. Emerging Infectious Diseases, 8(9), 983-986. https://dx.doi.org/10.3201/eid0809.020060.
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  • Antibodies to Nipah-Like Virus in Bats (Pteropus lylei), Cambodia PDF Version [PDF - 216 KB - 2 pages]
    J. G. Olson et al.
        View Abstract

    Serum specimens from fruit bats were obtained at restaurants in Cambodia. We detected antibodies cross-reactive to Nipah virus by enzyme immunoassay in 11 (11.5%) of 96 Lyle’s flying foxes (Pteropus lylei). Our study suggests that viruses closely related to Nipah or Hendra viruses are more widespread in Southeast Asia than previously documented.

        Cite This Article
    EID Olson JG, Rupprecht CE, Rollin PE, An US, Niezgoda M, Clemins T, et al. Antibodies to Nipah-Like Virus in Bats (Pteropus lylei), Cambodia. Emerg Infect Dis. 2002;8(9):987-988. https://dx.doi.org/10.3201/eid0809.010515
    AMA Olson JG, Rupprecht CE, Rollin PE, et al. Antibodies to Nipah-Like Virus in Bats (Pteropus lylei), Cambodia. Emerging Infectious Diseases. 2002;8(9):987-988. doi:10.3201/eid0809.010515.
    APA Olson, J. G., Rupprecht, C. E., Rollin, P. E., An, U. S., Niezgoda, M., Clemins, T....Ksiazek, T. G. (2002). Antibodies to Nipah-Like Virus in Bats (Pteropus lylei), Cambodia. Emerging Infectious Diseases, 8(9), 987-988. https://dx.doi.org/10.3201/eid0809.010515.
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  • Cerebral Aspergillosis Caused by Neosartorya hiratsukae, Brazil PDF Version [PDF - 569 KB - 3 pages]
    J. Guarro et al.
        View Abstract

    We report the first case of infection by Neosartorya hiratsukae, an ascomycete in which the conidial state resembles Aspergillus fumigatus. The fungus caused a brain infection in a Brazilian woman, who died despite itraconazole treatment. Diagnosis was established by direct microscopic examination, computed tomographic scan, and magnetic resonance imaging of the brain, and repeated cultures from the lesions. The in vitro antifungal susceptibility of the isolate is provided.

        Cite This Article
    EID Guarro J, Kallas EG, Godoy P, Karenina A, Gené J, Stchigel A, et al. Cerebral Aspergillosis Caused by Neosartorya hiratsukae, Brazil. Emerg Infect Dis. 2002;8(9):989-991. https://dx.doi.org/10.3201/eid0809.020073
    AMA Guarro J, Kallas EG, Godoy P, et al. Cerebral Aspergillosis Caused by Neosartorya hiratsukae, Brazil. Emerging Infectious Diseases. 2002;8(9):989-991. doi:10.3201/eid0809.020073.
    APA Guarro, J., Kallas, E. G., Godoy, P., Karenina, A., Gené, J., Stchigel, A....Colombo, A. (2002). Cerebral Aspergillosis Caused by Neosartorya hiratsukae, Brazil. Emerging Infectious Diseases, 8(9), 989-991. https://dx.doi.org/10.3201/eid0809.020073.
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  • Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad PDF Version [PDF - 438 KB - 3 pages]
    P. C. Döller et al.
        View Abstract

    This outbreak is the first foodborne cyclosporiasis outbreak reported from central Europe. The illness was reported in 34 persons who attended luncheons at a German restaurant. The overall attack rate was 85% (34/40). The only foods associated with significant disease risk were two salad side dishes prepared from lettuce imported from southern Europe and spiced with fresh green leafy herbs (p=0.0025).

        Cite This Article
    EID Döller PC, Dietrich K, Filipp N, Brockmann S, Dreweck C, Vonthein R, et al. Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad. Emerg Infect Dis. 2002;8(9):992-994. https://dx.doi.org/10.3201/eid0809.010517
    AMA Döller PC, Dietrich K, Filipp N, et al. Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad. Emerging Infectious Diseases. 2002;8(9):992-994. doi:10.3201/eid0809.010517.
    APA Döller, P. C., Dietrich, K., Filipp, N., Brockmann, S., Dreweck, C., Vonthein, R....Wiedenmann, A. (2002). Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad. Emerging Infectious Diseases, 8(9), 992-994. https://dx.doi.org/10.3201/eid0809.010517.
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  • Seroepidemiology of Human Enterovirus 71, Singapore PDF Version [PDF - 710 KB - 3 pages]
    E. Ooi et al.
        View Abstract

    Human enterovirus 71 has caused outbreaks in many parts of the world, especially Southeast Asia, with some fatal cases. The epidemiology of this viral infection is not well understood. We conducted a serologic survey in Singapore children, and the results indicate that infection occurs largely in preschool settings.

        Cite This Article
    EID Ooi E, Phoon M, Ishak B, Chan S. Seroepidemiology of Human Enterovirus 71, Singapore. Emerg Infect Dis. 2002;8(9):995-997. https://dx.doi.org/10.3201/eid0809.010397
    AMA Ooi E, Phoon M, Ishak B, et al. Seroepidemiology of Human Enterovirus 71, Singapore. Emerging Infectious Diseases. 2002;8(9):995-997. doi:10.3201/eid0809.010397.
    APA Ooi, E., Phoon, M., Ishak, B., & Chan, S. (2002). Seroepidemiology of Human Enterovirus 71, Singapore. Emerging Infectious Diseases, 8(9), 995-997. https://dx.doi.org/10.3201/eid0809.010397.
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Another Dimension

  • Madness PDF Version [PDF - 1017 KB - 1 page]
    G. N. Callahan
            Cite This Article
    EID Callahan GN. Madness. Emerg Infect Dis. 2002;8(9):998-1002. https://dx.doi.org/10.3201/eid0809.AD0809
    AMA Callahan GN. Madness. Emerging Infectious Diseases. 2002;8(9):998-1002. doi:10.3201/eid0809.AD0809.
    APA Callahan, G. N. (2002). Madness. Emerging Infectious Diseases, 8(9), 998-1002. https://dx.doi.org/10.3201/eid0809.AD0809.
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Letters

  • Lethal Leptospiral Pulmonary Hemorrhage: An Emerging Disease in Buenos Aires, Argentina PDF Version [PDF - 166 KB - 2 pages]
    A. Seijo et al.
            Cite This Article
    EID Seijo A, Coto H, San Juan J, Videla J, Deodato B, Cernigoi B, et al. Lethal Leptospiral Pulmonary Hemorrhage: An Emerging Disease in Buenos Aires, Argentina. Emerg Infect Dis. 2002;8(9):1004-1005. https://dx.doi.org/10.3201/eid0809.010499
    AMA Seijo A, Coto H, San Juan J, et al. Lethal Leptospiral Pulmonary Hemorrhage: An Emerging Disease in Buenos Aires, Argentina. Emerging Infectious Diseases. 2002;8(9):1004-1005. doi:10.3201/eid0809.010499.
    APA Seijo, A., Coto, H., San Juan, J., Videla, J., Deodato, B., Cernigoi, B....Parma, A. (2002). Lethal Leptospiral Pulmonary Hemorrhage: An Emerging Disease in Buenos Aires, Argentina. Emerging Infectious Diseases, 8(9), 1004-1005. https://dx.doi.org/10.3201/eid0809.010499.
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  • First Documentation of Human Crimean-Congo Hemorrhagic Fever, Kenya PDF Version [PDF - 167 KB - 2 pages]
    L. Dunster et al.
            Cite This Article
    EID Dunster L, Dunster M, Ofula V, Beti D, Kazooba-Voskamp F, Burt F, et al. First Documentation of Human Crimean-Congo Hemorrhagic Fever, Kenya. Emerg Infect Dis. 2002;8(9):1005-1006. https://dx.doi.org/10.3201/eid0809.010510
    AMA Dunster L, Dunster M, Ofula V, et al. First Documentation of Human Crimean-Congo Hemorrhagic Fever, Kenya. Emerging Infectious Diseases. 2002;8(9):1005-1006. doi:10.3201/eid0809.010510.
    APA Dunster, L., Dunster, M., Ofula, V., Beti, D., Kazooba-Voskamp, F., Burt, F....DeCock, K. M. (2002). First Documentation of Human Crimean-Congo Hemorrhagic Fever, Kenya. Emerging Infectious Diseases, 8(9), 1005-1006. https://dx.doi.org/10.3201/eid0809.010510.
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  • Preparing at the Local Level for Events Involving Weapons of Mass Destruction PDF Version [PDF - 167 KB - 2 pages]
    M. L. Hoard et al.
            Cite This Article
    EID Hoard ML, Williams JM, Helmkamp JC, Furbee PM, Manley WG, Russell FK, et al. Preparing at the Local Level for Events Involving Weapons of Mass Destruction. Emerg Infect Dis. 2002;8(9):1006-1007. https://dx.doi.org/10.3201/eid0809.010520
    AMA Hoard ML, Williams JM, Helmkamp JC, et al. Preparing at the Local Level for Events Involving Weapons of Mass Destruction. Emerging Infectious Diseases. 2002;8(9):1006-1007. doi:10.3201/eid0809.010520.
    APA Hoard, M. L., Williams, J. M., Helmkamp, J. C., Furbee, P. M., Manley, W. G., & Russell, F. K. (2002). Preparing at the Local Level for Events Involving Weapons of Mass Destruction. Emerging Infectious Diseases, 8(9), 1006-1007. https://dx.doi.org/10.3201/eid0809.010520.
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About the Cover

Conference Summaries

  • Fifth Annual Conference on New and Re-Emerging Infectious Diseases PDF Version [PDF - 202 KB - 1 page]
    R. Docampo
        View Abstract

    The fifth annual Conference on New and Re-Emerging Infectious Diseases was hosted on April 18–19, 2002, by the College of Veterinary Medicine, University of Illinois at Urbana-Champaign (UIUC). The conference featured 8 speakers and 35 poster presentations.

        Cite This Article
    EID Docampo R. Fifth Annual Conference on New and Re-Emerging Infectious Diseases. Emerg Infect Dis. 2002;8(9):1008. https://dx.doi.org/10.3201/eid0809.020279
    AMA Docampo R. Fifth Annual Conference on New and Re-Emerging Infectious Diseases. Emerging Infectious Diseases. 2002;8(9):1008. doi:10.3201/eid0809.020279.
    APA Docampo, R. (2002). Fifth Annual Conference on New and Re-Emerging Infectious Diseases. Emerging Infectious Diseases, 8(9), 1008. https://dx.doi.org/10.3201/eid0809.020279.
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  • Global Infectious Disease Policy PDF Version [PDF - 111 KB - 1 page]
    E. D. Mintz
            Cite This Article
    EID Mintz ED. Global Infectious Disease Policy. Emerg Infect Dis. 2002;8(9):1008. https://dx.doi.org/10.3201/eid0809.020314
    AMA Mintz ED. Global Infectious Disease Policy. Emerging Infectious Diseases. 2002;8(9):1008. doi:10.3201/eid0809.020314.
    APA Mintz, E. D. (2002). Global Infectious Disease Policy. Emerging Infectious Diseases, 8(9), 1008. https://dx.doi.org/10.3201/eid0809.020314.
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