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Issue Cover for Volume 9, Number 10—October 2003

Volume 9, Number 10—October 2003

[PDF - 7.42 MB - 171 pages]

Perspective

Syndromic Surveillance and Bioterrorism-related Epidemics [PDF - 318 KB - 8 pages]
J. W. Buehler et al.

To facilitate rapid detection of a future bioterrorist attack, an increasing number of public health departments are investing in new surveillance systems that target the early manifestations of bioterrorism-related disease. Whether this approach is likely to detect an epidemic sooner than reporting by alert clinicians remains unknown. The detection of a bioterrorism-related epidemic will depend on population characteristics, availability and use of health services, the nature of an attack, epidemiologic features of individual diseases, surveillance methods, and the capacity of health departments to respond to alerts. Predicting how these factors will combine in a bioterrorism attack may be impossible. Nevertheless, understanding their likely effect on epidemic detection should help define the usefulness of syndromic surveillance and identify approaches to increasing the likelihood that clinicians recognize and report an epidemic.

EID Buehler JW, Berkelman RL, Hartley DM, Peters CJ. Syndromic Surveillance and Bioterrorism-related Epidemics. Emerg Infect Dis. 2003;9(10):1197-1204. https://dx.doi.org/10.3201/eid0910.030231
AMA Buehler JW, Berkelman RL, Hartley DM, et al. Syndromic Surveillance and Bioterrorism-related Epidemics. Emerging Infectious Diseases. 2003;9(10):1197-1204. doi:10.3201/eid0910.030231.
APA Buehler, J. W., Berkelman, R. L., Hartley, D. M., & Peters, C. J. (2003). Syndromic Surveillance and Bioterrorism-related Epidemics. Emerging Infectious Diseases, 9(10), 1197-1204. https://dx.doi.org/10.3201/eid0910.030231.
Research

Illness in Intensive Care Staff after Brief Exposure to Severe Acute Respiratory Syndrome [PDF - 240 KB - 6 pages]
D. C. Scales et al.
EID Scales DC, Green K, Chan AK, Poutanen SM, Foster D, Nowak K, et al. Illness in Intensive Care Staff after Brief Exposure to Severe Acute Respiratory Syndrome. Emerg Infect Dis. 2003;9(10):1205-1210. https://dx.doi.org/10.3201/eid0910.030525
AMA Scales DC, Green K, Chan AK, et al. Illness in Intensive Care Staff after Brief Exposure to Severe Acute Respiratory Syndrome. Emerging Infectious Diseases. 2003;9(10):1205-1210. doi:10.3201/eid0910.030525.
APA Scales, D. C., Green, K., Chan, A. K., Poutanen, S. M., Foster, D., Nowak, K....Stewart, T. E. (2003). Illness in Intensive Care Staff after Brief Exposure to Severe Acute Respiratory Syndrome. Emerging Infectious Diseases, 9(10), 1205-1210. https://dx.doi.org/10.3201/eid0910.030525.

Superantigens and Streptococcal Toxic Shock Syndrome [PDF - 352 KB - 8 pages]
T. Proft et al.

Superantigens produced by Streptococcus pyogenes have been implicated with streptococcal toxic shock syndrome (STSS). We analyzed 19 acute-phase serum samples for mitogenic activity from patients with severe streptococcal disease. The serum samples from two patients in the acute phase of STSS showed strong proliferative activity. Streptococcal mitogenic exotoxin (SME) Z-1 and streptococcal pyrogenic exotoxin (SPE)-J were identified in one patient with peritonitis who recovered after 2 weeks in intensive care. SMEZ-16 was found in a second patient who died on the day of admission. Sequential serum samples taken on day 3 after admission from patient 1 showed clearance of mitogenic activity but absence of neutralizing anti-SMEZ antibodies. Serum samples taken on day 9 from this patient showed evidence of seroconversion with high levels of anti-SMEZ antibodies that neutralized SMEZ-1 and 12 other SMEZ-variants. These results imply that a high level of SMEZ production by group A streptococcus is a causative event in the onset and subsequent severity of STSS.

EID Proft T, Sriskandan S, Yang L, Fraser JD. Superantigens and Streptococcal Toxic Shock Syndrome. Emerg Infect Dis. 2003;9(10):1211-1218. https://dx.doi.org/10.3201/eid0910.030042
AMA Proft T, Sriskandan S, Yang L, et al. Superantigens and Streptococcal Toxic Shock Syndrome. Emerging Infectious Diseases. 2003;9(10):1211-1218. doi:10.3201/eid0910.030042.
APA Proft, T., Sriskandan, S., Yang, L., & Fraser, J. D. (2003). Superantigens and Streptococcal Toxic Shock Syndrome. Emerging Infectious Diseases, 9(10), 1211-1218. https://dx.doi.org/10.3201/eid0910.030042.

Hazards of Healthy Living: Bottled Water and Salad Vegetables as Risk Factors for Campylobacter Infection [PDF - 350 KB - 7 pages]
M. R. Evans et al.

Campylobacter is the most common cause of bacterial gastroenteritis worldwide, yet the etiology of this infection remains only partly explained. In a retrospective cohort study, we compared 213 sporadic campylobacter case-patients with 1,144 patients with negative fecal samples. Information was obtained on food history, animal contact, foreign travel, leisure activities, medical conditions, and medication use. Eating chicken, eating food from a fried chicken outlet, eating salad vegetables, drinking bottled water, and direct contact with cows or calves were all independently associated with infection. The population-attributable fractions for these risk factors explained nearly 70% of sporadic campylobacter infections. Eating chicken is a well-established risk factor, but consuming salad and bottled water are not. The association with salad may be explained by cross-contamination of food within the home, but the possibility that natural mineral water is a risk factor for campylobacter infection could have wide public health implications.

EID Evans MR, Ribeiro CD, Salmon RL. Hazards of Healthy Living: Bottled Water and Salad Vegetables as Risk Factors for Campylobacter Infection. Emerg Infect Dis. 2003;9(10):1219-1225. https://dx.doi.org/10.3201/eid0910.020823
AMA Evans MR, Ribeiro CD, Salmon RL. Hazards of Healthy Living: Bottled Water and Salad Vegetables as Risk Factors for Campylobacter Infection. Emerging Infectious Diseases. 2003;9(10):1219-1225. doi:10.3201/eid0910.020823.
APA Evans, M. R., Ribeiro, C. D., & Salmon, R. L. (2003). Hazards of Healthy Living: Bottled Water and Salad Vegetables as Risk Factors for Campylobacter Infection. Emerging Infectious Diseases, 9(10), 1219-1225. https://dx.doi.org/10.3201/eid0910.020823.

Escherichia coli O157 Exposure in Wyoming and Seattle: Serologic Evidence of Rural Risk [PDF - 251 KB - 5 pages]
J. P. Haack et al.

We tested the hypothesis that rural populations have increased exposure to Escherichia coli O157:H7. We measured circulating antibodies against the O157 lipopolysaccharide in rural Wyoming residents and in blood donors from Casper, Wyoming, and Seattle, Washington, by enzyme immunoassay (EIA). EIA readings were compared by analysis of variance and the least squares difference multiple comparison procedure. Rural Wyoming residents had higher antibody levels to O157 LPS than did Casper donors, who, in turn, had higher levels than did Seattle donors (respective least squares means: 0.356, 0.328, and 0.310; p<0.05, Seattle vs. Casper, p<0.001, rural Wyoming vs. either city). Lower age was significantly correlated with EIA scores; gender; and, in rural Wyoming, history of bloody diarrhea, town, duration of residence, and use of nontreated water at home were not significantly correlated. These data suggest that rural populations are more exposed to E. coli O157:H7 than urban populations.

EID Haack JP, Jelacic S, Besser TE, Weinberger E, Kirk DJ, McKee GL, et al. Escherichia coli O157 Exposure in Wyoming and Seattle: Serologic Evidence of Rural Risk. Emerg Infect Dis. 2003;9(10):1227-1231. https://dx.doi.org/10.3201/eid0910.020254
AMA Haack JP, Jelacic S, Besser TE, et al. Escherichia coli O157 Exposure in Wyoming and Seattle: Serologic Evidence of Rural Risk. Emerging Infectious Diseases. 2003;9(10):1227-1231. doi:10.3201/eid0910.020254.
APA Haack, J. P., Jelacic, S., Besser, T. E., Weinberger, E., Kirk, D. J., McKee, G. L....Tarr, P. I. (2003). Escherichia coli O157 Exposure in Wyoming and Seattle: Serologic Evidence of Rural Risk. Emerging Infectious Diseases, 9(10), 1227-1231. https://dx.doi.org/10.3201/eid0910.020254.

Characterization of Waterborne Outbreak–associated Campylobacter jejuni, Walkerton, Ontario [PDF - 426 KB - 10 pages]
C. G. Clark et al.

The Walkerton, Canada, waterborne outbreak of 2000 resulted from entry of Escherichia coli O157:H7 and Campylobacter spp. from neighboring farms into the town water supply. Isolates of Campylobacter jejuni and Campylobacter coli obtained from outbreak investigations were characterized by phenotypic and genotypic methods, including heat-stable and heat-labile serotyping, phage typing, biotyping, fla–restriction fragment length polymorphism (RFLP) typing, and pulsed-field gel electrophoresis. Two main outbreak strains were identified on the basis of heat-stable serotyping and fla-RFLP typing. These strains produced a limited number of types when tested by other methods. Isolates with types indistinguishable from, or similar to, the outbreak types were found only on one farm near the town of Walkerton, whereas cattle from other farms carried a variety of Campylobacter strains with different type characteristics. Results of these analyses confirmed results from epidemiologic studies and the utility of using several different typing and subtyping methods for completely characterizing bacterial populations.

EID Clark CG, Price L, Ahmed R, Woodward DL, Melito PL, Rodgers FG, et al. Characterization of Waterborne Outbreak–associated Campylobacter jejuni, Walkerton, Ontario. Emerg Infect Dis. 2003;9(10):1232-1241. https://dx.doi.org/10.3201/eid0910.020584
AMA Clark CG, Price L, Ahmed R, et al. Characterization of Waterborne Outbreak–associated Campylobacter jejuni, Walkerton, Ontario. Emerging Infectious Diseases. 2003;9(10):1232-1241. doi:10.3201/eid0910.020584.
APA Clark, C. G., Price, L., Ahmed, R., Woodward, D. L., Melito, P. L., Rodgers, F. G....Ellis, A. (2003). Characterization of Waterborne Outbreak–associated Campylobacter jejuni, Walkerton, Ontario. Emerging Infectious Diseases, 9(10), 1232-1241. https://dx.doi.org/10.3201/eid0910.020584.

Cultural Contexts of Ebola in Northern Uganda [PDF - 186 KB - 7 pages]
B. S. Hewlett and R. P. Amola

Technical guidelines for the control of Ebola hemorrhagic fever (EHF) indicate that understanding local views and responses to an outbreak is essential. However, few studies with such information exist. Thus, we used qualitative and quantitative methods to determine how local residents of Gulu, Uganda, viewed and responded to the 2000–2001 outbreak of EHF. Results indicated that Acholi people used at least three explanatory models to explain and respond to the outbreak; indigenous epidemic control measures were often implemented and consistent with those being promoted by healthcare workers; and some cultural practices amplified the outbreak (e.g., burial practices). However, most persons were willing to modify and work with national and international healthcare workers.

EID Hewlett BS, Amola RP. Cultural Contexts of Ebola in Northern Uganda. Emerg Infect Dis. 2003;9(10):1242-1248. https://dx.doi.org/10.3201/eid0910.020493
AMA Hewlett BS, Amola RP. Cultural Contexts of Ebola in Northern Uganda. Emerging Infectious Diseases. 2003;9(10):1242-1248. doi:10.3201/eid0910.020493.
APA Hewlett, B. S., & Amola, R. P. (2003). Cultural Contexts of Ebola in Northern Uganda. Emerging Infectious Diseases, 9(10), 1242-1248. https://dx.doi.org/10.3201/eid0910.020493.

1918 Influenza Pandemic and Highly Conserved Viruses with Two Receptor-Binding Variants [PDF - 263 KB - 5 pages]
A. H. Reid et al.

The “Spanish influenza pandemic swept the globe in the autumn and winter of 1918–19, and resulted in the deaths of approximately 40 million people. Clinically, epidemiologically, and pathologically, the disease was remarkably uniform, which suggests that similar viruses were causing disease around the world. To assess the homogeneity of the 1918 pandemic influenza virus, partial hemagglutinin gene sequences have been determined for five cases, including two newly identified samples from London, United Kingdom. The strains show 98.9% to 99.8% nucleotide sequence identity. One of the few differences between the strains maps to the receptor-binding site of hemagglutinin, suggesting that two receptor-binding configurations were co-circulating during the pandemic. The results suggest that in the early stages of an influenza A pandemic, mutations that occur during replication do not become fixed so that a uniform “consensus” strain circulates for some time.

EID Reid AH, Janczewski TA, Lourens RM, Elliot AJ, Daniels RS, Berry CL, et al. 1918 Influenza Pandemic and Highly Conserved Viruses with Two Receptor-Binding Variants. Emerg Infect Dis. 2003;9(10):1249-1253. https://dx.doi.org/10.3201/eid0910.020789
AMA Reid AH, Janczewski TA, Lourens RM, et al. 1918 Influenza Pandemic and Highly Conserved Viruses with Two Receptor-Binding Variants. Emerging Infectious Diseases. 2003;9(10):1249-1253. doi:10.3201/eid0910.020789.
APA Reid, A. H., Janczewski, T. A., Lourens, R. M., Elliot, A. J., Daniels, R. S., Berry, C. L....Taubenberger, J. K. (2003). 1918 Influenza Pandemic and Highly Conserved Viruses with Two Receptor-Binding Variants. Emerging Infectious Diseases, 9(10), 1249-1253. https://dx.doi.org/10.3201/eid0910.020789.

Cephamycin Resistance in Clinical Isolates and Laboratory-derived Strains of Escherichia coli, Nova Scotia, Canada [PDF - 345 KB - 6 pages]
B. Clarke et al.

AmpC β-lactamase, altered porins, or both are usually responsible for cefoxitin resistance in Escherichia coli. We examined the relative importance of each. We studied 18 strains of clinical isolates with reduced cefoxitin susceptibility and 10 initially-susceptible strains passaged through cefoxitin-gradient plates. Of 18 wild-resistant strains, 9 had identical promoter mutations (including creation of a consensus 17-bp spacer) and related pulsed-field gel electrophoresis patterns; the other 9 strains were unrelated. Nine strains had attenuator mutations; two strains did not express OmpC or OmpF. After serial passage, 8 of 10 strains developed cefoxitin resistance, none developed promoter or attenuator mutations, 6 lost both the OmpC and OmpF porin proteins, and 1 showed decreased production of both. One strain had neither porin alteration or increased AmpC production. Porin mutants may occur more commonly and be less fit and less inclined to spread or cause disease than strains with increased β-lactamase expression.

EID Clarke B, Hiltz M, Musgrave H, Forward KR. Cephamycin Resistance in Clinical Isolates and Laboratory-derived Strains of Escherichia coli, Nova Scotia, Canada. Emerg Infect Dis. 2003;9(10):1254-1259. https://dx.doi.org/10.3201/eid0910.030093
AMA Clarke B, Hiltz M, Musgrave H, et al. Cephamycin Resistance in Clinical Isolates and Laboratory-derived Strains of Escherichia coli, Nova Scotia, Canada. Emerging Infectious Diseases. 2003;9(10):1254-1259. doi:10.3201/eid0910.030093.
APA Clarke, B., Hiltz, M., Musgrave, H., & Forward, K. R. (2003). Cephamycin Resistance in Clinical Isolates and Laboratory-derived Strains of Escherichia coli, Nova Scotia, Canada. Emerging Infectious Diseases, 9(10), 1254-1259. https://dx.doi.org/10.3201/eid0910.030093.

Mass Antibiotic Treatment for Group A Streptococcus Outbreaks in Two Long-Term Care Facilities [PDF - 270 KB - 6 pages]
A. Smith et al.

Outbreaks of invasive infections caused by group A β-hemolytic streptococcus (GAS) may occur in long-term care settings and are associated with a high case-fatality rate in debilitated adults. Targeted antibiotic treatment only to residents and staff known to be at specific risk of GAS may be an ineffective outbreak control measure. We describe two institutional outbreaks in which mass antibiotic treatment was used as a control measure. In the first instance, mass treatment was used after targeted antibiotic treatment was not successful. In the second instance, mass treatment was used to control a rapidly evolving outbreak with a high case-fatality rate. Although no further clinical cases were seen after the introduction of mass antibiotic treatment, persistence of the outbreak strain was documented in one institution >1 year after cases had ceased. Strain persistence was associated with the presence of a chronically colonized resident and poor infection control practices.

EID Smith A, Li A, Tolomeo O, Tyrell GJ, Jamieson FB, Fisman D. Mass Antibiotic Treatment for Group A Streptococcus Outbreaks in Two Long-Term Care Facilities. Emerg Infect Dis. 2003;9(10):1260-1265. https://dx.doi.org/10.3201/eid0910.030130
AMA Smith A, Li A, Tolomeo O, et al. Mass Antibiotic Treatment for Group A Streptococcus Outbreaks in Two Long-Term Care Facilities. Emerging Infectious Diseases. 2003;9(10):1260-1265. doi:10.3201/eid0910.030130.
APA Smith, A., Li, A., Tolomeo, O., Tyrell, G. J., Jamieson, F. B., & Fisman, D. (2003). Mass Antibiotic Treatment for Group A Streptococcus Outbreaks in Two Long-Term Care Facilities. Emerging Infectious Diseases, 9(10), 1260-1265. https://dx.doi.org/10.3201/eid0910.030130.

Anthelmintic Baiting of Foxes against Urban Contamination with Echinococcus multilocularis [PDF - 312 KB - 7 pages]
D. Hegglin et al.

In recent years, increases in the urban fox population have been observed in many countries of the Northern Hemisphere. As a result, Echinococcus multilocularis has entered the urban environment. Because of a possible increased risk for alveolar echinococcosis, intervention strategies need to be evaluated. In Zürich, Switzerland, 50 praziquantel-containing baits per km2 were distributed monthly in six 1-km2 bait areas and one 6-km2 bait area from April 2000 through October 2001. The proportion of E. multilocularis coproantigen–positive fox fecal samples collected remained unchanged in six control areas but decreased significantly in the 1-km2 bait areas (from 38.6% to 5.5%) and in the 6-km2 bait area (from 66.7% to 1.8%). E. multilocularis prevalence in the intermediate host Arvicola terrestris also decreased significantly in baited areas. This controlled baiting study shows that a pronounced reduction of E. multilocularis egg contamination is feasible in urban areas where the organism is highly endemic.

EID Hegglin D, Ward PI, Deplazes P. Anthelmintic Baiting of Foxes against Urban Contamination with Echinococcus multilocularis. Emerg Infect Dis. 2003;9(10):1266-1272. https://dx.doi.org/10.3201/eid0910.030138
AMA Hegglin D, Ward PI, Deplazes P. Anthelmintic Baiting of Foxes against Urban Contamination with Echinococcus multilocularis. Emerging Infectious Diseases. 2003;9(10):1266-1272. doi:10.3201/eid0910.030138.
APA Hegglin, D., Ward, P. I., & Deplazes, P. (2003). Anthelmintic Baiting of Foxes against Urban Contamination with Echinococcus multilocularis. Emerging Infectious Diseases, 9(10), 1266-1272. https://dx.doi.org/10.3201/eid0910.030138.

Cephalosporin-resistant Escherichia coli among Summer Camp Attendees with Salmonellosis [PDF - 641 KB - 8 pages]
G. Prats et al.

Investigation of an acute gastroenteritis outbreak involving >100 persons at a summer camp in Girona, Spain, in June 2002 led to the detection of Salmonella and extended-spectrum cephalosporin-resistant Escherichia coli (ESCREC). Stool cultures were performed for 22 symptomatic campers, three asymptomatic food handlers, and 10 healthy household members. Of the 22 campers, 19 had Salmonella enterica, 9 had an ESCREC strain carrying an extended-spectrum β-lactamase, and 2 had a second ESCREC strain carrying a plasmidic cephamycinase. Related ESCREC were detected in two (salmonella-negative) asymptomatic food handlers and in none of the healthy household members. Fecal ESCREC and its β-lactamases and plasmids were extensively characterized. Three of the five ESCREC clones were recovered from multiple hosts. The apparent dissemination of ESCREC suggests a food or water vehicle. The observed distribution of resistance plasmids and β-lactamase genes in several clones indicates a high degree of horizontal transfer. Heightened vigilance and increased efforts must be made to discover the reservoirs and vehicles for community dissemination of ESCREC.

EID Prats G, Mirelis B, Miró E, Navarro F, Llovet T, Johnson JR, et al. Cephalosporin-resistant Escherichia coli among Summer Camp Attendees with Salmonellosis. Emerg Infect Dis. 2003;9(10):1273-1280. https://dx.doi.org/10.3201/eid0910.030179
AMA Prats G, Mirelis B, Miró E, et al. Cephalosporin-resistant Escherichia coli among Summer Camp Attendees with Salmonellosis. Emerging Infectious Diseases. 2003;9(10):1273-1280. doi:10.3201/eid0910.030179.
APA Prats, G., Mirelis, B., Miró, E., Navarro, F., Llovet, T., Johnson, J. R....Salleras, L. (2003). Cephalosporin-resistant Escherichia coli among Summer Camp Attendees with Salmonellosis. Emerging Infectious Diseases, 9(10), 1273-1280. https://dx.doi.org/10.3201/eid0910.030179.

Multijurisdictional Approach to Biosurveillance, Kansas City [PDF - 324 KB - 6 pages]
M. A. Hoffman et al.

An electronic reporting system for a network of 22 laboratories was implemented in Kansas City, Missouri, with an independent organization acting as a data clearinghouse between the reporting laboratories and public health departments. The system ran in tandem with conventional reporting methods. Laboratory test orders and results were aggregated and mapped to a common nomenclature. Reports were delivered through a secure Internet connection to the Kansas City Health Department (KCHD); during the first 200 days of operation, 359 qualified results were delivered electronically to KCHD. Data were received more quickly than they were with conventional reporting methods: notification of chlamydia cases arrived 2 days earlier, invasive group A streptococcal disease cases arrived 2.3 days sooner, and salmonellosis cases arrived 2.7 days sooner. Data were more complete for all demographic fields, including address, age, sex, race, and date of birth. Two hundred fourteen cases reported electronically were not received by conventional means.

EID Hoffman MA, Wilkinson TH, Bush A, Myers W, Griffin RG. Multijurisdictional Approach to Biosurveillance, Kansas City. Emerg Infect Dis. 2003;9(10):1281-1286. https://dx.doi.org/10.3201/eid0910.030060
AMA Hoffman MA, Wilkinson TH, Bush A, et al. Multijurisdictional Approach to Biosurveillance, Kansas City. Emerging Infectious Diseases. 2003;9(10):1281-1286. doi:10.3201/eid0910.030060.
APA Hoffman, M. A., Wilkinson, T. H., Bush, A., Myers, W., & Griffin, R. G. (2003). Multijurisdictional Approach to Biosurveillance, Kansas City. Emerging Infectious Diseases, 9(10), 1281-1286. https://dx.doi.org/10.3201/eid0910.030060.

Environmental Risk and Meningitis Epidemics in Africa [PDF - 415 KB - 7 pages]
A. M. Molesworth et al.

Epidemics of meningococcal meningitis occur in areas with particular environmental characteristics. We present evidence that the relationship between the environment and the location of these epidemics is quantifiable and propose a model based on environmental variables to identify regions at risk for meningitis epidemics. These findings, which have substantial implications for directing surveillance activities and health policy, provide a basis for monitoring the impact of climate variability and environmental change on epidemic occurrence in Africa.

EID Molesworth AM, Cuevas LE, Connor SJ, Morse AP, Thomson MC. Environmental Risk and Meningitis Epidemics in Africa. Emerg Infect Dis. 2003;9(10):1287-1293. https://dx.doi.org/10.3201/eid0910.030182
AMA Molesworth AM, Cuevas LE, Connor SJ, et al. Environmental Risk and Meningitis Epidemics in Africa. Emerging Infectious Diseases. 2003;9(10):1287-1293. doi:10.3201/eid0910.030182.
APA Molesworth, A. M., Cuevas, L. E., Connor, S. J., Morse, A. P., & Thomson, M. C. (2003). Environmental Risk and Meningitis Epidemics in Africa. Emerging Infectious Diseases, 9(10), 1287-1293. https://dx.doi.org/10.3201/eid0910.030182.
Dispatches

Severe Acute Respiratory Syndrome: Lessons from Singapore [PDF - 222 KB - 5 pages]
K. Singh et al.

An outbreak of severe acute respiratory syndrome (SARS) occurred in Singapore in March 2003. To illustrate the problems in diagnosing and containing SARS in the hospital, we describe a case series and highlight changes in triage and infection control practices that resulted. By implementing these changes, we have stopped the nosocomial transmission of the virus.

EID Singh K, Hsu L, Villacian JS, Habib A, Fisher D, Tambyah PA. Severe Acute Respiratory Syndrome: Lessons from Singapore. Emerg Infect Dis. 2003;9(10):1294-1298. https://dx.doi.org/10.3201/eid0910.030388
AMA Singh K, Hsu L, Villacian JS, et al. Severe Acute Respiratory Syndrome: Lessons from Singapore. Emerging Infectious Diseases. 2003;9(10):1294-1298. doi:10.3201/eid0910.030388.
APA Singh, K., Hsu, L., Villacian, J. S., Habib, A., Fisher, D., & Tambyah, P. A. (2003). Severe Acute Respiratory Syndrome: Lessons from Singapore. Emerging Infectious Diseases, 9(10), 1294-1298. https://dx.doi.org/10.3201/eid0910.030388.

West Nile Virus Transmission in Resident Birds, Dominican Republic [PDF - 345 KB - 4 pages]
O. Komar et al.

We report West Nile virus (WNV) activity in the Dominican Republic for the first time. Specific anti-WNV antibodies were detected in 5 (15%) of 33 resident birds sampled at one location in November 2002. One seropositive bird was <4 months old, indicating a recent infection.

EID Komar O, Robbins MB, Klenk K, Blitvich BJ, Marlenee NL, Burkhalter KL, et al. West Nile Virus Transmission in Resident Birds, Dominican Republic. Emerg Infect Dis. 2003;9(10):1299-1302. https://dx.doi.org/10.3201/eid0910.030222
AMA Komar O, Robbins MB, Klenk K, et al. West Nile Virus Transmission in Resident Birds, Dominican Republic. Emerging Infectious Diseases. 2003;9(10):1299-1302. doi:10.3201/eid0910.030222.
APA Komar, O., Robbins, M. B., Klenk, K., Blitvich, B. J., Marlenee, N. L., Burkhalter, K. L....Komar, N. (2003). West Nile Virus Transmission in Resident Birds, Dominican Republic. Emerging Infectious Diseases, 9(10), 1299-1302. https://dx.doi.org/10.3201/eid0910.030222.

West Nile Virus Encephalitis and Myocarditis in Wolf and Dog [PDF - 336 KB - 4 pages]
C. A. Lichtensteiger et al.

In the third season (2002) of the West Nile virus epidemic in the United States, two canids (wolf and dog) were diagnosed with West Nile virus encephalitis and myocarditis with similarities to known affected species (humans, horses, and birds). The West Nile virus infections were confirmed by immunohistochemistry and polymerase chain reaction.

EID Lichtensteiger CA, Heinz-Taheny K, Osborne TS, Novak RJ, Lewis BA, Firth ML. West Nile Virus Encephalitis and Myocarditis in Wolf and Dog. Emerg Infect Dis. 2003;9(10):1303-1306. https://dx.doi.org/10.3201/eid0910.020617
AMA Lichtensteiger CA, Heinz-Taheny K, Osborne TS, et al. West Nile Virus Encephalitis and Myocarditis in Wolf and Dog. Emerging Infectious Diseases. 2003;9(10):1303-1306. doi:10.3201/eid0910.020617.
APA Lichtensteiger, C. A., Heinz-Taheny, K., Osborne, T. S., Novak, R. J., Lewis, B. A., & Firth, M. L. (2003). West Nile Virus Encephalitis and Myocarditis in Wolf and Dog. Emerging Infectious Diseases, 9(10), 1303-1306. https://dx.doi.org/10.3201/eid0910.020617.

Weissella confusa Infection in Primate (Cercopithecus mona) [PDF - 346 KB - 3 pages]
A. I. Vela et al.

We describe the first systemic infection by Weissella confusa in a mona monkey (Cercopithecus mona) on the basis of microbiologic, molecular genetic, and histologic data. The same strain of W. confusa, as determined by pulsed-field gel electrophoresis, was isolated in pure culture from brain, liver, spleen, and intestine of this primate, illustrating the clinical importance of the isolations.

EID Vela AI, Porrero C, Goyache J, Nieto A, Sánchez B, Briones V, et al. Weissella confusa Infection in Primate (Cercopithecus mona). Emerg Infect Dis. 2003;9(10):1307-1309. https://dx.doi.org/10.3201/eid0910.020667
AMA Vela AI, Porrero C, Goyache J, et al. Weissella confusa Infection in Primate (Cercopithecus mona). Emerging Infectious Diseases. 2003;9(10):1307-1309. doi:10.3201/eid0910.020667.
APA Vela, A. I., Porrero, C., Goyache, J., Nieto, A., Sánchez, B., Briones, V....Fernández-Garayzábal, J. F. (2003). Weissella confusa Infection in Primate (Cercopithecus mona). Emerging Infectious Diseases, 9(10), 1307-1309. https://dx.doi.org/10.3201/eid0910.020667.

Mycobacterium tuberculosis Beijing Genotype, the Netherlands [PDF - 325 KB - 4 pages]
M. W. Borgdorff et al.

To determine whether the Beijing genotype of Mycobacterium tuberculosis is emerging in the Netherlands, we collected data on 6,829 patients during 1993 to 2000. Six percent had the Beijing genotype. This genotype was associated with diagnosis in recent years, young age, nationality, and multidrug resistance.

EID Borgdorff MW, de Haas P, Kremer K, van Soolingen D. Mycobacterium tuberculosis Beijing Genotype, the Netherlands. Emerg Infect Dis. 2003;9(10):1310-1313. https://dx.doi.org/10.3201/eid0910.020743
AMA Borgdorff MW, de Haas P, Kremer K, et al. Mycobacterium tuberculosis Beijing Genotype, the Netherlands. Emerging Infectious Diseases. 2003;9(10):1310-1313. doi:10.3201/eid0910.020743.
APA Borgdorff, M. W., de Haas, P., Kremer, K., & van Soolingen, D. (2003). Mycobacterium tuberculosis Beijing Genotype, the Netherlands. Emerging Infectious Diseases, 9(10), 1310-1313. https://dx.doi.org/10.3201/eid0910.020743.

Saliva and Meningococcal Transmission [PDF - 187 KB - 2 pages]
H. J. Orr et al.

Neisseria meningitidis carriage was compared in swab specimens of nasopharynx, tonsils, and saliva taken from 258 students. We found a higher yield in nasopharyngeal than in tonsillar swabs (32% vs. 19%, p<0.001). Low prevalence of carriage in saliva swabs (one swab [0.4%]) suggests that low levels of salivary contact are unlikely to transmit meningococci.

EID Orr HJ, Gray SJ, Macdonald M, Stuart JM. Saliva and Meningococcal Transmission. Emerg Infect Dis. 2003;9(10):1314-1315. https://dx.doi.org/10.3201/eid0910.030444
AMA Orr HJ, Gray SJ, Macdonald M, et al. Saliva and Meningococcal Transmission. Emerging Infectious Diseases. 2003;9(10):1314-1315. doi:10.3201/eid0910.030444.
APA Orr, H. J., Gray, S. J., Macdonald, M., & Stuart, J. M. (2003). Saliva and Meningococcal Transmission. Emerging Infectious Diseases, 9(10), 1314-1315. https://dx.doi.org/10.3201/eid0910.030444.

Small Colony Variants of Staphylococcus aureus and Pacemaker-related Infection [PDF - 198 KB - 3 pages]
H. Seifert et al.

We describe the first known case of a device-related bloodstream infection caused by Staphylococcus aureus small colony variants. Recurrent pacemaker-related bloodstream infection within a 7-month period illustrates the poor clinical and microbiologic response to prolonged antimicrobial therapy in a patient infected with this S. aureus subpopulation.

EID Seifert H, Wisplinghoff H, Schnabel P, von Eiff C. Small Colony Variants of Staphylococcus aureus and Pacemaker-related Infection. Emerg Infect Dis. 2003;9(10):1316-1318. https://dx.doi.org/10.3201/eid0910.030200
AMA Seifert H, Wisplinghoff H, Schnabel P, et al. Small Colony Variants of Staphylococcus aureus and Pacemaker-related Infection. Emerging Infectious Diseases. 2003;9(10):1316-1318. doi:10.3201/eid0910.030200.
APA Seifert, H., Wisplinghoff, H., Schnabel, P., & von Eiff, C. (2003). Small Colony Variants of Staphylococcus aureus and Pacemaker-related Infection. Emerging Infectious Diseases, 9(10), 1316-1318. https://dx.doi.org/10.3201/eid0910.030200.

West Nile Virus Detection in American Crows [PDF - 199 KB - 3 pages]
S. A. Yaremych et al.

A dipstick immunochromatographic assay used for West Nile virus (WNV) detection in mosquitoes was investigated for application to testing of fecal, saliva, and tissue samples from dead American Crows (Corvus brachyrhynchos). Results suggest that VecTest may be an efficient method for WNV detection in field-collected, dead American Crows, although confirmation of results and further investigation are warranted.

EID Yaremych SA, Warner RE, Van de Wyngaerde MT, Ringia AM, Lampman R, Novak RJ. West Nile Virus Detection in American Crows. Emerg Infect Dis. 2003;9(10):1319-1321. https://dx.doi.org/10.3201/eid0910.030306
AMA Yaremych SA, Warner RE, Van de Wyngaerde MT, et al. West Nile Virus Detection in American Crows. Emerging Infectious Diseases. 2003;9(10):1319-1321. doi:10.3201/eid0910.030306.
APA Yaremych, S. A., Warner, R. E., Van de Wyngaerde, M. T., Ringia, A. M., Lampman, R., & Novak, R. J. (2003). West Nile Virus Detection in American Crows. Emerging Infectious Diseases, 9(10), 1319-1321. https://dx.doi.org/10.3201/eid0910.030306.

Severe Histoplasmosis in Travelers to Nicaragua [PDF - 234 KB - 4 pages]
M. Weinberg et al.

We investigated an outbreak of unexpectedly severe histoplasmosis among 14 healthy adventure travelers from the United States who visited a bat-infested cave in Nicaragua. Although histoplasmosis has rarely been reported to cause serious illness among travelers, this outbreak demonstrates that cases may be severe among travelers, even young, healthy persons.

EID Weinberg M, Weeks J, Lance-Parker S, Traeger M, Wiersma S, Phan QN, et al. Severe Histoplasmosis in Travelers to Nicaragua. Emerg Infect Dis. 2003;9(10):1322-1325. https://dx.doi.org/10.3201/eid0910.030049
AMA Weinberg M, Weeks J, Lance-Parker S, et al. Severe Histoplasmosis in Travelers to Nicaragua. Emerging Infectious Diseases. 2003;9(10):1322-1325. doi:10.3201/eid0910.030049.
APA Weinberg, M., Weeks, J., Lance-Parker, S., Traeger, M., Wiersma, S., Phan, Q. N....Hajjeh, R. (2003). Severe Histoplasmosis in Travelers to Nicaragua. Emerging Infectious Diseases, 9(10), 1322-1325. https://dx.doi.org/10.3201/eid0910.030049.

Mayaro Virus in Wild Mammals, French Guiana [PDF - 214 KB - 4 pages]
B. de Thoisy et al.

A serologic survey for Mayaro virus (Alphavirus, Togaviridae) in 28 wild nonflying forest mammal species in French Guiana showed a prevalence ranging from 0% to 52% and increasing with age. Species active during the day and those who spent time in trees were significantly more infected, results consistent with transmission implicating diurnal mosquitoes and continuous infectious pressure.

EID de Thoisy B, Gardon J, Salas RA, Morvan J, Kazanji M. Mayaro Virus in Wild Mammals, French Guiana. Emerg Infect Dis. 2003;9(10):1326-1329. https://dx.doi.org/10.3201/eid0910.030161
AMA de Thoisy B, Gardon J, Salas RA, et al. Mayaro Virus in Wild Mammals, French Guiana. Emerging Infectious Diseases. 2003;9(10):1326-1329. doi:10.3201/eid0910.030161.
APA de Thoisy, B., Gardon, J., Salas, R. A., Morvan, J., & Kazanji, M. (2003). Mayaro Virus in Wild Mammals, French Guiana. Emerging Infectious Diseases, 9(10), 1326-1329. https://dx.doi.org/10.3201/eid0910.030161.

The European Commission’s Task Force on Bioterrorism [PDF - 177 KB - 3 pages]
A. Tegnell et al.

In response to the increased threat of bioterrorism, a task force on health security was established in the European Commission. Task force members address a broad range of issues related to preparedness for and response to bioterrorist events and seek to bring about a greater collaboration between the European Union member states.

EID Tegnell A, Bossi P, Baka A, Van Loock F, Hendriks J, Wallyn S, et al. The European Commission’s Task Force on Bioterrorism. Emerg Infect Dis. 2003;9(10):1330-1332. https://dx.doi.org/10.3201/eid0910.030368
AMA Tegnell A, Bossi P, Baka A, et al. The European Commission’s Task Force on Bioterrorism. Emerging Infectious Diseases. 2003;9(10):1330-1332. doi:10.3201/eid0910.030368.
APA Tegnell, A., Bossi, P., Baka, A., Van Loock, F., Hendriks, J., Wallyn, S....Gouvras, G. (2003). The European Commission’s Task Force on Bioterrorism. Emerging Infectious Diseases, 9(10), 1330-1332. https://dx.doi.org/10.3201/eid0910.030368.

Wild-type Measles Virus in Brain Tissue of Children with Subacute Sclerosing Panencephalitis, Argentina [PDF - 233 KB - 4 pages]
P. R. Barrero et al.

We studied eight children who had measles at 6 to 10 months of age during the 1998 Argentine measles outbreak and in whom subacute sclerosing panencephalitis developed 4 years later. We report the genetic characterization of brain tissue–associated measles virus samples from three patients. Phylogenetic relationships clustered these viruses with the wild-type D6 genotype isolated during the 1998 outbreak. The children received measles vaccine; however, vaccinal strains were not found.

EID Barrero PR, Grippo J, Viegas M, Mistchenko AS. Wild-type Measles Virus in Brain Tissue of Children with Subacute Sclerosing Panencephalitis, Argentina. Emerg Infect Dis. 2003;9(10):1333-1336. https://dx.doi.org/10.3201/eid0910.030180
AMA Barrero PR, Grippo J, Viegas M, et al. Wild-type Measles Virus in Brain Tissue of Children with Subacute Sclerosing Panencephalitis, Argentina. Emerging Infectious Diseases. 2003;9(10):1333-1336. doi:10.3201/eid0910.030180.
APA Barrero, P. R., Grippo, J., Viegas, M., & Mistchenko, A. S. (2003). Wild-type Measles Virus in Brain Tissue of Children with Subacute Sclerosing Panencephalitis, Argentina. Emerging Infectious Diseases, 9(10), 1333-1336. https://dx.doi.org/10.3201/eid0910.030180.

Cat or Dog Ownership and Seroprevalence of Ehrlichiosis, Q Fever, and Cat-Scratch Disease [PDF - 289 KB - 4 pages]
M. Skerget et al.

Concerns have been raised about the role of domestic cats or dogs in the acquisition of zoonoses, in particular in pregnant women or immune-suppressed persons. We report that cat or dog ownership is not associated with an increased seroprevalence of antibodies to Anaplasma phagozytophilum, Coxiella burnetii, and Bartonella henselae in symptom-free persons in Styria, Austria.

EID Skerget M, Wenisch C, Daxboeck F, Krause R, Haberl R, Stuenzner D. Cat or Dog Ownership and Seroprevalence of Ehrlichiosis, Q Fever, and Cat-Scratch Disease. Emerg Infect Dis. 2003;9(10):1337-1340. https://dx.doi.org/10.3201/eid0910.030206
AMA Skerget M, Wenisch C, Daxboeck F, et al. Cat or Dog Ownership and Seroprevalence of Ehrlichiosis, Q Fever, and Cat-Scratch Disease. Emerging Infectious Diseases. 2003;9(10):1337-1340. doi:10.3201/eid0910.030206.
APA Skerget, M., Wenisch, C., Daxboeck, F., Krause, R., Haberl, R., & Stuenzner, D. (2003). Cat or Dog Ownership and Seroprevalence of Ehrlichiosis, Q Fever, and Cat-Scratch Disease. Emerging Infectious Diseases, 9(10), 1337-1340. https://dx.doi.org/10.3201/eid0910.030206.

Flying Squirrel–associated Typhus, United States [PDF - 192 KB - 3 pages]
M. G. Reynolds et al.

In March 2002, typhus fever was diagnosed in two patients residing in West Virginia and Georgia. Both patients were hospitalized with severe febrile illnesses, and both had been recently exposed to or had physical contact with flying squirrels or flying squirrel nests. Laboratory results indicated Rickettsia prowazekii infection.

EID Reynolds MG, Krebs JW, Comer JA, Sumner JW, Rushton TC, Lopez CE, et al. Flying Squirrel–associated Typhus, United States. Emerg Infect Dis. 2003;9(10):1341-1343. https://dx.doi.org/10.3201/eid0910.030278
AMA Reynolds MG, Krebs JW, Comer JA, et al. Flying Squirrel–associated Typhus, United States. Emerging Infectious Diseases. 2003;9(10):1341-1343. doi:10.3201/eid0910.030278.
APA Reynolds, M. G., Krebs, J. W., Comer, J. A., Sumner, J. W., Rushton, T. C., Lopez, C. E....Childs, J. E. (2003). Flying Squirrel–associated Typhus, United States. Emerging Infectious Diseases, 9(10), 1341-1343. https://dx.doi.org/10.3201/eid0910.030278.

Chlamydia trachomatis Infections in Female Soldiers, Israel [PDF - 317 KB - 3 pages]
E. S. Bamberger et al.

We examined the prevalence of Chlamydia trachomatis infection in Israeli female soldiers. The prevalence was 3.2% among soldiers seeking medical care; rural residence was identified as a significant risk factor. Nevertheless, given the study design, recommending broad-scale screening of Israeli female soldiers may be premature.2

EID Bamberger ES, Siegler E, Makler-Shiran E, Patel MV, Steinberg JM, Gershtein R, et al. Chlamydia trachomatis Infections in Female Soldiers, Israel. Emerg Infect Dis. 2003;9(10):1344-1346. https://dx.doi.org/10.3201/eid0910.030100
AMA Bamberger ES, Siegler E, Makler-Shiran E, et al. Chlamydia trachomatis Infections in Female Soldiers, Israel. Emerging Infectious Diseases. 2003;9(10):1344-1346. doi:10.3201/eid0910.030100.
APA Bamberger, E. S., Siegler, E., Makler-Shiran, E., Patel, M. V., Steinberg, J. M., Gershtein, R....Srugo, I. (2003). Chlamydia trachomatis Infections in Female Soldiers, Israel. Emerging Infectious Diseases, 9(10), 1344-1346. https://dx.doi.org/10.3201/eid0910.030100.
Letters

Clostridium tertium in Necrotizing Fasciitis and Gangrene [PDF - 165 KB - 2 pages]
P. Ray et al.
EID Ray P, Das A, Singh K, Bhansali A, Yadav T. Clostridium tertium in Necrotizing Fasciitis and Gangrene. Emerg Infect Dis. 2003;9(10):1347-1348. https://dx.doi.org/10.3201/eid0910.030287
AMA Ray P, Das A, Singh K, et al. Clostridium tertium in Necrotizing Fasciitis and Gangrene. Emerging Infectious Diseases. 2003;9(10):1347-1348. doi:10.3201/eid0910.030287.
APA Ray, P., Das, A., Singh, K., Bhansali, A., & Yadav, T. (2003). Clostridium tertium in Necrotizing Fasciitis and Gangrene. Emerging Infectious Diseases, 9(10), 1347-1348. https://dx.doi.org/10.3201/eid0910.030287.

Dengue Hemorrhagic Fever, Uttaradit, Thailand [PDF - 169 KB - 3 pages]
J. Patumanond et al.
EID Patumanond J, Tawichasri C, Nopparat S. Dengue Hemorrhagic Fever, Uttaradit, Thailand. Emerg Infect Dis. 2003;9(10):1348-1350. https://dx.doi.org/10.3201/eid0910.020681
AMA Patumanond J, Tawichasri C, Nopparat S. Dengue Hemorrhagic Fever, Uttaradit, Thailand. Emerging Infectious Diseases. 2003;9(10):1348-1350. doi:10.3201/eid0910.020681.
APA Patumanond, J., Tawichasri, C., & Nopparat, S. (2003). Dengue Hemorrhagic Fever, Uttaradit, Thailand. Emerging Infectious Diseases, 9(10), 1348-1350. https://dx.doi.org/10.3201/eid0910.020681.

Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Dahl) [PDF - 164 KB - 2 pages]
M. Helms et al.
EID Helms M, Vastrup P, Mølbak K. Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Dahl). Emerg Infect Dis. 2003;9(10):1350-1351. https://dx.doi.org/10.3201/eid0910.030029
AMA Helms M, Vastrup P, Mølbak K. Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Dahl). Emerging Infectious Diseases. 2003;9(10):1350-1351. doi:10.3201/eid0910.030029.
APA Helms, M., Vastrup, P., & Mølbak, K. (2003). Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Dahl). Emerging Infectious Diseases, 9(10), 1350-1351. https://dx.doi.org/10.3201/eid0910.030029.

Serogroup A Neisseria meningitidis outside Meningitis Belt in Southwest Cameroon [PDF - 169 KB - 3 pages]
P. Cunin et al.
EID Cunin P, Fonkoua M, Kollo B, Bedifeh BA, Bayanak P, Martin P. Serogroup A Neisseria meningitidis outside Meningitis Belt in Southwest Cameroon. Emerg Infect Dis. 2003;9(10):1351-1353. https://dx.doi.org/10.3201/eid0910.030170
AMA Cunin P, Fonkoua M, Kollo B, et al. Serogroup A Neisseria meningitidis outside Meningitis Belt in Southwest Cameroon. Emerging Infectious Diseases. 2003;9(10):1351-1353. doi:10.3201/eid0910.030170.
APA Cunin, P., Fonkoua, M., Kollo, B., Bedifeh, B. A., Bayanak, P., & Martin, P. (2003). Serogroup A Neisseria meningitidis outside Meningitis Belt in Southwest Cameroon. Emerging Infectious Diseases, 9(10), 1351-1353. https://dx.doi.org/10.3201/eid0910.030170.

West Nile Virus Meningitis in Patient with Common Variable Immunodeficiency [PDF - 153 KB - 2 pages]
A. M. Alonto et al.
EID Alonto AM, Aronoff DM, Malani PN. West Nile Virus Meningitis in Patient with Common Variable Immunodeficiency. Emerg Infect Dis. 2003;9(10):1353-1354. https://dx.doi.org/10.3201/eid0910.030195
AMA Alonto AM, Aronoff DM, Malani PN. West Nile Virus Meningitis in Patient with Common Variable Immunodeficiency. Emerging Infectious Diseases. 2003;9(10):1353-1354. doi:10.3201/eid0910.030195.
APA Alonto, A. M., Aronoff, D. M., & Malani, P. N. (2003). West Nile Virus Meningitis in Patient with Common Variable Immunodeficiency. Emerging Infectious Diseases, 9(10), 1353-1354. https://dx.doi.org/10.3201/eid0910.030195.

Isolation of Enterobacter sakazakii from Midgut of Stomoxys calcitrans [PDF - 193 KB - 2 pages]
J. V. Hamilton et al.
EID Hamilton JV, Lehane MJ, Braig HR. Isolation of Enterobacter sakazakii from Midgut of Stomoxys calcitrans. Emerg Infect Dis. 2003;9(10):1355-1356. https://dx.doi.org/10.3201/eid0910.030218
AMA Hamilton JV, Lehane MJ, Braig HR. Isolation of Enterobacter sakazakii from Midgut of Stomoxys calcitrans. Emerging Infectious Diseases. 2003;9(10):1355-1356. doi:10.3201/eid0910.030218.
APA Hamilton, J. V., Lehane, M. J., & Braig, H. R. (2003). Isolation of Enterobacter sakazakii from Midgut of Stomoxys calcitrans. Emerging Infectious Diseases, 9(10), 1355-1356. https://dx.doi.org/10.3201/eid0910.030218.

Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Helms) [PDF - 159 KB - 1 page]
J. Dahl
EID Dahl J. Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Helms). Emerg Infect Dis. 2003;9(10):1350. https://dx.doi.org/10.3201/eid0910.020716
AMA Dahl J. Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Helms). Emerging Infectious Diseases. 2003;9(10):1350. doi:10.3201/eid0910.020716.
APA Dahl, J. (2003). Antimicrobial Drug-resistant Salmonella Typhimurium (Reply to Helms). Emerging Infectious Diseases, 9(10), 1350. https://dx.doi.org/10.3201/eid0910.020716.
Books and Media

Exotic Viral Diseases: A Global Guide [PDF - 135 KB - 1 page]
M. Bell
EID Bell M. Exotic Viral Diseases: A Global Guide. Emerg Infect Dis. 2003;9(10):1357. https://dx.doi.org/10.3201/eid0910.030490
AMA Bell M. Exotic Viral Diseases: A Global Guide. Emerging Infectious Diseases. 2003;9(10):1357. doi:10.3201/eid0910.030490.
APA Bell, M. (2003). Exotic Viral Diseases: A Global Guide. Emerging Infectious Diseases, 9(10), 1357. https://dx.doi.org/10.3201/eid0910.030490.
About the Cover

Jacques-Louis David (1748–1825). Coronation of Empress Josephine by Napoleon I at Notre Dame de Paris, 2 December 1804 (1806–1807) [PDF - 134 KB - 1 page]
P. Potter
EID Potter P. Jacques-Louis David (1748–1825). Coronation of Empress Josephine by Napoleon I at Notre Dame de Paris, 2 December 1804 (1806–1807). Emerg Infect Dis. 2003;9(10):1360. https://dx.doi.org/10.3201/eid0910.ac0910
AMA Potter P. Jacques-Louis David (1748–1825). Coronation of Empress Josephine by Napoleon I at Notre Dame de Paris, 2 December 1804 (1806–1807). Emerging Infectious Diseases. 2003;9(10):1360. doi:10.3201/eid0910.ac0910.
APA Potter, P. (2003). Jacques-Louis David (1748–1825). Coronation of Empress Josephine by Napoleon I at Notre Dame de Paris, 2 December 1804 (1806–1807). Emerging Infectious Diseases, 9(10), 1360. https://dx.doi.org/10.3201/eid0910.ac0910.
News and Notes

Drug-resistant Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus Surveillance [PDF - 175 KB - 2 pages]
L. A. Hawley et al.
EID Hawley LA, Fridkin SK, Whitney CG. Drug-resistant Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus Surveillance. Emerg Infect Dis. 2003;9(10):1358-1359. https://dx.doi.org/10.3201/eid0910.030454
AMA Hawley LA, Fridkin SK, Whitney CG. Drug-resistant Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus Surveillance. Emerging Infectious Diseases. 2003;9(10):1358-1359. doi:10.3201/eid0910.030454.
APA Hawley, L. A., Fridkin, S. K., & Whitney, C. G. (2003). Drug-resistant Streptococcus pneumoniae and Methicillin-resistant Staphylococcus aureus Surveillance. Emerging Infectious Diseases, 9(10), 1358-1359. https://dx.doi.org/10.3201/eid0910.030454.
Page created: July 10, 2012
Page updated: July 10, 2012
Page reviewed: July 10, 2012
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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