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Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005–2019 [PDF - 480 KB - 8 pages]
R. A. Blakney et al.

To further clarify differences in the risk for nontuberculous mycobacterial pulmonary infection (NTM-PI) among ethnic populations in Hawaii, USA, we conducted a retrospective cohort study among beneficiaries of Kaiser Permanente Hawaii (KPH). We abstracted demographic, socioeconomic, clinical, and microbiological data from KPH electronic health records for 2005–2019. An NTM-PI case-patient was defined as a person from whom >1 NTM pulmonary isolate was obtained. We performed Cox proportional hazards regression to estimate incidence of NTM-PI while controlling for confounders. Across ethnic groups, risk for NTM-PI was higher among persons who were underweight (body mass index [BMI] <18.5 kg/m2). Among beneficiaries who self-identified as any Asian ethnicity, risk for incident NTM-PI was increased by 30%. Low BMI may increase susceptibility to NTM-PI, and risk may be higher for persons who self-identify as Asian, independent of BMI.

EID Blakney RA, Ricotta EE, Frankland TB, Honda S, Zelazny A, Mayer-Barber KD, et al. Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005–2019. Emerg Infect Dis. 2022;28(8):1543-1550. https://doi.org/10.3201/eid2808.212375
AMA Blakney RA, Ricotta EE, Frankland TB, et al. Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005–2019. Emerging Infectious Diseases. 2022;28(8):1543-1550. doi:10.3201/eid2808.212375.
APA Blakney, R. A., Ricotta, E. E., Frankland, T. B., Honda, S., Zelazny, A., Mayer-Barber, K. D....Prevots, D. (2022). Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005–2019. Emerging Infectious Diseases, 28(8), 1543-1550. https://doi.org/10.3201/eid2808.212375.

Investigation of COVID-19 Outbreak among Wildland Firefighters during Wildfire Response, Colorado, USA, 2020 [PDF - 4.01 MB - 8 pages]
A. Metz et al.

A COVID-19 outbreak occurred among Cameron Peak Fire responders in Colorado, USA, during August 2020–January 2021. The Cameron Peak Fire was the largest recorded wildfire in Colorado history, lasting August–December 2020. At least 6,123 responders were involved, including 1,260 firefighters in 63 crews who mobilized to the fire camps. A total of 79 COVID-19 cases were identified among responders, and 273 close contacts were quarantined. State and local public health investigated the outbreak and coordinated with wildfire management teams to prevent disease spread. We performed whole-genome sequencing and applied social network analysis to visualize clusters and transmission dynamics. Phylogenetic analysis identified 8 lineages among sequenced specimens, implying multiple introductions. Social network analysis identified spread between and within crews. Strategies such as implementing symptom screening and testing of arriving responders, educating responders about overlapping symptoms of smoke inhalation and COVID-19, improving physical distancing of crews, and encouraging vaccinations are recommended.

EID Metz A, Bauer M, Epperly C, Stringer G, Marshall KE, Webb L, et al. Investigation of COVID-19 Outbreak among Wildland Firefighters during Wildfire Response, Colorado, USA, 2020. Emerg Infect Dis. 2022;28(8):1551-1558. https://doi.org/10.3201/eid2808.220310
AMA Metz A, Bauer M, Epperly C, et al. Investigation of COVID-19 Outbreak among Wildland Firefighters during Wildfire Response, Colorado, USA, 2020. Emerging Infectious Diseases. 2022;28(8):1551-1558. doi:10.3201/eid2808.220310.
APA Metz, A., Bauer, M., Epperly, C., Stringer, G., Marshall, K. E., Webb, L....Burakoff, A. (2022). Investigation of COVID-19 Outbreak among Wildland Firefighters during Wildfire Response, Colorado, USA, 2020. Emerging Infectious Diseases, 28(8), 1551-1558. https://doi.org/10.3201/eid2808.220310.

Medscape CME Activity
Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies [PDF - 2.08 MB - 10 pages]
H. Cheng et al.

Ribavirin has been used widely to treat Lassa fever in West Africa since the 1980s. However, few studies have systematically appraised the evidence for its use. We conducted a systematic review of published and unpublished literature retrieved from electronic databases and gray literature from inception to March 8, 2022. We identified 13 studies of the comparative effectiveness of ribavirin versus no ribavirin treatment on mortality outcomes, including unpublished data from a study in Sierra Leone provided through a US Freedom of Information Act request. Although ribavirin was associated with decreased mortality rates, results of these studies were at critical or serious risk for bias when appraised using the ROBINS-I tool. Important risks for bias related to lack of control for confounders, immortal time bias, and missing outcome data. Robust evidence supporting the use of ribavirin in Lassa fever is lacking. Well-conducted clinical trials to elucidate the effectiveness of ribavirin for Lassa fever are needed.

EID Cheng H, French CE, Salam AP, Dawson S, McAleenan A, McGuinness LA, et al. Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies. Emerg Infect Dis. 2022;28(8):1559-1568. https://doi.org/10.3201/eid2808.211787
AMA Cheng H, French CE, Salam AP, et al. Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies. Emerging Infectious Diseases. 2022;28(8):1559-1568. doi:10.3201/eid2808.211787.
APA Cheng, H., French, C. E., Salam, A. P., Dawson, S., McAleenan, A., McGuinness, L. A....Sterne, J. (2022). Lack of Evidence for Ribavirin Treatment of Lassa Fever in Systematic Review of Published and Unpublished Studies. Emerging Infectious Diseases, 28(8), 1559-1568. https://doi.org/10.3201/eid2808.211787.
Research

Dominant Carbapenemase-Encoding Plasmids in Clinical Enterobacterales Isolates and Hypervirulent Klebsiella pneumoniae, Singapore [PDF - 3.02 MB - 11 pages]
M. Yong et al.

Dissemination of carbapenemase-encoding plasmids by horizontal gene transfer in multidrug-resistant bacteria is the major driver of rising carbapenem-resistance, but the conjugative mechanics and evolution of clinically relevant plasmids are not yet clear. We performed whole-genome sequencing on 1,215 clinical Enterobacterales isolates collected in Singapore during 2010–2015. We identified 1,126 carbapenemase-encoding plasmids and discovered pKPC2 is becoming the dominant plasmid in Singapore, overtaking an earlier dominant plasmid, pNDM1. pKPC2 frequently conjugates with many Enterobacterales species, including hypervirulent Klebsiella pneumoniae, and maintains stability in vitro without selection pressure and minimal adaptive sequence changes. Furthermore, capsule and decreasing taxonomic relatedness between donor and recipient pairs are greater conjugation barriers for pNDM1 than pKPC2. The low fitness costs pKPC2 exerts in Enterobacterales species indicate previously undetected carriage selection in other ecological settings. The ease of conjugation and stability of pKPC2 in hypervirulent K. pneumoniae could fuel spread into the community.

EID Yong M, Chen Y, Oo G, Chang K, Chu W, Teo J, et al. Dominant Carbapenemase-Encoding Plasmids in Clinical Enterobacterales Isolates and Hypervirulent Klebsiella pneumoniae, Singapore. Emerg Infect Dis. 2022;28(8):1578-1588. https://doi.org/10.3201/eid2808.212542
AMA Yong M, Chen Y, Oo G, et al. Dominant Carbapenemase-Encoding Plasmids in Clinical Enterobacterales Isolates and Hypervirulent Klebsiella pneumoniae, Singapore. Emerging Infectious Diseases. 2022;28(8):1578-1588. doi:10.3201/eid2808.212542.
APA Yong, M., Chen, Y., Oo, G., Chang, K., Chu, W., Teo, J....Gan, Y. (2022). Dominant Carbapenemase-Encoding Plasmids in Clinical Enterobacterales Isolates and Hypervirulent Klebsiella pneumoniae, Singapore. Emerging Infectious Diseases, 28(8), 1578-1588. https://doi.org/10.3201/eid2808.212542.

Increasing and More Commonly Refractory Mycobacterium avium Pulmonary Disease, Toronto, Ontario, Canada [PDF - 410 KB - 8 pages]
D. Raats et al.

In mid-2014, Public Health Ontario Laboratories identified coincident increasing Mycobacterium avium isolation and falling M. xenopi isolation in the Toronto, Ontario, Canada, area. We performed a retrospective cohort of all patients in a Toronto clinic who began treatment for either M. avium or M. xenopi pulmonary disease during 2009–2012 (early period) or 2015–2018 (late period), studying their relative proportions and sputum culture conversion. We conducted a subgroup analysis among patients who lived in the Toronto-York region. The proportion of patients with M. avium was higher in the late period (138/146 [94.5%] vs. 82/106 [77.4%]; p<0.001). Among M. avium patients, conversion was lower in the late period (26.1% vs. 39.0%; p = 0.05). The increase in the proportion of patients with M. avium pulmonary disease and the reduction in the frequency of sputum culture conversion is unexplained but could suggest an increase in environmental M. avium exposure.

EID Raats D, Brode SK, Mehrabi M, Marras TK. Increasing and More Commonly Refractory Mycobacterium avium Pulmonary Disease, Toronto, Ontario, Canada. Emerg Infect Dis. 2022;28(8):1589-1596. https://doi.org/10.3201/eid2808.220464
AMA Raats D, Brode SK, Mehrabi M, et al. Increasing and More Commonly Refractory Mycobacterium avium Pulmonary Disease, Toronto, Ontario, Canada. Emerging Infectious Diseases. 2022;28(8):1589-1596. doi:10.3201/eid2808.220464.
APA Raats, D., Brode, S. K., Mehrabi, M., & Marras, T. K. (2022). Increasing and More Commonly Refractory Mycobacterium avium Pulmonary Disease, Toronto, Ontario, Canada. Emerging Infectious Diseases, 28(8), 1589-1596. https://doi.org/10.3201/eid2808.220464.

Dog Ownership and Risk for Alveolar Echinococcosis, Germany [PDF - 2.91 MB - 9 pages]
J. Schmidberger et al.

Human alveolar echinococcosis is caused by the parasite Echinococcus multilocularis, and dog ownership has been identified as a risk factor. We sought to specify the factors of dog ownership underlying this risk by conducting a case–control study among dog owners in Germany. The analysis revealed an increased odds ratio of ≈7-fold for dog owners whose dogs roam unattended in fields, 13-fold for dog owners who feed their dogs organic waste daily, 4-fold for dog owners who take their dog to a veterinarian only in case of illness, and 10-fold for dog owners who have never been informed by a veterinarian about the risk for infection. The results highlight the risk for infection associated with various factors of dog ownership and the value of veterinarians informing owners about prevention.

EID Schmidberger J, Uhlenbruck J, Schlingeloff P, Maksimov P, Conraths FJ, Mayer B, et al. Dog Ownership and Risk for Alveolar Echinococcosis, Germany. Emerg Infect Dis. 2022;28(8):1597-1605. https://doi.org/10.3201/eid2808.212514
AMA Schmidberger J, Uhlenbruck J, Schlingeloff P, et al. Dog Ownership and Risk for Alveolar Echinococcosis, Germany. Emerging Infectious Diseases. 2022;28(8):1597-1605. doi:10.3201/eid2808.212514.
APA Schmidberger, J., Uhlenbruck, J., Schlingeloff, P., Maksimov, P., Conraths, F. J., Mayer, B....Kratzer, W. (2022). Dog Ownership and Risk for Alveolar Echinococcosis, Germany. Emerging Infectious Diseases, 28(8), 1597-1605. https://doi.org/10.3201/eid2808.212514.

Characterization of Emerging Serotype 19A Pneumococcal Strains in Invasive Disease and Carriage, Belgium [PDF - 1.06 MB - 9 pages]
S. Desmet et al.

After switching from 13-valent to 10-valent pneumococcal conjugate vaccine (PCV10) (2015–2016) for children in Belgium, we observed rapid reemergence of serotype 19A invasive pneumococcal disease (IPD). Whole-genome sequencing of 166 serotype 19A IPD isolates from children (n = 54) and older adults (n = 56) and carriage isolates from healthy children (n = 56) collected after the vaccine switch (2017–2018) showed 24 sequence types (STs). ST416 (global pneumococcal sequence cluster [GPSC] 4) and ST994 (GPSC146) accounted for 75.9% of IPD strains from children and 65.7% of IPD (children and older adults) and carriage isolates in the PCV10 period (2017–2018). These STs differed from predominant 19A IPD STs after introduction of PCV7 (2011) in Belgium (ST193 [GPSC11] and ST276 [GPSC10]), which indicates that prediction of emerging strains cannot be based solely on historical emerging strains. Despite their susceptible antimicrobial drug profiles, these clones spread in carriage and IPD during PCV10 use.

EID Desmet S, Theeten H, Laenen L, Cuypers L, Maes P, Bossuyt W, et al. Characterization of Emerging Serotype 19A Pneumococcal Strains in Invasive Disease and Carriage, Belgium. Emerg Infect Dis. 2022;28(8):1606-1614. https://doi.org/10.3201/eid2808.212440
AMA Desmet S, Theeten H, Laenen L, et al. Characterization of Emerging Serotype 19A Pneumococcal Strains in Invasive Disease and Carriage, Belgium. Emerging Infectious Diseases. 2022;28(8):1606-1614. doi:10.3201/eid2808.212440.
APA Desmet, S., Theeten, H., Laenen, L., Cuypers, L., Maes, P., Bossuyt, W....Lagrou, K. (2022). Characterization of Emerging Serotype 19A Pneumococcal Strains in Invasive Disease and Carriage, Belgium. Emerging Infectious Diseases, 28(8), 1606-1614. https://doi.org/10.3201/eid2808.212440.

Invasive Pneumococcal Disease and Long-Term Mortality Rates in Adults, Alberta, Canada [PDF - 1.07 MB - 9 pages]
K. A. Versluys et al.

The relationship between increased short-term mortality rates after invasive pneumococcal disease (IPD) has been frequently studied. However, the relationship between IPD and long-term mortality rates is unknown. IPD patients in Alberta, Canada, had clinical data collected that were linked to administrative databases. We used Cox proportional hazards modeling, and the primary outcome was time to all-cause deaths. First IPD events were identified in 4,522 patients, who had a median follow-up of 3.2 years (interquartile range 0.8‒9.1 years). Overall all-cause mortality rates were consistently higher among cases than controls at 30 days (adjusted hazard ratio [aHR] 3.75, 95% CI 3.29–4.28), 30‒90 days (aHR 1.56, 95% CI 1.27‒1.93), and >90 days (aHR 1.43, 95% CI 1.33–1.54). IPD increases risk for short, intermediate, and long-term mortality rates regardless of age, sex, or concurrent conditions. These findings can help clinicians focus on postdischarge patient plans to limit long-term effects after acute IPD infection.

EID Versluys KA, Eurich DT, Marrie TJ, Tyrrell GJ. Invasive Pneumococcal Disease and Long-Term Mortality Rates in Adults, Alberta, Canada. Emerg Infect Dis. 2022;28(8):1615-1623. https://doi.org/10.3201/eid2808.212469
AMA Versluys KA, Eurich DT, Marrie TJ, et al. Invasive Pneumococcal Disease and Long-Term Mortality Rates in Adults, Alberta, Canada. Emerging Infectious Diseases. 2022;28(8):1615-1623. doi:10.3201/eid2808.212469.
APA Versluys, K. A., Eurich, D. T., Marrie, T. J., & Tyrrell, G. J. (2022). Invasive Pneumococcal Disease and Long-Term Mortality Rates in Adults, Alberta, Canada. Emerging Infectious Diseases, 28(8), 1615-1623. https://doi.org/10.3201/eid2808.212469.

COVID-19 Symptoms and Deaths among Healthcare Workers, United States [PDF - 589 KB - 9 pages]
S. Lin et al.

We evaluated whether demographics and COVID-19 symptoms predicted COVID-19 deaths among healthcare workers (HCWs) in the United States by comparing COVID-19 deaths in HCWs with 3 control groups (HCW nondeaths, non-HCW deaths, and non-HCW nondeaths) using a case–control design. We obtained patient-level data of 33 variables reported during January 1, 2020–October 12, 2021, in all US states. We used logistic regression analysis while controlling for confounders. We found that persons who were >50 years of age, male, Black, or Asian experienced significantly more deaths than matched controls. In addition, HCWs who died had higher risks for the most severe clinical indicators. We also found that the most indicative symptoms were preexisting medical conditions, shortness of breath, fever, cough, and gastrointestinal symptoms. In summary, minority, male, and older HCWs had greater risk for COVID-19 death. Severe clinical indicators and specific symptoms may predict COVID-19–related deaths among HCWs.

EID Lin S, Deng X, Ryan I, Zhang K, Zhang W, Oghaghare E, et al. COVID-19 Symptoms and Deaths among Healthcare Workers, United States. Emerg Infect Dis. 2022;28(8):1624-1641. https://doi.org/10.3201/eid2808.212200
AMA Lin S, Deng X, Ryan I, et al. COVID-19 Symptoms and Deaths among Healthcare Workers, United States. Emerging Infectious Diseases. 2022;28(8):1624-1641. doi:10.3201/eid2808.212200.
APA Lin, S., Deng, X., Ryan, I., Zhang, K., Zhang, W., Oghaghare, E....Shaw, B. (2022). COVID-19 Symptoms and Deaths among Healthcare Workers, United States. Emerging Infectious Diseases, 28(8), 1624-1641. https://doi.org/10.3201/eid2808.212200.

Factors Associated with Delayed or Missed Second-Dose mRNA COVID-19 Vaccination among Persons >12 Years of Age, United States [PDF - 1.73 MB - 9 pages]
L. Meng et al.

To identify demographic factors associated with delaying or not receiving a second dose of the 2-dose primary mRNA COVID-19 vaccine series, we matched 323 million single Pfizer-BioNTech (https://www.pfizer.com) and Moderna (https://www.modernatx.com) COVID-19 vaccine administration records from 2021 and determined whether second doses were delayed or missed. We used 2 sets of logistic regression models to examine associated factors. Overall, 87.3% of recipients received a timely second dose (≤42 days between first and second dose), 3.4% received a delayed second dose (>42 days between first and second dose), and 9.4% missed the second dose. Persons more likely to have delayed or missed the second dose belonged to several racial/ethnic minority groups, were 18–39 years of age, lived in more socially vulnerable areas, and lived in regions other than the northeastern United States. Logistic regression models identified specific subgroups for providing outreach and encouragement to receive subsequent doses on time.

EID Meng L, Murthy N, Murthy B, Zell E, Saelee R, Irving M, et al. Factors Associated with Delayed or Missed Second-Dose mRNA COVID-19 Vaccination among Persons >12 Years of Age, United States. Emerg Infect Dis. 2022;28(8):1633-1641. https://doi.org/10.3201/eid2808.220557
AMA Meng L, Murthy N, Murthy B, et al. Factors Associated with Delayed or Missed Second-Dose mRNA COVID-19 Vaccination among Persons >12 Years of Age, United States. Emerging Infectious Diseases. 2022;28(8):1633-1641. doi:10.3201/eid2808.220557.
APA Meng, L., Murthy, N., Murthy, B., Zell, E., Saelee, R., Irving, M....Chorba, T. (2022). Factors Associated with Delayed or Missed Second-Dose mRNA COVID-19 Vaccination among Persons >12 Years of Age, United States. Emerging Infectious Diseases, 28(8), 1633-1641. https://doi.org/10.3201/eid2808.220557.

COVID-19 Vaccination Intent and Belief that Vaccination Will End the Pandemic [PDF - 1.05 MB - 8 pages]
M. de Vries et al.

High vaccination coverage is considered to be key in dealing with the coronavirus disease (COVID-19) pandemic. However, vaccine hesitancy can limit uptake. We examined the specific coronavirus beliefs that persons have regarding COVID-19 and COVID-19 vaccines and to what extent these beliefs explain COVID-19 vaccination intentions. We conducted a survey among 4,033 residents of the Netherlands that examined COVID-19 vaccination intentions and various beliefs. Random forest regression analysis explained 76% of the variance in vaccination intentions. The strongest determinant in the model was the belief the COVID-19 crisis will only end if many persons get vaccinated. Other strong determinants were beliefs about safety of vaccines, specifically in relation to vaccine development and approval process; (social) benefits of vaccination; social norms regarding vaccination behavior; and effectiveness of vaccines. We propose to address these specific beliefs in communications about COVID-19 vaccinations to stimulate vaccine uptake.

EID de Vries M, Claassen L, Lambooij M, Leung K, Boersma K, Timen A. COVID-19 Vaccination Intent and Belief that Vaccination Will End the Pandemic. Emerg Infect Dis. 2022;28(8):1642-1649. https://doi.org/10.3201/eid2808.212556
AMA de Vries M, Claassen L, Lambooij M, et al. COVID-19 Vaccination Intent and Belief that Vaccination Will End the Pandemic. Emerging Infectious Diseases. 2022;28(8):1642-1649. doi:10.3201/eid2808.212556.
APA de Vries, M., Claassen, L., Lambooij, M., Leung, K., Boersma, K., & Timen, A. (2022). COVID-19 Vaccination Intent and Belief that Vaccination Will End the Pandemic. Emerging Infectious Diseases, 28(8), 1642-1649. https://doi.org/10.3201/eid2808.212556.

Association of Environmental Factors with Seasonal Intensity of Erysipelothrix rhusiopathiae Seropositivity among Arctic Caribou [PDF - 2.50 MB - 9 pages]
O. Aleuy et al.

Several caribou (Rangifer tarandus) populations have been declining concurrently with increases in infectious diseases in the Arctic. Erysipelothrix rhusiopathiae, a zoonotic bacterium, was first described in 2015 as a notable cause of illness and death among several Arctic wildlife species. We investigated epidemiologic and environmental factors associated with the seroprevalence of E. rhusiopathiae in the Arctic and found that seropositivity was highest during warmer months, peaking in September, and was highest among adult males. Summer seroprevalence increases tracked with the oestrid index from the previous year, icing and snowing events, and precipitation from the same year but decreased with growing degree days in the same year. Seroprevalence of E. rhusiopathiae varied more during the later years of the study. Our findings provide key insights into the influence of environmental factors on disease prevalence that can be instrumental for anticipating and mitigating diseases associated with climate change among Arctic wildlife and human populations.

EID Aleuy O, Anholt M, Orsel K, Mavrot F, Gagnon CA, Beckmen K, et al. Association of Environmental Factors with Seasonal Intensity of Erysipelothrix rhusiopathiae Seropositivity among Arctic Caribou. Emerg Infect Dis. 2022;28(8):1650-1658. https://doi.org/10.3201/eid2808.212144
AMA Aleuy O, Anholt M, Orsel K, et al. Association of Environmental Factors with Seasonal Intensity of Erysipelothrix rhusiopathiae Seropositivity among Arctic Caribou. Emerging Infectious Diseases. 2022;28(8):1650-1658. doi:10.3201/eid2808.212144.
APA Aleuy, O., Anholt, M., Orsel, K., Mavrot, F., Gagnon, C. A., Beckmen, K....Kutz, S. (2022). Association of Environmental Factors with Seasonal Intensity of Erysipelothrix rhusiopathiae Seropositivity among Arctic Caribou. Emerging Infectious Diseases, 28(8), 1650-1658. https://doi.org/10.3201/eid2808.212144.

Transmissibility of SARS-CoV-2 B.1.1.214 and Alpha Variants during 4 COVID-19 Waves, Kyoto, Japan, January 2020–June 2021 [PDF - 1.10 MB - 9 pages]
Y. Matsumura et al.

Household transmission is a primary source of SARS-CoV-2 spread. We used COVID-19 epidemiologic investigation data and viral genome analysis data collected in the city of Kyoto, Japan, during January 2020–June 2021 to evaluate the effects of different settings and viral strains on SARS-CoV-2 transmission. Epidemiologic investigations of 5,061 COVID-19 cases found that the most common category for close contact was within households (35.3%); this category also had the highest reverse transcription PCR positivity. The prevalent viral lineage shifted from B.1.1.214 in the third wave to the Alpha variant in the fourth wave. The proportion of secondary cases associated with households also increased from the third to fourth waves (27% vs. 29%). Among 564 contacts from 206 households, Alpha variant was significantly associated with household transmission (odds ratio 1.52, 95% CI 1.06–2.18) compared with B.1.1.214. Public health interventions targeting household contacts and specific variants could help control SARS-CoV-2 transmission.

EID Matsumura Y, Nagao M, Yamamoto M, Tsuchido Y, Noguchi T, Shinohara K, et al. Transmissibility of SARS-CoV-2 B.1.1.214 and Alpha Variants during 4 COVID-19 Waves, Kyoto, Japan, January 2020–June 2021. Emerg Infect Dis. 2022;28(8):1569-1577. https://doi.org/10.3201/eid2808.220420
AMA Matsumura Y, Nagao M, Yamamoto M, et al. Transmissibility of SARS-CoV-2 B.1.1.214 and Alpha Variants during 4 COVID-19 Waves, Kyoto, Japan, January 2020–June 2021. Emerging Infectious Diseases. 2022;28(8):1569-1577. doi:10.3201/eid2808.220420.
APA Matsumura, Y., Nagao, M., Yamamoto, M., Tsuchido, Y., Noguchi, T., Shinohara, K....Ikeda, T. (2022). Transmissibility of SARS-CoV-2 B.1.1.214 and Alpha Variants during 4 COVID-19 Waves, Kyoto, Japan, January 2020–June 2021. Emerging Infectious Diseases, 28(8), 1569-1577. https://doi.org/10.3201/eid2808.220420.
Dispatches

Culling of Urban Norway Rats and Carriage of Bartonella spp. Bacteria, Vancouver, British Columbia, Canada [PDF - 5.74 MB - 5 pages]
K. A. Byers et al.

We investigated the effects of culling on Bartonella spp. bacteria carriage among urban rats in Canada. We found that the odds of Bartonella spp. carriage increased across city blocks except those in which culling occurred. Removing rats may have prevented an increase in Bartonella spp. prevalence, potentially lowering human health risks.

EID Byers KA, Lee MJ, Hill JE, Fernando C, Speerin L, Donovan CM, et al. Culling of Urban Norway Rats and Carriage of Bartonella spp. Bacteria, Vancouver, British Columbia, Canada. Emerg Infect Dis. 2022;28(8):1659-1663. https://doi.org/10.3201/eid2808.211164
AMA Byers KA, Lee MJ, Hill JE, et al. Culling of Urban Norway Rats and Carriage of Bartonella spp. Bacteria, Vancouver, British Columbia, Canada. Emerging Infectious Diseases. 2022;28(8):1659-1663. doi:10.3201/eid2808.211164.
APA Byers, K. A., Lee, M. J., Hill, J. E., Fernando, C., Speerin, L., Donovan, C. M....Himsworth, C. G. (2022). Culling of Urban Norway Rats and Carriage of Bartonella spp. Bacteria, Vancouver, British Columbia, Canada. Emerging Infectious Diseases, 28(8), 1659-1663. https://doi.org/10.3201/eid2808.211164.

Zoonotic Threat of G4 Genotype Eurasian Avian-Like Swine Influenza A(H1N1) Viruses, China, 2020 [PDF - 1.15 MB - 5 pages]
M. Gu et al.

We investigated genetic and biologic characteristics of 2 Eurasian avian-like H1N1 swine influenza viruses from pigs in China that belong to the predominant G4 genotype. One swine isolate exhibited strikingly great homology to contemporaneous human Eurasian avian-like H1N1 isolates, preferential binding to the human-type receptor, and vigorous replication in mice without adaptation.

EID Gu M, Chen K, Ge Z, Jiao J, Cai T, Liu S, et al. Zoonotic Threat of G4 Genotype Eurasian Avian-Like Swine Influenza A(H1N1) Viruses, China, 2020. Emerg Infect Dis. 2022;28(8):1664-1668. https://doi.org/10.3201/eid2808.212530
AMA Gu M, Chen K, Ge Z, et al. Zoonotic Threat of G4 Genotype Eurasian Avian-Like Swine Influenza A(H1N1) Viruses, China, 2020. Emerging Infectious Diseases. 2022;28(8):1664-1668. doi:10.3201/eid2808.212530.
APA Gu, M., Chen, K., Ge, Z., Jiao, J., Cai, T., Liu, S....Liu, X. (2022). Zoonotic Threat of G4 Genotype Eurasian Avian-Like Swine Influenza A(H1N1) Viruses, China, 2020. Emerging Infectious Diseases, 28(8), 1664-1668. https://doi.org/10.3201/eid2808.212530.

Increased Incidence of Invasive Pneumococcal Disease among Children after COVID-19 Pandemic, England [PDF - 1.00 MB - 4 pages]
M. Bertran et al.

During July–December 2021, after COVID-19 restrictions were removed in England, invasive pneumococcal disease incidence in children <15 years of age was higher (1.96/100,000 children) than during the same period in 2020 (0.7/100,000 children) and in prepandemic years 2017–2019 (1.43/100,000 children). Childhood vaccine coverage should be maintained to protect the population.

EID Bertran M, Amin-Chowdhury Z, Sheppard CL, Eletu S, Zamarreño DV, Ramsay ME, et al. Increased Incidence of Invasive Pneumococcal Disease among Children after COVID-19 Pandemic, England. Emerg Infect Dis. 2022;28(8):1669-1672. https://doi.org/10.3201/eid2808.220304
AMA Bertran M, Amin-Chowdhury Z, Sheppard CL, et al. Increased Incidence of Invasive Pneumococcal Disease among Children after COVID-19 Pandemic, England. Emerging Infectious Diseases. 2022;28(8):1669-1672. doi:10.3201/eid2808.220304.
APA Bertran, M., Amin-Chowdhury, Z., Sheppard, C. L., Eletu, S., Zamarreño, D. V., Ramsay, M. E....Ladhani, S. N. (2022). Increased Incidence of Invasive Pneumococcal Disease among Children after COVID-19 Pandemic, England. Emerging Infectious Diseases, 28(8), 1669-1672. https://doi.org/10.3201/eid2808.220304.

Novel Chronic Anaplasmosis in Splenectomized Patient, Amazon Rainforest [PDF - 1.31 MB - 4 pages]
O. Duron et al.

We report a case of unusual human anaplasmosis in the Amazon rainforest of French Guiana. Molecular typing demonstrated that the pathogen is a novel Anaplasma species, distinct to all known species, and more genetically related to recently described Anaplasma spp. causing infections in rainforest wild fauna of Brazil.

EID Duron O, Koual R, Musset L, Buysse M, Lambert Y, Jaulhac B, et al. Novel Chronic Anaplasmosis in Splenectomized Patient, Amazon Rainforest. Emerg Infect Dis. 2022;28(8):1673-1676. https://doi.org/10.3201/eid2808.212425
AMA Duron O, Koual R, Musset L, et al. Novel Chronic Anaplasmosis in Splenectomized Patient, Amazon Rainforest. Emerging Infectious Diseases. 2022;28(8):1673-1676. doi:10.3201/eid2808.212425.
APA Duron, O., Koual, R., Musset, L., Buysse, M., Lambert, Y., Jaulhac, B....Douine, M. (2022). Novel Chronic Anaplasmosis in Splenectomized Patient, Amazon Rainforest. Emerging Infectious Diseases, 28(8), 1673-1676. https://doi.org/10.3201/eid2808.212425.

Anthelmintic Baiting of Foxes against Echinococcus multilocularis in Small Public Area, Japan [PDF - 2.62 MB - 4 pages]
K. Uraguchi et al.

We distributed anthelmintic baits on a university campus in Japan inhabited by foxes infected with Echinococcus multilocularis to design an effective baiting protocol for small public areas. High-density baiting can reduce the risk for human exposure to the parasite to near zero. However, monthly baiting is recommended to maintain this effect.

EID Uraguchi K, Irie T, Kouguchi H, Inamori A, Sashika M, Shimozuru M, et al. Anthelmintic Baiting of Foxes against Echinococcus multilocularis in Small Public Area, Japan. Emerg Infect Dis. 2022;28(8):1677-1680. https://doi.org/10.3201/eid2808.212016
AMA Uraguchi K, Irie T, Kouguchi H, et al. Anthelmintic Baiting of Foxes against Echinococcus multilocularis in Small Public Area, Japan. Emerging Infectious Diseases. 2022;28(8):1677-1680. doi:10.3201/eid2808.212016.
APA Uraguchi, K., Irie, T., Kouguchi, H., Inamori, A., Sashika, M., Shimozuru, M....Yagi, K. (2022). Anthelmintic Baiting of Foxes against Echinococcus multilocularis in Small Public Area, Japan. Emerging Infectious Diseases, 28(8), 1677-1680. https://doi.org/10.3201/eid2808.212016.

Spiroplasma ixodetis Infections in Immunocompetent and Immunosuppressed Patients after Tick Exposure, Sweden [PDF - 621 KB - 5 pages]
J. Eimer et al.

We report 2 cases of Spiroplasma ixodetis infection in an immunocompetent patient and an immunocompromised patient who had frequent tick exposure. Fever, thrombocytopenia, and increased liver aminotransferase levels raised the suspicion of anaplasmosis, but 16S rRNA PCR and Sanger sequencing yielded a diagnosis of spiroplasmosis. Both patients recovered after doxycycline treatment.

EID Eimer J, Fernström L, Rohlén L, Grankvist A, Loo K, Nyman E, et al. Spiroplasma ixodetis Infections in Immunocompetent and Immunosuppressed Patients after Tick Exposure, Sweden. Emerg Infect Dis. 2022;28(8):1681-1685. https://doi.org/10.3201/eid2808.212524
AMA Eimer J, Fernström L, Rohlén L, et al. Spiroplasma ixodetis Infections in Immunocompetent and Immunosuppressed Patients after Tick Exposure, Sweden. Emerging Infectious Diseases. 2022;28(8):1681-1685. doi:10.3201/eid2808.212524.
APA Eimer, J., Fernström, L., Rohlén, L., Grankvist, A., Loo, K., Nyman, E....Schön, T. (2022). Spiroplasma ixodetis Infections in Immunocompetent and Immunosuppressed Patients after Tick Exposure, Sweden. Emerging Infectious Diseases, 28(8), 1681-1685. https://doi.org/10.3201/eid2808.212524.

Toxigenic Corynebacterium diphtheriae Infection in Cat, Texas, USA [PDF - 268 KB - 3 pages]
R. Tyler et al.

We report a toxigenic strain of Corynebacterium diphtheriae isolated from an oozing dermal wound in a pet cat in Texas, USA. We also describe the epidemiologic public health efforts conducted to identify potential sources of infection and mitigate its spread and the molecular and genetic studies performed to identify the bacterium.

EID Tyler R, Rincon L, Weigand MR, Xiaoli L, Acosta AM, Kurien D, et al. Toxigenic Corynebacterium diphtheriae Infection in Cat, Texas, USA. Emerg Infect Dis. 2022;28(8):1686-1688. https://doi.org/10.3201/eid2808.220018
AMA Tyler R, Rincon L, Weigand MR, et al. Toxigenic Corynebacterium diphtheriae Infection in Cat, Texas, USA. Emerging Infectious Diseases. 2022;28(8):1686-1688. doi:10.3201/eid2808.220018.
APA Tyler, R., Rincon, L., Weigand, M. R., Xiaoli, L., Acosta, A. M., Kurien, D....Prot, E. (2022). Toxigenic Corynebacterium diphtheriae Infection in Cat, Texas, USA. Emerging Infectious Diseases, 28(8), 1686-1688. https://doi.org/10.3201/eid2808.220018.

Child Melioidosis Deaths Caused by Burkholderia pseudomallei–Contaminated Borehole Water, Vietnam, 2019 [PDF - 6.59 MB - 5 pages]
Q. Tran et al.

Within 8 months, 3 children from 1 family in northern Vietnam died from melioidosis. Burkholderia pseudomallei of the same sequence type, 541, was isolated from clinical samples, borehole water, and garden and rice field soil. Boreholes should be properly constructed and maintained to avoid B. pseudomallei contamination.

EID Tran Q, Phan PH, Bui L, Bui H, Hoang N, Tran DM, et al. Child Melioidosis Deaths Caused by Burkholderia pseudomallei–Contaminated Borehole Water, Vietnam, 2019. Emerg Infect Dis. 2022;28(8):1689-1693. https://doi.org/10.3201/eid2808.220113
AMA Tran Q, Phan PH, Bui L, et al. Child Melioidosis Deaths Caused by Burkholderia pseudomallei–Contaminated Borehole Water, Vietnam, 2019. Emerging Infectious Diseases. 2022;28(8):1689-1693. doi:10.3201/eid2808.220113.
APA Tran, Q., Phan, P. H., Bui, L., Bui, H., Hoang, N., Tran, D. M....Trinh, T. T. (2022). Child Melioidosis Deaths Caused by Burkholderia pseudomallei–Contaminated Borehole Water, Vietnam, 2019. Emerging Infectious Diseases, 28(8), 1689-1693. https://doi.org/10.3201/eid2808.220113.

Association of Phylogenomic Relatedness among Neisseria gonorrhoeae Strains with Antimicrobial Resistance, Austria, 2016–2020 [PDF - 2.76 MB - 5 pages]
J. Schaeffer et al.

We investigated genomic determinants of antimicrobial resistance in 1,318 Neisseria gonorrhoeae strains isolated in Austria during 2016–2020. Sequence type (ST) 9363 and ST11422 isolates had high rates of azithromycin resistance, and ST7363 isolates correlated with cephalosporin resistance. These results underline the benefit of genomic surveillance for antimicrobial resistance monitoring.

EID Schaeffer J, Lippert K, Pleininger S, Stöger A, Hasenberger P, Stadlbauer S, et al. Association of Phylogenomic Relatedness among Neisseria gonorrhoeae Strains with Antimicrobial Resistance, Austria, 2016–2020. Emerg Infect Dis. 2022;28(8):1694-1698. https://doi.org/10.3201/eid2808.220071
AMA Schaeffer J, Lippert K, Pleininger S, et al. Association of Phylogenomic Relatedness among Neisseria gonorrhoeae Strains with Antimicrobial Resistance, Austria, 2016–2020. Emerging Infectious Diseases. 2022;28(8):1694-1698. doi:10.3201/eid2808.220071.
APA Schaeffer, J., Lippert, K., Pleininger, S., Stöger, A., Hasenberger, P., Stadlbauer, S....Ruppitsch, W. (2022). Association of Phylogenomic Relatedness among Neisseria gonorrhoeae Strains with Antimicrobial Resistance, Austria, 2016–2020. Emerging Infectious Diseases, 28(8), 1694-1698. https://doi.org/10.3201/eid2808.220071.

Serial Intervals for SARS-CoV-2 Omicron and Delta Variants, Belgium, November 19–December 31, 2021 [PDF - 1.25 MB - 4 pages]
C. Kremer et al.

We investigated the serial interval for SARS-CoV-2 Omicron BA.1 and Delta variants and observed a shorter serial interval for Omicron, suggesting faster transmission. Results indicate a relationship between empirical serial interval and vaccination status for both variants. Further assessment of the causes and extent of Omicron dominance over Delta is warranted.

EID Kremer C, Braeye T, Proesmans K, André E, Torneri A, Hens N. Serial Intervals for SARS-CoV-2 Omicron and Delta Variants, Belgium, November 19–December 31, 2021. Emerg Infect Dis. 2022;28(8):1699-1702. https://doi.org/10.3201/eid2808.220220
AMA Kremer C, Braeye T, Proesmans K, et al. Serial Intervals for SARS-CoV-2 Omicron and Delta Variants, Belgium, November 19–December 31, 2021. Emerging Infectious Diseases. 2022;28(8):1699-1702. doi:10.3201/eid2808.220220.
APA Kremer, C., Braeye, T., Proesmans, K., André, E., Torneri, A., & Hens, N. (2022). Serial Intervals for SARS-CoV-2 Omicron and Delta Variants, Belgium, November 19–December 31, 2021. Emerging Infectious Diseases, 28(8), 1699-1702. https://doi.org/10.3201/eid2808.220220.

Novel Reassortant Avian Influenza A(H5N6) Virus, China, 2021 [PDF - 1.80 MB - 5 pages]
J. Chen et al.

Although reports of human infection with influenza A(H5N6) increased in 2021, reports of similar H5N6 virus infection in poultry are few. We detected 10 avian influenza A(H5N6) clade 2.3.4.4b viruses in poultry from 4 provinces in China. The viruses showed strong immune-escape capacity and complex genetic reassortment, suggesting further transmission risk.

EID Chen J, Xu L, Liu T, Xie S, Li K, Li X, et al. Novel Reassortant Avian Influenza A(H5N6) Virus, China, 2021. Emerg Infect Dis. 2022;28(8):1703-1707. https://doi.org/10.3201/eid2808.212241
AMA Chen J, Xu L, Liu T, et al. Novel Reassortant Avian Influenza A(H5N6) Virus, China, 2021. Emerging Infectious Diseases. 2022;28(8):1703-1707. doi:10.3201/eid2808.212241.
APA Chen, J., Xu, L., Liu, T., Xie, S., Li, K., Li, X....Jia, W. (2022). Novel Reassortant Avian Influenza A(H5N6) Virus, China, 2021. Emerging Infectious Diseases, 28(8), 1703-1707. https://doi.org/10.3201/eid2808.212241.

Effectiveness of Naturally Acquired and Vaccine-Induced Immune Responses to SARS-CoV-2 Mu Variant [PDF - 1.58 MB - 5 pages]
E. F. de Oliveira-Filho et al.

SARS-CoV-2 Mu variant emerged in Colombia in 2021 and spread globally. In 49 serum samples from vaccinees and COVID-19 survivors in Colombia, neutralization was significantly lower (p<0.0001) for Mu than a parental strain and variants of concern. Only the Omicron variant of concern demonstrated higher immune evasion.

EID de Oliveira-Filho EF, Rincon-Orozco B, Jones-Cifuentes N, Peña-López B, Mühlemann B, Drosten C, et al. Effectiveness of Naturally Acquired and Vaccine-Induced Immune Responses to SARS-CoV-2 Mu Variant. Emerg Infect Dis. 2022;28(8):1708-1712. https://doi.org/10.3201/eid2808.220584
AMA de Oliveira-Filho EF, Rincon-Orozco B, Jones-Cifuentes N, et al. Effectiveness of Naturally Acquired and Vaccine-Induced Immune Responses to SARS-CoV-2 Mu Variant. Emerging Infectious Diseases. 2022;28(8):1708-1712. doi:10.3201/eid2808.220584.
APA de Oliveira-Filho, E. F., Rincon-Orozco, B., Jones-Cifuentes, N., Peña-López, B., Mühlemann, B., Drosten, C....Drexler, J. (2022). Effectiveness of Naturally Acquired and Vaccine-Induced Immune Responses to SARS-CoV-2 Mu Variant. Emerging Infectious Diseases, 28(8), 1708-1712. https://doi.org/10.3201/eid2808.220584.
Research Letters

Lymphocytic Choriomeningitis Virus Infection, Australia [PDF - 538 KB - 3 pages]
L. Caly et al.

During a mouse plague in early 2021, a farmer from New South Wales, Australia, sought treatment for aseptic meningitis and was subsequently diagnosed with locally acquired lymphocytic choriomeningitis virus infection. Whole-genome sequencing identified a divergent and geographically distinct lymphocytic choriomeningitis virus strain compared with other published sequences.

EID Caly L, Porter AF, Chua J, Collet JP, Druce JD, Catton MG, et al. Lymphocytic Choriomeningitis Virus Infection, Australia. Emerg Infect Dis. 2022;28(8):1713-1715. https://doi.org/10.3201/eid2808.220119
AMA Caly L, Porter AF, Chua J, et al. Lymphocytic Choriomeningitis Virus Infection, Australia. Emerging Infectious Diseases. 2022;28(8):1713-1715. doi:10.3201/eid2808.220119.
APA Caly, L., Porter, A. F., Chua, J., Collet, J. P., Druce, J. D., Catton, M. G....Duchene, S. (2022). Lymphocytic Choriomeningitis Virus Infection, Australia. Emerging Infectious Diseases, 28(8), 1713-1715. https://doi.org/10.3201/eid2808.220119.

Public Health Risk of Foodborne Pathogens in Edible African Land Snails, Cameroon [PDF - 528 KB - 3 pages]
M. Tanyitiku et al.

In tropical countries, land snails are an important food source; however, foodborne disease risks are poorly quantified. We detected Campylobacter spp., Yersinia spp., Listeria spp., Salmonella spp., or Shiga-toxigenic Escherichia coli in 57%–86% of snails in Cameroon. Snail meat is a likely vector for enteric diseases in sub-Saharan Africa countries.

EID Tanyitiku M, Nicholas G, Petcheu I, Sullivan JJ, On S. Public Health Risk of Foodborne Pathogens in Edible African Land Snails, Cameroon. Emerg Infect Dis. 2022;28(8):1715-1717. https://doi.org/10.3201/eid2808.220722
AMA Tanyitiku M, Nicholas G, Petcheu I, et al. Public Health Risk of Foodborne Pathogens in Edible African Land Snails, Cameroon. Emerging Infectious Diseases. 2022;28(8):1715-1717. doi:10.3201/eid2808.220722.
APA Tanyitiku, M., Nicholas, G., Petcheu, I., Sullivan, J. J., & On, S. (2022). Public Health Risk of Foodborne Pathogens in Edible African Land Snails, Cameroon. Emerging Infectious Diseases, 28(8), 1715-1717. https://doi.org/10.3201/eid2808.220722.

Bacillus subtilis variant natto Bacteremia of Gastrointestinal Origin, Japan [PDF - 989 KB - 2 pages]
I. Tanaka et al.

We report a case of bacteremia caused by Bacillus subtilis variant natto after a gastrointestinal perforation in a patient in Japan. Genotypic and phenotypic studies of biotin identified B. subtilis var. natto. This case and 3 others in Japan may have been caused by consuming natto (fermented soybeans).

EID Tanaka I, Kutsuna S, Ohkusu M, Kato T, Miyashita M, Moriya A, et al. Bacillus subtilis variant natto Bacteremia of Gastrointestinal Origin, Japan. Emerg Infect Dis. 2022;28(8):1718-1719. https://doi.org/10.3201/eid2808.211567
AMA Tanaka I, Kutsuna S, Ohkusu M, et al. Bacillus subtilis variant natto Bacteremia of Gastrointestinal Origin, Japan. Emerging Infectious Diseases. 2022;28(8):1718-1719. doi:10.3201/eid2808.211567.
APA Tanaka, I., Kutsuna, S., Ohkusu, M., Kato, T., Miyashita, M., Moriya, A....Ohkusu, K. (2022). Bacillus subtilis variant natto Bacteremia of Gastrointestinal Origin, Japan. Emerging Infectious Diseases, 28(8), 1718-1719. https://doi.org/10.3201/eid2808.211567.

Invasive Streptococcus oralis Expressing Serotype 3 Pneumococcal Capsule, Japan [PDF - 809 KB - 3 pages]
B. Chang et al.

We report 2 adult cases of invasive disease in Japan caused by Streptococcus oralis that expressed the serotype 3 pneumococcal capsule and formed mucoid colonies. Whole-genome sequencing revealed that the identical serotype 3 pneumococcal capsule locus and hyl fragment were recombined into the genomes of 2 distinct S. oralis strains.

EID Chang B, Morita M, Nariai A, Kasahara K, Kakutani A, Ogawa M, et al. Invasive Streptococcus oralis Expressing Serotype 3 Pneumococcal Capsule, Japan. Emerg Infect Dis. 2022;28(8):1720-1722. https://doi.org/10.3201/eid2808.212176
AMA Chang B, Morita M, Nariai A, et al. Invasive Streptococcus oralis Expressing Serotype 3 Pneumococcal Capsule, Japan. Emerging Infectious Diseases. 2022;28(8):1720-1722. doi:10.3201/eid2808.212176.
APA Chang, B., Morita, M., Nariai, A., Kasahara, K., Kakutani, A., Ogawa, M....Oishi, K. (2022). Invasive Streptococcus oralis Expressing Serotype 3 Pneumococcal Capsule, Japan. Emerging Infectious Diseases, 28(8), 1720-1722. https://doi.org/10.3201/eid2808.212176.

Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan [PDF - 399 KB - 3 pages]
A. Ahmed et al.

We report hepatitis E virus (HEV) outbreaks among refugees from Ethiopia in Sudan during June 2021–February 2022. We identified 1,589 cases of acute jaundice syndrome and used PCR to confirm HEV infection in 64% of cases. Implementing vaccination, water, sanitation, and hygiene programs might reduce HEV outbreak risk.

EID Ahmed A, Ali Y, Siddig E, Hamed J, Mohamed NS, Khairy A, et al. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan. Emerg Infect Dis. 2022;28(8):1722-1724. https://doi.org/10.3201/eid2808.220397
AMA Ahmed A, Ali Y, Siddig E, et al. Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan. Emerging Infectious Diseases. 2022;28(8):1722-1724. doi:10.3201/eid2808.220397.
APA Ahmed, A., Ali, Y., Siddig, E., Hamed, J., Mohamed, N. S., Khairy, A....Zinsstag, J. (2022). Hepatitis E Virus Outbreak among Tigray War Refugees from Ethiopia, Sudan. Emerging Infectious Diseases, 28(8), 1722-1724. https://doi.org/10.3201/eid2808.220397.

Emergence of Dengue Virus Serotype 2 Cosmopolitan Genotype, Brazil [PDF - 1.18 MB - 3 pages]
M. Giovanetti et al.

We used nanopore sequencing and phylogenetic analyses to identify a cosmopolitan genotype of dengue virus serotype 2 that was isolated from a 56-year-old male patient from the state of Goiás in Brazil. The emergence of a cosmopolitan genotype in Brazil will require risk assessment and surveillance to reduce epidemic potential.

EID Giovanetti M, Pereira L, Santiago GA, Fonseca V, Mendoza M, de Oliveira C, et al. Emergence of Dengue Virus Serotype 2 Cosmopolitan Genotype, Brazil. Emerg Infect Dis. 2022;28(8):1725-1727. https://doi.org/10.3201/eid2808.220550
AMA Giovanetti M, Pereira L, Santiago GA, et al. Emergence of Dengue Virus Serotype 2 Cosmopolitan Genotype, Brazil. Emerging Infectious Diseases. 2022;28(8):1725-1727. doi:10.3201/eid2808.220550.
APA Giovanetti, M., Pereira, L., Santiago, G. A., Fonseca, V., Mendoza, M., de Oliveira, C....Alcantara, L. (2022). Emergence of Dengue Virus Serotype 2 Cosmopolitan Genotype, Brazil. Emerging Infectious Diseases, 28(8), 1725-1727. https://doi.org/10.3201/eid2808.220550.

Early SARS-CoV-2 Reinfections within 60 Days and Implications for Retesting Policies [PDF - 662 KB - 3 pages]
L. Nevejan et al.

Illustrated by a clinical case supplemented by epidemiologic data, early reinfections with SARS-CoV-2 Omicron BA.1 after infection with Delta variant, and reinfection with Omicron BA.2 after Omicron BA.1 infection, can occur within 60 days, especially in young, unvaccinated persons. The case definition of reinfection, which influences retesting policies, should be reconsidered.

EID Nevejan L, Cuypers L, Laenen L, Van Loo L, Vermeulen F, Wollants E, et al. Early SARS-CoV-2 Reinfections within 60 Days and Implications for Retesting Policies. Emerg Infect Dis. 2022;28(8):1729-1731. https://doi.org/10.3201/eid2808.220617
AMA Nevejan L, Cuypers L, Laenen L, et al. Early SARS-CoV-2 Reinfections within 60 Days and Implications for Retesting Policies. Emerging Infectious Diseases. 2022;28(8):1729-1731. doi:10.3201/eid2808.220617.
APA Nevejan, L., Cuypers, L., Laenen, L., Van Loo, L., Vermeulen, F., Wollants, E....André, E. (2022). Early SARS-CoV-2 Reinfections within 60 Days and Implications for Retesting Policies. Emerging Infectious Diseases, 28(8), 1729-1731. https://doi.org/10.3201/eid2808.220617.

Household Secondary Attack Rates of SARS-CoV-2 Omicron Variant, South Korea, February 2022 [PDF - 620 KB - 4 pages]
D. Lim et al.

We studied the effect of booster vaccinations on reducing household transmission of SARS-CoV-2 B.1.1529 (Omicron) variant in a February 2022 sampling of contacts in South Korea. The secondary attack rate was lower for vaccinated versus unvaccinated contacts, and booster vaccination resulted in a lower incidence rate ratio.

EID Lim D, Choe Y, Man Kim Y, Lee S, Jang E, Kim J, et al. Household Secondary Attack Rates of SARS-CoV-2 Omicron Variant, South Korea, February 2022. Emerg Infect Dis. 2022;28(8):1731-1734. https://doi.org/10.3201/eid2808.220384
AMA Lim D, Choe Y, Man Kim Y, et al. Household Secondary Attack Rates of SARS-CoV-2 Omicron Variant, South Korea, February 2022. Emerging Infectious Diseases. 2022;28(8):1731-1734. doi:10.3201/eid2808.220384.
APA Lim, D., Choe, Y., Man Kim, Y., Lee, S., Jang, E., Kim, J....Park, Y. (2022). Household Secondary Attack Rates of SARS-CoV-2 Omicron Variant, South Korea, February 2022. Emerging Infectious Diseases, 28(8), 1731-1734. https://doi.org/10.3201/eid2808.220384.

Estimating COVID-19 Vaccine Effectiveness for Skilled Nursing Facility Healthcare Personnel, California, USA [PDF - 318 KB - 3 pages]
M. Magro et al.

We estimated real-world vaccine effectiveness among skilled nursing facility healthcare personnel who were regularly tested for SARS-CoV-2 infection in California, USA, during January‒March 2021. Vaccine effectiveness for fully vaccinated healthcare personnel was 73.3% (95% CI 57.5%–83.3%). We observed high real-world vaccine effectiveness in this population.

EID Magro M, Parriott A, Mitsunaga T, Epson E. Estimating COVID-19 Vaccine Effectiveness for Skilled Nursing Facility Healthcare Personnel, California, USA. Emerg Infect Dis. 2022;28(8):1734-1736. https://doi.org/10.3201/eid2808.220650
AMA Magro M, Parriott A, Mitsunaga T, et al. Estimating COVID-19 Vaccine Effectiveness for Skilled Nursing Facility Healthcare Personnel, California, USA. Emerging Infectious Diseases. 2022;28(8):1734-1736. doi:10.3201/eid2808.220650.
APA Magro, M., Parriott, A., Mitsunaga, T., & Epson, E. (2022). Estimating COVID-19 Vaccine Effectiveness for Skilled Nursing Facility Healthcare Personnel, California, USA. Emerging Infectious Diseases, 28(8), 1734-1736. https://doi.org/10.3201/eid2808.220650.
Letters

Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance [PDF - 233 KB - 2 pages]
A. Freitas et al.
EID Freitas A, Pezzi L, Cavalcanti L, Simon F. Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance. Emerg Infect Dis. 2022;28(8):1736-1737. https://doi.org/10.3201/eid2808.220558
AMA Freitas A, Pezzi L, Cavalcanti L, et al. Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance. Emerging Infectious Diseases. 2022;28(8):1736-1737. doi:10.3201/eid2808.220558.
APA Freitas, A., Pezzi, L., Cavalcanti, L., & Simon, F. (2022). Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance. Emerging Infectious Diseases, 28(8), 1736-1737. https://doi.org/10.3201/eid2808.220558.

Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance (Response) [PDF - 236 KB - 2 pages]
J. J. Anzinger
EID Anzinger JJ. Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance (Response). Emerg Infect Dis. 2022;28(8):1737-1738. https://doi.org/10.3201/eid2808.221006
AMA Anzinger JJ. Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance (Response). Emerging Infectious Diseases. 2022;28(8):1737-1738. doi:10.3201/eid2808.221006.
APA Anzinger, J. J. (2022). Seroprevalence of Chikungunya Virus, Jamaica, and New Tools for Surveillance (Response). Emerging Infectious Diseases, 28(8), 1737-1738. https://doi.org/10.3201/eid2808.221006.

Imported Monkeypox from International Traveler, Maryland, USA, 2021 [PDF - 227 KB - 1 page]
F. S. Minhaj et al.
EID Minhaj FS, Rao AK, McCollum AM. Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerg Infect Dis. 2022;28(8):1738. https://doi.org/10.3201/eid2808.220726
AMA Minhaj FS, Rao AK, McCollum AM. Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerging Infectious Diseases. 2022;28(8):1738. doi:10.3201/eid2808.220726.
APA Minhaj, F. S., Rao, A. K., & McCollum, A. M. (2022). Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerging Infectious Diseases, 28(8), 1738. https://doi.org/10.3201/eid2808.220726.

Imported Monkeypox from International Traveler, Maryland, USA, 2021 (Response) [PDF - 208 KB - 1 page]
V. Costello et al.
EID Costello V, Sowash M, Gaur A, Cardis M, Pasieka H, Wortmann G, et al. Imported Monkeypox from International Traveler, Maryland, USA, 2021 (Response). Emerg Infect Dis. 2022;28(8):1739. https://doi.org/10.3201/eid2808.220830
AMA Costello V, Sowash M, Gaur A, et al. Imported Monkeypox from International Traveler, Maryland, USA, 2021 (Response). Emerging Infectious Diseases. 2022;28(8):1739. doi:10.3201/eid2808.220830.
APA Costello, V., Sowash, M., Gaur, A., Cardis, M., Pasieka, H., Wortmann, G....Ramdeen, S. (2022). Imported Monkeypox from International Traveler, Maryland, USA, 2021 (Response). Emerging Infectious Diseases, 28(8), 1739. https://doi.org/10.3201/eid2808.220830.
In Memoriam

In Memoriam: Karen Foster (1955–2022) [PDF - 471 KB - 1 page]
B. Breedlove
EID Breedlove B. In Memoriam: Karen Foster (1955–2022). Emerg Infect Dis. 2022;28(8):1740. https://doi.org/10.3201/eid2808.220746
AMA Breedlove B. In Memoriam: Karen Foster (1955–2022). Emerging Infectious Diseases. 2022;28(8):1740. doi:10.3201/eid2808.220746.
APA Breedlove, B. (2022). In Memoriam: Karen Foster (1955–2022). Emerging Infectious Diseases, 28(8), 1740. https://doi.org/10.3201/eid2808.220746.
About the Cover

“A Great Synthesis of Labor, Light, and Movement” [PDF - 3.19 MB - 2 pages]
B. Breedlove
EID Breedlove B. “A Great Synthesis of Labor, Light, and Movement”. Emerg Infect Dis. 2022;28(8):1740-1742. https://doi.org/10.3201/eid2808.ac2808
AMA Breedlove B. “A Great Synthesis of Labor, Light, and Movement”. Emerging Infectious Diseases. 2022;28(8):1740-1742. doi:10.3201/eid2808.ac2808.
APA Breedlove, B. (2022). “A Great Synthesis of Labor, Light, and Movement”. Emerging Infectious Diseases, 28(8), 1740-1742. https://doi.org/10.3201/eid2808.ac2808.
Etymologia

Dermatophilus congolensis [PDF - 517 KB - 1 page]
R. D. Ollhoff et al.
EID Ollhoff RD, Pogliani FC, Sellera FP. Dermatophilus congolensis. Emerg Infect Dis. 2022;28(8):1663. https://doi.org/10.3201/eid2808.212573
AMA Ollhoff RD, Pogliani FC, Sellera FP. Dermatophilus congolensis. Emerging Infectious Diseases. 2022;28(8):1663. doi:10.3201/eid2808.212573.
APA Ollhoff, R. D., Pogliani, F. C., & Sellera, F. P. (2022). Dermatophilus congolensis. Emerging Infectious Diseases, 28(8), 1663. https://doi.org/10.3201/eid2808.212573.

Etymologia: Anopheles culicifacies [PDF - 728 KB - 1 page]
G. Kumar
EID Kumar G. Etymologia: Anopheles culicifacies. Emerg Infect Dis. 2022;28(8):1728. https://doi.org/10.3201/eid2808.211875
AMA Kumar G. Etymologia: Anopheles culicifacies. Emerging Infectious Diseases. 2022;28(8):1728. doi:10.3201/eid2808.211875.
APA Kumar, G. (2022). Etymologia: Anopheles culicifacies. Emerging Infectious Diseases, 28(8), 1728. https://doi.org/10.3201/eid2808.211875.
Online Reports

Medscape CME Activity
Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches [PDF - 673 KB - 11 pages]
L. E. Manhart et al.

Since Mycoplasma genitalium was identified 40 years ago, much of the epidemiology has been described, diagnostic tests have been developed and approved, and recommended treatment approaches have been identified. However, the natural history remains incompletely understood, and antimicrobial resistance has rapidly increased. This review summarizes evidence published since the US Centers for Disease Control and Prevention 2015 Sexually Transmitted Diseases Treatment Guidelines. Data on sequelae remain insufficient, macrolide resistance is common, and fluoroquinolone resistance is increasing. Potential benefits of testing and treatment include resolving symptoms, interrupting transmission, and preventing sequelae. Potential harms include cost, patient anxiety, and increasing antimicrobial resistance.

EID Manhart LE, Geisler WM, Bradshaw CS, Jensen JS, Martin DH. Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches. Emerg Infect Dis. 2022;28(8):1-11. https://doi.org/10.3201/eid2808.220094
AMA Manhart LE, Geisler WM, Bradshaw CS, et al. Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches. Emerging Infectious Diseases. 2022;28(8):1-11. doi:10.3201/eid2808.220094.
APA Manhart, L. E., Geisler, W. M., Bradshaw, C. S., Jensen, J. S., & Martin, D. H. (2022). Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches. Emerging Infectious Diseases, 28(8), 1-11. https://doi.org/10.3201/eid2808.220094.
Page created: July 22, 2022
Page updated: July 24, 2022
Page reviewed: July 24, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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