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Early Release

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Volume 27, Number 1—January 2021

  • Aspergillosis Complicating Severe Coronavirus Disease
    K. A. Marr et al.

    Aspergillosis complicating severe influenza infection has been increasingly detected worldwide. Recently, coronavirus disease–associated pulmonary aspergillosis (CAPA) has been detected through rapid reports, primarily from centers in Europe. We provide a case series of CAPA, adding 20 cases to the literature, with review of pathophysiology, diagnosis, and outcomes. The syndromes of pulmonary aspergillosis complicating severe viral infections are distinct from classic invasive aspergillosis, which is recognized most frequently in persons with neutropenia and in other immunocompromised persons. Combined with severe viral infection, aspergillosis comprises a constellation of airway-invasive and angio-invasive disease and results in risks associated with poor airway fungus clearance and killing, including virus- or inflammation-associated epithelial damage, systemic immunosuppression, and underlying lung disease. Radiologic abnormalities can vary, reflecting different pathologies. Prospective studies reporting poor outcomes in CAPA patients underscore the urgent need for strategies to improve diagnosis, prevention, and therapy.

  • Nosocomial Coronavirus Disease Outbreak Containment, Hanoi, Vietnam, March–April 2020
    C. Duy et al.

    We report on the public health response generated by an outbreak of coronavirus disease (COVID-19) that occurred during March 2020 at Bach Mai Hospital (BMH) in Hanoi, northern Vietnam’s largest hospital complex. On March 18, a total of 3 distinct clusters of COVID-19 cases were identified at BMH. Diagnosis of the initial 3 COVID-19 cases led to contact tracing, symptom screening, and testing of 495 persons and limited quarantine of affected institutes or departments. When 27 staff members in the catering company tested positive for SARS-CoV-2, the entire BMH staff (7,664 persons) was put under quarantine. Contact tracing in the community resulted in an additional 52,239 persons being quarantined. After 3 weeks, the hospital outbreak was contained; no further spread occurred in the hospital. Rapid screening of cases, extensive testing, prompt quarantine, contact tracing, and social distancing contributed to prevent community transmission in Hanoi and northern Vietnam.

  • Impact of Human Papillomavirus Vaccination, Rwanda and Bhutan
    I. Baussano et al.
  • Comparative Omics Analysis of Historic and Recent Isolates of Bordetella pertussis and Effects of Genome Rearrangements on Evolution
    A. Dienstbier et al.
  • Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States
    S. A. Collier et al.
  • Using Repeated Serosurveys to Estimate the Force of Dengue Virus Infection in Ouagadougou, Burkina Faso
    J. K. Lim et al.
  • Performance of Nucleic Acid Amplification Tests for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Prospectively Pooled Specimens
    H. Wang et al.

    Pooled nucleic acid amplification tests for severe acute respiratory syndrome coronavirus 2 could increase availability of testing at decreased cost. However, the effect of dilution on analytical sensitivity through sample pooling has not been well characterized. We tested 1,648 prospectively pooled specimens by using 3 nucleic acid amplification tests for severe acute respiratory syndrome coronavirus 2: a laboratory-developed real-time reverse transcription PCR targeting the envelope gene, and 2 commercially available Panther System assays targeting open reading frame 1ab. Positive percent agreement (PPA) of pooled versus individual testing ranged from 71.7% to 82.6% for pools of 8 and from 82.9% to 100.0% for pools of 4. We developed and validated an independent stochastic simulation model to estimate effects of dilution on PPA and efficiency of a 2-stage pooled real-time reverse transcription PCR testing algorithm. PPA was dependent on the proportion of tests with positive results, cycle threshold distribution, and assay limit of detection.

  • Intrafamilial Exposure to SARS-CoV-2 Associated with Cellular Immune Response without Seroconversion
    F. Gallais et al.
  • Differential Yellow Fever Susceptibility in New World Nonhuman Primates, Comparison with Humans, and Implications for Surveillance
    N. A. Fernandes et al.
  • Using Structured Expert Judgment for Attribution of Foodborne and Waterborne Illnesses to Comprehensive Transmission Pathways, United States
    E. Beshearse et al.
  • Cellular Immunity in COVID-19 Convalescents with PCR-Confirmed Infection but with Undetectable SARS-CoV-2–Specific IgG
    S. Schwarzkopf et al.

    We investigated immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among a group of convalescent, potential blood donors in Germany who had PCR-confirmed SARS-CoV-2 infection. Sixty days after onset of symptoms, 13/78 (17%) study participants had borderline or negative results to an ELISA detecting IgG against the S1 protein of SARS-CoV-2. We analyzed participants with PCR-confirmed infection who had strong antibody responses (ratio >3) as positive controls and participants without symptoms of SARS-CoV-2 infection and without household contact with infected patients as negative controls. Using interferon-γ ELISpot, we observed that 78% of PCR-positive volunteers with undetectable antibodies showed T cell immunity against SARS-CoV-2. We observed a similar frequency (80%) of T-cell immunity in convalescent donors with strong antibody responses but did not detect immunity in negative controls. We concluded that, in convalescent patients with undetectable SARS-CoV-2 IgG, immunity may be mediated through T cells.

  • Human Diversity of Killer Cell Immunoglobulin-Like Receptors and Human Leukocyte Antigen Class I Alleles, and Ebola Virus Disease Outcomes
    T. Wawina-Bokalanga et al.
  • IgG Seroconversion and Pathophysiology in Severe Acute Respiratory Syndrome Coronavirus 2 Infection
    H. M. Staines et al.
  • Hospitalization for Invasive Pneumococcal Diseases in Young Children Before Use of 13-Valent Pneumococcal Conjugate Vaccine, Suzhou, China
    K. Chen et al.
  • Susceptibility of Domestic Swine to Experimental Infection with Severe Acute Respiratory Syndrome Coronavirus 2
    B. S. Pickering et al.
  • Prevalence of Acute Rheumatic Fever and Rheumatic Heart Disease among Ethnic Groups, New Zealand, 2000–2018
    J. Bennett et al.
  • Post–13-Valent Pneumococcal Conjugate Vaccine Dynamics of Serotypes Included in Candidate Extended-Spectrum Conjugate Vaccines in Young Children
    S. Ben-Shimol et al.
  • Delineating and Analyzing Locality-Level Determinants of Cholera, Haiti
    K. Griffiths et al.
  • A Territory-Wide Study of Early Coronavirus Disease Outbreak, Hong Kong, China
    K. Leung et al.
  • Recency-Weighted Statistical Modeling Approach to Attribute Illnesses Caused by 4 Pathogens to Food Sources Using Outbreak Data, United States
    M. B. Batz et al.
  • Precise Species Identification by Whole Genome Sequencing of Enterobacter-Caused Bloodstream Infection, China
    W. Wu et al.
  • Viral Metagenomic Analysis of Cerebrospinal Fluid from Patients with Acute Central Nervous System Infections of Unknown Origin, Vietnam
    N. T. Anh et al.
Historical Review
  • Hannibal’s Ophthalmia—A New Answer to An Ancient Question
    J. T. Denholm and P. N. Hunt
  • Primary Amebic Meningoencephalitis Associated with Recreational Aquatic Exposures, USA, 1978–2018
    R. Gharpure et al.
  • In Vivo Observation of Cutaneous Larva Migrans by Fluorescence-Advanced Videodermatoscopy
    A. Ramondetta et al.
  • Ocular Filariasis in Human Caused by Breinlia (Johnstonema) annulipapillata, Australia
    A. V. Koehler et al.
  • Listeriosis Caused by Persistence of Listeria monocytogenes Serotype 4b Sequence Type 6 in Cheese Production Environment
    M. Nüesch-Inderbinen et al.
  • Fatal Case of Chronic Jamestown Canyon Virus Encephalitis Diagnosed by Metagenomic Sequencing in a Patient on Rituximab
    I. H. Solomon et al.
  • Prevalence of SARS-CoV-2, Verona, Italy, April–May 2020
    M. Guerriero et al.
  • Severe Human Bocavirus-Associated Pneumonia in Adults at a Referral Hospital, Seoul, South Korea
    S. Choi et al.
  • Large-Scale Testing of Asymptomatic Healthcare Personnel for Severe Acute Respiratory Syndrome Coronavirus 2
    C. A. Hogan et al.
  • Economic Burden of Legionnaires’ Disease, United States, 2014
    M. Baker-Goering et al.
  • Coronavirus Disease among Workers in Food Processing, Food Manufacturing, and Agriculture Workplaces
    M. A. Waltenburg et al.

    We describe coronavirus disease (COVID-19) among US food manufacturing and agriculture workers and provide updated information on meat and poultry processing workers. Among 742 food and agriculture workplaces in 30 states, 8,978 workers had confirmed COVID-19; 55 workers died. Racial and ethnic minority workers could be disproportionately affected by COVID-19.

  • Impact of a Nationwide Lockdown on SARS-CoV-2 Transmissibility, Italy
    G. Guzzetta et al.

    On March 11, 2020, Italy imposed a national lockdown to curtail the spread of severe acute respiratory syndrome coronavirus 2. We estimate that, 14 days after lockdown, the net reproduction number had dropped below 1 and remained stable at »0.76 (95% CI 0.67–0.85) in all regions for >3 of the following weeks.

  • Limited Specificity of Serologic Tests for SARS-CoV-2 Antibody Detection, Benin
    A. Yadouleton et al.
  • Emerging Human Metapneumovirus Gene Duplication Variants in Patients with Severe Acute Respiratory Infection, China, 2017–2019
    Z. Xie et al.
  • Increase in Kelch13 Polymorphisms in Plasmodium falciparum, Southern Rwanda
    C. Bergmann et al.
  • Fatal 3-Nitropropionic Acid Poisoning after Consuming Coconut Water
    T. Birkelund et al.
  • Detection of Norovirus Variant GII.4 Hong Kong in Asia and Europe, 2017−2019
    M. Chan et al.
  • Optimization of Notification Criteria for Shiga Toxin–Producing Escherichia coli Surveillance, the Netherlands
    I. Friesema et al.
Research Letters
  • Risk for SARS-CoV-2 Infection in Healthcare Workers, Turin, Italy
    A. Calcagno et al.

    We measured severe acute respiratory syndrome coronavirus 2 spike protein subunits S1/S2 antibodies by using capillary electrophoresis and a chemiluminescence immunoassay for 5,444 active healthcare workers in Italy. Seroprevalence was 6.9% and higher among participants having contact with patients. Seroconversion was not observed in 37/213 previously infected participants.

  • Waning Antibody Responses in Asymptomatic and Symptomatic SARS-CoV-2 Infection
    P. Choe et al.

    We investigated the kinetics of severe acute respiratory syndrome coronavirus 2 neutralizing antibodies in 7 asymptomatic persons and 11 patients with pneumonia. The geometric mean titer of neutralizing antibodies declined from 219.4 at 2 months to 143.7 at 5 months after infection, indicating a waning antibody response.

  • Attitudes about COVID-19 Lockdown among General Population, France, March 2020
    P. Peretti-Watel et al.

    Because the effectiveness of a coronavirus disease lockdown in curbing coronavirus disease spread depends on public support, acquiring real-time information about the way populations reacted to the lockdown is crucial. In France, such public support remained fragile among low-income persons, probably because the lockdown exacerbated preexisting social inequalities and conflicts.

  • Etiology of Severe Acute Respiratory Infections, Bangladesh, 2017
    M. R. Rahaman et al.
  • SARS-CoV-2 Cluster in Nursery, Poland
    M. Okarska-Napierała et al.

    We report a cluster of surprisingly high spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated with a single nursery in Poland. Our findings contrast with the presumed negligible role of children in driving the SARS-CoV-2 pandemic. Children 1–2 years of age might be effective SARS-CoV-2 spreaders.

  • Nonpolio Enterovirus Activity during the COVID-19 Pandemic, Taiwan, 2020
    S. Kuo et al.
  • Superspreading Event of SARS-CoV-2 Infection at a Bar, Ho Chi Minh City, Vietnam
    N. Chau et al.

    We report a superspreading event of severe acute respiratory syndrome coronavirus 2 infection initiated at a bar in Vietnam with evidence of symptomatic and asymptomatic transmission, based on ministry of health reports, patient interviews, and whole-genome sequence analysis. Crowds in enclosed indoor settings with poor ventilation may be considered at high risk for transmission.

  • Absence of SARS-CoV-2 Transmission from Children in Isolation to Guardians, South Korea
    E. Lee et al.
  • Racial and Workplace Disparities in Seroprevalence of SARS-CoV-2, Baton Rouge, Louisiana, USA
    A. K. Feehan et al.

    By using paired molecular and antibody testing for severe acute respiratory syndrome coronavirus 2 infection, we determined point prevalence and seroprevalence in Louisiana, USA, during the second phase of reopening. Infections were highly variable by race and ethnicity, work environment, and ZIP code. Census-weighted seroprevalence was 3.6%, and point prevalence was 3.0%.

  • Novel 6-Month Treatment for Drug-Resistant Tuberculosis, United States
    C. A. Haley et al.

    The US Food and Drug Administration approved a 6-month regimen of pretomanid, bedaquiline, and linezolid for extensively drug-resistant or multidrug-intolerant tuberculosis after a trial in South Africa demonstrated 90% effectiveness 6 months posttreatment. We report on a patient who completed the regimen using a lower linezolid dose.

  • Developing Endemicity of Schistosomiasis, Corsica, France
    C. Rothe et al.
  • Relapsing Fever Group Borreliae in Human-Biting Soft Ticks, Brazil
    S. Muñoz-Leal et al.


Volume 27, Number 2—February 2021

  • Childcare Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 for 4-Year-Old Presymptomatic Child, South Korea
    Y. Yoon et al.

    Data on transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from preschool-age children to children and adults are limited. We investigated SARS-CoV-2 exposure at a childcare center in South Korea. A 4-year-old child, probably infected by his grandmother, attended the center during the presymptomatic period (February 19–21, 2020). Fever developed on February 22, and he was given a diagnosis SARS-CoV-2 infection on February 27. At the center, 190 persons (154 children and 36 adults) were identified as contacts; 44 (23.2%) were defined as close contacts (37 children and 7 adults). All 190 persons were negative for SARS-CoV-2 on days 8–9 after the last exposure. Two close contacts (1 child and 1 adult) showed development of symptoms on the last day of quarantine. However, subsequent test resilts were negative. This investigation adds indirect evidence of low potential infectivity in a childcare setting with exposure to a presymptomatic child.

  • Symptom Onset and Progression in Hospitalized and Nonhospitalized Patients with Coronavirus Disease, Colorado, USA
    G. M. Vahey et al.
  • Characteristics and Timing of Initial Virus Shedding in Severe Acute Respiratory Syndrome Coronavirus 2, Utah, USA
    N. M. Lewis et al.
  • Addressing COVID-19 Misinformation on Social Media Preemptively and Responsively
    E. K. Vraga and L. Bode
  • Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May–June, 2020
    M. Wallace et al.
  • Nationwide Outbreak of Severe Vomiting in Dogs Associated with a Canine Enteric Coronavirus, United Kingdom
    A. D. Radford et al.
  • Excess Deaths during Influenza and Coronavirus Disease and Infection-Fatality Rate for Severe Acute Respiratory Syndrome Coronavirus 2, the Netherlands
    L. van Asten et al.
  • Universal Admission Screening for SARS-CoV-2 Infections among Hospitalized Patients, Switzerland, 2020
    T. Scheier et al.
  • Murine Typhus in Canary Islands, Spain, 1999–2015
    J. Robaina-Bordón et al.
  • Salmonella enterica Serovar Typhi AcrB-R717Q/L Azithromycin-Resistant Isolates, Singapore
    S. Octavia et al.
  • Evidence of Zika Virus Infection in Pigs and Mosquitoes, Mexico
    D. Nunez-Avellaneda et al.
  • Prevalence of SARS-CoV-2–Specific Antibodies, Japan, June 2020
    T. Yoshiyama et al.
  • Novel Arterivirus Associated with Outbreak of Fatal Encephalitis in European Hedgehogs, England
    A. Dastjerdi et al.
  • Early Transmission Dynamics, Spread, and Genomic Characterization of SARS-CoV-2 in Panama
    D. Franco et al.
  • Plasmodium cynomolgi Coinfections among Symptomatic Malaria Patients, Thailand
    C. Putaporntip et al.
  • SARS-CoV-2 Transmission between Mink (Neovison vison) and Humans, Denmark
    A. Hammer et al.

    Severe acute respiratory syndrome coronavirus 2 has caused a pandemic in humans. Farmed mink (Neovison vison) are also susceptible. In Denmark, this virus has spread rapidly among farmed mink, resulting in some respiratory disease. Full-length virus genome sequencing revealed novel virus variants in mink. These variants subsequently appeared within the local human community.

Research Letters
  • Potential Association between Zika Infection and Microcephaly during 2007 Fever Outbreak, Gabon
    C. K. Koumavor et al.
  • Seroprevalence of SARS-CoV-2 in Guilan Province, Iran, April 2020
    M. Shakiba et al.
  • COVID-19–Related Misinformation and Parents of Patients with Pediatric Cancer
    J. Guidry et al.
  • Intrauterine Transmission of SARS-CoV-2
    E. S. Stonoga et al.

    We documented fetal death associated with intrauterine transmission of severe acute respiratory syndrome coronavirus 2. We found chronic histiocytic intervillositis, maternal and fetal vascular malperfusion, microglial hyperplasia, and lymphocytic infiltrate in muscle in the placenta and fetal tissue. Placenta and umbilical cord blood tested positive for the virus by PCR, confirming transplacental transmission.

  • Protective Immunity and Persistent Lung Sequalae in Domestic Cats after SARS-CoV-2 Infection
    S. Chiba et al.
  • Puumala Virus Infection in Family, Switzerland
    P. Vetter et al.
  • Asymptomatic or Mildly Symptomatic Long-Term Humoral Immune Response to SARS-CoV-2, Vietnam
    H. Mai et al.
  • Genomic Diversity of Burkholderia pseudomallei Isolates, Colombia
    C. Duarte et al.
  • COVID-19 Infection Control Measures in Long-Term Care Facility, Pennsylvania, USA
    S. T. Shimotsu et al.

    Residents of long-term care facilities are at risk for coronavirus disease. We report a surveillance exercise at such a facility in Pennsylvania, USA. After introduction of a testing strategy and other measures, this facility had a 17-fold lower coronavirus disease case rate compared with those of neighboring facilities.

  • Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in a Nightclub, Germany, 2020
    N. Muller et al.


Volume 27, Number 3—March 2021

  • Parallels and Mutual Lessons in Tuberculosis and COVID-19 Transmission, Prevention, and Control
    P. C. Hopewell et al.

    The coronavirus disease (COVID-19) pandemic has had unprecedented negative effects on global health and economies, drawing attention and resources from many other public health services. To minimize negative effects, the parallels, lessons, and resources from existing public health programs need to be identified and used. Often underappreciated synergies relating to COVID-19 are with tuberculosis (TB). COVID-19 and TB share commonalities in transmission and public health response: case finding, contact identification, and evaluation. Data supporting interventions for either disease are, understandably, vastly different, given the diseases’ different histories. However, many of the evolving issues affecting these diseases are increasingly similar. As previously done for TB, all aspects of congregate investigations and preventive and therapeutic measures for COVID-19 must be prospectively studied for optimal evidence-based interventions. New attention garnered by the pandemic can ensure that knowledge and investment can benefit both COVID-19 response and traditional public health programs such as TB programs.

  • Bedaquiline as Treatment for Disseminated Nontuberculous Mycobacterial Infection in 2 Patients Co-Infected with HIV
    E. Gil et al.
  • Implementation of an Animal Sporotrichosis Surveillance and Control Program, Southeastern Brazil
    S. M. Moreira et al.
Research Letters
  • Validity of Diagnosis Code–Based Claims to Identify Pulmonary NTM Disease in Bronchiectasis Patients
    J. H. Ku et al.
  • Histoplasmosis—a Common Disease Caused by a Well-Hidden Fungus in an Unusual Setting
    Y. Schmiedel et al.
  • Severe Pulmonary Disease Caused by Mycolicibacter kumamotonensis
    K. Manika et al.


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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