Early Release

Synopses

• Reemergence of Yellow Fever, Magdalena Valley, Colombia, 2024–2025
  J. Cuéllar-Sáenz et al. View Abstract

  Yellow fever, a zoonotic arboviral disease, has reemerged in Colombia, triggering a major outbreak in the country. During 2024 through mid-2025, a total of 132 human cases and 68 infections in nonhuman primates were confirmed, primarily in the department of Tolima, historically considered a low-risk area. We analyzed the historical and current epidemiology of yellow fever in Colombia, highlighting ecologic, social, and surveillance factors that contributed to the outbreak. Low vaccination coverage, insufficient epizootic and entomological surveillance, deforestation, habitat fragmentation, and limited application of One Health approaches have all exacerbated the situation. The high mortality rate of nonhuman primate species indicated a more profound ecologic crisis. Immediate, comprehensive measures, including mass vaccination, genomic surveillance, and integrated One Health frameworks, are urgently needed. Colombia’s experience underscores the need to reevaluate risk stratification and preparedness strategies across the Americas to prevent future yellow fever outbreaks in previously unaffected regions.

• Retrospective Multicenter Study of Human Granulocytic Anaplasmosis, France, 2012–2024
  V. Gerber et al. View Abstract

  Human granulocytic anaplasmosis (HGA), caused by Anaplasma phagocytophilum transmitted through tick bites, remains poorly documented in France. We conducted a retrospective, multicenter study of cases in Alsace during 2012–2024, including 39 HGA episodes in 38 patients PCR positive for A. phagocytophilum. Most (63.2%) patients were men, median age was 60.5 years, and 76.3% lived in rural areas. A tick bite was reported in 61.6% of cases. Frequent symptoms included fever (97.4%), fatigue (61.5%), and headache (61.5%). Laboratory findings showed elevated C-reactive protein (100%), thrombocytopenia (94.9%), leukopenia (59.0%), and cytolysis (66.7%). One patient had secondary hemophagocytic lymphohistiocytosis. Most (87.2%) patients were hospitalized; none required intensive care unit admission. Doxycycline was administered in 29 cases, and all patients recovered. HGA should be considered in febrile patients with recent tick exposure and cytopenia. Although often benign, rare severe HGA forms can occur and justify increased clinical awareness, especially in A. phagocytophilum–endemic areas.

• Two Concurrent Outbreaks of Listeria monocytogenes Infections Linked to Packaged Salads, United States, 2014–2022
  A. Palacios et al. View Abstract

  We describe 2 genetically unrelated outbreaks of Listeria monocytogenes infections (outbreak A and outbreak B) linked to packaged salads from 2 different firms that were investigated simultaneously in 2021. Combined, the outbreaks caused 30 illnesses, 27 hospitalizations, and 4 deaths over 8 years. Those investigations led to recalls of product from 2 different firms and highlight how L. monocytogenes contamination can persist for long periods and cause illnesses over many years. Outbreak A was investigated 3 times with illnesses occurring over 8 years, whereas illnesses in outbreak B occurred over 5 years. Both outbreaks illustrate the importance of routine and epidemiologically directed sampling by state partners, without which these outbreaks likely would have gone unsolved. The outbreaks were the second and third multistate outbreaks of listeriosis linked to packaged salads, providing further documentation of the potential for L. monocytogenes infections from consumption of contaminated packaged salads.

Research

• Silent Propagation of Classical Scrapie Prions in Homozygous 222K Transgenic Mice, Europe
  N. Fernández-Borges et al.
• Oral Transmission of Classical Bovine Spongiform Encephalopathy in ARR/ARR Sheep
  A. Huor et al.
• Pregnancy Outcomes after Exposure to Tuberculosis Treatment in Phase 3 Clinical Trial, 2016–2020
  E. V. Kurbatova et al.
• Guinea Pig Model for Lassa Virus Infection of Reproductive Tract and Considerations for Sexual and Vertical Transmission
  J. N. Seixas et al.

Dispatches

• Healthcare Worker Attitudes and Perceptions toward Ebola Vaccine, United States, 2024
  R. Goswami et al.
• Novel Highly Pathogenic Avian Influenza A(H5N1) Virus, Argentina, 2025
  R. Vanstreels et al. View Abstract

  Genomic sequencing of reemerging highly pathogenic avian influenza A(H5N1) virus detected in Argentina in February 2025 revealed novel triple-reassortant viruses containing gene segments from Eurasian H5N1 and low pathogenicity viruses from South and North American lineages. Our findings highlight continued evolution and diversification of clade 2.3.4.4b H5N1 in the Americas.

• West Nile Virus–Associated Hemophagocytic Lymphohistiocytosis, Switzerland
  C. Lascano et al. View Abstract

  A 62-year-old patient was hospitalized in Geneva, Switzerland, with an atypical manifestation of West Nile virus infection. Initially, he sought care for febrile diarrhea and vomiting; his condition deteriorated and hemophagocytic lymphohistiocytosis and meningoencephalitis developed. Corticosteroids improved his condition. We used high-throughput sequencing and ophthalmologic findings to diagnose West Nile virus.

• Persistent Infection in Harbor Seals Years after Phocine Distemper Virus Epizootics
  M. van de Bildt et al.
• Pancreatic Schistosomiasis in People’s Republic of China, 2020–2024
  L. He et al.
• Case of Congenital Tularemia with Neuroinvasive Disease, Utah, USA
  B. D. Nelson et al. View Abstract

  We diagnosed neuroinvasive tularemia in a neonate in Utah who had culture-negative pleocytosis in cerebrospinal fluid, rim-enhancing lesions on brain magnetic resonance imaging, and blood microbial cell-free DNA Francisella tularensis detection. Maternal history, serologic testing, and Francisella sp. identified in the fallopian tube by immunohistochemistry and 16S rRNA gene PCR strongly support congenital infection.

• Human Infection by Zoonotic Eye Fluke Philophthalmus lacrymosus, South America
  T. Weitzel et al. View Abstract

  We report a case of severe conjunctivitis in a traveler infected with a Philophthalmus lacrymosus eye fluke, probably acquired on the Galápagos Islands in Ecuador. This zoonotic parasite is endemic in Brazil and Venezuela, where it has been reported in birds and capybaras.

• Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus Infection in Poultry Farm Workers, Washington, United States, 2024
  Y. Hatta et al.
• Bat Reovirus as Cause of Acute Respiratory Disease and Encephalitis in Humans, Bangladesh, 2022–2023
  S. Sultana et al.
• Macrolide Resistance and P1 Cytadhesin Genotyping of Mycoplasma pneumoniae during Outbreak, Canada, 2024–2025
  Z. Fatima et al.
• Abnormal Prion Protein in Nasal Swabs of Macaques Infected with Creutzfeldt-Jakob Disease
  J. Cervenak et al.

Research Letters

• Wild and Domestic Animal Exposure among Deceased Persons Referred for Organ Procurement, United States
  D. W. McCormick et al. View Abstract

  Rabies is transmissible through transplantation. Wild mammal bites or scratches carry a high risk for rabies, but their frequency among organ donors is unknown. During 2024, an estimated 12 (95% CI 7–20; 0.07%) of 16,989 deceased US donors had high-risk exposures. Identifying such exposures can mitigate rabies transmission to transplant recipients.

• Metatranscriptomic Identification of Trubanaman Virus in Patient with Encephalitis, Australia
  K. Hajkowicz et al.
• Trombiculiasis in 4 Dogs with Neurological Signs, The Netherlands, 2024
  K. M. Santifort and H. A. Reijmerink
• Enhanced Risk for Epidemic Cholera Transmission, Haiti
  A. J. Curtis et al.
• Carbapenem-Resistant Salmonella Typhi Infection in Traveler Returning from India, Germany 2024
  S. Simon et al.
• Macrolide-Resistant Mycoplasma pneumoniae in Children, Ohio, USA
  H. Wang et al.
• Serological Evidence of Influenza D Virus in Black Donkeys, Northern China
  M. Shen et al.

Letter

• Brucellae Transmission in Surgical Settings
  P. Yagupsky

Online Report

• Diphtheria Antitoxin Production and Procurement Practices and Challenges
  C. Marshall et al.

Synopses

• Pulmonary Histoplasmosis, Taiwan, 1997–2024
  T. Kao et al.
• Case Series of Bacteremia Associated with Probiotic Use in Children after Cardiac Surgery
  X. Wang et al.
• Two Cases of Q Fever in Pregnancy, including Management of the Newborn, Australia
  R. Silcock et al.

Research

• Emergence of NDM-14–Producing Klebsiella pneumoniae Sequence Type 147 Clone in Spain and Outbreak in the Canary Islands
  P. Aja-Macaya et al.
• Reduced RSV-Related Emergency Department Visits and Hospitalizations in Infants after Universal Immunization, Italy, 2024–2025
  S. Villa et al.
• Group A Streptococcus Meningitis, United States, 1997–2022
  P. A. Hawkins et al.

Dispatches

• Identification of Sphingobacterium hotanense Infections, North America, 2020–2025
  K. Abu-Zeinah et al.
• Dermacentor occidentalis Ticks Linked to Rickettsia lanei Infections, California, USA
  W. S. Probert et al.

• Nonspecific Symptoms Attributable to Lyme Disease in High-Incidence Areas, United States, 2017–2021
  C. C. Nawrocki et al. View Abstract

  For some patients who have Lyme disease (LD), nonspecific symptoms can persist after treatment and impair quality of life. Estimating the frequency and duration of such symptoms is challenging. Using commercial insurance claims data from 2017–2021 for enrollees residing in states where LD is common, we identified 24,503 case-patients with LD and matched them (1:5) with 122,095 control-patients with other diagnoses by demographics, medical service date, and inpatient/outpatient setting. We compared relative frequencies of diagnosis codes for pain, fatigue, and cognitive difficulties between case-patients and control-patients in the year after diagnosis. Those symptom codes occurred 5.0% more frequently among case-patients than among control-patients and comprised »11.0% of the total symptom codes among case-patients. Symptom code frequency among case-patients declined significantly in the 6–12 months after LD diagnosis and reached levels similar to control-patients by the end of the year, with the exception of fatigue.

• Progress Toward Understanding Infection-Associated Chronic Conditions and Illnesses
  A. E. Fiore
• Persistence of Symptoms among Commercially Insured Patients with Coccidioidomycosis, United States, 2017–2023
  I. Hennessee et al. View Abstract

  Some patients with coccidioidomycosis experience prolonged respiratory and systemic symptoms. However, data on prevalence and persistence of most symptoms are lacking. Using an insurance claims database, we identified patients with coccidioidomycosis diagnoses in the United States during 2017–2023. We assessed prevalence of associated symptoms from 6 months before to 1 year after first diagnosis code (index date) and compared post–index date prevalence to baseline (within 6 to 4 months before index date). Among 2,640 patients, cough (20.8%), dyspnea (13.0%), and fatigue (8.8%) were the most common symptoms at index date. Dyspnea and erythema nodosum were elevated 3–6 months post–index date (p<0.03), and fatigue, headache, joint pain, and weakness were elevated 9–12 months post–index date compared with baseline (p<0.05).These findings demonstrate that symptoms can persist in coccidioidomycosis patients, which could help inform clinical management and refine estimates of the health and economic burden of coccidioidomycosis.

• Long-Term Illness in Adults Hospitalized for Respiratory Syncytial Virus Disease, United States, February 2022–September 2023
  A. M. Leis et al. View Abstract

  Respiratory syncytial virus (RSV) can cause severe illness, but little is known about long-term consequences in hospitalized adults. We surveyed adults (>18 years of age) who survived hospitalization for RSV or COVID-19 during February 2022–September 2023 about physical functioning and quality of life; surveys were conducted 6–12 months after hospitalization. We compared outcomes after RSV hospitalization by age (<60 vs. >60 years) and to those hospitalized for COVID-19 by using multivariable regression models. Among 146 adults hospitalized with RSV, 27.4% reported severe breathlessness and 21.9% poor quality of life at follow-up. Few differences were seen in posthospital illness by age. After adjustment, participants with RSV had 1.81 (95% CI 1.08–3.04) times increased odds of worse dyspnea than did those with COVID-19. Participants reported functional and quality of life impairments after RSV hospitalization, regardless of age, and a postdischarge sequelae constellation similar to that for those hospitalized for COVID-19.

• Thrombotic Events and Stroke in the Year After Sars-Cov-2 or Other Acute Respiratory Infection
  C. Q. Pratt et al.