Early Release

Supplement

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

Synopses

• Haematospirillum jordaniae Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020
  M. Dulcey et al.
• Trichosporon austroamericanum Infections among Hospitalized Patients, France, 2022–2024
  E. Burel et al. View Abstract

  During 2022–2024, six cases of invasive fungal infection occurred among immunocompromised patients at Marseille University Hospital, Marseille, France. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry initially identified Trichosporon inkin fungi. However, phylogenetic analysis of intergenic spacer region 1 and whole-genome sequences revealed the genetically distinct species T. austroamericanum. Analysis of core genome and mitogenome from 6 patient isolates and 1 environmental isolate revealed substantial genetic diversity among T. austroamericanum strains, indicating a polyclonal outbreak. Furthermore, the mitochondrial genome emerged as a potential marker for intraspecies differentiation, which potentially could aid in epidemiologic investigations. Identified in 2024 but potentially underestimated, T. austroamericanum has since been reported in case clusters from hospital settings in France, highlighting the need for accurate fungal identification and suggesting previously identified T. inkin cases should be re-evaluated for T. austroamericanum. Clinical T. austroamericanum is emerging in hospital settings and should be included in the differential diagnosis of fungal infections.

Research

• Independent Acquisitions of Multidrug Resistance Gene lsaC in Serotype 20 Sequence Type 1257 Streptococcus pneumoniae Isolates
  B. Beall et al.
• Performance of Community Driven Text Message-Based Surveillance System During COVID-19 Pandemic, Los Angeles County, California, USA, 2020–2024
  J. B. Braunfeld et al.
• Isolation and Characterization of Rickettsia finnyi, Novel Pathogenic Spotted Fever Group Rickettsia in Dogs, United States
  P. K. Korla et al.
• Tickborne Neoehrlichia mikurensis in the Blood of Blood Donors, Norway, 2023
  H. Quarsten et al. View Abstract

  The tickborne bacterial pathogen Neoehrlichia mikurensis has been detected in <1% of blood donors in Sweden. N. mikurensis can give rise to asymptomatic persistent infections. Up to 25% of Ixodes ricinus ticks in southern Norway are infected with N. mikurensis. We investigated the incidence of N. mikurensis infection among blood donors in this region. We detected N. mikurensis in the blood of 45/499 (9%) blood donors by independent PCR methods; 69% of those were repeatedly positive 1–7 months after the first detection and tested negative after doxycycline treatment. We tested 8/19 adult recipients of potentially infected blood; none tested positive for N. mikurensis at the time of testing (191–301 days after transfusion). Our study identified a very high rate of infection with N. mikurensis in blood donors in Norway; whether infection can be transmitted by transfusion of blood products, however, remains unclear.

• Monkeypox Virus Partial Genome Amplicon Sequencing for Improvement of Genomic Surveillance during Mpox Outbreaks
  J. Deng et al.

Dispatches

• Borrelia afzelii Hepatitis in Patient Treated with Venetoclax and Obinutuzumab, Switzerland
  G. Capoferri et al.
• A Prospective Multicenter Study of Neoehrlichia mikurensis in Ticks and Tick-Bitten Individuals in Sweden and Finland, 2008-2009
  E. Hero et al.
• Two Autochthonous Cases of Anaplasmosis, Washington State, USA, 2022–2023
  H. Schnitzler et al.
• Bjerkandera Species Pulmonary Infection in Immunocompromised Hosts, Germany
  R. Sprute et al.
• Novel Dolphin Tupavirus from Stranded Atlantic White-Sided Dolphin with Severe Encephalitis, Canada, 2024
  O. Vernygora et al. View Abstract

  We sequenced a novel rhabdovirus, Tupavirus delphini (dolphin tupavirus), from the brain of a stranded dead Atlantic white-sided dolphin with severe encephalitis in Canada. In situ hybridization linked presence of the virus to the animal’s brain pathology and death. Our findings underscore the importance of monitoring marine mammals for unexpected pathogens.

• Shifting Dynamics of Dengue Virus Serotype DENV-2 and Emergence of Cosmopolitan Genotype, Costa Rica, 2024
  M. González-Elizondo et al.
• Spiroplasma ixodetis in Ticks Removed from Humans, Sweden and Åland Islands, Finland
  M. Lager et al.

Research Letters

• Two Cases of Autochthonous West Nile Virus Encephalitis, Paris, France, 2025
  N. Hassold-Rugolino et al. View Abstract

  We report 2 cases of febrile lymphocytic meningitis with encephalitis in patients in France. One patient had not traveled outside Paris; the other had traveled to eastern France. Laboratory findings revealed acute West Nile virus infection. The cases occurred days apart, raising concern the virus has spread further in France.

• Molecular Evidence of Dengue Virus Type 2 Emergence from Returning Travelers, Sinai Peninsula
  N. S. Zuckerman et al.
• Human Infection with Avian Influenza A(H10N3) Virus, China, 2024
  J. Wang et al. View Abstract

  We describe the clinical symptoms and epidemiologic characteristics of a patient infected with avian influenza A(H10N3) virus in Guangxi Province, China, in December 2024. Whole-genome sequencing showed that the virus was highly homologous to a virus from Yunnan Province. H10 subtype viruses should be monitored for potential zoonotic or reassortant events.

• Extensively Drug-Resistant Tuberculosis with Conflicting Resistance Testing Results, Lesotho
  K. J. Seung et al.
• Emergence of Dengue Virus Serotype 3, Lineage III_B.3.2, Angola
  J. de Vasconcelos et al.
• Fatal Tick-Borne Encephalitis in Unvaccinated Traveler from the United States to Switzerland, 2022
  C. Scotti et al. View Abstract

  We report an unvaccinated traveler from the United States who contracted fulminant fatal tick-borne encephalitis while visiting Switzerland. Climate changes and international travel are intensifying tick exposure for unvaccinated persons. The increasing incidence of tick-borne encephalitis across Europe underscores the importance of tick bite prevention and vaccination against tick-borne encephalitis virus.

• Orientia among Patients with Eschars and Suspected Tickborne Disease, North Carolina, 2020–2022
  H. A. Abernathy et al.
• Yellow Fever Virus in Aedes albopictus from an Urban Green Area in São Paulo State, Brazil
  E. S. Bergo et al.
• Crimean-Congo Hemorrhagic Fever Virus in Cattle and Ticks, Israel
  N. Rudoler et al.
• Mortality Event in Rainbow Snakes Linked to Snake Fungal Disease, United States
  D. A. Conley et al.
• Detection of Aedes (Fredwardsius) vittatus Mosquitoes, Yucatán Peninsula, Mexico, 2025
  R. J. Chan-Chable et al. View Abstract

  We report detection of Aedes (Fredwardsius) vittatus mosquitoes in continental North America, in Yucatán, Mexico. Phylogenetic analysis clustered the sequence from mosquitoes collected in Mexico with Caribbean mosquito lineages, suggesting species introduction via the Caribbean. Given its arbovirus competence, urgent inclusion of the Ae. vittatus mosquito in surveillance programs is warranted.

Etymologia

• Cladophialophora carrionii [kladˊ-ō-fī-əl-ō-for-ə karˊ-ē-ō-nē-ī]
  D. Moraes et al.

Synopses

• Reemergence of Yellow Fever, Magdalena Valley, Colombia, 2024–2025
  J. Cuéllar-Sáenz et al.
• Two Concurrent Outbreaks of Listeria monocytogenes Infections Linked to Packaged Salads, 2014–2022
  A. Palacios et al.

Research

• Group A Streptococcus Meningitis, United States, 1997–2022
  P. A. Hawkins et al.
• 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.

Dispatches

• Healthcare Worker Attitudes and Perceptions toward Ebola Vaccine, United States, 2024
  R. Goswami et al.
• Novel Highly Pathogenic Avian Influenza (A)H5N1 Triple Reassortant Virus, Argentina, 2025
  R. T. Vanstreels et al.
• Hemophagocytic lymphohistiocytosis associated with West Nile virus infection: a case report
  C. Lascano et al.
• 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.
• Human Infection by Zoonotic Eye Fluke Philophthalmus lacrymosus, South America
  T. Weitzel et al.
• 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.

Research Letter

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

Online Report

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