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Volume 27, Number 1—January 2021
Aspergillosis Complicating Severe Coronavirus Disease
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
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
- Comparative Omics Analysis of Historic and Recent Isolates of Bordetella pertussis and Effects of Genome Rearrangements on Evolution
- Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States
- Using Repeated Serosurveys to Estimate the Force of Dengue Virus Infection in Ouagadougou, Burkina Faso
Performance of Nucleic Acid Amplification Tests for Detection of Severe Acute Respiratory Syndrome Coronavirus 2 in Prospectively Pooled Specimens
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
- Differential Yellow Fever Susceptibility in New World Nonhuman Primates, Comparison with Humans, and Implications for Surveillance
- Using Structured Expert Judgment for Attribution of Foodborne and Waterborne Illnesses to Comprehensive Transmission Pathways, United States
Cellular Immunity in COVID-19 Convalescents with PCR-Confirmed Infection but with Undetectable SARS-CoV-2–Specific IgG
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
- IgG Seroconversion and Pathophysiology in Severe Acute Respiratory Syndrome Coronavirus 2 Infection
- Hospitalization for Invasive Pneumococcal Diseases in Young Children Before Use of 13-Valent Pneumococcal Conjugate Vaccine, Suzhou, China
- Susceptibility of Domestic Swine to Experimental Infection with Severe Acute Respiratory Syndrome Coronavirus 2
- Prevalence of Acute Rheumatic Fever and Rheumatic Heart Disease among Ethnic Groups, New Zealand, 2000–2018
- Post–13-Valent Pneumococcal Conjugate Vaccine Dynamics of Serotypes Included in Candidate Extended-Spectrum Conjugate Vaccines in Young Children
- Delineating and Analyzing Locality-Level Determinants of Cholera, Haiti
- A Territory-Wide Study of Early Coronavirus Disease Outbreak, Hong Kong, China
- Recency-Weighted Statistical Modeling Approach to Attribute Illnesses Caused by 4 Pathogens to Food Sources Using Outbreak Data, United States
- Precise Species Identification by Whole Genome Sequencing of Enterobacter-Caused Bloodstream Infection, China
- Viral Metagenomic Analysis of Cerebrospinal Fluid from Patients with Acute Central Nervous System Infections of Unknown Origin, Vietnam
- Hannibal’s Ophthalmia—A New Answer to An Ancient Question
- Primary Amebic Meningoencephalitis Associated with Recreational Aquatic Exposures, USA, 1978–2018
- In Vivo Observation of Cutaneous Larva Migrans by Fluorescence-Advanced Videodermatoscopy
- Ocular Filariasis in Human Caused by Breinlia (Johnstonema) annulipapillata, Australia
- Listeriosis Caused by Persistence of Listeria monocytogenes Serotype 4b Sequence Type 6 in Cheese Production Environment
- Fatal Case of Chronic Jamestown Canyon Virus Encephalitis Diagnosed by Metagenomic Sequencing in a Patient on Rituximab
- Prevalence of SARS-CoV-2, Verona, Italy, April–May 2020
- Severe Human Bocavirus-Associated Pneumonia in Adults at a Referral Hospital, Seoul, South Korea
- Large-Scale Testing of Asymptomatic Healthcare Personnel for Severe Acute Respiratory Syndrome Coronavirus 2
- Economic Burden of Legionnaires’ Disease, United States, 2014
Coronavirus Disease among Workers in Food Processing, Food Manufacturing, and Agriculture Workplaces
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
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
- Emerging Human Metapneumovirus Gene Duplication Variants in Patients with Severe Acute Respiratory Infection, China, 2017–2019
- Increase in Kelch13 Polymorphisms in Plasmodium falciparum, Southern Rwanda
- Fatal 3-Nitropropionic Acid Poisoning after Consuming Coconut Water
- Detection of Norovirus Variant GII.4 Hong Kong in Asia and Europe, 2017−2019
- Optimization of Notification Criteria for Shiga Toxin–Producing Escherichia coli Surveillance, the Netherlands
Risk for SARS-CoV-2 Infection in Healthcare Workers, Turin, Italy
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
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
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
SARS-CoV-2 Cluster in Nursery, Poland
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
Superspreading Event of SARS-CoV-2 Infection at a Bar, Ho Chi Minh City, Vietnam
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
Racial and Workplace Disparities in Seroprevalence of SARS-CoV-2, Baton Rouge, Louisiana, USA
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
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
- Relapsing Fever Group Borreliae in Human-Biting Soft Ticks, Brazil
Volume 27, Number 2—February 2021
Childcare Exposure to Severe Acute Respiratory Syndrome Coronavirus 2 for 4-Year-Old Presymptomatic Child, South Korea
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
- Characteristics and Timing of Initial Virus Shedding in Severe Acute Respiratory Syndrome Coronavirus 2, Utah, USA
- Addressing COVID-19 Misinformation on Social Media Preemptively and Responsively
- Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May–June, 2020
- Nationwide Outbreak of Severe Vomiting in Dogs Associated with a Canine Enteric Coronavirus, United Kingdom
- Excess Deaths during Influenza and Coronavirus Disease and Infection-Fatality Rate for Severe Acute Respiratory Syndrome Coronavirus 2, the Netherlands
- Universal Admission Screening for SARS-CoV-2 Infections among Hospitalized Patients, Switzerland, 2020
- Murine Typhus in Canary Islands, Spain, 1999–2015
- Salmonella enterica Serovar Typhi AcrB-R717Q/L Azithromycin-Resistant Isolates, Singapore
- Evidence of Zika Virus Infection in Pigs and Mosquitoes, Mexico
- Prevalence of SARS-CoV-2–Specific Antibodies, Japan, June 2020
- Novel Arterivirus Associated with Outbreak of Fatal Encephalitis in European Hedgehogs, England
- Early Transmission Dynamics, Spread, and Genomic Characterization of SARS-CoV-2 in Panama
- Plasmodium cynomolgi Coinfections among Symptomatic Malaria Patients, Thailand
SARS-CoV-2 Transmission between Mink (Neovison vison) and Humans, Denmark
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.
- Potential Association between Zika Infection and Microcephaly during 2007 Fever Outbreak, Gabon
- Seroprevalence of SARS-CoV-2 in Guilan Province, Iran, April 2020
- COVID-19–Related Misinformation and Parents of Patients with Pediatric Cancer
Intrauterine Transmission of SARS-CoV-2
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
- Puumala Virus Infection in Family, Switzerland
- Asymptomatic or Mildly Symptomatic Long-Term Humoral Immune Response to SARS-CoV-2, Vietnam
- Genomic Diversity of Burkholderia pseudomallei Isolates, Colombia
COVID-19 Infection Control Measures in Long-Term Care Facility, Pennsylvania, USA
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
Volume 27, Number 3—March 2021
Parallels and Mutual Lessons in Tuberculosis and COVID-19 Transmission, Prevention, and Control
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
- Implementation of an Animal Sporotrichosis Surveillance and Control Program, Southeastern Brazil
- Validity of Diagnosis Code–Based Claims to Identify Pulmonary NTM Disease in Bronchiectasis Patients
- Histoplasmosis—a Common Disease Caused by a Well-Hidden Fungus in an Unusual Setting
- Severe Pulmonary Disease Caused by Mycolicibacter kumamotonensis