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Early Release

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Issues Available

Volume 29, Number 5—May 2023

  • Recurrent Clostridioides difficile Infection, New Haven County, Connecticut, USA, 2015–2020
    C. M. Okafor et al.
  • Phylogenetic Analysis of Transmission Dynamics of Dengue in Large and Small Population Centers, Northern Ecuador
    S. Márquez et al.
  • Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana
    C. R. Baker et al.
  • Environmental, Occupational, and Demographic Risk Factors for Clinical Scrub Typhus, Bhutan
    T. Zangpo et al.

    Underdiagnosis and underreporting of scrub typhus has increasingly affected public health in Bhutan since its initial detection in 2008. Identifying scrub typhus risk factors would support early diagnosis and treatment for this nonspecific febrile disease, reducing the incidence of potentially fatal complications. We conducted a hospital-based, case‒control study during October‒December 2015 in 11 scrub typhus‒prone districts. We identified harvesting cardamom as the major risk factor (odds ratio 1,519; p<0.001); other factors were traditional housing, largely caused by an outside toilet location, as well as owning a goat and frequently sitting on grass. Harvesting vegetables, herding cattle in the forest, and female sex were protective. Age had a nonlinear effect; children and the elderly were more likely to seek treatment for clinical scrub typhus. This study has informed public health policies and awareness programs for healthcare workers through development of National Guidelines for Prevention, Treatment and Control of Scrub Typhus in Bhutan.

  • Leishmania donovani Transmission Cycle Associated with Human Infection, Phlebotomus alexandri Sand Flies, and Hare Blood Meals, Israel
    L. Studentsky et al.
  • Emergence of Erythromycin-Resistant Invasive Group A Streptococcus, West Virginia, USA
    L. M. Powell et al.
  • Misdiagnosis of Clostridioides difficile Infections by Standard-of-Care Specimen Collection and Testing among Hospitalized Adults, Louisville, Kentucky, USA, 2019–2020
    J. A. Ramirez et al.

    Although Clostridioides difficile infection (CDI) incidence is high in the United States, standard-of-care (SOC) stool collection and testing practices might result in incidence overestimation or underestimation. We conducted diarrhea surveillance among inpatients >50 years of age in Louisville, Kentucky, USA, during October 14, 2019–October 13, 2020; concurrent SOC stool collection and CDI testing occurred independently. A study CDI case was nucleic acid amplification test‒/cytotoxicity neutralization assay‒positive or nucleic acid amplification test‒positive stool in a patient with pseudomembranous colitis. Study incidence was adjusted for hospitalization share and specimen collection rate and, in a sensitivity analysis, for diarrhea cases without study testing. SOC hospitalized CDI incidence was 121/100,000 population/year; study incidence was 154/100,000 population/year and, in sensitivity analysis, 202/100,000 population/year. Of 75 SOC CDI cases, 12 (16.0%) were not study diagnosed; of 109 study CDI cases, 44 (40.4%) were not SOC diagnosed. CDI incidence estimates based on SOC CDI testing are probably underestimated.

  • Case-Control Study of Long COVID, Sapporo, Japan
    T. Asakura et al.
  • Disparities in Implementing COVID-19 Prevention Strategies in Public Schools, United States, 2021–22 School Year
    S. Pampati et al.

    During the COVID-19 pandemic, US schools have been encouraged to take a layered approach to prevention, incorporating multiple strategies to curb transmission of SARS-CoV-2. Using survey data representative of US public K–12 schools (N = 437), we determined prevalence estimates of COVID-19 prevention strategies early in the 2021–22 school year and describe disparities in implementing strategies by school characteristics. Prevalence of prevention strategies ranged from 9.3% (offered COVID-19 screening testing to students and staff) to 95.1% (had a school-based system to report COVID-19 outcomes). Schools with a full-time school nurse or school-based health center had significantly higher odds of implementing several strategies, including those related to COVID-19 vaccination. We identified additional disparities in prevalence of strategies by locale, school level, and poverty. Advancing school health workforce and infrastructure, ensuring schools use available COVID-19 funding effectively, and promoting efforts in schools with the lowest prevalence of infection prevention strategies are needed for pandemic preparedness.

  • Influence of Sex-Based Differences and Disparities on Tuberculosis Prevalence, Vietnam, 2017–2018
    H. Nguyen et al.
  • SARS-CoV-2 Seroprevalence Compared with Confirmed COVID-19 Cases among Children, Colorado, USA, May–July 2021
    S. C. O’Brien et al.

    To compare SARS-CoV-2 antibody seroprevalence among children with seropositive confirmed COVID-19 case counts (case ascertainment by molecular amplification) in Colorado, USA, we conducted a cross-sectional serosurvey during May–July 2021. For a convenience sample of 829 Colorado children, SARS-CoV-2 seroprevalence was 36.7%, compared with prevalence of 6.5% according to individually matched COVID-19 test results reported to public health. Compared with non-Hispanic White children, seroprevalence was higher among Hispanic, non-Hispanic Black, and non-Hispanic other race children, and case ascertainment was significantly lower among Hispanic and non-Hispanic Black children. This serosurvey accurately estimated SARS-CoV-2 prevalence among children compared with confirmed COVID-19 case counts and revealed substantial racial/ethnic disparities in infections and case ascertainment. Continued efforts to address racial and ethnic differences in disease burden and to overcome potential barriers to case ascertainment, including access to testing, may help mitigate these ongoing disparities.

  • Poor Prognosis for Puumala Virus Infections Predicted by Lymphopenia and Dyspnea
    S. Hatzl et al.
  • Fatal Case of Heartland Virus Disease Acquired in the Mid-Atlantic Region, United States
    S. Liu et al.

    Heartland virus (HRTV) disease is an emerging tickborne illness in the midwestern and southern United States. We describe a reported fatal case of HRTV infection in the Maryland and Virginia region, states not widely recognized to have human HRTV disease cases. The range of HRTV could be expanding in the United States.

  • Case Report and Literature Review of Occupational Transmission of Monkeypox Virus to Healthcare Workers, South Korea
    Y. Choi et al.

    We report a case of occupational monkeypox virus infection from a needlestick injury in a healthcare worker in South Korea and review similar reports in the literature during 2022. Postexposure prophylactic treatment with a third-generation smallpox vaccine and antiviral agent tecovirimat inhibited local virus spread and alleviated lesion pain.

  • Cutaneous Leishmaniasis Caused by Leishmania infantum, Israel, 2018–2021
    M. Solomon et al.

    Cutaneous leishmaniasis (CL) is endemic to Israel. Previously, CL caused by Leishmania infantum had been reported in Israel only once (in 2016). We report 8 L. infantum CL cases; 7 occurred during 2020–2021. None of the patients had systemic disease. L. infantum CL may be an emerging infection in Israel.

  • Novel Circovirus in Blood from Intravenous Drug Users, Yunnan, China
    Y. Li et al.
  • Characteristics and Treatment of Gordonia bacteraemias, France
    A. Barthel et al.
  • Comparative Aerosol and Surface Stability of SARS-CoV-2 Variants of Concern
    T. Bushmaker et al.
  • No Substantial Histopathologic Changes in Mops condylurus Bats Naturally Infected with Bombali Ebolavirus, Kenya
    L. Kareinen et al.
  • Spatiotemporal Evolution of SARS-CoV-2 Alpha and Delta Variants during Large Nationwide Outbreak, Vietnam, 2021
    N. Tam et al.
  • Severe Streptococcus equi subspecies zooepidemicus Outbreak from Unpasteurized Dairy Product Consumption, Italy
    S. Bosica et al.
  • Limited Nosocomial Transmission of Drug-Resistant Tuberculosis, Moldova
    E. Noroc et al.
  • An Unknown Circovirus Detected in an Immunosuppressed Patient With Acute Hepatitis, France, 2022
    C. Rodriguez et al.
  • Emerging M1UK Lineage Invasive Group A Streptococcus Isolates Detected by Allele-Specific PCR, England, 2020
    X. Zhi et al.
Research Letters
  • Norovirus GII.3[P25] in Patients and Produce, Chanthaburi, Thailand, 2022
    W. Chuchaona et al.
  • Panton-Valentine Leukocidin–Positive CC398 MRSA in Urban Clinical Settings, the Netherlands
    J. Gooskens et al.

    We report detection of Panton-Valentine leukocidin–positive clonal complex 398 human-origin methicillin-resistant Staphylococcus aureus L2 in the Netherlands. This hypervirulent lineage originated in the Asia-Pacific Region and could become community-acquired in Europe after recurrent travel-related introductions. Genomic surveillance enables early detection to guide control measures and help limit pathogen spread in urban settings.

  • New Genotype of Coxiella burnetii Causing Epizootic Q Fever Outbreak in Rodents, Northern Senegal
    J. Mangombi-Pambou et al.
  • Cystic Echinococcosis in Northern New Hampshire, USA
    A. AlSalman et al.

    In April 2022 and December 2022, the New Hampshire Department of Health and Human Services confirmed 2 cases of locally acquired human pulmonary cystic echinococcosis caused by Echinococcus granulosus tapeworms. Both patients reported dressing locally hunted moose and exposure to dogs.

  • Burkholderia pseudomallei Laboratory Exposure, Arizona, USA
    L. J. Speiser et al.
  • Epizootic Hemorrhagic Disease Virus Serotype 8, Italy, November 2022
    A. Lorusso et al.
  • Mpox among Public Festival Attendees, Chicago, Illinois, USA, July–August 2022
    E. Faherty et al.

    We investigated an mpox outbreak after a 2022 LGBTQ event in Chicago, Illinois, USA. Among case-patients, 38% had received 1 dose of mpox vaccine, none 2 doses; most reported sexual activity during the probable exposure period. Among other preventive measures, persons at risk should complete mpox vaccination 14 days before an event.

  • COVID-19 Vaccine Uptake by Infection Status in New South Wales, Australia
    H. Gidding et al.
  • Emergence of Leishmania Lineage Diversity, Neotropics
    F. Van den Broeck et al.
Online Report
  • US National Institutes of Health Prioritization of SARS-CoV-2 Variants
    S. Turner et al.


Volume 29, Number 6—June 2023

  • Association of Persistent Symptoms after Lyme Neuroborreliosis and Increased Levels of Interferon-α in Blood
    S. A. Hernández et al.
  • Probable Transmission of SARS-CoV-2 from African Lion to Zoo Employees
    A. A. Siegrist et al.
  • Case Studies and Literature Review of Francisella tularensis–Related Prosthetic Joint Infection
    L. Ponderand et al.
  • Epidemiologic Characteristics of Mpox Infections among People Experiencing Homelessness, Los Angeles County, California, USA, 2022
    H. K. Brosnan et al.
  • Prevalence of Nonfalciparum and Plasmodium falciparum Malaria Infections among Schoolchildren, Tanzania
    R. Sendor et al.
  • Rising Incidence of Sporothrix brasiliensis Infections, 2011–2022, Curitiba, Brazil
    R. C. Cognialli et al.
  • Results of PCR Analysis of Mpox Clinical Samples, Sweden, 2022
    J. Edman-Wallér et al.
  • Tanapox, South Africa, 2022
    M. Birkhead et al.
  • MERS-CoV‒Specific T-Cell Responses in Camels after Single MVA-MERS-S Vaccination
    C. Meyer zu Natrup et al.
  • Detection of Novel Poxvirus from Gray Seal (Halichoerus grypus), Germany
    F. Pfaff et al.
  • Tropism and Replication Competence of Novel Zoonotic-like Avian Influenza A(H3N8) in Ex Vivo Human Bronchus and Lung
    K. Hui et al.
Research Letters
  • Limited Cutaneous Leishmaniasis as Ulcerated Verrucous Plaque on Leg, Tucson, Arizona, USA
    C. B. Dagenet et al.
  • Genomic Surveillance of Monkeypox Virus, Minas Gerais, Brazil, 2022
    N. R. Guimarães 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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