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Articles from Emerging Infectious Diseases

Synopses

Medscape CME Activity
Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021–2022 [PDF - 1.82 MB - 11 pages]
T. J. Doyle et al.

In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men. The hepatitis A outbreak (153 cases) was associated with hepatitis A virus genotype IA. The IMD outbreak (44 cases) was associated with Neisseria meningitidis serogroup C, sequence type 11, clonal complex 11. The mpox outbreak in Florida (2,845 cases) was part of a global epidemic. The hepatitis A and IMD outbreaks were concentrated in Central Florida and peaked during March–­June, whereas mpox cases were more heavily concentrated in South Florida and had peak incidence in August. HIV infection was more common (52%) among mpox cases than among hepatitis A (21%) or IMD (34%) cases. Where feasible, vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among at-risk groups and offered along with program services that target those groups.

EID Doyle TJ, Gumke M, Stanek D, Moore J, Buck B, Locksmith T, et al. Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021–2022. Emerg Infect Dis. 2024;30(4):634-643. https://doi.org/10.3201/eid3004.231392
AMA Doyle TJ, Gumke M, Stanek D, et al. Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021–2022. Emerging Infectious Diseases. 2024;30(4):634-643. doi:10.3201/eid3004.231392.
APA Doyle, T. J., Gumke, M., Stanek, D., Moore, J., Buck, B., Locksmith, T....Chacreton, D. (2024). Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021–2022. Emerging Infectious Diseases, 30(4), 634-643. https://doi.org/10.3201/eid3004.231392.
Research

Medscape CME Activity
Deaths Associated with Pediatric Hepatitis of Unknown Etiology, United States, October 2021–June 2023 [PDF - 1.13 MB - 10 pages]
O. Almendares et al.

During October 2021–June 2023, a total of 392 cases of acute hepatitis of unknown etiology in children in the United States were reported to Centers for Disease Control and Prevention as part of national surveillance. We describe demographic and clinical characteristics, including potential involvement of adenovirus in development of acute hepatitis, of 8 fatally ill children who met reporting criteria. The children had diverse courses of illness. Two children were immunocompromised when initially brought for care. Four children tested positive for adenovirus in multiple specimen types, including 2 for whom typing was completed. One adenovirus-positive child had no known underlying conditions, supporting a potential relationship between adenovirus and acute hepatitis in previously healthy children. Our findings emphasize the importance of continued investigation to determine the mechanism of liver injury and appropriate treatment. Testing for adenovirus in similar cases could elucidate the role of the virus.

EID Almendares O, Baker JM, Sugerman DE, Parashar UD, Reagan-Steiner S, Kirking HL, et al. Deaths Associated with Pediatric Hepatitis of Unknown Etiology, United States, October 2021–June 2023. Emerg Infect Dis. 2024;30(4):644-653. https://doi.org/10.3201/eid3004.231140
AMA Almendares O, Baker JM, Sugerman DE, et al. Deaths Associated with Pediatric Hepatitis of Unknown Etiology, United States, October 2021–June 2023. Emerging Infectious Diseases. 2024;30(4):644-653. doi:10.3201/eid3004.231140.
APA Almendares, O., Baker, J. M., Sugerman, D. E., Parashar, U. D., Reagan-Steiner, S., Kirking, H. L....Tate, J. E. (2024). Deaths Associated with Pediatric Hepatitis of Unknown Etiology, United States, October 2021–June 2023. Emerging Infectious Diseases, 30(4), 644-653. https://doi.org/10.3201/eid3004.231140.

Crimean-Congo Hemorrhagic Fever Virus Diversity and Reassortment, Pakistan, 2017–2020 [PDF - 4.17 MB - 11 pages]
M. Umair et al.

Sporadic cases and outbreaks of Crimean-Congo hemorrhagic fever (CCHF) have been documented across Pakistan since 1976; however, data regarding the diversity of CCHF virus (CCHFV) in Pakistan is sparse. We whole-genome sequenced 36 CCHFV samples collected from persons infected in Pakistan during 2017–2020. Most CCHF cases were from Rawalpindi (n = 10), followed by Peshawar (n = 7) and Islamabad (n = 4). Phylogenetic analysis revealed the Asia-1 genotype was dominant, but 4 reassorted strains were identified. Strains with reassorted medium gene segments clustered with Asia-2 (n = 2) and Africa-2 (n = 1) genotypes; small segment reassortments clustered with the Asia-2 genotype (n = 2). Reassorted viruses showed close identity with isolates from India, Iran, and Tajikistan, suggesting potential crossborder movement of CCHFV. Improved and continuous human, tick, and animal surveillance is needed to define the diversity of circulating CCHFV strains in Pakistan and prevent transmission.

EID Umair M, Rehman Z, Whitmer S, Mobley M, Fahim A, Ikram A, et al. Crimean-Congo Hemorrhagic Fever Virus Diversity and Reassortment, Pakistan, 2017–2020. Emerg Infect Dis. 2024;30(4):654-664. https://doi.org/10.3201/eid3004.231155
AMA Umair M, Rehman Z, Whitmer S, et al. Crimean-Congo Hemorrhagic Fever Virus Diversity and Reassortment, Pakistan, 2017–2020. Emerging Infectious Diseases. 2024;30(4):654-664. doi:10.3201/eid3004.231155.
APA Umair, M., Rehman, Z., Whitmer, S., Mobley, M., Fahim, A., Ikram, A....Klena, J. D. (2024). Crimean-Congo Hemorrhagic Fever Virus Diversity and Reassortment, Pakistan, 2017–2020. Emerging Infectious Diseases, 30(4), 654-664. https://doi.org/10.3201/eid3004.231155.

Clostridium butyricum Bacteremia Associated with Probiotic Use, Japan [PDF - 518 KB - 7 pages]
R. Sada et al.

Clostridium butyricum, a probiotic commonly prescribed in Asia, most notably as MIYA-BM (Miyarisan Pharmaceutical Co., Ltd.; https://www.miyarisan.com), occasionally leads to bacteremia. The prevalence and characteristics of C. butyricum bacteremia and its bacteriologic and genetic underpinnings remain unknown. We retrospectively investigated patients admitted to Osaka University Hospital during September 2011–February 2023. Whole-genome sequencing revealed 5 (0.08%) cases of C. butyricum bacteremia among 6,576 case-patients who had blood cultures positive for any bacteria. Four patients consumed MIYA-BM, and 1 patient consumed a different C. butyricum-containing probiotic. Most patients had compromised immune systems, and common symptoms included fever and abdominal distress. One patient died of nonocclusive mesenteric ischemia. Sequencing results confirmed that all identified C. butyricum bacteremia strains were probiotic derivatives. Our findings underscore the risk for bacteremia resulting from probiotic use, especially in hospitalized patients, necessitating judicious prescription practices.

EID Sada R, Matsuo H, Motooka D, Kutsuna S, Hamaguchi S, Yamamoto G, et al. Clostridium butyricum Bacteremia Associated with Probiotic Use, Japan. Emerg Infect Dis. 2024;30(4):665-671. https://doi.org/10.3201/eid3004.231633
AMA Sada R, Matsuo H, Motooka D, et al. Clostridium butyricum Bacteremia Associated with Probiotic Use, Japan. Emerging Infectious Diseases. 2024;30(4):665-671. doi:10.3201/eid3004.231633.
APA Sada, R., Matsuo, H., Motooka, D., Kutsuna, S., Hamaguchi, S., Yamamoto, G....Ueda, A. (2024). Clostridium butyricum Bacteremia Associated with Probiotic Use, Japan. Emerging Infectious Diseases, 30(4), 665-671. https://doi.org/10.3201/eid3004.231633.

Animal Exposure Model for Mapping Crimean-Congo Hemorrhagic Fever Virus Emergence Risk [PDF - 1.97 MB - 9 pages]
S. Baz-Flores et al.

To estimate the determinants of spatial variation in Crimean-Congo hemorrhagic fever virus (CCHFV) transmission and to create a risk map as a preventive public health tool, we designed a survey of small domestic ruminants in Andalusia, Spain. To assess CCHFV exposure spatial distribution, we analyzed serum from 2,440 sheep and goats by using a double-antigen ELISA and modeled exposure probability with environmental predictors by using generalized linear mixed models. CCHFV antibodies detected in 84 samples confirmed low CCHFV prevalence in small domestic ruminants in the region. The best-fitted statistical model indicated that the most significant predictors of virus exposure risk were cattle/horse density and the normalized difference vegetation index. Model validation showed 99.7% specificity and 10.2% sensitivity for identifying CCHFV circulation areas. To map CCHFV exposure risk, we projected the model at a 1 × 1-km spatial resolution. Our study provides insight into CCHFV ecology that is useful for preventing virus transmission.

EID Baz-Flores S, Jiménez-Martín D, Peralbo-Moreno A, Herraiz C, Cano-Terriza D, Cuadrado-Matías R, et al. Animal Exposure Model for Mapping Crimean-Congo Hemorrhagic Fever Virus Emergence Risk. Emerg Infect Dis. 2024;30(4):672-680. https://doi.org/10.3201/eid3004.221604
AMA Baz-Flores S, Jiménez-Martín D, Peralbo-Moreno A, et al. Animal Exposure Model for Mapping Crimean-Congo Hemorrhagic Fever Virus Emergence Risk. Emerging Infectious Diseases. 2024;30(4):672-680. doi:10.3201/eid3004.221604.
APA Baz-Flores, S., Jiménez-Martín, D., Peralbo-Moreno, A., Herraiz, C., Cano-Terriza, D., Cuadrado-Matías, R....Ruiz-Fons, F. (2024). Animal Exposure Model for Mapping Crimean-Congo Hemorrhagic Fever Virus Emergence Risk. Emerging Infectious Diseases, 30(4), 672-680. https://doi.org/10.3201/eid3004.221604.

Geographic Disparities in Domestic Pig Population Exposure to Ebola Viruses, Guinea, 2017–2019 [PDF - 2.71 MB - 10 pages]
S. Grayo et al.

Although pigs are naturally susceptible to Reston virus and experimentally to Ebola virus (EBOV), their role in Orthoebolavirus ecology remains unknown. We tested 888 serum samples collected from pigs in Guinea during 2017–2019 (between the 2013–16 epidemic and its resurgence in 2021) by indirect ELISA against the EBOV nucleoprotein. We identified 2 hotspots of possible pig exposure by IgG titer levels: the northern coast had 48.7% of positive serum samples (37/76), and Forest Guinea, bordering Sierra Leone and Liberia, where the virus emerged and reemerged, had 50% of positive serum samples (98/196). The multitarget Luminex approach confirms ELISA results against Ebola nucleoprotein and highlights cross-reactivities to glycoprotein of EBOV, Reston virus, and Bundibugyo virus. Those results are consistent with previous observations of the circulation of Orthoebolavirus species in pig farming regions in Sierra Leone and Ghana, suggesting potential risk for Ebola virus disease in humans, especially in Forest Guinea.

EID Grayo S, Camara A, Doukouré B, Ellis I, Troupin C, Fischer K, et al. Geographic Disparities in Domestic Pig Population Exposure to Ebola Viruses, Guinea, 2017–2019. Emerg Infect Dis. 2024;30(4):681-690. https://doi.org/10.3201/eid3004.231034
AMA Grayo S, Camara A, Doukouré B, et al. Geographic Disparities in Domestic Pig Population Exposure to Ebola Viruses, Guinea, 2017–2019. Emerging Infectious Diseases. 2024;30(4):681-690. doi:10.3201/eid3004.231034.
APA Grayo, S., Camara, A., Doukouré, B., Ellis, I., Troupin, C., Fischer, K....Tordo, N. (2024). Geographic Disparities in Domestic Pig Population Exposure to Ebola Viruses, Guinea, 2017–2019. Emerging Infectious Diseases, 30(4), 681-690. https://doi.org/10.3201/eid3004.231034.

Emergence of Poultry-Associated Human Salmonella enterica Serovar Abortusovis Infections, New South Wales, Australia [PDF - 2.13 MB - 10 pages]
M. Payne et al.

Salmonella enterica serovar Abortusovis is a ovine-adapted pathogen that causes spontaneous abortion. Salmonella Abortusovis was reported in poultry in 2009 and has since been reported in human infections in New South Wales, Australia. Phylogenomic analysis revealed a clade of 51 closely related isolates from Australia originating in 2004. That clade was genetically distinct from ovine-associated isolates. The clade was widespread in New South Wales poultry production facilities but was only responsible for sporadic human infections. Some known virulence factors associated with human infections were only found in the poultry-associated clade, some of which were acquired through prophages and plasmids. Furthermore, the ovine-associated clade showed signs of genome decay, but the poultry-associated clade did not. Those genomic changes most likely led to differences in host range and disease type. Surveillance using the newly identified genetic markers will be vital for tracking Salmonella Abortusovis transmission in animals and to humans and preventing future outbreaks.

EID Payne M, Williamson S, Wang Q, Zhang X, Sintchenko V, Pavic A, et al. Emergence of Poultry-Associated Human Salmonella enterica Serovar Abortusovis Infections, New South Wales, Australia. Emerg Infect Dis. 2024;30(4):691-700. https://doi.org/10.3201/eid3004.230958
AMA Payne M, Williamson S, Wang Q, et al. Emergence of Poultry-Associated Human Salmonella enterica Serovar Abortusovis Infections, New South Wales, Australia. Emerging Infectious Diseases. 2024;30(4):691-700. doi:10.3201/eid3004.230958.
APA Payne, M., Williamson, S., Wang, Q., Zhang, X., Sintchenko, V., Pavic, A....Lan, R. (2024). Emergence of Poultry-Associated Human Salmonella enterica Serovar Abortusovis Infections, New South Wales, Australia. Emerging Infectious Diseases, 30(4), 691-700. https://doi.org/10.3201/eid3004.230958.

A One Health Perspective on Salmonella enterica Serovar Infantis, an Emerging Human Multidrug-Resistant Pathogen [PDF - 2.35 MB - 10 pages]
J. Mattock et al.

Salmonella enterica serovar Infantis presents an ever-increasing threat to public health because of its spread throughout many countries and association with high levels of antimicrobial resistance (AMR). We analyzed whole-genome sequences of 5,284 Salmonella Infantis strains from 74 countries, isolated during 1989–2020 from a wide variety of human, animal, and food sources, to compare genetic phylogeny, AMR determinants, and plasmid presence. The global Salmonella Infantis population structure diverged into 3 clusters: a North American cluster, a European cluster, and a global cluster. The levels of AMR varied by Salmonella Infantis cluster and by isolation source; 73% of poultry isolates were multidrug resistant, compared with 35% of human isolates. This finding correlated with the presence of the pESI megaplasmid; 71% of poultry isolates contained pESI, compared with 32% of human isolates. This study provides key information for public health teams engaged in reducing the spread of this pathogen.

EID Mattock J, Chattaway M, Hartman H, Dallman TJ, Smith AM, Keddy K, et al. A One Health Perspective on Salmonella enterica Serovar Infantis, an Emerging Human Multidrug-Resistant Pathogen. Emerg Infect Dis. 2024;30(4):701-710. https://doi.org/10.3201/eid3004.231031
AMA Mattock J, Chattaway M, Hartman H, et al. A One Health Perspective on Salmonella enterica Serovar Infantis, an Emerging Human Multidrug-Resistant Pathogen. Emerging Infectious Diseases. 2024;30(4):701-710. doi:10.3201/eid3004.231031.
APA Mattock, J., Chattaway, M., Hartman, H., Dallman, T. J., Smith, A. M., Keddy, K....Langridge, G. C. (2024). A One Health Perspective on Salmonella enterica Serovar Infantis, an Emerging Human Multidrug-Resistant Pathogen. Emerging Infectious Diseases, 30(4), 701-710. https://doi.org/10.3201/eid3004.231031.

Bus Riding as Amplification Mechanism for SARS-CoV-2 Transmission, Germany, 2021 [PDF - 2.86 MB - 10 pages]
M. Schöll et al.

To examine the risk associated with bus riding and identify transmission chains, we investigated a COVID-19 outbreak in Germany in 2021 that involved index case-patients among bus-riding students. We used routine surveillance data, performed laboratory analyses, interviewed case-patients, and conducted a cohort study. We identified 191 case-patients, 65 (34%) of whom were elementary schoolchildren. A phylogenetically unique strain and epidemiologic analyses provided a link between air travelers and cases among bus company staff, schoolchildren, other bus passengers, and their respective household members. The attack rate among bus-riding children at 1 school was ≈4 times higher than among children not taking a bus to that school. The outbreak exemplifies how an airborne agent may be transmitted effectively through (multiple) short (<20 minutes) public transport journeys and may rapidly affect many persons.

EID Schöll M, Höhn C, Boucsein J, Moek F, Plath J, an der Heiden M, et al. Bus Riding as Amplification Mechanism for SARS-CoV-2 Transmission, Germany, 2021. Emerg Infect Dis. 2024;30(4):711-720. https://doi.org/10.3201/eid3004.231299
AMA Schöll M, Höhn C, Boucsein J, et al. Bus Riding as Amplification Mechanism for SARS-CoV-2 Transmission, Germany, 2021. Emerging Infectious Diseases. 2024;30(4):711-720. doi:10.3201/eid3004.231299.
APA Schöll, M., Höhn, C., Boucsein, J., Moek, F., Plath, J., an der Heiden, M....Lachmann, R. (2024). Bus Riding as Amplification Mechanism for SARS-CoV-2 Transmission, Germany, 2021. Emerging Infectious Diseases, 30(4), 711-720. https://doi.org/10.3201/eid3004.231299.

Isolation of Diverse Simian Arteriviruses Causing Hemorrhagic Disease [PDF - 4.71 MB - 11 pages]
T. M. Shaw et al.

Genetically diverse simian arteriviruses (simarteriviruses) naturally infect geographically and phylogenetically diverse monkeys, and cross-species transmission and emergence are of considerable concern. Characterization of most simarteriviruses beyond sequence analysis has not been possible because the viruses fail to propagate in the laboratory. We attempted to isolate 4 simarteriviruses, Kibale red colobus virus 1, Pebjah virus, simian hemorrhagic fever virus, and Southwest baboon virus 1, by inoculating an immortalized grivet cell line (known to replicate simian hemorrhagic fever virus), primary macaque cells, macrophages derived from macaque induced pluripotent stem cells, and mice engrafted with macaque CD34+-enriched hematopoietic stem cells. The combined effort resulted in successful virus isolation; however, no single approach was successful for all 4 simarteriviruses. We describe several approaches that might be used to isolate additional simarteriviruses for phenotypic characterization. Our results will expedite laboratory studies of simarteriviruses to elucidate virus-host interactions, assess zoonotic risk, and develop medical countermeasures.

EID Shaw TM, Dettle ST, Mejia A, Hayes JM, Simmons HA, Basu P, et al. Isolation of Diverse Simian Arteriviruses Causing Hemorrhagic Disease. Emerg Infect Dis. 2024;30(4):721-731. https://doi.org/10.3201/eid3004.231457
AMA Shaw TM, Dettle ST, Mejia A, et al. Isolation of Diverse Simian Arteriviruses Causing Hemorrhagic Disease. Emerging Infectious Diseases. 2024;30(4):721-731. doi:10.3201/eid3004.231457.
APA Shaw, T. M., Dettle, S. T., Mejia, A., Hayes, J. M., Simmons, H. A., Basu, P....Bailey, A. L. (2024). Isolation of Diverse Simian Arteriviruses Causing Hemorrhagic Disease. Emerging Infectious Diseases, 30(4), 721-731. https://doi.org/10.3201/eid3004.231457.

Nephropathia Epidemica Caused by Puumala Virus in Bank Voles, Scania, Southern Sweden [PDF - 678 KB - 6 pages]
J. Ling et al.

In 2018, a local case of nephropathia epidemica was reported in Scania, southern Sweden, more than 500 km south of the previously known presence of human hantavirus infections in Sweden. Another case emerged in the same area in 2020. To investigate the zoonotic origin of those cases, we trapped rodents in Ballingslöv, Norra Sandby, and Sörby in southern Sweden during 2020‒2021. We found Puumala virus (PUUV) in lung tissues from 9 of 74 Myodes glareolus bank voles by screening tissues using a hantavirus pan–large segment reverse transcription PCR. Genetic analysis revealed that the PUUV strains were distinct from those found in northern Sweden and Denmark and belonged to the Finnish PUUV lineage. Our findings suggest an introduction of PUUV from Finland or Karelia, causing the human PUUV infections in Scania. This discovery emphasizes the need to understand the evolution, cross-species transmission, and disease outcomes of this newly found PUUV variant.

EID Ling J, Lundeberg E, Wasberg A, Faria IR, Vucicevic S, Settergren B, et al. Nephropathia Epidemica Caused by Puumala Virus in Bank Voles, Scania, Southern Sweden. Emerg Infect Dis. 2024;30(4):732-737. https://doi.org/10.3201/eid3004.231414
AMA Ling J, Lundeberg E, Wasberg A, et al. Nephropathia Epidemica Caused by Puumala Virus in Bank Voles, Scania, Southern Sweden. Emerging Infectious Diseases. 2024;30(4):732-737. doi:10.3201/eid3004.231414.
APA Ling, J., Lundeberg, E., Wasberg, A., Faria, I. R., Vucicevic, S., Settergren, B....Lundkvist, Å. (2024). Nephropathia Epidemica Caused by Puumala Virus in Bank Voles, Scania, Southern Sweden. Emerging Infectious Diseases, 30(4), 732-737. https://doi.org/10.3201/eid3004.231414.

Divergent Pathogenesis and Transmission of Highly Pathogenic Avian Influenza A(H5N1) in Swine [PDF - 5.91 MB - 14 pages]
B. Arruda et al.

Highly pathogenic avian influenza (HPAI) viruses have potential to cross species barriers and cause pandemics. Since 2022, HPAI A(H5N1) belonging to the goose/Guangdong 2.3.4.4b hemagglutinin phylogenetic clade have infected poultry, wild birds, and mammals across North America. Continued circulation in birds and infection of multiple mammalian species with strains possessing adaptation mutations increase the risk for infection and subsequent reassortment with influenza A viruses endemic in swine. We assessed the susceptibility of swine to avian and mammalian HPAI H5N1 clade 2.3.4.4b strains using a pathogenesis and transmission model. All strains replicated in the lung of pigs and caused lesions consistent with influenza A infection. However, viral replication in the nasal cavity and transmission was only observed with mammalian isolates. Mammalian adaptation and reassortment may increase the risk for incursion and transmission of HPAI viruses in feral, backyard, or commercial swine.

EID Arruda B, Baker A, Buckley A, Anderson TK, Torchetti M, Bergeson N, et al. Divergent Pathogenesis and Transmission of Highly Pathogenic Avian Influenza A(H5N1) in Swine. Emerg Infect Dis. 2024;30(4):738-751. https://doi.org/10.3201/eid3004.231141
AMA Arruda B, Baker A, Buckley A, et al. Divergent Pathogenesis and Transmission of Highly Pathogenic Avian Influenza A(H5N1) in Swine. Emerging Infectious Diseases. 2024;30(4):738-751. doi:10.3201/eid3004.231141.
APA Arruda, B., Baker, A., Buckley, A., Anderson, T. K., Torchetti, M., Bergeson, N....Lantz, K. (2024). Divergent Pathogenesis and Transmission of Highly Pathogenic Avian Influenza A(H5N1) in Swine. Emerging Infectious Diseases, 30(4), 738-751. https://doi.org/10.3201/eid3004.231141.
Historical Review

Alfred Whitmore and the Discovery of Melioidosis [PDF - 2.43 MB - 5 pages]
J. Savelkoel and D. Dance

We review the discovery of the tropical infectious disease melioidosis by Alfred Whitmore, a pathologist from England, and his assistant from India, C.S. Krishnaswami. We discuss how the subsequent disappearance of melioidosis from the medical literature of Burma holds parallels with the current neglect and under recognition of the disease. We urge global and national public health authorities to add melioidosis to existing neglected tropical diseases surveillance systems.

EID Savelkoel J, Dance D. Alfred Whitmore and the Discovery of Melioidosis. Emerg Infect Dis. 2024;30(4):752-756. https://doi.org/10.3201/eid3004.230693
AMA Savelkoel J, Dance D. Alfred Whitmore and the Discovery of Melioidosis. Emerging Infectious Diseases. 2024;30(4):752-756. doi:10.3201/eid3004.230693.
APA Savelkoel, J., & Dance, D. (2024). Alfred Whitmore and the Discovery of Melioidosis. Emerging Infectious Diseases, 30(4), 752-756. https://doi.org/10.3201/eid3004.230693.
Dispatches

Effects of Shock and Vibration on Product Quality during Last-Mile Transportation of Ebola Vaccine under Refrigerated Conditions [PDF - 825 KB - 4 pages]
L. Bus-Jacobs et al.

Analyzing vaccine stability under different storage and transportation conditions is critical to ensure that effectiveness and safety are not affected by distribution. In a simulation of the last mile in the supply chain, we found that shock and vibration had no effect on Ad26.ZEBOV/MVA-BN-Filo Ebola vaccine regimen quality under refrigerated conditions.

EID Bus-Jacobs L, Lau R, Soethoudt M, Gebbia L, Janssens E, Hermans T. Effects of Shock and Vibration on Product Quality during Last-Mile Transportation of Ebola Vaccine under Refrigerated Conditions. Emerg Infect Dis. 2024;30(4):757-760. https://doi.org/10.3201/eid3004.231060
AMA Bus-Jacobs L, Lau R, Soethoudt M, et al. Effects of Shock and Vibration on Product Quality during Last-Mile Transportation of Ebola Vaccine under Refrigerated Conditions. Emerging Infectious Diseases. 2024;30(4):757-760. doi:10.3201/eid3004.231060.
APA Bus-Jacobs, L., Lau, R., Soethoudt, M., Gebbia, L., Janssens, E., & Hermans, T. (2024). Effects of Shock and Vibration on Product Quality during Last-Mile Transportation of Ebola Vaccine under Refrigerated Conditions. Emerging Infectious Diseases, 30(4), 757-760. https://doi.org/10.3201/eid3004.231060.

Co-Circulating Monkeypox and Swinepox Viruses, Democratic Republic of the Congo, 2022 [PDF - 1.30 MB - 5 pages]
T. Kalonji et al.

In September 2022, deaths of pigs manifesting pox-like lesions caused by swinepox virus were reported in Tshuapa Province, Democratic Republic of the Congo. Two human mpox cases were found concurrently in the surrounding community. Specific diagnostics and robust sequencing are needed to characterize multiple poxviruses and prevent potential poxvirus transmission.

EID Kalonji T, Malembi E, Matela J, Likafi T, Kinganda-Lusamaki E, Vakaniaki E, et al. Co-Circulating Monkeypox and Swinepox Viruses, Democratic Republic of the Congo, 2022. Emerg Infect Dis. 2024;30(4):761-765. https://doi.org/10.3201/eid3004.231413
AMA Kalonji T, Malembi E, Matela J, et al. Co-Circulating Monkeypox and Swinepox Viruses, Democratic Republic of the Congo, 2022. Emerging Infectious Diseases. 2024;30(4):761-765. doi:10.3201/eid3004.231413.
APA Kalonji, T., Malembi, E., Matela, J., Likafi, T., Kinganda-Lusamaki, E., Vakaniaki, E....Mbala-Kingebeni, P. (2024). Co-Circulating Monkeypox and Swinepox Viruses, Democratic Republic of the Congo, 2022. Emerging Infectious Diseases, 30(4), 761-765. https://doi.org/10.3201/eid3004.231413.

Case Report of Nasal Rhinosporidiosis in South Africa [PDF - 1.75 MB - 4 pages]
H. Mayet et al.

We describe a classic case of nasal rhinosporidiosis in a woman who resided in Johannesburg, South Africa, but originated from a rural area in Eastern Cape Province. We confirmed histologic diagnosis using PCR testing and compared details with those from records on 17 other cases from South Africa.

EID Mayet H, Reddy DL, Alvarez T, Atiya Y, Govender NP, Birkhead M, et al. Case Report of Nasal Rhinosporidiosis in South Africa. Emerg Infect Dis. 2024;30(4):766-769. https://doi.org/10.3201/eid3004.240018
AMA Mayet H, Reddy DL, Alvarez T, et al. Case Report of Nasal Rhinosporidiosis in South Africa. Emerging Infectious Diseases. 2024;30(4):766-769. doi:10.3201/eid3004.240018.
APA Mayet, H., Reddy, D. L., Alvarez, T., Atiya, Y., Govender, N. P., Birkhead, M....Pather, S. (2024). Case Report of Nasal Rhinosporidiosis in South Africa. Emerging Infectious Diseases, 30(4), 766-769. https://doi.org/10.3201/eid3004.240018.

Reemergence of Sylvatic Dengue Virus Serotype 2 in Kedougou, Senegal, 2020 [PDF - 1.90 MB - 5 pages]
I. Dieng et al.

In 2020, a sylvatic dengue virus serotype 2 infection outbreak resulted in 59 confirmed dengue cases in Kedougou, Senegal, suggesting those strains might not require adaptation to reemerge into urban transmission cycles. Large-scale genomic surveillance and updated molecular diagnostic tools are needed to effectively prevent dengue virus infections in Senegal.

EID Dieng I, Diarra M, Sadio B, Sow B, Gaye A, Diallo A, et al. Reemergence of Sylvatic Dengue Virus Serotype 2 in Kedougou, Senegal, 2020. Emerg Infect Dis. 2024;30(4):770-774. https://doi.org/10.3201/eid3004.231301
AMA Dieng I, Diarra M, Sadio B, et al. Reemergence of Sylvatic Dengue Virus Serotype 2 in Kedougou, Senegal, 2020. Emerging Infectious Diseases. 2024;30(4):770-774. doi:10.3201/eid3004.231301.
APA Dieng, I., Diarra, M., Sadio, B., Sow, B., Gaye, A., Diallo, A....Diagne, M. (2024). Reemergence of Sylvatic Dengue Virus Serotype 2 in Kedougou, Senegal, 2020. Emerging Infectious Diseases, 30(4), 770-774. https://doi.org/10.3201/eid3004.231301.

Novel Oral Poliovirus Vaccine 2 Safety Evaluation during Nationwide Supplemental Immunization Activity, Uganda, 2022 [PDF - 400 KB - 4 pages]
F. A. Tobolowsky et al.

Given its enhanced genetic stability, novel oral poliovirus vaccine type 2 was deployed for type 2 poliovirus outbreak responses under World Health Organization Emergency Use Listing. We evaluated the safety profile of this vaccine. No safety signals were identified using a multipronged approach of passive and active surveillance.

EID Tobolowsky FA, Nsubuga F, Gilani Z, Kisakye A, Ndagije H, Kyabayinze D, et al. Novel Oral Poliovirus Vaccine 2 Safety Evaluation during Nationwide Supplemental Immunization Activity, Uganda, 2022. Emerg Infect Dis. 2024;30(4):775-778. https://doi.org/10.3201/eid3004.231361
AMA Tobolowsky FA, Nsubuga F, Gilani Z, et al. Novel Oral Poliovirus Vaccine 2 Safety Evaluation during Nationwide Supplemental Immunization Activity, Uganda, 2022. Emerging Infectious Diseases. 2024;30(4):775-778. doi:10.3201/eid3004.231361.
APA Tobolowsky, F. A., Nsubuga, F., Gilani, Z., Kisakye, A., Ndagije, H., Kyabayinze, D....Gidudu, J. F. (2024). Novel Oral Poliovirus Vaccine 2 Safety Evaluation during Nationwide Supplemental Immunization Activity, Uganda, 2022. Emerging Infectious Diseases, 30(4), 775-778. https://doi.org/10.3201/eid3004.231361.

Phylogenetic Characterization of Orthohantavirus dobravaense (Dobrava Virus) [PDF - 3.16 MB - 4 pages]
M. Erdin et al.

We report complete coding sequences of Orthohantavirus dobravaense (Dobrava virus) Igneada strains and phylogenetic characterization of all available complete coding sequences. Our analyses suggested separation of host-dependent lineages, followed by geographic clustering. Surveillance of orthohantaviruses using complete genomes would be useful for assessing public health threats from Dobrava virus.

EID Erdin M, Polat C, Smura T, Irmak S, Cetintas O, Cogal M, et al. Phylogenetic Characterization of Orthohantavirus dobravaense (Dobrava Virus). Emerg Infect Dis. 2024;30(4):779-782. https://doi.org/10.3201/eid3004.230912
AMA Erdin M, Polat C, Smura T, et al. Phylogenetic Characterization of Orthohantavirus dobravaense (Dobrava Virus). Emerging Infectious Diseases. 2024;30(4):779-782. doi:10.3201/eid3004.230912.
APA Erdin, M., Polat, C., Smura, T., Irmak, S., Cetintas, O., Cogal, M....Oktem, I. (2024). Phylogenetic Characterization of Orthohantavirus dobravaense (Dobrava Virus). Emerging Infectious Diseases, 30(4), 779-782. https://doi.org/10.3201/eid3004.230912.

Acanthamoeba Infection and Nasal Rinsing, United States, 1994–2022 [PDF - 330 KB - 3 pages]
J. C. Haston et al.

We describe 10 patients with nonkeratitis Acanthamoeba infection who reported performing nasal rinsing before becoming ill. All were immunocompromised, 7 had chronic sinusitis, and many used tap water for nasal rinsing. Immunocompromised persons should be educated about safe nasal rinsing to prevent free-living ameba infections.

EID Haston JC, Serra C, Imada E, Martin E, Ali IM, Cope JR. Acanthamoeba Infection and Nasal Rinsing, United States, 1994–2022. Emerg Infect Dis. 2024;30(4):783-785. https://doi.org/10.3201/eid3004.231076
AMA Haston JC, Serra C, Imada E, et al. Acanthamoeba Infection and Nasal Rinsing, United States, 1994–2022. Emerging Infectious Diseases. 2024;30(4):783-785. doi:10.3201/eid3004.231076.
APA Haston, J. C., Serra, C., Imada, E., Martin, E., Ali, I. M., & Cope, J. R. (2024). Acanthamoeba Infection and Nasal Rinsing, United States, 1994–2022. Emerging Infectious Diseases, 30(4), 783-785. https://doi.org/10.3201/eid3004.231076.

Isolation of Batborne Neglected Zoonotic Agent Issyk-Kul Virus, Italy [PDF - 1.87 MB - 5 pages]
D. Lelli et al.

We isolated Issyk-Kul virus (ISKV) from a bat sampled from Italy in 2021 and conducted ISKV-specific surveillance in bats collected in Italy during 2017–2023. ISKV circulation among synanthropic and sedentary species of bat, such as Savi’s pipistrelle bat (Hypsugo savii) in northern Italy, may have public health implications in this region.

EID Lelli D, Moreno A, Canziani S, Soliani L, Carrera M, Castelli A, et al. Isolation of Batborne Neglected Zoonotic Agent Issyk-Kul Virus, Italy. Emerg Infect Dis. 2024;30(4):786-790. https://doi.org/10.3201/eid3004.231186
AMA Lelli D, Moreno A, Canziani S, et al. Isolation of Batborne Neglected Zoonotic Agent Issyk-Kul Virus, Italy. Emerging Infectious Diseases. 2024;30(4):786-790. doi:10.3201/eid3004.231186.
APA Lelli, D., Moreno, A., Canziani, S., Soliani, L., Carrera, M., Castelli, A....Lavazza, A. (2024). Isolation of Batborne Neglected Zoonotic Agent Issyk-Kul Virus, Italy. Emerging Infectious Diseases, 30(4), 786-790. https://doi.org/10.3201/eid3004.231186.

Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021 [PDF - 842 KB - 4 pages]
P. Tantirat et al.

In September 2021, a total of 25 patients diagnosed with COVID-19 developed acute melioidosis after (median 7 days) admission to a COVID-19 field hospital in Thailand. Eight nonpotable tap water samples and 6 soil samples were culture-positive for Burkholderia pseudomallei. Genomic analysis suggested contaminated tap water as the likely cause of illness.

EID Tantirat P, Chantarawichian Y, Taweewigyakarn P, Kripattanapong S, Jitpeera C, Doungngern P, et al. Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021. Emerg Infect Dis. 2024;30(4):791-794. https://doi.org/10.3201/eid3004.231476
AMA Tantirat P, Chantarawichian Y, Taweewigyakarn P, et al. Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021. Emerging Infectious Diseases. 2024;30(4):791-794. doi:10.3201/eid3004.231476.
APA Tantirat, P., Chantarawichian, Y., Taweewigyakarn, P., Kripattanapong, S., Jitpeera, C., Doungngern, P....Limmathurotsakul, D. (2024). Melioidosis in Patients with COVID-19 Exposed to Contaminated Tap Water, Thailand, 2021. Emerging Infectious Diseases, 30(4), 791-794. https://doi.org/10.3201/eid3004.231476.

Uncommon Salmonella Infantis Variants with Incomplete Antigenic Formula in the Poultry Food Chain, Italy [PDF - 1.38 MB - 5 pages]
S. Petrin et al.

Uncommon Salmonella Infantis variants displaying only flagellar antigens phenotypically showed identical incomplete antigenic formula but differed by molecular serotyping. Although most formed rough colonies, all shared antimicrobial resistances and the presence of usg gene with wild-type Salmonella Infantis. Moreover, they were undistinguishable wild-type Salmonella Infantis by whole-genome sequencing.

EID Petrin S, Tiengo A, Longo A, Furlan M, Marafin E, Zavagnin P, et al. Uncommon Salmonella Infantis Variants with Incomplete Antigenic Formula in the Poultry Food Chain, Italy. Emerg Infect Dis. 2024;30(4):795-799. https://doi.org/10.3201/eid3004.231074
AMA Petrin S, Tiengo A, Longo A, et al. Uncommon Salmonella Infantis Variants with Incomplete Antigenic Formula in the Poultry Food Chain, Italy. Emerging Infectious Diseases. 2024;30(4):795-799. doi:10.3201/eid3004.231074.
APA Petrin, S., Tiengo, A., Longo, A., Furlan, M., Marafin, E., Zavagnin, P....Barco, L. (2024). Uncommon Salmonella Infantis Variants with Incomplete Antigenic Formula in the Poultry Food Chain, Italy. Emerging Infectious Diseases, 30(4), 795-799. https://doi.org/10.3201/eid3004.231074.
Commentaries

Ten Years of High-Consequence Pathogens—Research Gains, Readiness Gaps, and Future Goals [PDF - 238 KB - 3 pages]
J. H. McQuiston et al.
EID McQuiston JH, Montgomery JM, Hutson CL. Ten Years of High-Consequence Pathogens—Research Gains, Readiness Gaps, and Future Goals. Emerg Infect Dis. 2024;30(4):800-802. https://doi.org/10.3201/eid3004.240160
AMA McQuiston JH, Montgomery JM, Hutson CL. Ten Years of High-Consequence Pathogens—Research Gains, Readiness Gaps, and Future Goals. Emerging Infectious Diseases. 2024;30(4):800-802. doi:10.3201/eid3004.240160.
APA McQuiston, J. H., Montgomery, J. M., & Hutson, C. L. (2024). Ten Years of High-Consequence Pathogens—Research Gains, Readiness Gaps, and Future Goals. Emerging Infectious Diseases, 30(4), 800-802. https://doi.org/10.3201/eid3004.240160.
Research Letters

Successful Treatment of Confirmed Naegleria fowleri Primary Amebic Meningoencephalitis [PDF - 491 KB - 3 pages]
A. Burki et al.

Primary amebic meningoencephalitis caused by Naegleria fowleri is a rare but nearly always fatal parasitic infection of the brain. Globally, few survivors have been reported, and the disease has no specific treatment. We report a confirmed case in Pakistan in a 22-year-old man who survived after aggressive therapy.

EID Burki A, Satti L, Mahboob S, Anwar S, Bizanjo M, Rafique M, et al. Successful Treatment of Confirmed Naegleria fowleri Primary Amebic Meningoencephalitis. Emerg Infect Dis. 2024;30(4):803-805. https://doi.org/10.3201/eid3004.230979
AMA Burki A, Satti L, Mahboob S, et al. Successful Treatment of Confirmed Naegleria fowleri Primary Amebic Meningoencephalitis. Emerging Infectious Diseases. 2024;30(4):803-805. doi:10.3201/eid3004.230979.
APA Burki, A., Satti, L., Mahboob, S., Anwar, S., Bizanjo, M., Rafique, M....Ghanchi, N. (2024). Successful Treatment of Confirmed Naegleria fowleri Primary Amebic Meningoencephalitis. Emerging Infectious Diseases, 30(4), 803-805. https://doi.org/10.3201/eid3004.230979.

Case Management of Imported Crimean-Congo Hemorrhagic Fever, Senegal, July 2023 [PDF - 281 KB - 3 pages]
Y. Gueye et al.

We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

EID Gueye Y, Sall Y, Roka J, Diagne I, Sow K, Diallo A, et al. Case Management of Imported Crimean-Congo Hemorrhagic Fever, Senegal, July 2023. Emerg Infect Dis. 2024;30(4):805-807. https://doi.org/10.3201/eid3004.231492
AMA Gueye Y, Sall Y, Roka J, et al. Case Management of Imported Crimean-Congo Hemorrhagic Fever, Senegal, July 2023. Emerging Infectious Diseases. 2024;30(4):805-807. doi:10.3201/eid3004.231492.
APA Gueye, Y., Sall, Y., Roka, J., Diagne, I., Sow, K., Diallo, A....Pasi, O. (2024). Case Management of Imported Crimean-Congo Hemorrhagic Fever, Senegal, July 2023. Emerging Infectious Diseases, 30(4), 805-807. https://doi.org/10.3201/eid3004.231492.

Potential Sexual Transmission of Antifungal-Resistant Trichophyton indotineae [PDF - 932 KB - 3 pages]
S. Spivack et al.

We describe a case of tinea genitalis in an immunocompetent woman in Pennsylvania, USA. Infection was caused by Trichophyton indotineae potentially acquired through sexual contact. The fungus was resistant to terbinafine (first-line antifungal) but improved with itraconazole. Clinicians should be aware of T. indotineae as a potential cause of antifungal-resistant genital lesions.

EID Spivack S, Gold J, Lockhart SR, Anand P, Quilter L, Smith DJ, et al. Potential Sexual Transmission of Antifungal-Resistant Trichophyton indotineae. Emerg Infect Dis. 2024;30(4):807-809. https://doi.org/10.3201/eid3004.240115
AMA Spivack S, Gold J, Lockhart SR, et al. Potential Sexual Transmission of Antifungal-Resistant Trichophyton indotineae. Emerging Infectious Diseases. 2024;30(4):807-809. doi:10.3201/eid3004.240115.
APA Spivack, S., Gold, J., Lockhart, S. R., Anand, P., Quilter, L., Smith, D. J....Ghannoum, M. A. (2024). Potential Sexual Transmission of Antifungal-Resistant Trichophyton indotineae. Emerging Infectious Diseases, 30(4), 807-809. https://doi.org/10.3201/eid3004.240115.

Chlamydia pneumoniae Upsurge at Tertiary Hospital, Lausanne, Switzerland [PDF - 660 KB - 3 pages]
F. Tagini et al.

Chlamydia pneumoniae infection cases have usually accounted for <1.5% of community-acquired respiratory tract infections. Currently, Lausanne, Switzerland is experiencing a notable upsurge in cases, with 28 reported within a span of a few months. This upsurge in cases highlights the need for heightened awareness among clinicians.

EID Tagini F, Opota O, Greub G. Chlamydia pneumoniae Upsurge at Tertiary Hospital, Lausanne, Switzerland. Emerg Infect Dis. 2024;30(4):810-812. https://doi.org/10.3201/eid3004.231610
AMA Tagini F, Opota O, Greub G. Chlamydia pneumoniae Upsurge at Tertiary Hospital, Lausanne, Switzerland. Emerging Infectious Diseases. 2024;30(4):810-812. doi:10.3201/eid3004.231610.
APA Tagini, F., Opota, O., & Greub, G. (2024). Chlamydia pneumoniae Upsurge at Tertiary Hospital, Lausanne, Switzerland. Emerging Infectious Diseases, 30(4), 810-812. https://doi.org/10.3201/eid3004.231610.

Highly Pathogenic Avian Influenza A(H5N1) Viruses from Multispecies Outbreak, Argentina, August 2023 [PDF - 1.65 MB - 3 pages]
A. Rimondi et al.

We report full-genome characterization of highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b virus from an outbreak among sea lions (August 2023) in Argentina and possible spillover to fur seals and terns. Mammalian adaptation mutations in virus isolated from marine mammals and a human in Chile were detected in mammalian and avian hosts.

EID Rimondi A, Vanstreels R, Olivera V, Donini A, Lauriente M, Uhart MM. Highly Pathogenic Avian Influenza A(H5N1) Viruses from Multispecies Outbreak, Argentina, August 2023. Emerg Infect Dis. 2024;30(4):812-814. https://doi.org/10.3201/eid3004.231725
AMA Rimondi A, Vanstreels R, Olivera V, et al. Highly Pathogenic Avian Influenza A(H5N1) Viruses from Multispecies Outbreak, Argentina, August 2023. Emerging Infectious Diseases. 2024;30(4):812-814. doi:10.3201/eid3004.231725.
APA Rimondi, A., Vanstreels, R., Olivera, V., Donini, A., Lauriente, M., & Uhart, M. M. (2024). Highly Pathogenic Avian Influenza A(H5N1) Viruses from Multispecies Outbreak, Argentina, August 2023. Emerging Infectious Diseases, 30(4), 812-814. https://doi.org/10.3201/eid3004.231725.

Link between Monkeypox Virus Genomes from Museum Specimens and 1965 Zoo Outbreak [PDF - 1001 KB - 3 pages]
M. Hämmerle et al.

We used pathogen genomics to test orangutan specimens from a museum in Bonn, Germany, to identify the origin of the animals and the circumstances of their death. We found monkeypox virus genomes in the samples and determined that they represent cases from a 1965 outbreak at Rotterdam Zoo in Rotterdam, the Netherlands.

EID Hämmerle M, Rymbekova A, Gelabert P, Sawyer S, Cheronet O, Bernardi P, et al. Link between Monkeypox Virus Genomes from Museum Specimens and 1965 Zoo Outbreak. Emerg Infect Dis. 2024;30(4):815-817. https://doi.org/10.3201/eid3004.231546
AMA Hämmerle M, Rymbekova A, Gelabert P, et al. Link between Monkeypox Virus Genomes from Museum Specimens and 1965 Zoo Outbreak. Emerging Infectious Diseases. 2024;30(4):815-817. doi:10.3201/eid3004.231546.
APA Hämmerle, M., Rymbekova, A., Gelabert, P., Sawyer, S., Cheronet, O., Bernardi, P....Pinhasi, R. (2024). Link between Monkeypox Virus Genomes from Museum Specimens and 1965 Zoo Outbreak. Emerging Infectious Diseases, 30(4), 815-817. https://doi.org/10.3201/eid3004.231546.

Case of Human Orthohantavirus Infection, Michigan, USA, 2021 [PDF - 985 KB - 5 pages]
S. M. Goodfellow et al.

Orthohantaviruses cause hantavirus cardiopulmonary syndrome; most cases occur in the southwest region of the United States. We discuss a clinical case of orthohantavirus infection in a 65-year-old woman in Michigan and the phylogeographic link of partial viral fragments from the patient and rodents captured near the presumed site of infection.

EID Goodfellow SM, Nofchissey RA, Arsnoe D, Ye C, Lee S, Park J, et al. Case of Human Orthohantavirus Infection, Michigan, USA, 2021. Emerg Infect Dis. 2024;30(4):817-821. https://doi.org/10.3201/eid3004.231138
AMA Goodfellow SM, Nofchissey RA, Arsnoe D, et al. Case of Human Orthohantavirus Infection, Michigan, USA, 2021. Emerging Infectious Diseases. 2024;30(4):817-821. doi:10.3201/eid3004.231138.
APA Goodfellow, S. M., Nofchissey, R. A., Arsnoe, D., Ye, C., Lee, S., Park, J....Bradfute, S. B. (2024). Case of Human Orthohantavirus Infection, Michigan, USA, 2021. Emerging Infectious Diseases, 30(4), 817-821. https://doi.org/10.3201/eid3004.231138.

Autochthonous Ascariasis, Mississippi, USA [PDF - 221 KB - 3 pages]
C. V. Hobbs et al.

We describe a case of a 2-year-old child who expelled a single adult female Ascaris lumbricoides worm. The patient is from a rural county in Mississippi, USA, with no reported travel outside of the United States. The caregivers in the home practice good sanitation. Exposure to domestic pigs is the likely source of infection.

EID Hobbs CV, Rhinewalt J, Arguello I, Malloch L, Martin L, Poston WM, et al. Autochthonous Ascariasis, Mississippi, USA. Emerg Infect Dis. 2024;30(4):821-823. https://doi.org/10.3201/eid3004.240176
AMA Hobbs CV, Rhinewalt J, Arguello I, et al. Autochthonous Ascariasis, Mississippi, USA. Emerging Infectious Diseases. 2024;30(4):821-823. doi:10.3201/eid3004.240176.
APA Hobbs, C. V., Rhinewalt, J., Arguello, I., Malloch, L., Martin, L., Poston, W. M....Bradbury, R. S. (2024). Autochthonous Ascariasis, Mississippi, USA. Emerging Infectious Diseases, 30(4), 821-823. https://doi.org/10.3201/eid3004.240176.

Detection of Rat Hepatitis E Virus in Pigs, Spain, 2023 [PDF - 303 KB - 2 pages]
L. Rios-Muñoz et al.

We identified rat hepatitis E virus (HEV) RNA in farmed pigs from Spain. Our results indicate that pigs might be susceptible to rat HEV and could serve as viral intermediaries between rodents and humans. Europe should evaluate the prevalence of rat HEV in farmed pigs to assess the risk to public health.

EID Rios-Muñoz L, Gonzálvez M, Caballero-Gomez J, Castro-Scholten S, Casares-Jimenez M, Agulló-Ros I, et al. Detection of Rat Hepatitis E Virus in Pigs, Spain, 2023. Emerg Infect Dis. 2024;30(4):823-826. https://doi.org/10.3201/eid3004.231629
AMA Rios-Muñoz L, Gonzálvez M, Caballero-Gomez J, et al. Detection of Rat Hepatitis E Virus in Pigs, Spain, 2023. Emerging Infectious Diseases. 2024;30(4):823-826. doi:10.3201/eid3004.231629.
APA Rios-Muñoz, L., Gonzálvez, M., Caballero-Gomez, J., Castro-Scholten, S., Casares-Jimenez, M., Agulló-Ros, I....Rivero, A. (2024). Detection of Rat Hepatitis E Virus in Pigs, Spain, 2023. Emerging Infectious Diseases, 30(4), 823-826. https://doi.org/10.3201/eid3004.231629.

Seroprevalence of Avian Influenza A(H5N6) Virus Infection, Guangdong Province, China, 2022 [PDF - 579 KB - 3 pages]
Y. Wang et al.

In 2022, we assessed avian influenza A virus subtype H5N6 seroprevalence among the general population in Guangdong Province, China, amid rising numbers of human infections. Among the tested samples, we found 1 to be seropositive, suggesting that the virus poses a low but present risk to the general population.

EID Wang Y, Yang C, Liu Y, Zhang J, Qu W, Liang J, et al. Seroprevalence of Avian Influenza A(H5N6) Virus Infection, Guangdong Province, China, 2022. Emerg Infect Dis. 2024;30(4):826-828. https://doi.org/10.3201/eid3004.231226
AMA Wang Y, Yang C, Liu Y, et al. Seroprevalence of Avian Influenza A(H5N6) Virus Infection, Guangdong Province, China, 2022. Emerging Infectious Diseases. 2024;30(4):826-828. doi:10.3201/eid3004.231226.
APA Wang, Y., Yang, C., Liu, Y., Zhang, J., Qu, W., Liang, J....Pan, W. (2024). Seroprevalence of Avian Influenza A(H5N6) Virus Infection, Guangdong Province, China, 2022. Emerging Infectious Diseases, 30(4), 826-828. https://doi.org/10.3201/eid3004.231226.

Ocular Dirofilariasis in Migrant from Sri Lanka, Australia [PDF - 578 KB - 2 pages]
E. D. Cope et al.

We describe a case of imported ocular dirofilariasis in Australia, linked to the Hong Kong genotype of Dirofilaria sp., in a migrant from Sri Lanka. Surgical extraction and mitochondrial sequences analyses confirmed this filarioid nematode as the causative agent and a Dirofilaria sp. not previously reported in Australia.

EID Cope ED, Gupta N, Koehler AV, Gasser RB, Crowe A. Ocular Dirofilariasis in Migrant from Sri Lanka, Australia. Emerg Infect Dis. 2024;30(4):829-830. https://doi.org/10.3201/eid3004.240125
AMA Cope ED, Gupta N, Koehler AV, et al. Ocular Dirofilariasis in Migrant from Sri Lanka, Australia. Emerging Infectious Diseases. 2024;30(4):829-830. doi:10.3201/eid3004.240125.
APA Cope, E. D., Gupta, N., Koehler, A. V., Gasser, R. B., & Crowe, A. (2024). Ocular Dirofilariasis in Migrant from Sri Lanka, Australia. Emerging Infectious Diseases, 30(4), 829-830. https://doi.org/10.3201/eid3004.240125.

Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017–2022 [PDF - 714 KB - 3 pages]
V. Dahl et al.

In 2021, the World Health Organization recommended new extensively drug-resistant (XDR) and pre-XDR tuberculosis (TB) definitions. In a recent cohort of TB patients in Eastern Europe, we show that XDR TB as currently defined is associated with exceptionally poor treatment outcomes, considerably worse than for the former definition (31% vs. 54% treatment success).

EID Dahl V, Butova T, Rosenthal A, Grinev A, Gabrielian A, Vashakidze S, et al. Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017–2022. Emerg Infect Dis. 2024;30(4):831-833. https://doi.org/10.3201/eid3004.231732
AMA Dahl V, Butova T, Rosenthal A, et al. Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017–2022. Emerging Infectious Diseases. 2024;30(4):831-833. doi:10.3201/eid3004.231732.
APA Dahl, V., Butova, T., Rosenthal, A., Grinev, A., Gabrielian, A., Vashakidze, S....Butov, D. (2024). Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017–2022. Emerging Infectious Diseases, 30(4), 831-833. https://doi.org/10.3201/eid3004.231732.

Opportunistic Elizabethkingia miricola Infections in Intensive Care Unit, Spain [PDF - 318 KB - 3 pages]
E. Soler-Iborte et al.

In 2021, we identified a cluster of Elizabethkingia miricola cases in an intensive care unit in Spain. Because E. miricola is not considered a special surveillance agent in Spain, whole-genome sequencing was not performed. The bacterial source was not identified. All Elizabethkingia species should be listed as special surveillance bacteria.

EID Soler-Iborte E, Rivera-Izquierdo M, Valero-Ubierna C. Opportunistic Elizabethkingia miricola Infections in Intensive Care Unit, Spain. Emerg Infect Dis. 2024;30(4):833-835. https://doi.org/10.3201/eid3004.231491
AMA Soler-Iborte E, Rivera-Izquierdo M, Valero-Ubierna C. Opportunistic Elizabethkingia miricola Infections in Intensive Care Unit, Spain. Emerging Infectious Diseases. 2024;30(4):833-835. doi:10.3201/eid3004.231491.
APA Soler-Iborte, E., Rivera-Izquierdo, M., & Valero-Ubierna, C. (2024). Opportunistic Elizabethkingia miricola Infections in Intensive Care Unit, Spain. Emerging Infectious Diseases, 30(4), 833-835. https://doi.org/10.3201/eid3004.231491.

Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania [PDF - 669 KB - 3 pages]
E. C. Hughes et al.

We conducted a cross-sectional study of Crimean-Congo hemorrhagic fever virus (CCHFV) in northern Tanzania. CCHFV seroprevalence in humans and ruminant livestock was high, as were spatial heterogeneity levels. CCHFV could represent an unrecognized human health risk in this region and should be included as a differential diagnosis for febrile illness.

EID Hughes EC, de Glanville W, Kibona T, Mmbaga B, Rostal MK, Swai ES, et al. Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania. Emerg Infect Dis. 2024;30(4):836-838. https://doi.org/10.3201/eid3004.231204
AMA Hughes EC, de Glanville W, Kibona T, et al. Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania. Emerging Infectious Diseases. 2024;30(4):836-838. doi:10.3201/eid3004.231204.
APA Hughes, E. C., de Glanville, W., Kibona, T., Mmbaga, B., Rostal, M. K., Swai, E. S....Allan, K. J. (2024). Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania. Emerging Infectious Diseases, 30(4), 836-838. https://doi.org/10.3201/eid3004.231204.
Books and Media

Breaking Through: My Life in Science [PDF - 323 KB - 1 page]
S. C. Keller
EID Keller SC. Breaking Through: My Life in Science. Emerg Infect Dis. 2024;30(4):839. https://doi.org/10.3201/eid3004.231656
AMA Keller SC. Breaking Through: My Life in Science. Emerging Infectious Diseases. 2024;30(4):839. doi:10.3201/eid3004.231656.
APA Keller, S. C. (2024). Breaking Through: My Life in Science. Emerging Infectious Diseases, 30(4), 839. https://doi.org/10.3201/eid3004.231656.
About the Cover

Standing Ready to Respond [PDF - 1.57 MB - 3 pages]
B. Breedlove
EID Breedlove B. Standing Ready to Respond. Emerg Infect Dis. 2024;30(4):840-842. https://doi.org/10.3201/eid3004.ac3004
AMA Breedlove B. Standing Ready to Respond. Emerging Infectious Diseases. 2024;30(4):840-842. doi:10.3201/eid3004.ac3004.
APA Breedlove, B. (2024). Standing Ready to Respond. Emerging Infectious Diseases, 30(4), 840-842. https://doi.org/10.3201/eid3004.ac3004.
Online Reports

Prioritizing Mental Health within HIV and Tuberculosis Services in PEPFAR [PDF - 602 KB - 5 pages]
R. Fukunaga et al.

Underprioritization of mental health is a global problem and threatens the decades-long progress of the US President’s Emergency Plan for AIDS Relief (PEPFAR) program. In recent years, mental health has become globally recognized as a part of universal healthcare, making this an opportune moment for the global community to integrate mental health services into routine programming. PEPFAR is well positioned to lead by example. We conceptualized 5 key strategies that might help serve as a framework to support mental health programming as part of PEPFAR’s current 5-year strategic plan. PEPFAR and the global community have an opportunity to identify mental health service gaps and interweave global mental health priorities with actions to end the HIV and TB epidemics by 2030.

EID Fukunaga R, Pierre P, Williams JK, Briceno-Robaugh R, Kalibala S, Peterson M, et al. Prioritizing Mental Health within HIV and Tuberculosis Services in PEPFAR. Emerg Infect Dis. 2024;30(4):1-5. https://doi.org/10.3201/eid3004.231726
AMA Fukunaga R, Pierre P, Williams JK, et al. Prioritizing Mental Health within HIV and Tuberculosis Services in PEPFAR. Emerging Infectious Diseases. 2024;30(4):1-5. doi:10.3201/eid3004.231726.
APA Fukunaga, R., Pierre, P., Williams, J. K., Briceno-Robaugh, R., Kalibala, S., Peterson, M....Moonan, P. K. (2024). Prioritizing Mental Health within HIV and Tuberculosis Services in PEPFAR. Emerging Infectious Diseases, 30(4), 1-5. https://doi.org/10.3201/eid3004.231726.
Corrections

Correction: Vol. 17, No. 10 [PDF - 198 KB - 1 page]
EID Correction: Vol. 17, No. 10. Emerg Infect Dis. 2024;30(4):842. https://doi.org/10.3201/eid3004.c23004
AMA Correction: Vol. 17, No. 10. Emerging Infectious Diseases. 2024;30(4):842. doi:10.3201/eid3004.c23004.
APA (2024). Correction: Vol. 17, No. 10. Emerging Infectious Diseases, 30(4), 842. https://doi.org/10.3201/eid3004.c23004.

Correction: Vol. 30, No. 4 [PDF - 198 KB - 1 page]
EID Correction: Vol. 30, No. 4. Emerg Infect Dis. 2024;30(4):842. https://doi.org/10.3201/eid3004.c13004
AMA Correction: Vol. 30, No. 4. Emerging Infectious Diseases. 2024;30(4):842. doi:10.3201/eid3004.c13004.
APA (2024). Correction: Vol. 30, No. 4. Emerging Infectious Diseases, 30(4), 842. https://doi.org/10.3201/eid3004.c13004.
Page created: March 19, 2024
Page updated: March 25, 2024
Page reviewed: March 25, 2024
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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