Ahead of Print -Unmet Needs for a Rapid Diagnosis of Chikungunya Virus Infection - Volume 22, Number 10—October 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Unmet Needs for a Rapid Diagnosis of Chikungunya Virus Infection - Volume 22, Number 10—October 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Chikungunya Virus in Febrile Humans and Aedes aegypti Mosquitoes, Yucatan, Mexico - Volume 22, Number 10—October 2016 - Emerging Infectious Disease journal - CDC

Chikungunya virus (CHIKV) was isolated from 12 febrile humans in Yucatan, Mexico, in 2015. One patient was co-infected with dengue virus type 1. Two additional CHIKV isolates were obtained from Aedes aegyptimosquitoes collected in the homes of patients. Phylogenetic analysis showed that the CHIKV isolates belong to the Asian lineage.



Ahead of Print -Chikungunya Virus in Febrile Humans and Aedes aegypti Mosquitoes, Yucatan, Mexico - Volume 22, Number 10—October 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Increase in Eyeworm Infections in Eastern Europe - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Increase in Eyeworm Infections in Eastern Europe - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Fatal Septic Meningitis in Child Caused by Streptococcus suis Serotype 24 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

In 2015, community event–based surveillance (CEBS) was implemented in Sierra Leone to assist with the detection of Ebola virus disease (EVD) cases. We assessed the sensitivity of CEBS for finding EVD cases during a 7-month period, and in a 6-week subanalysis, we assessed the timeliness of reporting cases with no known epidemiologic links at time of detection. Of the 12,126 CEBS reports, 287 (2%) met the suspected case definition, and 16 were confirmed positive. CEBS detected 30% (16/53) of the EVD cases identified during the study period. During the subanalysis, CEBS staff identified 4 of 6 cases with no epidemiologic links. These CEBS-detected cases were identified more rapidly than those detected by the national surveillance system; however, too few cases were detected to determine system timeliness. Although CEBS detected EVD cases, it largely generated false alerts. Future versions of community-based surveillance could improve case detection through increased staff training and community engagement.



Ahead of Print -Assessment of Community Event–Based Surveillance for Ebola Virus Disease, Sierra Leone, 2015 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Influenza A(H7N7) Virus among Poultry Workers, Italy, 2013 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Influenza D Virus Infection in Herd of Cattle, Japan - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Influenza D Virus Infection in Herd of Cattle, Japan - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Toward Developing a Preventive MERS-CoV Vaccine—Report from a Workshop Organized by the Saudi Arabia Ministry of Health and the International Vaccine Institute, Riyadh, Saudi Arabia, November 14–15, 2015 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Middle East respiratory syndrome (MERS) remains a serious international public health threat. With the goal of accelerating the development of countermeasures against MERS coronavirus (MERS-CoV), funding agencies, nongovernmental organizations, and researchers across the world assembled in Riyadh, Saudi Arabia, on November 14–15, 2015, to discuss vaccine development challenges. The meeting was spearheaded by the Saudi Ministry of Health and co-organized by the International Vaccine Institute, South Korea. Accelerating the development of a preventive vaccine requires a better understanding of MERS epidemiology, transmission, and pathogenesis in humans and animals. A combination of rodent and nonhuman primate models should be considered in evaluating and developing preventive and therapeutic vaccine candidates. Dromedary camels should be considered for the development of veterinary vaccines. Several vaccine technology platforms targeting the MERS-CoV spike protein were discussed. Mechanisms to maximize investment, provide robust data, and affect public health are urgently needed.



Ahead of Print -Toward Developing a Preventive MERS-CoV Vaccine—Report from a Workshop Organized by the Saudi Arabia Ministry of Health and the International Vaccine Institute, Riyadh, Saudi Arabia, November 14–15, 2015 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Correction: Vol. 22, No. 5 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Correction: Vol. 22, No. 5 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Correction: Vol. 22, No. 4 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Correction: Vol. 22, No. 4 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda1 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

A survey of asymptomatic children in Uganda showed Plasmodium malariae and P. falciparum parasites in 45% and 55% of microscopy-positive samples, respectively. Although 36% of microscopy-positive samples were negative by rapid diagnostic test, 75% showed P. malariae or P. ovale parasites by PCR, indicating that routine diagnostic testing misses many non–P. falciparum malarial infections.



Ahead of Print -Asymptomatic Plasmodium Infections in Children in Low Malaria Transmission Setting, Southwestern Uganda1 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Adventures of a Female Medical Detective in Pursuit of Smallpox and AIDS - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Adventures of a Female Medical Detective in Pursuit of Smallpox and AIDS - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Artemisinin-Resistant Plasmodium falciparum K13 Mutant Alleles, Thailand–Myanmar Border - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

We report a case of human tick-borne encephalitis (TBE) in which the TBE virus was isolated from the biting tick. Viral growth and sequence were characterized and compared with those of a reference strain. Virus isolation from ticks from patients with TBE may offer a new approach for studies of epidemiology and pathogenicity.



Ahead of Print -Human Tick-Borne Encephalitis and Characterization of Virus from Biting Tick - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Lyssavirus in Indian Flying Foxes, Sri Lanka - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

A novel lyssavirus was isolated from brains of Indian flying foxes (Pteropus medius) in Sri Lanka. Phylogenetic analysis of complete virus genome sequences, and geographic location and host species, provides strong evidence that this virus is a putative new lyssavirus species, designated as Gannoruwa bat lyssavirus.



Ahead of Print -Lyssavirus in Indian Flying Foxes, Sri Lanka - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Episodes of delayed hemolysis 2–6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3–2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR −0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia.



Ahead of Print -Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Snakeborne Armillifer pentastomiasis is an emerging human parasitic infection in rural tropical areas where snake meat is eaten. After a series of severe ocular A. grandis larval infections and anecdotal abdominal infection in Sankuru District, Democratic Republic of the Congo, during 2014–2015, we systematically investigated possible pentastomid etiology in patients who underwent surgery in the region. Histologic and molecular analyses by established pentastomid 18S rDNA- and newly developed Armillifer-specific cytochrome oxidase PCRs revealed larval pentastomid lesions in 3.7% of patients. Some persons had A. armillatus and A. grandis co-infections. Another pentastomid larva, Raillietiella sp., was molecularly detected in 1 patient who had concomitant A. grandis and A. armillatus infection. The PCRs used were suitable for detecting pentastomid species even in highly necrotic tissues. Phylogenetic analyses ofArmillifer cytochrome oxidase genes detected multiple local strains.



Ahead of Print -Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

In November 2014, the Rhode Island Department of Health investigated a cluster of 3 listeriosis cases. Using whole-genome sequencing to support epidemiologic, laboratory, and environmental investigations, the department identified 1 restaurant as the likely source of the outbreak and also linked the establishment to a listeriosis case that occurred in 2013.



Ahead of Print -Whole-Genome Sequencing Detection of Ongoing Listeria Contamination at a Restaurant, Rhode Island, USA, 2014 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

After severe neurocognitive decline developed in an otherwise healthy 63-year-old man, brain magnetic resonance imaging showed eosinophilic meningoencephalitis and enhancing lesions. The patient tested positive for antibodies to Baylisascaris spp. roundworms, was treated with albendazole and dexamethasone, and showed improvement after 3 months. Baylisascariasis should be considered for all patients with eosinophilic meningitis.



Ahead of Print -Baylisascaris procyonis–Associated Meningoencephalitis in a Previously Healthy Adult, California, USA - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Rare Human Infection with Pacific Broad Tapeworm Adenocephalus pacificus, Australia - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

We performed deep sequencing analysis of the enterovirus 5′ noncoding region in cardiac biopsies from a patient with dilated cardiomyopathy. Results displayed a mix of deleted and full-length coxsackievirus B3, characterized by a low viral RNA load (8.102 copies/μg of nucleic acids) and a low viral RNA positive-sense to RNA negative-sense ratio of 4.8.



Ahead of Print -Major Persistent 5′ Terminally Deleted Coxsackievirus B3 Populations in Human Endomyocardial Tissues - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Virulence and Evolution of West Nile Virus, Australia, 1960–2012 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Worldwide, West Nile virus (WNV) causes encephalitis in humans, horses, and birds. The Kunjin strain of WNV (WNVKUN) is endemic to northern Australia, but infections are usually asymptomatic. In 2011, an unprecedented outbreak of equine encephalitis occurred in southeastern Australia; most of the ≈900 reported cases were attributed to a newly emerged WNVKUN strain. To investigate the origins of this virus, we performed genetic analysis and in vitro and in vivo studies of 13 WNVKUN isolates collected from different regions of Australia during 1960–2012. Although no disease was recorded for 1984, 2000, or 2012, isolates collected during those years (from Victoria, Queensland, and New South Wales, respectively) exhibited levels of virulence in mice similar to that of the 2011 outbreak strain. Thus, virulent strains of WNVKUN have circulated in Australia for >30 years, and the first extensive outbreak of equine disease in Australia probably resulted from a combination of specific ecologic and epidemiologic conditions.



Ahead of Print -Virulence and Evolution of West Nile Virus, Australia, 1960–2012 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

We confirmed Borrelia miyamotoi infection in 7 patients who had contracted an illness while near La Crosse, Wisconsin, USA, an area where Ixodes scapularis ticks are endemic. B. miyamatoi infection should now be considered among differential diagnoses for patients from the midwestern United States who have signs and symptoms suggestive of tickborne illness.



Ahead of Print -Borrelia miyamotoi Infection in Patients from Upper Midwestern United States, 2014–2015 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Infections of humans with the zoonotic simian malaria parasite Plasmodium knowlesi occur throughout Southeast Asia, although most cases have occurred in Malaysia, where P. knowlesi is now the dominant malaria species. This apparently skewed distribution prompted an investigation of the phylogeography of this parasite in 2 geographically separated regions of Malaysia, Peninsular Malaysia and Malaysian Borneo. We investigated samples collected from humans and macaques in these regions. Haplotype network analyses of sequences from 2 P. knowlesi genes, type A small subunit ribosomal 18S RNA and cytochrome c oxidase subunit I, showed 2 genetically distinct divergent clusters, 1 from each of the 2 regions of Malaysia. We propose that these parasites represent 2 distinct P. knowlesi types that independently became zoonotic. These types would have evolved after the sea-level rise at the end of the last ice age, which separated Malaysian Borneo from Peninsular Malaysia.



Ahead of Print -Phylogeographic Evidence for 2 Genetically Distinct Zoonotic Plasmodium knowlesi Parasites, Malaysia - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Lack of Mimivirus Detection in Patients with Respiratory Disease, China - Volume 22, Number 11—November 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Lack of Mimivirus Detection in Patients with Respiratory Disease, China - Volume 22, Number 11—November 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

We report the characterization of Trypanosoma cruzi of southern South American origin among humans, domestic vectors, and peridomestic hosts in Colombia using high-resolution nuclear and mitochondrial genotyping. Expanding our understanding of the geographic range of lineage TcVI, which is associated with severe Chagas disease, will help clarify risk of human infection for improved disease control.



Ahead of Print -Importation of Hybrid Human-Associated Trypanosoma cruzi Strains of Southern South American Origin, Colombia - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Human Babesiosis, Bolivia, 2013 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

To investigate human babesiosis in the Bolivian Chaco, in 2013 we tested blood samples from 271 healthy persons living in 2 rural communities in this region. Microscopy and PCR indicated that 3.3% of persons were positive for Babesia microti parasites (US lineage); seroprevalence was 45.7%. Appropriate screening should mitigate the risk for transfusion-associated babesiosis.



Ahead of Print -Human Babesiosis, Bolivia, 2013 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Baylisascaris procyonis Parasites in Raccoons, Costa Rica, 2014 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Orientia tsutsugamushi, which requires specialized facilities for culture, is a substantial cause of disease in Asia. We demonstrate that O. tsutsugamushi numbers increased for up to 5 days in conventional hemocultures. Performing such a culture step before molecular testing could increase the sensitivity of O. tsutsugamushi molecular diagnosis.



Ahead of Print -Survival and Growth of Orientia tsutsugamushi in Conventional Hemocultures - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13–October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case–control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.



Ahead of Print -Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

To identify township-level high-risk foci of malaria transmission in Yunnan Province, China, along the international border, we retrospectively reviewed data collected in hospitals and clinics of 58 townships in 4 counties during 2011–2013. We analyzed spatiotemporal distribution, especially hot spots of confirmed malaria, using geographic information systems and Getis-Ord Gi*(d) cluster analysis. Malaria incidence, transmission seasonality, and Plasmodium vivax:P. falciparum ratio remained almost unchanged from 2011 to 2013, but heterogeneity in distribution increased. The number of townships with confirmed malaria decreased significantly during the 3 years; incidence became increasingly concentrated within a few townships. High-/low-incidence clusters of P. falciparum shifted in location and size every year, whereas the locations of high-incidence P. vivax townships remained unchanged. All high-incidence clusters were located along the China–Myanmar border. Because of increasing heterogeneity in malaria distribution, microgeographic analysis of malaria transmission hot spots provided useful information for designing targeted malaria intervention during the elimination phase.



Ahead of Print -Microgeographic Heterogeneity of Border Malaria During Elimination Phase, Yunnan Province, China, 2011–2013 - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Persistence of Antibodies against Middle East Respiratory Syndrome Coronavirus - Volume 22, Number 10—October 2016 - Emerging Infectious Disease journal - CDC

To determine how long antibodies against Middle East respiratory syndrome coronavirus persist, we measured long-term antibody responses among persons serologically positive or indeterminate after a 2012 outbreak in Jordan. Antibodies, including neutralizing antibodies, were detectable in 6 (86%) of 7 persons for at least 34 months after the outbreak.



Ahead of Print -Persistence of Antibodies against Middle East Respiratory Syndrome Coronavirus - Volume 22, Number 10—October 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Chromosomal Locations of mcr-1 and blaCTX-M-15 in Fluoroquinolone-Resistant Escherichia coli ST410 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Chromosomal Locations of mcr-1 and blaCTX-M-15 in Fluoroquinolone-Resistant Escherichia coli ST410 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Mutation in West Nile Virus Structural Protein prM during Human Infection - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

A mutation leading to substitution of a key amino acid in the prM protein of West Nile virus (WNV) occurred during persistent infection of an immunocompetent patient. WNV RNA persisted in the patient’s urine and serum in the presence of low-level neutralizing antibodies. This case demonstrates active replication of WNV during persistent infection.



Ahead of Print -Mutation in West Nile Virus Structural Protein prM during Human Infection - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Changing Diagnostic Methods and Increased Detection of Verotoxigenic Escherichia coli, Ireland - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

The recent paradigm shift in infectious disease diagnosis from culture-based to molecular-based approaches is exemplified in the findings of a national study assessing the detection of verotoxigenic Escherichia coliinfections in Ireland. The methodologic changes have been accompanied by a dramatic increase in detections of non-O157 verotoxigenic E. coli serotypes.



Ahead of Print -Changing Diagnostic Methods and Increased Detection of Verotoxigenic Escherichia coli, Ireland - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Medscape CME Activity - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Medscape CME Activity - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Comparing Characteristics of Sporadic and Outbreak-Associated Foodborne Illnesses, United States, 2004–2011 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Outbreak data have been used to estimate the proportion of illnesses attributable to different foods. Applying outbreak-based attribution estimates to nonoutbreak foodborne illnesses requires an assumption of similar exposure pathways for outbreak and sporadic illnesses. This assumption cannot be tested, but other comparisons can assess its veracity. Our study compares demographic, clinical, temporal, and geographic characteristics of outbreak and sporadic illnesses from Campylobacter, Escherichia coli O157,Listeria, and Salmonella bacteria ascertained by the Foodborne Diseases Active Surveillance Network (FoodNet). Differences among FoodNet sites in outbreak and sporadic illnesses might reflect differences in surveillance practices. For Campylobacter, Listeria, and Escherichia coli O157, outbreak and sporadic illnesses are similar for severity, sex, and age. For Salmonella, outbreak and sporadic illnesses are similar for severity and sex. Nevertheless, the percentage of outbreak illnesses in the youngest age category was lower. Therefore, we do not reject the assumption that outbreak and sporadic illnesses are similar.



Comparing Characteristics of Sporadic and Outbreak-Associated Foodborne Illnesses, United States, 2004–2011 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Turtle-Associated Salmonellosis, United States, 2006–2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

During 2006–2014, a total of 15 multistate outbreaks of turtle-associated salmonellosis in humans were reported in the United States. Exposure to small pet turtles has long been recognized as a source of human salmonellosis. The risk to public health has persisted and may be increasing. Turtles are a popular reptilian pet among children, and numerous risky behaviors for the zoonotic transmission of Salmonella bacteria to children have been reported in recent outbreaks. Despite a long-standing federal ban against the sale and distribution of turtles <4 in (<10.16 cm) long, these small reptiles can be readily acquired through multiple venues and continue to be the main source of turtle-associated salmonellosis in children. Enhanced efforts are needed to minimize the disease risk associated with small turtle exposure. Prevention will require novel partnerships and a comprehensive One Health approach involving human, animal, and environmental health.



Turtle-Associated Salmonellosis, United States, 2006–2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Yellow Fever in a Worker Returning to China from Angola, March 2016 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Yellow Fever in a Worker Returning to China from Angola, March 2016 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Travel-Associated Rabies in Pets and Residual Rabies Risk, Western Europe - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

In 2015, countries in western Europe were declared free of rabies in nonflying mammals. Surveillance data for 2001–2013 indicate that risk for residual rabies is not 0 because of pet importation from countries with enzootic rabies. However, the risk is so low (7.52 × 10−10) that it probably can be considered negligible.



Ahead of Print -Travel-Associated Rabies in Pets and Residual Rabies Risk, Western Europe - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Colistin-Resistant mcr-1–Positive Pathogenic Escherichia coli in Swine, Japan, 2007−2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Colistin-Resistant mcr-1–Positive Pathogenic Escherichia coli in Swine, Japan, 2007−2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -New Chimeric Porcine Coronavirus in Swine Feces, Germany, 2012 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -New Chimeric Porcine Coronavirus in Swine Feces, Germany, 2012 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Two Related Occupational Cases of Legionella longbeachae Infection, Quebec, Canada - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Two patients with no exposure to gardening compost had related Legionella longbeachae infections in Quebec, Canada. Epidemiologic investigation and laboratory results from patient and soil samples identified the patients’ workplace, a metal recycling plant, as the likely source of infection, indicating a need to suspect occupational exposure for L. longbeachae infections.



Ahead of Print -Two Related Occupational Cases of Legionella longbeachae Infection, Quebec, Canada - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Highly Pathogenic Avian Influenza Viruses and Generation of Novel Reassortants, United States, 2014–2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Asian highly pathogenic avian influenza A(H5N8) viruses spread into North America in 2014 during autumn bird migration. Complete genome sequencing and phylogenetic analysis of 32 H5 viruses identified novel H5N1, H5N2, and H5N8 viruses that emerged in late 2014 through reassortment with North American low-pathogenicity avian influenza viruses.



Ahead of Print -Highly Pathogenic Avian Influenza Viruses and Generation of Novel Reassortants, United States, 2014–2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Pegivirus Infection in Domestic Pigs, Germany - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Pegivirus Infection in Domestic Pigs, Germany - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Response to Emergence of Middle East Respiratory Syndrome Coronavirus, Abu Dhabi, United Arab Emirates, 2013–2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

In January 2013, several months after Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia, Abu Dhabi, United Arab Emirates, began surveillance for MERS-CoV. We analyzed medical chart and laboratory data collected by the Health Authority–Abu Dhabi during January 2013–May 2014. Using real-time reverse transcription PCR, we tested respiratory tract samples for MERS-CoV and identified 65 case-patients. Of these patients, 23 (35%) were asymptomatic at the time of testing, and 4 (6%) showed positive test results for >3 weeks (1 had severe symptoms and 3 had mild symptoms). We also identified 6 clusters of MERS-CoV cases. This report highlights the potential for virus shedding by mildly ill and asymptomatic case-patients. These findings will be useful for MERS-CoV management and infection prevention strategies.



Ahead of Print -Response to Emergence of Middle East Respiratory Syndrome Coronavirus, Abu Dhabi, United Arab Emirates, 2013–2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Hepatitis E Virus Infection in Dromedaries, North and East Africa, United Arab Emirates, and Pakistan, 1983–2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

A new hepatitis E virus (HEV-7) was recently found in dromedaries and 1 human from the United Arab Emirates. We screened 2,438 dromedary samples from Pakistan, the United Arab Emirates, and 4 African countries. HEV-7 is long established, diversified and geographically widespread. Dromedaries may constitute a neglected source of zoonotic HEV infections.



Ahead of Print -Hepatitis E Virus Infection in Dromedaries, North and East Africa, United Arab Emirates, and Pakistan, 1983–2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Use of Plasma Therapy for Severe Fever with Thrombocytopenia Syndrome Encephalopathy - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Use of Plasma Therapy for Severe Fever with Thrombocytopenia Syndrome Encephalopathy - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Vesicular Disease in 9-Week-Old Pigs Experimentally Infected with Senecavirus A - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Senecavirus A has been infrequently associated with vesicular disease in swine since 1988. However, clinical disease has not been reproduced after experimental infection with this virus. We report vesicular disease in 9-week-old pigs after Sencavirus A infection by the intranasal route under experimental conditions.



Ahead of Print -Vesicular Disease in 9-Week-Old Pigs Experimentally Infected with Senecavirus A - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Heat Wave–Associated Vibriosis, Sweden and Finland, 2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

During summer 2014, a total of 89 Vibrio infections were reported in Sweden and Finland, substantially more yearly infections than previously have been reported in northern Europe. Infections were spread across most coastal counties of Sweden and Finland, but unusually, numerous infections were reported in subarctic regions; cases were reported as far north as 65°N, ≈100 miles (160 km) from the Arctic Circle. Most infections were caused by non-O1/O139 V. cholerae (70 cases, corresponding to 77% of the total, all strains were negative for the cholera toxin gene). An extreme heat wave in northern Scandinavia during summer 2014 led to unprecedented high sea surface temperatures, which appear to have been responsible for the emergence of Vibrio bacteria at these latitudes. The emergence of vibriosis in high-latitude regions requires improved diagnostic detection and clinical awareness of these emerging pathogens.



Ahead of Print -Heat Wave–Associated Vibriosis, Sweden and Finland, 2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Naturally Circulating Hepatitis A Virus in Olive Baboons, Uganda - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Naturally Circulating Hepatitis A Virus in Olive Baboons, Uganda - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Detection and Genomic Characterization of Senecavirus A, Ohio, USA, 2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Detection and Genomic Characterization of Senecavirus A, Ohio, USA, 2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Outbreak of Vibrio parahaemolyticus Sequence Type 120, Peru, 2009 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

In 2009, an outbreak of Vibrio parahaemolyticus occurred in Piura, Cajamarca, Lambayeque, and Lima, Peru. Whole-genome sequencing of clinical and environmental samples from the outbreak revealed a new V. parahaemolyticus clone. All the isolates identified belonged to a single clonal complex described exclusively in Asia before its emergence in Peru.



Ahead of Print -Outbreak of Vibrio parahaemolyticus Sequence Type 120, Peru, 2009 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Porcine Bocavirus Infection Associated with Encephalomyelitis in a Pig, Germany1 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Porcine Bocavirus Infection Associated with Encephalomyelitis in a Pig, Germany1 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Two Linked Enteroinvasive Escherichia coli Outbreaks, Nottingham, UK, June 2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Enteroinvasive Escherichia coli (EIEC) outbreaks are uncommon in Europe. In June 2014, two EIEC outbreaks occurred in Nottingham, UK, within 2 days; outbreak A was linked to a takeaway restaurant and outbreak B to a wedding party. We conducted 2 analytical studies: a case–control study for outbreak A and a cohort study for outbreak B. We tested microbiological and environmental samples, including by using whole-genome sequencing. For both outbreaks combined, we identified 157 probable case-patients; 27 were laboratory-confirmed as EIEC O96:H19–positive. Combined epidemiologic, microbiological, and environmental findings implicated lettuce as the vehicle of infection in outbreak A, but the source of the organism remained unknown. Whole-genome sequencing identified the same organism in cases from both outbreaks, but no epidemiologic link was confirmed. These outbreaks highlight that EIEC has the capacity to cause large and severe gastrointestinal disease outbreaks and should be considered as a potential pathogen in foodborne outbreaks in Europe.



Ahead of Print -Two Linked Enteroinvasive Escherichia coli Outbreaks, Nottingham, UK, June 2014 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -An Immortal Hero, an Enduring Challenge - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -An Immortal Hero, an Enduring Challenge - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Etymologia: Batrachochytrium salamandrivorans - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Etymologia: Batrachochytrium salamandrivorans - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Google shareholder calls exec a 'lady CFO,' Twitter erupts - Jun. 8, 2016

Oh no he didn't.



Twitter users were enraged by a (male) Alphabet shareholder who referred to Ruth Porat as the "lady CFO" of Google's (GOOG) parent company at its annual meeting.



Google shareholder calls exec a 'lady CFO,' Twitter erupts - Jun. 8, 2016

Ahead of Print -Postbooster Antibodies from Humans as Source of Diphtheria Antitoxin - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Diphtheria antitoxin for therapeutic use is in limited supply. A potential source might be affinity-purified antibodies originally derived from plasma of adults who received a booster dose of a vaccine containing diphtheria toxin. These antibodies might be useful for treating even severe cases of diphtheria.



Ahead of Print -Postbooster Antibodies from Humans as Source of Diphtheria Antitoxin - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Infection with Possible Novel Parapoxvirus in Horse, Finland, 2013 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

A horse in Finland exhibited generalized granulomatous inflammation and severe proliferative dermatitis. After euthanization, we detected poxvirus DNA from a skin lesion sample. The virus sequence grouped with parapoxviruses, closely resembling a novel poxvirus detected in humans in the United States after horse contact. Our findings indicate horses may be a reservoir for zoonotic parapoxvirus.



Ahead of Print -Infection with Possible Novel Parapoxvirus in Horse, Finland, 2013 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Crimean-Congo Hemorrhagic Fever with Acute Subdural Hematoma, Mauritania, 2012 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Crimean-Congo Hemorrhagic Fever with Acute Subdural Hematoma, Mauritania, 2012 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Red Fox as Sentinel for Blastomyces dermatitidis, Ontario, Canada - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Blastomyces dermatitidis, a fungus that can cause fatal infection in humans and other mammals, is not readily recoverable from soil, its environmental reservoir. Because of the red fox’s widespread distribution, susceptibility to B. dermatitidis, close association with soil, and well-defined home ranges, this animal has potential utility as a sentinel for this fungus.



Ahead of Print -Red Fox as Sentinel for Blastomyces dermatitidis, Ontario, Canada - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -African Swine Fever Epidemic, Poland, 2014–2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

In Poland, African swine fever (ASF) emerged in February 2014; by August 2015, the virus had been detected in >130 wild boar and in pigs in 3 backyard holdings. We evaluated ASF spread in Poland during these 18 months. Phylogenetic analysis indicated repeated incursions of genetically distinct ASF viruses of genotype II; the number of cases positively correlated with the number of wild boar; and disease spread was very slow. More cases were reported during summer than autumn. The 18-month prevalence of ASF in areas under various animal movement restrictions was 18.6% among wild boar found dead or killed by vehicles and only 0.2% in hunted wild boar. Repeated introductions of the virus into the country, the primary role of wild boar in virus maintenance, and the slow spread of the disease indicate a need for enhanced biosecurity at pig holdings and continuous and intensive surveillance for fast detection of ASF.



Ahead of Print -African Swine Fever Epidemic, Poland, 2014–2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Restaurant Cooking Trends and Increased Risk for Campylobacter Infection - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

In the United Kingdom, outbreaks of Campylobacter infection are increasingly attributed to undercooked chicken livers, yet many recipes, including those of top chefs, advocate short cooking times and serving livers pink. During 2015, we studied preferences of chefs and the public in the United Kingdom and investigated the link between liver rareness and survival of Campylobacter. We used photographs to assess chefs’ ability to identify chicken livers meeting safe cooking guidelines. To investigate the microbiological safety of livers chefs hey preferred to serve, we modeled Campylobacter survival in infected chicken livers cooked to various temperatures. Most chefs correctly identified safely cooked livers but overestimated the public’s preference for rareness and thus preferred to serve them more rare. We estimated that 19%–52% of livers served commercially in the United Kingdom fail to reach 70°C and that predicted Campylobacter survival rates are 48%–98%. These findings indicate that cooking trends are linked to increasing Campylobacterinfections.



Ahead of Print -Restaurant Cooking Trends and Increased Risk for Campylobacter Infection - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Natural Norovirus Infections in Rhesus Macaques - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Using a recently developed real-time reverse transcription PCR, I retested 500 fecal samples from rhesus macaques collected in 2008. Previous conventional reverse transcription PCR testing identified 1 isolate of GII norovirus; retesting found GI, GII, and possible GIV noroviruses in the samples, indicating the natural circulation of noroviruses in nonhuman primate colonies.



Ahead of Print -Natural Norovirus Infections in Rhesus Macaques - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Senecavirus A in Pigs, United States, 2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Senecavirus A in Pigs, United States, 2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Novel Senecavirus A in Swine with Vesicular Disease, United States, July 2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Novel Senecavirus A in Swine with Vesicular Disease, United States, July 2015 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Confirming Legionnaires’ Disease Outbreak by Genome-Based Method, Germany, 2012 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Confirming Legionnaires’ Disease Outbreak by Genome-Based Method, Germany, 2012 - Volume 22, Number 7—July 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

The 2013–2016 outbreak of Ebola virus disease (EVD) in West Africa infected >28,000 people, including >11,000 who died, and disrupted social life in the region. We retrospectively studied clinical signs and symptoms and risk factors for fatal outcome among 31 Ebola virus–positive patients admitted to the Ebola Treatment Center in Moyamba District, Sierra Leone. We found a higher rate of bleeding manifestations than reported elsewhere during the outbreak. Significant predictors for death were shorter time from symptom onset to admission, male sex, high viral load on initial laboratory testing, severe pain, diarrhea, bloody feces, and development of other bleeding manifestations during hospitalization. These risk factors for death could be used to identify patients in need of more intensive medical support. The lack of fever in as many as one third of EVD cases may have implications for temperature-screening practices and case definitions.



Ahead of Print -Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Local Persistence of Novel MRSA Lineage after Hospital Ward Outbreak, Cambridge, UK, 2011–2013 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Local Persistence of Novel MRSA Lineage after Hospital Ward Outbreak, Cambridge, UK, 2011–2013 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Ahead of Print -Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC

Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.



Ahead of Print -Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015 - Volume 22, Number 9—September 2016 - Emerging Infectious Disease journal - CDC