Perspective
Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections
Antimicrobial resistance in healthcare-associated bacterial pathogens and the infections they cause are major public health threats affecting nearly all healthcare facilities. Antimicrobial-resistant bacterial infections can occur when colonizing pathogenic bacteria that normally make up a small fraction of the human microbiota increase in number in response to clinical perturbations. Such infections are especially likely when pathogens are resistant to the collateral effects of antimicrobial agents that disrupt the human microbiome, resulting in loss of colonization resistance, a key host defense. Pathogen reduction is an emerging strategy to prevent transmission of, and infection with, antimicrobial-resistant healthcare-associated pathogens. We describe the basis for pathogen reduction as an overall prevention strategy, the evidence for its effectiveness, and the role of the human microbiome in colonization resistance that also reduces the risk for infection once colonized. In addition, we explore ideal attributes of current and future pathogen-reducing approaches.
EID | Mangalea MR, Halpin A, Haile M, Elkins CA, McDonald L. Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerg Infect Dis. 2024;30(6):1069-1076. https://doi.org/10.3201/eid3006.231338 |
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AMA | Mangalea MR, Halpin A, Haile M, et al. Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerging Infectious Diseases. 2024;30(6):1069-1076. doi:10.3201/eid3006.231338. |
APA | Mangalea, M. R., Halpin, A., Haile, M., Elkins, C. A., & McDonald, L. (2024). Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerging Infectious Diseases, 30(6), 1069-1076. https://doi.org/10.3201/eid3006.231338. |
Synopses
Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France
Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis. For this article, we reviewed 7 cases of Scedosporium spp. and L. prolificans arteritis from the Scedosporiosis/lomentosporiosis Observational Study and 13 cases from published literature. Underlying immunosuppression was reported in 70% (14/20) of case-patients, mainly those who had solid organ transplants (10/14). Osteoarticular localization of infection was observed in 50% (10/20) of cases; infections were frequently (7/10) contiguous with vascular infection sites. Scedosporium spp./Lomentospora prolificans infections were diagnosed in 9 of 20 patients ≈3 months after completing treatment for nonvascular scedosporiosis/lomentosporiosis. Aneurysms were found in 8/11 aortitis and 6/10 peripheral arteritis cases. Invasive fungal disease–related deaths were high (12/18 [67%]). The vascular tropism of Scedosporium spp. and L. prolificans indicates vascular imaging, such as computed tomography angiography, is needed to manage infections, especially for osteoarticular locations.
EID | Vignals C, Emmerich J, Begueret H, Garcia-Hermoso D, Martin-Blondel G, Angoulvant A, et al. Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerg Infect Dis. 2024;30(6):1077-1087. https://doi.org/10.3201/eid3006.231409 |
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AMA | Vignals C, Emmerich J, Begueret H, et al. Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerging Infectious Diseases. 2024;30(6):1077-1087. doi:10.3201/eid3006.231409. |
APA | Vignals, C., Emmerich, J., Begueret, H., Garcia-Hermoso, D., Martin-Blondel, G., Angoulvant, A....Bronnimann, D. (2024). Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerging Infectious Diseases, 30(6), 1077-1087. https://doi.org/10.3201/eid3006.231409. |
Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019
The characteristics of severe human parainfluenza virus (HPIV)–associated pneumonia in adults have not been well evaluated. We investigated epidemiologic and clinical characteristics of 143 patients with severe HPIV-associated pneumonia during 2010–2019. HPIV was the most common cause (25.2%) of severe virus-associated hospital-acquired pneumonia and the third most common cause (15.7%) of severe virus-associated community-acquired pneumonia. Hematologic malignancy (35.0%), diabetes mellitus (23.8%), and structural lung disease (21.0%) were common underlying conditions. Co-infections occurred in 54.5% of patients admitted to an intensive care unit. The 90-day mortality rate for HPIV-associated pneumonia was comparable to that for severe influenza virus–associated pneumonia (55.2% vs. 48.4%; p = 0.22). Ribavirin treatment was not associated with lower mortality rates. Fungal co-infections were associated with 82.4% of deaths. Clinicians should consider the possibility of pathogenic co-infections in patients with HPIV-associated pneumonia. Contact precautions and environmental cleaning are crucial to prevent HPIV transmission in hospital settings.
EID | Park JH, Hong S, Huh J, Jung J, Kim M, Chong Y, et al. Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019. Emerg Infect Dis. 2024;30(6):1088-1095. https://doi.org/10.3201/eid3006.230670 |
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AMA | Park JH, Hong S, Huh J, et al. Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019. Emerging Infectious Diseases. 2024;30(6):1088-1095. doi:10.3201/eid3006.230670. |
APA | Park, J. H., Hong, S., Huh, J., Jung, J., Kim, M., Chong, Y....Choi, S. (2024). Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019. Emerging Infectious Diseases, 30(6), 1088-1095. https://doi.org/10.3201/eid3006.230670. |
Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness
Viral respiratory illness surveillance has traditionally focused on single pathogens (e.g., influenza) and required fever to identify influenza-like illness (ILI). We developed an automated system applying both laboratory test and syndrome criteria to electronic health records from 3 practice groups in Massachusetts, USA, to monitor trends in respiratory viral–like illness (RAVIOLI) across multiple pathogens. We identified RAVIOLI syndrome using diagnosis codes associated with respiratory viral testing or positive respiratory viral assays or fever. After retrospectively applying RAVIOLI criteria to electronic health records, we observed annual winter peaks during 2015–2019, predominantly caused by influenza, followed by cyclic peaks corresponding to SARS-CoV-2 surges during 2020–2024, spikes in RSV in mid-2021 and late 2022, and recrudescent influenza in late 2022 and 2023. RAVIOLI rates were higher and fluctuations more pronounced compared with traditional ILI surveillance. RAVIOLI broadens the scope, granularity, sensitivity, and specificity of respiratory viral illness surveillance compared with traditional ILI surveillance.
EID | Cocoros NM, Eberhardt K, Nguyen V, Brown CM, DeMaria A, Madoff LC, et al. Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness. Emerg Infect Dis. 2024;30(6):1096-1103. https://doi.org/10.3201/eid3006.230473 |
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AMA | Cocoros NM, Eberhardt K, Nguyen V, et al. Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness. Emerging Infectious Diseases. 2024;30(6):1096-1103. doi:10.3201/eid3006.230473. |
APA | Cocoros, N. M., Eberhardt, K., Nguyen, V., Brown, C. M., DeMaria, A., Madoff, L. C....Klompas, M. (2024). Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness. Emerging Infectious Diseases, 30(6), 1096-1103. https://doi.org/10.3201/eid3006.230473. |
Research
We conducted surveillance for carbapenem-resistant Enterobacterales (CRE) during 2016–2020 at 10 US sites and extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E) during 2019–2020 at 6 US sites. Among 159 CRE cases in children (median age 5 years), CRE was isolated from urine for 131 (82.4%) and blood from 20 (12.6%). Annual CRE incidence rate (cases/100,000 population) was 0.47–0.87. Among 207 ESBL-E cases in children (median age 6 years), ESBL-E was isolated from urine of 196 (94.7%) and blood of 8 (3.9%). Annual ESBL-E incidence rate was 26.5 in 2019 and 19.63 in 2020. CRE and ESBL-E rates were >2-fold higher among infants than other age groups. Most CRE and ESBL-E cases were healthcare-associated community-onset (68 [43.0%] for CRE vs. 40 [23.7%] for ESBL-E) or community-associated (43 [27.2%] for CRE vs. 109 [64.5%] for ESBL-E). Programs to detect, prevent, and treat multidrug-resistant infections must include pediatric populations (particularly the youngest) and outpatient settings.
EID | Grome HN, Grass JE, Duffy N, Bulens SN, Ansari U, Campbell D, et al. Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020. Emerg Infect Dis. 2024;30(6):1104-1114. https://doi.org/10.3201/eid3006.231734 |
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AMA | Grome HN, Grass JE, Duffy N, et al. Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020. Emerging Infectious Diseases. 2024;30(6):1104-1114. doi:10.3201/eid3006.231734. |
APA | Grome, H. N., Grass, J. E., Duffy, N., Bulens, S. N., Ansari, U., Campbell, D....Guh, A. Y. (2024). Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020. Emerging Infectious Diseases, 30(6), 1104-1114. https://doi.org/10.3201/eid3006.231734. |
Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru
The World Health Organization’s end TB strategy promotes the use of symptom and chest radiograph screening for tuberculosis (TB) disease. However, asymptomatic early states of TB beyond latent TB infection and active disease can go unrecognized using current screening criteria. We conducted a longitudinal cohort study enrolling household contacts initially free of TB disease and followed them for the occurrence of incident TB over 1 year. Among 1,747 screened contacts, 27 (52%) of the 52 persons in whom TB subsequently developed during follow-up had a baseline abnormal radiograph. Of contacts without TB symptoms, persons with an abnormal radiograph were at higher risk for subsequent TB than persons with an unremarkable radiograph (adjusted hazard ratio 15.62 [95% CI 7.74–31.54]). In young adults, we found a strong linear relationship between radiograph severity and time to TB diagnosis. Our findings suggest chest radiograph screening can extend to detecting early TB states, thereby enabling timely intervention.
EID | Tan Q, Huang C, Becerra MC, Calderon R, Contreras C, Lecca L, et al. Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru. Emerg Infect Dis. 2024;30(6):1115-1124. https://doi.org/10.3201/eid3006.231699 |
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AMA | Tan Q, Huang C, Becerra MC, et al. Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru. Emerging Infectious Diseases. 2024;30(6):1115-1124. doi:10.3201/eid3006.231699. |
APA | Tan, Q., Huang, C., Becerra, M. C., Calderon, R., Contreras, C., Lecca, L....Murray, M. B. (2024). Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru. Emerging Infectious Diseases, 30(6), 1115-1124. https://doi.org/10.3201/eid3006.231699. |
Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022
During October 2022, enteric redmouth disease (ERM) affected Chinese sturgeons at a farm in Hubei, China, causing mass mortality. Affected fish exhibited characteristic red mouth and intestinal inflammation. Investigation led to isolation of a prominent bacterial strain, zhx1, from the internal organs and intestines of affected fish. Artificial infection experiments confirmed the role of zhx1 as the pathogen responsible for the deaths. The primary pathologic manifestations consisted of degeneration, necrosis, and inflammatory reactions, resulting in multiple organ dysfunction and death. Whole-genome sequencing of the bacteria identified zhx1 as Yersinia ruckeri, which possesses 135 drug-resistance genes and 443 virulence factor-related genes. Drug-susceptibility testing of zhx1 demonstrated high sensitivity to chloramphenicol and florfenicol but varying degrees of resistance to 18 other antimicrobial drugs. Identifying the pathogenic bacteria associated with ERM in Chinese sturgeons establishes a theoretical foundation for the effective prevention and control of this disease.
EID | Yang Y, Xu S, He H, Zhu X, Liu Y, Hu M, et al. Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022. Emerg Infect Dis. 2024;30(6):1125-1132. https://doi.org/10.3201/eid3006.231354 |
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AMA | Yang Y, Xu S, He H, et al. Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022. Emerging Infectious Diseases. 2024;30(6):1125-1132. doi:10.3201/eid3006.231354. |
APA | Yang, Y., Xu, S., He, H., Zhu, X., Liu, Y., Hu, M....Zhang, H. (2024). Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022. Emerging Infectious Diseases, 30(6), 1125-1132. https://doi.org/10.3201/eid3006.231354. |
Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada
We describe an unusual mortality event caused by a highly pathogenic avian influenza (HPAI) A(H5N1) virus clade 2.3.4.4b involving harbor (Phoca vitulina) and gray (Halichoerus grypus) seals in the St. Lawrence Estuary, Quebec, Canada, in 2022. Fifteen (56%) of the seals submitted for necropsy were considered to be fatally infected by HPAI H5N1 containing fully Eurasian or Eurasian/North American genome constellations. Concurrently, presence of large numbers of bird carcasses infected with HPAI H5N1 at seal haul-out sites most likely contributed to the spillover of infection to the seals. Histologic changes included meningoencephalitis (100%), fibrinosuppurative alveolitis, and multiorgan acute necrotizing inflammation. This report of fatal HPAI H5N1 infection in pinnipeds in Canada raises concerns about the expanding host of this virus, the potential for the establishment of a marine mammal reservoir, and the public health risks associated with spillover to mammals.
Nous décrivons un événement de mortalité inhabituelle causé par un virus de l’influenza aviaire hautement pathogène A(H5N1) clade 2.3.4.4b chez des phoques communs (Phoca vitulina) et gris (Halichoerus grypus) dans l’estuaire du Saint-Laurent au Québec, Canada, en 2022. Quinze (56%) des phoques soumis pour nécropsie ont été considérés comme étant fatalement infectés par le virus H5N1 de lignées eurasiennes ou de réassortiment eurasiennes/nord-américaines. Un grand nombre simultané de carcasses d’oiseaux infectés par le H5N1 sur les sites d’échouement a probablement contribué à la contamination de ces phoques. Les changements histologiques associés à cette infection incluaient : méningo-encéphalite (100%), alvéolite fibrinosuppurée et inflammation nécrosante aiguë multi-organique. Cette documentation soulève des préoccupations quant à l’émergence de virus mortels, à la possibilité d’établissement de réservoirs chez les mammifères marins, et aux risques pour la santé publique associés aux propagations du virus chez les mammifères.
EID | Lair S, Quesnel L, Signore AV, Delnatte P, Embury-Hyatt C, Nadeau M, et al. Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada. Emerg Infect Dis. 2024;30(6):1133-1143. https://doi.org/10.3201/eid3006.231033 |
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AMA | Lair S, Quesnel L, Signore AV, et al. Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada. Emerging Infectious Diseases. 2024;30(6):1133-1143. doi:10.3201/eid3006.231033. |
APA | Lair, S., Quesnel, L., Signore, A. V., Delnatte, P., Embury-Hyatt, C., Nadeau, M....Berhane, Y. (2024). Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada. Emerging Infectious Diseases, 30(6), 1133-1143. https://doi.org/10.3201/eid3006.231033. |
Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States
Few precise estimates of hospitalization and fatality rates from COVID-19 exist for naive populations, especially within demographic subgroups. We estimated rates among persons with SARS-CoV-2 infection in the United States during May 1–December 1, 2020, before vaccines became available. Both rates generally increased with age; fatality rates were highest for persons >85 years of age (24%) and lowest for children 1–14 years of age (0.01%). Age-adjusted case hospitalization rates were highest for African American or Black, not Hispanic persons (14%), and case-fatality rates were highest for Asian or Pacific Islander, not Hispanic persons (4.4%). Eighteen percent of hospitalized patients and 44.2% of those admitted to an intensive care unit died. Male patients had higher hospitalization (6.2% vs. 5.2%) and fatality rates (1.9% vs. 1.5%) than female patients. These findings highlight the importance of collecting surveillance data to devise appropriate control measures for persons in underserved racial/ethnic groups and older adults.
EID | Griffin I, King J, Lyons B, Singleton AL, Deng X, Bruce BB, et al. Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States. Emerg Infect Dis. 2024;30(6):1144-1153. https://doi.org/10.3201/eid3006.231285 |
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AMA | Griffin I, King J, Lyons B, et al. Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States. Emerging Infectious Diseases. 2024;30(6):1144-1153. doi:10.3201/eid3006.231285. |
APA | Griffin, I., King, J., Lyons, B., Singleton, A. L., Deng, X., Bruce, B. B....Griffin, P. M. (2024). Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States. Emerging Infectious Diseases, 30(6), 1144-1153. https://doi.org/10.3201/eid3006.231285. |
Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea
We investigated trends in notifiable infectious diseases in both humans and animals during the COVID-19 pandemic in South Korea and compared those data against expected trends had nonpharmaceutical interventions (NPIs) not been implemented. We found that human respiratory infectious diseases other than COVID-19 decreased by an average of 54.7% after NPIs were introduced. On the basis of that trend, we estimated that annual medical expenses associated with respiratory infections other than COVID-19 also decreased by 3.8% in 2020 and 18.9% in 2021. However, human gastrointestinal infectious diseases and livestock diseases exhibited similar or even higher incidence rates after NPIs were instituted. Our investigation revealed that the preventive effect of NPIs varied among diseases and that NPIs might have had limited effectiveness in reducing the spread of certain types of infectious diseases. These findings suggest the need for future, novel public health interventions to compensate for such limitations.
EID | Chang T, Cho S, Yoo D, Min K. Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea. Emerg Infect Dis. 2024;30(6):1154-1163. https://doi.org/10.3201/eid3006.231422 |
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AMA | Chang T, Cho S, Yoo D, et al. Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea. Emerging Infectious Diseases. 2024;30(6):1154-1163. doi:10.3201/eid3006.231422. |
APA | Chang, T., Cho, S., Yoo, D., & Min, K. (2024). Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea. Emerging Infectious Diseases, 30(6), 1154-1163. https://doi.org/10.3201/eid3006.231422. |
Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark
As a follow-up to a previous study, we investigated vaccine effectiveness (VE) of 23-valent pneumococcal polysaccharide vaccine (PPSV23) against invasive pneumococcal disease (IPD) among 1,254,498 persons >65 years of age as part of a vaccination program in Denmark during April 2020–January 2023. We assessed VE by using a Cox regression model and adjusted for age, sex, and underlying conditions. Using nationwide data, we estimated a VE of PPSV23 against all-type IPD of 32% and against PPSV23-serotype IPD of 41%. Because this follow-up study had more statistical power than the original study, we also estimated VE against IPD caused by PPSV23-serotypes excluding serotype 3; serotype 3; serotype 8; serotype 22F; PPSV23 non-PCV15 serotypes; PPSV23 non-PCV20 serotypes; and IPD over time. Our findings suggest PPSV23 vaccination can protect persons >65 years of age against IPD caused by all serotypes or serotype groupings, except serotype 3.
EID | Nielsen K, Nielsen L, Dalby T, Lomholt F, Slotved H, Fuursted K, et al. Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark. Emerg Infect Dis. 2024;30(6):1164-1172. https://doi.org/10.3201/eid3006.230975 |
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AMA | Nielsen K, Nielsen L, Dalby T, et al. Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark. Emerging Infectious Diseases. 2024;30(6):1164-1172. doi:10.3201/eid3006.230975. |
APA | Nielsen, K., Nielsen, L., Dalby, T., Lomholt, F., Slotved, H., Fuursted, K....Valentiner-Branth, P. (2024). Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark. Emerging Infectious Diseases, 30(6), 1164-1172. https://doi.org/10.3201/eid3006.230975. |
Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates
Understanding changes in the transmission dynamics of mpox requires comparing recent estimates of key epidemiologic parameters with historical data. We derived historical estimates for the incubation period and serial interval for mpox and contrasted them with pooled estimates from the 2022 outbreak. Our findings show the pooled mean infection-to-onset incubation period was 8.1 days for the 2022 outbreak and 8.2 days historically, indicating the incubation periods remained relatively consistent over time, despite a shift in the major mode of transmission. However, we estimated the onset-to-onset serial interval at 8.7 days using 2022 data, compared with 14.2 days using historical data. Although the reason for this shortening of the serial interval is unclear, it may be because of increased public health interventions or a shift in the mode of transmission. Recognizing such temporal shifts is essential for informed response strategies, and public health measures remain crucial for controlling mpox and similar future outbreaks.
EID | Ponce L, Linton NM, Toh W, Cheng H, Thompson RN, Akhmetzhanov AR, et al. Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates. Emerg Infect Dis. 2024;30(6):1173-1181. https://doi.org/10.3201/eid3006.231095 |
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AMA | Ponce L, Linton NM, Toh W, et al. Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates. Emerging Infectious Diseases. 2024;30(6):1173-1181. doi:10.3201/eid3006.231095. |
APA | Ponce, L., Linton, N. M., Toh, W., Cheng, H., Thompson, R. N., Akhmetzhanov, A. R....Dushoff, J. (2024). Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates. Emerging Infectious Diseases, 30(6), 1173-1181. https://doi.org/10.3201/eid3006.231095. |
SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022
In adults, viral load and disease severity can differ by SARS-CoV-2 variant, patterns less understood in children. We evaluated symptomatology, cycle threshold (Ct) values, and SARS-CoV-2 variants among 2,299 pediatric SARS-CoV-2 patients (0–21 years of age) in Colorado, USA, to determine whether children infected with Delta or Omicron had different symptom severity or Ct values than during earlier variants. Children infected during the Delta and Omicron periods had lower Ct values than those infected during pre-Delta, and children <1 year of age had lower Ct values than older children. Hospitalized symptomatic children had lower Ct values than asymptomatic patients. Compared with pre-Delta, more children infected during Delta and Omicron were symptomatic (75.4% pre-Delta, 95.3% Delta, 99.5% Omicron), admitted to intensive care (18.8% pre-Delta, 39.5% Delta, 22.9% Omicron), or received oxygen support (42.0% pre-Delta, 66.3% Delta, 62.3% Omicron). Our data reinforce the need to include children, especially younger children, in pathogen surveillance efforts.
EID | Bankers L, O’Brien SC, Tapay DM, Ho E, Armistead I, Burakoff A, et al. SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022. Emerg Infect Dis. 2024;30(6):1182-1192. https://doi.org/10.3201/eid3006.231427 |
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AMA | Bankers L, O’Brien SC, Tapay DM, et al. SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022. Emerging Infectious Diseases. 2024;30(6):1182-1192. doi:10.3201/eid3006.231427. |
APA | Bankers, L., O’Brien, S. C., Tapay, D. M., Ho, E., Armistead, I., Burakoff, A....Matzinger, S. R. (2024). SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022. Emerging Infectious Diseases, 30(6), 1182-1192. https://doi.org/10.3201/eid3006.231427. |
Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids
Chronic wasting disease (CWD) is a cervid prion disease with unknown zoonotic potential that might pose a risk to humans who are exposed. To assess the potential of CWD to infect human neural tissue, we used human cerebral organoids with 2 different prion genotypes, 1 of which has previously been associated with susceptibility to zoonotic prion disease. We exposed organoids from both genotypes to high concentrations of CWD inocula from 3 different sources for 7 days, then screened for infection periodically for up to 180 days. No de novo CWD propagation or deposition of protease-resistant forms of human prions was evident in CWD-exposed organoids. Some persistence of the original inoculum was detected, which was equivalent in prion gene knockout organoids and thus not attributable to human prion propagation. Overall, the unsuccessful propagation of CWD in cerebral organoids supports a strong species barrier to transmission of CWD prions to humans.
EID | Groveman BR, Williams K, Race B, Foliaki S, Thomas T, Hughson AG, et al. Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids. Emerg Infect Dis. 2024;30(6):1193-1202. https://doi.org/10.3201/eid3006.231568 |
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AMA | Groveman BR, Williams K, Race B, et al. Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids. Emerging Infectious Diseases. 2024;30(6):1193-1202. doi:10.3201/eid3006.231568. |
APA | Groveman, B. R., Williams, K., Race, B., Foliaki, S., Thomas, T., Hughson, A. G....Haigh, C. L. (2024). Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids. Emerging Infectious Diseases, 30(6), 1193-1202. https://doi.org/10.3201/eid3006.231568. |
Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022
Major dengue epidemics throughout Nicaragua’s history have been dominated by 1 of 4 dengue virus serotypes (DENV-1–4). To examine serotypes during the dengue epidemic in Nicaragua in 2022, we performed real-time genomic surveillance in-country and documented cocirculation of all 4 serotypes. We observed a shift toward co-dominance of DENV-1 and DENV-4 over previously dominant DENV-2. By analyzing 135 new full-length DENV sequences, we found that introductions underlay the resurgence: DENV-1 clustered with viruses from Ecuador in 2014 rather than those previously seen in Nicaragua; DENV-3, which last circulated locally in 2014, grouped instead with Southeast Asia strains expanding into Florida and Cuba in 2022; and new DENV-4 strains clustered within a South America lineage spreading to Florida in 2022. In contrast, DENV-2 persisted from the formerly dominant Nicaragua clade. We posit that the resurgence emerged from travel after the COVID-19 pandemic and that the resultant intensifying hyperendemicity could affect future dengue immunity and severity.
EID | Cerpas C, Vásquez G, Moreira H, Juarez JG, Coloma J, Harris E, et al. Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerg Infect Dis. 2024;30(6):1203-1213. https://doi.org/10.3201/eid3006.231553 |
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AMA | Cerpas C, Vásquez G, Moreira H, et al. Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerging Infectious Diseases. 2024;30(6):1203-1213. doi:10.3201/eid3006.231553. |
APA | Cerpas, C., Vásquez, G., Moreira, H., Juarez, J. G., Coloma, J., Harris, E....Balmaseda, Á. (2024). Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerging Infectious Diseases, 30(6), 1203-1213. https://doi.org/10.3201/eid3006.231553. |
Dispatches
Autochthonous Plasmodium vivax Infections, Florida, USA, 2023
During May–July 2023, a cluster of 7 patients at local hospitals in Florida, USA, received a diagnosis of Plasmodium vivax malaria. Whole-genome sequencing of the organism from 4 patients and phylogenetic analysis with worldwide representative P. vivax genomes indicated probable single parasite introduction from Central/South America.
EID | Muneer A, Adapa SR, Silbert S, Scanlan K, Vore H, Cannons A, et al. Autochthonous Plasmodium vivax Infections, Florida, USA, 2023. Emerg Infect Dis. 2024;30(6):1214-1217. https://doi.org/10.3201/eid3006.240336 |
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AMA | Muneer A, Adapa SR, Silbert S, et al. Autochthonous Plasmodium vivax Infections, Florida, USA, 2023. Emerging Infectious Diseases. 2024;30(6):1214-1217. doi:10.3201/eid3006.240336. |
APA | Muneer, A., Adapa, S. R., Silbert, S., Scanlan, K., Vore, H., Cannons, A....Cui, L. (2024). Autochthonous Plasmodium vivax Infections, Florida, USA, 2023. Emerging Infectious Diseases, 30(6), 1214-1217. https://doi.org/10.3201/eid3006.240336. |
Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China
We characterized the evolution and molecular characteristics of avian influenza A(H7N9) viruses isolated in China during 2021–2023. We systematically analyzed the 10-year evolution of the hemagglutinin gene to determine the evolutionary branch. Our results showed recent antigenic drift, providing crucial clues for updating the H7N9 vaccine and disease prevention and control.
EID | Liu Y, Chen Y, Yang Z, Lin Y, Fu S, Chen J, et al. Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China. Emerg Infect Dis. 2024;30(6):1218-1222. https://doi.org/10.3201/eid3006.230530 |
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AMA | Liu Y, Chen Y, Yang Z, et al. Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China. Emerging Infectious Diseases. 2024;30(6):1218-1222. doi:10.3201/eid3006.230530. |
APA | Liu, Y., Chen, Y., Yang, Z., Lin, Y., Fu, S., Chen, J....Jia, W. (2024). Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China. Emerging Infectious Diseases, 30(6), 1218-1222. https://doi.org/10.3201/eid3006.230530. |
Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023
Highly pathogenic avian influenza H5N6 and H5N1 viruses of clade 2.3.4.4b were simultaneously introduced into South Korea at the end of 2023. An outbreak at a broiler duck farm consisted of concurrent infection by both viruses. Sharing genetic information and international surveillance of such viruses in wild birds and poultry is critical.
EID | Heo G, Kang Y, An S, Kim Y, Cha RM, Jang Y, et al. Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023. Emerg Infect Dis. 2024;30(6):1223-1227. https://doi.org/10.3201/eid3006.240194 |
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AMA | Heo G, Kang Y, An S, et al. Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023. Emerging Infectious Diseases. 2024;30(6):1223-1227. doi:10.3201/eid3006.240194. |
APA | Heo, G., Kang, Y., An, S., Kim, Y., Cha, R. M., Jang, Y....Lee, K. (2024). Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023. Emerging Infectious Diseases, 30(6), 1223-1227. https://doi.org/10.3201/eid3006.240194. |
Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy
We describe group B Streptococcus linked to disease in farmed pigs and wild porcupines in Italy. Occurrence in pigs was attributed to transmission from nonpasteurized bovine milk whey. Antimicrobial-resistance profiles in isolates from porcupines suggest no common source of infection. Our findings expand the known host range for group B Streptococcus disease.
EID | Garbarino C, Bariselli S, Pupillo G, Bassi P, Luppi A, Taddei R, et al. Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy. Emerg Infect Dis. 2024;30(6):1228-1231. https://doi.org/10.3201/eid3006.231322 |
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AMA | Garbarino C, Bariselli S, Pupillo G, et al. Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy. Emerging Infectious Diseases. 2024;30(6):1228-1231. doi:10.3201/eid3006.231322. |
APA | Garbarino, C., Bariselli, S., Pupillo, G., Bassi, P., Luppi, A., Taddei, R....Zadoks, R. N. (2024). Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy. Emerging Infectious Diseases, 30(6), 1228-1231. https://doi.org/10.3201/eid3006.231322. |
Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess
A 3-year-old patient in India experiencing headaches and seizures was diagnosed with a fungal infection, initially misidentified as Cladophialophora bantiana. Follow-up sequencing identified the isolate to be Fonsecaea monophora fungus. This case demonstrates the use of molecular methods for the correct identification of F. monophora, an agent of fungal brain abscess.
EID | Gourav S, Singh G, Pandey M, Rana B, Gupta S, Mishra H, et al. Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess. Emerg Infect Dis. 2024;30(6):1232-1235. https://doi.org/10.3201/eid3006.240077 |
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AMA | Gourav S, Singh G, Pandey M, et al. Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess. Emerging Infectious Diseases. 2024;30(6):1232-1235. doi:10.3201/eid3006.240077. |
APA | Gourav, S., Singh, G., Pandey, M., Rana, B., Gupta, S., Mishra, H....Xess, I. (2024). Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess. Emerging Infectious Diseases, 30(6), 1232-1235. https://doi.org/10.3201/eid3006.240077. |
Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia
A fecal survey in Tamil Nadu, India, revealed 2 persons passed schistosome eggs, later identified as Schistosoma incognitum, a parasite of pigs, dogs, and rats. We investigated those cases and reviewed autochthonous schistosomiasis cases from India and Nepal. Whether the 2 new cases represent true infection or spurious passage is undetermined.
EID | Ajjampur S, Sarkar R, Bradbury RS. Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia. Emerg Infect Dis. 2024;30(6):1236-1239. https://doi.org/10.3201/eid3006.231641 |
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AMA | Ajjampur S, Sarkar R, Bradbury RS. Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia. Emerging Infectious Diseases. 2024;30(6):1236-1239. doi:10.3201/eid3006.231641. |
APA | Ajjampur, S., Sarkar, R., & Bradbury, R. S. (2024). Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia. Emerging Infectious Diseases, 30(6), 1236-1239. https://doi.org/10.3201/eid3006.231641. |
Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease
A 2022 canine gastroenteritis outbreak in the United Kingdom was associated with circulation of a new canine enteric coronavirus closely related to a 2020 variant with an additional spike gene recombination. The variants are unrelated to canine enteric coronavirus–like viruses associated with human disease but represent a model for coronavirus population adaptation.
EID | Cunningham-Oakes E, Pilgrim J, Darby AC, Appleton C, Jewell C, Rowlingson B, et al. Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease. Emerg Infect Dis. 2024;30(6):1240-1244. https://doi.org/10.3201/eid3006.231184 |
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AMA | Cunningham-Oakes E, Pilgrim J, Darby AC, et al. Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease. Emerging Infectious Diseases. 2024;30(6):1240-1244. doi:10.3201/eid3006.231184. |
APA | Cunningham-Oakes, E., Pilgrim, J., Darby, A. C., Appleton, C., Jewell, C., Rowlingson, B....Radford, A. D. (2024). Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease. Emerging Infectious Diseases, 30(6), 1240-1244. https://doi.org/10.3201/eid3006.231184. |
Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA
Choanephora infundibulifera is a member of the Mucorales order of fungi. The species is associated with plants as a saprophyte or parasite and may be responsible for spoilage or disease but is an uncommon cause of human infection. We describe C. infundibulifera rhinosinusitis in a young man with leukemia in Tennessee, USA.
EID | Max A, Glasgow HL, Santiago T, Holland A, Inaba H, Cañete-Gibas CF, et al. Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA. Emerg Infect Dis. 2024;30(6):1245-1248. https://doi.org/10.3201/eid3006.230794 |
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AMA | Max A, Glasgow HL, Santiago T, et al. Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA. Emerging Infectious Diseases. 2024;30(6):1245-1248. doi:10.3201/eid3006.230794. |
APA | Max, A., Glasgow, H. L., Santiago, T., Holland, A., Inaba, H., Cañete-Gibas, C. F....Adderson, E. E. (2024). Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA. Emerging Infectious Diseases, 30(6), 1245-1248. https://doi.org/10.3201/eid3006.230794. |
Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China
Burkholderia semiarida was previously identified solely as a plant pathogen within the Burkholderia cepacia complex. We present a case in China involving recurrent pneumonia attributed to B. semiarida infection. Of note, the infection manifested in an immunocompetent patient with no associated primary diseases and endured for >3 years.
EID | Kuang D, Liu F, Tian S, Liu W, Li A, Zhou Y, et al. Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China. Emerg Infect Dis. 2024;30(6):1249-1252. https://doi.org/10.3201/eid3006.231676 |
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AMA | Kuang D, Liu F, Tian S, et al. Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China. Emerging Infectious Diseases. 2024;30(6):1249-1252. doi:10.3201/eid3006.231676. |
APA | Kuang, D., Liu, F., Tian, S., Liu, W., Li, A., Zhou, Y....Xia, Q. (2024). Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China. Emerging Infectious Diseases, 30(6), 1249-1252. https://doi.org/10.3201/eid3006.231676. |
SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023
We conducted a serologic and molecular study to assess exposure of captive nonhuman primates (NHPs) to SARS-CoV-2 in Spain during the 2020–2023 COVID-19 pandemic. We found limited exposure of NHPs to SARS-CoV-2. Biosafety measures must be strictly maintained to avoid SARS-CoV-2 reverse-zoonotic transmission in the human–NHP interface.
EID | Cano-Terriza D, Beato-Benítez A, Fernández-Bastit L, Segalés J, Vergara-Alert J, Martínez-Nevado E, et al. SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023. Emerg Infect Dis. 2024;30(6):1253-1257. https://doi.org/10.3201/eid3006.231247 |
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AMA | Cano-Terriza D, Beato-Benítez A, Fernández-Bastit L, et al. SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023. Emerging Infectious Diseases. 2024;30(6):1253-1257. doi:10.3201/eid3006.231247. |
APA | Cano-Terriza, D., Beato-Benítez, A., Fernández-Bastit, L., Segalés, J., Vergara-Alert, J., Martínez-Nevado, E....García-Bocanegra, I. (2024). SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023. Emerging Infectious Diseases, 30(6), 1253-1257. https://doi.org/10.3201/eid3006.231247. |
Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021
Ancylostoma ceylanicum is the second most common hookworm infecting humans in the Asia-Pacific region. Recent reports suggest presence of the parasite in the Americas. We report A. ceylanicum infections in coyotes from the Guanacaste Conservation Area, Costa Rica. Our findings call for active surveillance in humans and animals.
EID | Zendejas-Heredia PA, Robleto-Quesada J, Solano A, Rojas A, Colella V. Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021. Emerg Infect Dis. 2024;30(6):1258-1262. https://doi.org/10.3201/eid3006.231618 |
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AMA | Zendejas-Heredia PA, Robleto-Quesada J, Solano A, et al. Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021. Emerging Infectious Diseases. 2024;30(6):1258-1262. doi:10.3201/eid3006.231618. |
APA | Zendejas-Heredia, P. A., Robleto-Quesada, J., Solano, A., Rojas, A., & Colella, V. (2024). Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021. Emerging Infectious Diseases, 30(6), 1258-1262. https://doi.org/10.3201/eid3006.231618. |
Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic
We retrospectively analyzed of 211 frozen cerebrospinal fluid samples from immunocompetent persons in the Czech Republic and detected 6 Encephalitozoon cuniculi–positive samples. Microsporidiosis is generally underestimated and patients are not usually tested for microsporidia, but latent infection in immunodeficient and immunocompetent patients can cause serious complications if not detected and treated.
EID | Sak B, Mansfeldová K, Brdíčková K, Gottliebová P, Nyčová E, Holubová N, et al. Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic. Emerg Infect Dis. 2024;30(6):1263-1266. https://doi.org/10.3201/eid3006.231585 |
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AMA | Sak B, Mansfeldová K, Brdíčková K, et al. Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic. Emerging Infectious Diseases. 2024;30(6):1263-1266. doi:10.3201/eid3006.231585. |
APA | Sak, B., Mansfeldová, K., Brdíčková, K., Gottliebová, P., Nyčová, E., Holubová, N....Kváč, M. (2024). Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic. Emerging Infectious Diseases, 30(6), 1263-1266. https://doi.org/10.3201/eid3006.231585. |
Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023
We assessed SARS-CoV-2 seroprevalence in Japan during July–August 2023, with a focus on 2 key age groups, 0–15 and >80 years. We estimated overall seroprevalence of 45.3% for nucleocapsid antibodies and 95.4% for spike antibodies and found notable maternally derived spike antibodies in infants 6–11 months of age (90.0%).
EID | Kinoshita R, Miyamoto S, Sakuraba S, Sugihara J, Suzuki M, Suzuki T, et al. Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023. Emerg Infect Dis. 2024;30(6):1267-1270. https://doi.org/10.3201/eid3006.231454 |
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AMA | Kinoshita R, Miyamoto S, Sakuraba S, et al. Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023. Emerging Infectious Diseases. 2024;30(6):1267-1270. doi:10.3201/eid3006.231454. |
APA | Kinoshita, R., Miyamoto, S., Sakuraba, S., Sugihara, J., Suzuki, M., Suzuki, T....Yoneoka, D. (2024). Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023. Emerging Infectious Diseases, 30(6), 1267-1270. https://doi.org/10.3201/eid3006.231454. |
Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA
We detected antibodies to H5 and N1 subtype influenza A viruses in 4/194 (2%) dogs from Washington, USA, that hunted or engaged in hunt tests and training with wild birds. Historical data provided by dog owners showed seropositive dogs had high levels of exposure to waterfowl.
EID | Brown JD, Black A, Haman KH, Diel DG, Ramirez VE, Ziejka RS, et al. Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA. Emerg Infect Dis. 2024;30(6):1271-1274. https://doi.org/10.3201/eid3006.231459 |
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AMA | Brown JD, Black A, Haman KH, et al. Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA. Emerging Infectious Diseases. 2024;30(6):1271-1274. doi:10.3201/eid3006.231459. |
APA | Brown, J. D., Black, A., Haman, K. H., Diel, D. G., Ramirez, V. E., Ziejka, R. S....Stallknecht, D. E. (2024). Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA. Emerging Infectious Diseases, 30(6), 1271-1274. https://doi.org/10.3201/eid3006.231459. |
Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria
We investigated a cohort of 370 patients in Austria with hantavirus infections (7.8% ICU admission rate) and detected 2 cases (cumulative incidence 7%) of invasive pulmonary aspergillosis; 1 patient died. Hantavirus-associated pulmonary aspergillosis may complicate the course of critically ill patients who have hemorrhagic fever with renal syndrome.
EID | Hatzl S, Scholz L, Posch F, Eller P, Reisinger AC, Zacharias M, et al. Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria. Emerg Infect Dis. 2024;30(6):1275-1278. https://doi.org/10.3201/eid3006.231720 |
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AMA | Hatzl S, Scholz L, Posch F, et al. Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria. Emerging Infectious Diseases. 2024;30(6):1275-1278. doi:10.3201/eid3006.231720. |
APA | Hatzl, S., Scholz, L., Posch, F., Eller, P., Reisinger, A. C., Zacharias, M....Krause, R. (2024). Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria. Emerging Infectious Diseases, 30(6), 1275-1278. https://doi.org/10.3201/eid3006.231720. |
IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022
We characterized a collection of IMI-like–producing Enterobacter spp. isolates (n = 112) in France. The main clone corresponded to IMI-1–producing sequence type 820 E. cloacae subspecies cloacae that was involved in an outbreak. Clinicians should be aware of potential antimicrobial resistance among these bacteria.
EID | Emeraud C, Girlich D, Deschamps M, Rezzoug I, Jacquemin A, Jousset AB, et al. IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022. Emerg Infect Dis. 2024;30(6):1279-1282. https://doi.org/10.3201/eid3006.231525 |
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AMA | Emeraud C, Girlich D, Deschamps M, et al. IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022. Emerging Infectious Diseases. 2024;30(6):1279-1282. doi:10.3201/eid3006.231525. |
APA | Emeraud, C., Girlich, D., Deschamps, M., Rezzoug, I., Jacquemin, A., Jousset, A. B....Dortet, L. (2024). IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022. Emerging Infectious Diseases, 30(6), 1279-1282. https://doi.org/10.3201/eid3006.231525. |
Research Letters
Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine
Because novel SARS-CoV-2 variants continue to emerge, immunogenicity of XBB.1.5 monovalent vaccines against live clinical isolates needs to be evaluated. We report boosting of IgG (2.1×), IgA (1.5×), and total IgG/A/M (1.7×) targeting the spike receptor-binding domain and neutralizing titers against WA1 (2.2×), XBB.1.5 (7.4×), EG.5.1 (10.5×), and JN.1 (4.7×) variants.
EID | Nguyenla X, Bates TA, Trank-Greene M, Wahedi M, Tafesse FG, Curlin ME. Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine. Emerg Infect Dis. 2024;30(6):1282-1283. https://doi.org/10.3201/eid3006.240051 |
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AMA | Nguyenla X, Bates TA, Trank-Greene M, et al. Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine. Emerging Infectious Diseases. 2024;30(6):1282-1283. doi:10.3201/eid3006.240051. |
APA | Nguyenla, X., Bates, T. A., Trank-Greene, M., Wahedi, M., Tafesse, F. G., & Curlin, M. E. (2024). Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine. Emerging Infectious Diseases, 30(6), 1282-1283. https://doi.org/10.3201/eid3006.240051. |
Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023
We isolated novel reassortant avian influenza A(H5N6) viruses containing genes from clade 2.3.4.4b H5N1 virus and low pathogenicity avian influenza viruses in carcasses of whooper swans and bean geese in South Korea during December 2023. Neuraminidase gene was from a clade 2.3.4.4b H5N6 virus infecting poultry and humans in China.
EID | Cho A, Si Y, Kim D, Seo Y, Lee D, Kim D, et al. Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023. Emerg Infect Dis. 2024;30(6):1285-1288. https://doi.org/10.3201/eid3006.240192 |
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AMA | Cho A, Si Y, Kim D, et al. Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023. Emerging Infectious Diseases. 2024;30(6):1285-1288. doi:10.3201/eid3006.240192. |
APA | Cho, A., Si, Y., Kim, D., Seo, Y., Lee, D., Kim, D....Lee, D. (2024). Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023. Emerging Infectious Diseases, 30(6), 1285-1288. https://doi.org/10.3201/eid3006.240192. |
Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan
Using the GISAID EpiCoV database, we identified 256 COVID-19 patients in Japan during March 31–December 31, 2023, who had mutations in the SARS-CoV-2 nonstructural protein 5 conferring ensitrelvir resistance. Ongoing genomic surveillance is required to monitor emergence of SARS-CoV-2 mutations that are resistant to anticoronaviral drugs.
EID | Doi A, Ota M, Saito M, Matsuyama S. Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan. Emerg Infect Dis. 2024;30(6):1289-1291. https://doi.org/10.3201/eid3006.240023 |
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AMA | Doi A, Ota M, Saito M, et al. Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan. Emerging Infectious Diseases. 2024;30(6):1289-1291. doi:10.3201/eid3006.240023. |
APA | Doi, A., Ota, M., Saito, M., & Matsuyama, S. (2024). Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan. Emerging Infectious Diseases, 30(6), 1289-1291. https://doi.org/10.3201/eid3006.240023. |
Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020
Food irradiation can reduce foodborne illnesses but is rarely used in the United States. We determined whether outbreaks related to Campylobacter, Salmonella, Escherichia coli, and Listeria monocytogenes were linked to irradiation-eligible foods. Of 482 outbreaks, 155 (32.2%) were linked to an irradiation-eligible food, none of which were known to be irradiated.
EID | Zlotnick M, Eisenstein T, Robyn M, Marshall KE. Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020. Emerg Infect Dis. 2024;30(6):1291-1293. https://doi.org/10.3201/eid3006.230922 |
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AMA | Zlotnick M, Eisenstein T, Robyn M, et al. Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020. Emerging Infectious Diseases. 2024;30(6):1291-1293. doi:10.3201/eid3006.230922. |
APA | Zlotnick, M., Eisenstein, T., Robyn, M., & Marshall, K. E. (2024). Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020. Emerging Infectious Diseases, 30(6), 1291-1293. https://doi.org/10.3201/eid3006.230922. |
Effect of Myxoma Virus Species Jump on Iberian Hare Populations
The myxoma virus species jump from European rabbits (Oryctolagus cuniculus) to Iberian hares (Lepus granatensis) has raised concerns. We assess the decline suffered by Iberian hare populations on the Iberian Peninsula and discuss the association between the effect of myxomatosis and the average abundance index, which we estimated by using hunting bags.
EID | Cardoso B, García-Bocanegra I, Queirós J, Fernández-López J, Alves PC, Acevedo P. Effect of Myxoma Virus Species Jump on Iberian Hare Populations. Emerg Infect Dis. 2024;30(6):1293-1296. https://doi.org/10.3201/eid3006.231280 |
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AMA | Cardoso B, García-Bocanegra I, Queirós J, et al. Effect of Myxoma Virus Species Jump on Iberian Hare Populations. Emerging Infectious Diseases. 2024;30(6):1293-1296. doi:10.3201/eid3006.231280. |
APA | Cardoso, B., García-Bocanegra, I., Queirós, J., Fernández-López, J., Alves, P. C., & Acevedo, P. (2024). Effect of Myxoma Virus Species Jump on Iberian Hare Populations. Emerging Infectious Diseases, 30(6), 1293-1296. https://doi.org/10.3201/eid3006.231280. |
Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil
Cetacean morbillivirus is an etiologic agent associated with strandings of live and dead cetacean species occurring sporadically or as epizootics worldwide. We report 2 cases of cetacean morbillivirus in humpback whales (Megaptera novaeangliae) in Brazil and describe the anatomopathological, immunohistochemical, and molecular characterization findings in the specimens.
EID | de Amorim DB, de Camargo LJ, Ribeiro PR, Budaszewski RF, Menegatt JO, Paz MC, et al. Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil. Emerg Infect Dis. 2024;30(6):1296-1298. https://doi.org/10.3201/eid3006.231769 |
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AMA | de Amorim DB, de Camargo LJ, Ribeiro PR, et al. Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil. Emerging Infectious Diseases. 2024;30(6):1296-1298. doi:10.3201/eid3006.231769. |
APA | de Amorim, D. B., de Camargo, L. J., Ribeiro, P. R., Budaszewski, R. F., Menegatt, J. O., Paz, M. C....Sonne, L. (2024). Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil. Emerging Infectious Diseases, 30(6), 1296-1298. https://doi.org/10.3201/eid3006.231769. |
Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China
We isolated severe fever with thrombocytopenia syndrome virus (SFTSV) from farmed minks in China, providing evidence of natural SFTSV infection in farmed minks. Our findings support the potential role of farmed minks in maintaining SFTSV and are helpful for the development of public health interventions to reduce human infection.
EID | Wang Y, Yang M, Zhou H, Quan C, Kang H. Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China. Emerg Infect Dis. 2024;30(6):1299-1301. https://doi.org/10.3201/eid3006.240283 |
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AMA | Wang Y, Yang M, Zhou H, et al. Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China. Emerging Infectious Diseases. 2024;30(6):1299-1301. doi:10.3201/eid3006.240283. |
APA | Wang, Y., Yang, M., Zhou, H., Quan, C., & Kang, H. (2024). Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China. Emerging Infectious Diseases, 30(6), 1299-1301. https://doi.org/10.3201/eid3006.240283. |
Letters
Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA
EID | See I, Jackson KA, Byram R, Toney N, Grigg C, Magill SS. Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA. Emerg Infect Dis. 2024;30(6):1302. https://doi.org/10.3201/eid3006.240431 |
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AMA | See I, Jackson KA, Byram R, et al. Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA. Emerging Infectious Diseases. 2024;30(6):1302. doi:10.3201/eid3006.240431. |
APA | See, I., Jackson, K. A., Byram, R., Toney, N., Grigg, C., & Magill, S. S. (2024). Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA. Emerging Infectious Diseases, 30(6), 1302. https://doi.org/10.3201/eid3006.240431. |
Books and Media
Antimicrobial Stewardship in Non-Traditional Settings
EID | Hashem N, Yek C. Antimicrobial Stewardship in Non-Traditional Settings. Emerg Infect Dis. 2024;30(6):1303. https://doi.org/10.3201/eid3006.240255 |
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AMA | Hashem N, Yek C. Antimicrobial Stewardship in Non-Traditional Settings. Emerging Infectious Diseases. 2024;30(6):1303. doi:10.3201/eid3006.240255. |
APA | Hashem, N., & Yek, C. (2024). Antimicrobial Stewardship in Non-Traditional Settings. Emerging Infectious Diseases, 30(6), 1303. https://doi.org/10.3201/eid3006.240255. |
About the Cover
Architecture that Might Have Contributed to Disease Prevention
EID | Chorba T. Architecture that Might Have Contributed to Disease Prevention. Emerg Infect Dis. 2024;30(6):1304-1306. https://doi.org/10.3201/eid3006.ac3006 |
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AMA | Chorba T. Architecture that Might Have Contributed to Disease Prevention. Emerging Infectious Diseases. 2024;30(6):1304-1306. doi:10.3201/eid3006.ac3006. |
APA | Chorba, T. (2024). Architecture that Might Have Contributed to Disease Prevention. Emerging Infectious Diseases, 30(6), 1304-1306. https://doi.org/10.3201/eid3006.ac3006. |
News and Notes
Notice to Readers: New Article Category for Letters from the Emerging Infections Network
EID | Notice to Readers: New Article Category for Letters from the Emerging Infections Network. Emerg Infect Dis. 2024;30(6):1-3. https://doi.org/10.3201/eid3006.nn3006 |
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AMA | Notice to Readers: New Article Category for Letters from the Emerging Infections Network. Emerging Infectious Diseases. 2024;30(6):1-3. doi:10.3201/eid3006.nn3006. |
APA | (2024). Notice to Readers: New Article Category for Letters from the Emerging Infections Network. Emerging Infectious Diseases, 30(6), 1-3. https://doi.org/10.3201/eid3006.nn3006. |