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Articles from Emerging Infectious Diseases

Synopses

Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India [PDF - 1.66 MB - 8 pages]
S. Joshi et al.

We provide an overview of the epidemiology and clinical course of mucormycosis in the coronavirus disease (COVID-19) pandemic era. We conducted a retrospective chart review of 178 patients with clinical or diagnostic, endoscopically or histopathologically confirmed rhino-sino-orbital or cerebral mucormycosis after COVID-19 treatment during the second wave of COVID-19 in Pune, India. Median time to symptom onset from COVID-19 detection was 28 days. Moderate or severe COVID-19 was seen in 73% of patients and diabetes in 74.2%. A total of 52.8% received steroids. Eschar over or inside the nose was seen in 75%, but baseline clinical and laboratory parameters were mostly unremarkable. Bone penetration was present in ≈90% of cases, 30% had soft-tissue swelling of the pterygopalatine fossa and 7% had cavernous sinus thrombosis, and 60% had multifocal mucormycosis. Of the 178 study cases, 151 (85%) underwent surgical debridement. Twenty-six (15%) died, and 16 (62%) of those had multifocal mucormycosis.

EID Joshi S, Telang R, Tambe M, Havaldar R, Sane M, Shaikh A, et al. Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India. Emerg Infect Dis. 2022;28(1):1-8. https://doi.org/10.3201/eid2801.211636
AMA Joshi S, Telang R, Tambe M, et al. Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India. Emerging Infectious Diseases. 2022;28(1):1-8. doi:10.3201/eid2801.211636.
APA Joshi, S., Telang, R., Tambe, M., Havaldar, R., Sane, M., Shaikh, A....Mave, V. (2022). Outbreak of Mucormycosis in Coronavirus Disease Patients, Pune, India. Emerging Infectious Diseases, 28(1), 1-8. https://doi.org/10.3201/eid2801.211636.

Severe Acute Respiratory Syndrome Coronavirus 2 and Respiratory Virus Sentinel Surveillance, California, USA, May 10, 2020–June 12, 2021 [PDF - 2.21 MB - 11 pages]
G. Cooksey et al.

State and local health departments established the California Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Respiratory Virus Sentinel Surveillance System to conduct enhanced surveillance for SARS-CoV-2 and other respiratory pathogens at sentinel outpatient testing sites in 10 counties throughout California, USA. We describe results obtained during May 10, 2020‒June 12, 2021, and compare persons with positive and negative SARS-CoV-2 PCR results by using Poisson regression. We detected SARS-CoV-2 in 1,696 (19.6%) of 8,662 specimens. Among 7,851 specimens tested by respiratory panel, rhinovirus/enterovirus was detected in 906 (11.5%) specimens and other respiratory pathogens in 136 (1.7%) specimens. We also detected 23 co-infections with SARS-CoV-2 and another pathogen. SARS-CoV-2 positivity was associated with male participants, an age of 35–49 years, Latino race/ethnicity, obesity, and work in transportation occupations. Sentinel surveillance can provide useful virologic and epidemiologic data to supplement other disease monitoring activities and might become increasingly useful as routine testing decreases.

EID Cooksey G, Morales C, Linde L, Schildhauer S, Guevara H, Chan E, et al. Severe Acute Respiratory Syndrome Coronavirus 2 and Respiratory Virus Sentinel Surveillance, California, USA, May 10, 2020–June 12, 2021. Emerg Infect Dis. 2022;28(1):9-19. https://doi.org/10.3201/eid2801.211682
AMA Cooksey G, Morales C, Linde L, et al. Severe Acute Respiratory Syndrome Coronavirus 2 and Respiratory Virus Sentinel Surveillance, California, USA, May 10, 2020–June 12, 2021. Emerging Infectious Diseases. 2022;28(1):9-19. doi:10.3201/eid2801.211682.
APA Cooksey, G., Morales, C., Linde, L., Schildhauer, S., Guevara, H., Chan, E....Jain, S. (2022). Severe Acute Respiratory Syndrome Coronavirus 2 and Respiratory Virus Sentinel Surveillance, California, USA, May 10, 2020–June 12, 2021. Emerging Infectious Diseases, 28(1), 9-19. https://doi.org/10.3201/eid2801.211682.

Medscape CME Activity
Using the Acute Flaccid Paralysis Surveillance System to Identify Cases of Acute Flaccid Myelitis, Australia, 2000‒2018 [PDF - 1.54 MB - 9 pages]
L. J. Walker et al.

Since 2012, the United States has reported a distinct syndrome of acute flaccid paralysis (AFP) with anterior myelitis, predominantly in children. This polio-like syndrome was termed acute flaccid myelitis (AFM). Australia routinely conducts AFP surveillance to exclude poliomyelitis. We reviewed 915 AFP cases in Australia for children <15 years of age during 2000‒2018 and reclassified a subset to AFM by using the US Council of State and Territorial Epidemiologists case definition. We confirmed 37 AFM cases by using magnetic resonance imaging findings and 4 probable AFM cases on the basis of cerebrospinal fluid pleocytosis. Nonpolio enteroviruses were detected in 33% of AFM cases from which stool samples were tested. Average annual AFM incidence was 0.07 cases/100,000 person-years in children <15 years of age. AFM occurred sporadically in Australia before 2010 but regularly since then, indicating sustained, albeit rare, clinical manifestation in children. The AFP surveillance system in Australia is well-positioned to identify future AFM cases.

EID Walker LJ, Thorley BR, Morris A, Elliott EJ, Saul N, Britton PN. Using the Acute Flaccid Paralysis Surveillance System to Identify Cases of Acute Flaccid Myelitis, Australia, 2000‒2018. Emerg Infect Dis. 2022;28(1):20-28. https://doi.org/10.3201/eid2801.211690
AMA Walker LJ, Thorley BR, Morris A, et al. Using the Acute Flaccid Paralysis Surveillance System to Identify Cases of Acute Flaccid Myelitis, Australia, 2000‒2018. Emerging Infectious Diseases. 2022;28(1):20-28. doi:10.3201/eid2801.211690.
APA Walker, L. J., Thorley, B. R., Morris, A., Elliott, E. J., Saul, N., & Britton, P. N. (2022). Using the Acute Flaccid Paralysis Surveillance System to Identify Cases of Acute Flaccid Myelitis, Australia, 2000‒2018. Emerging Infectious Diseases, 28(1), 20-28. https://doi.org/10.3201/eid2801.211690.

Medscape CME Activity
Fungal Infections Caused by Kazachstania spp., Strasbourg, France, 2007–2020 [PDF - 1.83 MB - 6 pages]
C. Kaeuffer et al.

Rare fungal pathogens are emerging as agents of invasive fungal infections. We analyzed 13 cases of fungal infections caused by Kazachstania (Arxiozyma) spp. in Strasbourg University Hospital, Strasbourg, France. Among the cases, 4 patients had proven fungal disease (3 cases of invasive fungal disease and 1 mucocutaneous infection) and 9 were colonized by Kazachstania (Arxiozyma) spp. Candida albicans was also isolated from 11 of the 13 patients. None of the patients with proven invasive fungal disease met host criteria, but most had underlying diseases. All strains were identified as K. telluris by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and 3 were confirmed as K. bovina by internal transcribed spacer sequencing. For all tested strains, the MICs for fluconazole were >2 μg/mL. Emergence of this rare fungal infection might be explained by the increasing number of patients with immunocompromised conditions and gastroesophageal diseases.

EID Kaeuffer C, Baldacini M, Ruge T, Ruch Y, Zhu Y, De Cian M, et al. Fungal Infections Caused by Kazachstania spp., Strasbourg, France, 2007–2020. Emerg Infect Dis. 2022;28(1):29-34. https://doi.org/10.3201/eid2801.211543
AMA Kaeuffer C, Baldacini M, Ruge T, et al. Fungal Infections Caused by Kazachstania spp., Strasbourg, France, 2007–2020. Emerging Infectious Diseases. 2022;28(1):29-34. doi:10.3201/eid2801.211543.
APA Kaeuffer, C., Baldacini, M., Ruge, T., Ruch, Y., Zhu, Y., De Cian, M....Danion, F. (2022). Fungal Infections Caused by Kazachstania spp., Strasbourg, France, 2007–2020. Emerging Infectious Diseases, 28(1), 29-34. https://doi.org/10.3201/eid2801.211543.

Multistate Outbreak of SARS-CoV-2 Infections, Including Vaccine Breakthrough Infections, Associated with Large Public Gatherings, United States [PDF - 1.82 MB - 9 pages]
R. Gharpure et al.

During July 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.617.2 variant infections, including vaccine breakthrough infections, occurred after large public gatherings in Provincetown, Massachusetts, USA, prompting a multistate investigation. Public health departments identified primary and secondary cases by using coronavirus disease surveillance data, case investigations, and contact tracing. A primary case was defined as SARS-CoV-2 detected <14 days after travel to or residence in Provincetown during July 3–17. A secondary case was defined as SARS-CoV-2 detected <14 days after close contact with a person who had a primary case but without travel to or residence in Provincetown during July 3–August 10. We identified 1,098 primary cases and 30 secondary cases associated with 26 primary cases among fully and non–fully vaccinated persons. Large gatherings can have widespread effects on SARS-CoV-2 transmission, and fully vaccinated persons should take precautions, such as masking, to prevent SARS-CoV-2 transmission, particularly during substantial or high transmission.

EID Gharpure R, Sami S, Vostok J, Johnson H, Hall N, Foreman A, et al. Multistate Outbreak of SARS-CoV-2 Infections, Including Vaccine Breakthrough Infections, Associated with Large Public Gatherings, United States. Emerg Infect Dis. 2022;28(1):35-43. https://doi.org/10.3201/eid2801.212220
AMA Gharpure R, Sami S, Vostok J, et al. Multistate Outbreak of SARS-CoV-2 Infections, Including Vaccine Breakthrough Infections, Associated with Large Public Gatherings, United States. Emerging Infectious Diseases. 2022;28(1):35-43. doi:10.3201/eid2801.212220.
APA Gharpure, R., Sami, S., Vostok, J., Johnson, H., Hall, N., Foreman, A....Laney, A. (2022). Multistate Outbreak of SARS-CoV-2 Infections, Including Vaccine Breakthrough Infections, Associated with Large Public Gatherings, United States. Emerging Infectious Diseases, 28(1), 35-43. https://doi.org/10.3201/eid2801.212220.

Potential Association of Legionnaires’ Disease with Hot Spring Water, Hot Springs National Park and Hot Springs, Arkansas, USA, 2018–2019 [PDF - 1.47 MB - 7 pages]
A. E. James et al.

Legionella pneumophila is the cause of Legionnaires’ disease, a life-threatening pneumonia that occurs after inhalation of aerosolized water containing the bacteria. Legionella growth occurs in stagnant, warm-to-hot water (77°F–113°F) that is inadequately disinfected. Piped hot spring water in Hot Springs National Park, Arkansas, USA, has naturally high temperatures (>135°F) that prevent Legionella growth, and Legionnaires’ disease has not previously been associated with the park or other hot springs in the United States. During 2018–2019, Legionnaires’ disease occurred in 5 persons after they visited the park; 3 of these persons were potentially exposed in spa facilities that used untreated hot spring water. Environmental testing revealed Legionella bacteria in piped spring water, including 134°F stagnant pipe water. These findings underscore the importance of water management programs to reduce Legionella growth in plumbing through control activities such as maintaining hot water temperatures, reducing stored water age, and ensuring adequate water flow.

EID James AE, Kesteloot K, Paul J, McMullen RL, Louie S, Waters C, et al. Potential Association of Legionnaires’ Disease with Hot Spring Water, Hot Springs National Park and Hot Springs, Arkansas, USA, 2018–2019. Emerg Infect Dis. 2022;28(1):44-50. https://doi.org/10.3201/eid2801.211090
AMA James AE, Kesteloot K, Paul J, et al. Potential Association of Legionnaires’ Disease with Hot Spring Water, Hot Springs National Park and Hot Springs, Arkansas, USA, 2018–2019. Emerging Infectious Diseases. 2022;28(1):44-50. doi:10.3201/eid2801.211090.
APA James, A. E., Kesteloot, K., Paul, J., McMullen, R. L., Louie, S., Waters, C....Said, M. A. (2022). Potential Association of Legionnaires’ Disease with Hot Spring Water, Hot Springs National Park and Hot Springs, Arkansas, USA, 2018–2019. Emerging Infectious Diseases, 28(1), 44-50. https://doi.org/10.3201/eid2801.211090.

Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018–2019 [PDF - 2.72 MB - 11 pages]
I. Kracalik et al.

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) producing the Verona integron‒encoded metallo-β-lactamase (VIM) are highly antimicrobial drug-resistant pathogens that are uncommon in the United States. We investigated the source of VIM-CRPA among US medical tourists who underwent bariatric surgery in Tijuana, Mexico. Cases were defined as isolation of VIM-CRPA or CRPA from a patient who had an elective invasive medical procedure in Mexico during January 2018‒December 2019 and within 45 days before specimen collection. Whole-genome sequencing of isolates was performed. Thirty-eight case-patients were identified in 18 states; 31 were operated on by surgeon 1, most frequently at facility A (27/31 patients). Whole-genome sequencing identified isolates linked to surgeon 1 were closely related and distinct from isolates linked to other surgeons in Tijuana. Facility A closed in March 2019. US patients and providers should acknowledge the risk for colonization or infection after medical tourism with highly drug-resistant pathogens uncommon in the United States.

EID Kracalik I, Ham D, McAllister G, Smith AR, Vowles M, Kauber K, et al. Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018–2019. Emerg Infect Dis. 2022;28(1):51-61. https://doi.org/10.3201/eid2801.211880
AMA Kracalik I, Ham D, McAllister G, et al. Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018–2019. Emerging Infectious Diseases. 2022;28(1):51-61. doi:10.3201/eid2801.211880.
APA Kracalik, I., Ham, D., McAllister, G., Smith, A. R., Vowles, M., Kauber, K....Walters, M. (2022). Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018–2019. Emerging Infectious Diseases, 28(1), 51-61. https://doi.org/10.3201/eid2801.211880.
Research

Effects of Nonpharmaceutical COVID-19 Interventions on Pediatric Hospitalizations for Other Respiratory Virus Infections, Hong Kong [PDF - 2.27 MB - 7 pages]
S. S. Chiu et al.

To determine the effects of nonpharmaceutical interventions (NPIs) for coronavirus disease on pediatric hospitalizations for infection with respiratory viruses other than severe acute respiratory syndrome coronavirus 2, we analyzed hospital data for 2017–2021. Compared with 2017–2019, age-specific hospitalization rates associated with respiratory viruses greatly decreased in 2020, when NPIs were in place. Also when NPIs were in place, rates of hospitalization decreased among children of all ages for infection with influenza A and B viruses, respiratory syncytial virus, adenovirus, parainfluenza viruses, human metapneumovirus, and rhinovirus/enterovirus. Regression models adjusted for age and seasonality indicated that hospitalization rates for acute febrile illness/respiratory symptoms of any cause were reduced by 76% and by 85%–99% for hospitalization for infection with these viruses. NPIs in Hong Kong were clearly associated with reduced pediatric hospitalizations for respiratory viruses; implementing NPIs and reopening schools were associated with only a small increase in hospitalizations for rhinovirus/enterovirus infections.

EID Chiu SS, Cowling BJ, Peiris J, Chan E, Wong W, Lee K. Effects of Nonpharmaceutical COVID-19 Interventions on Pediatric Hospitalizations for Other Respiratory Virus Infections, Hong Kong. Emerg Infect Dis. 2022;28(1):62-68. https://doi.org/10.3201/eid2801.211099
AMA Chiu SS, Cowling BJ, Peiris J, et al. Effects of Nonpharmaceutical COVID-19 Interventions on Pediatric Hospitalizations for Other Respiratory Virus Infections, Hong Kong. Emerging Infectious Diseases. 2022;28(1):62-68. doi:10.3201/eid2801.211099.
APA Chiu, S. S., Cowling, B. J., Peiris, J., Chan, E., Wong, W., & Lee, K. (2022). Effects of Nonpharmaceutical COVID-19 Interventions on Pediatric Hospitalizations for Other Respiratory Virus Infections, Hong Kong. Emerging Infectious Diseases, 28(1), 62-68. https://doi.org/10.3201/eid2801.211099.

Mask Effectiveness for Preventing Secondary Cases of COVID-19, Johnson County, Iowa, USA [PDF - 1.16 MB - 7 pages]
J. Riley et al.

In September of 2020, the Iowa Department of Public Health released guidance stating that persons exposed to someone with coronavirus disease (COVID-19) need not quarantine if the case-patient and the contact wore face masks at the time of exposure. This guidance differed from that issued by the Centers for Disease Control and Prevention. To determine the best action, we matched exposure information from COVID-19 case investigations with reported test results and calculated the secondary attack rates (SARs) after masked and unmasked exposures. Mask use by both parties reduced the SAR by half, from 25.6% to 12.5%. Longer exposure duration significantly increased SARs. Masks significantly reduced virus transmission when worn by both the case-patient and the contact, but SARs for each group were higher than anticipated. This finding suggests that quarantine after COVID-19 exposure is beneficial even if parties wore masks.

EID Riley J, Huntley JM, Miller JA, Slaichert A, Brown GD. Mask Effectiveness for Preventing Secondary Cases of COVID-19, Johnson County, Iowa, USA. Emerg Infect Dis. 2022;28(1):69-75. https://doi.org/10.3201/eid2801.211591
AMA Riley J, Huntley JM, Miller JA, et al. Mask Effectiveness for Preventing Secondary Cases of COVID-19, Johnson County, Iowa, USA. Emerging Infectious Diseases. 2022;28(1):69-75. doi:10.3201/eid2801.211591.
APA Riley, J., Huntley, J. M., Miller, J. A., Slaichert, A., & Brown, G. D. (2022). Mask Effectiveness for Preventing Secondary Cases of COVID-19, Johnson County, Iowa, USA. Emerging Infectious Diseases, 28(1), 69-75. https://doi.org/10.3201/eid2801.211591.

Transmission Dynamics of Large Coronavirus Disease Outbreak in Homeless Shelter, Chicago, Illinois, USA, 2020 [PDF - 2.14 MB - 9 pages]
Y. Chang et al.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential for rapid transmission in congregate settings. We describe the multidisciplinary response to an outbreak of coronavirus disease (COVID-19) in a large homeless shelter in Chicago, Illinois, USA. The response to the outbreak included 4 rounds of mass PCR testing of all staff and residents and subsequent isolation of persons who tested positive for SARS-CoV-2. We further describe the dynamics of the shelter outbreak by fitting a modified susceptible-exposed-infectious-recovered compartmental model incorporating the widespread SARS-CoV-2 testing and isolation measures implemented in this shelter. Our model demonstrates that rapid transmission of COVID-19 in the shelter occurred before the outbreak was detected; rates of transmission declined after widespread testing and isolation measures were put in place. Overall, we demonstrate the feasibility of mass PCR testing and isolation in congregate settings and suggest the necessity of prompt response to suspected COVID-19 outbreaks in homeless shelters.

EID Chang Y, Mayer S, Davis ES, Figueroa E, Leo P, Finn PW, et al. Transmission Dynamics of Large Coronavirus Disease Outbreak in Homeless Shelter, Chicago, Illinois, USA, 2020. Emerg Infect Dis. 2022;28(1):76-84. https://doi.org/10.3201/eid2801.210780
AMA Chang Y, Mayer S, Davis ES, et al. Transmission Dynamics of Large Coronavirus Disease Outbreak in Homeless Shelter, Chicago, Illinois, USA, 2020. Emerging Infectious Diseases. 2022;28(1):76-84. doi:10.3201/eid2801.210780.
APA Chang, Y., Mayer, S., Davis, E. S., Figueroa, E., Leo, P., Finn, P. W....Perkins, D. L. (2022). Transmission Dynamics of Large Coronavirus Disease Outbreak in Homeless Shelter, Chicago, Illinois, USA, 2020. Emerging Infectious Diseases, 28(1), 76-84. https://doi.org/10.3201/eid2801.210780.

Systematic Genomic and Clinical Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections and Recurrences Involving the Same Strain [PDF - 1.88 MB - 10 pages]
C. Rodríguez-Grande et al.

Estimates of the burden of severe acute respiratory syndrome coronavirus 2 reinfections are limited by the scarcity of population-level studies incorporating genomic support. We conducted a systematic study of reinfections in Madrid, Spain, supported by genomic viral analysis and host genetic analysis, to cleanse laboratory errors and to discriminate between reinfections and recurrences involving the same strain. Among the 41,195 cases diagnosed (March 2020–March 2021), 93 (0.23%) had 2 positive reverse transcription PCR tests (55–346 days apart). After eliminating cases with specimens not stored, of suboptimal sequence quality, or belonging to different persons, we obtained valid data from 22 cases. Of those, 4 (0.01%) cases were recurrences involving the same strain; case-patients were 39–93 years of age, and 3 were immunosuppressed. Eighteen (0.04%) cases were reinfections; patients were 19–84 years of age, and most had no relevant clinical history. The second episode was more severe in 8 cases.

EID Rodríguez-Grande C, Alcalá L, Estévez A, Sola-Campoy PJ, Buenestado-Serrano S, Martínez-Laperche C, et al. Systematic Genomic and Clinical Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections and Recurrences Involving the Same Strain. Emerg Infect Dis. 2022;28(1):85-94. https://doi.org/10.3201/eid2801.211952
AMA Rodríguez-Grande C, Alcalá L, Estévez A, et al. Systematic Genomic and Clinical Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections and Recurrences Involving the Same Strain. Emerging Infectious Diseases. 2022;28(1):85-94. doi:10.3201/eid2801.211952.
APA Rodríguez-Grande, C., Alcalá, L., Estévez, A., Sola-Campoy, P. J., Buenestado-Serrano, S., Martínez-Laperche, C....de Viedma, D. (2022). Systematic Genomic and Clinical Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfections and Recurrences Involving the Same Strain. Emerging Infectious Diseases, 28(1), 85-94. https://doi.org/10.3201/eid2801.211952.

Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May–December 2020 [PDF - 2.35 MB - 9 pages]
N. Chea et al.

To determine risk factors for coronavirus disease (COVID-19) among US healthcare personnel (HCP), we conducted a case–control analysis. We collected data about activities outside the workplace and COVID-19 patient care activities from HCP with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test results (cases) and from HCP with negative test results (controls) in healthcare facilities in 5 US states. We used conditional logistic regression to calculate adjusted matched odds ratios and 95% CIs for exposures. Among 345 cases and 622 controls, factors associated with risk were having close contact with persons with COVID-19 outside the workplace, having close contact with COVID-19 patients in the workplace, and assisting COVID-19 patients with activities of daily living. Protecting HCP from COVID-19 may require interventions that reduce their exposures outside the workplace and improve their ability to more safely assist COVID-19 patients with activities of daily living.

EID Chea N, Brown CJ, Eure T, Ramirez R, Blazek G, Penna AR, et al. Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May–December 2020. Emerg Infect Dis. 2022;28(1):95-103. https://doi.org/10.3201/eid2801.211803
AMA Chea N, Brown CJ, Eure T, et al. Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May–December 2020. Emerging Infectious Diseases. 2022;28(1):95-103. doi:10.3201/eid2801.211803.
APA Chea, N., Brown, C. J., Eure, T., Ramirez, R., Blazek, G., Penna, A. R....Grigg, C. T. (2022). Risk Factors for SARS-CoV-2 Infection Among US Healthcare Personnel, May–December 2020. Emerging Infectious Diseases, 28(1), 95-103. https://doi.org/10.3201/eid2801.211803.

High-Level Quinolone-Resistant Haemophilus haemolyticus in Pediatric Patient with No History of Quinolone Exposure [PDF - 1.66 MB - 7 pages]
E. Tanaka et al.

The prevalence of antimicrobial resistance among Haemophilus spp. is a critical concern, but high-level quinolone-resistant strains had not been isolated from children. We isolated high-level quinolone-resistant H. haemolyticus from the suction sputum of a 9-year-old patient. The patient had received home medical care with mechanical ventilation for 2 years and had not been exposed to any quinolones for >3 years. The H. haemolyticus strain we isolated, 2019-19, shared biochemical features with H. influenzae. However, whole-genome analysis found this strain was closer to H. haemolyticus. Phylogenetic and mass spectrometry analyses indicated that strain 2019-19 was in the same cluster as H. haemolyticus. Comparison of quinolone resistance–determining regions showed strain 2019-19 possessed various amino acid substitutions, including those associated with quinolone resistance. This report highlights the existence of high-level quinolone-resistant Haemophilus species that have been isolated from both adults and children.

EID Tanaka E, Hirai Y, Wajima T, Ishida Y, Kawamura Y, Nakaminami H. High-Level Quinolone-Resistant Haemophilus haemolyticus in Pediatric Patient with No History of Quinolone Exposure. Emerg Infect Dis. 2022;28(1):104-110. https://doi.org/10.3201/eid2801.210248
AMA Tanaka E, Hirai Y, Wajima T, et al. High-Level Quinolone-Resistant Haemophilus haemolyticus in Pediatric Patient with No History of Quinolone Exposure. Emerging Infectious Diseases. 2022;28(1):104-110. doi:10.3201/eid2801.210248.
APA Tanaka, E., Hirai, Y., Wajima, T., Ishida, Y., Kawamura, Y., & Nakaminami, H. (2022). High-Level Quinolone-Resistant Haemophilus haemolyticus in Pediatric Patient with No History of Quinolone Exposure. Emerging Infectious Diseases, 28(1), 104-110. https://doi.org/10.3201/eid2801.210248.

Global Genome Diversity and Recombination in Mycoplasma pneumoniae [PDF - 1.14 MB - 7 pages]
Y. Hsieh et al.

Genomic changes in Mycoplasma pneumoniae caused by adaptation to environmental or ecologic pressures are poorly understood. We collected M. pneumoniae from children who had confirmed pneumonia in Taiwan during 2017–2020. We used whole-genome sequencing to compare these isolates with a worldwide collection of current and historical clinical strains for characterizing population structures. A phylogenetic tree for 284 strains showed that all sequenced strains consisted of 5 clades: T1–1 (sequence type [ST]1), T1–2 (mainly ST3), T1–3 (ST17), T2–1 (mainly ST2), and T2–2 (mainly ST14). We identified a putative recombination block containing 6 genes (MPN366‒371). Macrolide resistance involving 23S rRNA mutations was detected for each clade. Clonal expansion of macrolide resistance occurred mostly within subtype 1 strains, of which clade T1–2 showed the highest recombination rate and genome diversity. Functional characterization of recombined regions provided clarification of the biologic role of these recombination events in the evolution of M. pneumoniae.

EID Hsieh Y, Li S, Chen Y, Kuo C, Chen Y, Chang I, et al. Global Genome Diversity and Recombination in Mycoplasma pneumoniae. Emerg Infect Dis. 2022;28(1):111-117. https://doi.org/10.3201/eid2801.210497
AMA Hsieh Y, Li S, Chen Y, et al. Global Genome Diversity and Recombination in Mycoplasma pneumoniae. Emerging Infectious Diseases. 2022;28(1):111-117. doi:10.3201/eid2801.210497.
APA Hsieh, Y., Li, S., Chen, Y., Kuo, C., Chen, Y., Chang, I....Liao, W. (2022). Global Genome Diversity and Recombination in Mycoplasma pneumoniae. Emerging Infectious Diseases, 28(1), 111-117. https://doi.org/10.3201/eid2801.210497.

Invasive Multidrug-Resistant emm93.0 Streptococcus pyogenes Strain Harboring a Novel Genomic Island, Israel, 2017–2019 [PDF - 2.52 MB - 9 pages]
M. Ron et al.

Invasive group A Streptococcus (iGAS) infections have increased in Israel since 2016 as successful lineages have emerged. We report the emergence and outbreak of a multidrug-resistant S. pyogenes emm93.0, sequence type 10, among iGAS infections in Israel since 2017. This type has been observed very rarely in other countries. During this period, emm93.0 was the cause of 116 infections in Israel and became the leading type during 2018. Most of the infections were from bacteremia (75%), and most patients were male (76%). We observed infections across Israel, mainly in adults. Of note, we observed multidrug resistance for clindamycin, tetracycline, and trimethoprim/sulfamethoxazole. Whole-genome sequencing confirmed clonality among geographically disseminated isolates. The local emm93.0 sequence type 10 clone contained a novel genomic island harboring the resistance genes lsa(E), lnu(B), and ant (6)-Ia aph(3′)-III. Further phenotypic and genomic studies are required to determine the prevalence of this resistance element in other iGAS types.

EID Ron M, Brosh-Nissimov T, Korenman Z, Treygerman O, Sagi O, Valinsky L, et al. Invasive Multidrug-Resistant emm93.0 Streptococcus pyogenes Strain Harboring a Novel Genomic Island, Israel, 2017–2019. Emerg Infect Dis. 2022;28(1):118-126. https://doi.org/10.3201/eid2801.210733
AMA Ron M, Brosh-Nissimov T, Korenman Z, et al. Invasive Multidrug-Resistant emm93.0 Streptococcus pyogenes Strain Harboring a Novel Genomic Island, Israel, 2017–2019. Emerging Infectious Diseases. 2022;28(1):118-126. doi:10.3201/eid2801.210733.
APA Ron, M., Brosh-Nissimov, T., Korenman, Z., Treygerman, O., Sagi, O., Valinsky, L....Rokney, A. (2022). Invasive Multidrug-Resistant emm93.0 Streptococcus pyogenes Strain Harboring a Novel Genomic Island, Israel, 2017–2019. Emerging Infectious Diseases, 28(1), 118-126. https://doi.org/10.3201/eid2801.210733.

Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe [PDF - 2.90 MB - 12 pages]
G. Hanquet et al.

We evaluated invasive pneumococcal disease (IPD) during 8 years of infant pneumococcal conjugate vaccine (PCV) programs using 10-valent (PCV10) and 13-valent (PCV13) vaccines in 10 countries in Europe. IPD incidence declined during 2011–2014 but increased during 2015–2018 in all age groups. From the 7-valent PCV period to 2018, IPD incidence declined by 42% in children <5 years of age, 32% in persons 5–64 years of age, and 7% in persons >65 years of age; non-PCV13 serotype incidence increased by 111%, 63%, and 84%, respectively, for these groups. Trends were similar in countries using PCV13 or PCV10, despite different serotype distribution. Serotypes included in the 15-valent PCV represented one third of cases and those in the 20-valent PCVs two thirds of cases in children <5 years of age and in persons >65 years of age in 2018. Non-PCV13 serotype increases reduced the overall effect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.

EID Hanquet G, Krizova P, Dalby T, Ladhani SN, Nuorti J, Danis K, et al. Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe. Emerg Infect Dis. 2022;28(1):137-138. https://doi.org/10.3201/eid2801.210734
AMA Hanquet G, Krizova P, Dalby T, et al. Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe. Emerging Infectious Diseases. 2022;28(1):137-138. doi:10.3201/eid2801.210734.
APA Hanquet, G., Krizova, P., Dalby, T., Ladhani, S. N., Nuorti, J., Danis, K....Savulescu, C. (2022). Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe. Emerging Infectious Diseases, 28(1), 137-138. https://doi.org/10.3201/eid2801.210734.

New Sequence Types and Antimicrobial Drug–Resistant Strains of Streptococcus suis in Diseased Pigs, Italy, 2017–2019 [PDF - 1.40 MB - 9 pages]
L. Cucco et al.

Streptococcus suis is a pathogen associated with severe diseases in pigs and humans. Human infections have a zoonotic origin in pigs. To assess circulating strains, we characterized the serotypes, sequence types, and antimicrobial susceptibility of 78 S. suis isolates from diseased farmed pigs in Italy during 2017–2019. Almost 60% of infections were caused by serotypes 1/2 and 9. All but 1 of the serotype 2 and 1/2 isolates were confined to a single cluster, and serotype 9 isolates were distributed along the phylogenetic tree. Besides sequence type (ST) 1, the serotype 2 cluster included ST7, which caused severe human infections in China in 1998 and 2005. A large proportion of serotype 9 isolates, assigned to ST123, were resistant to penicillin. The emergence of this clone threatens the successful treatment of S. suis infection. Characterizing S. suis isolates from pigs will promote earlier detection of emerging clones.

EID Cucco L, Paniccià M, Massacci F, Morelli A, Ancora M, Mangone I, et al. New Sequence Types and Antimicrobial Drug–Resistant Strains of Streptococcus suis in Diseased Pigs, Italy, 2017–2019. Emerg Infect Dis. 2022;28(1):139-147. https://doi.org/10.3201/eid2801.210816
AMA Cucco L, Paniccià M, Massacci F, et al. New Sequence Types and Antimicrobial Drug–Resistant Strains of Streptococcus suis in Diseased Pigs, Italy, 2017–2019. Emerging Infectious Diseases. 2022;28(1):139-147. doi:10.3201/eid2801.210816.
APA Cucco, L., Paniccià, M., Massacci, F., Morelli, A., Ancora, M., Mangone, I....Magistrali, C. (2022). New Sequence Types and Antimicrobial Drug–Resistant Strains of Streptococcus suis in Diseased Pigs, Italy, 2017–2019. Emerging Infectious Diseases, 28(1), 139-147. https://doi.org/10.3201/eid2801.210816.

Coronavirus Disease Case Definitions, Diagnostic Testing Criteria, and Surveillance in 25 Countries with Highest Reported Case Counts [PDF - 824 KB - 9 pages]
A. B. Suthar et al.

We compared case definitions for suspected, probable, and confirmed coronavirus disease (COVID-19), as well as diagnostic testing criteria, used in the 25 countries with the highest reported case counts as of October 1, 2020. Of the identified countries, 56% followed World Health Organization (WHO) recommendations for using a combination of clinical and epidemiologic criteria as part of the suspected case definition. A total of 75% of identified countries followed WHO recommendations on using clinical, epidemiologic, and diagnostic criteria for probable cases; 72% followed WHO recommendations to use PCR testing to confirm COVID-19. Finally, 64% of countries used testing eligibility criteria at least as permissive as WHO. We observed marked heterogeneity in testing eligibility requirements and in how countries define a COVID-19 case. This heterogeneity affects the ability to compare case counts, transmission, and vaccine effectiveness, as well as estimates derived from case surveillance data across countries.

EID Suthar AB, Schubert S, Garon J, Couture A, Brown AM, Charania S. Coronavirus Disease Case Definitions, Diagnostic Testing Criteria, and Surveillance in 25 Countries with Highest Reported Case Counts. Emerg Infect Dis. 2022;28(1):148-156. https://doi.org/10.3201/eid2801.211082
AMA Suthar AB, Schubert S, Garon J, et al. Coronavirus Disease Case Definitions, Diagnostic Testing Criteria, and Surveillance in 25 Countries with Highest Reported Case Counts. Emerging Infectious Diseases. 2022;28(1):148-156. doi:10.3201/eid2801.211082.
APA Suthar, A. B., Schubert, S., Garon, J., Couture, A., Brown, A. M., & Charania, S. (2022). Coronavirus Disease Case Definitions, Diagnostic Testing Criteria, and Surveillance in 25 Countries with Highest Reported Case Counts. Emerging Infectious Diseases, 28(1), 148-156. https://doi.org/10.3201/eid2801.211082.

Effect of Hepatitis E Virus RNA Universal Blood Donor Screening, Catalonia, Spain, 2017‒2020 [PDF - 2.14 MB - 9 pages]
M. Bes et al.

Hepatitis E virus (HEV) is the major cause of acute viral hepatitis in several countries in Europe. HEV is acquired mainly by consumption of contaminated pork but can also be transmitted through blood transfusion. HEV infection is usually self-limited but can become persistent in immunocompromised persons. During the first 30 months of HEV RNA universal screening of blood donations in Catalonia, Spain, we identified 151 HEV RNA–positive donations (1/4,341 blood donations). Most infected donors reported consumption of pates and sausages, and 58% were negative for HEV IgM and IgG. All HEV isolates belonged to genotype 3. All infected donors spontaneously resolved the infection, and no neurologic symptoms and reinfections were observed after 1 year of follow-up. Since the implementation of HEV RNA universal screening, no new cases of transfusion-transmitted HEV infection were reported. Our data indicate HEV screening of blood donations provides safer blood for all recipients, especially for immunosuppressed persons.

EID Bes M, Costafreda MI, Riveiro-Barciela M, Piron M, Rico A, Quer J, et al. Effect of Hepatitis E Virus RNA Universal Blood Donor Screening, Catalonia, Spain, 2017‒2020. Emerg Infect Dis. 2022;28(1):157-165. https://doi.org/10.3201/eid2801.211466
AMA Bes M, Costafreda MI, Riveiro-Barciela M, et al. Effect of Hepatitis E Virus RNA Universal Blood Donor Screening, Catalonia, Spain, 2017‒2020. Emerging Infectious Diseases. 2022;28(1):157-165. doi:10.3201/eid2801.211466.
APA Bes, M., Costafreda, M. I., Riveiro-Barciela, M., Piron, M., Rico, A., Quer, J....Sauleda, S. (2022). Effect of Hepatitis E Virus RNA Universal Blood Donor Screening, Catalonia, Spain, 2017‒2020. Emerging Infectious Diseases, 28(1), 157-165. https://doi.org/10.3201/eid2801.211466.

Streptococcus pneumoniae Serotypes Associated with Death, South Africa, 2012–2018 [PDF - 2.64 MB - 14 pages]
A. Müller et al.

The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity. We assessed the association of serotype with case-fatality ratio (CFR) in invasive pneumococcal disease (IPD) and meningitis in South Africa, 2012–2018 (vaccine era), using multivariable logistic regression by manual backward elimination. The most common serotypes causing IPD were 8 and 19A. In patients <15 years of age, serotypes associated with increased CFR in IPD, compared with serotype 8 and controlling for confounding factors, were 11A, 13, 19F, 15A, and 6A. None of these serotypes were associated with increased CFR in meningitis. Among IPD patients >15 years of age, serotype 15B/C was associated with increased CFR. Among meningitis patients of all ages, serotype 1 was associated with increased CFR. PCV13 serotypes 1, 3, 6A, 19A, and 19F should be monitored, and serotypes 8, 12F, 15A, and 15B/C should be considered for inclusion in vaccines to reduce deaths caused by S. pneumoniae.

EID Müller A, Kleynhans J, de Gouveia L, Meiring S, Cohen C, Hathaway L, et al. Streptococcus pneumoniae Serotypes Associated with Death, South Africa, 2012–2018. Emerg Infect Dis. 2022;28(1):166-179. https://doi.org/10.3201/eid2801.210956
AMA Müller A, Kleynhans J, de Gouveia L, et al. Streptococcus pneumoniae Serotypes Associated with Death, South Africa, 2012–2018. Emerging Infectious Diseases. 2022;28(1):166-179. doi:10.3201/eid2801.210956.
APA Müller, A., Kleynhans, J., de Gouveia, L., Meiring, S., Cohen, C., Hathaway, L....von Gottberg, A. (2022). Streptococcus pneumoniae Serotypes Associated with Death, South Africa, 2012–2018. Emerging Infectious Diseases, 28(1), 166-179. https://doi.org/10.3201/eid2801.210956.

Effect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, São Paulo, Brazil [PDF - 2.30 MB - 8 pages]
M. L. Moura et al.

Although restricting over-the-counter (OTC) antimicrobial drug sales is recommended globally, no data track its effect on antimicrobial resistance (AMR) in bacteria. We evaluated the effect of a national policy restricting OTC antimicrobial sales, put in place in November 2010, on AMR in a metropolitan region of São Paulo, Brazil. We reviewed associations between antimicrobial sales from private pharmacies and AMR in 404,558 Escherichia coli and 5,797 Streptococcus pneumoniae isolates using a dynamic regression model based on a Bayesian approach. After policy implementation, a substantial drop in AMR in both bacterial species followed decreased amoxicillin and trimethoprim/sulfamethoxazole sales. Conversely, increased ciprofloxacin sales were associated with increased ciprofloxacin resistance, and extended spectrum β-lactamases–positive E. coli isolates and azithromycin sales increases after 2013 were associated with increased erythromycin resistance in S. pneumoniae isolates. These findings suggest that restricting OTC antimicrobial sales may influence patterns of AMR, but multifaceted approaches are needed to avoid unintended consequences.

EID Moura ML, Boszczowski I, Blaque M, Mussarelli RM, Fossaluza V, Pierrotti LC, et al. Effect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, São Paulo, Brazil. Emerg Infect Dis. 2022;28(1):180-187. https://doi.org/10.3201/eid2801.201928
AMA Moura ML, Boszczowski I, Blaque M, et al. Effect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, São Paulo, Brazil. Emerging Infectious Diseases. 2022;28(1):180-187. doi:10.3201/eid2801.201928.
APA Moura, M. L., Boszczowski, I., Blaque, M., Mussarelli, R. M., Fossaluza, V., Pierrotti, L. C....Levin, A. S. (2022). Effect on Antimicrobial Resistance of a Policy Restricting Over-the-Counter Antimicrobial Sales in a Large Metropolitan Area, São Paulo, Brazil. Emerging Infectious Diseases, 28(1), 180-187. https://doi.org/10.3201/eid2801.201928.
Dispatches

Coronavirus Disease Spread during Summer Vacation, Israel, 2020 [PDF - 1.23 MB - 4 pages]
I. Somekh et al.

The relative increase in coronavirus disease incidence during summer 2020 in Israel was most prominent in young children. This finding contrasts with the lower increase in incidence observed in children than in adults during the school attendance period. School closure without lockdown conditions might not be independently effective at reducing spread.

EID Somekh I, Simões EF, Somekh E. Coronavirus Disease Spread during Summer Vacation, Israel, 2020. Emerg Infect Dis. 2022;28(1):188-191. https://doi.org/10.3201/eid2801.210177
AMA Somekh I, Simões EF, Somekh E. Coronavirus Disease Spread during Summer Vacation, Israel, 2020. Emerging Infectious Diseases. 2022;28(1):188-191. doi:10.3201/eid2801.210177.
APA Somekh, I., Simões, E. F., & Somekh, E. (2022). Coronavirus Disease Spread during Summer Vacation, Israel, 2020. Emerging Infectious Diseases, 28(1), 188-191. https://doi.org/10.3201/eid2801.210177.

Streptococcus gallolyticus and Bacterial Endocarditis in Swine, United States, 2015–2020 [PDF - 1.39 MB - 4 pages]
P. Sitthicharoenchai et al.

To evaluate trends in bacterial causes of valvular endocarditis in swine, we retrospectively analyzed 321 cases diagnosed at Iowa State University Veterinary Diagnostic Laboratory (Ames, IA, USA) during May 2015–­April 2020. Streptococcus gallolyticus was the causative agent for 7.59% of cases. This emerging infection in swine could aid study of endocarditis in humans.

EID Sitthicharoenchai P, Burrough ER, Arruda BL, Sahin O, dos Santos JG, Magstadt DR, et al. Streptococcus gallolyticus and Bacterial Endocarditis in Swine, United States, 2015–2020. Emerg Infect Dis. 2022;28(1):192-195. https://doi.org/10.3201/eid2801.210998
AMA Sitthicharoenchai P, Burrough ER, Arruda BL, et al. Streptococcus gallolyticus and Bacterial Endocarditis in Swine, United States, 2015–2020. Emerging Infectious Diseases. 2022;28(1):192-195. doi:10.3201/eid2801.210998.
APA Sitthicharoenchai, P., Burrough, E. R., Arruda, B. L., Sahin, O., dos Santos, J. G., Magstadt, D. R....Rahe, M. C. (2022). Streptococcus gallolyticus and Bacterial Endocarditis in Swine, United States, 2015–2020. Emerging Infectious Diseases, 28(1), 192-195. https://doi.org/10.3201/eid2801.210998.

SARS-CoV-2 RNA Shedding in Semen and Oligozoospermia of Patient with Severe Coronavirus Disease 11 Weeks after Infection [PDF - 1.40 MB - 5 pages]
L. J. Purpura et al.

We report severe acute respiratory syndrome coronavirus 2 in semen by using quantitative reverse transcription PCR during the late convalescent phase. Virus was associated with adequate humoral and cell-mediated responses, suggesting possible seeding of the immune-privileged testes. We provide longitudinal semen quality data for 6 other men, including 3 who had oligozoospermia.

EID Purpura LJ, Alukal J, Chong AM, Liu L, Cantos A, Shah J, et al. SARS-CoV-2 RNA Shedding in Semen and Oligozoospermia of Patient with Severe Coronavirus Disease 11 Weeks after Infection. Emerg Infect Dis. 2022;28(1):196-200. https://doi.org/10.3201/eid2801.211521
AMA Purpura LJ, Alukal J, Chong AM, et al. SARS-CoV-2 RNA Shedding in Semen and Oligozoospermia of Patient with Severe Coronavirus Disease 11 Weeks after Infection. Emerging Infectious Diseases. 2022;28(1):196-200. doi:10.3201/eid2801.211521.
APA Purpura, L. J., Alukal, J., Chong, A. M., Liu, L., Cantos, A., Shah, J....Yin, M. T. (2022). SARS-CoV-2 RNA Shedding in Semen and Oligozoospermia of Patient with Severe Coronavirus Disease 11 Weeks after Infection. Emerging Infectious Diseases, 28(1), 196-200. https://doi.org/10.3201/eid2801.211521.

Melioidosis Manifesting as Chronic Femoral Osteomyelitis in Patient from Ghana [PDF - 1015 KB - 4 pages]
D. Mabayoje et al.

A 33-year-old man from Ghana who had diabetes had chronic osteomyelitis of the femoral shaft develop. Tissue samples from surgical debridement grew Burkholderia pseudomallei. He received meropenem, followed by oral trimethoprim/sulfamethoxazole and doxycycline, and fully recovered without complications. Our case report extends the range of countries in Africa as sources of culture-confirmed melioidosis.

EID Mabayoje D, Kenna D, Dance D, NicFhogartaigh C. Melioidosis Manifesting as Chronic Femoral Osteomyelitis in Patient from Ghana. Emerg Infect Dis. 2022;28(1):201-204. https://doi.org/10.3201/eid2801.211800
AMA Mabayoje D, Kenna D, Dance D, et al. Melioidosis Manifesting as Chronic Femoral Osteomyelitis in Patient from Ghana. Emerging Infectious Diseases. 2022;28(1):201-204. doi:10.3201/eid2801.211800.
APA Mabayoje, D., Kenna, D., Dance, D., & NicFhogartaigh, C. (2022). Melioidosis Manifesting as Chronic Femoral Osteomyelitis in Patient from Ghana. Emerging Infectious Diseases, 28(1), 201-204. https://doi.org/10.3201/eid2801.211800.

Emergence of SARS-CoV-2 Delta Variant, Benin, May–July 2021 [PDF - 2.02 MB - 5 pages]
A. Yadouleton et al.

Severe acute respiratory syndrome coronavirus 2 Delta variant epidemiology in Africa is unknown. We found Delta variant was introduced in Benin during April–May 2021 and became predominant within 2 months, after which a steep increase in reported coronavirus disease incidence occurred. Benin might require increased nonpharmaceutical interventions and vaccination coverage.

EID Yadouleton A, Sander A, Adewumi P, de Oliveira Filho EF, Tchibozo C, Hounkanrin G, et al. Emergence of SARS-CoV-2 Delta Variant, Benin, May–July 2021. Emerg Infect Dis. 2022;28(1):205-209. https://doi.org/10.3201/eid2801.211909
AMA Yadouleton A, Sander A, Adewumi P, et al. Emergence of SARS-CoV-2 Delta Variant, Benin, May–July 2021. Emerging Infectious Diseases. 2022;28(1):205-209. doi:10.3201/eid2801.211909.
APA Yadouleton, A., Sander, A., Adewumi, P., de Oliveira Filho, E. F., Tchibozo, C., Hounkanrin, G....Drexler, J. (2022). Emergence of SARS-CoV-2 Delta Variant, Benin, May–July 2021. Emerging Infectious Diseases, 28(1), 205-209. https://doi.org/10.3201/eid2801.211909.

Salmonella Serotypes Associated with Illnesses after Thanksgiving Holiday, United States, 1998–2018 [PDF - 935 KB - 4 pages]
F. A. Tobolowsky et al.

We sought to determine which Salmonella serotypes cause illness related to the Thanksgiving holiday in the United States and to foods disproportionately eaten then (e.g., turkey). Using routine surveillance for 1998–2018 and a case-crossover design, we found serotype Reading to be most strongly associated with Thanksgiving.

EID Tobolowsky FA, Cui Z, Hoekstra RM, Bruce BB. Salmonella Serotypes Associated with Illnesses after Thanksgiving Holiday, United States, 1998–2018. Emerg Infect Dis. 2022;28(1):210-213. https://doi.org/10.3201/eid2801.211986
AMA Tobolowsky FA, Cui Z, Hoekstra RM, et al. Salmonella Serotypes Associated with Illnesses after Thanksgiving Holiday, United States, 1998–2018. Emerging Infectious Diseases. 2022;28(1):210-213. doi:10.3201/eid2801.211986.
APA Tobolowsky, F. A., Cui, Z., Hoekstra, R. M., & Bruce, B. B. (2022). Salmonella Serotypes Associated with Illnesses after Thanksgiving Holiday, United States, 1998–2018. Emerging Infectious Diseases, 28(1), 210-213. https://doi.org/10.3201/eid2801.211986.

Use of Private Sector Workforce Respiratory Disease Short-Term Disability Claims to Assess SARS-CoV-2, Mexico, 2020 [PDF - 1.83 MB - 5 pages]
M. Hernandez-Avila et al.

We examined respiratory disease short-term disability claims submitted to the Mexican Social Security Institute during 2020. A total of 1,631,587 claims were submitted by 19.1 million insured workers. Cumulative incidence (8.5%) was 3.6 times higher than that for January 2015‒December-2019. Workers in healthcare, social assistance, self-service, and retail stores were disproportionately affected.

EID Hernandez-Avila M, Tamayo-Ortiz M, Vieyra-Romero W, Gutierrez-Diaz H, Zepeda-Tello R, Barros-Sierra D, et al. Use of Private Sector Workforce Respiratory Disease Short-Term Disability Claims to Assess SARS-CoV-2, Mexico, 2020. Emerg Infect Dis. 2022;28(1):214-218. https://doi.org/10.3201/eid2801.211357
AMA Hernandez-Avila M, Tamayo-Ortiz M, Vieyra-Romero W, et al. Use of Private Sector Workforce Respiratory Disease Short-Term Disability Claims to Assess SARS-CoV-2, Mexico, 2020. Emerging Infectious Diseases. 2022;28(1):214-218. doi:10.3201/eid2801.211357.
APA Hernandez-Avila, M., Tamayo-Ortiz, M., Vieyra-Romero, W., Gutierrez-Diaz, H., Zepeda-Tello, R., Barros-Sierra, D....Ortega-Alvarez, M. (2022). Use of Private Sector Workforce Respiratory Disease Short-Term Disability Claims to Assess SARS-CoV-2, Mexico, 2020. Emerging Infectious Diseases, 28(1), 214-218. https://doi.org/10.3201/eid2801.211357.

Transfusion-Transmitted Hepatitis A Virus, France, 2018 [PDF - 1.50 MB - 5 pages]
C. Lefeuvre et al.

We report a transfusion-transmitted hepatitis A virus infection in an immunocompromised patient in France, detected shortly after a transfusion of pathogen-reduced pooled platelets. This case raises questions about the efficacy of donor screening methods. Additional safety measures, such as routine donation screening, should be considered.

EID Lefeuvre C, Lefort C, Boyer F, Le Cam S, Mouna L, Roque-Afonso A, et al. Transfusion-Transmitted Hepatitis A Virus, France, 2018. Emerg Infect Dis. 2022;28(1):219-223. https://doi.org/10.3201/eid2801.210403
AMA Lefeuvre C, Lefort C, Boyer F, et al. Transfusion-Transmitted Hepatitis A Virus, France, 2018. Emerging Infectious Diseases. 2022;28(1):219-223. doi:10.3201/eid2801.210403.
APA Lefeuvre, C., Lefort, C., Boyer, F., Le Cam, S., Mouna, L., Roque-Afonso, A....Mahieu, R. (2022). Transfusion-Transmitted Hepatitis A Virus, France, 2018. Emerging Infectious Diseases, 28(1), 219-223. https://doi.org/10.3201/eid2801.210403.

Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France [PDF - 2.77 MB - 5 pages]
S. Dellière et al.

We describe 7 cases of extensive tinea corporis since 2018 in a hospital in Paris, France, after failure to cure with terbinafine. Molecular analysis indicated Trichophyton mentagrophytes internal transcribed spacer type VIII (T. indotineae). This strain, which has mutations in the squalene epoxidase gene, is spreading on the Indian subcontinent.

EID Dellière S, Joannard B, Benderdouche M, Mingui A, Gits-Muselli M, Hamane S, et al. Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France. Emerg Infect Dis. 2022;28(1):224-228. https://doi.org/10.3201/eid2801.210810
AMA Dellière S, Joannard B, Benderdouche M, et al. Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France. Emerging Infectious Diseases. 2022;28(1):224-228. doi:10.3201/eid2801.210810.
APA Dellière, S., Joannard, B., Benderdouche, M., Mingui, A., Gits-Muselli, M., Hamane, S....Bretagne, S. (2022). Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France. Emerging Infectious Diseases, 28(1), 224-228. https://doi.org/10.3201/eid2801.210810.

Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France [PDF - 2.40 MB - 5 pages]
A. Jabet et al.

Extensive dermatophytosis caused by terbinafine-resistant Trichophyton indotineae harboring Phe397Leu and Leu393Ser substitutions in the squalene epoxidase enzyme was diagnosed in France. Analysis of internal transcribed spacer sequences revealed the wide spread of this species in Asia and Europe. Detection of T. indotineae in animals suggests their possible role as reservoirs.

EID Jabet A, Brun S, Normand A, Imbert S, Akhoundi M, Dannaoui E, et al. Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France. Emerg Infect Dis. 2022;28(1):229-233. https://doi.org/10.3201/eid2801.210883
AMA Jabet A, Brun S, Normand A, et al. Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France. Emerging Infectious Diseases. 2022;28(1):229-233. doi:10.3201/eid2801.210883.
APA Jabet, A., Brun, S., Normand, A., Imbert, S., Akhoundi, M., Dannaoui, E....Sabater, A. (2022). Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France. Emerging Infectious Diseases, 28(1), 229-233. https://doi.org/10.3201/eid2801.210883.

Intercontinental Spread of Eurasian Highly Pathogenic Avian Influenza A(H5N1) to Senegal [PDF - 1.18 MB - 4 pages]
F. T. Lo et al.

In January 2021, Senegal reported the emergence of highly pathogenic avian influenza virus A(H5N1), which was detected on a poultry farm in Thies, Senegal, and in great white pelicans in the Djoudj National Bird Sanctuary. We report evidence of new transcontinental spread of H5N1 from Europe toward Africa.

EID Lo FT, Zecchin B, Diallo AA, Racky O, Tassoni L, Diop A, et al. Intercontinental Spread of Eurasian Highly Pathogenic Avian Influenza A(H5N1) to Senegal. Emerg Infect Dis. 2022;28(1):234-237. https://doi.org/10.3201/eid2801.211401
AMA Lo FT, Zecchin B, Diallo AA, et al. Intercontinental Spread of Eurasian Highly Pathogenic Avian Influenza A(H5N1) to Senegal. Emerging Infectious Diseases. 2022;28(1):234-237. doi:10.3201/eid2801.211401.
APA Lo, F. T., Zecchin, B., Diallo, A. A., Racky, O., Tassoni, L., Diop, A....Monne, I. (2022). Intercontinental Spread of Eurasian Highly Pathogenic Avian Influenza A(H5N1) to Senegal. Emerging Infectious Diseases, 28(1), 234-237. https://doi.org/10.3201/eid2801.211401.

Multistate Outbreak of Salmonella enterica Serovar Heidelberg with Unidentified Source, Australia, 2018–2019 [PDF - 931 KB - 4 pages]
E. J. Kerr et al.

We report a multistate Salmonella enterica serovar Heidelberg outbreak in Australia during 2018–2019. Laboratory investigation of cases reported across 5 jurisdictions over a 7-month period could not identify a source of infection but detected indicators of severity and invasiveness. The hospitalization rate of 36% suggested a moderately severe clinical picture.

EID Kerr EJ, Stafford R, Rathnayake IU, Graham R, Fearnley E, Gregory J, et al. Multistate Outbreak of Salmonella enterica Serovar Heidelberg with Unidentified Source, Australia, 2018–2019. Emerg Infect Dis. 2022;28(1):238-241. https://doi.org/10.3201/eid2801.211462
AMA Kerr EJ, Stafford R, Rathnayake IU, et al. Multistate Outbreak of Salmonella enterica Serovar Heidelberg with Unidentified Source, Australia, 2018–2019. Emerging Infectious Diseases. 2022;28(1):238-241. doi:10.3201/eid2801.211462.
APA Kerr, E. J., Stafford, R., Rathnayake, I. U., Graham, R., Fearnley, E., Gregory, J....Jennison, A. V. (2022). Multistate Outbreak of Salmonella enterica Serovar Heidelberg with Unidentified Source, Australia, 2018–2019. Emerging Infectious Diseases, 28(1), 238-241. https://doi.org/10.3201/eid2801.211462.

Public Acceptance of and Willingness to Pay for Mosquito Control, Texas, USA
K. L. Dickinson et al.

Mosquito control is essential to reduce vectorborne disease risk. We surveyed residents in Harris, Tarrant, and Hidalgo Counties, Texas, USA, to estimate willingness-to-pay for mosquito control and acceptance of control methods. Results show an unmet demand for expanded mosquito control that could be funded through local taxes or fees.

Research Letters

Low Seroprevalence among Undetected COVID-19 Cases, Faroe Islands, November 2020 [PDF - 713 KB - 3 pages]
M. Petersen et al.

We conducted a second nationwide severe acute respiratory syndrome coronavirus 2 seroprevalence study in the Faroe Islands during November 2020. We found crude seroprevalence was 0.3% and prevalence was 0.4% after adjusting for test sensitivity and specificity. This low seroprevalence supports the prevention strategies used in the Faroe Islands.

EID Petersen M, Strøm M, Fjallsbak J, Hansen J, Larsen S, Eliasen EH, et al. Low Seroprevalence among Undetected COVID-19 Cases, Faroe Islands, November 2020. Emerg Infect Dis. 2022;28(1):242-244. https://doi.org/10.3201/eid2801.210917
AMA Petersen M, Strøm M, Fjallsbak J, et al. Low Seroprevalence among Undetected COVID-19 Cases, Faroe Islands, November 2020. Emerging Infectious Diseases. 2022;28(1):242-244. doi:10.3201/eid2801.210917.
APA Petersen, M., Strøm, M., Fjallsbak, J., Hansen, J., Larsen, S., Eliasen, E. H....Weihe, P. (2022). Low Seroprevalence among Undetected COVID-19 Cases, Faroe Islands, November 2020. Emerging Infectious Diseases, 28(1), 242-244. https://doi.org/10.3201/eid2801.210917.

Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2–Associated Deaths [PDF - 1.24 MB - 4 pages]
F. Heinrich et al.

We investigated the infectivity of 128 severe acute respiratory disease coronavirus 2–associated deaths and evaluated predictive values of standard diagnostic procedures. Maintained infectivity (20%) did not correlate with viral RNA loads but correlated well with anti-S antibody levels. Sensitivity >90% for antigen-detecting rapid diagnostic tests supports their usefulness for assessment.

EID Heinrich F, Schröder A, Gerberding A, Gerling M, Langenwalder F, Lange P, et al. Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2–Associated Deaths. Emerg Infect Dis. 2022;28(1):244-247. https://doi.org/10.3201/eid2801.211749
AMA Heinrich F, Schröder A, Gerberding A, et al. Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2–Associated Deaths. Emerging Infectious Diseases. 2022;28(1):244-247. doi:10.3201/eid2801.211749.
APA Heinrich, F., Schröder, A., Gerberding, A., Gerling, M., Langenwalder, F., Lange, P....Lütgehetmann, M. (2022). Postmortem Antigen-Detecting Rapid Diagnostic Tests to Predict Infectivity of SARS-CoV-2–Associated Deaths. Emerging Infectious Diseases, 28(1), 244-247. https://doi.org/10.3201/eid2801.211749.

Monitoring International Travelers Arriving in Hong Kong for Genomic Surveillance of SARS-CoV-2 [PDF - 1.09 MB - 4 pages]
H. Gu et al.

We sequenced ≈50% of coronavirus disease cases imported to Hong Kong during March–July 2021 and identified 70 cases caused by Delta variants of severe acute respiratory syndrome coronavirus 2. The genomic diversity detected in Hong Kong was similar to global diversity, suggesting travel hubs can play a substantial role in surveillance.

EID Gu H, Cheng S, Krishnan P, Ng D, Chang L, Liu G, et al. Monitoring International Travelers Arriving in Hong Kong for Genomic Surveillance of SARS-CoV-2. Emerg Infect Dis. 2022;28(1):247-250. https://doi.org/10.3201/eid2801.211804
AMA Gu H, Cheng S, Krishnan P, et al. Monitoring International Travelers Arriving in Hong Kong for Genomic Surveillance of SARS-CoV-2. Emerging Infectious Diseases. 2022;28(1):247-250. doi:10.3201/eid2801.211804.
APA Gu, H., Cheng, S., Krishnan, P., Ng, D., Chang, L., Liu, G....Poon, L. (2022). Monitoring International Travelers Arriving in Hong Kong for Genomic Surveillance of SARS-CoV-2. Emerging Infectious Diseases, 28(1), 247-250. https://doi.org/10.3201/eid2801.211804.

Effectiveness of International Travel Controls for Delaying Local Outbreaks of COVID-19 [PDF - 2.64 MB - 3 pages]
B. Yang et al.

During the coronavirus disease pandemic, international travel controls have been widely adopted. To determine the effectiveness of these measures, we analyzed data from 165 countries and found that early implementation of international travel controls led to a mean delay of 5 weeks in the first epidemic peak of cases.

EID Yang B, Sullivan SG, Du Z, Tsang TK, Cowling BJ. Effectiveness of International Travel Controls for Delaying Local Outbreaks of COVID-19. Emerg Infect Dis. 2022;28(1):251-253. https://doi.org/10.3201/eid2801.211944
AMA Yang B, Sullivan SG, Du Z, et al. Effectiveness of International Travel Controls for Delaying Local Outbreaks of COVID-19. Emerging Infectious Diseases. 2022;28(1):251-253. doi:10.3201/eid2801.211944.
APA Yang, B., Sullivan, S. G., Du, Z., Tsang, T. K., & Cowling, B. J. (2022). Effectiveness of International Travel Controls for Delaying Local Outbreaks of COVID-19. Emerging Infectious Diseases, 28(1), 251-253. https://doi.org/10.3201/eid2801.211944.

Atezolizumab Treatment for Progressive Multifocal Leukoencephalopathy [PDF - 827 KB - 4 pages]
N. Lambert et al.

Atezolizumab successfully reinvigorated JC virus immunity in a patient in Belgium with progressive multifocal leukoencephalopathy, as demonstrated by clinical, virologic, and radiologic response to treatment. However, the treatment also resulted in immune reconstitution inflammatory syndrome and life-threatening immune-related adverse events. These conditions were treated with corticosteroids, leading to treatment resistance.

EID Lambert N, Dauby S, Dive D, Sadzot B, Maquet P. Atezolizumab Treatment for Progressive Multifocal Leukoencephalopathy. Emerg Infect Dis. 2022;28(1):253-256. https://doi.org/10.3201/eid2801.204809
AMA Lambert N, Dauby S, Dive D, et al. Atezolizumab Treatment for Progressive Multifocal Leukoencephalopathy. Emerging Infectious Diseases. 2022;28(1):253-256. doi:10.3201/eid2801.204809.
APA Lambert, N., Dauby, S., Dive, D., Sadzot, B., & Maquet, P. (2022). Atezolizumab Treatment for Progressive Multifocal Leukoencephalopathy. Emerging Infectious Diseases, 28(1), 253-256. https://doi.org/10.3201/eid2801.204809.

Unexpectedly High Prevalence of Hepatitis C Virus Infection, Southern Laos [PDF - 1.07 MB - 4 pages]
A. P. Black et al.

During 2017–2019, a total of 88/753 (11.7%) of patients 5–90 years of age in hospitals in Saravan Province, Laos, were seropositive for hepatitis C virus antibodies. Viral RNA was found in 44 samples. Sequencing showed high diversity within genotype 6. We recommend exposure-risk investigations and targeted testing and treatment.

EID Black AP, Khounvisith V, Xaydalasouk K, Sayasinh K, Sausy A, Muller CP, et al. Unexpectedly High Prevalence of Hepatitis C Virus Infection, Southern Laos. Emerg Infect Dis. 2022;28(1):256-259. https://doi.org/10.3201/eid2801.211307
AMA Black AP, Khounvisith V, Xaydalasouk K, et al. Unexpectedly High Prevalence of Hepatitis C Virus Infection, Southern Laos. Emerging Infectious Diseases. 2022;28(1):256-259. doi:10.3201/eid2801.211307.
APA Black, A. P., Khounvisith, V., Xaydalasouk, K., Sayasinh, K., Sausy, A., Muller, C. P....Hübschen, J. M. (2022). Unexpectedly High Prevalence of Hepatitis C Virus Infection, Southern Laos. Emerging Infectious Diseases, 28(1), 256-259. https://doi.org/10.3201/eid2801.211307.

Limited Propagation of SARS-CoV-2 among Children in a Childcare Center, Canada, 2021 [PDF - 1.01 MB - 4 pages]
A. Li et al.

An outbreak of severe acute respiratory syndrome coronavirus 2 with no definitive source and potential exposure to variants of concern was declared at a childcare center in Ontario, Canada, in March 2021. We developed a robust outbreak management approach to detect, contain, and interrupt this outbreak and limit propagation among children.

EID Li A, Moore K, Bowthorpe L, Sousa J, Guan T. Limited Propagation of SARS-CoV-2 among Children in a Childcare Center, Canada, 2021. Emerg Infect Dis. 2022;28(1):259-262. https://doi.org/10.3201/eid2801.211811
AMA Li A, Moore K, Bowthorpe L, et al. Limited Propagation of SARS-CoV-2 among Children in a Childcare Center, Canada, 2021. Emerging Infectious Diseases. 2022;28(1):259-262. doi:10.3201/eid2801.211811.
APA Li, A., Moore, K., Bowthorpe, L., Sousa, J., & Guan, T. (2022). Limited Propagation of SARS-CoV-2 among Children in a Childcare Center, Canada, 2021. Emerging Infectious Diseases, 28(1), 259-262. https://doi.org/10.3201/eid2801.211811.

Cluster of SARS-CoV-2 Gamma Variant Infections, Parintins, Brazil, March 2021 [PDF - 1.05 MB - 3 pages]
J. F. da Silva et al.

High case counts after the Gamma (P. 1) variant of severe acute respiratory syndrome coronavirus 2 emerged in Brazil raised concerns that previously infected persons might become reinfected. Investigation of a cluster of coronavirus disease cases in Parintins, in the Brazilian Amazon, suggested household transmission but did not identify high rates of reinfection.

EID da Silva JF, Esteves RJ, Siza C, Soares EP, Ramos TC, Campelo EC, et al. Cluster of SARS-CoV-2 Gamma Variant Infections, Parintins, Brazil, March 2021. Emerg Infect Dis. 2022;28(1):262-264. https://doi.org/10.3201/eid2801.211817
AMA da Silva JF, Esteves RJ, Siza C, et al. Cluster of SARS-CoV-2 Gamma Variant Infections, Parintins, Brazil, March 2021. Emerging Infectious Diseases. 2022;28(1):262-264. doi:10.3201/eid2801.211817.
APA da Silva, J. F., Esteves, R. J., Siza, C., Soares, E. P., Ramos, T. C., Campelo, E. C....Naveca, F. (2022). Cluster of SARS-CoV-2 Gamma Variant Infections, Parintins, Brazil, March 2021. Emerging Infectious Diseases, 28(1), 262-264. https://doi.org/10.3201/eid2801.211817.
Letters

New Delhi Metallo-β-Lactamase-Producing Enterobacterales Bacteria [PDF - 653 KB - 1 page]
Y. Yao et al.
EID Yao Y, Imirzalioglu C, Falgenhauer L, Chakraborty T. New Delhi Metallo-β-Lactamase-Producing Enterobacterales Bacteria. Emerg Infect Dis. 2022;28(1):265. https://doi.org/10.3201/eid2801.212106
AMA Yao Y, Imirzalioglu C, Falgenhauer L, et al. New Delhi Metallo-β-Lactamase-Producing Enterobacterales Bacteria. Emerging Infectious Diseases. 2022;28(1):265. doi:10.3201/eid2801.212106.
APA Yao, Y., Imirzalioglu, C., Falgenhauer, L., & Chakraborty, T. (2022). New Delhi Metallo-β-Lactamase-Producing Enterobacterales Bacteria. Emerging Infectious Diseases, 28(1), 265. https://doi.org/10.3201/eid2801.212106.
Books and Media

Snyder and Champness Molecular Genetics of Bacteria, 5th Edition [PDF - 881 KB - 1 page]
R. A. Moore and C. E. Carr
EID Moore RA, Carr CE. Snyder and Champness Molecular Genetics of Bacteria, 5th Edition. Emerg Infect Dis. 2022;28(1):266. https://doi.org/10.3201/eid2801.211628
AMA Moore RA, Carr CE. Snyder and Champness Molecular Genetics of Bacteria, 5th Edition. Emerging Infectious Diseases. 2022;28(1):266. doi:10.3201/eid2801.211628.
APA Moore, R. A., & Carr, C. E. (2022). Snyder and Champness Molecular Genetics of Bacteria, 5th Edition. Emerging Infectious Diseases, 28(1), 266. https://doi.org/10.3201/eid2801.211628.

Food Microbiology: Fundamentals and Frontiers, 5th Edition [PDF - 738 KB - 1 page]
E. G. Dudley
EID Dudley EG. Food Microbiology: Fundamentals and Frontiers, 5th Edition. Emerg Infect Dis. 2022;28(1):267. https://doi.org/10.3201/eid2801.211862
AMA Dudley EG. Food Microbiology: Fundamentals and Frontiers, 5th Edition. Emerging Infectious Diseases. 2022;28(1):267. doi:10.3201/eid2801.211862.
APA Dudley, E. G. (2022). Food Microbiology: Fundamentals and Frontiers, 5th Edition. Emerging Infectious Diseases, 28(1), 267. https://doi.org/10.3201/eid2801.211862.
About the Cover

Bowing Out of Shaking Hands? [PDF - 2.03 MB - 2 pages]
N. M. M’ikanatha and B. Breedlove
EID M’ikanatha NM, Breedlove B. Bowing Out of Shaking Hands?. Emerg Infect Dis. 2022;28(1):268-269. https://doi.org/10.3201/eid2801.ac2801
AMA M’ikanatha NM, Breedlove B. Bowing Out of Shaking Hands?. Emerging Infectious Diseases. 2022;28(1):268-269. doi:10.3201/eid2801.ac2801.
APA M’ikanatha, N. M., & Breedlove, B. (2022). Bowing Out of Shaking Hands?. Emerging Infectious Diseases, 28(1), 268-269. https://doi.org/10.3201/eid2801.ac2801.
Corrections

Correction: Vol. 27, No. 9 [PDF - 653 KB - 1 page]
EID Correction: Vol. 27, No. 9. Emerg Infect Dis. 2022;28(1):265. https://doi.org/10.3201/eid2801.c12801
AMA Correction: Vol. 27, No. 9. Emerging Infectious Diseases. 2022;28(1):265. doi:10.3201/eid2801.c12801.
APA (2022). Correction: Vol. 27, No. 9. Emerging Infectious Diseases, 28(1), 265. https://doi.org/10.3201/eid2801.c12801.
Page created: December 20, 2021
Page updated: January 13, 2022
Page reviewed: January 13, 2022
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