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Issue Cover for Volume 28, Number 12—December 2022

Volume 28, Number 12—December 2022

[PDF - 10.37 MB - 238 pages]

Synopses

Medscape CME Activity
Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients with Vibrio Infections, Bay of Biscay, France, 2001–2019 [PDF - 666 KB - 7 pages]
F. Hoefler et al.

Noncholera vibriosis is a rare, opportunistic bacterial infection caused by Vibrio spp. other than V. cholerae O1/O139 and diagnosed mainly during the hot summer months in patients after seaside activities. Detailed knowledge of circulating pathogenic strains and heterogeneities in infection outcomes and disease dynamics may help in patient management. We conducted a multicenter case-series study documenting Vibrio infections in 67 patients from 8 hospitals in the Bay of Biscay, France, over a 19-year period. Infections were mainly caused by V. alginolyticus (34%), V. parahaemolyticus (30%), non-O1/O139 V. cholerae (15%), and V. vulnificus (10%). Drug-susceptibility testing revealed intermediate and resistant strains to penicillins and first-generation cephalosporins. The acute infections (e.g., those involving digestive disorder, cellulitis, osteitis, pneumonia, and endocarditis) led to a life-threatening event (septic shock), amputation, or death in 36% of patients. Physicians may need to add vibriosis to their list of infections to assess in patients with associated risk factors.

EID Hoefler F, Pouget-Abadie X, Roncato-Saberan M, Lemarié R, Takoudju E, Raffi F, et al. Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients with Vibrio Infections, Bay of Biscay, France, 2001–2019. Emerg Infect Dis. 2022;28(12):2367-2373. https://doi.org/10.3201/eid2812.220748
AMA Hoefler F, Pouget-Abadie X, Roncato-Saberan M, et al. Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients with Vibrio Infections, Bay of Biscay, France, 2001–2019. Emerging Infectious Diseases. 2022;28(12):2367-2373. doi:10.3201/eid2812.220748.
APA Hoefler, F., Pouget-Abadie, X., Roncato-Saberan, M., Lemarié, R., Takoudju, E., Raffi, F....Allix-Béguec, C. (2022). Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients with Vibrio Infections, Bay of Biscay, France, 2001–2019. Emerging Infectious Diseases, 28(12), 2367-2373. https://doi.org/10.3201/eid2812.220748.

Probable Aerosol Transmission of SARS-CoV-2 through Floors and Walls of Quarantine Hotel, Taiwan, 2021 [PDF - 2.81 MB - 9 pages]
H. Wei et al.

We investigated a cluster of SARS-CoV-2 infections in a quarantine hotel in Taiwan in December 2021. The cluster involved 3 case patients who lived in nonadjacent rooms on different floors. They had no direct contact during their stay. By direct exploration of the space above the room ceilings, we found residual tunnels, wall defects, and truncated pipes between their rooms. We conducted a simplified tracer-gas experiment to assess the interconnection between rooms. Aerosol transmission through structural defects in floors and walls in this poorly ventilated hotel was the most likely route of virus transmission. This event demonstrates the high transmissibility of Omicron variants, even across rooms and floors, through structural defects. Our findings emphasize the importance of ventilation and integrity of building structure in quarantine facilities.

EID Wei H, Chang C, Liu M, Mu J, Lin Y, Dai Y, et al. Probable Aerosol Transmission of SARS-CoV-2 through Floors and Walls of Quarantine Hotel, Taiwan, 2021. Emerg Infect Dis. 2022;28(12):2374-2382. https://doi.org/10.3201/eid2812.220666
AMA Wei H, Chang C, Liu M, et al. Probable Aerosol Transmission of SARS-CoV-2 through Floors and Walls of Quarantine Hotel, Taiwan, 2021. Emerging Infectious Diseases. 2022;28(12):2374-2382. doi:10.3201/eid2812.220666.
APA Wei, H., Chang, C., Liu, M., Mu, J., Lin, Y., Dai, Y....Su, C. (2022). Probable Aerosol Transmission of SARS-CoV-2 through Floors and Walls of Quarantine Hotel, Taiwan, 2021. Emerging Infectious Diseases, 28(12), 2374-2382. https://doi.org/10.3201/eid2812.220666.

Iceland as Stepping Stone for Spread of Highly Pathogenic Avian Influenza Virus between Europe and North America [PDF - 1.28 MB - 6 pages]
A. Günther et al.

Highly pathogenic avian influenza viruses (HPAIVs) of hemagglutinin type H5 and clade 2.3.4.4b have widely spread within the northern hemisphere since 2020 and threaten wild bird populations, as well as poultry production. We present phylogeographic evidence that Iceland has been used as a stepping stone for HPAIV translocation from northern Europe to North America by infected but mobile wild birds. At least 2 independent incursions of HPAIV H5N1 clade 2.3.4.4b assigned to 2 hemagglutinin clusters, B1 and B2, are documented for summer‒autumn 2021 and spring 2022. Spread of HPAIV H5N1 to and among colony-breeding pelagic avian species in Iceland is ongoing. Potentially devastating effects (i.e., local losses >25%) on these species caused by extended HPAIV circulation in space and time are being observed at several affected breeding sites throughout the North Atlantic.

EID Günther A, Krone O, Svansson V, Pohlmann A, King J, Hallgrimsson G, et al. Iceland as Stepping Stone for Spread of Highly Pathogenic Avian Influenza Virus between Europe and North America. Emerg Infect Dis. 2022;28(12):2383-2388. https://doi.org/10.3201/eid2812.221086
AMA Günther A, Krone O, Svansson V, et al. Iceland as Stepping Stone for Spread of Highly Pathogenic Avian Influenza Virus between Europe and North America. Emerging Infectious Diseases. 2022;28(12):2383-2388. doi:10.3201/eid2812.221086.
APA Günther, A., Krone, O., Svansson, V., Pohlmann, A., King, J., Hallgrimsson, G....Harder, T. (2022). Iceland as Stepping Stone for Spread of Highly Pathogenic Avian Influenza Virus between Europe and North America. Emerging Infectious Diseases, 28(12), 2383-2388. https://doi.org/10.3201/eid2812.221086.

Systematic Review and Meta-analysis of Lyme Disease Data and Seropositivity for Borrelia burgdorferi, China, 2005‒2020 [PDF - 1.84 MB - 9 pages]
J. Stark et al.

Since its initial identification in 1986, Lyme disease has been clinically diagnosed in 29 provinces in China; however, national incidence data are lacking. To summarize Lyme disease seropositivity data among persons across China, we conducted a systematic literature review of Chinese- and English-language journal articles published during 2005‒2020. According to 72 estimates that measured IgG by using a diagnostic enzyme-linked assay (EIA) alone, the seropositivity point prevalence with a fixed-effects model was 9.1%. A more conservative 2-tier testing approach of EIA plus a confirmatory Western immunoblot (16 estimates) yielded seropositivity 1.8%. Seropositivity by EIA for high-risk exposure populations was 10.0% and for low-risk exposure populations was 4.5%; seropositivity was highest in the northeastern and western provinces. Our analysis confirms Lyme disease prevalence, measured by seropositivity, in many Chinese provinces and populations at risk. This information can be used to focus prevention measures in provinces where seropositivity is high.

EID Stark J, Li X, Zhang J, Burn L, Valluri SR, Liang J, et al. Systematic Review and Meta-analysis of Lyme Disease Data and Seropositivity for Borrelia burgdorferi, China, 2005‒2020. Emerg Infect Dis. 2022;28(12):2389-2397. https://doi.org/10.3201/eid2812.212612
AMA Stark J, Li X, Zhang J, et al. Systematic Review and Meta-analysis of Lyme Disease Data and Seropositivity for Borrelia burgdorferi, China, 2005‒2020. Emerging Infectious Diseases. 2022;28(12):2389-2397. doi:10.3201/eid2812.212612.
APA Stark, J., Li, X., Zhang, J., Burn, L., Valluri, S. R., Liang, J....Gessner, B. D. (2022). Systematic Review and Meta-analysis of Lyme Disease Data and Seropositivity for Borrelia burgdorferi, China, 2005‒2020. Emerging Infectious Diseases, 28(12), 2389-2397. https://doi.org/10.3201/eid2812.212612.
Research

Medscape CME Activity
Acinetobacter baumannii among Patients Receiving Glucocorticoid Aerosol Therapy during Invasive Mechanical Ventilation, China [PDF - 1.20 MB - 11 pages]
W. Zhang et al.

Acinetobacter baumannii is a nosocomial pathogen associated with severe illness and death. Glucocorticoid aerosol is a common inhalation therapy in patients receiving invasive mechanical ventilation. We conducted a prospective cohort study to analyze the association between glucocorticoid aerosol therapy and A. baumannii isolation from ventilator patients in China. Of 497 enrolled patients, 262 (52.7%) received glucocorticoid aerosol, and A. baumannii was isolated from 159 (32.0%). Glucocorticoid aerosol therapy was an independent risk factor for A. baumannii isolation (hazard ratio 1.5, 95% CI 1.02–2.28; p = 0.038). Patients receiving glucocorticoid aerosol had a higher cumulative hazard for A. baumannii isolation and analysis showed that glucocorticoid aerosol therapy increased A. baumannii isolation in most subpopulations. Glucocorticoid aerosol was not a direct risk factor for 30-day mortality, but A. baumannii isolation was independently associated with 30-day mortality in ventilator patients. Physicians should consider potential A. baumannii infection when prescribing glucocorticoid aerosol therapy.

EID Zhang W, Yin M, Li W, Xu N, Lu H, Qin W, et al. Acinetobacter baumannii among Patients Receiving Glucocorticoid Aerosol Therapy during Invasive Mechanical Ventilation, China. Emerg Infect Dis. 2022;28(12):2404. https://doi.org/10.3201/eid2812.220347
AMA Zhang W, Yin M, Li W, et al. Acinetobacter baumannii among Patients Receiving Glucocorticoid Aerosol Therapy during Invasive Mechanical Ventilation, China. Emerging Infectious Diseases. 2022;28(12):2404. doi:10.3201/eid2812.220347.
APA Zhang, W., Yin, M., Li, W., Xu, N., Lu, H., Qin, W....Wang, H. (2022). Acinetobacter baumannii among Patients Receiving Glucocorticoid Aerosol Therapy during Invasive Mechanical Ventilation, China. Emerging Infectious Diseases, 28(12), 2404. https://doi.org/10.3201/eid2812.220347.

Observational Cohort Study of Evolving Epidemiologic, Clinical, and Virologic Features of Monkeypox in Southern France [PDF - 1.10 MB - 7 pages]
N. Cassir et al.

We enrolled 136 patients with laboratory-confirmed monkeypox during June 4–August 31, 2022, at the University Hospital Institute Méditerranée Infection in Marseille, France. The median patient age was 36 years (interquartile range 31–42 years). Of 136 patients, 125 (92%) were men who have sex with men, 15 (11%) reported previous smallpox vaccinations, and 21 (15.5%) were HIV-positive. The most frequent lesion locations were the genitals (68 patients, 53%), perianal region (65 patients, 49%), and oral/perioral area (22 patients, 17%). Lesion locations largely corresponded with the route of contamination. Most (68%) patients had isolated anal, genital, or oral lesions when they were first seen, including 56 (61%) who had >1 positive site without a visible lesion. Concurrent sexually transmitted infections were diagnosed in 19 (15%) patients, and 7 patients (5%) were asymptomatic. We recommend vaccination campaigns, intensified testing for sexually transmitted infections, and increased contact tracing to control the ongoing monkeypox outbreak.

EID Cassir N, Cardona F, Tissot-Dupont H, Bruel C, Doudier B, Lahouel S, et al. Observational Cohort Study of Evolving Epidemiologic, Clinical, and Virologic Features of Monkeypox in Southern France. Emerg Infect Dis. 2022;28(12):2409-2415. https://doi.org/10.3201/eid2812.221440
AMA Cassir N, Cardona F, Tissot-Dupont H, et al. Observational Cohort Study of Evolving Epidemiologic, Clinical, and Virologic Features of Monkeypox in Southern France. Emerging Infectious Diseases. 2022;28(12):2409-2415. doi:10.3201/eid2812.221440.
APA Cassir, N., Cardona, F., Tissot-Dupont, H., Bruel, C., Doudier, B., Lahouel, S....Million, M. (2022). Observational Cohort Study of Evolving Epidemiologic, Clinical, and Virologic Features of Monkeypox in Southern France. Emerging Infectious Diseases, 28(12), 2409-2415. https://doi.org/10.3201/eid2812.221440.

Continued Circulation of Tick-Borne Encephalitis Virus Variants and Detection of Novel Transmission Foci, the Netherlands [PDF - 1.05 MB - 9 pages]
H. J. Esser et al.

Tick-borne encephalitis virus (TBEV) is an emerging pathogen that was first detected in ticks and humans in the Netherlands in 2015 (ticks) and 2016 (humans). To learn more about its distribution and prevalence in the Netherlands, we conducted large-scale surveillance in ticks and rodents during August 2018–September 2020. We tested 320 wild rodents and >46,000 ticks from 48 locations considered to be at high risk for TBEV circulation. We found TBEV RNA in 3 rodents (0.9%) and 7 tick pools (minimum infection rate 0.02%) from 5 geographically distinct foci. Phylogenetic analyses indicated that 3 different variants of the TBEV-Eu subtype circulate in the Netherlands, suggesting multiple independent introductions. Combined with recent human cases outside known TBEV hotspots, our data demonstrate that the distribution of TBEV in the Netherlands is more widespread than previously thought.

EID Esser HJ, Lim SM, de Vries A, Sprong H, Dekker DJ, Pascoe EL, et al. Continued Circulation of Tick-Borne Encephalitis Virus Variants and Detection of Novel Transmission Foci, the Netherlands. Emerg Infect Dis. 2022;28(12):2416-2424. https://doi.org/10.3201/eid2812.220552
AMA Esser HJ, Lim SM, de Vries A, et al. Continued Circulation of Tick-Borne Encephalitis Virus Variants and Detection of Novel Transmission Foci, the Netherlands. Emerging Infectious Diseases. 2022;28(12):2416-2424. doi:10.3201/eid2812.220552.
APA Esser, H. J., Lim, S. M., de Vries, A., Sprong, H., Dekker, D. J., Pascoe, E. L....Koenraadt, C. (2022). Continued Circulation of Tick-Borne Encephalitis Virus Variants and Detection of Novel Transmission Foci, the Netherlands. Emerging Infectious Diseases, 28(12), 2416-2424. https://doi.org/10.3201/eid2812.220552.

Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA [PDF - 1.47 MB - 10 pages]
J. Meisner et al.

SARS-CoV-2 likely emerged from an animal reservoir. However, the frequency of and risk factors for interspecies transmission remain unclear. We conducted a community-based study in Idaho, USA, of pets in households that had >1 confirmed SARS-CoV-2 infections in humans. Among 119 dogs and 57 cats, clinical signs consistent with SARS-CoV-2 were reported for 20 dogs (21%) and 19 cats (39%). Of 81 dogs and 32 cats sampled, 40% of dogs and 43% of cats were seropositive, and 5% of dogs and 8% of cats were PCR positive. This discordance might be caused by delays in sampling. Respondents commonly reported close human‒animal contact and willingness to take measures to prevent transmission to their pets. Reported preventive measures showed a slightly protective but nonsignificant trend for both illness and seropositivity in pets. Sharing of beds and bowls had slight harmful effects, reaching statistical significance for sharing bowls and seropositivity.

EID Meisner J, Baszler TV, Kuehl KE, Ramirez V, Baines A, Frisbie LA, et al. Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA. Emerg Infect Dis. 2022;28(12):2425-2434. https://doi.org/10.3201/eid2812.220215
AMA Meisner J, Baszler TV, Kuehl KE, et al. Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA. Emerging Infectious Diseases. 2022;28(12):2425-2434. doi:10.3201/eid2812.220215.
APA Meisner, J., Baszler, T. V., Kuehl, K. E., Ramirez, V., Baines, A., Frisbie, L. A....Rabinowitz, P. M. (2022). Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA. Emerging Infectious Diseases, 28(12), 2425-2434. https://doi.org/10.3201/eid2812.220215.

National Monkeypox Surveillance, Central African Republic, 2001–2021 [PDF - 3.49 MB - 11 pages]
C. Besombes et al.

We analyzed monkeypox disease surveillance in Central African Republic (CAR) during 2001–2021. Surveillance data show 95 suspected outbreaks, 40 of which were confirmed as monkeypox, comprising 99 confirmed and 61 suspected monkeypox cases. After 2018, CAR’s annual rate of confirmed outbreaks increased, and 65% of outbreaks occurred in 2 forested regions bordering the Democratic Republic of the Congo. The median patient age for confirmed cases was 15.5 years. The overall case-fatality ratio was 7.5% (12/160) for confirmed and suspected cases, 9.6% (8/83) for children <16 years of age. Decreasing cross-protective immunity from smallpox vaccination and recent ecologic alterations likely contribute to increased monkeypox outbreaks in Central Africa. High fatality rates associated with monkeypox virus clade I also are a local and international concern. Ongoing investigations of zoonotic sources and environmental changes that increase human exposure could inform practices to prevent monkeypox expansion into local communities and beyond endemic areas.

EID Besombes C, Mbrenga F, Schaeffer L, Malaka C, Gonofio E, Landier J, et al. National Monkeypox Surveillance, Central African Republic, 2001–2021. Emerg Infect Dis. 2022;28(12):2435-2445. https://doi.org/10.3201/eid2812.220897
AMA Besombes C, Mbrenga F, Schaeffer L, et al. National Monkeypox Surveillance, Central African Republic, 2001–2021. Emerging Infectious Diseases. 2022;28(12):2435-2445. doi:10.3201/eid2812.220897.
APA Besombes, C., Mbrenga, F., Schaeffer, L., Malaka, C., Gonofio, E., Landier, J....Nakouné-Yandoko, E. (2022). National Monkeypox Surveillance, Central African Republic, 2001–2021. Emerging Infectious Diseases, 28(12), 2435-2445. https://doi.org/10.3201/eid2812.220897.

Development of Differentiating Infected from Vaccinated Animals (DIVA) Real-Time PCR for African Horse Sickness Virus Serotype 1 [PDF - 2.86 MB - 9 pages]
Y. Wang et al.

African horse sickness (AHS) is a highly infectious and often fatal disease caused by 9 serotypes of the orbivirus African horse sickness virus (AHSV). In March 2020, an AHS outbreak was reported in Thailand in which AHSV serotype 1 was identified as the causative agent. Trivalent live attenuated vaccines serotype 1, 3, and 4 were used in a targeted vaccination campaign within a 50-km radius surrounding the infected cases, which promptly controlled the spread of the disease. However, AHS-like symptoms in vaccinated horses required laboratory diagnostic methods to differentiate infected horses from vaccinated horses, especially for postvaccination surveillance. We describe a real-time reverse transcription PCR–based assay for rapid characterization of the affecting field strain. The development and validation of this assay should imbue confidence in differentiating AHS-vaccinated horses from nonvaccinated horses. This method should be applied to determining the epidemiology of AHSV in future outbreaks.

EID Wang Y, Ong J, Ng O, Songkasupa T, Koh EY, Wong J, et al. Development of Differentiating Infected from Vaccinated Animals (DIVA) Real-Time PCR for African Horse Sickness Virus Serotype 1. Emerg Infect Dis. 2022;28(12):2446-2454. https://doi.org/10.3201/eid2812.220594
AMA Wang Y, Ong J, Ng O, et al. Development of Differentiating Infected from Vaccinated Animals (DIVA) Real-Time PCR for African Horse Sickness Virus Serotype 1. Emerging Infectious Diseases. 2022;28(12):2446-2454. doi:10.3201/eid2812.220594.
APA Wang, Y., Ong, J., Ng, O., Songkasupa, T., Koh, E. Y., Wong, J....Yap, H. (2022). Development of Differentiating Infected from Vaccinated Animals (DIVA) Real-Time PCR for African Horse Sickness Virus Serotype 1. Emerging Infectious Diseases, 28(12), 2446-2454. https://doi.org/10.3201/eid2812.220594.

Daily Rapid Antigen Exit Testing to Tailor University COVID-19 Isolation Policy [PDF - 1.39 MB - 8 pages]
R. Earnest et al.

We evaluated daily rapid antigen test (RAT) data from 323 COVID-19–positive university students in Connecticut, USA, during an Omicron-dominant period. Day 5 positivity was 47% for twice-weekly screeners and 26%–28% for less-frequent screeners, approximately halving each subsequent day. Testing negative >10 days before diagnosis (event time ratio (ETR) 0.85 [95% CI 0.75–0.96]) and prior infection >90 days (ETR 0.50 [95% CI 0.33–0.76]) were significantly associated with shorter RAT positivity duration. Symptoms before or at diagnosis (ETR 1.13 [95% CI 1.02–1.25]) and receipt of 3 vaccine doses (ETR 1.20 [95% CI 1.04–1.39]) were significantly associated with prolonged positivity. Exit RATs enabled 53%–74% of students to leave isolation early when they began isolation at the time of the first positive test, but 15%–22% remained positive beyond the recommended isolation period. Factors associated with RAT positivity duration should be further explored to determine relationships with infection duration.

EID Earnest R, Chen C, Chaguza C, Hahn AM, Grubaugh ND, Wilson MS. Daily Rapid Antigen Exit Testing to Tailor University COVID-19 Isolation Policy. Emerg Infect Dis. 2022;28(12):2455-2462. https://doi.org/10.3201/eid2812.220969
AMA Earnest R, Chen C, Chaguza C, et al. Daily Rapid Antigen Exit Testing to Tailor University COVID-19 Isolation Policy. Emerging Infectious Diseases. 2022;28(12):2455-2462. doi:10.3201/eid2812.220969.
APA Earnest, R., Chen, C., Chaguza, C., Hahn, A. M., Grubaugh, N. D., & Wilson, M. S. (2022). Daily Rapid Antigen Exit Testing to Tailor University COVID-19 Isolation Policy. Emerging Infectious Diseases, 28(12), 2455-2462. https://doi.org/10.3201/eid2812.220969.

Orthopoxvirus Seroprevalence and Infection Susceptibility in France, Bolivia, Laos, and Mali [PDF - 1.16 MB - 9 pages]
L. Luciani et al.

To determine a demographic overview of orthopoxvirus seroprevalence, we tested blood samples collected during 2003–2019 from France (n = 4,876), Bolivia (n = 601), Laos (n = 657), and Mali (n = 255) for neutralizing antibodies against vaccinia virus. In addition, we tested 4,448 of the 4,876 samples from France for neutralizing antibodies against cowpox virus. We confirmed extensive cross-immunity between the 2 viruses. Seroprevalence of antibodies was <1% in Bolivia, <5% in Laos, and 17.25% in Mali. In France, we found low prevalence of neutralizing antibodies in persons who were unvaccinated and vaccinated for smallpox, suggesting immunosenescence occurred in vaccinated persons, and smallpox vaccination compliance declined before the end of compulsory vaccination. Our results suggest that populations in Europe, Africa, Asia, and South America are susceptible to orthopoxvirus infections, which might have precipitated the emergence of orthopoxvirus infections such as the 2022 spread of monkeypox in Europe.

EID Luciani L, Lapidus N, Amroun A, Falchi A, Souksakhone C, Mayxay M, et al. Orthopoxvirus Seroprevalence and Infection Susceptibility in France, Bolivia, Laos, and Mali. Emerg Infect Dis. 2022;28(12):2463-2471. https://doi.org/10.3201/eid2812.221136
AMA Luciani L, Lapidus N, Amroun A, et al. Orthopoxvirus Seroprevalence and Infection Susceptibility in France, Bolivia, Laos, and Mali. Emerging Infectious Diseases. 2022;28(12):2463-2471. doi:10.3201/eid2812.221136.
APA Luciani, L., Lapidus, N., Amroun, A., Falchi, A., Souksakhone, C., Mayxay, M....de Lamballerie, X. (2022). Orthopoxvirus Seroprevalence and Infection Susceptibility in France, Bolivia, Laos, and Mali. Emerging Infectious Diseases, 28(12), 2463-2471. https://doi.org/10.3201/eid2812.221136.

Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo [PDF - 3.77 MB - 10 pages]
G. Charnley et al.

Cholera outbreaks contribute substantially to illness and death in low- and middle-income countries. Cholera outbreaks are associated with several social and environmental risk factors, and extreme conditions can act as catalysts. A social extreme known to be associated with infectious disease outbreaks is conflict, causing disruption to services, loss of income, and displacement. To determine the extent of this association, we used the self-controlled case-series method and found that conflict increased the risk for cholera in Nigeria by 3.6 times and in the Democratic Republic of the Congo by 2.6 times. We also found that 19.7% of cholera outbreaks in Nigeria and 12.3% of outbreaks in the Democratic Republic of the Congo were attributable to conflict. Our results highlight the value of providing rapid and sufficient assistance during conflict-associated cholera outbreaks and working toward conflict resolution and addressing preexisting vulnerabilities, such as poverty and access to healthcare.

EID Charnley G, Jean K, Kelman I, Gaythorpe K, Murray KA. Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo. Emerg Infect Dis. 2022;28(12):2472-2481. https://doi.org/10.3201/eid2812.212398
AMA Charnley G, Jean K, Kelman I, et al. Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo. Emerging Infectious Diseases. 2022;28(12):2472-2481. doi:10.3201/eid2812.212398.
APA Charnley, G., Jean, K., Kelman, I., Gaythorpe, K., & Murray, K. A. (2022). Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo. Emerging Infectious Diseases, 28(12), 2472-2481. https://doi.org/10.3201/eid2812.212398.

Emergence and Evolutionary Response of Vibrio cholerae to Novel Bacteriophage, Democratic Republic of the Congo [PDF - 3.17 MB - 9 pages]
M. T. Alam et al.

Cholera causes substantial illness and death in Africa. We analyzed 24 toxigenic Vibrio cholerae O1 strains isolated in 2015–2017 from patients in the Great Lakes region of the Democratic Republic of the Congo. Strains originating in southern Asia appeared to be part of the T10 introduction event in eastern Africa. We identified 2 main strain lineages, most recently a lineage corresponding to sequence type 515, a V. cholerae cluster previously reported in the Lake Kivu region. In 41% of fecal samples from cholera patients, we also identified a novel ICP1 (Bangladesh cholera phage 1) bacteriophage, genetically distinct from ICP1 isolates previously detected in Asia. Bacteriophage resistance occurred in distinct clades along both internal and external branches of the cholera phylogeny. This bacteriophage appears to have served as a major driver for cholera evolution and spread, and its appearance highlights the complex evolutionary dynamic that occurs between predatory phage and bacterial host.

EID Alam MT, Mavian C, Paisie TK, Tagliamonte MS, Cash MN, Angermeyer A, et al. Emergence and Evolutionary Response of Vibrio cholerae to Novel Bacteriophage, Democratic Republic of the Congo. Emerg Infect Dis. 2022;28(12):2482-2490. https://doi.org/10.3201/eid2812.220572
AMA Alam MT, Mavian C, Paisie TK, et al. Emergence and Evolutionary Response of Vibrio cholerae to Novel Bacteriophage, Democratic Republic of the Congo. Emerging Infectious Diseases. 2022;28(12):2482-2490. doi:10.3201/eid2812.220572.
APA Alam, M. T., Mavian, C., Paisie, T. K., Tagliamonte, M. S., Cash, M. N., Angermeyer, A....Ali, A. (2022). Emergence and Evolutionary Response of Vibrio cholerae to Novel Bacteriophage, Democratic Republic of the Congo. Emerging Infectious Diseases, 28(12), 2482-2490. https://doi.org/10.3201/eid2812.220572.

Hedgehogs as Amplifying Hosts of Severe Fever with Thrombocytopenia Syndrome Virus, China [PDF - 2.13 MB - 9 pages]
C. Zhao et al.

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a tickborne bandavirus mainly transmitted by Haemaphysalis longicornis ticks in East Asia, mostly in rural areas. As of April 2022, the amplifying host involved in the natural transmission of SFTSV remained unidentified. Our epidemiologic field survey conducted in endemic areas in China showed that hedgehogs were widely distributed, had heavy tick infestations, and had high SFTSV seroprevalence and RNA prevalence. After experimental infection of Erinaceus amurensis and Atelerix albiventris hedgehogs with SFTSV, we detected robust but transitory viremias that lasted for 9–11 days. We completed the SFTSV transmission cycle between hedgehogs and nymph and adult H. longicornis ticks under laboratory conditions with 100% efficiency. Furthermore, naive H. longicornis ticks could be infected by SFTSV-positive ticks co-feeding on naive hedgehogs; we confirmed transstadial transmission of SFTSV. Our study suggests that the hedgehogs are a notable wildlife amplifying host of SFTSV in China.

EID Zhao C, Zhang X, Si X, Ye L, Lawrence K, Lu Y, et al. Hedgehogs as Amplifying Hosts of Severe Fever with Thrombocytopenia Syndrome Virus, China. Emerg Infect Dis. 2022;28(12):2491-2499. https://doi.org/10.3201/eid2812.220668
AMA Zhao C, Zhang X, Si X, et al. Hedgehogs as Amplifying Hosts of Severe Fever with Thrombocytopenia Syndrome Virus, China. Emerging Infectious Diseases. 2022;28(12):2491-2499. doi:10.3201/eid2812.220668.
APA Zhao, C., Zhang, X., Si, X., Ye, L., Lawrence, K., Lu, Y....Zheng, A. (2022). Hedgehogs as Amplifying Hosts of Severe Fever with Thrombocytopenia Syndrome Virus, China. Emerging Infectious Diseases, 28(12), 2491-2499. https://doi.org/10.3201/eid2812.220668.
Dispatches

Isolation of Bat Sarbecoviruses, Japan [PDF - 1.26 MB - 4 pages]
S. Murakami et al.

Surveillance of bat betacoronaviruses is crucial for understanding their spillover potential. We isolated bat sarbecoviruses from Rhinolophus cornutus bats in multiple locations in Japan. These viruses grew efficiently in cells expressing R. cornutus angiotensin converting enzyme-2, but not in cells expressing human angiotensin converting enzyme-2, suggesting a narrow host range.

EID Murakami S, Kitamura T, Matsugo H, Kamiki H, Oyabu K, Sekine W, et al. Isolation of Bat Sarbecoviruses, Japan. Emerg Infect Dis. 2022;28(12):2500-2503. https://doi.org/10.3201/eid2812.220801
AMA Murakami S, Kitamura T, Matsugo H, et al. Isolation of Bat Sarbecoviruses, Japan. Emerging Infectious Diseases. 2022;28(12):2500-2503. doi:10.3201/eid2812.220801.
APA Murakami, S., Kitamura, T., Matsugo, H., Kamiki, H., Oyabu, K., Sekine, W....Horimoto, T. (2022). Isolation of Bat Sarbecoviruses, Japan. Emerging Infectious Diseases, 28(12), 2500-2503. https://doi.org/10.3201/eid2812.220801.

Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia [PDF - 1.19 MB - 4 pages]
H. Biasizzo et al.

We report a case of human Dirofilaria repens infection in a woman in Slovenia who had concomitant pleural and subcutaneous manifestations of the infection. This case report illustrates the clinical course of a severe symptomatic parasitic infection that had multisystemic manifestations.

EID Biasizzo H, Šoba B, Ilovski F, Harlander M, Lukin M, Blatnik O, et al. Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia. Emerg Infect Dis. 2022;28(12):2504-2507. https://doi.org/10.3201/eid2812.221366
AMA Biasizzo H, Šoba B, Ilovski F, et al. Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia. Emerging Infectious Diseases. 2022;28(12):2504-2507. doi:10.3201/eid2812.221366.
APA Biasizzo, H., Šoba, B., Ilovski, F., Harlander, M., Lukin, M., Blatnik, O....Beović, B. (2022). Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia. Emerging Infectious Diseases, 28(12), 2504-2507. https://doi.org/10.3201/eid2812.221366.

Myocarditis Attributable to Monkeypox Virus Infection in 2 Patients, United States, 2022 [PDF - 1.98 MB - 5 pages]
G. Rodriguez-Nava et al.

We report 2 immunocompetent and otherwise healthy adults in the United States who had monkeypox and required hospitalization for viral myocarditis. Both patients were unvaccinated against orthopoxviruses. They had shortness of breath or chest pain and elevated cardiac biomarkers. No immediate complications were observed. They were discharged home after symptoms resolved.

EID Rodriguez-Nava G, Kadlecik P, Filardo TD, Ain DL, Cooper JD, McCormick DW, et al. Myocarditis Attributable to Monkeypox Virus Infection in 2 Patients, United States, 2022. Emerg Infect Dis. 2022;28(12):2508-2512. https://doi.org/10.3201/eid2812.221276
AMA Rodriguez-Nava G, Kadlecik P, Filardo TD, et al. Myocarditis Attributable to Monkeypox Virus Infection in 2 Patients, United States, 2022. Emerging Infectious Diseases. 2022;28(12):2508-2512. doi:10.3201/eid2812.221276.
APA Rodriguez-Nava, G., Kadlecik, P., Filardo, T. D., Ain, D. L., Cooper, J. D., McCormick, D. W....Sahni, H. K. (2022). Myocarditis Attributable to Monkeypox Virus Infection in 2 Patients, United States, 2022. Emerging Infectious Diseases, 28(12), 2508-2512. https://doi.org/10.3201/eid2812.221276.

Monkeypox Virus Detection in Different Clinical Specimen Types [PDF - 285 KB - 3 pages]
M. Hasso et al.

A global monkeypox outbreak began in May 2022. Limited data exist on specimen type performance in associated molecular diagnostics. Consequently, a diverse range of specimen sources were collected in the initial weeks of the outbreak in Ontario, Canada. Our clinical evaluation identified skin lesions as the optimal diagnostic specimen source.

EID Hasso M, Perusini S, Eshaghi A, Tang E, Olsha R, Zhang H, et al. Monkeypox Virus Detection in Different Clinical Specimen Types. Emerg Infect Dis. 2022;28(12):2513-2515. https://doi.org/10.3201/eid2812.221160
AMA Hasso M, Perusini S, Eshaghi A, et al. Monkeypox Virus Detection in Different Clinical Specimen Types. Emerging Infectious Diseases. 2022;28(12):2513-2515. doi:10.3201/eid2812.221160.
APA Hasso, M., Perusini, S., Eshaghi, A., Tang, E., Olsha, R., Zhang, H....Gubbay, J. B. (2022). Monkeypox Virus Detection in Different Clinical Specimen Types. Emerging Infectious Diseases, 28(12), 2513-2515. https://doi.org/10.3201/eid2812.221160.

Monkeypox after Occupational Needlestick Injury from Pustule [PDF - 1.40 MB - 4 pages]
J. P. Caldas et al.

We report a case of monkeypox in a physician after an occupational needlestick injury from a pustule. This case highlights risk for occupational transmission and manifestations of the disease after percutaneous transmission: a short incubation period, followed by a solitary lesion at the injured site and later by systemic symptoms.

EID Caldas JP, Valdoleiros SR, Rebelo S, Tavares M. Monkeypox after Occupational Needlestick Injury from Pustule. Emerg Infect Dis. 2022;28(12):2516-2519. https://doi.org/10.3201/eid2812.221374
AMA Caldas JP, Valdoleiros SR, Rebelo S, et al. Monkeypox after Occupational Needlestick Injury from Pustule. Emerging Infectious Diseases. 2022;28(12):2516-2519. doi:10.3201/eid2812.221374.
APA Caldas, J. P., Valdoleiros, S. R., Rebelo, S., & Tavares, M. (2022). Monkeypox after Occupational Needlestick Injury from Pustule. Emerging Infectious Diseases, 28(12), 2516-2519. https://doi.org/10.3201/eid2812.221374.

Possible Occupational Infection of Healthcare Workers with Monkeypox Virus, Brazil [PDF - 1.06 MB - 4 pages]
R. Salvato et al.

We evaluated epidemiologic and molecular characteristics of monkeypox virus (MPXV) infections sampled from 2 healthcare nurses. Five days after collecting samples from an infected patient, the nurses showed typical MPXV manifestations; quantitative PCR and whole-genome sequencing confirmed MPXV infection, most likely transmitted through contact with fomites.

EID Salvato R, Rodrigues Ikeda M, Barcellos R, Godinho F, Sesterheim P, Bitencourt L, et al. Possible Occupational Infection of Healthcare Workers with Monkeypox Virus, Brazil. Emerg Infect Dis. 2022;28(12):2520-2523. https://doi.org/10.3201/eid2812.221343
AMA Salvato R, Rodrigues Ikeda M, Barcellos R, et al. Possible Occupational Infection of Healthcare Workers with Monkeypox Virus, Brazil. Emerging Infectious Diseases. 2022;28(12):2520-2523. doi:10.3201/eid2812.221343.
APA Salvato, R., Rodrigues Ikeda, M., Barcellos, R., Godinho, F., Sesterheim, P., Bitencourt, L....Wallau, G. (2022). Possible Occupational Infection of Healthcare Workers with Monkeypox Virus, Brazil. Emerging Infectious Diseases, 28(12), 2520-2523. https://doi.org/10.3201/eid2812.221343.

Natural Mediterranean Spotted Fever Foci, Qingdao, China [PDF - 724 KB - 4 pages]
X. Gu et al.

We sequenced DNA from spleens of rodents captured in rural areas of Qingdao, East China, during 2013–2015. We found 1 Apodemus agrarius mouse infected with Rickettsia conorii, indicating a natural Mediterranean spotted fever foci exists in East China and that the range of R. conorii could be expanding.

EID Gu X, Wang R, Zhou C, Cui J, Li Z, Jiang Z, et al. Natural Mediterranean Spotted Fever Foci, Qingdao, China. Emerg Infect Dis. 2022;28(12):2524-2527. https://doi.org/10.3201/eid2812.221097
AMA Gu X, Wang R, Zhou C, et al. Natural Mediterranean Spotted Fever Foci, Qingdao, China. Emerging Infectious Diseases. 2022;28(12):2524-2527. doi:10.3201/eid2812.221097.
APA Gu, X., Wang, R., Zhou, C., Cui, J., Li, Z., Jiang, Z....Yu, X. (2022). Natural Mediterranean Spotted Fever Foci, Qingdao, China. Emerging Infectious Diseases, 28(12), 2524-2527. https://doi.org/10.3201/eid2812.221097.

Highly Diverse Arenaviruses in Neotropical Bats, Brazil [PDF - 2.29 MB - 6 pages]
L. Bentim Góes et al.

We detected arenavirus RNA in 1.6% of 1,047 bats in Brazil that were sampled during 2007–2011. We identified Tacaribe virus in 2 Artibeus sp. bats and a new arenavirus species in Carollia perspicillata bats that we named Tietê mammarenavirus. Our results suggest that bats are an underrecognized arenavirus reservoir.

EID Bentim Góes L, Fischer C, Almeida Campos A, de Carvalho C, Moreira-Soto A, Ambar G, et al. Highly Diverse Arenaviruses in Neotropical Bats, Brazil. Emerg Infect Dis. 2022;28(12):2528-2533. https://doi.org/10.3201/eid2812.220980
AMA Bentim Góes L, Fischer C, Almeida Campos A, et al. Highly Diverse Arenaviruses in Neotropical Bats, Brazil. Emerging Infectious Diseases. 2022;28(12):2528-2533. doi:10.3201/eid2812.220980.
APA Bentim Góes, L., Fischer, C., Almeida Campos, A., de Carvalho, C., Moreira-Soto, A., Ambar, G....Drexler, J. (2022). Highly Diverse Arenaviruses in Neotropical Bats, Brazil. Emerging Infectious Diseases, 28(12), 2528-2533. https://doi.org/10.3201/eid2812.220980.

Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus in Poultry, Benin, 2021 [PDF - 1.25 MB - 4 pages]
I. Sanogo et al.

In August 2021, we detected highly pathogenic avian influenza A(H5N1) clade 2.3.4.4b viruses in poultry in southern Benin. The isolates were genetically similar to H5N1 viruses of clade 2.3.4.4b isolated during the same period in Africa and Europe. We also found evidence for 2 separate introductions of these viruses into Benin.

EID Sanogo I, Djegui F, Akpo Y, Gnanvi C, Dupré G, Rubrum A, et al. Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus in Poultry, Benin, 2021. Emerg Infect Dis. 2022;28(12):2534-2537. https://doi.org/10.3201/eid2812.221020
AMA Sanogo I, Djegui F, Akpo Y, et al. Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus in Poultry, Benin, 2021. Emerging Infectious Diseases. 2022;28(12):2534-2537. doi:10.3201/eid2812.221020.
APA Sanogo, I., Djegui, F., Akpo, Y., Gnanvi, C., Dupré, G., Rubrum, A....Ducatez, M. F. (2022). Highly Pathogenic Avian Influenza A(H5N1) Clade 2.3.4.4b Virus in Poultry, Benin, 2021. Emerging Infectious Diseases, 28(12), 2534-2537. https://doi.org/10.3201/eid2812.221020.

Mass Mortality Caused by Highly Pathogenic Influenza A(H5N1) Virus in Sandwich Terns, the Netherlands, 2022 [PDF - 1.42 MB - 5 pages]
J. M. Rijks et al.

We collected data on mass mortality in Sandwich terns (Thalasseus sandvicensis) during the 2022 breeding season in the Netherlands. Mortality was associated with at least 2 variants of highly pathogenic avian influenza A(H5N1) virus clade 2.3.4.4b. We report on carcass removal efforts relative to survival in colonies. Mitigation strategies urgently require structured research.

EID Rijks JM, Leopold MF, Kühn S, in ‘t Veld R, Schenk F, Brenninkmeijer A, et al. Mass Mortality Caused by Highly Pathogenic Influenza A(H5N1) Virus in Sandwich Terns, the Netherlands, 2022. Emerg Infect Dis. 2022;28(12):2538-2542. https://doi.org/10.3201/eid2812.221292
AMA Rijks JM, Leopold MF, Kühn S, et al. Mass Mortality Caused by Highly Pathogenic Influenza A(H5N1) Virus in Sandwich Terns, the Netherlands, 2022. Emerging Infectious Diseases. 2022;28(12):2538-2542. doi:10.3201/eid2812.221292.
APA Rijks, J. M., Leopold, M. F., Kühn, S., in ‘t Veld, R., Schenk, F., Brenninkmeijer, A....Beerens, N. (2022). Mass Mortality Caused by Highly Pathogenic Influenza A(H5N1) Virus in Sandwich Terns, the Netherlands, 2022. Emerging Infectious Diseases, 28(12), 2538-2542. https://doi.org/10.3201/eid2812.221292.

Hepatitis E Virus Infections in Free-Ranging and Captive Cetaceans, Spain, 2011–2022 [PDF - 1.74 MB - 5 pages]
J. Caballero-Gómez et al.

Epidemiologic surveillance of hepatitis E virus in over 300 free-ranging and captive cetaceans in waters off Spain revealed extensive exposure to this pathogen. We suggest the persistent and widespread presence of hepatitis E in the marine environment off the coast of Spain may be driven by terrestrial sources of contamination.

EID Caballero-Gómez J, Rivero-Juarez A, Beato-Benítez A, Fernández-Maldonado C, Domingo M, García-Párraga D, et al. Hepatitis E Virus Infections in Free-Ranging and Captive Cetaceans, Spain, 2011–2022. Emerg Infect Dis. 2022;28(12):2543-2547. https://doi.org/10.3201/eid2812.221188
AMA Caballero-Gómez J, Rivero-Juarez A, Beato-Benítez A, et al. Hepatitis E Virus Infections in Free-Ranging and Captive Cetaceans, Spain, 2011–2022. Emerging Infectious Diseases. 2022;28(12):2543-2547. doi:10.3201/eid2812.221188.
APA Caballero-Gómez, J., Rivero-Juarez, A., Beato-Benítez, A., Fernández-Maldonado, C., Domingo, M., García-Párraga, D....García-Bocanegra, I. (2022). Hepatitis E Virus Infections in Free-Ranging and Captive Cetaceans, Spain, 2011–2022. Emerging Infectious Diseases, 28(12), 2543-2547. https://doi.org/10.3201/eid2812.221188.

Sylvatic Transmission of Chikungunya Virus among Nonhuman Primates in Myanmar [PDF - 1.35 MB - 4 pages]
T. Evans et al.

Nonhuman primates living in proximity to humans increase risks for sylvatic arbovirus transmission. We collected serum samples from nonhuman primates in Hlawga National Park near Yangon, Myanmar, and detected antibodies against chikungunya (33%) and Japanese encephalitis (4%) viruses. Buffer zones between primate and human communities might reduce cross-species arbovirus transmission.

EID Evans T, Aung O, Cords O, Coffey LL, Wong T, Weiss CM, et al. Sylvatic Transmission of Chikungunya Virus among Nonhuman Primates in Myanmar. Emerg Infect Dis. 2022;28(12):2548-2551. https://doi.org/10.3201/eid2812.220893
AMA Evans T, Aung O, Cords O, et al. Sylvatic Transmission of Chikungunya Virus among Nonhuman Primates in Myanmar. Emerging Infectious Diseases. 2022;28(12):2548-2551. doi:10.3201/eid2812.220893.
APA Evans, T., Aung, O., Cords, O., Coffey, L. L., Wong, T., Weiss, C. M....Johnson, C. K. (2022). Sylvatic Transmission of Chikungunya Virus among Nonhuman Primates in Myanmar. Emerging Infectious Diseases, 28(12), 2548-2551. https://doi.org/10.3201/eid2812.220893.
Research Letters

Hemotropic Mycoplasma spp. in Aquatic Mammals, Amazon Basin, Brazil [PDF - 570 KB - 4 pages]
A. Duarte-Benvenuto et al.

Hemotropic Mycoplasma spp. (hemoplasmas) are uncultivable bacteria that infect mammals, including humans. We detected a potentially novel hemoplasma species in blood samples from wild river dolphins in the Amazon River Basin, Brazil. Further investigation could determine pathogenicity and zoonotic potential of the detected hemoplasma.

EID Duarte-Benvenuto A, Sacristán C, Ewbank A, Sacristán I, Zamana-Ramblas R, Gravena W, et al. Hemotropic Mycoplasma spp. in Aquatic Mammals, Amazon Basin, Brazil. Emerg Infect Dis. 2022;28(12):2556-2559. https://doi.org/10.3201/eid2812.220971
AMA Duarte-Benvenuto A, Sacristán C, Ewbank A, et al. Hemotropic Mycoplasma spp. in Aquatic Mammals, Amazon Basin, Brazil. Emerging Infectious Diseases. 2022;28(12):2556-2559. doi:10.3201/eid2812.220971.
APA Duarte-Benvenuto, A., Sacristán, C., Ewbank, A., Sacristán, I., Zamana-Ramblas, R., Gravena, W....Catão-Dias, J. L. (2022). Hemotropic Mycoplasma spp. in Aquatic Mammals, Amazon Basin, Brazil. Emerging Infectious Diseases, 28(12), 2556-2559. https://doi.org/10.3201/eid2812.220971.

Human Thelaziosis Caused by Thelazia callipaeda Eyeworm, Hungary [PDF - 870 KB - 3 pages]
H. Juhász et al.

Ocular infections with Thelazia callipaeda eyeworms in Europe have become more common. We report a case in Hungary caused by T. callipaeda eyeworms in a 45-year-old woman who had no travel history abroad.

EID Juhász H, Thury G, Szécsényi M, Tóth-Molnár E, Burián K, Deim Z, et al. Human Thelaziosis Caused by Thelazia callipaeda Eyeworm, Hungary. Emerg Infect Dis. 2022;28(12):2559-2561. https://doi.org/10.3201/eid2812.220757
AMA Juhász H, Thury G, Szécsényi M, et al. Human Thelaziosis Caused by Thelazia callipaeda Eyeworm, Hungary. Emerging Infectious Diseases. 2022;28(12):2559-2561. doi:10.3201/eid2812.220757.
APA Juhász, H., Thury, G., Szécsényi, M., Tóth-Molnár, E., Burián, K., Deim, Z....Terhes, G. (2022). Human Thelaziosis Caused by Thelazia callipaeda Eyeworm, Hungary. Emerging Infectious Diseases, 28(12), 2559-2561. https://doi.org/10.3201/eid2812.220757.

Severe Human Case of Zoonotic Infection with Swine-Origin Influenza A Virus, Denmark, 2021 [PDF - 920 KB - 4 pages]
K. M. Andersen et al.

During routine surveillance at the National Influenza Center, Denmark, we detected a zoonotic swine influenza A virus in a patient who became severely ill. We describe the clinical picture and the genetic characterization of this variant virus, which is distinct from another variant found previously in Denmark.

EID Andersen KM, Vestergaard LS, Nissen JN, George SJ, Ryt-Hansen P, Hjulsager CK, et al. Severe Human Case of Zoonotic Infection with Swine-Origin Influenza A Virus, Denmark, 2021. Emerg Infect Dis. 2022;28(12):2561-2564. https://doi.org/10.3201/eid2812.220935
AMA Andersen KM, Vestergaard LS, Nissen JN, et al. Severe Human Case of Zoonotic Infection with Swine-Origin Influenza A Virus, Denmark, 2021. Emerging Infectious Diseases. 2022;28(12):2561-2564. doi:10.3201/eid2812.220935.
APA Andersen, K. M., Vestergaard, L. S., Nissen, J. N., George, S. J., Ryt-Hansen, P., Hjulsager, C. K....Trebbien, R. (2022). Severe Human Case of Zoonotic Infection with Swine-Origin Influenza A Virus, Denmark, 2021. Emerging Infectious Diseases, 28(12), 2561-2564. https://doi.org/10.3201/eid2812.220935.

Autochthonous Angiostrongylus cantonensis Lungworms in Urban Rats, Valencia, Spain, 2021 [PDF - 746 KB - 4 pages]
M. Galán-Puchades et al.

To determine the role of rats as potential reservoirs of zoonotic parasites, we examined rats trapped in urban sewers of Valencia, Spain, in 2021. Morphologic and molecular identification and sequencing identified autochthonous Angiostrongylus cantonensis nematodes, the most common cause of human eosinophilic meningitis, in pulmonary arteries of Rattus norvegicus and R. rattus rats.

EID Galán-Puchades M, Gómez-Samblás M, Osuna A, Sáez-Durán S, Bueno-Marí R, Fuentes MV. Autochthonous Angiostrongylus cantonensis Lungworms in Urban Rats, Valencia, Spain, 2021. Emerg Infect Dis. 2022;28(12):2564-2567. https://doi.org/10.3201/eid2812.220418
AMA Galán-Puchades M, Gómez-Samblás M, Osuna A, et al. Autochthonous Angiostrongylus cantonensis Lungworms in Urban Rats, Valencia, Spain, 2021. Emerging Infectious Diseases. 2022;28(12):2564-2567. doi:10.3201/eid2812.220418.
APA Galán-Puchades, M., Gómez-Samblás, M., Osuna, A., Sáez-Durán, S., Bueno-Marí, R., & Fuentes, M. V. (2022). Autochthonous Angiostrongylus cantonensis Lungworms in Urban Rats, Valencia, Spain, 2021. Emerging Infectious Diseases, 28(12), 2564-2567. https://doi.org/10.3201/eid2812.220418.

Laboratory Features of Trichinellosis and Eosinophilia Threshold for Testing, Nunavik, Quebec, Canada, 2009–2019 [PDF - 446 KB - 3 pages]
L. B. Harrison et al.

Prolonged eosinophilia is characteristic of trichinellosis. To determine the optimal eosinophil threshold for reflex Trichinella testing, we examined all 43 cases in Nunavik, Quebec, Canada, during 2009–2019. Using receiver operating characteristic analysis, we determined that eosinophil counts >0.8 × 109 cells/L should prompt consideration of trichinellosis and testing to rapidly identify potential outbreaks.

EID Harrison LB, Libman MD, Caya C, Ndao M, Yansouni CP. Laboratory Features of Trichinellosis and Eosinophilia Threshold for Testing, Nunavik, Quebec, Canada, 2009–2019. Emerg Infect Dis. 2022;28(12):2567-2569. https://doi.org/10.3201/eid2812.221144
AMA Harrison LB, Libman MD, Caya C, et al. Laboratory Features of Trichinellosis and Eosinophilia Threshold for Testing, Nunavik, Quebec, Canada, 2009–2019. Emerging Infectious Diseases. 2022;28(12):2567-2569. doi:10.3201/eid2812.221144.
APA Harrison, L. B., Libman, M. D., Caya, C., Ndao, M., & Yansouni, C. P. (2022). Laboratory Features of Trichinellosis and Eosinophilia Threshold for Testing, Nunavik, Quebec, Canada, 2009–2019. Emerging Infectious Diseases, 28(12), 2567-2569. https://doi.org/10.3201/eid2812.221144.

Dirofilaria repens Testicular Infection in Child, Italy [PDF - 838 KB - 4 pages]
S. Ugolini et al.

Testicular Dirofilaria repens infection was identified and confirmed by sequence analysis in a child in northeastern Italy. Because human dirofilariasis is emerging in southern and eastern Europe, this parasitic infection should be considered in the differential diagnosis of scrotal swelling in disease-endemic countries to avoid unnecessary interventions, such as orchiectomy.

EID Ugolini S, Lima M, Maffi M, Pierangeli F, Vastano M, Gargano T, et al. Dirofilaria repens Testicular Infection in Child, Italy. Emerg Infect Dis. 2022;28(12):2569-2572. https://doi.org/10.3201/eid2812.220424
AMA Ugolini S, Lima M, Maffi M, et al. Dirofilaria repens Testicular Infection in Child, Italy. Emerging Infectious Diseases. 2022;28(12):2569-2572. doi:10.3201/eid2812.220424.
APA Ugolini, S., Lima, M., Maffi, M., Pierangeli, F., Vastano, M., Gargano, T....Fioravanti, M. L. (2022). Dirofilaria repens Testicular Infection in Child, Italy. Emerging Infectious Diseases, 28(12), 2569-2572. https://doi.org/10.3201/eid2812.220424.

Severe Fever with Thrombocytopenia Syndrome Virus Infection, Thailand, 2019–2020 [PDF - 635 KB - 3 pages]
P. Rattanakomol et al.

Infection with severe fever with thrombocytopenia syndrome (SFTS) virus, which can cause hemorrhagic febrile illness, is often transmitted by ticks. We identified 3 patients with SFTS in or near Bangkok, Thailand. Our results underscore a need for heightened awareness by clinicians of possible SFTS virus, even in urban centers.

EID Rattanakomol P, Khongwichit S, Linsuwanon P, Lee K, Vongpunsawad S, Poovorawan Y. Severe Fever with Thrombocytopenia Syndrome Virus Infection, Thailand, 2019–2020. Emerg Infect Dis. 2022;28(12):2572-2574. https://doi.org/10.3201/eid2812.221183
AMA Rattanakomol P, Khongwichit S, Linsuwanon P, et al. Severe Fever with Thrombocytopenia Syndrome Virus Infection, Thailand, 2019–2020. Emerging Infectious Diseases. 2022;28(12):2572-2574. doi:10.3201/eid2812.221183.
APA Rattanakomol, P., Khongwichit, S., Linsuwanon, P., Lee, K., Vongpunsawad, S., & Poovorawan, Y. (2022). Severe Fever with Thrombocytopenia Syndrome Virus Infection, Thailand, 2019–2020. Emerging Infectious Diseases, 28(12), 2572-2574. https://doi.org/10.3201/eid2812.221183.

Omicron BA.5 Neutralization among Vaccine-Boosted Persons with Prior Omicron BA.1/BA.2 Infections [PDF - 551 KB - 3 pages]
R. M. Pedersen et al.

Worldwide, millions of persons have received multiple COVID-19 vaccinations and subsequently recovered from SARS-CoV-2 Omicron breakthrough infections. In 2 small, matched cohorts (n = 12, n = 24) in Denmark, we found Omicron BA.1/BA.2 breakthrough infection after 3-dose BNT162b2 vaccination provided improved Omicron BA.5 neutralization over 3-dose vaccination alone.

EID Pedersen RM, Bang LL, Tornby DS, Madsen LW, Holm DK, Sydenham TV, et al. Omicron BA.5 Neutralization among Vaccine-Boosted Persons with Prior Omicron BA.1/BA.2 Infections. Emerg Infect Dis. 2022;28(12):2575-2577. https://doi.org/10.3201/eid2812.221304
AMA Pedersen RM, Bang LL, Tornby DS, et al. Omicron BA.5 Neutralization among Vaccine-Boosted Persons with Prior Omicron BA.1/BA.2 Infections. Emerging Infectious Diseases. 2022;28(12):2575-2577. doi:10.3201/eid2812.221304.
APA Pedersen, R. M., Bang, L. L., Tornby, D. S., Madsen, L. W., Holm, D. K., Sydenham, T. V....Andersen, T. E. (2022). Omicron BA.5 Neutralization among Vaccine-Boosted Persons with Prior Omicron BA.1/BA.2 Infections. Emerging Infectious Diseases, 28(12), 2575-2577. https://doi.org/10.3201/eid2812.221304.

Serologic Surveillance for SARS-CoV-2 Infection among Wild Rodents, Europe [PDF - 957 KB - 4 pages]
V. Bourret et al.

We report results from serologic surveillance for exposure to SARS-CoV-2 among 1,237 wild rodents and small mammals across Europe. All samples were negative, with the possible exception of 1. Despite suspected potential for human-to-rodent spillover, no evidence of widespread SARS-CoV-2 circulation in rodent populations has been reported to date.

Esitämme tulokset serologisesta tutkimuksesta, jossa seulottiin SARS-CoV-2 tartuntojen varalta 1,237 luonnonvaraista jyrsijää ja piennisäkästä eri puolilta Eurooppaa. Kaikki näytteet olivat negatiivisia, yhtä näytettä lukuun ottamatta. SARS-CoV-2:n läikkymisen ihmisistä jyrsijöihin on arveltu olevan mahdollista, mutta todisteet viruksen laajamittaisesta leviämisestä jyrsijäpopulaatioissa puuttuvat.

EID Bourret V, Dutra L, Alburkat H, Mäki S, Lintunen E, Wasniewski M, et al. Serologic Surveillance for SARS-CoV-2 Infection among Wild Rodents, Europe. Emerg Infect Dis. 2022;28(12):2577-2580. https://doi.org/10.3201/eid2812.221235
AMA Bourret V, Dutra L, Alburkat H, et al. Serologic Surveillance for SARS-CoV-2 Infection among Wild Rodents, Europe. Emerging Infectious Diseases. 2022;28(12):2577-2580. doi:10.3201/eid2812.221235.
APA Bourret, V., Dutra, L., Alburkat, H., Mäki, S., Lintunen, E., Wasniewski, M....Sironen, T. (2022). Serologic Surveillance for SARS-CoV-2 Infection among Wild Rodents, Europe. Emerging Infectious Diseases, 28(12), 2577-2580. https://doi.org/10.3201/eid2812.221235.

Delayed Diagnosis of Acute Q Fever, China [PDF - 465 KB - 3 pages]
D. Li et al.

We report a patient in China with fever of unknown origin who visited 3 hospitals in 3 weeks and was finally given a diagnosis of acute Q fever, determined by metagenomics next-generation sequencing. Our results indicate that physicians are unfamiliar with Q fever and the disease is neglected in China.

EID Li D, Liu H, Liu M, Chang C, Zhao X, Yu H, et al. Delayed Diagnosis of Acute Q Fever, China. Emerg Infect Dis. 2022;28(12):2580-2582. https://doi.org/10.3201/eid2812.221118
AMA Li D, Liu H, Liu M, et al. Delayed Diagnosis of Acute Q Fever, China. Emerging Infectious Diseases. 2022;28(12):2580-2582. doi:10.3201/eid2812.221118.
APA Li, D., Liu, H., Liu, M., Chang, C., Zhao, X., Yu, H....Yu, X. (2022). Delayed Diagnosis of Acute Q Fever, China. Emerging Infectious Diseases, 28(12), 2580-2582. https://doi.org/10.3201/eid2812.221118.

Bombali Ebolavirus in Mops condylurus Bats (Molossidae), Mozambique [PDF - 4.06 MB - 3 pages]
C. Lebarbenchon et al.

We detected Bombali ebolavirus RNA in 3 free-tailed bats (Mops condylurus, Molossidae) in Mozambique. Sequencing of the large protein gene revealed 98% identity with viruses previously detected in Sierra Leone, Kenya, and Guinea. Our findings further support the suspected role of Mops condylurus bats in maintaining Bombali ebolavirus.

EID Lebarbenchon C, Goodman SM, Hoarau A, Le Minter G, Dos Santos A, Schoeman M, et al. Bombali Ebolavirus in Mops condylurus Bats (Molossidae), Mozambique. Emerg Infect Dis. 2022;28(12):2583-2585. https://doi.org/10.3201/eid2812.220853
AMA Lebarbenchon C, Goodman SM, Hoarau A, et al. Bombali Ebolavirus in Mops condylurus Bats (Molossidae), Mozambique. Emerging Infectious Diseases. 2022;28(12):2583-2585. doi:10.3201/eid2812.220853.
APA Lebarbenchon, C., Goodman, S. M., Hoarau, A., Le Minter, G., Dos Santos, A., Schoeman, M....Mavingui, P. (2022). Bombali Ebolavirus in Mops condylurus Bats (Molossidae), Mozambique. Emerging Infectious Diseases, 28(12), 2583-2585. https://doi.org/10.3201/eid2812.220853.
Letters

Hand, Foot, and Mouth Disease as Differential Diagnosis of Monkeypox, Germany, August 2022 [PDF - 493 KB - 1 page]
A. Fathi and S. Schmiedel
EID Fathi A, Schmiedel S. Hand, Foot, and Mouth Disease as Differential Diagnosis of Monkeypox, Germany, August 2022. Emerg Infect Dis. 2022;28(12):2586. https://doi.org/10.3201/eid2812.221487
AMA Fathi A, Schmiedel S. Hand, Foot, and Mouth Disease as Differential Diagnosis of Monkeypox, Germany, August 2022. Emerging Infectious Diseases. 2022;28(12):2586. doi:10.3201/eid2812.221487.
APA Fathi, A., & Schmiedel, S. (2022). Hand, Foot, and Mouth Disease as Differential Diagnosis of Monkeypox, Germany, August 2022. Emerging Infectious Diseases, 28(12), 2586. https://doi.org/10.3201/eid2812.221487.
Another Dimension

Pandemic or Panzootic—A Reflection on Terminology for SARS-CoV-2 Infection [PDF - 275 KB - 4 pages]
S. Agnelli and I. Capua

As of October 2022, a total of 675 natural outbreaks of SARS-CoV-2 infection have occurred in animal species worldwide. Here, we provide a linguistic and etymologic critique of the term “pandemic” being used to describe the COVID-19 health crisis, as opposed to the term “panzootic,” and discuss policy ramifications of more inclusive terminology.

EID Agnelli S, Capua I. Pandemic or Panzootic—A Reflection on Terminology for SARS-CoV-2 Infection. Emerg Infect Dis. 2022;28(12):2552-2555. https://doi.org/10.3201/eid2812.220819
AMA Agnelli S, Capua I. Pandemic or Panzootic—A Reflection on Terminology for SARS-CoV-2 Infection. Emerging Infectious Diseases. 2022;28(12):2552-2555. doi:10.3201/eid2812.220819.
APA Agnelli, S., & Capua, I. (2022). Pandemic or Panzootic—A Reflection on Terminology for SARS-CoV-2 Infection. Emerging Infectious Diseases, 28(12), 2552-2555. https://doi.org/10.3201/eid2812.220819.
Books and Media

Global Health Security: A Blueprint for the Future [PDF - 207 KB - 1 page]
K. M. Bianchi
EID Bianchi KM. Global Health Security: A Blueprint for the Future. Emerg Infect Dis. 2022;28(12):2587. https://doi.org/10.3201/eid2812.221035
AMA Bianchi KM. Global Health Security: A Blueprint for the Future. Emerging Infectious Diseases. 2022;28(12):2587. doi:10.3201/eid2812.221035.
APA Bianchi, K. M. (2022). Global Health Security: A Blueprint for the Future. Emerging Infectious Diseases, 28(12), 2587. https://doi.org/10.3201/eid2812.221035.
About the Cover

A Multiplicity of Perspectives [PDF - 2.31 MB - 2 pages]
B. Breedlove
EID Breedlove B. A Multiplicity of Perspectives. Emerg Infect Dis. 2022;28(12):2588-2589. https://doi.org/10.3201/eid2812.ac2812
AMA Breedlove B. A Multiplicity of Perspectives. Emerging Infectious Diseases. 2022;28(12):2588-2589. doi:10.3201/eid2812.ac2812.
APA Breedlove, B. (2022). A Multiplicity of Perspectives. Emerging Infectious Diseases, 28(12), 2588-2589. https://doi.org/10.3201/eid2812.ac2812.
Page created: November 21, 2022
Page updated: March 13, 2023
Page reviewed: March 13, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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