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Issue Cover for Volume 30, Number 6—June 2024

Volume 30, Number 6—June 2024

[PDF - 34.61 MB - 248 pages]

Perspective

Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections [PDF - 880 KB - 8 pages]
M. R. Mangalea et al.

Antimicrobial resistance in healthcare-associated bacterial pathogens and the infections they cause are major public health threats affecting nearly all healthcare facilities. Antimicrobial-resistant bacterial infections can occur when colonizing pathogenic bacteria that normally make up a small fraction of the human microbiota increase in number in response to clinical perturbations. Such infections are especially likely when pathogens are resistant to the collateral effects of antimicrobial agents that disrupt the human microbiome, resulting in loss of colonization resistance, a key host defense. Pathogen reduction is an emerging strategy to prevent transmission of, and infection with, antimicrobial-resistant healthcare-associated pathogens. We describe the basis for pathogen reduction as an overall prevention strategy, the evidence for its effectiveness, and the role of the human microbiome in colonization resistance that also reduces the risk for infection once colonized. In addition, we explore ideal attributes of current and future pathogen-reducing approaches.

EID Mangalea MR, Halpin A, Haile M, Elkins CA, McDonald L. Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerg Infect Dis. 2024;30(6):1069-1076. https://doi.org/10.3201/eid3006.231338
AMA Mangalea MR, Halpin A, Haile M, et al. Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerging Infectious Diseases. 2024;30(6):1069-1076. doi:10.3201/eid3006.231338.
APA Mangalea, M. R., Halpin, A., Haile, M., Elkins, C. A., & McDonald, L. (2024). Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections. Emerging Infectious Diseases, 30(6), 1069-1076. https://doi.org/10.3201/eid3006.231338.
Synopses

Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France [PDF - 3.18 MB - 11 pages]
C. Vignals et al.

Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis. For this article, we reviewed 7 cases of Scedosporium spp. and L. prolificans arteritis from the Scedosporiosis/lomentosporiosis Observational Study and 13 cases from published literature. Underlying immunosuppression was reported in 70% (14/20) of case-patients, mainly those who had solid organ transplants (10/14). Osteoarticular localization of infection was observed in 50% (10/20) of cases; infections were frequently (7/10) contiguous with vascular infection sites. Scedosporium spp./Lomentospora prolificans infections were diagnosed in 9 of 20 patients ≈3 months after completing treatment for nonvascular scedosporiosis/lomentosporiosis. Aneurysms were found in 8/11 aortitis and 6/10 peripheral arteritis cases. Invasive fungal disease­–related deaths were high (12/18 [67%]). The vascular tropism of Scedosporium spp. and L. prolificans indicates vascular imaging, such as computed tomography angiography, is needed to manage infections, especially for osteoarticular locations.

EID Vignals C, Emmerich J, Begueret H, Garcia-Hermoso D, Martin-Blondel G, Angoulvant A, et al. Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerg Infect Dis. 2024;30(6):1077-1087. https://doi.org/10.3201/eid3006.231409
AMA Vignals C, Emmerich J, Begueret H, et al. Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerging Infectious Diseases. 2024;30(6):1077-1087. doi:10.3201/eid3006.231409.
APA Vignals, C., Emmerich, J., Begueret, H., Garcia-Hermoso, D., Martin-Blondel, G., Angoulvant, A....Bronnimann, D. (2024). Deciphering Unexpected Vascular Locations of Scedosporium spp. and Lomentospora prolificans Fungal Infections, France. Emerging Infectious Diseases, 30(6), 1077-1087. https://doi.org/10.3201/eid3006.231409.

Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019 [PDF - 942 KB - 8 pages]
J. H. Park et al.

The characteristics of severe human parainfluenza virus (HPIV)–associated pneumonia in adults have not been well evaluated. We investigated epidemiologic and clinical characteristics of 143 patients with severe HPIV-associated pneumonia during 2010–2019. HPIV was the most common cause (25.2%) of severe virus-associated hospital-acquired pneumonia and the third most common cause (15.7%) of severe virus-associated community-acquired pneumonia. Hematologic malignancy (35.0%), diabetes mellitus (23.8%), and structural lung disease (21.0%) were common underlying conditions. Co-infections occurred in 54.5% of patients admitted to an intensive care unit. The 90-day mortality rate for HPIV-associated pneumonia was comparable to that for severe influenza virus–associated pneumonia (55.2% vs. 48.4%; p = 0.22). Ribavirin treatment was not associated with lower mortality rates. Fungal co-infections were associated with 82.4% of deaths. Clinicians should consider the possibility of pathogenic co-infections in patients with HPIV-associated pneumonia. Contact precautions and environmental cleaning are crucial to prevent HPIV transmission in hospital settings.

EID Park JH, Hong S, Huh J, Jung J, Kim M, Chong Y, et al. Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019. Emerg Infect Dis. 2024;30(6):1088-1095. https://doi.org/10.3201/eid3006.230670
AMA Park JH, Hong S, Huh J, et al. Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019. Emerging Infectious Diseases. 2024;30(6):1088-1095. doi:10.3201/eid3006.230670.
APA Park, J. H., Hong, S., Huh, J., Jung, J., Kim, M., Chong, Y....Choi, S. (2024). Severe Human Parainfluenza Virus Community- and Healthcare-Acquired Pneumonia in Adults at Tertiary Hospital, Seoul, South Korea, 2010–2019. Emerging Infectious Diseases, 30(6), 1088-1095. https://doi.org/10.3201/eid3006.230670.

Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness [PDF - 1.57 MB - 8 pages]
N. M. Cocoros et al.

Viral respiratory illness surveillance has traditionally focused on single pathogens (e.g., influenza) and required fever to identify influenza-like illness (ILI). We developed an automated system applying both laboratory test and syndrome criteria to electronic health records from 3 practice groups in Massachusetts, USA, to monitor trends in respiratory viral–like illness (RAVIOLI) across multiple pathogens. We identified RAVIOLI syndrome using diagnosis codes associated with respiratory viral testing or positive respiratory viral assays or fever. After retrospectively applying RAVIOLI criteria to electronic health records, we observed annual winter peaks during 2015–2019, predominantly caused by influenza, followed by cyclic peaks corresponding to SARS-CoV-2 surges during 2020–2024, spikes in RSV in mid-2021 and late 2022, and recrudescent influenza in late 2022 and 2023. RAVIOLI rates were higher and fluctuations more pronounced compared with traditional ILI surveillance. RAVIOLI broadens the scope, granularity, sensitivity, and specificity of respiratory viral illness surveillance compared with traditional ILI surveillance.

EID Cocoros NM, Eberhardt K, Nguyen V, Brown CM, DeMaria A, Madoff LC, et al. Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness. Emerg Infect Dis. 2024;30(6):1096-1103. https://doi.org/10.3201/eid3006.230473
AMA Cocoros NM, Eberhardt K, Nguyen V, et al. Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness. Emerging Infectious Diseases. 2024;30(6):1096-1103. doi:10.3201/eid3006.230473.
APA Cocoros, N. M., Eberhardt, K., Nguyen, V., Brown, C. M., DeMaria, A., Madoff, L. C....Klompas, M. (2024). Electronic Health Record–Based Algorithm for Monitoring Respiratory Virus–Like Illness. Emerging Infectious Diseases, 30(6), 1096-1103. https://doi.org/10.3201/eid3006.230473.
Research

Medscape CME Activity
Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020 [PDF - 912 KB - 11 pages]
H. N. Grome et al.

We conducted surveillance for carbapenem-resistant Enterobacterales (CRE) during 2016–2020 at 10 US sites and extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E) during 2019–2020 at 6 US sites. Among 159 CRE cases in children (median age 5 years), CRE was isolated from urine for 131 (82.4%) and blood from 20 (12.6%). Annual CRE incidence rate (cases/100,000 population) was 0.47–0.87. Among 207 ESBL-E cases in children (median age 6 years), ESBL-E was isolated from urine of 196 (94.7%) and blood of 8 (3.9%). Annual ESBL-E incidence rate was 26.5 in 2019 and 19.63 in 2020. CRE and ESBL-E rates were >2-fold higher among infants than other age groups. Most CRE and ESBL-E cases were healthcare-associated community-onset (68 [43.0%] for CRE vs. 40 [23.7%] for ESBL-E) or community-associated (43 [27.2%] for CRE vs. 109 [64.5%] for ESBL-E). Programs to detect, prevent, and treat multidrug-resistant infections must include pediatric populations (particularly the youngest) and outpatient settings.

EID Grome HN, Grass JE, Duffy N, Bulens SN, Ansari U, Campbell D, et al. Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020. Emerg Infect Dis. 2024;30(6):1104-1114. https://doi.org/10.3201/eid3006.231734
AMA Grome HN, Grass JE, Duffy N, et al. Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020. Emerging Infectious Diseases. 2024;30(6):1104-1114. doi:10.3201/eid3006.231734.
APA Grome, H. N., Grass, J. E., Duffy, N., Bulens, S. N., Ansari, U., Campbell, D....Guh, A. Y. (2024). Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020. Emerging Infectious Diseases, 30(6), 1104-1114. https://doi.org/10.3201/eid3006.231734.

Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru [PDF - 1.08 MB - 10 pages]
Q. Tan et al.

The World Health Organization’s end TB strategy promotes the use of symptom and chest radiograph screening for tuberculosis (TB) disease. However, asymptomatic early states of TB beyond latent TB infection and active disease can go unrecognized using current screening criteria. We conducted a longitudinal cohort study enrolling household contacts initially free of TB disease and followed them for the occurrence of incident TB over 1 year. Among 1,747 screened contacts, 27 (52%) of the 52 persons in whom TB subsequently developed during follow-up had a baseline abnormal radiograph. Of contacts without TB symptoms, persons with an abnormal radiograph were at higher risk for subsequent TB than persons with an unremarkable radiograph (adjusted hazard ratio 15.62 [95% CI 7.74–31.54]). In young adults, we found a strong linear relationship between radiograph severity and time to TB diagnosis. Our findings suggest chest radiograph screening can extend to detecting early TB states, thereby enabling timely intervention.

EID Tan Q, Huang C, Becerra MC, Calderon R, Contreras C, Lecca L, et al. Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru. Emerg Infect Dis. 2024;30(6):1115-1124. https://doi.org/10.3201/eid3006.231699
AMA Tan Q, Huang C, Becerra MC, et al. Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru. Emerging Infectious Diseases. 2024;30(6):1115-1124. doi:10.3201/eid3006.231699.
APA Tan, Q., Huang, C., Becerra, M. C., Calderon, R., Contreras, C., Lecca, L....Murray, M. B. (2024). Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru. Emerging Infectious Diseases, 30(6), 1115-1124. https://doi.org/10.3201/eid3006.231699.

Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022 [PDF - 2.78 MB - 8 pages]
Y. Yang et al.

During October 2022, enteric redmouth disease (ERM) affected Chinese sturgeons at a farm in Hubei, China, causing mass mortality. Affected fish exhibited characteristic red mouth and intestinal inflammation. Investigation led to isolation of a prominent bacterial strain, zhx1, from the internal organs and intestines of affected fish. Artificial infection experiments confirmed the role of zhx1 as the pathogen responsible for the deaths. The primary pathologic manifestations consisted of degeneration, necrosis, and inflammatory reactions, resulting in multiple organ dysfunction and death. Whole-genome sequencing of the bacteria identified zhx1 as Yersinia ruckeri, which possesses 135 drug-resistance genes and 443 virulence factor-related genes. Drug-susceptibility testing of zhx1 demonstrated high sensitivity to chloramphenicol and florfenicol but varying degrees of resistance to 18 other antimicrobial drugs. Identifying the pathogenic bacteria associated with ERM in Chinese sturgeons establishes a theoretical foundation for the effective prevention and control of this disease.

EID Yang Y, Xu S, He H, Zhu X, Liu Y, Hu M, et al. Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022. Emerg Infect Dis. 2024;30(6):1125-1132. https://doi.org/10.3201/eid3006.231354
AMA Yang Y, Xu S, He H, et al. Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022. Emerging Infectious Diseases. 2024;30(6):1125-1132. doi:10.3201/eid3006.231354.
APA Yang, Y., Xu, S., He, H., Zhu, X., Liu, Y., Hu, M....Zhang, H. (2024). Yersinia ruckeri Infection and Enteric Redmouth Disease among Endangered Chinese Sturgeons, China, 2022. Emerging Infectious Diseases, 30(6), 1125-1132. https://doi.org/10.3201/eid3006.231354.

Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada [PDF - 4.31 MB - 11 pages]
S. Lair et al.

We describe an unusual mortality event caused by a highly pathogenic avian influenza (HPAI) A(H5N1) virus clade 2.3.4.4b involving harbor (Phoca vitulina) and gray (Halichoerus grypus) seals in the St. Lawrence Estuary, Quebec, Canada, in 2022. Fifteen (56%) of the seals submitted for necropsy were considered to be fatally infected by HPAI H5N1 containing fully Eurasian or Eurasian/North American genome constellations. Concurrently, presence of large numbers of bird carcasses infected with HPAI H5N1 at seal haul-out sites most likely contributed to the spillover of infection to the seals. Histologic changes included meningoencephalitis (100%), fibrinosuppurative alveolitis, and multiorgan acute necrotizing inflammation. This report of fatal HPAI H5N1 infection in pinnipeds in Canada raises concerns about the expanding host of this virus, the potential for the establishment of a marine mammal reservoir, and the public health risks associated with spillover to mammals.

Nous décrivons un événement de mortalité inhabituelle causé par un virus de l’influenza aviaire hautement pathogène A(H5N1) clade 2.3.4.4b chez des phoques communs (Phoca vitulina) et gris (Halichoerus grypus) dans l’estuaire du Saint-Laurent au Québec, Canada, en 2022. Quinze (56%) des phoques soumis pour nécropsie ont été considérés comme étant fatalement infectés par le virus H5N1 de lignées eurasiennes ou de réassortiment eurasiennes/nord-américaines. Un grand nombre simultané de carcasses d’oiseaux infectés par le H5N1 sur les sites d’échouement a probablement contribué à la contamination de ces phoques. Les changements histologiques associés à cette infection incluaient : méningo-encéphalite (100%), alvéolite fibrinosuppurée et inflammation nécrosante aiguë multi-organique. Cette documentation soulève des préoccupations quant à l’émergence de virus mortels, à la possibilité d’établissement de réservoirs chez les mammifères marins, et aux risques pour la santé publique associés aux propagations du virus chez les mammifères.

EID Lair S, Quesnel L, Signore AV, Delnatte P, Embury-Hyatt C, Nadeau M, et al. Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada. Emerg Infect Dis. 2024;30(6):1133-1143. https://doi.org/10.3201/eid3006.231033
AMA Lair S, Quesnel L, Signore AV, et al. Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada. Emerging Infectious Diseases. 2024;30(6):1133-1143. doi:10.3201/eid3006.231033.
APA Lair, S., Quesnel, L., Signore, A. V., Delnatte, P., Embury-Hyatt, C., Nadeau, M....Berhane, Y. (2024). Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Virus in Seals, St. Lawrence Estuary, Quebec, Canada. Emerging Infectious Diseases, 30(6), 1133-1143. https://doi.org/10.3201/eid3006.231033.

Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States [PDF - 831 KB - 10 pages]
I. Griffin et al.

Few precise estimates of hospitalization and fatality rates from COVID-19 exist for naive populations, especially within demographic subgroups. We estimated rates among persons with SARS-CoV-2 infection in the United States during May 1–December 1, 2020, before vaccines became available. Both rates generally increased with age; fatality rates were highest for persons >85 years of age (24%) and lowest for children 1–14 years of age (0.01%). Age-adjusted case hospitalization rates were highest for African American or Black, not Hispanic persons (14%), and case-fatality rates were highest for Asian or Pacific Islander, not Hispanic persons (4.4%). Eighteen percent of hospitalized patients and 44.2% of those admitted to an intensive care unit died. Male patients had higher hospitalization (6.2% vs. 5.2%) and fatality rates (1.9% vs. 1.5%) than female patients. These findings highlight the importance of collecting surveillance data to devise appropriate control measures for persons in underserved racial/ethnic groups and older adults.

EID Griffin I, King J, Lyons B, Singleton AL, Deng X, Bruce BB, et al. Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States. Emerg Infect Dis. 2024;30(6):1144-1153. https://doi.org/10.3201/eid3006.231285
AMA Griffin I, King J, Lyons B, et al. Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States. Emerging Infectious Diseases. 2024;30(6):1144-1153. doi:10.3201/eid3006.231285.
APA Griffin, I., King, J., Lyons, B., Singleton, A. L., Deng, X., Bruce, B. B....Griffin, P. M. (2024). Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States. Emerging Infectious Diseases, 30(6), 1144-1153. https://doi.org/10.3201/eid3006.231285.

Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea [PDF - 2.23 MB - 10 pages]
T. Chang et al.

We investigated trends in notifiable infectious diseases in both humans and animals during the COVID-19 pandemic in South Korea and compared those data against expected trends had nonpharmaceutical interventions (NPIs) not been implemented. We found that human respiratory infectious diseases other than COVID-19 decreased by an average of 54.7% after NPIs were introduced. On the basis of that trend, we estimated that annual medical expenses associated with respiratory infections other than COVID-19 also decreased by 3.8% in 2020 and 18.9% in 2021. However, human gastrointestinal infectious diseases and livestock diseases exhibited similar or even higher incidence rates after NPIs were instituted. Our investigation revealed that the preventive effect of NPIs varied among diseases and that NPIs might have had limited effectiveness in reducing the spread of certain types of infectious diseases. These findings suggest the need for future, novel public health interventions to compensate for such limitations.

EID Chang T, Cho S, Yoo D, Min K. Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea. Emerg Infect Dis. 2024;30(6):1154-1163. https://doi.org/10.3201/eid3006.231422
AMA Chang T, Cho S, Yoo D, et al. Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea. Emerging Infectious Diseases. 2024;30(6):1154-1163. doi:10.3201/eid3006.231422.
APA Chang, T., Cho, S., Yoo, D., & Min, K. (2024). Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea. Emerging Infectious Diseases, 30(6), 1154-1163. https://doi.org/10.3201/eid3006.231422.

Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark [PDF - 1.30 MB - 9 pages]
K. Nielsen et al.

As a follow-up to a previous study, we investigated vaccine effectiveness (VE) of 23-valent pneumococcal polysaccharide vaccine (PPSV23) against invasive pneumococcal disease (IPD) among 1,254,498 persons >65 years of age as part of a vaccination program in Denmark during April 2020–January 2023. We assessed VE by using a Cox regression model and adjusted for age, sex, and underlying conditions. Using nationwide data, we estimated a VE of PPSV23 against all-type IPD of 32% and against PPSV23-serotype IPD of 41%. Because this follow-up study had more statistical power than the original study, we also estimated VE against IPD caused by PPSV23-serotypes excluding serotype 3; serotype 3; serotype 8; serotype 22F; PPSV23 non-PCV15 serotypes; PPSV23 non-PCV20 serotypes; and IPD over time. Our findings suggest PPSV23 vaccination can protect persons >65 years of age against IPD caused by all serotypes or serotype groupings, except serotype 3.

EID Nielsen K, Nielsen L, Dalby T, Lomholt F, Slotved H, Fuursted K, et al. Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark. Emerg Infect Dis. 2024;30(6):1164-1172. https://doi.org/10.3201/eid3006.230975
AMA Nielsen K, Nielsen L, Dalby T, et al. Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark. Emerging Infectious Diseases. 2024;30(6):1164-1172. doi:10.3201/eid3006.230975.
APA Nielsen, K., Nielsen, L., Dalby, T., Lomholt, F., Slotved, H., Fuursted, K....Valentiner-Branth, P. (2024). Follow-Up Study of Effectiveness of 23-Valent Pneumococcal Polysaccharide Vaccine Against All-Type and Serotype-Specific Invasive Pneumococcal Disease, Denmark. Emerging Infectious Diseases, 30(6), 1164-1172. https://doi.org/10.3201/eid3006.230975.

Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates [PDF - 1.43 MB - 9 pages]
L. Ponce et al.

Understanding changes in the transmission dynamics of mpox requires comparing recent estimates of key epidemiologic parameters with historical data. We derived historical estimates for the incubation period and serial interval for mpox and contrasted them with pooled estimates from the 2022 outbreak. Our findings show the pooled mean infection-to-onset incubation period was 8.1 days for the 2022 outbreak and 8.2 days historically, indicating the incubation periods remained relatively consistent over time, despite a shift in the major mode of transmission. However, we estimated the onset-to-onset serial interval at 8.7 days using 2022 data, compared with 14.2 days using historical data. Although the reason for this shortening of the serial interval is unclear, it may be because of increased public health interventions or a shift in the mode of transmission. Recognizing such temporal shifts is essential for informed response strategies, and public health measures remain crucial for controlling mpox and similar future outbreaks.

EID Ponce L, Linton NM, Toh W, Cheng H, Thompson RN, Akhmetzhanov AR, et al. Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates. Emerg Infect Dis. 2024;30(6):1173-1181. https://doi.org/10.3201/eid3006.231095
AMA Ponce L, Linton NM, Toh W, et al. Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates. Emerging Infectious Diseases. 2024;30(6):1173-1181. doi:10.3201/eid3006.231095.
APA Ponce, L., Linton, N. M., Toh, W., Cheng, H., Thompson, R. N., Akhmetzhanov, A. R....Dushoff, J. (2024). Incubation Period and Serial Interval of Mpox in 2022 Global Outbreak Compared with Historical Estimates. Emerging Infectious Diseases, 30(6), 1173-1181. https://doi.org/10.3201/eid3006.231095.

SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022 [PDF - 3.83 MB - 11 pages]
L. Bankers et al.

In adults, viral load and disease severity can differ by SARS-CoV-2 variant, patterns less understood in children. We evaluated symptomatology, cycle threshold (Ct) values, and SARS-CoV-2 variants among 2,299 pediatric SARS-CoV-2 patients (0–21 years of age) in Colorado, USA, to determine whether children infected with Delta or Omicron had different symptom severity or Ct values than during earlier variants. Children infected during the Delta and Omicron periods had lower Ct values than those infected during pre-Delta, and children <1 year of age had lower Ct values than older children. Hospitalized symptomatic children had lower Ct values than asymptomatic patients. Compared with pre-Delta, more children infected during Delta and Omicron were symptomatic (75.4% pre-Delta, 95.3% Delta, 99.5% Omicron), admitted to intensive care (18.8% pre-Delta, 39.5% Delta, 22.9% Omicron), or received oxygen support (42.0% pre-Delta, 66.3% Delta, 62.3% Omicron). Our data reinforce the need to include children, especially younger children, in pathogen surveillance efforts.

EID Bankers L, O’Brien SC, Tapay DM, Ho E, Armistead I, Burakoff A, et al. SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022. Emerg Infect Dis. 2024;30(6):1182-1192. https://doi.org/10.3201/eid3006.231427
AMA Bankers L, O’Brien SC, Tapay DM, et al. SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022. Emerging Infectious Diseases. 2024;30(6):1182-1192. doi:10.3201/eid3006.231427.
APA Bankers, L., O’Brien, S. C., Tapay, D. M., Ho, E., Armistead, I., Burakoff, A....Matzinger, S. R. (2024). SARS-CoV-2 Disease Severity and Cycle Threshold Values in Children Infected during Pre-Delta, Delta, and Omicron Periods, Colorado, USA, 2021–2022. Emerging Infectious Diseases, 30(6), 1182-1192. https://doi.org/10.3201/eid3006.231427.

Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids [PDF - 2.68 MB - 10 pages]
B. R. Groveman et al.

Chronic wasting disease (CWD) is a cervid prion disease with unknown zoonotic potential that might pose a risk to humans who are exposed. To assess the potential of CWD to infect human neural tissue, we used human cerebral organoids with 2 different prion genotypes, 1 of which has previously been associated with susceptibility to zoonotic prion disease. We exposed organoids from both genotypes to high concentrations of CWD inocula from 3 different sources for 7 days, then screened for infection periodically for up to 180 days. No de novo CWD propagation or deposition of protease-resistant forms of human prions was evident in CWD-exposed organoids. Some persistence of the original inoculum was detected, which was equivalent in prion gene knockout organoids and thus not attributable to human prion propagation. Overall, the unsuccessful propagation of CWD in cerebral organoids supports a strong species barrier to transmission of CWD prions to humans.

EID Groveman BR, Williams K, Race B, Foliaki S, Thomas T, Hughson AG, et al. Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids. Emerg Infect Dis. 2024;30(6):1193-1202. https://doi.org/10.3201/eid3006.231568
AMA Groveman BR, Williams K, Race B, et al. Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids. Emerging Infectious Diseases. 2024;30(6):1193-1202. doi:10.3201/eid3006.231568.
APA Groveman, B. R., Williams, K., Race, B., Foliaki, S., Thomas, T., Hughson, A. G....Haigh, C. L. (2024). Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids. Emerging Infectious Diseases, 30(6), 1193-1202. https://doi.org/10.3201/eid3006.231568.

Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022 [PDF - 2.64 MB - 11 pages]
C. Cerpas et al.

Major dengue epidemics throughout Nicaragua’s history have been dominated by 1 of 4 dengue virus serotypes (DENV-1–4). To examine serotypes during the dengue epidemic in Nicaragua in 2022, we performed real-time genomic surveillance in-country and documented cocirculation of all 4 serotypes. We observed a shift toward co-dominance of DENV-1 and DENV-4 over previously dominant DENV-2. By analyzing 135 new full-length DENV sequences, we found that introductions underlay the resurgence: DENV-1 clustered with viruses from Ecuador in 2014 rather than those previously seen in Nicaragua; DENV-3, which last circulated locally in 2014, grouped instead with Southeast Asia strains expanding into Florida and Cuba in 2022; and new DENV-4 strains clustered within a South America lineage spreading to Florida in 2022. In contrast, DENV-2 persisted from the formerly dominant Nicaragua clade. We posit that the resurgence emerged from travel after the COVID-19 pandemic and that the resultant intensifying hyperendemicity could affect future dengue immunity and severity.

EID Cerpas C, Vásquez G, Moreira H, Juarez JG, Coloma J, Harris E, et al. Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerg Infect Dis. 2024;30(6):1203-1213. https://doi.org/10.3201/eid3006.231553
AMA Cerpas C, Vásquez G, Moreira H, et al. Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerging Infectious Diseases. 2024;30(6):1203-1213. doi:10.3201/eid3006.231553.
APA Cerpas, C., Vásquez, G., Moreira, H., Juarez, J. G., Coloma, J., Harris, E....Balmaseda, Á. (2024). Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerging Infectious Diseases, 30(6), 1203-1213. https://doi.org/10.3201/eid3006.231553.
Dispatches

Autochthonous Plasmodium vivax Infections, Florida, USA, 2023 [PDF - 891 KB - 4 pages]
A. Muneer et al.

During May–July 2023, a cluster of 7 patients at local hospitals in Florida, USA, received a diagnosis of Plasmodium vivax malaria. Whole-genome sequencing of the organism from 4 patients and phylogenetic analysis with worldwide representative P. vivax genomes indicated probable single parasite introduction from Central/South America.

EID Muneer A, Adapa SR, Silbert S, Scanlan K, Vore H, Cannons A, et al. Autochthonous Plasmodium vivax Infections, Florida, USA, 2023. Emerg Infect Dis. 2024;30(6):1214-1217. https://doi.org/10.3201/eid3006.240336
AMA Muneer A, Adapa SR, Silbert S, et al. Autochthonous Plasmodium vivax Infections, Florida, USA, 2023. Emerging Infectious Diseases. 2024;30(6):1214-1217. doi:10.3201/eid3006.240336.
APA Muneer, A., Adapa, S. R., Silbert, S., Scanlan, K., Vore, H., Cannons, A....Cui, L. (2024). Autochthonous Plasmodium vivax Infections, Florida, USA, 2023. Emerging Infectious Diseases, 30(6), 1214-1217. https://doi.org/10.3201/eid3006.240336.

Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China [PDF - 985 KB - 5 pages]
Y. Liu et al.

We characterized the evolution and molecular characteristics of avian influenza A(H7N9) viruses isolated in China during 2021–2023. We systematically analyzed the 10-year evolution of the hemagglutinin gene to determine the evolutionary branch. Our results showed recent antigenic drift, providing crucial clues for updating the H7N9 vaccine and disease prevention and control.

EID Liu Y, Chen Y, Yang Z, Lin Y, Fu S, Chen J, et al. Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China. Emerg Infect Dis. 2024;30(6):1218-1222. https://doi.org/10.3201/eid3006.230530
AMA Liu Y, Chen Y, Yang Z, et al. Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China. Emerging Infectious Diseases. 2024;30(6):1218-1222. doi:10.3201/eid3006.230530.
APA Liu, Y., Chen, Y., Yang, Z., Lin, Y., Fu, S., Chen, J....Jia, W. (2024). Evolution and Antigenic Differentiation of Avian Influenza A(H7N9) Virus, China. Emerging Infectious Diseases, 30(6), 1218-1222. https://doi.org/10.3201/eid3006.230530.

Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023 [PDF - 1.43 MB - 5 pages]
G. Heo et al.

Highly pathogenic avian influenza H5N6 and H5N1 viruses of clade 2.3.4.4b were simultaneously introduced into South Korea at the end of 2023. An outbreak at a broiler duck farm consisted of concurrent infection by both viruses. Sharing genetic information and international surveillance of such viruses in wild birds and poultry is critical.

EID Heo G, Kang Y, An S, Kim Y, Cha RM, Jang Y, et al. Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023. Emerg Infect Dis. 2024;30(6):1223-1227. https://doi.org/10.3201/eid3006.240194
AMA Heo G, Kang Y, An S, et al. Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023. Emerging Infectious Diseases. 2024;30(6):1223-1227. doi:10.3201/eid3006.240194.
APA Heo, G., Kang, Y., An, S., Kim, Y., Cha, R. M., Jang, Y....Lee, K. (2024). Concurrent Infection with Clade 2.3.4.4b Highly Pathogenic Avian Influenza H5N6 and H5N1 Viruses, South Korea, 2023. Emerging Infectious Diseases, 30(6), 1223-1227. https://doi.org/10.3201/eid3006.240194.

Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy [PDF - 1.52 MB - 4 pages]
C. Garbarino et al.

We describe group B Streptococcus linked to disease in farmed pigs and wild porcupines in Italy. Occurrence in pigs was attributed to transmission from nonpasteurized bovine milk whey. Antimicrobial-resistance profiles in isolates from porcupines suggest no common source of infection. Our findings expand the known host range for group B Streptococcus disease.

EID Garbarino C, Bariselli S, Pupillo G, Bassi P, Luppi A, Taddei R, et al. Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy. Emerg Infect Dis. 2024;30(6):1228-1231. https://doi.org/10.3201/eid3006.231322
AMA Garbarino C, Bariselli S, Pupillo G, et al. Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy. Emerging Infectious Diseases. 2024;30(6):1228-1231. doi:10.3201/eid3006.231322.
APA Garbarino, C., Bariselli, S., Pupillo, G., Bassi, P., Luppi, A., Taddei, R....Zadoks, R. N. (2024). Emergence of Group B Streptococcus Disease in Pigs and Porcupines, Italy. Emerging Infectious Diseases, 30(6), 1228-1231. https://doi.org/10.3201/eid3006.231322.

Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess [PDF - 862 KB - 4 pages]
S. Gourav et al.

A 3-year-old patient in India experiencing headaches and seizures was diagnosed with a fungal infection, initially misidentified as Cladophialophora bantiana. Follow-up sequencing identified the isolate to be Fonsecaea monophora fungus. This case demonstrates the use of molecular methods for the correct identification of F. monophora, an agent of fungal brain abscess.

EID Gourav S, Singh G, Pandey M, Rana B, Gupta S, Mishra H, et al. Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess. Emerg Infect Dis. 2024;30(6):1232-1235. https://doi.org/10.3201/eid3006.240077
AMA Gourav S, Singh G, Pandey M, et al. Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess. Emerging Infectious Diseases. 2024;30(6):1232-1235. doi:10.3201/eid3006.240077.
APA Gourav, S., Singh, G., Pandey, M., Rana, B., Gupta, S., Mishra, H....Xess, I. (2024). Molecular Identification of Fonsecaea monophora, Novel Agent of Fungal Brain Abscess. Emerging Infectious Diseases, 30(6), 1232-1235. https://doi.org/10.3201/eid3006.240077.

Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia [PDF - 1.00 MB - 4 pages]
S. Ajjampur et al.

A fecal survey in Tamil Nadu, India, revealed 2 persons passed schistosome eggs, later identified as Schistosoma incognitum, a parasite of pigs, dogs, and rats. We investigated those cases and reviewed autochthonous schistosomiasis cases from India and Nepal. Whether the 2 new cases represent true infection or spurious passage is undetermined.

EID Ajjampur S, Sarkar R, Bradbury RS. Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia. Emerg Infect Dis. 2024;30(6):1236-1239. https://doi.org/10.3201/eid3006.231641
AMA Ajjampur S, Sarkar R, Bradbury RS. Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia. Emerging Infectious Diseases. 2024;30(6):1236-1239. doi:10.3201/eid3006.231641.
APA Ajjampur, S., Sarkar, R., & Bradbury, R. S. (2024). Human Passage of Schistosoma incognitum, Tamil Nadu, India, and Review of Autochthonous Schistosomiasis, South Asia. Emerging Infectious Diseases, 30(6), 1236-1239. https://doi.org/10.3201/eid3006.231641.

Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease [PDF - 1.03 MB - 5 pages]
E. Cunningham-Oakes et al.

A 2022 canine gastroenteritis outbreak in the United Kingdom was associated with circulation of a new canine enteric coronavirus closely related to a 2020 variant with an additional spike gene recombination. The variants are unrelated to canine enteric coronavirus–like viruses associated with human disease but represent a model for coronavirus population adaptation.

EID Cunningham-Oakes E, Pilgrim J, Darby AC, Appleton C, Jewell C, Rowlingson B, et al. Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease. Emerg Infect Dis. 2024;30(6):1240-1244. https://doi.org/10.3201/eid3006.231184
AMA Cunningham-Oakes E, Pilgrim J, Darby AC, et al. Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease. Emerging Infectious Diseases. 2024;30(6):1240-1244. doi:10.3201/eid3006.231184.
APA Cunningham-Oakes, E., Pilgrim, J., Darby, A. C., Appleton, C., Jewell, C., Rowlingson, B....Radford, A. D. (2024). Emerging Variants of Canine Enteric Coronavirus Associated with Outbreaks of Gastroenteric Disease. Emerging Infectious Diseases, 30(6), 1240-1244. https://doi.org/10.3201/eid3006.231184.

Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA [PDF - 1.40 MB - 4 pages]
A. Max et al.

Choanephora infundibulifera is a member of the Mucorales order of fungi. The species is associated with plants as a saprophyte or parasite and may be responsible for spoilage or disease but is an uncommon cause of human infection. We describe C. infundibulifera rhinosinusitis in a young man with leukemia in Tennessee, USA.

EID Max A, Glasgow HL, Santiago T, Holland A, Inaba H, Cañete-Gibas CF, et al. Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA. Emerg Infect Dis. 2024;30(6):1245-1248. https://doi.org/10.3201/eid3006.230794
AMA Max A, Glasgow HL, Santiago T, et al. Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA. Emerging Infectious Diseases. 2024;30(6):1245-1248. doi:10.3201/eid3006.230794.
APA Max, A., Glasgow, H. L., Santiago, T., Holland, A., Inaba, H., Cañete-Gibas, C. F....Adderson, E. E. (2024). Choanephora infundibulifera Rhinosinusitis in Man with Acute Lymphoblastic Leukemia, Tennessee, USA. Emerging Infectious Diseases, 30(6), 1245-1248. https://doi.org/10.3201/eid3006.230794.

Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China [PDF - 1.07 MB - 4 pages]
D. Kuang et al.

Burkholderia semiarida was previously identified solely as a plant pathogen within the Burkholderia cepacia complex. We present a case in China involving recurrent pneumonia attributed to B. semiarida infection. Of note, the infection manifested in an immunocompetent patient with no associated primary diseases and endured for >3 years.

EID Kuang D, Liu F, Tian S, Liu W, Li A, Zhou Y, et al. Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China. Emerg Infect Dis. 2024;30(6):1249-1252. https://doi.org/10.3201/eid3006.231676
AMA Kuang D, Liu F, Tian S, et al. Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China. Emerging Infectious Diseases. 2024;30(6):1249-1252. doi:10.3201/eid3006.231676.
APA Kuang, D., Liu, F., Tian, S., Liu, W., Li, A., Zhou, Y....Xia, Q. (2024). Burkholderia semiarida as Cause of Recurrent Pulmonary Infection in Immunocompetent Patient, China. Emerging Infectious Diseases, 30(6), 1249-1252. https://doi.org/10.3201/eid3006.231676.

SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023 [PDF - 1.01 MB - 5 pages]
D. Cano-Terriza et al.

We conducted a serologic and molecular study to assess exposure of captive nonhuman primates (NHPs) to SARS-CoV-2 in Spain during the 2020–2023 COVID-19 pandemic. We found limited exposure of NHPs to SARS-CoV-2. Biosafety measures must be strictly maintained to avoid SARS-CoV-2 reverse-zoonotic transmission in the human–NHP interface.

EID Cano-Terriza D, Beato-Benítez A, Fernández-Bastit L, Segalés J, Vergara-Alert J, Martínez-Nevado E, et al. SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023. Emerg Infect Dis. 2024;30(6):1253-1257. https://doi.org/10.3201/eid3006.231247
AMA Cano-Terriza D, Beato-Benítez A, Fernández-Bastit L, et al. SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023. Emerging Infectious Diseases. 2024;30(6):1253-1257. doi:10.3201/eid3006.231247.
APA Cano-Terriza, D., Beato-Benítez, A., Fernández-Bastit, L., Segalés, J., Vergara-Alert, J., Martínez-Nevado, E....García-Bocanegra, I. (2024). SARS-CoV-2 in Captive Nonhuman Primates, Spain, 2020–2023. Emerging Infectious Diseases, 30(6), 1253-1257. https://doi.org/10.3201/eid3006.231247.

Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021 [PDF - 996 KB - 5 pages]
P. A. Zendejas-Heredia et al.

Ancylostoma ceylanicum is the second most common hookworm infecting humans in the Asia-Pacific region. Recent reports suggest presence of the parasite in the Americas. We report A. ceylanicum infections in coyotes from the Guanacaste Conservation Area, Costa Rica. Our findings call for active surveillance in humans and animals.

EID Zendejas-Heredia PA, Robleto-Quesada J, Solano A, Rojas A, Colella V. Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021. Emerg Infect Dis. 2024;30(6):1258-1262. https://doi.org/10.3201/eid3006.231618
AMA Zendejas-Heredia PA, Robleto-Quesada J, Solano A, et al. Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021. Emerging Infectious Diseases. 2024;30(6):1258-1262. doi:10.3201/eid3006.231618.
APA Zendejas-Heredia, P. A., Robleto-Quesada, J., Solano, A., Rojas, A., & Colella, V. (2024). Zoonotic Ancylostoma ceylanicum Infection in Coyotes from Guanacaste Conservation Area, Costa Rica, 2021. Emerging Infectious Diseases, 30(6), 1258-1262. https://doi.org/10.3201/eid3006.231618.

Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic [PDF - 586 KB - 4 pages]
B. Sak et al.

We retrospectively analyzed of 211 frozen cerebrospinal fluid samples from immunocompetent persons in the Czech Republic and detected 6 Encephalitozoon cuniculi–positive samples. Microsporidiosis is generally underestimated and patients are not usually tested for microsporidia, but latent infection in immunodeficient and immunocompetent patients can cause serious complications if not detected and treated.

EID Sak B, Mansfeldová K, Brdíčková K, Gottliebová P, Nyčová E, Holubová N, et al. Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic. Emerg Infect Dis. 2024;30(6):1263-1266. https://doi.org/10.3201/eid3006.231585
AMA Sak B, Mansfeldová K, Brdíčková K, et al. Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic. Emerging Infectious Diseases. 2024;30(6):1263-1266. doi:10.3201/eid3006.231585.
APA Sak, B., Mansfeldová, K., Brdíčková, K., Gottliebová, P., Nyčová, E., Holubová, N....Kváč, M. (2024). Encephalitozoon cuniculi Microsporidia in Cerebrospinal Fluid from Immunocompetent Patients, Czech Republic. Emerging Infectious Diseases, 30(6), 1263-1266. https://doi.org/10.3201/eid3006.231585.

Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023 [PDF - 622 KB - 4 pages]
R. Kinoshita et al.

We assessed SARS-CoV-2 seroprevalence in Japan during July–August 2023, with a focus on 2 key age groups, 0–15 and >80 years. We estimated overall seroprevalence of 45.3% for nucleocapsid antibodies and 95.4% for spike antibodies and found notable maternally derived spike antibodies in infants 6–11 months of age (90.0%).

EID Kinoshita R, Miyamoto S, Sakuraba S, Sugihara J, Suzuki M, Suzuki T, et al. Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023. Emerg Infect Dis. 2024;30(6):1267-1270. https://doi.org/10.3201/eid3006.231454
AMA Kinoshita R, Miyamoto S, Sakuraba S, et al. Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023. Emerging Infectious Diseases. 2024;30(6):1267-1270. doi:10.3201/eid3006.231454.
APA Kinoshita, R., Miyamoto, S., Sakuraba, S., Sugihara, J., Suzuki, M., Suzuki, T....Yoneoka, D. (2024). Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence, Japan, 2023. Emerging Infectious Diseases, 30(6), 1267-1270. https://doi.org/10.3201/eid3006.231454.

Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA [PDF - 780 KB - 4 pages]
J. D. Brown et al.

We detected antibodies to H5 and N1 subtype influenza A viruses in 4/194 (2%) dogs from Washington, USA, that hunted or engaged in hunt tests and training with wild birds. Historical data provided by dog owners showed seropositive dogs had high levels of exposure to waterfowl.

EID Brown JD, Black A, Haman KH, Diel DG, Ramirez VE, Ziejka RS, et al. Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA. Emerg Infect Dis. 2024;30(6):1271-1274. https://doi.org/10.3201/eid3006.231459
AMA Brown JD, Black A, Haman KH, et al. Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA. Emerging Infectious Diseases. 2024;30(6):1271-1274. doi:10.3201/eid3006.231459.
APA Brown, J. D., Black, A., Haman, K. H., Diel, D. G., Ramirez, V. E., Ziejka, R. S....Stallknecht, D. E. (2024). Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington, USA. Emerging Infectious Diseases, 30(6), 1271-1274. https://doi.org/10.3201/eid3006.231459.

Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria [PDF - 332 KB - 4 pages]
S. Hatzl et al.

We investigated a cohort of 370 patients in Austria with hantavirus infections (7.8% ICU admission rate) and detected 2 cases (cumulative incidence 7%) of invasive pulmonary aspergillosis; 1 patient died. Hantavirus-associated pulmonary aspergillosis may complicate the course of critically ill patients who have hemorrhagic fever with renal syndrome.

EID Hatzl S, Scholz L, Posch F, Eller P, Reisinger AC, Zacharias M, et al. Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria. Emerg Infect Dis. 2024;30(6):1275-1278. https://doi.org/10.3201/eid3006.231720
AMA Hatzl S, Scholz L, Posch F, et al. Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria. Emerging Infectious Diseases. 2024;30(6):1275-1278. doi:10.3201/eid3006.231720.
APA Hatzl, S., Scholz, L., Posch, F., Eller, P., Reisinger, A. C., Zacharias, M....Krause, R. (2024). Invasive Pulmonary Aspergillosis in Critically Ill Patients with Hantavirus Infection, Austria. Emerging Infectious Diseases, 30(6), 1275-1278. https://doi.org/10.3201/eid3006.231720.

IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022 [PDF - 1.04 MB - 4 pages]
C. Emeraud et al.

We characterized a collection of IMI-like–producing Enterobacter spp. isolates (n = 112) in France. The main clone corresponded to IMI-1–producing sequence type 820 E. cloacae subspecies cloacae that was involved in an outbreak. Clinicians should be aware of potential antimicrobial resistance among these bacteria.

EID Emeraud C, Girlich D, Deschamps M, Rezzoug I, Jacquemin A, Jousset AB, et al. IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022. Emerg Infect Dis. 2024;30(6):1279-1282. https://doi.org/10.3201/eid3006.231525
AMA Emeraud C, Girlich D, Deschamps M, et al. IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022. Emerging Infectious Diseases. 2024;30(6):1279-1282. doi:10.3201/eid3006.231525.
APA Emeraud, C., Girlich, D., Deschamps, M., Rezzoug, I., Jacquemin, A., Jousset, A. B....Dortet, L. (2024). IMI-Type Carbapenemase-Producing Enterobacter cloacae Complex, France and Overseas Regions, 2012–2022. Emerging Infectious Diseases, 30(6), 1279-1282. https://doi.org/10.3201/eid3006.231525.
Research Letters

Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine [PDF - 611 KB - 3 pages]
X. Nguyenla et al.

Because novel SARS-CoV-2 variants continue to emerge, immunogenicity of XBB.1.5 monovalent vaccines against live clinical isolates needs to be evaluated. We report boosting of IgG (2.1×), IgA (1.5×), and total IgG/A/M (1.7×) targeting the spike receptor-binding domain and neutralizing titers against WA1 (2.2×), XBB.1.5 (7.4×), EG.5.1 (10.5×), and JN.1 (4.7×) variants.

EID Nguyenla X, Bates TA, Trank-Greene M, Wahedi M, Tafesse FG, Curlin ME. Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine. Emerg Infect Dis. 2024;30(6):1282-1283. https://doi.org/10.3201/eid3006.240051
AMA Nguyenla X, Bates TA, Trank-Greene M, et al. Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine. Emerging Infectious Diseases. 2024;30(6):1282-1283. doi:10.3201/eid3006.240051.
APA Nguyenla, X., Bates, T. A., Trank-Greene, M., Wahedi, M., Tafesse, F. G., & Curlin, M. E. (2024). Evaluating Humoral Immunity Elicited by XBB.1.5 Monovalent COVID-19 Vaccine. Emerging Infectious Diseases, 30(6), 1282-1283. https://doi.org/10.3201/eid3006.240051.

Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023 [PDF - 1014 KB - 4 pages]
A. Cho et al.

We isolated novel reassortant avian influenza A(H5N6) viruses containing genes from clade 2.3.4.4b H5N1 virus and low pathogenicity avian influenza viruses in carcasses of whooper swans and bean geese in South Korea during December 2023. Neuraminidase gene was from a clade 2.3.4.4b H5N6 virus infecting poultry and humans in China.

EID Cho A, Si Y, Kim D, Seo Y, Lee D, Kim D, et al. Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023. Emerg Infect Dis. 2024;30(6):1285-1288. https://doi.org/10.3201/eid3006.240192
AMA Cho A, Si Y, Kim D, et al. Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023. Emerging Infectious Diseases. 2024;30(6):1285-1288. doi:10.3201/eid3006.240192.
APA Cho, A., Si, Y., Kim, D., Seo, Y., Lee, D., Kim, D....Lee, D. (2024). Novel Avian Influenza A(H5N6) Virus in Wild Birds, South Korea, 2023. Emerging Infectious Diseases, 30(6), 1285-1288. https://doi.org/10.3201/eid3006.240192.

Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan [PDF - 486 KB - 3 pages]
A. Doi et al.

Using the GISAID EpiCoV database, we identified 256 COVID-19 patients in Japan during March 31–December 31, 2023, who had mutations in the SARS-CoV-2 nonstructural protein 5 conferring ensitrelvir resistance. Ongoing genomic surveillance is required to monitor emergence of SARS-CoV-2 mutations that are resistant to anticoronaviral drugs.

EID Doi A, Ota M, Saito M, Matsuyama S. Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan. Emerg Infect Dis. 2024;30(6):1289-1291. https://doi.org/10.3201/eid3006.240023
AMA Doi A, Ota M, Saito M, et al. Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan. Emerging Infectious Diseases. 2024;30(6):1289-1291. doi:10.3201/eid3006.240023.
APA Doi, A., Ota, M., Saito, M., & Matsuyama, S. (2024). Sporadic Occurrence of Ensitrelvir-Resistant SARS-CoV-2, Japan. Emerging Infectious Diseases, 30(6), 1289-1291. https://doi.org/10.3201/eid3006.240023.

Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020 [PDF - 278 KB - 3 pages]
M. Zlotnick et al.

Food irradiation can reduce foodborne illnesses but is rarely used in the United States. We determined whether outbreaks related to Campylobacter, Salmonella, Escherichia coli, and Listeria monocytogenes were linked to irradiation-eligible foods. Of 482 outbreaks, 155 (32.2%) were linked to an irradiation-eligible food, none of which were known to be irradiated.

EID Zlotnick M, Eisenstein T, Robyn M, Marshall KE. Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020. Emerg Infect Dis. 2024;30(6):1291-1293. https://doi.org/10.3201/eid3006.230922
AMA Zlotnick M, Eisenstein T, Robyn M, et al. Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020. Emerging Infectious Diseases. 2024;30(6):1291-1293. doi:10.3201/eid3006.230922.
APA Zlotnick, M., Eisenstein, T., Robyn, M., & Marshall, K. E. (2024). Foodborne Disease Outbreaks Linked to Foods Eligible for Irradiation, United States, 2009–2020. Emerging Infectious Diseases, 30(6), 1291-1293. https://doi.org/10.3201/eid3006.230922.

Effect of Myxoma Virus Species Jump on Iberian Hare Populations [PDF - 982 KB - 4 pages]
B. Cardoso et al.

The myxoma virus species jump from European rabbits (Oryctolagus cuniculus) to Iberian hares (Lepus granatensis) has raised concerns. We assess the decline suffered by Iberian hare populations on the Iberian Peninsula and discuss the association between the effect of myxomatosis and the average abundance index, which we estimated by using hunting bags.

EID Cardoso B, García-Bocanegra I, Queirós J, Fernández-López J, Alves PC, Acevedo P. Effect of Myxoma Virus Species Jump on Iberian Hare Populations. Emerg Infect Dis. 2024;30(6):1293-1296. https://doi.org/10.3201/eid3006.231280
AMA Cardoso B, García-Bocanegra I, Queirós J, et al. Effect of Myxoma Virus Species Jump on Iberian Hare Populations. Emerging Infectious Diseases. 2024;30(6):1293-1296. doi:10.3201/eid3006.231280.
APA Cardoso, B., García-Bocanegra, I., Queirós, J., Fernández-López, J., Alves, P. C., & Acevedo, P. (2024). Effect of Myxoma Virus Species Jump on Iberian Hare Populations. Emerging Infectious Diseases, 30(6), 1293-1296. https://doi.org/10.3201/eid3006.231280.

Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil [PDF - 2.19 MB - 3 pages]
D. B. de Amorim et al.

Cetacean morbillivirus is an etiologic agent associated with strandings of live and dead cetacean species occurring sporadically or as epizootics worldwide. We report 2 cases of cetacean morbillivirus in humpback whales (Megaptera novaeangliae) in Brazil and describe the anatomopathological, immunohistochemical, and molecular characterization findings in the specimens.

EID de Amorim DB, de Camargo LJ, Ribeiro PR, Budaszewski RF, Menegatt JO, Paz MC, et al. Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil. Emerg Infect Dis. 2024;30(6):1296-1298. https://doi.org/10.3201/eid3006.231769
AMA de Amorim DB, de Camargo LJ, Ribeiro PR, et al. Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil. Emerging Infectious Diseases. 2024;30(6):1296-1298. doi:10.3201/eid3006.231769.
APA de Amorim, D. B., de Camargo, L. J., Ribeiro, P. R., Budaszewski, R. F., Menegatt, J. O., Paz, M. C....Sonne, L. (2024). Characterization of Cetacean Morbillivirus in Humpback Whales, Brazil. Emerging Infectious Diseases, 30(6), 1296-1298. https://doi.org/10.3201/eid3006.231769.

Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China [PDF - 2.01 MB - 3 pages]
Y. Wang et al.

We isolated severe fever with thrombocytopenia syndrome virus (SFTSV) from farmed minks in China, providing evidence of natural SFTSV infection in farmed minks. Our findings support the potential role of farmed minks in maintaining SFTSV and are helpful for the development of public health interventions to reduce human infection.

EID Wang Y, Yang M, Zhou H, Quan C, Kang H. Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China. Emerg Infect Dis. 2024;30(6):1299-1301. https://doi.org/10.3201/eid3006.240283
AMA Wang Y, Yang M, Zhou H, et al. Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China. Emerging Infectious Diseases. 2024;30(6):1299-1301. doi:10.3201/eid3006.240283.
APA Wang, Y., Yang, M., Zhou, H., Quan, C., & Kang, H. (2024). Outbreak of Natural Severe Fever with Thrombocytopenia Syndrome Virus Infection in Farmed Minks, China. Emerging Infectious Diseases, 30(6), 1299-1301. https://doi.org/10.3201/eid3006.240283.
Letters

Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA [PDF - 230 KB - 1 page]
I. See et al.
EID See I, Jackson KA, Byram R, Toney N, Grigg C, Magill SS. Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA. Emerg Infect Dis. 2024;30(6):1302. https://doi.org/10.3201/eid3006.240431
AMA See I, Jackson KA, Byram R, et al. Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA. Emerging Infectious Diseases. 2024;30(6):1302. doi:10.3201/eid3006.240431.
APA See, I., Jackson, K. A., Byram, R., Toney, N., Grigg, C., & Magill, S. S. (2024). Nontuberculous Mycobacteria and Laboratory Surveillance, Virginia, USA. Emerging Infectious Diseases, 30(6), 1302. https://doi.org/10.3201/eid3006.240431.
Books and Media

Antimicrobial Stewardship in Non-Traditional Settings [PDF - 305 KB - 1 page]
N. Hashem and C. Yek
EID Hashem N, Yek C. Antimicrobial Stewardship in Non-Traditional Settings. Emerg Infect Dis. 2024;30(6):1303. https://doi.org/10.3201/eid3006.240255
AMA Hashem N, Yek C. Antimicrobial Stewardship in Non-Traditional Settings. Emerging Infectious Diseases. 2024;30(6):1303. doi:10.3201/eid3006.240255.
APA Hashem, N., & Yek, C. (2024). Antimicrobial Stewardship in Non-Traditional Settings. Emerging Infectious Diseases, 30(6), 1303. https://doi.org/10.3201/eid3006.240255.
About the Cover

Architecture that Might Have Contributed to Disease Prevention [PDF - 3.70 MB - 3 pages]
T. Chorba
EID Chorba T. Architecture that Might Have Contributed to Disease Prevention. Emerg Infect Dis. 2024;30(6):1304-1306. https://doi.org/10.3201/eid3006.ac3006
AMA Chorba T. Architecture that Might Have Contributed to Disease Prevention. Emerging Infectious Diseases. 2024;30(6):1304-1306. doi:10.3201/eid3006.ac3006.
APA Chorba, T. (2024). Architecture that Might Have Contributed to Disease Prevention. Emerging Infectious Diseases, 30(6), 1304-1306. https://doi.org/10.3201/eid3006.ac3006.
News and Notes

Notice to Readers: New Article Category for Letters from the Emerging Infections Network [PDF - 131 KB - 2 pages]
EID Notice to Readers: New Article Category for Letters from the Emerging Infections Network. Emerg Infect Dis. 2024;30(6):1-3. https://doi.org/10.3201/eid3006.nn3006
AMA Notice to Readers: New Article Category for Letters from the Emerging Infections Network. Emerging Infectious Diseases. 2024;30(6):1-3. doi:10.3201/eid3006.nn3006.
APA (2024). Notice to Readers: New Article Category for Letters from the Emerging Infections Network. Emerging Infectious Diseases, 30(6), 1-3. https://doi.org/10.3201/eid3006.nn3006.
Page created: May 22, 2024
Page updated: May 22, 2024
Page reviewed: May 22, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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